Hyperuricemia in female and male patients of chronic plaque psoriasis

Objective: To determine hyperuricemia in patients with chronic plaque psoriasis

Methods: Out of 194, 97 biopsy proven patients of psoriasis were taken as cases and 97 participants coming to OPD with any other skin disease like acne, alopecia, dermatomycosis etc. as controls. 5ml of venous blood was drawn in sterile syringe and using gel sample tube was sent to the laboratory for serum uric acid level

Results: There were 54.6% [106/194] male and 45.4% [88/194] female. Patients of psoriasis had hyperuricemia more frequently than controls [25.8% vs. 7.2%]. Although male patients and similar frequency of hyperuricemia as in controls [15.2% vs. 6.7%], female patients had significantly more frequent than controls [35.3% vs. 8.1%]

Conclusion: Hyperuricemia is a common finding in psoriatic patients. Its treatment might be clinically useful for the global treatment of patients. We found a female preponderance which could also be due to the overall more proportion of female patients visiting the clinic

Dyslipidemia and psoriasis: a case control study

To compare the mean values of lipid profile in psoriatic patients and healthy controls. Case control study. Department of Dermatology, PNS Shifa, Karachi, from November 2012 to April 2013. Patients with psoriasis fulfilling the inclusion and exclusion criteria were selected from Dermatology Outpatient Department [OPD] of PNS Shifa, Karachi. After fasting for 14 hours, 5 ml of venous blood was drawn in sterile syringe and submitted to the Hospital Laboratory for lipid profile, by enzymatic method on Hitachi [Roshe[Registered sign]] using reagents by the same firm. The mean values lipid profile in psoriatic patients versus healthy controls were recorded and compared. A total of 256 patients [128 in each group] were enrolled. Mean lipid profile in both groups revealed cholesterol [mg/dl] value of 203.43 +/- 11.43 in cases and 173.64 +/- 13.65 in controls. Triglyceride [mg/dl] was 178.87 +/- 43.60 and in cases 144.23 +/- 34.01 in controls, HDL-C [mg/dl] was 37.81 +/- 10.78 in cases and 41.41 +/- 9.72 in controls while LDL-C [mg/dl] was 139.52 +/- 13.71 in cases and 109.44 +/- 13.80 in controls. Each parameters had p-value < 0.05 which was significant. Dyslipidemia was found in a high percentage of psoriatic patients than healthy controls. Psoriatic patients require thorough lipid and cardiovascular examinations as they should be considered as individuals with increased risk of cardiovascular diseases

Antibiotic sensitivity patterns of staphylococcal skin infections

To determine the current sensitivity pattern against staphylococci found in skin and soft tissue infections. Patients were enrolled from OPD of Dermatology Department, PNS Shifa Hospital, Karachi. All the patients with skin infections showing growth of Staphylococcus aureus on culture medium were selected. After informed consent, swab specimens were collected under aseptic measures from skin lesions for microbial analysis and sensitivity pattern. Among skin infections, furunculosis was found most common, comprising of 45.7% [n=43], cellulitis 15.0% [n=14], ecthyma 8.5% [n=8], erysipelas 8.5% [n=8] and impetigo 22.3% [n=21]. According to drug sensitivity patterns, vancomycin was found sensitive in 100%, linezolid 98.9%, mupirocin 96.8%, rifampicin 95.7%, chloramphenicol 94.7%, clindamycin 86.2%, amikacin 84%, moxifloxacin 83%, fusidic acid 79.8%, gentamicin 76.6%, oxacillin 69.1%, ciprofloxacin 68.1%, amoxicillin-clavulanic acid 62.8%, erythromycin 60.6% and trimethoprimsulphamethaxazole 57.4% of cases Vancomycin, linezolid, rifampicin, clindamycin, moxifloxacin and chloramphenicol showed highest efficacy in this study. However, clinical studies are required to confirm in vivo efficacy and side effect profile of these drugs

Intralesional triamcinolone acetonide versus topical betamethasone valearate in the management of localized alopecia Areata

Objective: To compare the efficacy of intralesional triamcinolone and topical betamethasone in the management of localized alopecia areata

Study Design: A randomized trial

Place and Duration of Study: Dermatology OPD, PNS Shifa Hospital, Karachi, from January to June 2013

Methodology: Patients aged 18 - 50 years with localized alopecia areata were included in the study. Exclusion criteria were more than three patches and those on already steroid or immunosuppressive therapy. Patients were randomly allocated in two treatment groups: Group A received intralesional triamcinolone acetonide [10 mg/ml] and Group B received topical betamethasone valearate cream 0.1% twice daily. Final outcome was ascertained as re-growth of hair on 12th week of follow-up and labelled as efficacy. The data was entered and analyzed using SPSS version 11. Relevant descriptive statistics were calculated. Chi-square test was used to compare efficacy of hair re-growth in both groups. P-value < 0.05 was considered significant

Results: A total of 226 patients were enrolled, 113 in each group. The mean age was 34.36 +/- 8.7 years. One hundred and sixty-four [72.6%] were males and 62 [27.4%] were females with male to female ratio of 2.6:1. Hair re-growth was seen in 84 [74.3%] of the intralesional steroid group and in 53 [46.9%] of the topical betamethasone group [p < 0.001], which was a significant difference

Conclusion: Intralesional triamcinolone had a better efficacy in the treatment of localized alopecia areata as compared to topical betamethasone valearate

Frequency of undiagnosed diabetes mellitus in patient with herpes zoster

Objective: To determine frequency of undiagnosed diabetes mellitus in patients with herpes zoster. [HZ]

Methods: This cross-sectional study was performed at PNS Shifa hospital, Karachi from June, 2013 to December, 2013. A total of 89 patients suffering from HZ from age 40-70 years were included in this study after taking informed consent. All patients underwent fasting blood sugar evaluation from hospital laboratory

Results: 34 [38.2%] patients were of 40-55 years of age while 55 [61.8%] were of 56-70 year age group. Mean age was 56.93 +/- 8.24 years, 48 [53.9] were male and 41 [46.1%] were females while undiagnosed diabetes mellitus in patients with HZ occurred in 36 [40.5%] while 53 [59. 5%] had no findings of the morbidity

Conclusion: Frequency of undiagnosed diabetes mellitus is higher among patients with herpes zoster. So, it is recommended that every patient who present with HZ, should be evaluated for diabetes mellitus

Kindler's syndrome: a report of five cases in a family

Kindler's Syndrome [KS] is a rare genodermatosis with autosomal recessive mode of inheritance. The disease results from homozygous mutations on both alleles of the FERMT-1 gene [also known as KIND-1 gene] that encodes the protein Kindlin-1 [kindlerin]. Clinical features include a constellation of early infantile skin blistering and mild photosensitivity, which improves with age, and progressive poikiloderma with widespread cutaneous atrophy. The differential diagnosis of Kindler syndrome include other congenital poikilodermatous and photosensitive conditions including Bloom syndrome, Cockayne syndrome, dyskeratosis congenita, epidermolysis bullosa, Rothmund-Thomson syndrome and xeroderma pigmentosum. We herein, report the presence of the Kindler's syndrome in 5 out of 7 children of consanguineous parents. To authors' knowledge, this is the first report of Kindler's syndrome involving 5 members of a family