Association of cutaneous malignancy with epidermodysplasia verruciformis: a clinicopathological study

To find out presence of nonmelanoma skin cancer [NMSC] in a series of 13 patients with diagnosis of epidermodysplasia verruciformis [EDV]. This prospective descriptive study detailed the clinical presentation of patients with EDV associated with nonmelanoma cutaneous malignancy between 2007 and 2010 presenting to Dermatology OPD Pakistan Institute of Medical Sciences, Islamabad. Patients were diagnosed on clinical basis. Patients with all ages and both sexes were included. Skin biopsies were taken from lesions with suspicion of malignancy, stained with hematoxylin and eosin and studied in collaboration with histopathologist. Different histopathological findings were recorded and results analyzed. 13 cases were studied for presence of NMSC. NMSC were found in 3 [23%] out of 13 patients. Actinic keratosis was found in 2 patients and one patient had seborrheic keratosis with suspicious lesions. The clinically suspicious lesions should always be biopsied, as cutaneous malignancy is a well-known, frequent and serious complication of EDV and there is high potential in these patients to develop premalignant conditions

Injudicious use of topical steroids, a misconcept in treatment of patients with acne vulgaris

To determine the frequency of use of topical steroids by acne patients and to observe various cutaneous side effects in these patients. Descriptive study. This study was conducted in Dermatology out patient department, Pakistan Railway Hospital, Rawalpindi from February 15 to April 15, 2012. Total 110 patients were enrolled in the study. All the patients were having clinical diagnosis of acne vulgaris. Patients of both genders with age range of 13- 35 years were included in the study. Frequency of patients using topical steroids to treat acne was calculated and cutaneous side effects of topical steroids were noted. Out of 110 patients of acne, 76 were females [69%] and 34 were males [31%]. Age range of patients was from 13 to 35 years. Topical steroids were used by 68 patients [62%] with acne vulgaris. Mean duration of application of topical steroids ranged from 2weeks to Smonths. Most commonly used steroid was betamethasone valerate [62%], followed by clobetasol propionate [29%] and flucinolone acetonide [8%]. Out of 68 patients using topical steroids cutaneous side effects were seen in 50 patients in the form of aggravation of existing lesions in 18 patients [36%], perioral dermatitis 12 patients [24%], telangiectasias 8 patients [16%], increased facial hair growth 7 patients [14%], tinea incognito in 3 patients [6%] and acne rosacea in 2 patients [4%].This study shows that a large number of patients are using topical steroids to treat acne lesions. Use of topical steroids is a misconcept in treating the lesions of acne vulgaris and their use is associated with various cutaneous side effects including aggravation of acne lesions, skin atrophy, telangiectasias, perioral dermatitis, hirsutism, acne roacea and tinea in cognito