Cutaneous manifestations associated with obesity

Objective To study the frequency of cutaneous manifestations of obesity and their association with severity of disease in Pakistani population.

Methods 100 outdoor patients visiting Rawal Institute of Health Sciences, Islamabad were studied during a period from May 2014 to July 2015. BMI was calculated by measuring weight in kilogram divided by square in height in meter. Cutaneous manifestations in obese patients with class I [CI] [BMI >30-34.9Kg/m2] and class II [CII] [BMI 35-39Kg/m2] disease were recorded.

Results The mean age was 41.85+/-8.61 years while the mean BMI was 33.51+/-2.51 kg/m2. A significant difference for diabetes mellitus, striae and acanthosis nigricans was seen between CI and CII groups [p<0.05]. BMI showed significant positive correlation with DM [r=0.280, p=0.005] and acne [r=0.315, p=0.001] while diabetes mellitus showed with acanthosis nigricans [r=0.373; p=0.000] and skin tags [r=0.218, p=0.029]. Acne showed with miliaria [r=0.210, p=0.036] and varicose vein with xanthomas [r= 0.281, p=0.005].

Conclusion Skin tags, acanthosis nigricans and acne are seen more frequently in obesity.

Cigarette smoking among Pakistan army soldiers

To evaluate frequency, intensity and other characteristics of cigarette smoking in army soldiers. Various army units stationed at Multan Garrison. This is descriptive cross sectional study, in which one thousands male soldiers from various army units [both fighting and supporting arms] were randomly selected to fill the questionnaire. Nine hundred and eighty six responses were included in study and rests were discarded in view of inappropriateness. Among responders, 470 [47.6%] were smokers. Frequencies of occasional, mild, moderate and heavy smoking were 11.9%, 14.8%, 10.7% and 10.2% respectively. Twenty one percent were smokers prior to joining army while 26.6% picked up this habit after induction. According to age 84.3% were less than 40 years of age while remaining 15.7% were above 40. The respective frequencies of smoking in these two age groups were 49.3% and 38.9% [p<0.05]. The 56.7% of under-metric soldiers were smokers in comparison with 35.8% of over-metric [p<0.05]. Frequency of smoking was 52.2% among unskilled soldiers while it was 33% in skilled soldiers [p<0.05]. It was slightly higher among fighting units [52.3% vs. 47.7%]. The job related stress and peer pressure were major risk factors for initiation of smoking. Almost all smokers wanted to quit and significant number of smokers reported that had tried to quit smoking at least once in the past. Smoking frequency is quite high among army soldiers particularly among unskilled and less educated and there is strong need to address this issue

Cutaneous pseudolymphoma due to topical application of 4% hydroquinone cream for melasma

Cutaneous pseudolymphoma is an aggregate of mature or abnormal looking lymphocytes in the dermis, which clinically and /or histologically simulates lymphoma but has a benign course and outcome. Systemic drugs, especially anti-epileptics, are an important cause of cutaneous pseudolymphomas. Pseudolymphoma of the skin, secondary to topical drug application, is very rare. We report a case of cutaneous pseudolymphoma induced by local application of 4% hydroquinone cream to melasma over the cheeks

Reticulated multifocal fixed drug eruption due to mefenamic acid - a new morphological pattern

Fixed drug eruption is a heterogeneous pattern of cutaneous reaction to certain drugs. Different morphological patterns of fixed drug eruption can occur. We describe a new morphology of fixed drug eruption showing a reticulated pattern as a result of ingestion of mefenamic acid and discuss the possible mechanism underlying such an appearance