Efficacy and safety of thalidomide in treatment of prurigo nodularis

Objective: To determine the efficacy and safety of thalidomide in treatment of idiopathic prurigo nodularis

Methods: A total of 12 patients were enrolled in the study. Patients of child bearing potential and those with active systemic disease were excluded. All the patients had the histopathological confirmation of diagnosis. Patients were given 100mg/day of thalidomide for a period of three months. Follow up visit was every one month and therapy was stopped at three months. Patients were again evaluated for relapse two months after stopping the treatment

Results: 7 [58.3 percent] patients had successful response to the treatment. 3 [25 percent] patients had a partial response and 2 [16.7 percent] had unsuccessful treatment

Conclusion: Thalidomide is safe and effective treatment option for idiopathic recalcitrant prurigo nodulari

Efficacy and safety of sulphasalazine in treatment of alopecia areata

Objective To evaluate the safety and efficacy of sulphasalazine in treatment of severe alopecia areata.

Methods It was a non-randomized open therapeutic trial. 41 subjects were included in the study. Patients were enrolled from department of dermatology Unit-II of Mayo Hospital Lahore. Subjects were stared on 500mg/day of sulphasalazine to a maximum of 3gram/day. The dose for children was 10mg/kg/day. Patients were followed fortnightly. Responsive patients were followed for another 3 months. All the relevant data was recorded and analyzed.

Results Four out of 50 patients [4%] responded to the treatment. Two of them demonstrated partial response and two had total response. There was no significant sex difference for the treatment response. Major side effect observed was hepatotoxicity seen in 3 patients resulting in discontinuation of drug.

Conclusion It is concluded that sulphasalazine is relatively safe but not effective in treatment of severe AA.

Frequency of dyslipidemia in patients with psoriasis

To determine the frequency of dyslipidaemia in psoriatic patients. A cross-sectional study was carried out in the Department of Dermatology, Jinnah hospital, Lahore for the duration of six months. A total of 120 patients suffering from psoriasis, of any severity, belonging to either sex and with age between 15-70 years were included in the study. All patients in the study were investigated for total cholesterol, triglycerides, low-density lipoproteins and high-density lipoproteins after 12-14 hours of overnight fasting. The mean age of the patients was 38.59 +/- 13.86 years. There were 78 [65%] male and 42 [35%] female patients. The mean duration of psoriasis was 5.46 +/- 4.49 years. The mean PASI score was 14.98 +/- 8.95. There were 67 [55.8%] patients having dyslipidaemia and 53 [44.2%] patients had normal lipid levels. 34 [28.3%] patients had raised total cholesterol [>200mg/dl], 32 [26.7%] raised low-density lipoprotein-cholesterol [>130 mg/dl], 44 [36.7%] hypertriglyceridemia [>150mg/dl] and 35 [29.2%] patients had reduced high-density lipoprotein-cholesterol [> 130 mg/di], 44 [36.7%] hypetriglycerideia [> 150 mg/d] and35 [29.2%] patients had reduced high-density lipoprotein-cholesterol levels [< 40 mg/dl] it is concluded from this study that patients of psoriasis have a high incidence of dyslipidaemia, as it was found in 55.8% of psoriasis patients

Cutaneous manifestations in obesity

To study the frequency of various dermatoses in obese patients and their comparison with the control group of normal weight individuals. The duration of study was one year starting from March 2011 to March 2012. A total of 93 obese [BMI >30kg/m2] and 93 normal weight [BMI 18.5-24.9 kg/m2] individuals were included in the study. All the individuals underwent a complete medical and dermatological evaluation. All of them were evaluated for the presence of metabolic syndrome, as well. Common dermatoses seen in obese patients were acanthosis nigricans, striae, acrochordons, and various infections. Out of these acanthosis nigricans, acrochordons and striae had statistically significant relationship with obesity as compared to control group [p<0.05]. All the manifestations were also compared for diabetes, dyslipidemia and metabolic syndrome. Obesity is associated significantly with certain dermatoses. Understanding and thorough knowledge of these disorders is necessary both for the physicians as well as for a dermatologist, as many of these conditions are treatable, leading to an improved life quality. Early recognition of these lesions may also warn the patients for a need of weight reduction

Cutaneous manifestations in 1000 Pakistani newborns

Cutaneous manifestations are commonly seen in neonates. Benign dermatoses in newborns must be distinguished from more serious, life threatening disorders with cutaneous manifestations. To determine the frequency of various dermatoses i.e. physiological and pathological among newborns up to 96 hours of age. 1000 full-term neonates were enrolled from labour rooms and pediatric nursery of Jinnah hospital, Lahore and were evaluated for cutaneous manifestations. All the relevant data regarding history, clinical examination and investigations were recorded and analyzed. Out of 1000 neonates, there were 469 boys and 531 girls. Their mean age was 72 hours [6-96 hrs]. Cutaneous manifestations were present in 94% of babies and 82.5% babies had more than one manifestation. The most common dermatoses were Mongolian spots [63.2%], Epstein pearls [47.8%], sebaceous hyperplasia [44.8%], miliaria [12.8%], hypertrichosis [12%], erythema toxicum neonatorum [12%], salmon patch [12%] and impetigo [11.4%]. Uncommon manifestations included desquamation 8.5%, omphalitis 8% and birth trauma [7.7%]. Rare dermatoses were hemangiomas [3.5%], cafe-au-lait macules [2.6%], congenital melanocytic nevus [2.4%], acne neonatorum [0.9%], preauricular skin tag [0.4%], cutis marmorata telangiectatica congenita and collodion baby in [0.1%] each. Cutancous manifestations one are frequent in newborns