ABSTRACT
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
ABSTRACT
Objective To determine the frequency of cutaneous manifestations in patients suffering from type 2 diabetes mellitus and to observe the association of these manifestations with body mass index [BMI] and glycosylated hemoglobin [HbA1c] level
Methods This cross-sectional study was conducted in Shalamar Teaching Hospital / Shalamar Medical and Dental College, Lahore from October 2016 to March 2017. A total of 200 adult patients belonging to both genders having type 2 diabetes mellitus attending the outpatient department were studied. Detailed history and cutaneous examination was performed after taking the informed consent. Glycemic profiles including HbA1c were done. Height and weight were recorded too. Normal range of HbA1c was taken as 5 - 6.5 percent. Value of >/= 6.5 percent was taken as high. Normal range of BMI as taken as 18.5- 24.9 kg/m[2]. Patients having BMI 25-29.9 kg/m[2] were taken as overweight and >/= 30 kg/m[2] as obese
Results Of 200 patients, 174 [87 percent] patients were found to have cutaneous abnormalities. There were 53 [26.5 percent] males and 147 [73.5 percent] females. Mean age was 52.4+/-9.96 years. Mean HbA1c was 9.07+/-2.23 percent. The mean BMI was 29.46 kg/m[2] with 20 percent having normal BMI, 38 percent were overweight and 41 percent were obese. Most frequently observed skin disease was cutaneous infections including bacterial and fungal infections, followed by generalized xerosis, diabetic dermopathy, acanthosis nigricans, pruritus and acrochordons. Statistically significant correlation was observed between HbA1c and diabetic foot and between BMI and acanthosis nigricans and generalized xerosis
Conclusion About 87 percent patients with type 2 diabetes have cutaneous lesions, the most common of which was cutaneous infections. Hyperglycemia manifested with high HbA1c and obesity manifested with high BMI is associated with many cutaneous lesions
ABSTRACT
Objective: To determine the efficacy and safety of 50% glycolic acid peels in melasma in Fitzpatrick's skin type IV and V
Methods: 50 patients of melasma were included in the study. Type of melasma was identified with the help of Wood's lamp. Patients were advised a pre-peel program of daily application of tretinoin 0.05% at bedtime for 2-weeks. MASI scoring and colored photographs of each patient were taken before each peel with 50% glycolic acid and at the end of follow-up. Treatment was carried out with an interval of 2-weeks for a total of 6 sessions. Efficacy was assessed 4 weeks after the last session. Side effects, if any, were also recorded
Results:The mean age of the patients was 28.88 +/- 6.02 years. There were 44 [88%] females and 6 [12%] male patients. 20 [40%] patients had epidermal melasma, 28 [56%] had mixed type and only 2 [4%] patients presented with dermal melasma. Mean baseline MASI score was 15.54 +/- 5.76 and the mean MASI score at the end of treatment was 9.6 +/- 4.8. The mean percentage of reduction of MASI score was 40.57 +/- 11.9%. A significant improvement from baseline to 14 weeks was observed. Only a few side effects were seen in the form of mild erythema and burning sensation
Conclusion: This study demonstrates that serial glycolic acid peels are effective and safe in the treatment of melasma in Fitzpatrick's skin type IV and V
ABSTRACT
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.
ABSTRACT
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