ABSTRACT
Objective: to assess the outcome of CROSS technique with 100% trichloroacetic acid [TCA] on atrophic icepick acne scars
Methods: it was a quasi-experimental study held at dermatology department, Sir Ganga Ram Hospital, Lahore on 20th November 2013 till 19th April 2014. A total number of 60 patients were included in this study. There were 40 female [66.7%] patients and 20 male [33.3%] patients. After informed consent, four sessions of 100% TCA focal application on atrophic icepick acne scars by CROSS [chemical reconstruction of skin scars] technique were done at two weekly intervals and final outcome was assessed at three months after the last session
Results: in our study 41.7% patients showed excellent [>70% reduction of acne scars] response, 45% patients showed good [51-70% reduction of acne scars] response, 13.3% patients showed fair [30-50% reduction] response and no patient showed poor [<30% reduction] response
Conclusion: chemical reconstruction of skin scars [CROSS] technique with 100% TCA is a safe, minimally invasive and cost-effective technique for the treatment of icepick acne scars
ABSTRACT
Objective: To determine the frequency of different dermatological manifestations in patients of chronic kidney disease on regular hemodialysis
Methods: In this descriptive cross-sectional study, 160 patients were included from October, 2014 to April, 2015. Dermatological examination was performed and investigations were carried out where required to diagnose. Data was stratified for age, gender and duration of disease. Poststratification chi square test was applied. P value
Results: Mean age of the patients was 43.93+/-12.12 years. Out of 160 cases, 90 [56.2%] patients were males while remaining 70 [43.8%] patients were females. Mean duration of chronic kidney disease was 2.54 years with minimum 3 months and maximum 14 years. Patients were on hemodialysis, duration ranging from 3 months to 9 years. Distribution of dermatological lesions were as follows: pallor was present in 119 [74.4%] patients, hyperpigmentation in 115 [71.9%] patients, xerosis in 96 [60%], pruritus in 91 [56.9%], ecchymosis and petechiae in 28 [17.5%], fissured tongue in 18 [11.3%], angular cheilitis in 3 [1.9%], ulcerative stomatitis in 22 [13.8%], half-and-half nails in 55 [34.4%] and koilonychia was present in 5 [3.1%] patients. Other manifestations seen were reactive perforating collagenosis in 4 [2.5%] and onychomycosis in 6 [3.7%] patients. Out of 91 [56.87%] pruritic patients, mild pruritus was observed in 27 [16.9%] patients, moderate in 36 [22.5%], intractable and severe pruritus in 14 [8.8%] patients. Out of total 96 xerotic patients, xerosis was mild in 35 [21.8%] patients, moderate in 38 [23.8%], severe in 23 [14.4%] patients
Conclusion: Pallor, hyperpigmentation and xerosis were most common in CKD patients on hemodialysis, so early recognition of cutaneous signs can relieve suffering and decrease morbidity
ABSTRACT
Objective To compare the efficacy of alternate day fixed low-dose regimen of isotretinoin [20mg] with daily low-dose regimen in mild to moderate acne vulgaris.
Methods Sixty patients of mild to moderate acne vulgaris were divided into two groups A and B, each having 30 patients. In group A patients, oral Isotretinoin 20mg/day was used. In group B patients, oral isotretinoin 20 mg on alternate days was given. Both regimens were continued for six months. The disease severity was assessed by Global Acne Grading System. Patients were followed up monthly and their GAGS scores were calculated at each visit. Percentage decrease in GAGS score at the end of six months was taken as efficacy.
Results The mean age of the patients was noted as 20.72 +/- 4.06 years. There were 4 [7%] male patients whereas 56 [93%] patients were females. The mean weight of the patients was noted as 57.88 +/- 7.36 kg. In daily dose group, the mean percentage decrease in GAGS was 73.95 +/- 14.04 whereas in alternate day group, the mean percentage decrease in GAGS was 66.57 +/- 14.97 [P>0.05]. In daily dose group, efficacy was achieved in 27 [90%] patients whereas in alternate dose group, efficacy recorded was in 26 [86.7%] patients [P>0.05].
Conclusion In the management of mild to moderate acne vulgaris, the alternate day low-dose isotretinoin has almost equal efficacy as compared to daily low-dose therapy.
ABSTRACT
To observe the skin changes in patients of dengue fever. In this cross-sectional, observational study, 109 patients of dengue fever with cutaneous manifestations were enrolled from the dengue outpatient and inpatient departments of Lahore General Hospital, Lahore. This was done during the recent outbreak of dengue fever in Pakistan from 1[st] September 2011 to 31[st] October 2011. Demographic data of patients was recorded, cutaneous findings were noted and their percentages were calculated, consent for the photographs was taken. Out of 109 patients, 61 [56%] were males and 48 [44%] were females, male to female ratio being 1.3:1. Age range was 3 to 78 years. The mean age was 27.25 +/- 11.02 years. Cutaneous findings included blanchable erythema, observed in 47 [43%], followed by itching and burning in 33 [30.3%], maculopapular rash was seen in 17 [15.6%] patients, scaling in 11 [10.1%], herpes simplex was observed in 9 [8.3%] of the total patients, Petechiae/ecchymoses/purpura also in 9 [8.3%] and urticaria was the least common of the skin changes, occurring in only 4 [3.7%] patients. Mucosal involvement showed red eye in 41 [40.6%] patients. Oral mucosa showed diffuse erythema in 16 [14%] patients, candidiasis occurred in only 2 [1.9%] and oral aphthae presented in 2 [1.9%] patients. Cutaneous findings are commonly seen in patients of dengue fever. It may help in the early diagnosis of dengue fever, while the laboratory tests are still awaited
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Skin/pathology , Epidemics , Cross-Sectional Studies , Erythema , Pruritus , ExanthemaABSTRACT
Orf is a zoonotic infection seen in livestock handlers. We report a case of human to human transmission of orf infection in a patient of toxic epidermal necrolysis and his caretakers. To the best of our knowledge this is the first case of orf infection in the patient of toxic epidermal necrolysis
ABSTRACT
Cutis laxa is a disorder of skin due to defective elastin synthesis. In both the inherited type and the acquired type, the internal organs are frequently involved. A case of a 27-year-old female patient suffering from cutis laxa is reported who developed severe pulmonary and cardiac involvement in adulthood
Subject(s)
Humans , Female , Elastic Tissue/pathology , Facial Dermatoses , Elastin , Mutation , Cutis Laxa/geneticsABSTRACT
The treatment of vitiligo is a challenging task. Several therapeutic modalities have been tried till date. Topical calcipotriol alone and in conjunction with PUVA have shown good results in various international studies in the treatment of type I and II vitiliginous skin. Our aim was to evaluate and compare the efficacy of topical calcipotriol alone and in combination with PUVA in the treatment of vitiligo in type IV skin. Sixty patients of vitiligo [26 males and 34 females], aged 12-60 years and involving < 30% of the body surface area were enrolled and randomly divided into two equal groups. Group I patients were treated with twice daily application of topical calcipotriol for six months. In group II patients, in addition to topical calcipotriol, photochemotherapy [PUVA] was advised thrice a week for the same duration. Response was graded according to the degree of repigmentation. In group I, only one sixth [16.7%] of the cases responded and all of them had less than 50% repigmentation whereas in group II, all the patients responded. Seventy percent of the cases in this group showed excellent response [> 75% of repigmentation]. We conclude that topical calcipotriol alone has no role in the treatment of vitiligo in type IV skin but when combined with PUVA leads to an excellent response in greater than two third of the patients
ABSTRACT
Mycophenolic acid [MPA] was introduced in the 1970s as a treatment for psoriasis, it has since been reformulated as mycophenolate mofetil [MMF]. With an improved side effect profile and enhanced bioavailability, MMF is a promising drug for immune-mediated skin diseases. It is currently approved for the prevention of organ rejection. Its list of dermatological indications continues to grow. As a noncompetitive inhibitor of inosine monophosphate dehydrogenase [IMPDH], MMF inhibits de novo purine synthesis. Its relative lack of hepatonephrotoxicity and perhaps low risk of carcinogenicity offer important therapeutic advantages. This new formulation showed enhanced bioavailability, tolerability and efficacy. No doubt case reports and case series of MMF therapy dominate the dermatologic literature; preliminary results are sufficiently promising to warrant larger, randomized clinical trials with this emerging therapy
ABSTRACT
Cornelia De Lange Syndrome is a rare disorder of unknown etiology, characterized by peculiar facial appearance. Patients are small at birth and remain so as compared to children of the same age. Their ability to learn is delayed. All patients present delayed or limited speech development. A case of this rare disorder is reported here, which has a classical presentation, but unusual association with generalized pustular psoriasis not reported earlier