ABSTRACT
Background and Introduction: Insulin-Like Growth Factor-1 [IGF-1] belongs to the growth factor family, structurally resembling pro-insulin, enabling it to bind to insulin receptors. It plays an important role in many tissues including skin, particularly acne pathogenesis by stimulating sebum production and affecting androgen levels. Studies comparing IGF-1 levels in acne patients and controls have found statistically significant differences, proving acne as a sign of insulin resistance. However, no such study has been carried out in Pakistan
Methodology: After approval from the institutional ethical board and informed consent, a case-control study was carried out with 270 acne patients and 80 age and gender- matched controls. Patients belonged to either gender and aged between 15 - 35 years were divided into mild, moderate and severe categories. IGF-1 levels were noted after exclusion of any condition interfering with IGF-1 level and correlated with acne severity and with levels of testosterone, dihydrotestosterone [DHT] and dehydroepiandrosterone sulphate [DHEAS]. Quantitative variables were expressed as median and percentiles. Comparisons were done by Mann-WShitney test and correlations by Spearman correlation. A p value of
Results: Out of 350 cases and controls, There were 142 [41%] males and 208 [59%] females. In cases, there were 155 females and 115 males, whereas in controls, there were 54 females and 26 males. Median age of the patients was 20 years. Ninety-Seven patients had mild, 108 moderate and 65 had severe disease. Median levels of IGF-1 were 292 ng/m in cases. IGF-1 levels were significantly different between cases and controls and between mild and severe acne, but not between mild and moderate acne. IGF-1 levels were strongly correlated with the levels of androgenic hormones
Conclusion: Increase of IGF-1 levels in acne point to the role of insulin resistance and diet in acne. Future treatments may be targeted to treat IGF-1 levels by dietary interventions reducing glycemic load
ABSTRACT
Objective: to analyze pattern of skin diseases in remote areas of Punjab diagnosed by telemedicine network
Methods: rural centers at the district and tehsil levels [Rajanpur, Dera Ghazi Khan, Khushab, Sahiwal, Gujrat and Jhang regions of Punjab] were connected to tertiary care centers with specialized telemedicine equipment. The images were transmitted live. Prescriptions were written and duly forwarded. Patients were called to the tertiary care center for further investigations and examination if needed
Results: a total of 11,892 patients were treated. Acne was the commonest disorder [42%], followed by dermatophytosis [28%], scabies [22%] and eczemas [18%]. Infestations and infections are common in patients from poor socio-economic strata
Conclusion: telemedicine is beneficial for providing services to remote areas and can be used as a preventive measure by educating people
ABSTRACT
Objective: To compare the efficacy and safety of topical betamethasone valerate 0.1 percent with narrowband ultraviolet B [NB-UVB] therapy in atopic dermatitis
Method: Sixty patients with AD fulfilling the inclusion criteria were entered in the study. Patients were divided into 2 groups. Group A were given betamethasone valerate 0.1 percent twice a day for 4 weeks. Group B were given NB-UVB thrice a week for 8 weeks. Starting dose was 75 percent of minimal erythema dose [MED] for the skin type III and IV. Dose was increased by 20 percent on each visit as tolerated by the patients. During treatment patients were assessed at 2[nd]and 4[th]week for betamethasone valerate and 2[nd], 4[th], 6[th] and 8[th]week for NB-UVB
Results: 84 percent patients in group A [betamethasone] showed >50 percent reduction in Scoring of Atopic Dermatitis [SCORAD] whereas 94 percent patients in group B [NB-UVB] showed >50 percent reduction in SCORAD [p=0.554]. Side effects were seen in 34 percent patients in group A and 20 percent in group B
Conclusion: Both betamethasone valerate 0.1 percent and NB-UVB are almost equal in terms of efficacy but NB-UVB is more safe than betamethasone valerate 0.1 percent
ABSTRACT
Objective: To determine the efficacy of sclerotherapy in treating pyogenic granuloma
Methods: The present study was conducted at outpatient Department Dermatology, Unit I, Mayo Hospital, Lahore. 35 patients were enrolled and were injected with 0.1ml of 3% sodium tetradecyl sulfate with the help of an insulin syringe, without local anesthesia, till the point of blanching. Patient was called weekly for two weeks for follow up to see clearance of the lesion and then after 3 months to see any recurrence using a caliper
Results: The mean age of the patients was 28.48 +/- 11.64 years. 42.9% patients were males and 57.1% patients were females. Complete clearance of lesion was found in 30 [85.7%] patients whereas 2 [5.7%] patients showed no reduction
Conclusion: Sclerotherapy is an effective procedure for the treatment of pyogenic granuloma patients
ABSTRACT
Objective: To compare efficacy of intralesional 5-fluorouracil [5-FU] plus triamcinolone acetonide [TCA] versus intralesional TCA alone in the treatment of keloids
Methods The study included 100 patients with keloids. Patients were divided into two groups. Randomization was done through lottery method. For each 1 cm area, group A was given intralesional 5-FU 50 mg/ml [0.9ml] plus TCA 40mg/ml [0.1ml] after every 4 weeks and group B was given intralesional TCA 40mg/ml [0.1ml] after every 4 weeks for total period of 12 weeks. Administration of the drugs was continued till the keloid flattened or for a maximum period of 12 weeks. Follow-up was done every 4 weeks for total period of 12 weeks after the administration of last injection. Decrease in total score using Vancouver Scar Scale was calculated
Results: After the completion of study mean reduction in Vancouver Scar Score was -71.18 +/- 8.69 in the intralesional 5-FU plus TCA group as compared to -50.80 +/- 8.59 in the intralesional TCA group [p=0.001]. 5-FU + TCA was efficacious in 98% of cases [group A] and TCA alone in 62% of cases [group B]. No serious adverse effects were noticed in either group
Conclusion: Intralesional 5-FU plus TCA is significantly better than intralesional TCA alone in the treatment of keloids
ABSTRACT
Trichoepithelioma is a benign adnexal tumour arising from hair matrix cells. It can be sporadic, familial or a component of other genetic diseases. We report a 40-year-old female who presented with disseminated papulonodular lesions on the face only which were confirmed histopathologically as trichoepithelioma. Her daughter also had trichoepithelioma in the nasolabial folds. They had no other systemic features and were concerned the cosmetic disfigurement imparted by the disease
ABSTRACT
Objective: To determine the frequency of associated factors of onychomycosis in patients presenting in a tertiary care hospital
Methods: In this cross-sectional survey conducted in Dermatology Unit-I, Outpatient Department, Mayo Hospital, Lahore, 120 patients fulfilling the inclusion criteria were analyzed. After taking informed consent and recording demographic data, complete history was taken. Examination was performed and investigations were carried out where ever needed, for determination of factors associated with onychomycosis
Results: Females were 80.8% of study cases and elderly constituted 5.8%. Positive family history for onychomycosis and smoking, each was observed in 10%. Trauma was present in 11.7% cases. 5% of patients wore occlusive shoes and 9.2% subjects were diabetic
Conclusion: Onychomycosis affected females four times more than males. The most frequent factor observed was trauma. Smoking, positive family history and diabetes mellitus were other important factors