Propranolol for the treatment of infantile hemangioma: our experience at the children's hospital, Lahore

To assess the effect of propranolol in growing infantile hemangioma [IH]. 122 children 68 girls and 54 boys, mean age 4.5 months, having IH were treated with oral propranolol. After taking baseline pulse, blood pressure, blood glucose level and echocardiography, propranolol was started at 0.5mg/kg body weight. Patients were monitored hourly for pulse, blood pressure and blood glucose level were noted and if no side effects noted for four hours, treatment was continued at home. Patients were reevaluated on day 10 and the dose was increased to 1.5-2 mg/kg daily in divided doses. Patients were followed up monthly for response and side effects. To avoid hypoglycemia in infants under the age of 3 months, mothers were advised to feed them every 2 hours. The earliest effect was change in color seen in all cases. clinical evidence of softening and regression were seen after 2-3 weeks. Drug was given for mean period of 6.5 months. Overall clinical response was seen in 115 [94.3%] patients. It was graded as excellent [>75% improvement] in 92 [75.4%] and good [50-75% improvement] in 23 [18.9%] patients. Adverse effects during treatment were hypoglycemia 4 [3.3%], hypotension 3 [2.5%], cold extremities 2 [1.6%] and constipation 1 [0.8%]. Relapse rate was none. Propranolol given orally at 1.5-2.0 mg/kg/day has consistent, rapid therapeutic effect in shortening of natural course of IHs with good clinical safety

Comparison of 5% potassium hydroxide with 10% potassium hydroxide solution in treatment of molluscum contagiosum: a comparative study

To compare the results of 5% KOH versus 10% KOH in treatment of molluscum contagiosum [MC]. 40 children having MC were divided into 2 groups. 5% KOH solution or 10% KOH solution was applied by the patient or a parent on lesions once daily for two weeks or till the appearance of inflammatory signs. Patients were followed up 2, 4, 8 and 12 weeks for efficacy and side effect. Efficacy was categorized as complete remission [=/< 90% clearance of lesions], partial remission [60-90% clearance of lesions] and insignificant improvement [<60% clearance of lesions]. By the end of study 16 patients in group A [5% KOH] and 17 patients in group B [10% KOH] were evaluable. Partial remission was seen in 4 [25%] in group A while in group B, 7 [41.2%] patients showed complete remission and 10 [58.8%] partial remission. 100% patients in group B showed local side effect in group A and 52.3% developed local side effect in group B. The side effects were mild and did not require discontinuation of treatment. 10% KOH solution is more effective treatment option for molluscum contagiosurn than 5% KOH solution

Efficacy and safety of ablative fractional carbon dioxide laser for acne scars

Acne may lead to long term squelae including physical scars. Lasers have been used with variable degree of success but literature pertaining to Asian population is sparse. To evaluate the efficacy and safety of carbon dioxide [CO[2]] fractional laser in the treatment of acne scars in the local population. Twenty patients with mild to moderate atrophic acne scars were registered and subjected to monthly fractional CO[2] laser resurfacing for six sessions and final evaluation was done six months after the last treatment. More than 71% patients showed variable degree of improvement. No severe long term complications were noted in any patient. Study suggests that CO[2] Fractional laser may prove a useful addition in the management of acne scars in our patients as well

10% Potassium hydroxide solution vs. cryotherapy in the treatment of molluscum contagiosum: a case-control study

Molluscum contagiosum [MC] is a common viral infection affecting children. A number of chemical and physical modalities are available for its treatment. To evaluate the efficacy and safety of cryotherapy versus 10% potassium hydroxide [KOH] solution in treating MC. 40 children with MC were divided into two groups. Cryotherapy [one freeze-thaw cycle] was done in group A [n=20] or 10% potassium hydroxide solution [KOH] was applied [group B, n=20] by the patient or a parent twice daily until 12 weeks. Patients were followed up at baseline, week 2, week 4, week 8, and week 12 for efficacy [defined as clearance of lesions] or side effects. By the end of study, 14 patients in group A [cryotherapy] and 17 patients in group B [KOH] were evaluable. All 14 [100%] patients in cryotherapy group and 16/17 [94.1%] in KOH group showed complete clearance of lesions. 100% patients in group A [cryotherapy] and 88.2% in group B [KOH] developed local side effects. However, these were mild and did not warrant discontinuation of treatment. 10% KOH solution is as effective as cryotherapy for the treatment of MC in children. However, KOH is relatively safe and more patient friendly therapy

Clinical profile and morphologic types of infantile hemangioma. A study of 252 children

Hemangiomas are the most common benign tumours of infancy which can affect skin as well as internal viscera. Superficial hemangiomas may show clinical diversity in sites of involvement, number, age of onset, morphology etc. The objective of present study was to record the clinical profile and morphologic types of infantile hemangiomas. 252 children presenting with cutaneous hemangioma during a period of two years from January, 2003 to December, 2004 were included in the study. Their demographic characteristics, the clinical morphology, sites of involvement and complications were recorded. A total of 315 lesions were observed in 252 children. Median age of presentation was 6.8 months and females outnumbered males with 2.7:1 ratio. 69.2% lesions were confined to head and neck region. Localized type of lesions [83.2%] were the most frequent presentation than segmental [15.6%] or multifocal [1 .2%], usually presenting as nodules or plaques. The rate of extracutaneous hemangiomas, systemic complications or developmental anomalies was significantly low. Localized hemangiomas are a common occurrence during infancy and systemic complications usually do not arise

Effect of pregnancy on cutaneous disorders

During a period of one year, 140 patients were screened to evaluate the effect of pregnancy on various dermatoses. Patients were followed till delivery. Vaginal candidiasis was seen in 18 [12.9%], herpes simplex in 3 [2.1%], herpes zoster in 1 [0.7%], condyloma acuminata in 1 [0.7%], and lepromatous leprosy in 1 [0.7%] patient. Among immune-mediated disorders, 2 [1.4%] patients had pemphigus vulgaris and 1 [0.7%] had seronegative systemic lupus erythematosus. In all these cases the course of diseases was consistent with the reported literature. Fetal loss was seen in one case of pemphigus vulgaris, only. The cause fetal loss in this case was the disease itself, if properly diagnosed and treated, various dermatoses do not pose a serious threat to the mother or fetus