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 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
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
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
To determine the familial frequency of vitiligo and its association with autoimmune disorders. This cross-sectional study was conducted in the Department of Dermatology, Mayo Hospital, Lahore. Hundred patients of vitiligo of any age and either sex, diagnosed on the basis of history and clinical examination were enrolled from the outpatient department. Patients were evaluated for familial frequency of vitiligo and its association with other autoimmune diseases by means of a specially designed proforma. Total number of vitiligo patients was 100. Family history of vitiligo was seen in 22% of cases. Associated autoimmune disorders were seen in 23% of cases and were mainly diabetes mellitus, autoimmune thyroid disease, alopecia areata and eczemas. This study reveals that generalized vitiligo is associated with other autoimmune disorders, showing similar genetic basis. Therefore it is important to evaluate as well as investigate, where necessary, vitiligo patients for other autoimmune disorders
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Autoimmune DiseasesABSTRACT
Tuberculosis is a chronic and serious infection if left untreated. Currently one third of the world population is infected with this bacillus. The immunosuppression due to glucocorticoids in patients with skin diseases may cause acquisition of primary tuberculosis and the reactivation of nonactive tuberculosis. This review focuses on risk involved, diagnosis and treatment in such patients
Subject(s)
Humans , Dermatology , SteroidsABSTRACT
To determine the efficacy of intense pulsed light [IPL] in the treatment of melasma in Asian skin types. Fifty patients who fulfilled the inclusion criteria were selected for this study. Type of melasma was identified with the help of Wood's lamp. Before each session patients were asked to wash the area with bland soap and water. Cooling transparent gel was applied. Fluence and pulse duration of IPL was selected according to the Fitzpatrick skin type. Patients were treated with 560nm-1200nm wavelength. They were advised to use broad spectrum sunscreen with SPF >30 and to avoid heat and sunlight. Topical antibiotic was advised for few days till the crusts cleared. Treatment was carried out with an interval of three weeks for a total of four sessions. Efficacy was assessed four weeks after the last session. The mean age of the patients was 31.8 +/- 6.5 years. There were 5 [10%] males and 45 [90%] female patients. 7 [14%] patients had dermal melasma, 20 [40%] epidermal type and 23 [46%] patients had mixed disease. The mean percentage of reduction of MASI score was 29.4 +/- 10.9. In only 2 [4%] patients, IPL was found to be efficacious. Intense pulsed light is non-efficacious treatment for melasma in Asian persons.
ABSTRACT
Squamous cell carcinoma [SCC] is a rare late complication of chronic discoid lupus erythematosus [CDLE]. We report a case of SCC developing in lesions of CDLE in a 16-year-old girl suffering from SLE. A verrucous change or ulceration in lesions of CDLE should warrant a biopsy to rule out malignant transformation