Frequency of autoimmune disorders in patients of alopecia areata

Objective: To determine the frequency of autoimmune disorders associated alopecia areata in patients presenting in a tertiary care hospital

Methods: This study was conducted at the Dermatology Department, Unit II, KEMU/Mayo Hospital, Lahore. 120 patients fulfilling the inclusion criteria were entered in the study during May 2013 to January 2014. After takin informed consent and recording demographic data, complete history was taken. Examination was performed and investigations were carried out where needed, for determination of factors associated with alopecia areata

Results: Out of 120 patients studied, 30.8% of patients had positive family history of alopecia areata. Atopic dermatitis was found in 29.2% of patients. Vitiligo and hypothyroidism were seen in 4.2% each. Diabetes mellitus was seen in 1.7% of the cases and 0.8% were hyperthyroid

Conclusion: Positive family history and atopic dermatitis were seen in one third of our patients with alopecia areata. Vitiligo and hypothyroidism were other important associations observed

Chronic urticaria: an approach towards etiology and diagnosis. Part I

Chronic urticaria [CU] is one of the most frustrating and challenging dermatosis for patients and physicians both. Apparently easy to diagnose, CU is still considered as a difficult to manage disease. Subtypes of CU include chronic idiopathic [spontaneous] urticaria, inducible urticaria, physical urticaria, autoimmune chronic urticaria and urticarial vasculitis. Physical urticaria may coexist with chronic idiopathic [spontaneous] urticaria. Evaluation of a patient with CU should involve consideration of various possible causes, although in most cases the cause is not identifiable. Investigation of CU should be guided by a thorough history and physical examination.

Pattern of dermatoses and underlying psychopathological disorders in patients attending dermatology clinic in earthquake affected areas of Azad Kashmir

Psychological stress such as sexual assault, major earthquake, or plane crash has long been recognized as an etiological or precipitating factor in dermatological disorders. Treatment of these patients comprises of not only management of dermatological disorders but also on treating the underlying psychopathological diseases. These disorders can be identified by the application of the twelve item General Health Questionnaire [GHQ-12] which is a self-administered screening tool requiring only few minutes to complete and score the findings. To recognize different types of dermatoses and screen the patients for associated psychopathological disorders using General Health Questionnaire [GHQ-12] in the earthquake affected areas of Azad Kashmir. Subjects and an outpatient dermatology clinic was set up in the earthquake affected area of Muzaffarabad for four days. As it was advertised to be a dermatology specific clinic, so all patients presenting with some dermatological disorder were enrolled using non-probability convenient sampling technique. Demographic data was filled by social workers and clinical data was recorded by dermatologists on a specially designed pro forma. The patients were asked to complete 12 items General Health Questionnaire [GHQ] which was filled by patients who were literate while for others social workers assisted. Chi-Square test was used for data analysis. A total of 522 patients with different skin diseases were enrolled Dermatological infestations were seen in 207 [39%] cases followed by eczemas 90 [17.3%] and infections 80 [15.3%]. Stress mediated dermatological problems like acne 40 [7.6%] and psoriasis 27[5%] were found in these cases. Overall 192 [36.8%] patients were living in shelter based homeless situation and psychiatric morbidity was seen in 55% [173] cases having dermatological illness. Infestations, infections and eczemas were the most common skin diseases seen in earthquake victims and increased psychiatric morbidity may be responsible for rise in stress related dermatological disorders

Lichen planus/lupus erythematosus overlap with hypothyroidism: a case report

Lupus erythematosus [LE] and lichen planus [LP] are usually seen as individual entities. Their overlap comprises patients who have clinical, histological and/or immunopathological characteristics of both diseases simultaneously. This rare syndrome has been associated with certain other disorders e.g. vitiligo, pemphigus foliaceus, Hashimoto's thyroiditis and Reynold's syndrome. We report a case of LE/LP overlap associated with hypothyroidism