Efficacy of topical tacrolimus 0.1% and clobetasol propionate 0.05% in the treatment of alopecia areata

Objective: To assess the efficacy of tacrolimus and clobetasol propionate in the treatment of alopecia areata

Methods A clinical trial was carried out in the department of Dermatology and Venereology, Dhaka Medical College Hospital, Dhaka, Bangladesh from May 2013 to April 2014. Total sixty patients were enrolled and divided into group A and group B. Thirty of group A patients were treated with topical tacrolimus and thirty of group B patients were treated with topical clobetasol propionate

Results: In group A, the duration of illness ranged from 2 months to 36 months and in group B, from 1 month to 24 months. Among the patients of group A and B, 25 [83.3%] and 27 [90%] patients improved, respectively. After 16th week of treatment, slight response in 6 [20%] and 4 [13.3%] and moderate response in 18 [59.4%] and 22 [63.2%] and marked response in 1 [3.3%] and 1 [3.3%] was seen in group A and group B, respectively. No significant difference was observed [p value = 0.648]

Conclusion: Both the drugs, clobetasol propionate and tacrolimus when used individually, were found to be equally effective in the treatment of alopecia areata and tacrolimus ointment 0.1% can be used as an alternate therapeutic modality

Pattern of contact dermatitis in a tertiary level hospital in Bangladesh

To evaluate the pattern of contact dermatitis [CD] among patients in a tertiary care hospital in Dhaka, Bangladesh. In this cross-sectional study, 120 patients of contact dermatitis, diagnosed clinically were evaluated by detail history and clinical examination. The clinical patterns were correlated with the likely sources of allergens. Mean age was 32.8 +/- 14.0 years and majority of the patients were housewives 36 [30.0%] and students 33 [27.5%]. 60.0% of the patients came from low-middle class. Itching 117 [97.5%] and disfigurement 89 [74.2%] were chief complaints of the patients. 63 [52.5%] patients showed erythematous rash, 42 [35%] vesicular eruption, 34 [28.3%] pustular eruption and 16 [13.3%] post-inflammatory hyperpigmentation. Both hands 69 [57.5%], right hand 41 [34.2%], both feet 50 [41.7], neck and ear 42 [35%] and face 30 [25.0%] were the commonly involved sites. Allergic contact dermatitis [52.5%] was more common than photocontact CD [26.7%] and irritant CD [20.8%]. Regarding the source of contact dermatitis, detergents 88 [73.3%], cooking materials 67 [55.8%], shoes or sandals 61 [50.8%], cosmetics 42 [35%], gold/jewellery 38 [31.7%], insects 29 [24.2%] were the main etiological factors of contact dermatitis. The study highlighted that contact dermatitis depends on patients' occupational exposure of different substances.

Cutaneous morphological patterns of adverse drug reactions: a study of 50 cases

Adverse drug reactions are common complications in drug therapy. About 3-8% of all hospital admissions are the results of adverse drug reactions, and these can cause significant disability to patients. To evaluate the clinical spectrum of all cutaneous adverse drug reactions and to establish the causal link between suspected drug and the reaction. This observational cross-sectional study was done among the patients having cutaneous drug eruptions. 50 consecutive patients were enrolled. Purposive sampling was done. In every patient a detailed history was taken. Examination was carried out to find out the type of cutaneous reactions. Data were collected in a predesigned structured questionnaire. Statistical analysis was done with the help of SPSS. Out of 50 respondents, 20% had a history of indigenous drug intake followed by 18% sulphonamides, 14% NSAIDs, 14% quinolones, 8% anticonvulsants, 8% cephalosporins, 6% penicillins, 4% antituberculous drugs, 4% metronidazole and 4% tetracyclines. 34% had maculopapular rash, 24% Stevens-Johnson syndrome, 12% exfoliative dermatitis, 10% urticaria, 8% fixed drug eruption, 8% erythema multiforme, 8% bullae, 6% vesicles, 2% lichenoid eruption and 2% scaly eruptions. Frequency distribution of the offending drugs and the adverse reactions revealed that cephradine was responsible for maculopapular rash, sulphonamides for Stevens-Johnson syndrome, indigenous medicines for exfoliative dermatitis, NSAIDs for urticaria and paracetamol for fixed drug eruption