ABSTRACT
Objective To determine the frequency of cutaneous manifestations in patients suffering from type 2 diabetes mellitus and to observe the association of these manifestations with body mass index [BMI] and glycosylated hemoglobin [HbA1c] level
Methods This cross-sectional study was conducted in Shalamar Teaching Hospital / Shalamar Medical and Dental College, Lahore from October 2016 to March 2017. A total of 200 adult patients belonging to both genders having type 2 diabetes mellitus attending the outpatient department were studied. Detailed history and cutaneous examination was performed after taking the informed consent. Glycemic profiles including HbA1c were done. Height and weight were recorded too. Normal range of HbA1c was taken as 5 - 6.5 percent. Value of >/= 6.5 percent was taken as high. Normal range of BMI as taken as 18.5- 24.9 kg/m[2]. Patients having BMI 25-29.9 kg/m[2] were taken as overweight and >/= 30 kg/m[2] as obese
Results Of 200 patients, 174 [87 percent] patients were found to have cutaneous abnormalities. There were 53 [26.5 percent] males and 147 [73.5 percent] females. Mean age was 52.4+/-9.96 years. Mean HbA1c was 9.07+/-2.23 percent. The mean BMI was 29.46 kg/m[2] with 20 percent having normal BMI, 38 percent were overweight and 41 percent were obese. Most frequently observed skin disease was cutaneous infections including bacterial and fungal infections, followed by generalized xerosis, diabetic dermopathy, acanthosis nigricans, pruritus and acrochordons. Statistically significant correlation was observed between HbA1c and diabetic foot and between BMI and acanthosis nigricans and generalized xerosis
Conclusion About 87 percent patients with type 2 diabetes have cutaneous lesions, the most common of which was cutaneous infections. Hyperglycemia manifested with high HbA1c and obesity manifested with high BMI is associated with many cutaneous lesions
ABSTRACT
To determine the efficacy and safety of low dose [20 mg] isotretinoin for the treatment of mild to moderate acne for a duration of six to nine months. This was an observational, non-comparative, uncontrolled study. This study was carried out at the Department of Dermatology, Shalarnar Hospital Lahore from 01-1-2010 to 31-12-2013. Six hundred adult patients of either sex with mild to moderate acne and, ages between 15 to 25 years were enrolled. They were treated with a fixed low dose of isotretinoin daily irrespective of weight, for six to nine months. Patients were evaluated clinically at baseline, then monthly during the treatment and follow-up. Of the 600 patients enrolled, 580 completed the study. 94% of patients were completely cured in six months with a cumulative dose of 6237 mg/kg. Treatment was continued for 6% of patients, who still had active acne lesions. The cure rate reached 98.96% at the end of ninth months. Patients were followed for another six months and a relapse rate of 4.48% was observed. Mild cheilitis and xerosis were common. Laboratory abnormalities were mild and transient. Six to nine months treatment with a daily dose of 20 mg/day isotretinoin was found to be effective in patients with mild to moderate acne. The drug was well-tolerated and showed almost negligible clinical and laboratory side effects
ABSTRACT
To determine the frequency of allergic contact dermatitis in patients with hand eczema by patch testing with European standard and corticosteroid series. One hundred and five patients of either sex having hand eczema, aged 12 years or above were enrolled in the study from dermatology outdoor department. After taking informed consent, patch test was performed a fortnight after complete resolution of signs and symptoms of eczema and after complete withdrawal of the drugs. Patch testing was done with European standard and corticosteroid series. Readings were taken 48, 72 and 120 hours after patches removal. Patch test reactions were graded according to international contact dermatitis research group criteria. Data was analyzed according to age, sex and percentages of positive patch test results. Allergic reaction was recorded in 48.6% of patients with European standard series and 11.4% of patients with corticosteroid series. Common allergens detected with European standard series were potassium dichromate [21%], cobalt chloride [12%] and nickel sulphate [12%]. Common allergens detected with corticosteroid series were tixocortol-21-pivalate [8.6%] and hydrocortisone-17-butyrate [4.76%]. Almost half [48.6%] of the patients showed allergic reaction with European standard series and 11.4% of the cases gave positive results with corticosteroid series. Patch test needs to be performed with corticosteroid and European standard series in patients with hand eczema not responding to therapy.