Post-heretic neuralgia; intra-lesional triamcinolone in the treatment

Objectives: To assess the efficacy of intra-lesional triamcinolone in for the treatment of Post Herpetic Neuralgia. Study Design: Prospective interventional study. Setting: Dermatology Department of Dow University Hospital. Period: July 2014 to June 2015

Patients and Methods: Twenty nine patients with diagnosis of Post Herpetic Neuralgia were included after taking written and informed consent. An insulin syringe was used for the injections and the medicines were injected intralesionally. The mixture contained 30/70% of triamcinolone to xylocaine ratio for local infiltration in post herpetic scars. Pain relief assessment was done with the help of visual analogue scale [VAS] after two months. Mean pain score before therapy and after therapy was compared with one sample student t test

Results: Out of total 29 patients 14 were male and 15 were females. The mean age +/- SD was found to be 45.9 +/- 15.4 years. The most common region involved was Chest. The mean +/- SD duration of Symptoms was 5.58 +/- 1.80 weeks. The mean pain score before therapy was 6.86 +/- 1.66 which after one month of therapy reduced to 3.72 +/- 1.86. The reduction in pain was statistically significant [p<0.001]

Conclusion: Post Herpetic Neuralgia can be effectively treated by the local infiltration of a mixture of triamcinolone and lignocaine. It is recommended that long-term follow-up studies should be done with corticosteroids only or in combination with local anesthetics to additionally evaluate the effectiveness of such treatment in postherpetic neuralgia

Eczema; frequency of different types in a tertiary care hospital

Objectives: To determine the frequency of different types of eczema in patients presenting in a tertiary care hospital. Study Design: Cross sectional descriptive type of study. Setting: Hamdard University Hospital Karachi. Period: January 2013 till December 2013

Patients and Methods: All new cases of any type of eczema were registered by nonprobability convenient sampling. Total 192 patients of both genders and all ages were enrolled after taking informed consent. Diagnosis was made on detailed history and clinical examination by consultant dermatologist. All specific and relevant investigations were done according to requirement. Patients were divided in two groups, exogenous eczema and endogenous eczema, for convenience. Data was analyzed by the latest version of SPSS

Results: There were 192 patients, out of which 52.08% were males and 47.91% females. Out of the total presented patients 50% had endogenous eczema, 43.37% had exogenous eczema and 25.62% had unspecified eczema. In endogenous group 11.45% had hand dermatitis followed by seborrhoeic dermatitis, atopic dermatitis and asteatotic eczema in descending frequency of presentation. Pityriasis alba, discoid eczema and pompholyx were seen less frequent. In exogenous eczema allergic contact dermatitis was seen in 14.06% patients, while irritant contact dermatitis in 11.45% patients. Infective eczema and photo-allergic eczema were seen in small number of patients

Conclusion: It was found in this study that allergic contact dermatitis was most common type of eczema followed by other types. Whatever the type is, eczema can be treated, symptoms can be relieved and recurrences can be prevented by appropriate therapy. All types of eczema affect patient's quality of life adversely. However, they can be prevented by educating patients and their relatives to take adequate safety measures like using good quality emollients prophylactically

Common birth marks; to identify the frequency in infants presenting to out patient of Tertiary Care Hospital

Objectives: To identify the frequency of common birthmarks presenting in outpatients department of dermatology until and to increase awareness among doctor about the common phenomena

Patients and Study Design: A cross sectional study

Setting: OPD of Dermatology department of Dow University Hospital

Period: January 2014 till October 2014

Methods: During a year, by using non-probability convenient sampling only 100 patients of both genders were enrolled in the study after ensuring inclusion, exclusion criteria. Complete history was recorded and a thorough general physical and cutaneous examination was performed. Information was collected on predesigned questionnaire after taking informed consent. Data Analysis was carried out on SPSS statistics software

Results: Out of 100 patients, 43% were males and 57% were females. In 69.6% patients, the birthmarks were noticed around time of delivery, 28.3% patients were noticed within 1[st] year of life and 2.2% later in 5 year. Pigmented birthmarks were identified in 65.2% patients while 34.8 % have vascular birthmarks.71.1% had no changes in color during life span. While 37.8% had 1-3 cms birthmark and 45.7% have reported an increase in birthmark

Conclusions: We found birthmarks benign; they may grow with age but they do not need treatment unless there is concern either cosmetically or they have pain and discharge

Pattern of skin diseases in a tertiary care private hospital, Karachi

To determine the pattern of skin diseases in a tertiary care hospital in Karachi and to compare the results with local and international literature. The current study was carried out in the Dermatology Department, Hamdard University Hospital, Karachi from 1[st] September 2011 to 31[st] August 2012 over a period of 1 year. All the freshly registered patients presenting in the outpatient were enrolled irrespective of gender and age, after an informed consent. Clinical diagnosis was made on the basis of detailed history and clinical examination. Laboratory investigations were performed where required e.g. routine investigations and biochemical profile. Skin biopsy and histopathology were performed in doubtful cases. All the findings were recorded, compiled, tabulated and analyzed. 1733 patients comprising 936 [54%] females and 797 [46%] males were enrolled. There were 728 [42%] children and 1005 [58%] adults. Infections and infestations were the most common skin conditions constituting 37.4% of all the enrolled patients of which 399 [23%] were children and 250 [14.4%] adults. Eczema was next in frequency comprising 313 [18%] patients including 150 [8.6%] children and 163 [9.4%] adults. Acne was seen in 229 [13%] patients, urticaria in 97 [5.5%] while hair disorders were recorded in 66 [4%] patients. Papulosquamous disorders and pigmentary dermatoses were observed in less than 3% of the patients studied. Scabies presented with the highest frequency [18%] and among pyodermas [10%], furunculosis [4%] and impetigo 59 [3%], being the most frequent. Fungal infections [3%] had a frequency more then viral infections [2%]. Atopic dermatitis was the most frequently seen eczema [6%] followed by seborrhoeic dermatitis [5%] and contact dermatitis [4.5%]. The pattern of skin diseases is same in various cities of Pakistan with minor differences. Scabies and infections remain the most common diseases while eczema also constitutes an important group of dermatoses in our part of the world