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Objectives: To correlate acne severity with elevated androgen levels and to compare androgen levels between cases and controls
Methods: This case-control study was carried out in the Department of Dermatology, Mayo Hospital, Lahore from March 2016 - March 2017. Two hundred and seventy patients and eighty age and gender-matched controls were recruited after ethical approval and informed consent and categorized into mild, moderate and severe acne. Severity was correlated with serum Testosterone, Dihydrotestoststerone and Dihydroepiandrosterone Sulphate levels. Quantitative variables were expressed as median and percentiles, comparisons done by Mann-Whitney and correlations by Spearman correlation. P-value of <0.05 was considered statistically significant
Results: There were 142 [41%] males and 208 [59%] females. Ninety-Seven patients had mild, 108 moderate and 65 had severe disease. Median hormonal levels were 3.5ng/ml, 184pg/ml and 0.82ug/dl for Testosterone, Dihydrotestosterone and Dihydroepiandrosterone Sulphate respectively which differed significantly between cases and controls. There was no correlation with severity but the levels differed significantly between the different grades in case of Testosterone and DHEAS
Conclusion: Androgens are not directly correlated with acne severity, but affect acne severity as seen in difference between their levels in different grades of acne. Anti-androgens may be initiated early in acne resistant to conventional therapy
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Objective: to analyze pattern of skin diseases in remote areas of Punjab diagnosed by telemedicine network
Methods: rural centers at the district and tehsil levels [Rajanpur, Dera Ghazi Khan, Khushab, Sahiwal, Gujrat and Jhang regions of Punjab] were connected to tertiary care centers with specialized telemedicine equipment. The images were transmitted live. Prescriptions were written and duly forwarded. Patients were called to the tertiary care center for further investigations and examination if needed
Results: a total of 11,892 patients were treated. Acne was the commonest disorder [42%], followed by dermatophytosis [28%], scabies [22%] and eczemas [18%]. Infestations and infections are common in patients from poor socio-economic strata
Conclusion: telemedicine is beneficial for providing services to remote areas and can be used as a preventive measure by educating people
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Objective: to determine association between psoriasis and dyslipidemia
Methods: this cross-sectional study was done at Dermatology Department, Lahore General Hospital, Lahore. Non-probability convenient sampling 106 cases and 106 age-and gender-matched controls] were included in this research. Blood samples from both cases and controls were taken after fasting of 12 hours. Informed consent was taken in order to determine the level of their lipid profile. SPSS 21 version was utilized to evaluate the collected data
Results: the mean age of cases and controls in current study was 31.74 +/- 5.27 and 31.24 +/- 5.29 years, respectively. In cases there were 51 [48.1%] female and 55[51.9%] male patients while in control group, there were 68 [64.1%] males and 38 [35.9%] females. There was significant association of cases and dyslipidemia and there were 54 times more chances of having dyslipidemia for cases. The overall logistic model showed that there were 219.633 times more chances of dyslipidemia for cases, moreover, raised triglyceride and low HDL had significant association with cases while age and gender have no significant role
Conclusion: dyslipidemia is positively associated with psoriasis regardless of age, gender and severity of disease. As dyslipidemia is a major risk factor for microvascular complications and proved risk factor for cardiovascular disease, we must include serum fasting lipid profile as a routine investigation in psoriatic patients and early screening must be ensured to minimize the risk of cardio vascular diseases
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Background and Introduction: Insulin-Like Growth Factor-1 [IGF-1] belongs to the growth factor family, structurally resembling pro-insulin, enabling it to bind to insulin receptors. It plays an important role in many tissues including skin, particularly acne pathogenesis by stimulating sebum production and affecting androgen levels. Studies comparing IGF-1 levels in acne patients and controls have found statistically significant differences, proving acne as a sign of insulin resistance. However, no such study has been carried out in Pakistan
Methodology: After approval from the institutional ethical board and informed consent, a case-control study was carried out with 270 acne patients and 80 age and gender- matched controls. Patients belonged to either gender and aged between 15 - 35 years were divided into mild, moderate and severe categories. IGF-1 levels were noted after exclusion of any condition interfering with IGF-1 level and correlated with acne severity and with levels of testosterone, dihydrotestosterone [DHT] and dehydroepiandrosterone sulphate [DHEAS]. Quantitative variables were expressed as median and percentiles. Comparisons were done by Mann-WShitney test and correlations by Spearman correlation. A p value of
Results: Out of 350 cases and controls, There were 142 [41%] males and 208 [59%] females. In cases, there were 155 females and 115 males, whereas in controls, there were 54 females and 26 males. Median age of the patients was 20 years. Ninety-Seven patients had mild, 108 moderate and 65 had severe disease. Median levels of IGF-1 were 292 ng/m in cases. IGF-1 levels were significantly different between cases and controls and between mild and severe acne, but not between mild and moderate acne. IGF-1 levels were strongly correlated with the levels of androgenic hormones
Conclusion: Increase of IGF-1 levels in acne point to the role of insulin resistance and diet in acne. Future treatments may be targeted to treat IGF-1 levels by dietary interventions reducing glycemic load
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Objective: To determine the efficacy and safety of Q-switched Nd:YAG 1064nm laser for melasma treatment
Methods: Thirty patients with melasma were treated with Qs-Nd:YAG laser 1064nm, 6mm spot size with 2.5-3.2J/cm[2] for four sessions 2 weeks apart. Pigmentation was assessed objectively with photographic evaluation and by decrease in the MASI score and subjectively by decrease in pigmentation assessed by grades of improvement. Patients were assessed 8 weeks after the last session. Adverse effects were recorded at each visit
Results: After four sessions, 20 [65%] of patients showed marked improvement, 6 [20%] showed moderate improvement and 4 [13%] showed poor response after 14 weeks of treatment. No significant side effects were noted. A decreased MASI score was significant at the end of 14 week's evaluation [p<0.05]. Recurrence occurred in only 10% of patients who were advised to wear sunblock afterwards
Conclusion: Q-switched Nd:YAG 1064nm laser is an effective and safe treatment of melasma in our local population
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Objective: To compare the efficacy of topical hydroquinone 2% and oral tranexamic acid 500mg daily in patients of melisma
Methods: A total of 140 patients [70 patients in each group] were enrolled, who were randomly divided into 2 groups. Group A was treated with topical hydroquinone 2% and group B was given oral tranexamic acid 500mg daily. Follow-up was carried out at the end of 2[nd], 4[th] and 8[th] week to compare reduction in MASI score at last follow-up
Results: The mean age of patients was 29.67 +/- 6.38 years with an age range of 15 to 45 years. There were 28 [20%] male and 112 [80%] female patients. Majority i.e. 120 [85.7%] cases were married and 20 [14.3%] were unmarried. The age of onset was 15-25 years in 67 [47.9%] patients, 26-35 years in 52 [37.14%] and 36-45 years in 21[15%] patients. Both groups showed a decline in MASI score; however, the results were significantly greater in group B [oral tranexamic acid]. At final follow-up, the mean percentage reduction was higher in group B [77.97+/-8.37] as compared to group A [67.02+/-8.42], p < 0.001. Adverse effects like erythema, burning, allergic contact dermatitis and pigmentation were noticed in the first group. One [1.4%] patient developed nausea and vomiting and diarrhea with oral tranexamic acid
Conclusion: Oral tranexamic acid 500 mg had a better response when compared with topical hydroquinone 2% cream and better safety profile. It might be considered as a future treatment option
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Scrofuloderma is a common type of cutaneous tuberculosis characterized by a bluish-red nodule overlying an infected lymph gland, bone or joint that breaks down to form an undermined ulcer with a granulating tissue at the base. Progression of the disease leads to irregular adherent masses, densely fibrous at some places while fluctuant and discharging at others. It heals with a characteristic puckered scarring at the site of infection. The disease is caused by Mycobacterium tuberculosis and common anti-tuberculous drugs are recommended for treatment. Many similar cases with additional features have been reported in foreign literature. We describe a case of this disorder along with review of literature