Résumé
Objective: To assess the efficacy of Methotrexate in patients with plaque type psoriasis
Methods: This descriptive study was conducted in the department of Dermatology, Civil Hospital Karachi from September 2009 to March 2010. Seventy three patients between 18 to 50 years of age suffering I from plaque type psoriasis with PASI score of >10 were included in the study after taking the informed consent. Oral methotrexate in a dose of 7.5 mg/week was given for 8 weeks
The data collected included demographic profile [age and gender], duration of disease, site of involvement, size of plaque, severity of plaque measured by Psoriasis Area and Severity Index [PASI] score before starting the treatment and at the end of treatment. Efficacy was labeled with a PASI score of <5 at the end of 8 weeks
Results: Out of 73 patients there were 45 [61.6%] males and 28 [38.4%] females
The mean +/-SD age was 0.0+/-12.6 years. The mean baseline PASI score showed clear and comparable improvement from a meani SD PASI score of 14.8+/-4.2 to 4.9+/-4.3.Twenty nine [40%] patients had an almost complete remission during the 8 weeks of treatment. Partial remission was achieved in 44 [60%] patients
The clearance time for psoriasis ranged from 5 - 7 weeks [mean 6+/-0.89 weeks]
Conclusion: Treatment with methotrexate for chronic plaque psoriasis brings satisfactory disease control and improved quality of life
Résumé
Objective: To determine the frequency of different clinical presentations of cutaneous tuberculosis in a tertiary care hospital
Methods: This cross-sectional study was carried out in the Department of Dermatology, Civil Hospital, Karachi and Department of Dermatology, Ziauddin University, Karachi, over three years from 5[th] March 2007 to 4[th] March 2010. Patients of both sexes and all age groups suffering from histologically-confirmed cutaneous tuberculosis for last 1 month to 10 years were enrolled. A detailed history and examination were recorded on a predesigned proforma. The collected data were computed and analyzed
Results: 57 diagnosed [biopsy proven] cases of cutaneous tuberculosis comprising 35 females [61.4%] and 22 males [38.6%] were enrolled. The age range was 1 up to 80 years. Among these subjects, half the patients were aged between 11-30 years. 17 patients [29.8%] had the disease for 1-2 years constituting the highest frequency for the duration of illness. Most of the patients i.e. 33 [57.5%] had more than one lesion. The lesions were most commonly seen on limbs in 25 [43.4%] patients, followed by face and neck, trunk and genitalia. Chronic discharging sinuses and plaques were the most common presentations. Scrofuloderma was the most common tuberculosis cutis seen in 35 [62%] patients followed by lupus vulgaris, warty tuberculosis and tuberculids. Overall frequency was higher in females. However, some of the types were more frequent in females while others in males. Mean age of presentation for scrofuloderma was 25.7+/-16.9 years, warty tuberculosis 25.7+/-15.9 years, lupus vulgaris 29.4+/-16.5 years and tuberculids 30+/-11.9 years [p=0.197]
Conclusion: Scrofuloderma is the most common clinical presentation of tuberculosis cutis seen in our setting followed by lupus vulgaris, tuberculosis verrucosa cutis and tuberculids