Bone mineral density in patients with pemphigus vulgaris on long term steroid therapy

Osteoporosis is a common side-effect seen with long term steroid therapy. Patients at increased risk are over 50 years of age, postmenopausal, or have restricted mobility. To assess the bone mineral density [BMD] in patients with pemphigus vulgaris [PV] on long term steroid therapy. All patients with pemphigus vulgaris on oral/parenteral steroid therapy at the Department of Dermatology, Unit I, Mayo Hospital, Lahore were enrolled. Their BMD was measured at the heel with a quantitative ultrasound device. A control group comprising of 20 patients was also taken within the same time period that suffered from skin diseases other than pemphigus vulgaris and were not taking steroids in any form. There were 25 patients, 14 males and 11 females, with an average age of 33.8 years [range 12-60 years]. The average duration of PV was 24 months [6 months to 12 years]. The steroids used by these patients included prednisolone, betamethasone and dexamethasone. The duration of intake ranged from 2 months to 36 months. The highest dose was 120 mg and lowest was 10 mg. The mean BMD score of the patients was 0.39244 g/cm2 and 0.45773 g/cm2 for the control group. The mean T-score of the patients was -2.31, score was -2.61in female patients and -2.08 in males. The score was -1.74 in the control group. All patients requiring long-term glucocorticoid therapy are candidates for osteoporosis prevention

Evaluation and pattern of nickel dermatitis in patients with allergic contact dermatitis

Nickel is the most common allergen in allergic contact dermatitis with diverse clinical manifestations. To evaluate the clinical pattern of nickel dermatitis in our community by patch testing. 200 patients with clinical suspicion of allergic contact dermatitis of any age and either sex presenting to the department of dermatology, Mayo Hospital, Lahore were enrolled. All were patch tested using European Standard series. 23% patients had nickel sensitivity. Majority were housewives between 20-40 years of age, belonging to urban middle class. Duration of disease ranged from 2 months to 12 years. Previous history of metal allergy was seen in 41% patients. Polysensitivity was noted in 37% cases. Clinical judgment alone maybe misleading in making a correct diagnosis and patch testing with the European Standard Series is worthwhile