Vitamin D deficiency in alopecia areata

Objective: To compare the mean Vitamin D level in patients with alopecia areata [AA] with age and gender controlled matched healthy controls

Study Design: Case-control study

Place and Duration of Study: Dermatology OPD, JPMC, from October 2014 to March 2015

Methodology: All the patients diagnosed of alopecia areata by a trained dermatologist were selected. Controls were age and gender matched healthy volunteers. Venous blood was drawn and sent to hospital laboratory for 25 [OH] vitamin D by enzyme immunoassay method on chemical analyser. Data was recorded on SPSS version 16. Mann-Whitney test was applied to compare vitamin D levels of cases and controls. P-value <0.05 was taken as significant

Results: There are 30 cases of AA, and 30 age and gender matched controls. The mean age of our study group was 23.77 +/- 8.86 ng/dL in patients and 24.03 +/- 8.62 ng/dL in the control group. Fifteen [50%] patients presented between 3-12 months of onset of AA. Median [IQR] vitamin D level of cases was 13.5 [18.6] ng/dL and healthy controls was 22.5 [16.25] [p=0.001]

Conclusion: Serum Vitamin D levels were significantly lower in patients with alopecia areata compared to healthy controls

Intralesional triamcinolone acetonide versus topical betamethasone valearate in the management of localized alopecia Areata

Objective: To compare the efficacy of intralesional triamcinolone and topical betamethasone in the management of localized alopecia areata

Study Design: A randomized trial

Place and Duration of Study: Dermatology OPD, PNS Shifa Hospital, Karachi, from January to June 2013

Methodology: Patients aged 18 - 50 years with localized alopecia areata were included in the study. Exclusion criteria were more than three patches and those on already steroid or immunosuppressive therapy. Patients were randomly allocated in two treatment groups: Group A received intralesional triamcinolone acetonide [10 mg/ml] and Group B received topical betamethasone valearate cream 0.1% twice daily. Final outcome was ascertained as re-growth of hair on 12th week of follow-up and labelled as efficacy. The data was entered and analyzed using SPSS version 11. Relevant descriptive statistics were calculated. Chi-square test was used to compare efficacy of hair re-growth in both groups. P-value < 0.05 was considered significant

Results: A total of 226 patients were enrolled, 113 in each group. The mean age was 34.36 +/- 8.7 years. One hundred and sixty-four [72.6%] were males and 62 [27.4%] were females with male to female ratio of 2.6:1. Hair re-growth was seen in 84 [74.3%] of the intralesional steroid group and in 53 [46.9%] of the topical betamethasone group [p < 0.001], which was a significant difference

Conclusion: Intralesional triamcinolone had a better efficacy in the treatment of localized alopecia areata as compared to topical betamethasone valearate

Graham-Little-Piccardi-Lassueur syndrome: a rare case report and review of literature

Graham-Little-Piccardi-Lasseur syndrome [GLPLS] is a rare variant of lichen planopilaris comprising of a triad of multifocal cicatricial alopecia of scalp, non-cicatricial alopecia of axillae and pubic region and keratotic follicular papules over body. Its exact etiology is not known to date, but it primarily involves an immune mediated inflammation affecting hair follicles resulting in cicatricial alopecia. We report a case of 55 years old female diagnosed as having features of this syndrome with cicatricial alopecia of FFA and FADP.

Bazex-Dupre-Christol syndrome - a memorable family

Bazex-Dupre-Christol syndrome [BDCS] is clinically characterized by multiple basal cell carcinomas of the face occurring mainly during the second and third decade of life, follicular atrophoderma predominantly of the dorsum of hands and feet and generalized hypotrichosis, sometimes with pili torti and trichorrhexis nodosa. Common associated features are milia, hypohidrosis and calcifying epithelial tumours. We herein report four members of one family with BDC syndrome, a mother and her three daughters. In the mother and one daughter, the clinical picture was very typical with all major features, whereas in the others only follicular atrophoderma, milia and hypotrichosis were present. BDCS is a hereditary multiple BCC syndrome whose pattern of inheritance is thought to be X-linked dominant, which implies that all daughters of the affected mothers should have this disease. In this case three out of four daughters are suffering from BDCS but one is totally asymptomatic. To our knowledge, this is the first report of a family with BDC from Pakistan

Dyslipidemia and psoriasis: a case control study

To compare the mean values of lipid profile in psoriatic patients and healthy controls. Case control study. Department of Dermatology, PNS Shifa, Karachi, from November 2012 to April 2013. Patients with psoriasis fulfilling the inclusion and exclusion criteria were selected from Dermatology Outpatient Department [OPD] of PNS Shifa, Karachi. After fasting for 14 hours, 5 ml of venous blood was drawn in sterile syringe and submitted to the Hospital Laboratory for lipid profile, by enzymatic method on Hitachi [Roshe[Registered sign]] using reagents by the same firm. The mean values lipid profile in psoriatic patients versus healthy controls were recorded and compared. A total of 256 patients [128 in each group] were enrolled. Mean lipid profile in both groups revealed cholesterol [mg/dl] value of 203.43 +/- 11.43 in cases and 173.64 +/- 13.65 in controls. Triglyceride [mg/dl] was 178.87 +/- 43.60 and in cases 144.23 +/- 34.01 in controls, HDL-C [mg/dl] was 37.81 +/- 10.78 in cases and 41.41 +/- 9.72 in controls while LDL-C [mg/dl] was 139.52 +/- 13.71 in cases and 109.44 +/- 13.80 in controls. Each parameters had p-value < 0.05 which was significant. Dyslipidemia was found in a high percentage of psoriatic patients than healthy controls. Psoriatic patients require thorough lipid and cardiovascular examinations as they should be considered as individuals with increased risk of cardiovascular diseases

Efficacy and safety of glucantime for cutaneous leishmaniasis - eight years experience at a tertiary care hospital of Karachi

To observe the efficacy and adverse effect profile of Glucantime in treatment of cutanous leishmaniasis. Cross sectional study. This study was conducted in Dermatology Department, JPMC Karachi from Jan 2007 to Jan 2015. 252 patients of CL, diagnosed clinically and confirmed parasitologically were treated with injection glucantime. After taking history and physical examination, baseline complete blood count ,Liver function tests, Renal function tests and ECG were performed. 76 patients were treated with intralesional injection and 156 patients were treated with intramuscular Glucantime. Treatment response was observed and adverse effects were noted. The data was recorded and analysed on SPSS version 16. Mean +/- SD was calculated for continuous variables like age, duration of disease. Categorical values like gender, type, morphology, site of lesions efficacy and adverse effects were recorded as numbers and percentages. The mean age of I/L group was 31.4 +/- 11.6 and for I/M group. Efficacy of Intramuscular Glucantime was76.3% in intralesional group and 86.9%in intramuscular group. Adverse effects were seen in 25 % of intralesional and 26.9 % of intramuscular group. Glucantime is effective and well tolerated drug in Old world CL both by intramuscular or intralesional route

Kindler's syndrome: a report of five cases in a family

Kindler's Syndrome [KS] is a rare genodermatosis with autosomal recessive mode of inheritance. The disease results from homozygous mutations on both alleles of the FERMT-1 gene [also known as KIND-1 gene] that encodes the protein Kindlin-1 [kindlerin]. Clinical features include a constellation of early infantile skin blistering and mild photosensitivity, which improves with age, and progressive poikiloderma with widespread cutaneous atrophy. The differential diagnosis of Kindler syndrome include other congenital poikilodermatous and photosensitive conditions including Bloom syndrome, Cockayne syndrome, dyskeratosis congenita, epidermolysis bullosa, Rothmund-Thomson syndrome and xeroderma pigmentosum. We herein, report the presence of the Kindler's syndrome in 5 out of 7 children of consanguineous parents. To authors' knowledge, this is the first report of Kindler's syndrome involving 5 members of a family