Frequency of steroid induced acne among acne patients

Background: Topical corticosteroids [TCS] are commonly abused drugs because of their use in whitening creams and are important cause of steroid induced acne

Objective: To see the frequency of acne due to steroid abuse

Methodology: This cross sectional study was conducted from 1st September to 31st October 2017 and 100 acne patients included aged 10-40 years. A detailed history about the duration of use, source of prescription, type of acne lesions and other side effects were recorded. Ethical approval was sought from Institutional Review Board. Data was analyzed by using SPSS version 20

Results: Amongst 100 patients who fulfilled the inclusion criteria, 29% were males and 71% females. Of all 61% had used topical corticosteroids [TCS] in the form of whitening creams. Friends and family members [77%] were the most common source of prescription. Other than acne, erythema was the most common adverse effect

Conclusion: Topical corticosteroids are popular in our society as whitening agents especially among females and is a cause of acne

Medical school dermatology curriculum - are our graduates adequately prepared and aligned to community needs?

Background: There is paucity of research based information regarding the dermatology learning needs and their fulfilment in primary care physicians

Objective: To determine skin diseases burden in the community AND adequacy of preparedness of Primary Care Physicians to deal with skin diseases

Methodology: This was a cross sectional study conducted from 1[st] January 2015 to 31[st] December 2016 at Dermatology Outpatient Department of Sheikh Zayed Medical College/Hospital [SZMC/H], Rahim Yar Khan, for burden of skin diseases and feedback from Primary Care Physicians of both SZMC/H and Primary Health Care setups [BHUs and RHCs] of District Rahim Yar Khan regarding adequacy of their preparedness to deal with skin disease patients. Records from a tertiary care teaching hospital was sought from OPD to assess skin disease burden and Primary Care Physicians from tertiary care hospital and BHU and RHC of district were surveyed regarding content AND teaching adequacy of undergraduates through their dermatology curriculum. Data was entered and analyzed by using SPSS version 20

Results: A total of 356 doctors participated in this study. Of these 233 [65.4%] were males. It was found that 10% of patients attending OPD in Sheikh Zayed Hospital [A tertiary care teaching hospital] suffered from skin disease. Frequencies of "Common skin diseases" in the community were; eczema 12.9%, scabies 10.8%, fungal infection 9%, bacterial infection 8% and acne 7%. Of all participants, 274 [77%] reported that <10% of their patients suffered from skin disease and only 30 [8.4%] of them were fully confident while treating skin disease patients and only 36 [10.1%] reported that most of their patients were cured. It was noted that 145 [40.7%] participants could name only 1-3 of the common skin diseases in the community, 182 [51.1%] named 4-6 while only 12[3.4%] could name 7 or more and 17[4.8%] had no knowledge of even a single common skin disease in the community. Only 92[25.8%] participants rated that their undergraduate training was adequate while 264[74.2%] rated it to be inadequate

Conclusion: This study concluded that primary care physician were not adequately prepared for managing common skin diseases during their undergraduate training. Appropriate exposure and adequate teaching in dermatology throughout undergraduate medical curriculum is essential because skin presentations manifest throughout all aspects of medicine, and most often dermatological problems are dealt with exclusively by non-dermatologists

Frequency of tinea incognito among ring worm infections and health seeking behavior of these patients

Background: Ring worm infections are common in community and may be maltreated with steroids resulting in delay in proper diagnosis and treatment

Objective: To determine the frequency of tinea incognito among the ring worm infections of skin AND health seeking behavior of these patients

Methodology: This cross sectional study was conducted at Dermatology Outdoor of Sheikh Zayed Medical College Hospital Rahim Yar Khan from 1[st] March to 30[th] April 2017. A total of 170 patients of ring worm infections of skin were included in this study through convenient sampling. These patients were asked about the use of topical steroids through a pre-designed performa containing information about patients, diagnosis, type and duration of treatment and its prescriber. The data was entered and analyzed by using SPSS version 20

Results: Out of total 170 patients, 68[40%] has tinea incognito. Among these 26[15.29%] were treated by general practitioner, 30[17.6%] by relatives/friends, 3[1.8%] by Pharmacist and 9[5.3%] did self-medication

Conclusion: Use of topical steroids is quite common in ringworm infections of skin with poor health seeking behavior of these patients resulting in misdiagnosis and delay in proper treatment. Community should be educated in health seeking behavior for skin disease