Comparison of intralesional 5-fluorouracil and intralesional triamcinolone acetonide in the treatment of localized vitiligo.

The objective of this study was to compare the efficacy and safety of intralesional 5-fluorouracil (5-FU) and triamcinolone acetonide (TA) in the treatment of localized vitiligo. the A non-randomized control trial conducted at Sheikh Zayed Hospital, RYK, from January to June 2022 included sixty patients, aged 18-60 years, with stable vitiligo. Patients were divided into two groups: Group A received 5-FU and Group B received TA. The outcome was assessed using the Vitiligo Area Scoring Index (VASI). There were 58.3% male and 41.7% female, with an average age of 33.33±11.24 years. Baseline characteristics between the two treatment groups were comparable. At 12 weeks, treatment responses were classified as excellent (16.6%), good (16.6%), moderate (35%) and poor (31.6%), with no significant intergroup differences (p=0.203). The 5-FU group showed a more significant lesion size reduction (1.28±1.09cm²) than the TA group (0.61±1.21 cm²) (p=0.028). Adverse effects mainly included pain and erythema. Common side effects included pain and erythema. The study concludes that both intralesional 5-FU and TA are effective and safe for treating localized vitiligo, with 5-FU potentially being more efficacious in lesion size reduction and promoting repigmentation.

Comparing the Efficacy of Patelet-rich Plasma (PRP) versus Tranexamic Acid (4mg/mL) as Intradermal Treatments of Melasma.

OBJECTIVE: To compare the efficacy of intradermal platelet-rich-plasma vs. intradermal tranexamic acid in treatment of melasma. STUDY DESIGN: Non-randomised controlled trial. PLACE AND DURATION OF STUDY: Sheikh Zayed Hospital, Rahim Yar Khan from 1st October 2019 to 30th April 2020. METHODOLOGY: Cases of melasma from either gender with age 20-40 years, were included. Diagnosis of melasma was made clinically on the basis of hyperpigmentation at sun-exposed areas and by Wood's lamp.  Severity was labelled on the basis of melasma area and severity index (MASI) score. Cases in group A were managed with 1 ml of intradermal platelet-rich plasma (PRP) and those in group B were offered intradermal tranexamic acid in a dose of 4 mg. The treatment was offered every 4th week and for a total period of 12 weeks; and final outcome was seen at 24th week. At every visit, the cases were noted for their mean MASI score. RESULTS: In this study, there were a total of 64 cases, 32 in each group. There were 19 (59.38%) males in group A and 16 (50%) in group B (p=0.61). Mean age in group A and B was 24.63 ± 9.87 vs. 23.94 ± 8.93 years (p= 0.76). Mean MASI score at baseline was 29.84 ± 5.14 vs. 29.56 ± 4.39, p=0.21. MASI was significantly better in group A at 4 weeks where score was 29.44 ± 5.35 vs. 28.69 ± 4.10, p=0.01. Mean MASI was 12.81 ± 1.78 vs. 18.38 ± 3.50, p=00001 at 12 weeks and 8.72 ± 3.40 vs. 14.97±4.33, p=0.02 at 24 weeks in group A and B, respectively. CONCLUSION: Intradermal PRP is significantly better than intradermal tranexamic acid in management of melasma. Key Words: Melasma, Tranexamic acid, PRP, MASI.

Comparing the Efficacy of Intra-dermal Platelet Rich Plasma (PRP) Versus 50% Trichloracetic Acid (TCA) using Cross Technique for Atrophic Acne Scars.

ABSTRACT       Objective: To compare the efficacy of intra-dermal platelet rich plasma (PRP) versus 50% trichloracetic acid (TCA) using chemical reconstruction of skin scars (CROSS) technique in the treatment of atrophic acne scars. STUDY DESIGN: Non-randomised controlled trial. PLACE AND DURATION OF STUDY: Sheikh Zayed Hospital, Rahim Yar Khan, from October 2019 to April 2020. METHODOLOGY: In this study, cases of either gender and age 20 to 40 years with atrophic acne scars were included. The severity of the scar was graded on the basis of global acne scarring grading system. The cases in group A were managed by monthly injections of 1 ml intra-dermal PRP every month; while those in Group B were given treatment with 50% TCA, which was applied by CROSS technique every month. Both treatments were offered for three months. They were assessed at every four weeks for initial three months. Then these cases were followed another three months and final outcome was seen at 6th month. RESULTS: In this study, there were 92 cases, 46 in each group. The mean age in group A and B was 27.72 ± 8.05 vs. 26.50 ± 8.20 years (p= 0.474). The mean global scar score at baseline was 36.07 ± 5.37 vs. 38.70 ± 4.80 (p= 0.015). The mean scar score at 4 weeks was 28.87 ± 5.27 vs. 29.00 ± 3.07 (p= 0.885), at 8 weeks 23.22 ± 4.10 vs. 23.11±2.49 (p=0.878), at 12 weeks 14.15 ± 3.05 vs. 17.57 ± 4.51 (p<0.001), and at 24 weeks it was 7.09 ± 1.46 vs. 10.09 ± 3.58 (p = <0.001). CONCLUSION: PRP is significantly better than 50% TCA in reducing post-acne atrophic scars. Key Words: Acne, Atrophic scar, Platelet rich plasma, 50% TCA.