Transcriptome Analysis of Host Inflammatory Responses to the Ectoparasitic Mite Sarcoptes scabiei var. hominis.

Scabies, a human skin infestation caused by the ectoparasitic mite Sarcoptes scabiei var. hominis, affects more than 200 million people globally. The prevailing knowledge of the disease process and host immune response mechanisms is limited. A better understanding of the host-parasite relationship is essential for the identification of novel vaccine and drug targets. Here we aimed to interrogate the transcriptomic profiles of mite-infested human skin biopsies with clinical manifestations of ordinary scabies subjects ("OS"; n = 05) and subjects naive to scabies ("control"; n = 03) using RNASeq data analysis. A combined clustering, network, and pathway mapping approach enabled us to identify key signaling events in the host immune and pro-inflammatory responses to S. scabiei infestation. The clustering patterns showed various differentially expressed genes including inflammatory responses and innate immunity genes (DEFB4A, IL-19, CXCL8, CSF3, SERPINB4, S100A7A, HRNR) and notably upregulation of the JAK-STAT pathway in scabies-infested samples. Mite-infested human skin biopsies (GSE178563) were compared with an ex-vivo porcine infested model (E-MTAB-6433) and human skin equivalents (GSE48459). Marked enrichment of immune response pathways (JAK-STAT signaling, IL-4 and IL-13 pathway, and Toll receptor cascade), chemokine ligands and receptors (CCL17, CCL18, CCL3L1, CCL3L3, CCR7), and cytokines (IL-13 and IL-20) were observed. Additionally, genes known for their role in psoriasis and atopic dermatitis were upregulated, e.g., IL-19. The detailed transcriptomic profile has provided an insight into molecular functions, biological processes, and immunological responses and increased our understanding about transcriptomic regulation of scabies in human.

Comparison Of Efficacy Of 10% Potassium Hydroxide Solution Versus Cryotherapy In Treatment Of Molluscum Contagiosum.

BACKGROUND:: Different topical therapies are being used for treating molluscum contagiosum. Potassium hydroxide in varying solution strengths with irritant reaction on the skin can help in eliminating the infection. It is cheap, easily available, can be easily applied at home, with good safety profile and cost effectiveness. This study was conducted to compare the efficacy of 10% potassium hydroxide solution versus cryotherapy in treating molluscum contagiosum. METHODOLOGY: This study was a Randomized control trial conducted in the Department of dermatology, Military hospital Rawalpindi. Study included 120 randomly selected patients with molluscum contagiosum divided equally into two groups. Group A were treated with 10% potassium hydroxide aqueous solution applied daily to the lesions twice daily for 6 weeks while Group B received weekly cryotherapy with liquid nitrogen. The status of lesions was documented weekly for 6 weeks. RESULTS: Of the 120 patients enrolled, 67 (55.8%) were male and 53 (44.2%) were female. Mean age of patients was 20.53(±8.17) years. At base line Molluscum contagiosum lesion ranged from minimum of 2 lesions to maximum of 26 lesions with a mean of 8.95 (SD ±4.45) lesions. Of 120 patients, complete clearance was observed in 98(81.6%) of patients, 48(80%) patients had lesion clearance in Group A and 50 (83.3%) patients had lesion clearance was observed in Group B. No statistical significance was observed in the lesion clearance between the two groups (p-0.63). CONCLUSIONS: The efficacy of 10% potassium hydroxide solution and cryotherapy is statistically same over 6 weeks of treatment. Thus less expensive, easily available and cosmetically more acceptable potassium hydroxide solution can be used instead of cryotherapy in treating molluscum contagiosum.

Efficacy of clarithromycin in pityriasis rosea.

OBJECTIVE: To determine the efficacy of clarithromycin in the treatment of Pityriasis Rosea (PR). STUDY DESIGN: Double blind randomized controlled trial. PLACE AND DURATION OF STUDY: Dermatology OPD, Military Hospital, Rawalpindi, from July 2008 to July 2009. METHODOLOGY: Patients aged above 10 years, diagnosed with PR, were randomly assigned to two groups of 30 each to receive either clarithromycin or similar-looking placebo for one week. Neither the patient nor the treating physician knew to which group the patient belonged. Patients were assessed at 1, 2, 4 and 6 weeks after presentation and compared for complete, partial or no response. RESULTS: Among the 60 patients, no significant difference was found between the two groups at 2 weeks after presentation (p = 0.598). In the placebo group, complete response was seen in 20 (66.7%), partial response in 3 (10.0%) while no response was seen in 7 (23.3%). In clarithromycin group, there was complete response in 23 (76.7%), partial response in 3 (10.0%) and no response in 4 (13.3%) patients. CONCLUSION: Clarithromycin is not effective in treatment of pityriasis rosea.

Frequency of HCV infection in different dermatological disorders.

BACKGROUND: Hepatitis C Virus (HCV) has estimated affected nearly 3% of the world population. Studies in Pakistan have shown a somewhat higher prevalence. The objective of this study was to determine the frequency of hepatitis C virus infection in patients with dermatological disorders, known to be associated with HCV infection. METHOD: This was a descriptive study, conducted at Departments of Dermatology, Military Hospital, Rawalpindi and PNS Shifa, Karachi from September 2003 to November 2005. There were 355 patients of the dermatologic disorders mentioned above. HCV status was determined by the presence of anti-HCV antibodies in the serum, by third generation ELISA. RESULTS: In this study 14% of lichen planus, 8% of generalised pruritus, 7.8% of urticaria, 8.7% of prurigo, and 50% of porphyria cutanea tarda patients had underlying HCV infection. None of the patients of leukocytoclastic vasculitis, erythema multiforme or erythema nodosum had anti-HCV antibodies. No patient of mixed cryoglobulinaemia or polyarteritis nodosa was seen during the study period. CONCLUSIONS: Patients of lichen planus, generalised pruritus, urticaria, prurigo, and porphyria cutanea tarda have increased frequency of HCV infection compared to normal population of our country. In contrast, none of the patients of leukocytoclastic vasculitis, erythema multiforme or erythema nodosum had HCV infection.