Keloid is characterized by benign overgrowth of dermal collagen in response to skin injury in genetically predisposed individuals. Intralesional triamcinolone and bleomycin have been used with varying success in the treatment of keloids. To compare the efficacy of intralesional triamcinolone versus intralesional bleomycin in the treatment keloids. A total of 164 patients were randomized into two of 82 each. Group A received intralesional bleomycine and Group B received intralesional triamcinolone. Patients were scored at baseline and at the end of treatment for therapeutic response based on reduction on patient and observer scar assessment scale (POSAS). Mean baseline POSAS score was 91 ± 10.98 SD check in Group A and 90 ± 10.85 SD in Group B. POSAS score after 24 weeks 26 SD ± 11.91 in Group and 34 ± 12.28 in Group B. This difference was statistically difference. Intralesional bleomycin is more efficacious than intralesional triamcinolone acetonide in the treatment of keloids.
Background: Azathioprine is first line immunosuppressive agent in treatment of chronic actinic dermatitis. The role of methotrexate has been effective in different dermatosis and it seems reasonable to use it in the treatment of chronic actinic dermatitis. Aims: We sought to compare the efficacy of methotrexate versus azathioprine in treatment of chronic actinic dermatitis. Methods: Patients with chronic actinic dermatitis were randomized to receive methotrexate in group A and azathioprine in group B. The response to treatment in terms of percentage PASI reduction and side effects of medications were assessed 12 weeks follow-up. Results: In group A, the percentage PASI reduction was <25% in 2 (1.19%) patients, 25-49% in 47 (27.9%) patients, 50–74% was achieved by 35 (20.8%) patients while in group B, the percentage PASI reduction of 25% was achieved by 2 (1.19%) patients, 25–49% in 45 (26.7%) patients, 50–74% in 37 (22.0%) patients. More than or equal to 75 percentage PASI reduction was not achieved by any patient in the study. Both drugs were found efficacious in treatment of CAD. A total of 23 (27.38%) patients in group A and 22 (26.19%) patients in group B showed derangement in laboratory investigations during 12 weeks treatment. The limitation of study was inability to do photo-patch test, so patients were diagnosed clinically and biopsy was done in clinically challenging cases. Conclusion: This study shows that methotrexate is equally effective as azathioprine in the treatment of chronic actinic dermatitis with its added benefits of being cost effective and better safety profile.
Background: Acne vulgaris is a commonly diagnosed dermatological condition characterised by pilosebaceous unit blockage or inflammation. It may manifest as inflammatory, non-inflammatory, or a combination of the two. The acne vulgaris mostly the face of indvivdual and chest and back of individual is also affected sometime. the aim of my research is to compare the effectiveness of topical adapalene plus oral azithromycin versus topical adapalene plus oral doxycycline in treating acne. Acne is one of most common reason compelling a patient to see dermatological advice. Our goal is to find the most effective antibiotic to produce the best outcomes with the fewest possible unwanted effect (side effects) and a maximum level of patient satisfaction. Methods: From May 1 to October 31, 2019, a randomised control trial was performed at Dermatology department MTI Lady Reading Hospital Peshawar. Using the lottery form, all of the patients were split into 2 groups. For 12 weeks, patients in Group A were given oral doxycycline 100 mg once daily and topical adapalene, while patients in Group B were given oral azithromycin 250 mg on alternating days and topical adapalene. All patientswere followed at the end of 12 weeks after start of therapy to determine the efficacy in term of clearance of at least 60% of the number of lesions from baseline. Results: In Group A, 22 (59.45%) patients expressed positive results whereas in Group B, only 9 (24.32%) patients expressed positive results. p-value (0.0021.) Conlcusion: My data suggest that oral doxycycline 100mg in combination with adapalene gave better results as compared to oral azithromycin which was also found well-tolerated option for treatment of acne on face.
A seven-year retrospective study was held at the Department of Dermatology, Lady Reading Hospital, Peshawar, between 2013 to 2020 to determine the demography and clinical features of pemphigus. Among 148 patients included in this study 88 (58%) were females and 60 (40%) were males with a female to male ratio of 1.46:1. Average age at onset of the disease was 38±12 years (range 14-75 years). On the basis of Autoimmune Bullous Skin Disorder Score (ABSIS), 14 (9.3%) patients had mild disease, 58 (38.7%) had moderate disease, and 76 (50.7%) patients had severe disease. In total, 144 (96%) patients had pemphigus vulgaris, 3 (2%) patients had pemphigus foliaceous and 1 (0.7%) patient had paraneoplastic pemphigus. Severe pemphigus was more frequently associated with multiple relapses (p=0.00). This study shows poor prognostic factors like severe pemphigus vulgaris associated with multiple relapses.
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