Cicatricial pemphigoid (CP) is a subepidermal, autoimmune bullous dermatosis. It is classified as a clinical subset of bullous pemphigoid (BP). However, it differs from BP in some significant ways: (i) in CP mucosal involvement with clinical scarring is prominent; (ii) there is a prominent IgA class antibody response alone or in addition to the IgG class antibody response; and (iii) there is a heterogeneous antibody response in CP, whereas in BP the majority of the antibodies are directed against a 180-kDa hemidesmosomal protein, bullous pemphigoid antigen 2 (BPAg2). Oesophageal involvement in CP is a rare, but often devastating manifestation. In this study we examined the humoral autoimmune response in oesophageal CP, in an attempt to characterize the autoantibody reactivity profile. We used direct and indirect immunofluorescence and Western immunoblotting using normal human skin and oesophagus substrates. We studied patient sera over time in order to search for evidence of epitope spreading in these patients. All patients had positive direct immunofluorescence of perilesional oesophageal epithelium. All patients had positive circulating antibasement membrane zone autoantibody titres. There was a significant IgA class in addition to an IgG class autoantibody response. IgA and IgG antibodies demonstrated significant reactivity with BPAg2 and the 97 kDa linear IgA disease antigen on Western immunoblot suggesting intraprotein epitope spreading. There was no evidence of interprotein epitope spreading over time. Our findings suggest that there is a heterogeneous antibody response in oesophageal CP with the predominant antigen being BPAg2.

Objective: To compare the efficacy of intradermal platelet-rich-plasma vs. intradermal tranexamic acid in treatment of melasma. Study Design: Non-randomised controlled trial.

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.

Background: Wart is a viral skin infection. Its etiological agent is human papilloma virus. It is composed of non-malignant proliferations of keratinocytes. Different regimens have been tried for the treatment of warts. 35% Trichloroacetic acid (TCA) is used conventionally but 10% KOH has shown promising results. Objective: To compare the efficacy of topical 35% Trichloroacetic acid (TCA) versus topical 10% Potassium Hydroxide (KOH) in the treatment of palmoplantar warts in children up to 12 years of age. Methods: A total of 148 cases of palmoplantar warts with age between 3-12 years of either gender were enrolled in the study. These cases were divided into two groups (A and B each having 74 patients). The patients in group A were treated with topical 35% TCA and Group B patients were treated with topical 10% KOH. Patients were followed weekly for 8 weeks for treatment and for further 8 weeks to look for recurrence. Final outcome was seen at 16 weeks. The efficacy was labelled as yes in cases with clearance of all disease lesions. Results: In this study overall patients were 148 with 74 cases in each group. Group A had 36 (48.65%) males and group B had 37 (50%). The mean age in group A was 7.42±2.48 and in group B was 7.81±2.50 years. Group A had 44 (59.46%) cases and group B had 47 (63.51%) cases, with age range of 8-12 years. The efficacy in group A was seen in 28 (37.84%) of cases while in group B it was seen in 57 (77.03%) cases. There were significantly better results seen in group B as compared to group A in terms of efficacy with p= 0.0001. Conclusion: The efficacy of 10% KOH is significantly better than 35% TCA and this difference is again significantly better in terms of all the confounding variables i.e. age, site, size and duration of warts. Keywords: Warts, Human Papilloma Virus, 10% Potassium Hydroxide, 35% Trichloroacetic Acid

Objective: To compare the efficacy of Aloe Vera Mouthwash versus 0.1% Triamcinolone Acetonide in patients presenting with oral lichen planus at a tertiary care hospital. Introduction: Oral lichen planus is a chronic immune mediated dermatosis with periods of remissions and relapses. There are many treatment options to treat this condition; aloe vera mouth wash is one of the newer and safer options. Methodology: A total of 100 patients with oral lichen planus (OLP) were randomly divided into two groups (group A and B, each having 50 patients).The patients in group A were given aloe vera mouth wash and in group B were given triamcinolone acetonide paste (0.1%). Efficacy was observed after 2 months of treatment completion. Results: Overall Efficacy was noted in 58(58%) of all study cases. In group A 37 patients (74%) showed efficacy and in group B 21 patients (42%) showed efficacy.More efficacy was noted in female patients (87%) treated with Aloe Vera Mouth wash than those of treated with triamcinolone acetate paste (45%). Patients belonging to old age group (36-50 year) showed more efficacy (75%) to aloe vera mouth wash than that of triamcinolone acetonide paste (36%) Conclusion: In our population Aloe vera mouth wash is more efficacious than triamcinolone acetonide (0.1%) in the treatment of oral lichen planus Keywords: Oral lichen planus, Aloe vera, Triamcinolone acetonide

Introduction: Oral lichen planus (LP) is a chronic inflammatory condition and this inflammation leads to alteration in lipid metabolism and increase the cardiovascular risk factors. Objective: To determine the prevalance of dyslipidemias in patient with oral lichen planus coming in dermatology outdoor of Sheikh Zayed Hoapital Rahim Yar Khan. Methods: It was a case control study that was conducted at Department of Dermatology, Sheikh Zayed Hospital Rahim Yar Khan during October 2016 to April 2017. In this study there were total 50 cases of oral LP and 50 controls of both genders with age range of 15 to 60 years. The cases of both the groups underwent fasting lipid profile in terms to look for serum total cholesterol, triglyceride, LDL cholesterol and HDL cholesterol. Results: In this study there were total 100 cases out of which 50 were cases of oral LP and 50 were controls. In cases groups there were 27 (54%) males and 23 (46%) females while in control group there were same number of males and females were taken with p= 0.85. The mean age in case group was 37.22±8.15 years while in control group was 35.66± 7.78 years while the mean BMI was 24.42±2.21 and 25.11±3.01 respectively. The mean difference in cases and controls in terms of serum total cholesterol, TG, HDL Cholesterol and LDL cholesterol was found statistically significant. Conclusion: Dyslipidemias are common in cases with oral lichen planus and all its parameters have significant association with it especially TG. Keywords; LP, Dyslipidemia, LDL, HDL, TG

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