Background: Androgens enhance the sebum production and follicular keratosis that plays the key role in the aetiology of acne. Objective: To find out the association between serum testosterone and acne vulgaris. Methods: A case control study was carried out for a period of two years in the outpatient department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Female patients having acne vulgaris were selected as case. Healthy control (age and sex matched) were enrolled from the community. Results: The study showed that the mean age of the cases was 22.43 with standard deviation 5.2 years and the mean age of the control was 23.23 with standard deviation 5.9 years. The mean duration of disease was 62.6 months ranging from 12 months to 300 months. All the patients had presented with comedones (blackheads and whiteheads) followed by 94.3% had papules and 58.6% had pustules. Considering the site of lesion, all the patients had acne in the face. Data analysis revealed that the percentage of serum testosterone above normal was found to be high among the cases with acne (10%) whereas below normal level of serum testosterone was found among the control and the difference was statistically significant (p<0.001). Conclusion:The study found a significant association between serum testosterone and acne vulgaris. As serum testosterone is associated with acne vulgaris, testosterone levels should be measured in patients presenting with acne vulgaris especially in treatment resistant cases and anti-androgen treatment may be indicated in cases with elevated testosterone level.DOI: http://dx.doi.org/10.3329/bsmmuj.v5i1.10980 BSMMU J 2012; 5(1):1-5

The objectives of this study were to compare the adverse outcome of methotrexate and mini pulse betamethasone therapy in the treatment of lichen planus. It was a clinical trial conducted in the department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University, Dhaka, from January 2009 to December 2010. Forty four patients of lichen planus were included in the study. Patients in Group-A, (n = 23) were treated with methotrexate (10 mg) single morning dose and group-B (n = 21) were treated with mini pulse betamethasone (5 mg) single morning dose on 2 consecutive days during the period of 12 weeks. Adverse outcomes were measured by clinical examination and laboratory investigations during follow up visits. Anemia 3 (14.2%) and edema 12 (57.1%) developed in group-B but none in group-A. In group-B, dyspepsia 15 (71.4%), acne 10 (47.6%), mooning face 8 (38.1%), striae 8 (38.1%) and hypertrichosis 4 (19.0%) developed but none in group-A. Intermittent diarrhoea, headache, nausea and fatigue complained in both groups of patients but the percentage of complaints was higher among group-B compared to group-A. Menstrual abnormality developed in group-B 5(71.4%) but none in group-A. Laboratory investigations showed abnormality in platelet count and SGPT in group-A but none in group-B. The adverse effects of methotrexate on haematological parameter and liver functions were mild and could be prevented by reducing the dose but the adverse effects of betamethasone were unavoidable. The overall adverse effects were less in group-A than group-B. Therefore, methotrexate can be used as an alternative safer option for the treatment of lichen planus.

Cure rates for vitiligo are significantly lower because of problems to different studies have reported different response rate and different adverse effect for the treatment of vitiligo. This study was conducted to evaluate the response rate and adverse effect of topical tacrolimus 0.1% ointment in the treatment of vitiligo patients in the department of Dermatology and venereology, Bangladesh Medical college (BMC), Dhaka from January 2010 to July 2010. In this clinical trial, 30 newly diagnosed vitiligo (focal and segmental) patients, aged between 10 to 50 years were assigned for therapy and to observe the response and adverse effect. Each individual lesion was treated with topical tacrolimus 0.1% ointment twice daily for three months. All the patients completed three months treatment and available for statistical analysis. The highest percentage 13(43.3%) was in the age of 11-20 years. Sex ratio revealed higher in case of female 18(60%), with a male-female ratio 1:1.5 and 5(16.67%) patients had vitiligo among their families. Repigmentation was observed in 8 (26.7%) subjects at the end of 4th week, 15 (50.1%) subjects at 8th week and 25 (83.3%) subjects after 12 weeks of therapy. 25 (83.33%) subjects did not complain any adverse effect (like pruritus, burning etc.) and 5 (16.67%) subjects were suffered from different adverse effect of drug, like pruritus observed in 2 (6.7%) subjects and burning in 6 (20%) subjects. This study found that tacrolimus 0.1% ointment to be safe in the treatment of vitiligo, with reduction in the number of vitiliginous spots by increased repigmentation significantly. DOI: http://dx.doi.org/10.3329/bjms.v13i3.19147 Bangladesh Journal of Medical Science Vol.13(3) 2014 p.255-259

Skin biopsy for histopathology is the most reliable investigation for diagnosis of skin diseases. The main purpose of skin biopsy is to confirm clinical diagnosis but dermatologists usually looking for the concordance with histopathological report. The aim of the study was to observe the consistency of clinical and histopathological diagnosis of skin diseases. An observational study was conducted on 630 patients that undertaken skin biopsy and that was performed at the Department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University from January 2018 to January 2019. Patients who were advised for biopsy by outpatient and inpatient department and the biopsy was done accordingly was included in the study. Finally the inclusion was confirmed when the histopathological report was available. Demographic information, clinical diagnosis, type of biopsy procedure, types of specimen taken and send for histopathological procedure and the histopathological diagnosis was noted in data collection sheet. Histopathological diagnosis and its correlation with clinical diagnosis was assessed for consistency and it was the main outcome measure of the study. The mean age of patients on whom biopsy was performed was 35.14 ±16.57 years and the age range was 5-82 years. Male patients outnumbered female and the male to female ratio was 1.15: 1. Three types of biopsy were performed among them incisional biopsy was the commonest type (93.5%). In most of the cases collected specimen was skin 94.76%, others type of specimens were mucous membrane 2.6%, nail matrix 1.9% and 0.6% specimen was hair follicle. Among the cases 71.43% was diagnosed clinically. The common clinical diagnosis in which biopsy was done was psoriasis and its types 17.77%, lichen planus and its variants 14.12%, the connective tissue diseases 6.19% and infectious diseases 5.39%.  In 79.52% cases histopathological diagnosis was done and 68.22% diagnosis was consistent with the clinical diagnosis. The maximum clinico-pathological concordance was found in vesiculo-bullous disease 93.33%. Then connective tissue diseases 79.48%, vasculitides 75% and lichenoid diseases 73.56%. Skin biopsy is a conclusive tool to overcome diagnostic dilemmas in dermatological diseases. The clinico-pathological concordance is assumed lower than the expectation of dermatologists but the collective efforts of dermatologists and pathologists can improve the capacity of diagnosis of biopsy samples. Bangladesh Med J. 2020 Sept; 49(3) : 29-34

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