Favoure racouchot syndrome is a solar elastotic disorder in which sun exposure or radiation cause skin damageleading to development of multiple open comedones. It usually affects the areas around the eyes, temples and theneck characterized by a diffuse yellowish hue. Presented here is a case of favoure racouchot syndrome involvingscalp in a farmer. Scalp involvement has so far not been described as component of this syndrome. The eruptionis usually bilaterally symmetrical. The exact pathophysiology remains unclear.
We report a case of Langerhan Cell Histiocytosis in a three and a half years old child. The child presented with history of low grade fever, off and on for 9 months. There was 2 months history of progressive pallor and 5 days history of epistaxis. Blood complete picture revealed pancytopenia and the patient was referred to a paediatric oncologist. Initial diagnosis of acute lymphoblastic leukaemia (ALL), Lymphoma and disseminated Tuberculosis (TB) was made on basis of initial investigations. Coetaneous involvement occurred 7 months later along with Diabetes Insipidis, bone changes and pulmonary involvement.
Objective: To compare the effect of topical liquid Nitrogen and normal saline on pain during intradermal Platelet-rich Plasma therapy in androgenic alopecia.
Study Design: Prospective Comparative study.
Place and Duration of Study: Tertiary Care Hospital, Gujranwala Pakistan, from Mar to Nov 2021.
Methodology: Sixty-four patients with the clinical diagnosis of androgenic alopecia were enrolled after informed consent.After liquid Nitrogen contact application, Group- A patients opted to receive intradermal Platelet-rich Plasma on the scalp. In contrast, patients in Group-B opted to receive Platelet-rich Plasma after normal Saline topical application for improved pain tolerance.
Results: Out of Sixty-four patients, there were 45(70.3%) males, 19(29.7%) females. Pain in intradermal Platelet-rich Plasma injection of the scalp in Group-A had a median (IQR) score of 4 (3-5), while Group-B had a median (IQR) of 5(3-7.5). Patient satisfaction score at the end of three sessions of PRP in group-A had a median (IQR) of 1.5(1-2), and in Group-B, a median (IQR) of 2(1-2).
Conclusion: Topical liquid Nitrogen application improved pain tolerance during intradermal Platelet-rich Plasma therapy in androgenic alopecia compared to normal saline. Satisfaction of patients with Platelet-rich Plasma therapy between the two groups had no significant difference.
Objective: To assess short and long term aesthetic and functional outcomes of nasal ala reconstruction by three staged folded forehead flap.
Study Design: Prospective study.
Place and Duration of Study: Plastic and Reconstructive Surgery Department of Combined Military HospitalBahawalpur and Quetta, from Dec 2014 to Dec 2018.
Methodology: Total of 29 patients were enrolled through consecutive sampling technique. Nasal ala defects were reconstructed by three staged frontal forehead flap under general anesthesia. Follow up visit at 2 weeks bleeding, wound Infection, partial skin graft loss and partial flap necrosis was documented. Follow up at 24 weeks, functional outcome of nasal reconstruction was assessed by history and clinical examination for nasal obstruction and/or crusting. Patients’ subjective satisfaction about aesthetic outcome of nasal reconstruction was documented on 5 point likert scale. Objective aesthetic assessment of reconstruction was done on 2D photograph by two independent surgeons.
Results: Twenty six (89.66%) males and 3 (10.34%) females participated in study. The mean age was 35 yearsrange 16 to 64 years. Follow up at two weeks revealed postoperative bleeding in 2 (6.8%), wound infection in 1(3.4%) and partial flap loss in 1 (3.4%) patient. At 24 weeks follow up all patients had patent nasal ala. Subjectiveand objective assessment of nose shape was documented.
Conclusion: Use of three staged folded forehead flapis useful method of reconstruction for full thickness defects of nasal alaewith good functional and aesthetic outcome.
Objective To compare the clinical efficacy of trichloroacetic acid (TCA) 100% and cryotherapy in xanthelasma palpebrarum (XP). Methods 40 patients fulfilling the inclusion criteria were treated with cryotherapy on right eye (group A) and TCA on left eye (group B). Patients were followed up for 6 weeks and final outcome variable of efficacy i.e. complete resolution of xanthelasma was assessed at 6 weeks. Adverse side effects of therapy were also recorded as secondary outcome variables. Data were analyzed by SPSS 19.0. Results Mean age of patients was 43.75 ± 5.90 years and age ranged from 34 to 56 years. Out of 40 patients 9 (22.5%) were male and 40 (77.5%) were female. Complete resolution of xanthelasma was seen in only 7 (17.5%) in group A, while complete resolution of lesions was seen in 30 (75%) of patients in group B ( p = 0.000). Conclusion A single session of 100% TCA is highly effective than cryotherapy in the treatment of Xanthelasma palpebrarum .
Objective: To check the motivational factors behind the usage of skin lightening creams and users’ awareness in our setup by constructing a validated questionnaire.
Study Design: Cross-sectional study.
Place and Duration of Study: Outpatient Department of Dermatology, Combined Military Hospital Rawalpindi, from Oct to Nov 2020.
Methodology: Two fifty patients who were using skin-lightening creams (SLC) were recruited after the informed consent. Questionnaire was made following seven steps as mentioned in AMEE (Association for Medical Education Europe) guide 87. Data was analyzed by SPSS version 21. Reliability was be checked by Cronbach@. Descriptive statistics of responses including frequencies and percentages were calculated. Exploratory factor analysis of questionnaire was made.
Results: Skin lightening cream users had age range from 16-56 years, majority 190 (76%) were females. Out of 158 (63.2%) were married, 180 (72%) well educated and 146 (58.4%) had Fitzpatrick skin type 3-5 predominate. Cronbach alpha of our questionnaire was 0.802. The 5-point likert scale was used to record users’ perceptions in the domains i.e., motivational factors, awareness about product and intentions. Majority, 89 (35.6%) used the product on social media recommendation. Out of 201 (80.4%) developed side effects with telangiectasia and skin thinning being the commonest ones. Out of 88 (35.2%) were using other skin whitening practices besides these creams.
Conclusion: False perceptions about fairness and lack of user’s awareness govern the skin lightening practices in our society resulting in increased usage and side effects experienced by users. A mass educational awareness program regarding “skin lightening.........
Objective: To evaluate the role of aseptic measures in preventing surgical site infections in skin biopsy procedures. Study Design: Prospective, observational study. Place and Duration of Study: PAF Hospital, PAF Base Faisal, Karachi, 16 months (October 2019 to January 2021). Patients and Methods: The study included all patients requiring skin biopsies, except punch and shave biopsies. The procedure was done under strict aseptic measures in a dedicated room of the operation theatre, according to the standard protocol, and the patients were followed up for any surgical site infection. Demographic data of the patients along with other parameters, including comorbid conditions, presence or absence of surgical site infection, site of biopsy, type of biopsy, and type of sutures applied were recorded for each patient by direct observation. Data were analyzed using SPSS version 18. Results: One hundred and fifty-one patients, with a mean age of 36 ± 14 years, were included in the study. Out of 151 patients, 99(65.6%) were males and 52 (34.4%) were females. Excisional biopsy was done in 58 (38.4%) and incisional biopsy in 93 (61.6%)patients. The most commonly biopsied site was the trunk (45 patients). Wound infection was present in 04 patients. Two out of the 04 infected patients had diabetes mellitus and 01 was a smoker. Conclusion: Effective aseptic measures reduce surgical site infections in skin biopsy procedures.
Herpes zoster is a common disease of the dorsal root ganglia and sensory nerve fibers, clinically characterized by unilateral painful vesicular eruption of the skin in a dermatomal distribution. Segmental motor weakness is a rare complication that occurs in 0-5 percent of patients and is associated with an excellent prognosis for recovery. We herein, present a case of herpes zoster complicated by segmental motor paresis of abdominal musculature resulting in pseudohernia. This rare complication of herpes zoster, with an excellent prognosis for recovery, should be recognized by dermatologists and surgeons as it can save costly consultations and evaluations.
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