Ghulam Mujtaba

Cutaneous leishmaniasis in Multan, Pakistan.

Background Cutaneous leishmaniasis (CL) is endemic in certain areas of Pakistan. This study was carried out to determine the incidence and clinical pattern of the disease in Pakistan.Background Cutaneous leishmaniasis (CL) is endemic in certain areas of Pakistan. This study was carried out to determine the incidence and clinical pattern of the disease in Pakistan. Methods CL patients presenting in the out-patient clinic of the Department of Dermatology, Nishtar Hospital, Multan from January 1995 to June 1997 were included in the study. The patients were diagnosed clinically and confirmed by laboratory demonstration of the parasite in a Giemsa-stained smear from the lesion. All important clinical details were recorded on specially designed forms. Results Three hundred and five patients with 681 lesions were seen during 30 months. All the lesions were of the dry type. Most of the lesions (97%) were present on exposed areas of the body. One hundred and thirty-four (44%) patients had one and 75 (24%) had two lesions. Eight five per cent of the sufferers were less than 30 years of age. The disease was slightly more preponderant in males (60%). Most cases presented during winter. Conclusions Lack of wet type lesions may be due to complete absence of Leishmania major in this area. This is in contrast to other areas of Pakistan where both dry and wet types of CL are present.

Weekly vs. fortnightly intralesional meglumine antimoniate in cutaneous leishmaniasis

One hundred and four patients with a clinical diagnosis of cutaneous leishmaniasis (CL) and a positive Giemsa‐stained smear for the parasite were recruited after informed consent into this randomized clinical trial, comparing the efficacy of weekly vs. fortnightly intralesional injections of meglumine antimoniate. Patients having more than five lesions and pregnant women were not included.

Response of segmental vitiligo to 0.05% clobetasol propionate cream.

Forty patients with a definite clinical diagnosis of segmental vitiligo (SV) were treated with 0.05% clobetasol propionate cream to the vitiliginous areas twice daily. Patients with any doubt regarding the type of vitiligo were not included. Twelve (30%) patients were 5–10 years, 19 (47.5%) were 11–20 years, six (15%) were 21–30 years, and three (7.5%) were 31–34 years of age. The duration of the disease ranged from 1 month to 12 years (mean, 16.3 months); 11 (27.5%) patients presented within 6 months, 13 (32.5%) from 6 to 12 months, nine (22.5%) from 12 to 18 months, and seven (17.5%) after 18 months of the onset of the disease. Eighteen (45%) patients were male and 22 (55%) were female. The face and/or neck were affected in 16 (40%), trunk in 17 (42.5%), and extremities in seven (17.5%) patients. Therapy was interrupted for 2 weeks after every 6-week course, unless the severity of the side-effects dictated longer or earlier intervals. Patients were assessed every 2 weeks. Treatment was stopped after two courses in those patients who did not show any signs of recovery during this period. The remaining patients received three courses of treatment. No adjuvant therapy was used.