Tariq Rashid

A randomized, comparative trial of treatment of kerion celsi with griseofulvin plus oral prednisolone vs. griseofulvin alone

Glucocorticoids are often recommended along with oral antifungals in the treatment of kerion celsi. In this randomized study, the efficacy of combination therapy with oral griseofulvin and oral prednisolone (n =17) was compared to oral griseofulvin alone (n=13) in the treatment of kerion celsi. Both groups were treated with oral griseofulvin for 8 weeks whereas oral prednisolone was given in tapering doses for 3-4 weeks to the first group only. The final evaluation at week 12 showed a cure rate of 100% in both groups without any significant difference in terms of clinical or mycological cure (P>0.05). No adverse events were noted in either group. In our opinion the combination of oral prednisolone with griseofulvin does not result in additional objective or subjective improvement compared to griseofulvin alone in cases with kerion celsi.

Laser therapy of freckles and lentigines with quasi-continuous, frequency-doubled, Nd:YAG (532 nm) laser in Fitzpatrick skin type IV: a 24-month follow-up.

BACKGROUND : Newly developed lasers produce excellent results with minimal complications compared with traditional treatments for freckles and lentigines. OBJECTIVES : To assess the efficacy and safety of the frequency-doubled Nd:YAG (532 nm) laser in the treatment of freckles and lentigines in type IV skin. PATIENTS AND METHODS : Twenty adult patients (14 with freckles and six with lentigines) were subjected to a variable number of treatments with a minimum 4-week interval until no additional improvement occurred or > 75% improvement was obvious. Patients manifesting > 50% improvement were followed up once every 3 months for 24 months. The rest were regarded as treatment failures and not followed up. RESULTS : Sixteen (80%) of 20 patients (freckles, n = 10; lentigines, n = 6) manifested more than 50% improvement. They were irradiated between three and eight times with a 4-12-week interval. Complications included hypopigmentation (25%), mild textural changes (15%) and hyperpigmentation (10%). All these were mild and resolved within 2-6 months. Of 10 patients with freckles followed up for 24 months, four (40%) patients showed partial recurrence. However, all the patients maintained > 50% improvement. None of the patients with lentigines showed recurrence. CONCLUSION : The quasi-continuous, frequency-doubled Nd:YAG (532 nm) laser safely and effectively treats freckles and lentigines in Fitzpatrick skin type IV.

Suitability of the European standard series of patch test allergensin Pakistani patients

Results Of 350 patients, 215 (61%) were positive on patch testing. Positivity to 1 allergen was seen in 35%, and to 2 more allergens in 26% of patients. Results were considered relevant in 47% of patients. Table 1 enlists the top 11 allergens, positive in more than 2% of patients. Other positive allergens, with a frequency of less than 2%, were epoxy resin, lanolin alcohol, parabens, N-isopropyl-N-phenyl-4-phenylenediamine, quaternium-15, quinolone mix, Myroxylon Pereirae resin, mercapto mix,