[Paget's disease of the breast].

Background Alopecia areata (AA) may be associated with various systemic diseases according to several studies. Objective To identify prevalent and incident diseases in patients with AA and quantify their prevalence and odds and hazard ratios compared with those in controls without AA. Methods A systematic review of the studies published before February 28, 2018, was performed by using the MEDLINE, Embase, Web of Science, and Cochrane Library databases. Observational studies on prevalent or incident diseases in patients with AA were included, whereas studies limited to pediatrics or providing only laboratory results or continuous data were excluded. The inverse variance method with a random-effects model was used for meta-analyses. Results A total of 87 studies were analyzed. Atopic diseases, metabolic syndrome, Helicobacter pylori infection, lupus erythematosus, iron deficiency anemia, thyroid diseases, psychiatric diseases, vitamin D deficiency, and audiologic and ophthalmic abnormalities were more prevalent in patients with AA. Patients with AA had a higher risk of developing autoimmune diseases. Limitations Some diseases were investigated by an insufficient number of studies to be meta-analyzed. Meta-analysis of incident diseases was not performed owing to the limited availability of cohort studies. Conclusion AA is associated with various systemic and psychiatric diseases. Physicians are encouraged to evaluate and manage potential comorbid conditions to achieve better outcomes.

Comorbidities in alopecia areata: A systematic review and meta-analysis

Urticaria: impact on quality of life and economic cost.

Patients with Hidradenitis Suppurativa Have a High Psychiatric Disease Burden: A Finnish Nationwide Registry Study

The carcinogenic risk of treatments for severe psoriasis

Objective The aim of our study was to assess the prevalence of anxiety and depression in the patients suffering from skin disorders. Patients and methods Two hundred consecutive patients attending out-patient Department of Dermatology, Jinnah Hospital, Lahore, were studied. Hospital Anxiety and Depression Scale, Urdu version was administered to each patient after taking informed consent, as this scale was designed specifically for use in non-psychiatric hospital departments. A personal information sheet was also completed for the total sample of 200 patients. Results Among them 36.5% were males and 63.5% were females, with a majority in the age range of 16-30 years. 20% cases of depression and 28% cases of anxiety were found in the total sample, using cut off point as 11 or more on HAD Scale. High scores were associated with conditions like acne, psoriasis, eczema, all tending to be extensive, chronic and disfiguring and easily visible. The association between sex, marital status, employment status and caseness is discussed. Conclusion There is a high rate of psychological problems in dermatological out-patients suffering from chronic and disfiguring skin conditions.

https://www.jpad.com.pk/index.php/jpad/article/download/707/680

Psychiatric morbidity in dermatological outpatients: an issue to be recognized

Background:  Narrow band UVB (TL-01 lamp) has been proved more successful than broad band UVB in the treatment of chronic plaque psoriasis. It is equally effective but more safe than that of psoralen ultraviolet A (PUVA). Study Design:  Interventional study. Aims and Objectives:  To evaluate the success rate and safety of narrowband UVB in chronic plaque psoriasis in type IV skin. Material and methods:  It is an ongoing study of 60 patients. Till date, twenty patients aged between 8-70 years have completed the study. According to the skin type IV, the starting dose was 330 mJ/ cm 2 . All patients were exposed to whole body narrowband UVB chamber thrice a week until clearance or upto maximum of 24 sessions. Patients were assessed according to the PASI (Psoriatic Area and Severity Index) score at the baseline and then at 4 th and 8 th week of therapy. Results:  Out of a 20 patients, those who have completed the study till date, 18 have been cleared while two cases showed a poor response. None of our patients developed any adverse effect. Conclusion:  Narrowband UVB is a safe and effective therapy for chronic plaque psoriasis but long term follow up is needed to determine its carcinogenic effects. Key words:  Psoriasis, narrowband UVB, PASI.

Efficacy and Safety of Narrow Band UVB in the Treatment of Chronic Plaque Psoriasis

Objective To determine the efficacy and safety of simvastatin in chronic plaque psoriasis. Patients and method s Sixty patients of either sex, aged between 18 and 70 years were included in the study. Efficacy was determined by percentage reduction in psoriasis area and severity index (PASI) score from baseline. Safety of simvastatin was evaluated by measuring serum alanine aminotransferase (ALT), creatinine phosphokinase (CPK) and bilirubin at baseline, 4 th , 8 th and 12 th week. The data were analyzed for variables like age, sex and percentage reduction in PASI score. Results There was >50% reduction in PASI score in 20% patients. Out of these, 8 patients had moderate plaque psoriasis and 4 patients had severe psoriasis. In remaining 80% cases simvastatin did not prove to be efficacious. The drug was safe and well-tolerated. Conclusion Simvastatin can be affective in patients with moderate disease as compared to cases with severe plaque psoriasis. The drug was safe and well-tolerated.

Efficacy and safety of simvastatin in chronic plaque psoriasis

Objective To determine the frequency of skin dermatosis in patients with primary psychiatric conditions. Methods This cross-sectional study was conducted in the Fountain House, Lahore, which is a tertiary care center for psychiatric patients having indoor and outdoor facility. All the admitted psychiatric patients (294) were enrolled in the study. They were thoroughly examined for any skin dermatosis. Out of 294, skin disorders were seen in 172 (58.5%) patients, 89 (60.6%) males and 58 (39.4%) females. The most common primary psychiatric conditions was schizophrenia 47.5% followed by patients of substance abuse 26.5%, bipolar disorder 13.1%, depression and psychosis each in 8.2%. 2.7% patients were manic. Of the study group, 16.3% patients had infective dermatoses and the rest had noninfective dermatoses. A high incidence of generalized xerosis and pruritus was seen in both males and females. Among noninfective dermatoses, 10.1% had eczema, 6.2% acne, 5% melasma, 4.1% palmoplantar keratoderma, 3.2% neurotic excoriations, 3.2% dermatitis artifacta, 2.7% trichotillomania, 2.1% miliaria, and 1.4% had ichthyosis. Conclusion A high incidence of fungal infections mainly tinea versicolor and onychomycosis was seen in the patients with primary psychiatric conditions.

Skin disorders in patients with primary psychiatric conditions

Materials and Methods: This is a descriptive case study being conducted at the Dermatology Department Unit-II, King Edward Medical University / Mayo Hospital, Lahore. It is an ongoing study in which 40 patients have been enrolled till date. Forty patients, aged 12 years and above, of either sex having chronic eczema have been included. Patients using oral corticosteroids and other immunosuppressive drugs during the last 15 days as well as pregnant females were excluded from the study. Each patient was patch tested with allergens of medicament, corticosteroid and European standard series. Positive reactions were observed and recorded according to International Contact Dermatitis Research Group Criteria.

Faria Asad

Papers

Psychiatric morbidity in dermatological outpatients: an issue to be recognized

Efficacy and Safety of Narrow Band UVB in the Treatment of Chronic Plaque Psoriasis

Efficacy and safety of simvastatin in chronic plaque psoriasis

Skin disorders in patients with primary psychiatric conditions

Frequency of Allergic Contact Dermatitis in Patients with Chronic Eczema