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Pregnancy represents a transformative phase in a woman's life, often accompanied by distinct dermatological conditions. These skin conditions comprise a spectrum of inflammatory disorders that emerge exclusively during pregnancy, triggered by the dynamic physiological and hormonal changes. These dermatoses encompass atopic eruptions of pregnancy (AEP), polymorphic eruptions of pregnancy (PEP), gestational pemphigoid (GP), obstetric cholestasis (OC), and pustular psoriasis of pregnancy (PPP). Several of these specific dermatoses of pregnancy not only impact the mother's skin but also carry potential risks for the fetus, including prematurity, intrauterine growth restriction (IUGR), and, in severe cases, fetal demise. Unfortunately, there exists limited knowledge regarding the pathogenesis, clinical manifestations and management of these specific pregnancy-related dermatoses, not only among general practitioners, who typically serve as the initial point of contact for pregnant patients, as well as dermatologists and obstetricians to whom patients are often referred. This narrative review aims to provide healthcare professionals with a comprehensive understanding of these pregnancy-specific dermatoses. By enhancing awareness and knowledge about these conditions, we aim to equip healthcare providers with the necessary information to make informed decisions and deliver improved care to pregnant women. Ultimately, this collaborative effort strives to contribute to enhanced pregnancy outcomes and the well-being of both mothers and their unborn children. [ABSTRACT FROM AUTHOR]

Objective To identify the pattern of various clinical presentations of skin disorders in pediatric patients of DHQ teaching hospital, Gujranwala for improving health care planning and management. Methods The query describes a descriptive, cross-sectional hospital-based study that included the patients of all genders and ages upto 14 years who visited the Dermatology Outpatient Department within a year. The diagnoses of patients were confirmed after detailed history, examinations and necessary investigations. Results 9,526 children presented to the Dermatology Department. Out of those, 43% were males and 57% were females. Mean age noted was 5.5 years with standard deviation of 3.2 years. Scabies (32.2%), eczema (16.6%), tinea (13.4%), seborrheic dermatitis (4.3 %), furunculosis (4.0%), impetigo (3.7%), urticaria (3.0%), vitiligo (2.8%), diaper candidiasis (2.6%), viral exanthemas (2.0%), carbuncle (1.9%), atopic dermatitis (1.7%), molluscum contagiosum (1.5%), alopecia areata (1.5%) and pityriasis versicolor (1.3%) were included in the group of more common dermatoses. Rest of dermatoses were divided into less commom (6.3%) and rare dermatoses (1.2%). Conclusion There should be collaboration between pediatrician and dermatologist for the early diagnosis and management of most commonly observed dermatoses. It will reduce a lot of burden on our health care system. [ABSTRACT FROM AUTHOR]

Kindler syndrome is a rare autosomal recessive disorder belonging to the group of Epidermolysis Bullosa (EB), which encompasses genetic disorders affecting the skin and mucous membranes. This case report aims to contribute to the limited literature on Kindler syndrome by presenting two cases observed at a district hospital in Gujranwala, Pakistan. The cases involve a brother and sister displaying typical symptoms and having a family history of the disease. The objective is to enhance clinicians' awareness of this rare disorder and emphasize the significance of clinical diagnosisdriven management strategies. [ABSTRACT FROM AUTHOR]

Objective Melasma is characterized as grey brown patches of pigmentation on photo exposed areas of body, often requiring a multifaceted approach for its management in refractory. Topical tranexamic acid is commonly used but studies claimed that intralesional injection of tranexamic acid was more efficacious. The objective of the study is to compare the efficacy of tranexamic acid intralesional (localized microinjections) versus topical therapy in the treatment of melasma. Methods This study involved 72 patients of melasma of both genders between 20-50 years, randomly allocated into two treatment groups. Group-A was given topical TXA while Group-B was treated with intradermal injection of TXA. Efficacy was labeled as =50% reduction in baseline MASI score after 12 weeks of treatment. Results The mean age of the patients was 30.53±8.68 years. There were 13 (18.1%) male and 59 (81.9%) female patients. Majority (n=49, 68.1%) of the patients had Fitz-Patrick Type-V skin phototype. Moderate melasma in 47 (65.3%) patients and severe in 25 (34.7%) patients. Melasma was epidermal in 43 (59.7%) patients while dermal and mixed type was noted in 18.1% and 22.2% patient's respectively. The frequency of efficacy was significantly higher in patients treated with intralesional TXA as compared to topical TXA (66.7% vs. 27.8%; p-value=0.001). Conclusion Intralesional injection of tranexamic acid was found superior to conventional practice of its topical application in the management of patients with melasma regardless of patient's age, gender, marital and educational status, skin type and type, pattern and severity of disease which along with its well established safety profile and convenience of once-weekly dosage advocate the preferred use of this novel approach in the management of such patients in future dermatologic practice. [ABSTRACT FROM AUTHOR]

Background Scabies is a common infection caused by sarcoptes scabiei var.hominis. Ivermectin, an antiparasitic agent effective against a variety of ectoparasites and endoparasites. Permethrin an insecticide, applied topically kills the mite and its eggs but itching may persist for several weeks. Objective To compare the efficacy of oral ivermectin and topical permethrin 5% in treatment of scabies. Methods It was a randomized controlled trial conducted at Dermatology Department, Sir Gangaram Hospital Lahore/Fatima Jinnah Medical University Lahore. Sixty enrolled patients after informed consent were categorized in 2 groups. In group-A, cases were treated with Tab ivermectin orally in dose of 200 mcg/kg at day 0 and in group-B, all cases were treated with topical permethrin 5% at day 0. Clinical grading and itch grading scores were tools for comparison. The cured patients were provided antihistamines for further 1 week if itching is moderate to severe. Efficacy was determined after one week of treatment. Results Mean age in patients who received permethrin 5% was 41.67±10.35 years and those received ivermectin mean age was 39.67±12.38 years. In permethrin 5% group, 22 (73.3%) cases showed efficacy and ivermectin group 8 (26.7%) cases showed efficacy (p value< 0.05). Permethrin (5%) remained more efficacious. Conclusion Scabies can be treated with permethrin 5% to achieve higher cure, by doing so we can improve patient's quality of life. [ABSTRACT FROM AUTHOR]

Background Melasma is an acquired hypermelanosis affecting the sun-exposed areas of skin, most commonly the face and neck. There was significantly strong positive correlation between clinical severity of disease and disease related quality of life among patients with melasma and warranted routine assessment of melasma. Objective To study was to find clinical correlation between quality of life and clinical severity of melasma in female patients presenting in a tertiary care hospital. Methods This descriptive cross-sectional research was done at Department of Dermatology, Fatimah Jinnah medical university, Lahore including 80 females from 15-50 years suffering from melasma. These patients were evaluated by mMASI score for clinical severity of disease and MELASQoL score for effect on quality of life. Spearman correlation was used to evaluate correlation between clinical severity of melasma and quality of life. Results The mean age of the patients was 32.4±7.5 years. Majority (n=64, 80.0%) of the women was married. Most common type of melasma was centrofacial which was observed in 31 (38.8%) women followed by mixed (35.0%) and malar (26.2%) pattern. 25 (31.2%) women were illiterate while 47 (58.8%) women had matriculation or above degree. The mMASI score ranged from 1.2 to 35.7 with a mean of 15.81±8.87 while the MELASQoL score ranged from 13 to 70 with a mean of 46.59±16.95. There was significantly strong positive correlation between clinical severity of melasma over mMASI score and quality of life over MELASQoL score (spearman correlation coefficient r=0.852; p-value<0.001). Similar connection was noted among different subgroups of patients based on patient's age, educational and marital standing and type of melasma. Conclusion A strong positive correlation was observed between clinical severity of melasma and quality of life among patients presenting with melasma which warrants routine clinical assessment of such patients for severity of disease and associated effects on quality of life so that apart from treatment of disease, the psychosocial aspect of the disease is also addressed which will help in better patient management. [ABSTRACT FROM AUTHOR]

Over the past few decades, drugs targeting cytokines and their receptors have been researched and developed. These agents act on molecular targets at the subcellular level. The Janus Kinases family is a group of receptor-associated signaling molecules which are essential to the signal cascade originating from Type 1 and Type 2 cytokine receptors. Janus kinase inhibitors, also known as Jakinibs/JAK inhibitors, are molecules developed against this class of kinases. Initially developed for use in different inflammatory conditions, such as rheumatological problems, JAK inhibitors are emerging as new agents in dermatology. Although biologics have proved to be effective and safe in various disorders, not all patients respond to this therapy. Jakinibs are also being seen as an alternative oral therapy for such patients. This article will review the basic principles of mode of action, efficacy and safety of JAK inhibitors in autoimmune conditions such as psoriasis, alopecia areata, atopic dermatitis, lupus erythematosus, dermatomyositis and vitiligo. [ABSTRACT FROM AUTHOR]

Objective To determine the frequency of positive thyroid peroxidase antibodies in patients of generalized vitiligo. Methods This cross sectional study was conducted in the Dermatology Unit 1 of Jinnah Hospital, Lahore for a period of six months. 125 cases of generalized vitiligo, of both genders, ages between 15-60 years, and with any duration of disease were enrolled. Results A total of 125 cases of generalized vitiligo were enrolled. 61.6% (n=77) patients were between 15-30 years of age whereas 38.4 % (n=48) were between 31-60 years of age, Mean was calculated as 31.56±7.77 years, 56.8% (n=71) were male and 43.2% (n=54) were females. Frequency of positive thyroid peroxidase antibodies in patients of generalized vitiligo was recorded in 32.8% (n=41). Conclusion The frequency of positive thyroid peroxidase antibodies is significant in patients of generalized vitiligo. [ABSTRACT FROM AUTHOR]

Progressive hemifacial atrophy is a rare, unilateral, atrophic craniofacial form of morphea involving the dermis, subcutaneous tissue, fat, muscle, and even bone. We report a case of a child having progressive hemifacial atrophy, presented with rapidly progressive neurological symptoms and associated radiological manifestations. In this case of hemifacial atrophy, the sensitivity of MRI in detecting intracranial lesions is demonstrated. Recommendations for imaging these patients are proposed. [ABSTRACT FROM AUTHOR]

Generalized disabling pansclerotic morphea is a rare and mutilating form of morphea involving the dermis, subcutaneous tissue, fat, muscle, and even bone. It most often occurs in young children but adults can also be affected. We report a case of rapidly progressing and disabling adult onset generalized pansclerotic morphea, which responded well to methotrexate and steroid pulse therapy. [ABSTRACT FROM AUTHOR]

Background Nail involvement is frequently observed in various dermatoses including psoriasis, lichen planus, and alopecia areata. Vitiligo affects 0.1-4% of global population. It is associated with other autoimmune disorders having nail abnormalities. The frequency and nature of nail abnormalities in vitiligo are not known in our local population. Objective To determine the frequency and types of nail changes in patients of vitiligo. Methods This cross-sectional study was conducted in the Dermatology outpatient department of Jinnah Hospital Lahore, Pakistan for duration of six months. 240 cases of vitiligo, of both genders, ages between 15-50 years and with any duration of disease were enrolled. Results In our study population of 240 cases, 150 cases (62.5%) of vitiligo had nail changes. 40.67% (n=61) had longitudinal ridging, 12.67% (n=19) had leukonychia, 10.67% (n=16) had absent lunula, 5.33% (n=8) had trachonychia, 4.67% (n=7) had onycholysis, 4.67% (n=7) had clubbing and 4% (n=6) had splinter hemorrhages. Conclusion Nail changes were observed in more than sixty percent cases of vitiligo. Longitudinal ridging was the most common type of nail abnormality followed by leukonychia and absent lunula. [ABSTRACT FROM AUTHOR]

Background: Leprosy disease in the community is usually mistaken as a cursed disease. Leprosy disease is a chronic granulomatous infection caused by Mycobacterium leprae. Quality of life in leprosy patients with neuropathic pain in every region is varied. Objective: To determine the quality of life in leprosy patients with neuropathic pain by using the SALSA Scale and VAS. Methods: The research used analytic observational, a cross-sectional design and an interview technic. 37 subjects of 19 to 59 years age had leprosy with neuropathic pain at Donorojo Hospital. Results: SALSA score explains that 62.2% of the research subject has limitation of activity and has a correlation with leprosy disease with p 0.012. There is no correlation between VAS score and leprosy disease with p 0.034. SALSA score and VAS score in this research explain there is no correlation with p 0.458. The number of other medical conditions with limitation activity has a correlation score of 0.870 which has a very good correlation power. The number of used tools with limitation activity has a correlation score of 0.716 which has a good correlation power. Conclusion: There is activity limitation in leprosy patients with neuropathic pain at Donorojo Hospital Jepara District. The other aspect that affect activity limitation is the number of other medical conditions. Multibacillary type has more limitation than a Paucibacillary type. [ABSTRACT FROM AUTHOR]

Addison's disease is an adrenocortical insufficiency due to the dysfunction or destruction of the entire adrenal gland. The disease usually manifests when 90% or more of both adrenal cortices are dysfunctional or destroyed affecting both glucocorticoid and mineralocorticoid functions. The morbidity and mortality associated with Addison s disease is relatively high due to delay in diagnosis and initiation of therapy. Here, we report a case of a seven years old child who presented to us with diffuse hyperpigmentation of the body, body flexures, palmar creases and mucosae. He was diagnosed with Addison's disease, which is indeed a rare entity. In addition, this case report will also enhance the importance of cutaneous examination in suspecting Addison's disease. [ABSTRACT FROM AUTHOR]

Objective To determine the degree of agreement between clinical and dermoscopic diagnosis in patients of scabies. Methods A total of 210 patients with clinical suspicion of scabies were enrolled in the study. Patients were evaluated in a well lit room and those patients who met the definition of clinical diagnosis were recorded as having scabies. All patients were then subjected to dermoscopic examination of the suspicious areas e.g. interdigital clefts of hands, abdomen and groin. Findings were recorded on a predesigned proforma. Outcome variable was a positive or negative dermoscopic examination. Results Mean age of patients was 16±8.5 years with a range of 1 month to 87 yrs. Among 210 patients 116 (55.2%) were males and 94 (44.7 %) were females. Total of 112 patients (53.3%) were clinically diagnosed as scabies and 98 patients (46.7%) were not. Positive dermoscopic examination was recorded in 104 patients (49.5%) of whom 99 (95.2%) were also positive on clinical examination. Mite head was the most frequently visualized part, in 94.1% of the 104 cases. Negative dermoscopic examination was seen in 106 patients (50.5%) of whom 93 (87.7%) were also negative clinically. Hence 99 patients were true positives and 93 were true negatives. Kappa test was used to assess the difference between the two (K=0.829, P < 0.05). Conclusion The results of this study suggest that there is almost a perfect agreement between the clinical diagnoses and dermoscopy for scabies (K=0.829). [ABSTRACT FROM AUTHOR]

Eruptive vellus hair cysts are rare benign tumors of pilosebaceous unit with vellus hairs, which appear in childhood or young adults. Their etio-pathogenesis is poorly known. A review of the literature shows that eruptive vellus hair cysts (EVHC) might be inherited as autosomal dominant or acquired, and might be associated with other genodermatoses like pachyonychia congenita and anhidrotic ectodermal dysplasia. Although it is a benign tumor of pilosebaceous unit, this condition is rather difficult to treat. Here we report a case of 23 years old female with multiple, asymptomatic, slate-grey to bluish papules on face and ears for last 5 years, with a positive family history of similar lesions in other siblings. To the best of our knowledge, this is the first case of autosomal dominant facial variant of eruptive vellus hair cysts to be published from Pakistan. [ABSTRACT FROM AUTHOR]

Objective To determine the clinical spectrum of pediatric dermatoses at a tertiary care unit. Methods Three hundred and fifty cases aged up to 12 years, presenting to dermatology unit I, Jinnah Hospital, Lahore with skin diseases were enrolled over a period of 6 months. Detailed history and physical examination were done to diagnose the skin lesions. All the information was collected on a specially designed proforma. Results A total of 350 children with skin diseases, 186 (53.1%) males and 164 (46.9%) females were seen. The mean age of patients in the study was 4.18±2.97 years. Infections and infestations were the common dermatoses seen in 158 (45.1%) and 105 (30%) children, respectively. Eczema was present in 79 (22.6%) patients and diseases of sweat gland in 8 (2.3%). Conclusion Infection and infestations were seen as the most common pediatric dermatoses. [ABSTRACT FROM AUTHOR]

Objective To assess the frequency of steroid-induced hyperglycemia in patients taking systemic steroids (30mg or more of prednisolone or equivalent) for dermatological disorders. Methods We included 150 patients of either sex and with ages between 12 and 70 years in this cross-sectional study, carried out in the department of dermatology, Jinnah Hospital, Lahore for a duration of 6 months. Their baseline fasting blood glucose level prior to the start of steroid treatment was recorded. Patients taking 30mg or more of prednisolone (or equivalent) were followed up after one week of treatment and their random blood sugar levels were checked by the same laboratory on venous blood, to see whether they developed hyperglycemia or not after treatment with steroids. Results Mean age of the patients was 41.83±16.42 years. Ninety-four (62.7%) patients were male while 56 (37.3%) were female. Hyperglycemia was found in 28 out of 150 (18.7%) patients. Conclusion Steroid induce hyperglycemia occurred in 18.7% of the study population. [ABSTRACT FROM AUTHOR]

Toxic epidermal necrolysis (TEN) is an acute, life-threatening cutaneous drug reaction that predominantly involves the skin and mucous membranes. It is a rare disorder and treated as a medical emergency, due to its fatal outcome. The principles of management include immediate removal of culprit drug(s), supportive management and specific drug therapies or procedures, of which plasmapheresis is one treatment modality. We report two patients of TEN, being successfully treated with plasmapheresis, proving it to be a life saving treatment modality. [ABSTRACT FROM AUTHOR]

Objective To determine the learning resources and procedures used for dermatology postgraduate training in Pakistan. Methods Trainees from different centers accredited for dermatology postgraduate training in Pakistan were approached. A pre-designed proforma was filled by 100 dermatology trainees of FCPS, MCPS and MD programs . Results Hundred percent trainees followed Rook’s Textbook of Dermatology as a major learning resource. The most commonly read journal was Journal of American Academy of Dermatology. Scientific conferences had been attended by less than 50% students. Most of the students were participating in clinical case discussions, while clinical slide sessions and histopathology sessions were not being attended by all. Most commonly learnt diagnostic procedure was fungal scraping (92%), least common was immunofluorescence (16%). Out of various therapeutic procedures, electrocautery was being performed by 100% students while dermal fillers and botox injections by none. Conclusion There is a wide variation in exposure of dermatology residents to various learning resources and procedural skills across different teaching units of the country. The most lacking part of training highlighted in this study is the aesthetic or cosmetic aspects of dermatology.Objective To determine the learning resources and procedures used for dermatology postgraduate training in Pakistan. Methods Trainees from different centers accredited for dermatology postgraduate training in Pakistan were approached. A pre-designed proforma was filled by 100 dermatology trainees of FCPS, MCPS and MD programs . Results Hundred percent trainees followed Rook’s Textbook of Dermatology as a major learning resource. The most commonly read journal was Journal of American Academy of Dermatology. Scientific conferences had been attended by less than 50% students. Most of the students were participating in clinical case discussions, while clinical slide sessions and histopathology sessions were not being attended by all. Most commonly learnt diagnostic procedure was fungal scraping (92%), least common was immunofluorescence (16%). Out of various therapeutic procedures, electrocautery was being performed by 100% students while dermal fillers and botox injections by none. Conclusion There is a wide variation in exposure of dermatology residents to various learning resources and procedural skills across different teaching units of the country. The most lacking part of training highlighted in this study is the aesthetic or cosmetic aspects of dermatology.Objective To determine the learning resources and procedures used for dermatology postgraduate training in Pakistan. Methods Trainees from different centers accredited for dermatology postgraduate training in Pakistan were approached. A pre-designed proforma was filled by 100 dermatology trainees of FCPS, MCPS and MD programs . Results Hundred percent trainees followed Rook’s Textbook of Dermatology as a major learning resource. The most commonly read journal was Journal of American Academy of Dermatology. Scientific conferences had been attended by less than 50% students. Most of the students were participating in clinical case discussions, while clinical slide sessions and histopathology sessions were not being attended by all. Most commonly learnt diagnostic procedure was fungal scraping (92%), least common was immunofluorescence (16%). Out of various therapeutic procedures, electrocautery was being performed by 100% students while dermal fillers and botox injections by none. Conclusion There is a wide variation in exposure of dermatology residents to various learning resources and procedural skills across different teaching units of the country. The most lacking part of training highlighted in this study is the aesthetic or cosmetic aspects of dermatology.Objective To determine the learning resources and procedures used for dermatology postgraduate training in Pakistan. Methods Trainees from different centers accredited for dermatology postgraduate training in Pakistan were approached. A pre-designed proforma was filled by 100 dermatology trainees of FCPS, MCPS and MD programs . Results Hundred percent trainees followed Rook’s Textbook of Dermatology as a major learning resource. The most commonly read journal was Journal of American Academy of Dermatology. Scientific conferences had been attended by less than 50% students. Most of the students were participating in clinical case discussions, while clinical slide sessions and histopathology sessions were not being attended by all. Most commonly learnt diagnostic procedure was fungal scraping (92%), least common was immunofluorescence (16%). Out of various therapeutic procedures, electrocautery was being performed by 100% students while dermal fillers and botox injections by none. Conclusion There is a wide variation in exposure of dermatology residents to various learning resources and procedural skills across different teaching units of the country. The most lacking part of training highlighted in this study is the aesthetic or cosmetic aspects of dermatology. [ABSTRACT FROM AUTHOR]

Objective To determine the frequency of dyslipidaemia in psoriatic patients. Methods A cross-sectional study was carried out in the Department of Dermatology, Jinnah hospital, Lahore for the duration of six months. A total of 120 patients suffering from psoriasis, of any severity, belonging to either sex and with age between 15-70 years were included in the study. All patients in the study were investigated for total cholesterol, triglycerides, low-density lipoproteins and high-density lipoproteins after 12-14 hours of overnight fasting. Results The mean age of the patients was 38.59 ± 13.86 years. There were 78 (65%) male and 42 (35%) female patients. The mean duration of psoriasis was 5.46 ± 4.49 years. The mean PASI score was 14.98 ± 8.95. There were 67 (55.8%) patients having dyslipidaemia and 53 (44.2%) patients had normal lipid levels. 34 (28.3%) patients had raised total cholesterol (>200mg/dl), 32 (26.7%) raised low-density lipoprotein-cholesterol (>130 mg/dl), 44 (36.7%) hypertriglyceridemia (>150mg/dl) and 35 (29.2%) patients had reduced high-density lipoprotein-cholesterol levels (<40mg/dl). Conclusion It is concluded from this study that patients of psoriasis have a high incidence of dyslipidaemia, as it was found in 55.8% of psoriatic patients. [ABSTRACT FROM AUTHOR]

Objective To study the epidemiology and clinical features of childhood herpes zoster. Patients and methods The study was carried out from March 2008 till February 2012. Forty two cases of herpes zoster in children less than 12 years of age were enrolled from the outpatient departments of Lahore General Hospital and Jinnah Hospital Lahore. Patients were subjected to detailed history, physical examination and relevant investigations. Results Out of 42 patients with herpes zoster, 57.1 % were males and 42.9 % were females. The mean age was 8 years with an age range of 18 days to 12 years. In most patients a single dermatome was involved (69%) and thoracic dermatome was involved in the majority (40.4%). The most common symptom was pruritus in 52%, followed by pain in 12%. A positive history of previous exposure to varicella was present in 31% patients only, and out of these 61% were exposed before the age of two years. Six patients gave history of chickenpox in mother during pregnancy. Majority of patients i.e. 83.3% showed no evidence of immunosuppression on history, examination and investigations. Three patients were anti-HCV positive (7.1%), two (4.6%) had tuberculosis, one (2.3%) patient was taking steroids and one (2.3%) was diagnosed as leukemia. Conclusion Most of the children with herpes zoster had no obvious evidence of immunosuppression. History of previous exposure to varicella was found in only 31% with majority being exposed below two years of age. Herpes zoster is a relatively mild disease in children with pruritus being the main symptom in 52% and pain occurred in only 12% of cases. [ABSTRACT FROM AUTHOR]

Background Eczema is a pruritic skin disorder of exogenous or endogenous nature. Allergic contact dermatitis is of exogenous nature and can be caused by many allergens including plants. Patients and methods In this quasi-experimental study, 50 patients presenting with extensive eczematous eruption were enrolled. They were patch tested with fresh crushed extract of flowers of Parthenium hysterophorus. Three patch test readings were taken at 48 hours, 72 hours and 120 hours. Patch test readings were read according to ICDRG criteria. Results Forty four (88 %) out of 50 enrolled patients were male while 6 (12%) were female with male to female ratio of 7.3:1. Average age of the patients was 56.8 years with S.D ±12.6 years. Fifty four percent of enrolled patients showed positive patch test reactions to fresh crushed extract of flowers of P. hysterophorus with a male to female ratio of 5.7:1. Conclusion P. hysterophorus is a leading cause of extensive eczematous eruption of exogenous type in a specific group of patients [ABSTRACT FROM AUTHOR]

Werner's syndrome is a rare inherited disorder characterized by short stature, sclerosed skin, cataract and premature aging of the face. The disease involves multiple systems of the body and some of the abnormalities may cause life threatening complications such as myocardial infarction and malignancy. We report a case of this rare disorder. [ABSTRACT FROM AUTHOR]

Background Mucocutaneous manifestations are commonly observed in HIV patients. These range from various opportunistic infections, inflammatory dermatoses to neoplasms and drug reactions. Objective To observe the nature and frequency of mucocutaneous manifestations in patients of HIV, with or without antiretroviral therapy and their correlation with CD4 cell counts. Patients and methods The duration of study was one year, starting from July 2009 to July 2010. The patients were enrolled from the HIV clinic and inpatient departments of Jinnah Hospital Lahore. Patients meeting the inclusion and exclusion criteria were subjected to a detailed history and clinical examination. Investigations were carried out where required. Treatment profile was also noted. The data was recorded on a pro forma and was analyzed later. Results A total of sixty two patients were enrolled in the study. There were 49 (79%) males and 13 (21%) females. The age range was 4 to 58 years. Cutaneous manifestations were seen in 51 (82%) patients. The most common cutaneous findings were fungal infections seen in 33.87% patients, followed by viral infections (29.03%), xerosis (22.58%) and bacterial infections (12.9%). Less common manifestations were photosensitivity, scabies and hyperpigmentation. CD4 cell count was found to be more than 455x109 in 22 patients while it was less than 455x109 in 40 patients. Skin manifestations were found in 19 (86.36%) patients with a high count and in 33 (82.5%) patients with a low count. Conclusion Cutaneous manifestations are commonly seen in patients of HIV infection. [ABSTRACT FROM AUTHOR]

Cornelia de Lange syndrome is a rare developmental disorder characterized by hypertrichosis, low intelligence, delayed milestones and skeletal and dental abnormalities. Gastroesophageal dysfunction, ophthalmologic, cardiac and genitourinary anomalies, learning difficulties, and mental retardation may be present in severe cases. We report a case of this syndrome who presented for laser treatment for the problem of hypertrichosis, and on examination other features of the syndrome were noted. [ABSTRACT FROM AUTHOR]

The authors discuss the implications of the increasing number of women doctors entering the field of dermatology in Pakistan. They cite factors contributing to the gender shift, including dermatology's compatibility with the family life of a female doctor. They also describe problems associated with patients being examined by the opposite gender.