Search

Objective: This study was designed to determine the impact of COVID-19 on treatment compliance and mental health (anxiety and depression) in psoriasis patients. Methods: A descriptive cross-sectional study was undertaken in the Department of Dermatology at York teaching Hospital from April to August 2020. One hundred and eleven patients diagnosed with psoriasis were asked to complete a questionnaire (HADS). Patients were also asked about their compliance or self-modifications in their treatment regime due to fear of Covid-19. Using SPSS version 26.0 all of the collected data was analysed together. Results: 40 patients (36.03%) had depression and 52 patients (46.84%) anxiety on the basis of their HADS score. Twenty patients (18.01%) stopped treatment due to concerns regarding COVID-19. Prevalence of anxiety was more in female patients and those on traditional immuno-suppressants as compared to biological treatment or those receiving topical treatment only. Conclusion: Depression and anxiety are common in patients with psoriasis. Female patients and those on systemic medications are worse affected compared to patients on topical treatment or those receiving phototherapy. Fear of COVID-19 has led to 18% of patients self-stopping their treatment altogether. Keywords: Psoriasis, Mental Health, Covid-19, Compliance

Objective: To assess patient and observer reported scar quality after Basal cell carcinoma surgery of face using the Patient and Observer Scar Assessment Scale (POSAS). Study Design: Quasi experimental study. Place and Duration of Study: Dermatology Department, Tertiary Care Hospitals at Multan and Karachi and Plastic Surgery Department, Tertiary Care Hospital Multan, from Apr to Sep 2020. Methodology: Patients with basal cell carcinoma that full filled inclusion and exclusion criteria were enrolled by consecutive sampling technique at Dermatology and Plastic Surgery Department after informed consent. Surgical excision was followed by reconstruction of defect either by direct closure or by rotation or advancement flap. Surgical scar was assessed independently at 8 weeks by POSAS. Data was analyzed with SPSS-23. Results: A total of 27 patients were enrolled in study. There were 11 (37.9%) males and 16 (59.25%) females between ages of 45-70 years. Basal cell carcinoma was located on cheek in 15 (55.5%), nose in 9 (33.3%), temple 2 (7.4%) and forehead 1 (3.7%) cases. Direct closure was performed in 6 (22.2%), rotation flaps in 10 (40.7%), and advancement flaps in 11 (40.7%) cases. Mean score of observer opinion about surgical scar between different surgical techniques was not statistically significant (p=0.191). How-ever, mean score of patient opinion of scar between different surgical techniques was statistically significant (p=0.032). Conclusion: POSAS is a valid tool for scar evaluation by patient and observer-reported scar qualities after Basal cell carcinoma surgery.

Patient suffering from psoriasis can be severely affected in their day to day activities and it may also result in reduced work efficiency and absenteeism from work leading to financial burden on the patient's family. This study was conducted using Dermatology Life Quality Index to assess the quality of life of a patient suffering from psoriasis being treated at a military hospital.This cross-sectional study was conducted in the outpatient unit of Department of Dermatology, Combined Military Hospital Abbottabad from 1st October 2013 to 31stJune 2014. The demographic data and Dermatology Life Quality Index of patients of psoriasis were recorded using a standard questionnaire and their final score was calculated to assess the effect of disease on patient's life. Extent/ severity of disease were assessed according to the body surface area involved. The data was analysed using SPSS- 18. Mean and SD for numerical variables and frequencies and percentages for categorical were calculated.A total of 160 patients fulfilling the inclusion criteria were included in the study. Mean age of the patients was 40.48 years (±12.58 years) with minimum age of 18 years and maximum of 74 years. 118 patients were males were (73.8%) and 42 were females (26.2%). Twenty (12.5%) patients had no effect on their life by the disease while 5 (3.1%) had extremely large effect. Most patients, i.e., 68 (42.5%) had moderate effect on their lives. 69 patients had mild psoriasis as per body surface area involved, 70 had moderate disease and 21 had severe disease.Psoriasis affects quality of life of patients not only physically but also psychologically and financially even when patients are under treatment. Psychological aspects also need to be addressed while treating the physical morbidity.

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.

Psoriasis is a common, chronic, disfiguring, inflammatory and proliferative condition of skin manifested by red, scaly, sharply demarcated, indurated plaques present particularly over the extensor surfaces and scalp. The disease has been found to be associated with celiac disease related antibodies with variable frequencies in different populations of the world. The subset of patients showing this association have a higher psoriasis severity and also respond well to cost effective way of gluten free diet. There is a need to work out the frequency of these antibodies in our local psoriatic patients.The study was carried out in Department of Dermatology, Military Hospital Rawalpindi from 4th June to 4th December, 2008. A total of 80 patients of both gender, aged more than 15 with a clinical diagnosis of psoriasis attending dermatology outpatient department were selected. Relevant history and thorough physical examination was performed and disease characteristics like previous treatments received and history of arthropathy were obtained. Coeliac disease related antibodies were assessed on serum by indirect immunofluorescence and data was analysed using software SPSS-13.From the study of 80 patients, celiac disease related antibodies were found in none of the cases. All the severe and mild to moderate patients of psoriasis were negative for IgA antigliadin antibodies, IgG antigliadin antibodies and IgA anti-reticulin antibody.This study concludes that celiac disease related antibodies are not present in psoriatic patients irrespective of severity of disease in our local population.