Tuberculosis is a serious infection that affects many people worldwide, with a recent increasing prevalence especially in high-risk patients, such as HIV infection, intravenous drug abuse, diabetes mellitus, immunosuppressive therapy, malignancies, end-stage renal disease, and and/or with multiple comorbidities. Although the incidence of Cutaneous Tuberculosis (CTB) is rare, it should be considered in patients presenting with atypical skin lesions suggestive of an underlying infectious etiology. Most often TB is an airborne transmissible disease with skin manifestations presenting as a result of hematogenous spread or direct extension from a latent or active foci of infection. However, primary inoculation may occur as a direct introduction of the mycobacterium into the skin or mucosa of a susceptible individual by trauma or injury. Although rare, it is important for clinicians to recognize the many clinical variants of CTB to prevent missed or delayed diagnoses. It is imperative that physicians have a high index of suspicion in order to quickly and effectively diagnose and treat these substantially morbid skin conditions. We report here a case with atypical presentation that we saw in our Out Patient Department (OPD). The aim of this communication is to bring to attention this often overlooked, but definitely curable clinical entity. This case report demonstrates the importance of a proper history and physical examination as well as diligent laboratory and diagnostic testing in determining the etiology of a suspicious and treatment-resistant skin lesion. Prompt consideration leads to a swift diagnosis and proper treatment resulting in high patient satisfaction.
Introduction As the Human Immunodeficiency virus/ Acquired Immunodeficiency Syndrome (HIV/AIDS) continue to advance worldwide, sexually transmitted infections (STIs) rates remain high in much of the world. Each year about 330 million new cases of STIs occur, of which more than 90% are in developing countries. Prevalence of HIV in people effected with STIs is 10 times more as compared to general population i.e. 10%. Objectives To determine the frequency of HIV in patients who are presenting for the treatment of STIs in dermatology department of tertiary care hospital. Methods A descriptive cross-sectional study was conducted in the Department of Dermatology, KEMU/Mayo Hospital, Lahore in collaboration with Punjab AIDS Control Program (PACP). Study was carried out over a period of six months from 20-12-2016 to 19-06-2017. A total of 285 patients were included in the study. Whole blood sample was taken and tested for HIV using kit provided by PACP. Patients were also evaluated and investigated for the type of their STI and medications given for treatment of their STIs. HIV was confirmed by ELISA and they were referred to HIV clinic Mayo hospital, Lahore for further management. Results Mean age of the patients was 30 years. There were 153 males (53.7%), 121 females (42.5%) while 11 patients (3.8%) were hijras. Married patients were 55% and 45% patients were unmarried. Sexual orientation vise there were 8.8% homosexuals, 87.7% heterosexuals and 3.5% bisexuals. Out of 285 patients, 34% used condoms. History of blood transfusion was found in 4%. History of IV drug abuse was given by 5%. Types of STIs were as follows: warts 36%, secondary syphilis 20%), scabies 20%, tinea cruris 9%, vaginal discharge 11%), gonorrhoea 2%), and genital herpes 3%). Majority of the patients (88%) had 1-4 sexual partners. HIV positive patients found among these patients with STIs were 24 (8%). Conclusion In conclusion, the frequency of HIV among patients with STIs was 8%. To prevent HIV/STIs, campaigns promoting condom use are needed to boost the frequency of condom use.
Objective To assess the awareness, perceptions and practices towards acne vulgaris among acne patients. Methods The cross-sectional study was conducted on 100 patients of acne vulgaris visiting Dermatology outpatient department of Bahawal Victoria Hospital, Bahawalpur. Results In this study conducted on 100 patients, 72% were females and 28% were males. Out of 100 patients, only 10% were married. 30% belonged to rural areas and 70% had urban background. 53% of the participants having acne were students. Eighty-six (86%) had good knowledge and 14 (14%) had poor knowledge. Forty- eight percent participants were in favor of using traditional medicine on acne and 86% consulted doctor. Majority of patients 52% did not answer self-care questionnaire. Conclusion The present study showed that patients suffering from acne had poor practice and unfavorable attitude inspite of good knowledge.
Objective To determine the frequency of the skin diseases in patients attending dermatology OPD in a tertiary care Hospital in Faisalabad. Materials and Methods It is a descriptive study carried out from 1st September.2019 to 29th February 2020 for the period of six months. It was carried out on patients attending dermatology OPD at Aziz Fatima Hospital Faisalabad which is a tertiary care hospital affiliated with Aziz Fatima Hospital Faisalabad. Total of two thousand eight hundred seventy nine patients were enrolled after informal consent. Study was based on the newly diagnosed cases presenting in dermatology OPD, irrespective of age and sex. The diseases were diagnosed clinically and relevant investigations were carried out at laboratory of hospital. History and Physical examination was recorded on a predesigned standared proforma and analysed through computer Microsoft SPSS. Biochemical tests were carried out where needed. Skin biopsy and histopathology was carried out in selected cases where diagnosis was proved or otherwise. All the data was recorded and analyzed by SPSS software to assess the burden of these diseases in our setup and finally comparison was made with different studies. Results A total of 2879 patients were enrolled in the study from 1st September 2019 to 29th February 2020 for a period of six months. It include 1928 female patients (66.97%) and 951 male patients (33.03%), female to male ratio was 2:1 approximately. A general classification into infective and non infective groups was categorized. All the diseases were broadly divided in to infective and non infective groups. Infective group comprised of 1288(44.73%) and non infective group consists of 1592 patients.ie55.27%. Acne was most common (n=489 ie.16.98%) non infective disease. Scabies was (n=873 ie.30.32%) among the infective group. Conclusion Our study found the higher incidence of non-infective disease i.e. n= 1591(55.27%) and acne was most common disorder (n=489 i.e. 16.98%) and among infective disorder (n=1288 i.e. 44.73%) scabies was most common n=873 i.e30.32%.
Introduction The incidence of human immunodeficiency virus (HIV) infection, is increasing in Pakistan. Seborrheic dermatitis (SD) can be seen in patients having HIV infection, so it can be a marker of disease diagnosis and progression. Objective To see the occurrence of HIV infection in patients with SD. Methods A prospective study was conducted in Dermatology Department, DHQ teaching hospital, University Medical Complex and Research Center, Sargodha, from September, 2019-February, 2020. Two hundred and eighty-five cases of SD diagnosed clinically were taken and serological examination for HIV by rapid diagnostic test was done on all cases. Data analysis were done by Statistical Package for the Social Sciences (SPSS) Version 20 and expressed as frequency and percentage. Results In 285 cases of SD majority (53.6%) were males. Ages of patients ranged from 8 months to 60 years. Out of the 31 patients positive for HIV, 25 were males and rest were females. Majority of HIV positive cases (70.96%) had severe SD. Conclusion SD is a dermatological manifestation of HIV infection. As in developing countries like Pakistan with limited health facilities it is difficult to have CD4+ counts done, skin examination should be an important tool for assessing immune status and management of HIV positive patients.
