Publications by authors named "Nadia Iftikhar"

19 Publications

  • Page 1 of 1

Malignant Acanthosis Nigricans: An Indicator of Internal Malignancy.

J Coll Physicians Surg Pak 2019 Sep;29(9):888-890

Department of Dermatology, Pak Emirates Military Hospital, Rawalpindi, Pakistan.

Acanthosis nigricans is a skin disease characterised by symmetric velvety hyperpigmented, verrucous plaques of the intertriginous surfaces of the axilla, neck, inframammary, and mucocutaneous regions. Malignant acanthosis nigricans is a paraneoplastic phenomenon most commonly associated with gastric adenocarcinoma. Tripe palms, florid cutaneous papillomatosis and oral involvement along with generalised acanthosis nigricans are the features which are highly suggestive of internal malignancy. This case report describes a rare case of a patient who presented with combination of malignant acanthosis nigricans, tripe palms, florid cutaneous papillomatosis and oral involvement associated with undifferentiated malignant neoplasm of hepatic bile ducts.
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http://dx.doi.org/10.29271/jcpsp.2019.09.888DOI Listing
September 2019

Intertriginous eruption induced by terbinafine: a review of baboon syndrome.

Int J Dermatol 2017 Jan 6;56(1):100-103. Epub 2016 May 6.

The Practice Heart of Hounslow, Hounslow, London, UK.

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http://dx.doi.org/10.1111/ijd.13292DOI Listing
January 2017

HLA- DR Alleles in Pakistani Patients of Pemphigus Vulgaris.

J Coll Physicians Surg Pak 2015 Apr;25(4):233-6

Department of Immunology, Armed Forces Institute of Pathology (AFIP), Rawalpindi.

Objective: To determine frequency of HLA-DR alleles in Pakistani patients of pemphigus vulgaris in comparison with local healthy controls.

Study Design: Cross-sectional, comparative study.

Place And Duration Of Study: Department of Immunology, Armed Forces Institute of Pathology (AFIP), Rawalpindi, from January 2011 to January 2014.

Methodology: Twenty eight patients with biopsy proven diagnosis of pemphigus vulgaris referred from Department of Dermatology, Military Hospital, Rawalpindi were included. Patients were compared with a group of 150 unrelated local healthy subjects. DNA was extracted from peripheral blood collected in Tri-potassium EDTA. HLA-DRB1 typing was carried out on allele level (DRB1*01--DRB1*16) using SSP (sequence specific primers). HLA type was determined by agarose gel electrophoresis and results recorded. Phenotype frequency of various alleles among patient group and control group was calculated by direct counting and significance of their association was determined by Fisher's exact test/ Chi square test.

Results: A total of 12 male and 16 female patients, with age ranging from 21 to 34 (mean 23.4 years) were genotyped for HLA-DRB1 loci. A statistically significant association of the disease with HLA-DRB1*04 was observed (50% versus 20.7% in controls, p < 0.05).

Conclusion: There is a strong association of HLA-DRB1*04 with pemphigus vulgaris in Pakistani population.
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http://dx.doi.org/04.2015/JCPSP.233236DOI Listing
April 2015

Efficacy of clarithromycin in pityriasis rosea.

J Coll Physicians Surg Pak 2014 Nov;24(11):802-5

Department of Dermatology, Avicenna Medical College, Lahore.

Objective: To determine the efficacy of clarithromycin in the treatment of Pityriasis Rosea (PR).

Study Design: Double blind randomized controlled trial.

Place And Duration Of Study: Dermatology OPD, Military Hospital, Rawalpindi, from July 2008 to July 2009.

Methodology: Patients aged above 10 years, diagnosed with PR, were randomly assigned to two groups of 30 each to receive either clarithromycin or similar-looking placebo for one week. Neither the patient nor the treating physician knew to which group the patient belonged. Patients were assessed at 1, 2, 4 and 6 weeks after presentation and compared for complete, partial or no response.

Results: Among the 60 patients, no significant difference was found between the two groups at 2 weeks after presentation (p = 0.598). In the placebo group, complete response was seen in 20 (66.7%), partial response in 3 (10.0%) while no response was seen in 7 (23.3%). In clarithromycin group, there was complete response in 23 (76.7%), partial response in 3 (10.0%) and no response in 4 (13.3%) patients.

Conclusion: Clarithromycin is not effective in treatment of pityriasis rosea.
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http://dx.doi.org/11.2014/JCPSP.802805DOI Listing
November 2014

Adams-Oliver syndrome.

J Coll Physicians Surg Pak 2014 May;24 Suppl 2:S76-7

Department of Dermatology, Rehman Medical College, Peshawar.

A new-born male baby with typical features of Adams-Oliver syndrome (AOS) is described. Adams-Oliver syndrome is the association of aplasia cutis congenita with terminal transverse limb reduction defects with or without cutis marmorata telangiectatica congenita. The patient presented with brachydactyly involving all the digits of his hands and shortening of both big toes along with aplasia cutis on the scalp. There was no systemic involvement. The patient was placed on regular follow-up.
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http://dx.doi.org/05.2014/JCPSP.S76S77DOI Listing
May 2014

Scleroderma renal crisis in a newly diagnosed mixed connective tissue disease resulting in dialysis-dependent chronic kidney disease despite angiotensin-converting enzyme inhibition.

CEN Case Rep 2013 May 28;2(1):41-45. Epub 2012 Sep 28.

RIPAS Hospital Brunei Darussalam, Bandar Seri Begawan, Brunei.

Mixed connective tissue disease (MCTD) is a rheumatic disease with a combination of multiple connective tissue disorders, which includes dermatomyositis or polymyositis, systemic sclerosis, systemic lupus erythematosus, rheumatoid arthritis and Sjögren's syndrome. It affects various organs of the body, which includes the lungs, heart, kidneys, joints, muscles and the haematological system. Here, we report a case of MCTD consisting of scleroderma, Sjögren's syndrome and polymyositis complicated by scleroderma renal crisis (SRC) but with negative anti-nuclear antibody (ANA), anti-Scl 70 and anti-centromere antibodies. The patient was started on captopril for the treatment of SRC but developed chronic kidney disease despite adequate blood pressure control with angiotensin-converting enzyme inhibitor (ACEi).
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http://dx.doi.org/10.1007/s13730-012-0036-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5413725PMC
May 2013

Pseudoainhum in acute psoriasis.

J Coll Physicians Surg Pak 2012 Dec;22(12):786-8

Department of Dermatology, Military Hospital, Rawalpindi.

The term Pseudoainhum is used in medical literature to elaborate the presence of constricting bands around the digits of hands and feet due to variety of etiologies. This phenomenon can lead to irreversible damage to the supplying neurovasculature and sequential autoamputation of the affected digits. The report herein, describes the rare presentation of pseudoainhum occurring concomitantly in acute psoriasis. Timely recognition of such rare disease entities by physicians is imperative to avoid unnecessary complications.
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http://dx.doi.org/12.2012/JCPSP.786788DOI Listing
December 2012

Aplasia cutis congenita associated with azathioprine.

J Pak Med Assoc 2009 Nov;59(11):782-4

Department of Dermatology, Military Hospital, Rawalpindi.

Aplasia cutis congenita is a rare skin condition characterized by the absence of localized or widespread areas of skin at birth. We are reporting a variant aplasia cutis congenita, which involved over 90% of the body surface area, which occurred in a baby born to a mother with pemphigus vulgaris who was on oral prednisolone and azathioprine. A case of extensive aplasia cutis congenita was seen and oral intake of azathioprine by the mother during pregnancy was suspected as an etiologic factor. The parents of the patient did not consent for biopsy or autopsy so the histopathological picture was not available and hence involvement of other systems could not be ascertained. Due, to financial constraints some of the investigations which might have helped in assigning the patient to a particular category of aplasia cutis such as karyotyping and CT scan brain could not be carried out.
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November 2009

Vitiligo appearing in striae distensae as a Koebner phenomenon.

J Coll Physicians Surg Pak 2009 Dec;19(12):796-7

Department of Dermatology, Military Hospital, Rawalpindi.

Koebner phenomenon, the appearance of preexisting skin lesions following trauma to previously uninvolved skin, has been seen frequently with vitiligo. The type of trauma leading to Koebner phenomenon can vary from scratching, surgical scars, radiotherapy, burns, irritation from drug use and laser therapy. Striae distensae are a form of injury to the skin and in this particular case resulted from rapid increase in body size at puberty and possibly the use of systemic steroids for the treatment of vitiligo. The appearance of vitiligo in striae distensae as a form of Koebner phenomenon has been reported rarely. We describe a 14-year-old boy with vitiligo for the past 2 years, which Koebnerized in the striae distensae.
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http://dx.doi.org/12.2009/JCPSP.796797DOI Listing
December 2009

Patterns of psoriatic arthritis.

J Coll Physicians Surg Pak 2009 Sep;19(9):553-6

Department of Dermatology, Combined Military Hospital, Kharian Cantt.

Objective: To describe the clinical patterns of arthritis in psoriasis.

Study Design: Cross-sectional, observational study.

Place And Duration Of Study: Combined Military Hospital, Kharian Cantonment, Pakistan, from January to December 2007.

Methodology: One hundred consecutive patients with psoriasis reporting to dermatology outpatient department were included. Pregnant ladies (due to X-ray hazard) and rheumatoid factor positive patients were excluded. The demographic profile of patients was recorded. Psoriatic arthritis was diagnosed on the basis of Moll and Wright criteria. Standardized examination of axial and peripheral joints was made. The severity of psoriasis was assessed by PASI score. The presence of a clinical type of psoriatic arthritis, enthesitis, dactylitis, and nail changes were noted. X-ray films of involved joints were taken. A statistical analysis using chi-square test and student's t-test were done where applicable.

Results: The mean age of patients was 39.8+15.8 years. Seventy one percent were males and 29% were females. Forty six percent of the patients gave a history of joint involvement and fulfilled the Moll and Wright criteria. The mean PASI score in non-arthritic patients was 26.8+34.8 and in psoriatic arthritis patients it was 28.4+41.2, p=0.08. Thirteen patients (28.2%) had predominantly axial disease, while the rest had predominantly peripheral disease. Single joint involvement (monoarthritis) was the commonest clinical presentation. Nail involvement was seen in 29% of the patients without arthritis while in patients having arthritis, nail involvement was 74% (p=0.001).

Conclusion: Joint involvement is common in psoriatic patients. However, the criteria of diagnosis lack consensus.
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http://dx.doi.org/09.2009/JCPSP.553556DOI Listing
September 2009

Presentation of early onset psoriasis in comparison with late onset psoriasis: a clinical study from Pakistan.

Indian J Dermatol Venereol Leprol 2009 Jan-Feb;75(1):36-40

Combined Military Hospital, Kharian Cantonment, Pakistan.

Background: Early onset psoriasis and late onset psoriasis are known to have different clinical patterns in Caucasian population. However, there is paucity of data among Asian patients.

Aims: To compare the clinical presentation of early onset psoriasis with late onset psoriasis in Pakistani population.

Methods: During the study period, participating dermatologists filled a pre-tested questionnaire for each patient with psoriasis on first encounter. The questionnaire incorporated information regarding clinical and demographic features of psoriasis including age of onset, clinical type of psoriasis, nail or joint involvement, and PASI score. Patients were then divided into early onset (age of onset < 30 years, group I) and late onset (age of onset > or =30 years, group II) psoriasis.

Results: Five hundred and fifteen questionnaires were filled and returned for evaluation. There was no statistically significant difference in both groups with regards to gender, family history (P = 0.09), nail (P = 0.69) and joint (P = 0.74) involvement, disease severity (P = 0.68), and clinical type of psoriasis (P = 0.06). No significant difference between disease severities measured by PASI score was observed in the two groups (P = 0.68). Presence of nail involvement was associated with joint disease in both groups (odds ratio 2.8, confidence interval 1.9-4.1).

Conclusion: Patients with early and late onset psoriasis in Pakistani population do not show different clinical and demographic features contrary to the Western patients.
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http://dx.doi.org/10.4103/0378-6323.45218DOI Listing
November 2009

Comparison of 30% salicylic acid with Jessner's solution for superficial chemical peeling in epidermal melasma.

J Coll Physicians Surg Pak 2008 Apr;18(4):205-8

Department of Dermatology, Combined Military Hospital, Kharian Cantonment.

Objective: To compare the efficacy and safety of Jessner's solution with 30% salicylic acid as superficial chemical peeling agents in treating epidermal melasma in Asian skin.

Study Design: Double blind, randomized, interventional comparative study.

Place And Duration Of Study: Department of Dermatology, Combined Military Hospital, Malir Cantt, Karachi, from January to December 2004.

Patients And Methods: Sixty consenting patients with epidermal melasma were randomly divided into two groups. Group A was treated with Jessner's solution and Group B with 30% salicylic acid. Baseline Melasma Area Severity Index (MASI) score was noted and peeling started at 2-weekly intervals. Sunscreen in morning and moisturizer at night were prescribed in all patients. MASI score and adverse effects were recorded biweekly. Treatment was stopped at 12 weeks and patients were followed-up at 4 weekly intervals for further 12 weeks. Final MASI score and adverse effects were noted at the end of follow-up period. Mean MASI scores were compared using paired sample t-test and one-way ANOVA.

Results: Difference in baseline, treatment end and follow-up end MASI scores was not statistically significant between the two groups (p 0.54, 0.26, and 0.55 respectively). On the other hand, within group analysis of difference between pre and posttreatment MASI score was highly significant in both groups (p<0.0001). Adverse effects were mild and comparable in both groups.

Conclusion: Jessner's solution and 30% salicylic acid are equally effective and safe peeling agents for use in epidermal melasma in Asian skin.
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http://dx.doi.org/04.2008/JCPSP.205208DOI Listing
April 2008

Keratosis follicularis spinulosa decalvans associated with acne keloidalis nuchae and tufted hair folliculitis.

Am J Clin Dermatol 2008 ;9(2):137-40

Ayza Skin & Research Center, Lalamusa, Pakistan.

Keratosis follicularis spinulosa decalvans is a rare, X-linked disorder characterized by scarring alopecia of the scalp and eyebrows in the setting of widespread keratosis pilaris. Less frequent associations are ocular abnormalities and palmoplantar keratoderma. Acne keloidalis nuchae has previously been described in one patient with keratosis follicularis spinulosa decalvans. We report another case of keratosis follicularis spinulosa decalvans with acne keloidalis nuchae and tufted hair folliculitis, thus further establishing this association.
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http://dx.doi.org/10.2165/00128071-200809020-00009DOI Listing
April 2008

Dermatologic, periodontal, and skeletal manifestations of Haim-Munk syndrome in two siblings.

J Am Acad Dermatol 2008 Feb;58(2):339-44

Ayza Skin and Research Center, Lalamusa, Pakistan.

Haim-Munk syndrome is an extremely rare autosomal recessive disorder of keratinization characterized clinically by palmoplantar hyperkeratosis, severe early onset periodontitis, onychogryphosis, pes planus, arachnodactyly, and acro-osteolysis. Recently, germline mutations in the lysosomal protease cathepsin C gene have been identified as the underlying genetic defect in Haim-Munk syndrome and in the clinically related disorders, Papillon-Lefèvre syndrome and prepubertal periodontitis.
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http://dx.doi.org/10.1016/j.jaad.2007.08.004DOI Listing
February 2008

Dicaprylyl maleate--an emerging cosmetic allergen.

Contact Dermatitis 2007 Sep;57(3):169-72

Department of Dermatology, Southampton University Hospitals Trust, Southampton, UK.

Dicaprylyl maleate (DCM) has been reported rarely as a cause of allergic contact dermatitis. The objectives of this study were to identify patients from multiple centres with allergy to DCM in cosmetic products confirmed by patch testing and, in addition, to investigate the effect of testing with aged DCM. This is an international multicentre study of 22 patients with 26 reactions to products containing DCM. Patch testing was carried out to ingredients including DCM obtained from the manufacturer. Further testing was carried out with deliberately aged DCM in a sample of patients. 22 patients had clinical and positive patch test reactions at 4 days to a total of 26 cosmetic products containing DCM. 5 patients did not react to DCM prepared by the manufacturer from concurrent factory stock but did have positive reactions to a deliberately aged batch of DCM. DCM is an emerging cosmetic allergen. Testing with aged material yields a greater number of positive results. Co-operation between cosmetics manufacturers and clinicians is important in the identification of new allergens.
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http://dx.doi.org/10.1111/j.1600-0536.2007.01184.xDOI Listing
September 2007

Recurrent cutaneous leishmaniasis presenting as sporotrichoid abscesses: a rare presentation near Afghanistan border.

Dermatol Online J 2007 May 1;13(2):15. Epub 2007 May 1.

Combined Military Hospital, Kharian Cantt, Pakistan.

Cutaneous leishmaniasis caused by Leishmania tropica and Leishmania major is endemic in Pakistan and is the second most prevalent vector-borne disease in the country (after malaria). We report a case of non-ulcerating, sporotrichoid cutaneous leishmaniasis that recurred 2 years after successful treatment of two typical leishmaniasis ulcers. The patient came from Kohat, a border town in the northwestern region of Pakistan about 50 miles east of Afghanistan. It is important for physicians to be familiar with unusual presentations of this common condition.
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May 2007

Rare variants of Cutaneous Leishmaniasis: whitlow, paronychia, and sporotrichoid.

Int J Dermatol 2003 Oct;42(10):807-9

Department of Dermatology, Military Hospital, Rawalpindi, Pakistan.

Cutaneous Leishmaniasis is endemic in certain areas of Pakistan, with the wet form of the disease being the most prevalent. It has a number of morphological variants, which are dependent on the immune status of the host, the subspecies of the Leishmania, and also, to some extent, on the site of involvement. We describe here a case of Leishmaniasis showing two very rare variants, whitlow and paronychial lesions, occurring concurrently with sporotrichoid spread. The patient responded to intramuscular sodium stibogluconate with resolution of the skin lesions.
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http://dx.doi.org/10.1046/j.1365-4362.2003.02015.xDOI Listing
October 2003

Bilateral symmetrical herpes zoster in an immunocompetent patient (Herpes zoster duplex symmetricus).

J Coll Physicians Surg Pak 2003 Sep;13(9):524-5

Department of Dermatology, PAF Hospital, Sargodha, Pakistan.

Herpes zoster is a common disease of adulthood. Its incidence is low in childhood and adolescence. Certain risk factors like hematological malignancies or immunosuppression due to any cause may lead to onset at an early age. There is a unilateral appearance of grouped vesicular eruption on an erythematous background which may involve contiguous dermatomes. Rarely the lesions may occur bilaterally in an otherwise healthy individual. We present a case of herpes zoster, with lesions having atypical distribution involving bilaterally symmetrical dermatomes over the lower chest.
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http://dx.doi.org/09.2003/JCPSP.524525DOI Listing
September 2003