Comparative Efficacy of Intralesional Chloroquine With Intralesional Meglumine Antimoniate in the Treatment of Cutaneous Leishmaniasis.

BACKGROUND AND AIM: This comparative prospective study was conducted at the Department of Dermatology, Pak Emirates Military Hospital, Rawalpindi, from August 1, 2018, to January 31, 2019 (six months). This study aimed to compare the efficacy of intralesional chloroquine with intralesional meglumine antimoniate in the treatment of cutaneous leishmaniasis. MATERIALS AND METHODS: A total of 64 patients fulfilling the inclusion criteria reporting to the Department of Dermatology, Pak Emirates Military Hospital were included in this study. Informed consent was taken and demographic data including patients' hospital registration number, age, gender, and number of lesions were noted. The subjects were randomly assigned into two groups. In group A, intralesional chloroquine was injected two times per week, and in group B, intralesional meglumine antimoniate was injected two times per week. The efficacy of both treatments was noted after eight weeks of treatment. Frequency and percentages were computed for qualitative variables like gender and number of lesions. Mean±standard deviation was presented for quantitative variables like age. Analysis was done to compare the proportion of both groups. Chi-square test was applied to compare the efficacy of both groups, p≤0.05 was taken as significant. RESULTS: In this study, the mean age of patients was 29.69±08.95 years. There were 63 (98.44%) males and one (1.56%) female. In this study, efficacy was achieved in six (18.8%) patients in group A, while in 17 (53.1%) patients in group B. This difference was statistically significant, i.e., p=0.004. CONCLUSION: This study concluded that intralesional meglumine antimoniate is more effective in treating cutaneous leishmaniasis than intralesional chloroquine.

To Compare Efficacy Between Cryotherapy And Mitomycin Microneedling For The Treatment Of Plantar Warts.

BACKGROUND: Cryotherapy is a common destructive treatment modality for treating plantar warts that results in blistering and scarring. Mitomycin an antitumor drug with antiviral property is a safe, better and a promising option for treating plantar warts. Objective was to compare efficacy of cryotherapy and mitomycin microneedling in the management of plantar warts. It was a randomized controlled trial conducted at the Skin Department CMH Abbottabad from 1st May to 31st December 2021. METHODS: The study included 60 patients with plantar warts. Each group with 30 patients. Random tables were used to determine the distribution of patients within each group. Group A received mitomycin microneedling (1u/ml) repeated every 3 weeks. Group B was prescribed liquid nitrogen cryotherapy. The freeze-thaw cycle was 20 secs and repeated every 2 weeks. Both groups were treated for 4 months duration. For analysis of data, SPSS version 21.0 was used. Efficacy was compared by the application of Chi-square test between the two groups. p<0.05 was considered statistically significant. RESULTS: Mitomycin microneedling completely cured 76.7% of patients, while cryotherapy was effective for only 56.7%. Complete remission was observed after two to three sessions of mitomycin microneedling while average of 4 sessions of cryotherapy were required for complete remission. In general, microneedling with mitomycin had better tolerance, pain being the commonest adverse effect. CONCLUSIONS: Plantar warts can be effectively treated with mitomycin microneedling. Treatment of plantar warts with this method is more effective, requires fewer sessions, and may take less time to complete.

Comparative Study Between Intralesional Injection Of Platelet Rich Plasma And Intra Lesional Triamcinolone For The Treatment Of Alopecia Areata.

BACKGROUND: Alopecia areata is an autoimmune disorder of patchy non scarring hair loss. Steroids, either Intralesional, e.g, triamcinolone or potent topical, e.g, clobetasol are the first line treatment. Platelet rich plasma is an autologous concentrated plasma with growth factors which enhances regeneration of hair follicles. It is simple and effective treatment with no major side effects. Objective was to compare the efficacy of intralesional injection of platelet rich plasma and triamcinolone in patients of alopecia areata. It was a randomized controlled trial (open-labelled), conducted at the Dermatology Department, Combined Military Hospital Abbottabad from 1st May to 31st December 2021. METHODS: Sixty clinically diagnosed patients of alopecia areata of the scalp were enrolled in the study. They were divided into two groups, A and B. Random numbers table was used to allocate 30 patients into each group. Group A patients were given an intralesional injection of triamcinolone while intralesional platelet rich plasma was given to Group B. Both treatments were repeated at one-month intervals for four months. In the study, Chi-square tests were used to compare effectiveness. It was considered significant when the p-value turned out to be <0.05.. RESULTS: There was significant difference in complete response rate between intralesional injection of steroid and intralesional injection of platelet rich plasma. Platelet rich plasma was less effective (p =0.05). Local corticosteroid injection was significantly more effective than platelet rich plasma (p<0.05). CONCLUSIONS: Intralesional injection of steroid is an effective and considerable treatment for alopecia areata. This study also proposes intralesional injection of platelet rich plasma as an alternative therapy for alopecia areata as it is not associated with serious local side effects.