Cicatricial pemphigoid (CP) is a subepidermal, autoimmune bullous dermatosis. It is classified as a clinical subset of bullous pemphigoid (BP). However, it differs from BP in some significant ways: (i) in CP mucosal involvement with clinical scarring is prominent; (ii) there is a prominent IgA class antibody response alone or in addition to the IgG class antibody response; and (iii) there is a heterogeneous antibody response in CP, whereas in BP the majority of the antibodies are directed against a 180-kDa hemidesmosomal protein, bullous pemphigoid antigen 2 (BPAg2). Oesophageal involvement in CP is a rare, but often devastating manifestation. In this study we examined the humoral autoimmune response in oesophageal CP, in an attempt to characterize the autoantibody reactivity profile. We used direct and indirect immunofluorescence and Western immunoblotting using normal human skin and oesophagus substrates. We studied patient sera over time in order to search for evidence of epitope spreading in these patients. All patients had positive direct immunofluorescence of perilesional oesophageal epithelium. All patients had positive circulating antibasement membrane zone autoantibody titres. There was a significant IgA class in addition to an IgG class autoantibody response. IgA and IgG antibodies demonstrated significant reactivity with BPAg2 and the 97 kDa linear IgA disease antigen on Western immunoblot suggesting intraprotein epitope spreading. There was no evidence of interprotein epitope spreading over time. Our findings suggest that there is a heterogeneous antibody response in oesophageal CP with the predominant antigen being BPAg2.

Objective: To compare the efficacy of intradermal platelet-rich-plasma vs. intradermal tranexamic acid in treatment of melasma. Study Design: Non-randomised controlled trial.

Objective: To compare the efficacy of intra-dermal platelet rich plasma (PRP) versus 50% trichloracetic acid (TCA) using chemical reconstruction of skin scars (CROSS) technique in the treatment of atrophic acne scars. Study Design: Non-randomised controlled trial.

No abstract

Background: Wart is a viral skin infection. Its etiological agent is human papilloma virus. It is composed of non-malignant proliferations of keratinocytes. Different regimens have been tried for the treatment of warts. 35% Trichloroacetic acid (TCA) is used conventionally but 10% KOH has shown promising results. Objective: To compare the efficacy of topical 35% Trichloroacetic acid (TCA) versus topical 10% Potassium Hydroxide (KOH) in the treatment of palmoplantar warts in children up to 12 years of age. Methods: A total of 148 cases of palmoplantar warts with age between 3-12 years of either gender were enrolled in the study. These cases were divided into two groups (A and B each having 74 patients). The patients in group A were treated with topical 35% TCA and Group B patients were treated with topical 10% KOH. Patients were followed weekly for 8 weeks for treatment and for further 8 weeks to look for recurrence. Final outcome was seen at 16 weeks. The efficacy was labelled as yes in cases with clearance of all disease lesions. Results: In this study overall patients were 148 with 74 cases in each group. Group A had 36 (48.65%) males and group B had 37 (50%). The mean age in group A was 7.42±2.48 and in group B was 7.81±2.50 years. Group A had 44 (59.46%) cases and group B had 47 (63.51%) cases, with age range of 8-12 years. The efficacy in group A was seen in 28 (37.84%) of cases while in group B it was seen in 57 (77.03%) cases. There were significantly better results seen in group B as compared to group A in terms of efficacy with p= 0.0001. Conclusion: The efficacy of 10% KOH is significantly better than 35% TCA and this difference is again significantly better in terms of all the confounding variables i.e. age, site, size and duration of warts. Keywords: Warts, Human Papilloma Virus, 10% Potassium Hydroxide, 35% Trichloroacetic Acid