Objective: To compare the efficacy of Intradermal Tranexamic acid and topical 20% Azelaic acid cream in the treatment of melasma. Study Design: Comparative prospective study. Place and Duration of Study: Dermatology department, Combined Military Hospital Peshawar, from Sep 2018 to Mar 2019. Methodology: A total of 116 female patients, at the outpatient department of dermatology at Combined Military Hospital Peshawar, were randomly assigned into two groups; group A (intradermal tranexamic acid) and group B (topical azelaic acid) by lottery method. Patients in group A received intradermal injection, while the participants of group B received topical azelaic acid only, fortnightly for 6 weeks. Melasma area severity index score was calculated for each patient in both groups at the start and at the end of the treatment. Results: The mean Melasma area severity index score in group A (intradermal tranexamic acid) before and at 6 weeks of treatment was 7.10 ± 2.94 and 5.27 ± 2.44, respectively. The mean Melasma area severity index score in group B (topical azelaic acid) before and at 6 weeks of treatment was 7.56 ± 2.57 and 5.76 ± 2.89, respectively. Efficacy of intradermal tranexamic acid, as poor response, good response and excellent response was 27.6%, 41.4% and 31% respectively. While, efficacy of topical azelaic acid group as poor response, good response and excellent response was 62.1%, 20.7% and 17.2% respectively. The difference was statistically significant, (p=0.001). Conclusion: It can be concluded that intradermal tranexamic acid is more effective as compared to topical 20% azelaic acid in..................

Objective: To compare the efficacy of topical 5% Nicotinamide gel versus 2% Clindamycin gel in patients with mild to moderate acne. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Dermatology, Combined Military Hospital, Quetta Pakistan, from Jan to Jun 2019. Methodology: Patients with mild to moderate acne were enrolled in the study. A total of 372 patients were randomly and equally divided into two groups, Group-A (Clindamycin) and Group-B (Nicotinamide). Response to treatment was graded according to Acne Global Severity Score. Scoring was done in both groups at the start and after eight weeks of therapy.Therapy was considered efficacious if there was at least 2 step improvement in post-therapy scores compared to pre-therapy scores.Results: Total number of patients included was 372. Group-A (Clindamycin-Group) had 186 patients, of which 67 were males,and 119 were females. In Group-B (Nicotinamide-Group), out of 186 patients, 62 were males, and 124 were females. Regarding the treatment results, Clindamycin was found to be 31% efficacious, whereas the efficacy of Nicotinamide was 34.7% (pvalue=0.127). Conclusion: There is no significant difference in the efficacy of Clindamycin and Nicotinamide in treating mild to moderate acne.