Background: Warts are common cutaneous viral infections due to human papilloma virus (HPV) mostly affecting school age children and adults.1 Various therapeutic modalities are available including topical, physical, and systemic therapies. Physical therapies are considered to be effective in the management of viral warts. This study aims to compare the efficacy of electrocautery with cryotherapy in the treatment of viral warts.Patients and methods: This randomized trial was conducted in Dermatology Department of GHAQ / DHQ Teaching Hospital/SLMC, Sahiwal from October 2020 to March 2021.A total of 50 patients with clinical diagnosis of warts either sex with age ranging from 5-60 years were enrolled in the study and were divided into two equal groups. Patients excluded were those with evidence of any superadded infection and number of warts >6, having documented hypersensitivity to lignocaine or taking any treatment for warts in last month. After obtaining an informed written consent group A was treated with electrocautery and group B with liquid nitrogen cryotherapy. The patients were treated until the complete clearance of warts or maximum of eight sessions on weekly basis. Demographic and clinical data as efficacy (cleared if not palpable or visible to naked eye) was recorded on predesigned proforma and was analyzed by using chi-square test through SPSS version 25.  Results: Out of total 50 patients, there were 27 (54%) male and 23 (46%) female patients, with an overall male to female ratio was 1:0.7. Most commonly observed clinical type of wart were plantar warts in 28 (56%) followed by palmar in 6 (12%). Electrocautery was found to be effective therapy in treatment of wart as indicated by complete clearance noticed in 19 (76%) patients as compared to cryotherapy in 11 (44%) participants.Conclusion: Electrocautery is more effective as compared to cryotherapy in the treatment of warts especially plantar and deep-seated. However, promising effects of cryotherapy is seen in common and multiple warts as compared to electrocautery.

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Objective: Drug abuse and drug addiction cases have been increased immensely in last few decades in Pakistan. This study was conducted to assess the frequency of cutaneous manifestations in drug abuse patients. Study Design: Cross Sectional study. Settings: Dermatology Department of a DHQ Teaching Hospital/Sahiwal Medical College, Sahiwal and Central Jail Hospital, Sahiwal. Period: November 2019 to June 2020. Material & Methods: 50 patients with drug abuse irrespective of age and gender were selected. Skin manifestations based on history and examination recorded on predesigned proforma. Laboratory investigations and skin biopsies were performed to confirm diagnoses in doubtful cases. Results: A total of 50 male patients with age above 16 years were enrolled. Single drug addiction was noticed in 62% (n=31) and polydrug abuse was observed in 38% (n=19). Regarding mode of drug intake, single and multiple modes of drug administration were seen in equal number 50% (n=25) each. Major bulk of skin manifestations were chronic including skin scars 66% (n=33), xerosis 60% (n=30), hyperpigmentation 58% (n=29), oral mucosal changes 94% (n=47) and facial skin changes 60% (n=30). Acute along with chronic skin changes were observed in 30% (n=15) mainly including injection marks 30% (n=15), vascular changes 12% (n=6) and infections 8% (n=4). Conclusion: Skin scars, xerosis, hyperpigmentation and oral mucosal changes are the common skin changes observed among drug abusers. Thus, physicians need to be aware of skin signs of drug abuse for timely recognition of substance abuse disorders and effective management.

Objective: To assess the frequency of alopecia areata associated with other autoimmune disorder in a tertiary care hospital. Study Design: Prospective Cross Sectional study. Setting: Department of Dermatology GHAQ/DHQ Teaching Hospital/Sahiwal Medical College, Sahiwal. Period: January 2020 to December 2020. Material & Methods: A total of 24 patients fulfilling criteria were entered in the study. After taking informed consent, demographic data was recorded. History was taken and general physical and systemic examination was performed. Laboratory investigations were carried out where needed, for determination of factors associated with alopecia areata. Results: This study comprised of 24 patients with male n=12 (50%) and female n=12 (50%) in equal ratio 1:1. Mean age of patients of alopecia areata with SD was 19.75 ± 9.90 years. Most of the study patients were unmarried n=17 (70.8%). More than two third of patients had mild and moderate severity of disease n=18 (75%). Most common autoimmune disorder associated with alopecia areata was Diabetes Mellitus n=6 (20.9%) followed by atopic dermatitis n=3 (12.5%), anemia n=3 (12.5%) and thyroid disorders (hypothyroidism and hyperthyroidism) n=2 (8.3%). The p value in various autoimmune diseases was found to be non-significant. (> 0.05). Conclusion: Patients presenting with alopecia areata may have associated other autoimmune disorders which needs to be investigated, thus helping in the management of disease.