Autoimmune chronic spontaneous urticaria (aiCSU) is characterized by the presence of anti-FceR1 and anti-IgE autoantibodies. In this study we aimed to compare the efficacy and safety of bilastine versus cetirizine in aiCSU.

Intoduction:There are multiple treatment modalities for keloids but no single modality has been proven to be thegold standard. This study aims to compare the efficacy of intralesional triamcinolone acetonide (TAC)with silicone gel sheeting (SGS) in treating keloids and their effect on patients’ quality of life(QoL).Methods:This was a two-arm randomized-controlled trial involving 56 subjects in which intralesional TAC 20mg/mL after dilution with 2% lignocaine was administered on keloids monthly for patients in group1 while patients in group 2 applied SGS on keloids daily. Patients were treated for 12 weeks andfollowed-up for 16 weeks. Patient and Observer Scar Assessment Scale (POSAS) and DermatologyLife Quality Index (DLQI) were assessed to monitor treatment efficacy and patients’ QoL respectively.Results:There was 44.2% of improvement in the mean of total score of POSAS in group 1 as compared to11.6% in group 2 (p<0.001). Both groups showed significant improvement in vascularity, pigmentation,thickness and pliability but the improvement was more significant in group 1. Subjects in group 1demonstrated a 67.3% of DLQI score improvement as compared to 13.1% in group 2 (p<0.001). Sideeffects reported were pain during procedure in group 1 and pruritus in group 2.Conclusion:Intralesional TAC was superior than SGS in treating keloids as well as improving patients’ QoL andhence recommended as the first-line treatment. SGS can be considered as an alternative treatment forpatients who are intolerable to pain or as an adjunctive treatment.

ObjectiveTo observe the distribution of vitamin D receptor(VDR) gene polymorphisms in coal-burning borne fluorosis in Guizhou province and investigate the relationship between VDR gene polymorphisms and the susceptibility to coal-burning borne fluorosis.MethodsOne hundred and fifty villagers from non-improving cooking stove villages were selected as a non-intervention group in Bijie area,Guizhou province where coal-burning borne fluorosis was prevailing; 150 villagers were chosen from cooking stove improved villages as a intervention group; 150 villagers were selected from non-endemic area Changshun county as a control group.DNA was extracted from peripheral blood samples of these people.Genotype of VDR gene Bsm Ⅰ and Fok Ⅰ loci were detected using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).ResultsDistribution of Bsm Ⅰ polymorphism site of VDR gene of control group [AA:19.3％ (29/150),AG:39.3％ (59/150),GG:41.3％(62/150)],was compared with that[AA:4.7％(7/150),AG:14.0％(21/150),GG:81.3％(122/150)] of the non-intervention group and that[AA:7.3％(11/150),AG:23.3％(35/150),GG:69.3％(104/150)] of intervention group,and the difference was statistically significant(X2 =56.6,P ＜ 0.05).The frequency of VDR-Fok Ⅰ loci in non-intervention group [TT:29.3％(44/150),TC:55.3％(83/150),CC:15.3％(23/150)] and intervention group [TT:32.7％(49/150),TC:55.3％(83/150),CC:12.0％(18/150)] was compared with that [TT:45.3％(68/150),TC:48.7％(73/150),CC:6.0％(9/150)] of control group,and the difference was statistically significant(X2 =11.9,P ＜ 0.05).Univariate analysis showed that individuals carrying the GG genotype had increased risk of suffering fluorosis than individuals carrying the AA and AG genotypes(OR values were 6.2,3.2,all P ＜ 0.05),while carrying the TC and CC genotype had increased risk of suffering fluorosis than individuals carrying the TT genotype (OR values were 1.3,2.8,1.3,2.1,all P ＜ 0.05).ConclusionVDR gene polymorphisms may be one of the predisposing factors of coal-burning borne fluorosis.

Background: Acne vulgaris is a common chronic inflammatory skin disease. Long term therapy involving antibiotics warrants for drug with a long half-life to increase compliance of patients. Methods: A twelve-week prospective randomized study was performed on 40 subjects with moderate to severe facial acne to compare the efficacy of oral azithromycin with oral doxycycline. Thirty-six subjects completed the study. Subjects in azithromycin group received azithromycin 250mg three times a week plus topical benzoyl peroxide 5% (BPO), whereas subjects in doxycycline group received doxycycline 100mg daily plus topical BPO 5%. Efficacy evaluation included treatment success rate (Comprehensive Acne Severity Score /CASS of 0 or 1 or improvement of two grades from baseline) and lesion counts. Results: Treatment was successful in 94.4% of subjects in azithromycin group, compared to 88.9% in doxycycline group (p=1.000) at week 12.However, percentage of clear or almost clear by CASS was higher in the doxycycline group ( 83.3% vs 66.7%; p= 0.443).Percentage reduction of inflammatory lesion counts in azithromycin and doxycycline group following treatment for 12 weeks were 78.3% and 85.3% (p=0.133) respectively, whereas for non-inflammatory lesion counts were 77.7% and 78.8% (p=0.852) respectively. Nausea was reported in 77.8% at week 6 and 66.7% at week 12 in doxycycline group, but none in azithromycin group. There were no significant differences in incidence of diarrhoea and abdominal pain. Conclusion Azithromycin 250mg three times a week plus topical BPO 5% is as effective as doxycycline 100mg daily plus topical BPO 5%.
Azithromycin ; Doxycycline ; Acne Vulgaris--therapy

Introduction: Psoriasis vulgaris has a significant association with obstructive sleep apnoea (OSA). The study intended to explore the relation between the severity of psoriasis vulgaris and OSA risk, and to identify the factors that are attributed to increased risk of OSA. Methods: A cross sectional, observational study was carried out from October 2020 until April 2021 at the dermatology clinic of Hospital Tengku Ampuan Rahimah, Malaysia. All study participants were evaluated for OSA risk using the STOP-Bang and Epworth Sleepiness Scale questionnaires. Results: Our study recruited 237 participants and the results revealed a higher percentage of moderate to severe psoriasis participants with intermediate to high risk of OSA than participants with mild psoriasis (35.3% versus 17.7%, respectively). There was also a 2.3 times higher incidence of daytime sleepiness among participants with moderate to severe psoriasis as opposed to participants with mild psoriasis (44.1% versus 19.2%, respectively). We have also detected a significantly higher probability for OSA in psoriasis patients with diabetes mellitus versus those without (odds ratio: 2.09). We also noticed that for every unit rise in body mass index (BMI), there seemed to be a 1.06 times higher risk of OSA. Furthermore, patients with moderate to severe psoriasis were found to possess 3.32 times increased odds to have OSA. Conclusion: Our results suggest that psoriasis severity and the existence of comorbidities i.e. diabetes mellitus and high BMI are linked with an enhanced risk of OSA in adults with psoriasis.

Summary Eosinophilic granulomatosis with polyangiitis (EGPA), or Churg-Strauss Syndrome (CSS) is a rare granulomatous necrotizing vasculitic disease characterized by the presence of asthma, sinusitis, and hypereosinophilia. We describe a patient who was initially diagnosed with tuberculous lymphadenitis and later diagnosed with EGPA.
Granulomatosis with Polyangiitis ; Tuberculosis, Cutaneous ; Tuberculosis, Lymph Node

Summary Sporotrichosis is a rare and chronic granulomatous subcutaneous mycotic infection caused by a dimorphic fungus, Sporothrix schenckii. We describe a patient with disseminated cutaneous sporotrichosis who was later diagnosed with myeloproliferative neoplasm and discuss the challenges and importance in diagnosing this rare condition.
Sporotrichosis ; Granulomatous Disease, Chronic ; Myeloproliferative Disorders