DR ABBAS IQBAL

[ Case # 11 ]
" Neuro🧠 Fibroma🪐tosis 👀
Definition : Inherited Autosomal dominant condition in which Skin/Cns/ and eyes related problems are obvious.

C/F : 1 ) Neurofibromas
2 ) Café Au Laut Macules (Calms)
3) Crowe's sign (freckling in axilary/pelvic areas)
4) Lisch Nodules
5 ) May or not associated with neurological manifestations like Tremors/seizers/ Balance problems/loss of consciousness/vision problems

Types :
1 ) NF1 (only skin manifestation) most common but can involve (Musculoskeletal system/bone deformity/scoliosis)
2) NF2 (skin + Neurological manifestation)
Other types are rare.

How to Diagnose?

Hx: Are parents first degree relatives?
Any other person in family having this problem now or in past

1) Dermatologist will examine Neurofibromas
2) Neurophysician will Examine CnS
3) opthamologist will examin Iris for Lisch nodules

Investigations :
Eye examination via slit lamp examination
Brain imaging

Dx : NF

Rx : Symptomatic Plus Cosmetic

Credits:
Special Thanks To
Dr Rahmat Ali (Dermatologist)
Dr Fawad Ali (Neurologist)

[ Case # 10 ]

Myth about Dermatology diseases is that the patient can't die from your treatment & also can't be cured completely bcz of its reccurance..
But i think patient suffer & can be cured if treated correctly.
It was Simple scabies 1 month ago(mistreated) now with
" Infected scabies "
Some one has given him Steroid❌ injection plus AntiAllergics & Betagenic❌

(For Scabies Visit case # 6 in this page)👍

[ Case # 9 ]
"MELASMA" 🦋
Also known as Chloasma/mask of pregnancy

Def: Acquired 'Brown' hyperpigmentation of skin (Face /neck) in genetically predisposed Females (90%) Association with estrogen
(10% males)

Areas involved: Forehead , upper lip & chin areas are usually involved

How To Diagnose it ?

1) In Hx Ask about inflammatory s/s
~ If No inflammatory s/s occured before or during pigmentation & the brown pigmentation occured slowly over long period
~ If she is pregnant
~ Prolong Sun Exposure
~ Rule out other causes

2) On Examination:
Symmetric (both sides) macular (not raised/many but small) eruption of brown hyperpigmented spots

Dx: " MELASMA "

Causes:
1) Pregnancy (2/3rd trimester)
2) Sunlight exposure in susciptable individual
3) Estrogen containing oral Contraceptive pills
4) Vitamin D deficiency
5) Using Beauty cream /parlos makeup
6) Alot more ------

Rx :

A) Rule out the cause (stop cocps/use sunscreen/ Pregnancy induced usually reverses without Rx/Vit supplementation)

B) Protocol ~ Topical/Oral/ Laser
1) MelasH/Biofade/Clarimax plus Cream (raat ko mutasira jagah pe 8 weeks)
2) Hydroquine 2% containing Cream (mix with upper one)
3) Sunblock (around 30Spf) Din ko rozana.
4) Vit D supplementation
4) Azelaic Acid (Fenacia gel safe in Pregnancy)