MESSAGE FROM HOD

Welcome to Department of Dermatology at Madinah Teaching Hospital.

Our department was established in MTH on 18th December 2006. Since then, we are providing compassionate care to patients suffering from skin diseases with full devotion. Skin diseases are the fourth leading cause of disease associated physical, psychological and social burden worldwide. We consider it our responsibility to help cope with this burden in Pakistan by timely diagnosis and treatment of such diseases. We play our role in the prevention of skin diseases by educating patients, their families and health professionals.

Mission:

At the Department of Dermatology, we strive to achieve excellence in patient care, academics and research by

Providing evidence based dermatological care to patients
Maintaining a good doctor-patient relationship with special emphasis on ethical values, humane concerns and professionalism
Meeting highest academic standards in undergraduate and postgraduate education
Promoting a research culture

Services Offered:

The department of Dermatology conducts its outpatient clinic six days a week from 8:00 am to 2:00 pm from Monday to Saturday. We cater for about 25,000 patients per year, maintaining a high standard of care. Those patients requiring indoor care are admitted.

A variety of Dermatological procedures including diagnostic, therapeutic and cosmetic procedures are performed on an outdoor basis with minimum downtime. These include

Diagnostic Procedures

Skin biopsy with histopathology and immunohistochemistry

Dermatopathology sessions:

We discuss the histopathology slides of our patients who have undergone skin biopsies in a joint session with our consultant histopathologist. This integrated service helps in diagnosing challenging cases of skin diseases. Immunohistochemistry is also performed where required.

Microscopy for fungus, Leishmaniasis, scabies mite
Culture for fungus
Patch test for skin allergies

Therapeutic Procedures

Phototherapy with narrow band UVB

What is narrowband UVB phototherapy?

Light therapy, also known as phototherapy, is the use of ultraviolet (UV) light for its healing effects. The phototherapy unit emits specific wavelengths of light proven to benefit patients with various skin disorders.

There are different types of phototherapy like UVA1, PUVA, Narrowband UVB. “Narrowband" refers to a specific wavelength of ultraviolet (UV) radiation 311 to 312 nm. The narrowband range of UV radiation has proved to be the most beneficial component of natural sunlight and is the most common form of phototherapy used to treat skin diseases. We at Madina Teaching Hospital use the latest Foldalite III Narrowband UVB phototherapy device which has proved to be the most beneficial.

Where is it used?

Narrowband UVB therapy is used in many skin conditions and has very promising outcomes. Few indications of UVB therapy are:

Psoriasis
Atopic eczema
Vitiligo
Pruritus
Lichen planus
Polymorphous light eruption
Early cutaneous T-cell lymphoma
Dermographism
Electro surgery

Electrosurgery is a technique often used in dermatologic surgery to provide superficial or deep coagulation or cutting of the skin by using a special electrosurgical device. The main types of electrosurgery we use in Madinah Teaching Hospital includes electrocautery, electrofulguration, electrodesiccation, and biterminal electrocoagulation.

Electrosurgery is a very commonly used procedure on outdoor basis performed under local anesthesia. Electrosurgery is a safe procedure with minimum complications.

Where is it used?

It is effective in treating various skin conditions including

Plane wart
Common or genital wart
Molluscum contagiosum
Dermatosis papulosis nigra or small skin tags
Cherry angioma
Spider angioma and telangiectasia
Sebaceous hyperplasia
Syringoma
Verrucous epidermal nevus
Seborrheic keratosis
Freckle or lentigo
Intralesional injections

An intralesional steroid injection involves a corticosteroid such as triamcinolone acetonide injected directly into a lesion on or immediately below the skin. The injections may be repeated monthly for a few months while the lesions are active. Intralesional injections are effective for a wide range of indications, are easily performed, and are relatively safe.

Why do we use intralesional injections?

The rationale for intralesional therapy is simple: to deliver a medication directly into a specific skin lesion to treat local tissues with minimal systemic effects. The skin also serves as a reservoir, allowing medication deposited in the dermis to be delivered over a period of time, resulting in prolonged therapy while avoiding or minimizing the adverse effects of systemic therapy.

Where is it used?

An intralesional steroid injection may be indicated for the following skin conditions:

Alopecia areata
Discoid lupus erythematosus
Keloid/hypertrophic scar
Granuloma annulare
Hypertrophic lichen planus
Lichen simplex chronicus (neurodermatitis)
Localised psoriasis
Necrobiosis lipoidica
Acne cysts (nodulocystic acne) and inflamed epidermoid cysts
Small infantile haemangiomas

Cosmetology Procedures

PRP

WHAT IS PRP?

PRP stands for Platelet rich plasma. Platelets, along with red and white blood cells, and the liquid plasma make up your blood. Platelets are known for their clotting and healing ability. Platelet rich plasma is rich in cytokines and growth factors that offers a natural way to stimulate cell turnover and growth.

HOW IS IT PERFORMED?

In PRP treatment we will take a small amount of blood from your arm or hand in the same way you give blood for your laboratory work-up in any lab. We will then process this small amount of blood using specialized equipment to separate the platelets from other components of your blood and will concentrate the amount of platelets too. This plasma or liquid portion of blood with concentrated platelets will be injected into the skin/scalp.

WHERE IS IT USED?

PRP is being used in many fields from years. In Dermatology we recommend PRP in following conditions:

Thinning of hair
Baldness because of certain skin conditions
acne scars
Facial rejuvenation
dark eye circles
Lifting sagging skin
Erasing lines and wrinkles

Collagen induction therapy (Microneedling)

Collagen Induction Therapy, also known as micro needling is a relatively new approach to anti-ageing and atrophic scars. It stimulates natural collagen repair and growth processes in skin, leading to significantly improved tone and texture. It is a safe and cost effective treatment with minimal downtime. The procedure is used to treat

Acne scars
Ageing skin
Steroid induced skin damage
Striae

Chemical peels

WHAT IS CHEMICAL PEEL?

A chemical peel is a technique used to improve the appearance and smooth the texture of the skin on the face, neck or hands. Chemical peels are intended to remove the outermost layers of the skin. To accomplish this task, the chosen peel solution induces a controlled injury to the skin. Resulting wound healing processes begin to regenerate new tissues. The dead skin eventually peels off. The regenerated skin is usually smoother and less wrinkled than the old skin.

Why should I get a chemical peel?

Chemical peels have several benefits, including increased collagen production and reductions in pore size, excess surface oil and visible signs of aging. Chemical peels are an effective treatment for hyperpigmentation (dark spots) and acne.

What is involved with a chemical peel?

An acid solution is applied to the skin to remove dead skin cells; this solution is then washed off. You may feel a tingling, itching or burning sensation. Chemical peels are brief procedures that require very little recovery time, although multiple treatments are usually necessary to achieve the best results.

What are different types of peels?

There are different chemical peels available in the market. We, at Madina Teaching hospital, commonly use Glycolic acid, Jessner’s solution and TCA. These are relatively safe and have promising results.

Psoriasis clinic

Psoriasis clinic is an integrated, non-emergency, outpatient based service, offered by Dermatology Department in collaboration with Department of medicine. The clinic offers its services every Thursday from 8.00 am to 2.00pm. The service was started on 25th October, 2018 with the following objectives:

Offer a holistic and individualized management plan to every patient with psoriasis based on Biopsychosocial approach
Educate patients and their families regarding psoriasis and its management
Ensure a Multidisciplinary approach for patients who need it
Contribute through research in developing local guidelines about psoriasis management

How we work:

All patients suffering from or with a suspicion of psoriasis are evaluated through detailed history and physical examination by attending doctor
The attending doctor trainee discusses the cases with consultant Dermatologist regarding management plan
All patients suffering from or with a suspicion of psoriatic arthritis are discussed with Consultant Rheumatologist regarding management plan
Consultant Dermatologist and Rheumatologist will consult each other to jointly plan management for patients as and when needed
The patient data is entered in patient management software
Patients with psoriasis are educated regarding their disease and are encouraged to counsel other family members with suspicious skin lesions to consult us for screening
Patients with symptoms of anxiety and depression are referred for psychiatric opinion
Patients with co morbidities are referred to other specialist OPDs according to the nature of the problem

Training

The department is recognized by

PMDC for House job training
CPSP for FCPS Dermatology training
CPSP for MCPS Dermatology training