Roudsari Mohammad Rahmati; Malekzad Farhad; Sabeti Shahram; Ershadi Sarah; Yousefi Forough; Tonkaboni Mihan Pourabdollah
Volume 18, Issue 3 , 2015, , Pages 108-115
Abstract
Background: Scarring (cicatricial) alopecia represents a complex group of inflammatory disorders, mainly characterized by destruction of the hair follicle unit. Lichen planopilaris (LPP) and discoid lupus erythematosus (DLE) are the two main causes of primary cicatricial alopecia (PCA), both leading ...
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Background: Scarring (cicatricial) alopecia represents a complex group of inflammatory disorders, mainly characterized by destruction of the hair follicle unit. Lichen planopilaris (LPP) and discoid lupus erythematosus (DLE) are the two main causes of primary cicatricial alopecia (PCA), both leading to hair follicle destruction and irreversible alopecia. However, they are different in pathogenesis and sometimes are diagnostically challenging.Methods: Twenty-eight formalin-fixed paraffin-embedded (FFPE) specimens of skin biopsies from 17 patients with a clinicopathologic diagnosis of LPP and 11 patients diagnosed as DLE were included. Histopathological study was performed with Haematoxylin and Eosin (H&E)-stained slides; then, immunohistochemical staining (IHC) was performed against CD20, CD3, CD4, and CD8 to evaluate and compare the type and distribution pattern of dermal inflammatory infiltrate.Results: Immunohistochemical findings showed a predominance of T-cells in both groups. CD8+ T-cells were significantly more abundant in LPP (15 cases with 10-50% of infiltration) than DLE (11 cases with
Malekzad Farhad; Eshghi Gholamreza; Ebadi Atyeh; Younespour Shima
Volume 13, Issue 3 , 2010, , Pages 91-95
Abstract
Background: Alopecia areata is one of the most common human autoimmune disorders and its severe types are refractory to all conventional therapies. Corticosteroids have been used in severe alopecia areata since 1950s but there is concern over complications caused by high doses of corticosteroids. Methotrexate ...
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Background: Alopecia areata is one of the most common human autoimmune disorders and its severe types are refractory to all conventional therapies. Corticosteroids have been used in severe alopecia areata since 1950s but there is concern over complications caused by high doses of corticosteroids. Methotrexate has been used as an adjunctive therapy in some autoimmune disorders and has been proposed to be effective in the treatment of severe alopecia areata both as a monotherapy and in combination with corticosteroids. Methods: In this study, 120 patients of intractable alopecia areata totalis and universalis with a mean duration of 3.27 ±1.60 years were studied. We treated them with methotrexate in combination with intravenous and low dose of prednisolone for one year. Methotrexate 10 mg per week was administered in combination with three monthly methylprednisolone and oral prednisolone 15 mg per day for one year. Response to the treatment was evaluated clinically and by serial photographs. Results: Sixty four patients (57.7%) gained total hair regrowth after treatment with no significant difference between alopecia totalis and universalis. Almost half of the patients (44.75%) remained disease free until the end of the one-year follow-up. Relapse occurred in 34 patients (56.25%); of them 20% were focal relapses. Nine patients out of 120 patients (7.5%) experienced severe adverse effects of the therapy. Conclusion: Our study suggested that methotrexate could be used as a safe and well tolerated adjunctive therapy for severe alopecia areata although careful monitoring of adverse effect is necessary. Furthermore, controlled prospective clinical trials are warranted to answer many of the questions regarding methotrexate therapy for severe alopecia areata.
Malekzad Farhad; Qeisari Mehdi; Nasiri Soheila; Rahmati-Roudsari Mohammad; Saeedi Marjan; Sarlak Mojdeh
Volume 12, Issue 1 , 2009, , Pages 9-12
Abstract
Background: An elevated homocysteine level is an independent risk factor for cardiovascular disorders. Psoriatic patients have an increased risk of cardiovascular diseases; In addition, hyperhomocysteinemia is a complication of methotrexate treatment. We undertook a study to evaluate the plasma levels ...
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Background: An elevated homocysteine level is an independent risk factor for cardiovascular disorders. Psoriatic patients have an increased risk of cardiovascular diseases; In addition, hyperhomocysteinemia is a complication of methotrexate treatment. We undertook a study to evaluate the plasma levels of homocysteine, vitamin B12 and folate in patients with psoriasis before and after short-term low-dose methotrexate treatment. Methods: Twenty six patients with psoriasis were recruited. The plasma levels of homocysteine, vitamin B12 and folate were evaluated before and 8 weeks after methotrexate therapy (in the peak of methotrexate effect). Results: No significant difference was found between the plasma profile of homocysteine, vitamin B12 and folate before and after methotrexate treatment. Conclusion: In the short-term treatment of psoriasis, methotrexate does not increase homocysteine level.
Malekzad Farhad; Sarlak Mojdeh
Volume 11, Issue 2 , 2008, , Pages 89-91
Abstract
We report a 61-year-old man with multiple colored skin papules with central crusts in an archiform and linear pattern on his forehead as well as verrucus and hyperkeratotic plaques with central perforation on hands. Histologic examination of the lesions demonstrated a narrow channel of epidermal perforation ...
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We report a 61-year-old man with multiple colored skin papules with central crusts in an archiform and linear pattern on his forehead as well as verrucus and hyperkeratotic plaques with central perforation on hands. Histologic examination of the lesions demonstrated a narrow channel of epidermal perforation containing notrophils, basophilic debris and elastic fibers with eosinophilic degeneration compatible with the diagnosis of elastosis perforans serpiginosa.