Ali Asilian; Fariba Iraji; Saba Khalilian; Zabihollah Shahmoradi; Mina Saber
Abstract
Background: Psoriasis is an immune-mediated inflammatory disease with unclear pathophysiology. Although diverse medications have been applied, a paucity of knowledge is accessible regarding the use of corticosteroids for psoriasis management. We evaluated the efficacy of corticosteroid pulse therapy ...
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Background: Psoriasis is an immune-mediated inflammatory disease with unclear pathophysiology. Although diverse medications have been applied, a paucity of knowledge is accessible regarding the use of corticosteroids for psoriasis management. We evaluated the efficacy of corticosteroid pulse therapy in combination with methotrexate versus methotrexate alone for psoriasis treatment.Methods: This cohort study was conducted on 51 hospitalized patients with erythrodermic or pustular psoriasis who were assigned to one of the therapeutic interventions of subcutaneous methotrexate alone (n = 33) or in combination with betamethasone pulse therapy (n = 18). The first group was treated with weekly 15 mg subcutaneous methotrexate for six weeks, and the second group received a similar dose of methotrexate plus 3 mg oral betamethasone weekly. The patients were followed for six months and assessed regarding the disease remission, relapses, the interval between the medication and relapse incidence, and patient satisfaction with the regimens.Results: The studied groups were similar regarding gender (P = 0.296), age(P = 0.561), and the type of cutaneous lesions (P = 0.807). Six months follow-up of the two therapeutic interventions revealed insignificant differences in terms of early response to the treatment (P = 0.993), the incidence (P = 0.142) and frequency of relapses (P = 0.928), and the interval period between the treatment and relapse (P = 0.213). Besides, the patients’ treatment satisfaction did not differ between the groups (P = 0.453).Conclusion: Based on this study, combining methotrexate and lowdose corticosteroid pulse therapy does not lead to better outcomes than methotrexate alone for managing pustular and erythrodermic psoriasis. Further studies are strongly recommended.
Ali Asilian; Samaneh Mozafarpoor; Azadeh Goodarzi; Mohammad Amin Jafari; Parvin Rajabi; Mehdi Eftekhari
Abstract
Composite hemangioendothelioma (CHE) is a rare and little-known condition with combined benign, intermediate, and malignant features. In the current study, we describe the case of a young female with the presentations of CHE, representing the second known case in Iran. Also, we have comprehensively reviewed ...
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Composite hemangioendothelioma (CHE) is a rare and little-known condition with combined benign, intermediate, and malignant features. In the current study, we describe the case of a young female with the presentations of CHE, representing the second known case in Iran. Also, we have comprehensively reviewed previous case reports of CHE. A 30-year-old female was referred with a reddish hemorrhagic painless mass in the small right finger that appeared within a few days following trauma. The mass was primarily excised but recurred within three weeks; therefore, she underwent thorough clinical, laboratory, and imaging studies. Finally, the lesions were biopsied and diagnosed as CHE. Accordingly, the involved finger was amputated, and the patient underwent chemoradiotherapy. Although CHE is a rare malignant condition worldwide, attention to the clinical presentations of this malignancy can help scientists make better therapeutic approaches leading to the best outcomes.
Samaneh Mozafarpoor; Ali Asilian; Mohammad Amin Jafari; Azadeh Goodarzi
Abstract
Recessive dystrophic epidermolysis bullosa (RDEB) is an autosomal recessive disorder that affects type VII collagen, one of the main components of the basement membrane. Patients present with non-healing chronic wounds in the body, extremities, and mucosal areas. There are many suggestive medical and ...
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Recessive dystrophic epidermolysis bullosa (RDEB) is an autosomal recessive disorder that affects type VII collagen, one of the main components of the basement membrane. Patients present with non-healing chronic wounds in the body, extremities, and mucosal areas. There are many suggestive medical and surgical treatments, but most are ineffective. In this case, we discuss a new laserassisted surgical protocol for these types of patients. A 54-year-old male patient was suffering from RDEB with large, excruciating, non-healing wounds on his extremities dating ten months, with no reasonable improvement, despite receiving intensive wound care. After ruling out other diagnoses (particularly malignancies), treatment was performed with a fractional Er:YAG laser for a single session. After four weeks of follow-up, the patient showed significant improvement, with no considerable complications reported. Fractional ablative Er:YAG laser could be an effective treatment option in RDEB patients. Clinical trials are required with long-term follow-ups for this novel treatment approach.
Samaneh Mozafarpoor; Ali Asilian; Azadeh Goodarzi; Zahra Ebrahimi; Fatemeh Mokhtari; Zeynab Rastgar Moqaddam
Abstract
Lymphangioma is an unusual congenital malformation of the lymphatic system that affects the skin and subcutaneous tissue. A surgical procedure is among the options for lymphangioma treatment, although it can lead to significant complications. The Nd:YAG Laser appears to be one of the safest therapeutic ...
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Lymphangioma is an unusual congenital malformation of the lymphatic system that affects the skin and subcutaneous tissue. A surgical procedure is among the options for lymphangioma treatment, although it can lead to significant complications. The Nd:YAG Laser appears to be one of the safest therapeutic options rarely proposed to treat oral cavity lesions. This paper comprehensively reviewed the studies published from 2010 to date on the treatment of cutaneous and mucosal lymphangioma with different types of lasers. In the current report, an 18-yearold female presented with a lymphangiomatous lesion on the tongue diagnosed through a pathologic study. The patient initiallyunderwent three sessions of pulsed-dye laser (PDL) therapy that evoked an insignificant response. Therefore, the approach was changed to long-pulsed Nd:YAG laser therapy, and a dramatic response was observed within three sessions of the treatment.
Ali Asilian; Zabihollah Shahmoradi; Shahryar Rahmani; Hossein Hafezi; Samaneh Mozafarpoor
Abstract
Background: Bleomycin is used for the treatment of warts. However, only its injected form can be used due to systemic use side effects, and plantar warts have a high recurrence rate following administration of bleomycin tattooing alone. To find an effective alternative with fewer side effects, we decided ...
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Background: Bleomycin is used for the treatment of warts. However, only its injected form can be used due to systemic use side effects, and plantar warts have a high recurrence rate following administration of bleomycin tattooing alone. To find an effective alternative with fewer side effects, we decided to investigate the effectiveness of bleomycin tattooing combined with trichloroacetic acid (TCA) and shaving in the management of treatment-resistant plantar warts.
Methods: The patients with treatment-resistant plantar warts entered the present quasi-experimental study. the wart site was shaved ahead of bleomycin tattooing and TCA peeling. This treatment was provided at one-month intervals and was repeated a maximum of four times. Patients were followed for six months after completion of the therapy. Finally, the patients’ data were completed according to photographs (monthly photos taken of lesions) and careful examinations.
Results: The present study involved 56 patients with a mean age of 25.75 ± 12.22 years. Twelve patients (21.4%) recovered after the first treatment; 14 (25%) needed the second treatment, 12 (21.4%) needed the third, 10 (17.9%) the fourth, and eight (14.3%) did not recover after the fourth treatment. The recovery rate was 21.4% with one, 45.4% with two, 66.8% with three, and 85.7% with four treatment sessions.
Conclusion: The combination treatment of bleomycin plus TCA and shaving led to a remarkable recovery from treatment-resistant plantar warts (21.4% recovery with the first treatment session and up to 85.7% recovery after four sessions). The treatment included tattooing and local injections, leaving few side effects.
Ali Asilian; Hossein Hafezi; Zabihollah Shahmoradi; Gita Faghihi; Amir Hossein Siadat; Samaneh Mozafarpoor; Fatemeh Mohaghegh; Mojtaba Nasimi; Mahboobeh Talakoub
Abstract
Background: Becker’s nevus syndrome (BNS) is a benign hamartoma that is aesthetically bothersome and usually appears during puberty. Various modalities of laser therapy alone or in combination with other medications can be used for the treatment of BNS, but no unified approach with an acceptable ...
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Background: Becker’s nevus syndrome (BNS) is a benign hamartoma that is aesthetically bothersome and usually appears during puberty. Various modalities of laser therapy alone or in combination with other medications can be used for the treatment of BNS, but no unified approach with an acceptable response is yet available. The current study aimed to compare the outcomes of Q-switched ruby 694 nm laser (QSRL) alone and in combination with 4% topical flutamide for the management of BNS. Methods: The current randomized clinical trial was conducted on twenty-two BNS patients between 2016-2018. The patients were randomly allocated to treatment with QSRL 694 nm alone (group A) versus in combination with 4% topical flutamide (group B). The QSRL was administered twice with four-week intervals for both groups, while group B was also administered topical flutamide 4% twice a day for eight weeks. The treatment outcomes were assessed and compared at baseline and then within 4 and 8 weeks of commencing the interventions. Results: The evaluation of the two groups in terms of lesion size alterations, response to treatment, and patients' satisfaction showed insignificant differences between the two groups (P>0.05). In addition, neither approach A (P=0.33) nor approach B (P=0.46) led to remarkable changes in lesion color. Conclusion: Based on the findings of the current study, the use of QSRL alone or even in combination with topical 4% flutamide was not suitable for the management of BNS lesions.
Amir Hossein Siadat; Siamak Rahmani; Fariba Iraji; Ali Asilian; Seyed Mohasen Hosseini; Mohammad Ali Nilfroushzadeh
Abstract
Background: Keratosis rubra pilaris is a common condition with an estimated percentage of 40% involvement in the population. This condition is inherited as an autosomal dominant trait and more commonly involves patients with dry skin. In the current study, we evaluated the efficacy ...
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Background: Keratosis rubra pilaris is a common condition with an estimated percentage of 40% involvement in the population. This condition is inherited as an autosomal dominant trait and more commonly involves patients with dry skin. In the current study, we evaluated the efficacy of intense pulsed light (IPL) plus ammonium lactate versus ammonium lactate alone in the treatment of keratosis pilaris.Methods: A total of 50 patches were selected in 10 patients. If there were two similar patches with the same color and same location, each of them was randomized to receive ammonium lactate (Kerapil cream®) or ammonium lactate (Kerapil cream®) +IPL. Treatment was performed for 3 months, and improvement was rated by physicians and patients one month and two months after the intervention.Results: The grade of improvement in the IPL + ammonium lactate was not significantly higher than ammonium lactate alone group as rated by blinded physicians at week 4 (P > 0.05). However, the score of improvement was also higher, as rated by the patients, in the IPL + ammonium lactate versus ammonium lactate alone (P < 0.05) at week 8.Conclusion: Our results demonstrated that addition of IPL to ammonium lactate could improve the clinical response of keratosis pilaris lesions.