Nasrin Zand; Leila Ataie Fashtami
Ladan Esmalian Khamseh; Mehdi Asadi Mofarah; Somayeh Toorani
Abstract
Background: Psoriasis is a chronic autoimmune, complex and progressive disease having various physical, psychological and social consequences. This study aimed to investigate the effect of cognitive behavioral therapy on body image in women with psoriasis. Methods: The research was ...
Read More
Background: Psoriasis is a chronic autoimmune, complex and progressive disease having various physical, psychological and social consequences. This study aimed to investigate the effect of cognitive behavioral therapy on body image in women with psoriasis. Methods: The research was semi-experimental with pre-test and post-test design in both experimental and control groups, and follow-up after 3 months of intervention. The statisticalpopulation included women with psoriasis. A total of 60 patients were selected as available samples and randomly were divided into control and treatment (experiment) groups. The researchtool was the cash’s Body Image Questionnaire (1987) . Data were analyzed by the SPSS 24 software using the repeated measures analysis of variance. Results: Cognitive behavioral therapy guidance reduced the image body anxiety and its two sub-scales in women with psoriasis, and this effect was permanent after three months. Conclusion: Using this therapeutic approach, we can help to reduce the concern of the body image in patients with psoriasis. Conclusion: Using this therapeutic approach, we can help to reduce the concern of the body image in patients with psoriasis.
Vahid Mashayekhi Goyonlo; Hossein Hassan Abadi; Hanieh Zandi; Jamshid Jamali; Yalda Nahidi; Ahmad Reza Taheri; Bita Kiafar
Abstract
Background: The treatment of cutaneous leishmaniasis has long been a challenge. The application of heat to the lesions has been described in some studies, with no consensus regarding the types of thermotherapy and their practical implications.We sought to evaluate the efficacy of infrared thermotherapy ...
Read More
Background: The treatment of cutaneous leishmaniasis has long been a challenge. The application of heat to the lesions has been described in some studies, with no consensus regarding the types of thermotherapy and their practical implications.We sought to evaluate the efficacy of infrared thermotherapy in the treatment of cutaneous leishmaniasis. Methods: We evaluated the results of infrared thermotherapy in 35 cutaneous leishmaniasis patients (53 lesions) who attended the leishmaniasis clinic of Imam Reza Hospital, Mashhad, Iran. Three times a week, the lesions were warmed to 45 degrees centigrade for two cycles of 10 minutes. Treatment outcomes were classified as complete (90-100%), good (50-89%), and poor responses (less than 50% size reduction). Results: Thirteen (24.5%) lesions were cured after three months; 31 (58.5%) and 9 (17%) lesions showed good and poor responses, respectively. Treatment outcomes were significantly related to the number of treatment sessions (P ≤ 0.05). No significant side effects were seen. Conclusion: Infrared thermotherapy is a relatively effective and well-tolerated treatment for cutaneous leishmaniasis.
Khalifa E Sharquie; Raed I Jabbar
Abstract
Background: Xeroderma pigmentosum variant (XP-V) is a genetic disorder that starts in early childhood with a mild disease course. The aim of study was to record all cases of XP-V that were seen and examined over a specific period.Methods: This descriptive study included 48 patients; there were 4 (8.33%) ...
Read More
Background: Xeroderma pigmentosum variant (XP-V) is a genetic disorder that starts in early childhood with a mild disease course. The aim of study was to record all cases of XP-V that were seen and examined over a specific period.Methods: This descriptive study included 48 patients; there were 4 (8.33%) patients with xeroderma pigmentosum (XP) and 44 (91.66%) patients with XP-V. Patients with XP-V were divided into childhood and adult-onset types.Results: Childhood-onset type was detected in 34 patients, including 20 (58.82%) males and 14 (41.17%) females. Their ages ranged from 3-25 years, with a mean of 15 years. Freckling and solar keratosis were observed in 100% and 23.68% of patients, respectively, while non-melanoma skin cancer (NMSC) was detected in 8 (21.05%) patients, including one case with squamous cell carcinoma (SCC) and 7 with keratoacanthoma. In the adult-onset type, ten cases were seen, half of each gender. Their ages ranged from 23-60 years, with a mean of 32 years. Patients gave a history of early adult onset of their disease. Skin hyper-photosensitivity was the first problem, followed gradually by other features of solar damage to the face, including freckles and solar keratosis. SCC and keratoacanthoma were each observed in two patients.
Conclusions: The clinical picture of XP-V was similar to ordinary XP but with late age onset and a slower course. The clinical picture of adult-onset XP-V was similar to the childhood type.
Saurabh Swaroop Gupta; Aneet Mahendra; Sanjeev Gupta; Rohit Singla
Abstract
Background and Aim: Alopecia areata (AA) is a chronic, autoimmune disease that causes non-scarring hair loss. Recently, serum vitamin D has been implicated in the etiopathogenesis of AA due to its immunoregulatory effects. Its deficiency can cause a loss of selftolerance and predispose individuals to ...
Read More
Background and Aim: Alopecia areata (AA) is a chronic, autoimmune disease that causes non-scarring hair loss. Recently, serum vitamin D has been implicated in the etiopathogenesis of AA due to its immunoregulatory effects. Its deficiency can cause a loss of selftolerance and predispose individuals to autoimmune diseases. This study compared the serum vitamin D levels between AA cases and controls. We aimed to compare the serum levels of vitamin D between AA patients and age and sex-matched healthy controls and to elucidate any correlation between AA and vitamin D serum levels in terms of disease pattern, severity, and extent.Methods: A case group comprising 25 AA patients and a second group of 25 healthy controls of 10 years of age or older were involved in the study. A detailed history was taken, along with a complete clinical examination. Serum vitamin D levels were measured and compared between the groups.Results: The mean level of vitamin D in cases (17.15 ± 5.01 ng/ ml) was significantly lower as compared to controls (34.58 ± 20.83 ng/ml) (P < 0.001). The duration, pattern, and severity of AA had no significant relationship with patients’ serum vitamin D levels.Conclusion: We demonstrated a statistically significant variation in serum vitamin D between controls and cases, with lower values in patients. Our findings indicate a possible cause-and-effect relationship between low serum vitamin D and AA, which needs further exploration.
Alireza Ghanadan; Reza Shirkoohi; Reza Shahsiah; Samira Alihosseini; Reza Amiri; Nika Kianfar; Shahriar Hadadi Abianeh; Elham Sabbagh; Behzad Khodaei; Maryam Nasimi
Abstract
Background: NRAS and BRAF mutations are commonly reported in melanoma with various frequencies in different countries. However, their correlation with the development of malignant melanoma and tumor prognosis has not previously been studied in the Iranian population. This study determined the prevalence ...
Read More
Background: NRAS and BRAF mutations are commonly reported in melanoma with various frequencies in different countries. However, their correlation with the development of malignant melanoma and tumor prognosis has not previously been studied in the Iranian population. This study determined the prevalence of these mutations and their association with tumor-related factors.Methods: This cross-sectional study involved 50 patients admitted to two dermatology hospitals with a definitive diagnosis of melanoma (primary or metastatic) who received surgery as a selective therapeutic option. The genomics of the BRAF and NRAS mutations were determined with the real-time PCR technique.Results: BRAF and NRAS mutations were presented in 30% and 26% of patients, respectively. The NRAS mutation correlated with mitosis (P = 0.026), while the BRAF mutation correlated with visceral involvement (P = 0.023). None of the mutations correlated with gender, age, melanoma type (primary vs. metastasis), ulcer, microsatellitosis, and lymph node involvement.Conclusion: BRAF and NRAS mutations demonstrated relatively high prevalence in Iranian patients with melanoma, which may be valuable prognostic tools in predicting tumor prognosis and metastasis.
Mojgan Karbakhsh; Kosar Hedayat; Azadeh Goodarzi; Maryam Ghiasi; Narges Ghandi
Abstract
Background: Vitiligo is a stigmatizing, chronic, and usually progressive skin disorder that affects patients' quality of life and can interfere with their social participation. There are no studies in developing countries focusing on this aspect. Hence, we assessed social participation in patients with ...
Read More
Background: Vitiligo is a stigmatizing, chronic, and usually progressive skin disorder that affects patients' quality of life and can interfere with their social participation. There are no studies in developing countries focusing on this aspect. Hence, we assessed social participation in patients with vitiligo and its associations with Vitiligo Quality of Life (VitiQoL), Vitiligo Area Score Index (VASI), and demographic and clinical characteristics. Methods: This cross-sectional study was conducted between 2013-2014 on 170 patients, in Razi Hospital, Tehran, Iran. In the pilot phase, the Persian version of the Participation Scale (P-scale) and VitiQoL questionnaire were validated with the backward-forward translation method. Results: Among 173 vitiligo patients, the mean participation score was 15.12 (SD=13.88, median=11). Overall, 91 patients (52.6%) had no significant restriction, 38 (22%) suffered from mild, 23 (13.3%) moderate, 20 (11.6%) severe, and 1 (0.6%) suffered from extreme restriction in participation. The association between VitiQol and P-scale was highly significant (r=0.58; p <0.001). This association was also observed with the three subscales of VitiQol, namely participation limitation (r=0.59, p <0.001), behavior (r=0.43, p <0.001), and stigma (r=0.23, P=0.002). We did not find a significant association between P-scale and demographic characteristics, overall VASI, and face, genitals, and exposed areas VASI. Conclusion: Although the majority of our patients perceived no or mild limitation in their social participation, the P-scale score was highly correlated with their quality of life and its components.
Liyana D Aminuddin; Tarita Taib; Mohamad Rodi Isa; Mohan Arumugam; Sabrina A Wahab
Abstract
Background and Aim: Silicone-based products are often used to improve signs and symptoms of hypertrophic and keloid scars. An improved silicone product, ScarLess™ Hydrogel (SH), is a 5% silicone-based super-oxidized hydrogel meant to reduce keloid scars’ vascularity, elasticity, and height. ...
Read More
Background and Aim: Silicone-based products are often used to improve signs and symptoms of hypertrophic and keloid scars. An improved silicone product, ScarLess™ Hydrogel (SH), is a 5% silicone-based super-oxidized hydrogel meant to reduce keloid scars’ vascularity, elasticity, and height. This study aimed to compare the efficacy between SH and hydrocortisone (HCT) 1% ointment in keloid treatment.Methods: This study was a prospective, single-centered, randomized, double-blind study involving twenty-eight subjects with keloid scars. The scars were assigned randomly as Scar A and Scar B in a 1:1 ratio to receive HCT or SH under occlusion, respectively, for over 12 weeks. The Patient and Observer Scar Assessment Scale (POSAS) was used for clinical evaluation.Results: According to the POSAS, there were significant improvements in both patient and observer scorings in both treatment arms.Conclusion: SH has equal therapeutic efficacy as HCT in keloid treatment. SH did not present with any safety issues or side effects.
Maryam Aghaei; Shahrzad Aghaei; Fariba Iraji; Mohammad-Ali Nilforoushzadeh; Sayed Mohsen Hosseini; Zabihollah Shahmoradi; Seyed Hossein Hejazi
Abstract
Background: Vitiligo is an autoimmune disease of the skin that affects both sexes and people of any age. The genetic and environmental factors are involved in the vitiligo etiology. Helicobacter pylori (H. pylori) has an important role in vitiligo progression. Therefore, the present study evaluated H. ...
Read More
Background: Vitiligo is an autoimmune disease of the skin that affects both sexes and people of any age. The genetic and environmental factors are involved in the vitiligo etiology. Helicobacter pylori (H. pylori) has an important role in vitiligo progression. Therefore, the present study evaluated H. pylori seropositivity in vitiligo patients compared to healthy individuals.Method: H. pylori infection was investigated in 210 vitiligo patients and 127 sex- and age-matched healthy controls using Enzyme- Linked Immunosorbent Assay (ELISA) test. The data was analyzed using SPSS software version 20.0, and the groups were compared using T-test and ANOVA tests. P < 0.05 was considered statistically significant.Results: Vitiligo patients had higher median levels of IgG (29.68 ± 28.28 RU/mL) than (19.08 ± 20.12 RU/mL) in healthy controls (P < 0.000). Moreover, there was no significant difference between groups based on the level of IgM (P < 0.207). In the vitiligo group, IgG or IgM means were different compared to age (P < 0.33)/ (P < 0.017) and early symptoms (P < 0.00) (P < 0.02), respectively. Unlike IgG, there was a significant difference between the mean level of IgM, the onset age of vitiligo (P < 0.022), and the duration of the disease (P < 0.05). Moreover, males and females with vitiligo had a higher seropositivity to H. pylori antibodies than the control group.Conclusion: Vitiligo was found to be significantly associated with H. pylori in Iranian patients. Therefore, it seemed probable that H. pylori had an important role in the initiation or progression of disease activity in vitiligo.
Hojat Eftekhari; Seyyede Zeinab Azimi; Abbas Darjani; Rana Rafiei; Melika Amookhteh
Abstract
Background: Psoriasis is a chronic disease that may affect patients’ quality of life. We investigated the quality of life (QoL) and its related factors in psoriasis patients. Methods: In this cross-sectional study, 123 patients with psoriasis vulgaris were enrolled, who were at the ...
Read More
Background: Psoriasis is a chronic disease that may affect patients’ quality of life. We investigated the quality of life (QoL) and its related factors in psoriasis patients. Methods: In this cross-sectional study, 123 patients with psoriasis vulgaris were enrolled, who were at the age of 18-55 years. The QoL was assessed by the psoriasis disability index (PDI) questionnaire. The stress associated with psoriasis was evaluated by the psoriasis life stress inventory (PLSI) questionnaire. The severity of the disease (SoD) was measured based on the psoriasis area and severity index (PASI) score. Results: In this study, the mean age of the patients was 40.77 ± 0.73 years, and the mean duration of the disease was 8.7 ± 8.23 years. The average PASI score was 11.06, and the average PDI score was 11.98. The average PDI and PASI scores of smoker patients were significantly more than those of non-smokers (P = 0.017). There was a strong relationship between all parts of QoL and PLSI scores, as well as between PASI and PLSI (P < 0.05). Conclusions: Psoriasis reduced our patients’ quality of life. Thus, it is recommended that the QoL in psoriatic patients be evaluated. Stress management and psychological supporting methods are necessary for these patients.
Sandra Widaty; Eliza Miranda; Sri Linuwih Menaldi; Mufqi Handaru Priyanto; Henin Tirta Kusumawardhani; Aria Kekalih; Kusmarinah Bramono
Abstract
Background: Malassezia folliculitis (MF) is a chronic disease that develops in the pilosebaceous unit, caused by Malassezia species. Patients’ characteristics, clinical manifestations, laboratory examination, and treatment choice affect the clinical recovery in patients with MF. This study aimed ...
Read More
Background: Malassezia folliculitis (MF) is a chronic disease that develops in the pilosebaceous unit, caused by Malassezia species. Patients’ characteristics, clinical manifestations, laboratory examination, and treatment choice affect the clinical recovery in patients with MF. This study aimed to identify several potential factors that determine the treatment outcome of MF.Methods: This retrospective study was conducted at Dr. Cipto Mangunkusumo Hospital, Jakarta, from 2013 to 2017. Eligible patients diagnosed with MF based on clinical and microscopic examinations were included. Clinical outcomes were defined as complete cure or improvement with a decrease in the subjective symptoms (itchiness) and objective symptoms (lesions). Analyses were carried out using STATA version 5.0, and some analyses and graphics were generated in R (version 3.2.2 for Windows), GraphPad Prism version 6.01, and Microsoft Excel.Results: A total of 30 patients with MF were recruited. Several factors had a significant effect on the clinical outcomes such as predilection site (chest; HR 1.422; 95% CI 1.262–1.696; P = 0.018), isolated systemic therapy (HR 1.915, 95% CI 1.441–2.532; P = 0.002), and combination therapy (HR 1.858; 95% CI 1.350–2.541; P = 0.041).Conclusion: Lesions in the chest area, isolated systemic antifungal therapy, and combination therapy were associated with good outcomes following antifungal treatment.
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 ...
Read More
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.
Lotfollah Afzali; Shima Rahmati; Reza Zargarsaleh; Babak Alavi-Farzaneh; Mehdi Banitalebi
Abstract
Background: Wound healing in grade II burns is one of the treatment priorities. Advances in new sciences, such as stem cell therapy, biological scaffolds, and growth factors, have renewed hopes in this area. The present study aimed to assess the impact of ADSCs encapsulated in PRP/Chitosan-based gel ...
Read More
Background: Wound healing in grade II burns is one of the treatment priorities. Advances in new sciences, such as stem cell therapy, biological scaffolds, and growth factors, have renewed hopes in this area. The present study aimed to assess the impact of ADSCs encapsulated in PRP/Chitosan-based gel and PRP/Chitosan cell-free gel on the healing of grade-II burn wounds in rats as compared to the control group.Methods: Thirty rats were randomly assigned to one of three groups. Following adipose stem cell extraction, a deep grade II burn was induced in the back of the rats using a standardized catheter. The first group served as a control and received simply routine treatments. The second group received a gel based on PRP/Chitosan and ADSCs, and the third group received a gel free of PRP/Chitosan cells. The results were based on response to treatment, observable granulation tissue formation, or epithelialization at 7, 14, 21, and 28 days after treatment.Results: The findings revealed that the use of a cell-based PRP/ Chitosan scaffold or cell-free PRP/Chitosan scaffold reduced the rate of necrosis and inflammation and increased the rate of epithelialization, granulation, and neovascularization compared to the control group (P < 0.05). Moreover, the use of stem cells in scaffolds resulted in greater wound healing than the cell-free scaffolds group (P < 0.05).Conclusion: Due to their porosity and the improved efficacy of stem cells placed in them, PRP/Chitosan scaffolds could have a positive impact on healing and speed up the wound healing process.
Armaghan Ghareh Aghaji Zare; Afsaneh Radmehr; Sara Saniee; Mohadese Dalvand; Mohammad-Salar Hosseini
Abstract
Background and Aim: Autoimmune Bullous Diseases (AIBDs) are characterized by blistering skin and mucous membrane lesions. This study evaluated the quality of life and associated factors in patients with AIBDs.Methods: In this cross-sectional study, we included all clinicallyand laboratory-confirmed AIBD ...
Read More
Background and Aim: Autoimmune Bullous Diseases (AIBDs) are characterized by blistering skin and mucous membrane lesions. This study evaluated the quality of life and associated factors in patients with AIBDs.Methods: In this cross-sectional study, we included all clinicallyand laboratory-confirmed AIBD patients older than 16 years who sought care at the Dermatology and Hair Clinic of Sina Hospital (Tabriz, Iran) from March to September 2020. We collected the demographic characteristics, disease profile, Autoimmune Bullous Disease Quality of Life (ABQOL) score, and Autoimmune Bullous Skin Disorder Intensity Score (ABSIS). The recorded data were analyzed using SPSS v16 software.Results: One hundred patients (44 men and 46 women) with a mean age of 52 ± 2 years participated in this study. Among them, 76 had pemphigus vulgaris, 18 had bullous pemphigoid, and 6 had pemphigus foliaceous. A median score of six was recorded for the ABQOL, and a median score of one was recorded for the ABSISscale. The relationship between quality of life and disease severity was statistically significant (P = 0.001). Also, a weak but statistically significant association was observed between the quality of life and patients’ age (P = 0.049).Conclusion: We demonstrated that increased disease severity significantly impairs AIBD patients’ quality of life. On this account, patients with severe AIBDs require more social, psychological, and financial support.
Azadeh Goodarzi; Elham Behrangi; Mohammadreza Ghassemi; Golnaz Mehran; Niloofar Teymoori; Amir Pouyan Ghahremani; Maryam Biglari Abhari
Abstract
Background: Acne vulgaris is among common bothersome skin problems. Recognition of contributing factors would help to prevent acne. Some dietary and inflammatory factors are among suggested etiologies. Accordingly, in this study, the serum levels of calcium, vitamin D, phosphorous ...
Read More
Background: Acne vulgaris is among common bothersome skin problems. Recognition of contributing factors would help to prevent acne. Some dietary and inflammatory factors are among suggested etiologies. Accordingly, in this study, the serum levels of calcium, vitamin D, phosphorous and C-reactive protein (CRP) were determined and compared in acne patients and healthy subjects. Methods: In this case-control study, 144 consecutive subjects with and without acne (moderate-very severe) referred to Rasoul Akram Hospital in 2016 were enrolled. In this regard, the serumcalcium, phosphorous, CRP, vitamin D were determined in the subjects and compared between the groups. Results: The results indicated that serum CRP, calcium, and phosphorous level were alike between the groups (P > 0.05) without any relation to acne severity except CRP. The serum vitamin D level was significantly different (P = 0.0001), but it was not associated with acne severity. Serum calcium levels of males were significantly higher in both groups. Conclusions: Based on our results, it may be concluded that calcium, phosphorous, and CRP levels are not associated with acne incidence, but the serum vitamin D is related to acne presentation. CRP levels were positively associated with acne vulgaris severity.
Yalda Nahidi; Bita Kiafar; Zohre Sadeghinejad; Lida Jarahi; Tahmineh Mallakifard
Abstract
Background: Psoriasis is a disease that influences the physical, psychological, and social dimensions of the lives of those affected. We aimed to evaluate the effect of psoriasis disease on the quality of life of patients and their partners.Methods: Forty psoriasis patients were eligible for inclusion ...
Read More
Background: Psoriasis is a disease that influences the physical, psychological, and social dimensions of the lives of those affected. We aimed to evaluate the effect of psoriasis disease on the quality of life of patients and their partners.Methods: Forty psoriasis patients were eligible for inclusion in this study. Each participant’s clinical data were collected, including age, sex, PASI score, history of treatment, family history of the disease, educational level of the patients and their spouse, profession, and history of divorce. The patients and partners completed the Dermatology Life Quality Index (DLQI) and Family Dermatology Life Quality Index (FDLQI) questionnaires, respectively. The results were compared against 40 age and sexmatched healthy individuals and their partners.Results: The mean DLQI score was 11.75 ± 7.25 among patients, and the mean FDLQI score of their partners was 12.20 ± 5.63. There was a significant difference between the patients/partners and the respective control groups in DLQI and FDLQI scores (P < 0.001). There was a significant correlation between disease severity and DLQI/FDLQI scores (P < 0.05). Also, a meaningful relationship was noted between the quality of life of patients and their spouses (r = 0.48, P = 0.001). Besides, the PASI score shared a significant relationship with the DLQI (P = 0.003, r = 0.46) and FDLQI (P = 0.001, r = 0.56) scores.Conclusion: We conclude that psoriasis harms the quality of life of both patients and their families, which deteriorates with an increase in disease severity and PASI scores.
Rezvan Talaee; Mahdiyeh Mohammadzadeh; Habibollah Rahimi
Abstract
Background: Cracked nipples represent the most common complication of breastfeeding. This study aimed to compare the therapeutic effect of the Cicalfate® commercial cream (containing copper, zinc, and sucralfate) with white soft paraffin in treating cracked nipples. Methods: This study was a double-blind ...
Read More
Background: Cracked nipples represent the most common complication of breastfeeding. This study aimed to compare the therapeutic effect of the Cicalfate® commercial cream (containing copper, zinc, and sucralfate) with white soft paraffin in treating cracked nipples. Methods: This study was a double-blind clinical trial conducted on 115 patients with cracked nipples. Patients were randomly divided into two case and control groups. The case group received the Cicalfate® cream and the control group received white soft paraffin. After a period of one to two weeks of treatment, all patients were re-examined and the severity and rate of their recovery were recorded. Data were analyzed using SPSS version 15. Results: In this study, 68 patients were in the case group and 47 were in the control group. The comparison of the two groups in terms of improvement of the right nipple with the removal of other variables showed that the degree of cracking reduction in the case group was 3.3 times that of the control group (OR=3.3; CI=1.3-8.3). Also, the comparison of the two groups in terms of improvement of the left nipple with removing the effect of other variables showed that the degree of cracking reduction in the case group was 5.3 times that of the control group (OR=5.3; CI=2.0-14.1). Conclusion: The results of this study showed that the therapeutic effect of Cicalfate® is more than that of white soft paraffin.
Azadeh Rakhshan; Afshin Moradi; Hedieh Peiroolia
Abstract
Background: Androgenic hair loss (AGA) and alopecia areata (AA) are common conditions which sometimes are histologically difficult to differentiate. This study was conducted to detect differentiating features of these two disorders with IHC analysis of T-cell subsets in the inflammatory ...
Read More
Background: Androgenic hair loss (AGA) and alopecia areata (AA) are common conditions which sometimes are histologically difficult to differentiate. This study was conducted to detect differentiating features of these two disorders with IHC analysis of T-cell subsets in the inflammatory infiltrates of alopecia areata and androgenetic alopecia. Methods: This cross-sectional study was conducted at Shohadae-Tajrish Hospital in 2018. Twenty-eight cases of alopecia areata and 32 androgenic hair loss cases were evaluated. H&E and IHC staining for CD3, CD4, and CD8+ T-lymphocytes were performed. Lymphocytic densities were graded in a quintet grading system. The inflammation density in various areas of skin tissue was evaluated. Statistical analysis was performed using SPSS version 21. Results: Peribulbar lymphocytic infiltration was seen in 88.5% of AA patients and 12.5% of AGA patients (P = 0.000). Presence of melanin, pigmented casts, and lymphocytes in follicular stelawere in favor of AA diagnosis. CD3, CD4, and CD8+ T-cells in follicular stela, peri-bulbar, and subcutaneous regions were higher and denser in AA patients, while CD3 and CD4+ T-cells aroundsebaceous ducts were in favor of AGA diagnosis. Conclusion: Peribulbar lymphocytic infiltration is among the most important differentiating features of AA and AGA. Infiltration of T-cells in various regions of skin tissue has high diagnosticvalue. Histologic and immunohistochemical evaluation of skin tissues according to these factors can differentiate these two entities with high precision.
Alireza Ghanadan; Kambiz Kamyab; Rokhsareh Yadegar; Mehri Maghsoodi
Abstract
Background and Aim: Mycosis fungoides (MF) is the most common form of primary cutaneous lymphoma, resulting from the infiltration of malignant T cells into skin tissues. The disease has three distinct stages: patch, plaque, and tumor. In the patch and plaque stages, it can mimic the clinical features ...
Read More
Background and Aim: Mycosis fungoides (MF) is the most common form of primary cutaneous lymphoma, resulting from the infiltration of malignant T cells into skin tissues. The disease has three distinct stages: patch, plaque, and tumor. In the patch and plaque stages, it can mimic the clinical features of benign dermatoses. However, two scoring systems facilitate diagnosis at these stages, which will be discussed in more detail in this study.Methods: In this cross-sectional study, all formalin-fixed and paraffin-embedded skin specimens highly susceptible to MF based on clinical examination at the patch and plaque stages were collected from April 2017 to August 2019. They were subjected to H&E and IHC staining tests and examined according to Guitart and Pimpinelli criteria.Results: Out of 78 samples, 76 had histological criteria for MF according to Guitart’s criteria, 54 were immunologically significant according to Pimpinelli’s criteria for MF, and 52 were classified as definitive MF according to both criteria. CD3 and CD4 markers were the most frequent markers, respectively. In contrast to previous studies, the CD7 marker was expressed at 10% or higher in 24 cases. In addition, 65 of 78 samples had a CD8 marker, and only 13 samples were CD8-.Conclusion: In the early stages of MF, a single scoring system does not have sufficient sensitivity for the diagnosis. The triad of the patient’s clinical presentation and histological and immunohistochemical features play a key role in achieving the correct diagnosis.
Reza M Robati; Farahnaz Bidari Zerehpoosh; Azadeh Rakhshan; Mona Gorji; Zahra Razzaghi; Mostafa Rezaei-Tavirani; Sareh Salarinejad
Abstract
Background: Amyloidosis is a rare disease characterized by the extracellular deposition of a misfolded protein in multiple organs. Cutaneous amyloidosis (CA) is diagnosed by detecting amyloid deposition in the skin. Lichen amyloidosis (LA) and macular amyloidosis (MA) without visceral involvement are ...
Read More
Background: Amyloidosis is a rare disease characterized by the extracellular deposition of a misfolded protein in multiple organs. Cutaneous amyloidosis (CA) is diagnosed by detecting amyloid deposition in the skin. Lichen amyloidosis (LA) and macular amyloidosis (MA) without visceral involvement are two of its more prevalent types.Methods: This case-control study was conducted to evaluate C4d staining in amyloidosis to determine whether it could be used as a diagnostic tool for amyloidosis. Moreover, the results of C4d expression in amyloidosis with colloid bodies in lichen planus (LP) were compared. Therefore, 41 cases of CA and 43 cases of LP were selected. All samples were stained with C4d immunostain.Results: 12 of 41 cases of CA had apple green birefringence; however, all of them were positive for C4d, the same as the LP group. The CA group had 100% C4d and 29% Congo red sensitivities (P < 0.05). C4d had 100% sensitivity for colloid bodies in LP. Therefore, the C4d stain could serve as a new IHC marker for highlighting the colloid bodies.Conclusion: C4d immunohistochemical (IHC) staining could be a very valuable ancillary tool for diagnosing amyloidosis, although it did not differentiate amyloid deposition from colloid bodies of LP.
Madhulika A Mhatre; Shashikant Malkud; Venkataram Mysore
Abstract
Background: The Q-switched neodymium: yttrium aluminum garnet laser (QS-Nd:YAG) is effective in the treatment of tattoos and different pigmentary conditions; however, little has been published regarding the removal of facial cutaneous pigmented lesions. The aim of this study was to determine the effectiveness ...
Read More
Background: The Q-switched neodymium: yttrium aluminum garnet laser (QS-Nd:YAG) is effective in the treatment of tattoos and different pigmentary conditions; however, little has been published regarding the removal of facial cutaneous pigmented lesions. The aim of this study was to determine the effectiveness and safety of QS-Nd:YAG laser in the treatment of facial pigmentary lesions in Indian patients. Methods: Data of 100 patients with pigmented facial lesions treated with QS-Nd:YAG laser were analyzed. Clinical improvement of skin lesions was assessed by the physician’s global assessment of two blinded observers. This was done based on photographs taken at the baseline and after the last treatment session. Side effects were recorded if present, and patient satisfaction was evaluated after each treatment session. Results: The majority of the patients had post-inflammatory hyperpigmentation (n=41), followed by melasma (n=19), photomelanosis (n=15), nevus of Ota (n=5), periorbital melanosis (n=5), nevus spilus (n=3), Riehl melanosis (n=3), Café-au-lait macules (n=2), freckles (n=2), lichen planus pigmentosus (n=2), compound nevus (n=1), Hori’s nevus (n=1), and pigmentary demarcation lines (n=1). 10% of patients showed more than 50% improvement in pigmentation from the baseline level; no response was seen in 22% of patients, while 7% experienced worsened pigmentation. Conclusion: The degree of improvement and efficacy in clearing pigmentation is partial, variable, and inconsistent. Worsening of pigmentation may be seen and needs to be discussed with the patient prior to treatment
Kambiz Kamyab Hesari; AliReza Ghanadan; Vahidehsadat Azhari; Shirin Taraz Jamshidi; Reza Amiri; Hamidreza Mahmoudi; Ali Salehi Farid; Ali Nili; Anahita Borzouei; Maryam Daneshpazhooh
Abstract
Background: Lichen planopilaris (LPP) is the most common form of immune-mediated scarring alopecia. We evaluated the histopathologic features of LPP in vertical sections of scalp biopsies and compared findings between the scarring and nonscarring phases of the disease.Methods: From June 2019 to June ...
Read More
Background: Lichen planopilaris (LPP) is the most common form of immune-mediated scarring alopecia. We evaluated the histopathologic features of LPP in vertical sections of scalp biopsies and compared findings between the scarring and nonscarring phases of the disease.Methods: From June 2019 to June 2020, vertically sectioned scalp biopsies of 70 new cases of LPP were examined (H&E) according to North American Hair Research Society criteria. Furthermore, patients were divided into two groups based on either the presence or the absence of vertical fibrous bands, and other histopathological features were compared between these two groups.Results: Characteristic findings of LPP were perifollicular lymphocytic infiltration (97.1%), follicular interface degeneration (60%), and perifollicular plasmacytic infiltration (21.4%). Vacuolar degeneration in the dermo-epidermal junction (38.6%), perifollicular lamellar fibroplasia (67.1%), loss of sebaceous glands (87.1%), perifollicular cleft formation (28.6%), and vertical fibrous tracts (65.7%) were also found. Furthermore, we found a significant correlation between the presence of fibrous tracts with both loss of sebaceous glands (P = 0.005) and the presence of lamellar fibroplasia (P = 0.015).Conclusion: The most common findings in the histopathological examination of LPP slides are perifollicular lymphocytic infiltration and loss of the sebaceous glands. Furthermore, sebaceous gland loss and perifollicular lamellar fibroplasia correlate with the scarring phase of LPP.
Saeedeh Farajzadeh; Mahin Aflatoonian; Saman Mohammadi; Rezvan Amiri; Maryam Khalili; Zahra Heydarimoghadam
Abstract
Background and Aim: Infantile hemangioma is the most common type of vascular tumor in childhood. Risk factors for hemangioma include female gender, low birth weight, prematurity, higher maternal age, and multiple gestations. In this study, for the first time in Kerman, we describe and compare demographic ...
Read More
Background and Aim: Infantile hemangioma is the most common type of vascular tumor in childhood. Risk factors for hemangioma include female gender, low birth weight, prematurity, higher maternal age, and multiple gestations. In this study, for the first time in Kerman, we describe and compare demographic features of infants with hemangiomatous lesions treated with two different systemic beta-blockers (atenolol or propranolol), examining their efficacy and adverse effects.Methods: Forty-one infants with hemangiomatous lesions admitted to the pediatric dermatology ward of Afzalipour Hospital from 2011 to 2017 were enrolled in this study. Demographic features of infants and their mothers and clinical features and complications of hemangiomatous lesions were recorded. Also, we compared the efficacy and adverse effects of treatment protocols with two betablockers (atenolol and propranolol).Results: Most infants were female (70.7%), and 9.7% were premature. The majority of the lesions were superficial (53.7%) and located in the head and neck area (82.9%). Multiple hemangiomas were recorded in 4.8% of the cases. The most common complication was ulceration (29.3%). Two out of 18 patients treated with propranolol had a complete response rate. Adverse effects were observed more frequently with propranolol (26.8%) than with atenolol (14.6%).Conclusion: In our study, female gender and low birth weight were significantly more common in infantile hemangioma patients than in the normal population. Also, mothers of children with hemangioma had a significantly greater number of miscarriages than the average population. Propranolol and atenolol had no significant difference in efficacy and adverse effects.
Azadeh Goodarzi; Masoumeh Roohaninasab; Najmol Sadat Atefi; Afsaneh Sadeghzadeh Bazargan; Mohammadreza Ghassemi; Amir Pouyan Ghahremani; Niloofar Teymoori; Maryam Biglari Abhari
Abstract
Background: Acne vulgaris is a dermatologic disorder with a wide variety of distribution and presentation. Its high prevalence and important cosmetic and psychological concerns focusing on contributing factors would be of great value for better approach and prevention of acne vulgaris. ...
Read More
Background: Acne vulgaris is a dermatologic disorder with a wide variety of distribution and presentation. Its high prevalence and important cosmetic and psychological concerns focusing on contributing factors would be of great value for better approach and prevention of acne vulgaris. There are many articles that argue the role of some dietary and inflammatory factors in acnevulgaris. In this study, the serum levels of zinc in acne patients were determined and compared with healthy subjects. Methods: In this age and gender matched case-control study, 200 consecutive subjects with and without acne (moderate-very severe) referring to Rasoul Akram Hospital, 2016, were enrolled,and their serum zinc levels were determined and compared across the groups. Results: Serum zinc levels were alike across the groups (P > 0.05), and the severity of acne was not related to zinc level. The levels of zinc were significantly different between genders in the casegroup (men had lower levels). In female patients with acne, the level of zinc was inversely correlated with acne severity. Conclusion: Zinc is not related to acne incidence or its grade, but men with acne have lower levels of zinc compared with women. Also, acne severity in women is inversely correlated with zinc level. It can be assumed that zinc supplementation may be a good trend in men with acne or alleviate the severity of acne in women, which needs more evaluation and work up.
Mohnish Sekar; Arun Inamadar; Ajit Janagond
Abstract
Background: Atopic dermatitis (AD) is a prevalent, chronic, inflammatory skin disorder that primarily affects children, with just a few cases persisting into adulthood. Many theories exist to ascertain the relationship between atopic dermatitis and systemic inflammation. Neutrophil lymphocyte ratio (NLR), ...
Read More
Background: Atopic dermatitis (AD) is a prevalent, chronic, inflammatory skin disorder that primarily affects children, with just a few cases persisting into adulthood. Many theories exist to ascertain the relationship between atopic dermatitis and systemic inflammation. Neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and Mean platelet volume (MPV) are biomarkers of systemic inflammation, which in turn are related to atopic dermatitis. The present study aimed to assess the association between atopic dermatitis and NLR, PLR, and MPV values by calculating NLR, PLR, and MPV ratio and correlating their levels with the disease duration and severity of AD in pediatric atopic dermatitis.Methods: This cross-sectional study included 165 pediatric atopic dermatitis patients who met the clinical confirmation criteria of the U.K. working party. The patients with co-existing conditions such as molluscum contagiosum, impetigo, hand-foot and-mouth disease, and eczema herpeticum were excluded. The mean ± SD values of NLR, PLR, and MPV were compared after the severity groups were classified using SCOR Atopic Dermatitis (SCORAD). The association of SCORAD and disease duration with NLR, PLR, and MPV levels was evaluated.Results: Significant differences were noted between severity groups based on NLR, PLR, and MPV values. PLR and NLR had a positive correlation with the SCORAD score, whereas MPV was negatively correlated. In addition, NLR had a positive correlation with disease duration. PLR exhibited a higher diagnostic accuracy in predicting high SCORAD with a 100% sensitivity and specificity cut-off value of > 172.Conclusion: NLR, PLR, and MPV were cost-effective, feasible, andwidely available tests to detect systemic inflammation in AD with high sensitivity and specificity.
