Zahra Akbari; Mohammad Shafie'ei; Nastaran Sarvipour; Mohadese Ahmadzade; Hamidreza Rouientan; Saeedeh Farajzadeh; Najmeh Ahramiyanpour
Abstract
Background: Among many coronavirus disease 2019 (COVID-19)integumentary system involvements, alopecia is one of the leastinvestigated. This disorder has been reported in many individualswho have suffered from varying severities of COVID-19. Weaimed to systematically review studies evaluating the onset ...
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Background: Among many coronavirus disease 2019 (COVID-19)integumentary system involvements, alopecia is one of the leastinvestigated. This disorder has been reported in many individualswho have suffered from varying severities of COVID-19. Weaimed to systematically review studies evaluating the onset ofdifferent types of alopecia following COVID-19.Methods: The PubMed, Scopus, Web of Science, and Embasedatabases were searched with a specified string of relevantkeywords. After quality assessments, the data of eligible studieswere qualitatively and quantitatively synthesized.Results: Sixteen studies were included in our review, six ofwhich underwent meta-analysis for the differences in the risk ofalopecia between males and females. Though the disorder wasnot differentiated in all the cases, we found that COVID-19 wasassociated with several different types of alopecia, includingtelogen effluvium, alopecia areata, alopecia parvimaculata, andlichen planopilaris. Moreover, although statistically insignificant,the odds of developing alopecia favored the female population.Conclusion: Although many hypotheses have been suggested asto why an individual might be more predisposed to developingalopecia following COVID-19, the data obtained from the studiesyielded results that could not lead to definite conclusions. Therefore,we recommend that further studies be conducted to evaluatethe association between the two phenomena more confidently.
Saeid Fallah; Vahideh Raeisi
Abstract
Atrichia with papular lesions (APL) is a rare autosomal recessive disease caused by a genetic mutation in the human hairless gene’s zinc finger domain. It suddenly appears in the first months after birth and causes irreversible hair loss and keratin cysts on the head, face, and other body parts. ...
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Atrichia with papular lesions (APL) is a rare autosomal recessive disease caused by a genetic mutation in the human hairless gene’s zinc finger domain. It suddenly appears in the first months after birth and causes irreversible hair loss and keratin cysts on the head, face, and other body parts. Our patient is a 31-year-old female of a consanguineous marriage living in a deprived and remote city of Iran. She suffered from total hair loss and papules spreading all over the body. The patient showed no signs of other physical or mental health issues; she also had healthy physical growth and standard eyesight and hearing. Bone and teeth development were developed, and sweat glands were also robust. APL was diagnosed based on the clinical findings (total hair loss, emergence of papules, morbidity over the body from early childhood, and hypopigmented suture-like lines on the scalp), standard laboratory tests rejecting other differential diagnoses, and lack of response to all available treatments.
Siti Nurhidayah Pazil; Maryam Mohd Zulkifli; Rosediani Muhamad; Loh Ken Chen
Abstract
The use of highly active antiretroviral therapy (HAART) has prevented opportunistic infections that often lead to death in HIV-positive patients. However, in resource-poor countries, HAART is only initiated at an advanced stage. This could lead to the antiretroviral-induced immune reconstitution syndrome ...
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The use of highly active antiretroviral therapy (HAART) has prevented opportunistic infections that often lead to death in HIV-positive patients. However, in resource-poor countries, HAART is only initiated at an advanced stage. This could lead to the antiretroviral-induced immune reconstitution syndrome or the immune reconstitution inflammatory syndrome (IRIS). The most frequently implicated pathogens associated with these syndromes are mycobacteria, varicella-zoster, herpes viruses, and cytomegalovirus. There are few numbers of case reports of leprosy that have an association with HIV. Meanwhile, lepra reactions are immunological phenomena that can occur before, during, or at the end of multi-drug treatment (MDT). Here, we report the case of a 39-year-old man who presented with four hypoesthetic skin lesions with left ulnar nerve thickening after two months on antiretroviral treatment. He was diagnosed with borderline tuberculoid leprosy as his slit-skin smear showed negative results with four skin lesions and his skin biopsy revealed tuberculoid leprosy with perineural involvement. The patient was started on the paucibacillary MDT regime consisting of dapsone and rifampicin. However, he developed two new hypoesthetic skin lesions over the left gluteal region and left arm, thus being switched to multibacillary MDT. He further developed a type 1 lepra reaction after one month of the regime, though this was successfully treated with prednisolone.
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.
Farnoosh Seirafianpour; Farzaneh Mashayekhi; Milad Dodangeh; Forough Seifi Gharabaghloo; Masoud Pourghahramani Koltapeh; Ali Jamshidi Naeini; Rohollah Valizadeh; Davood Lakestani; Samaneh Mozafarpoor; Azadeh Goodarzi
Abstract
Background: About 20% of patients with coronavirus disease2019 (COVID-19) present with mucocutaneous eruptions. Earlyskin or dermatological manifestations can help pediatriciansprevent the spread of the disease by suspecting COVID-19 inasymptomatic or minimally symptomatic patients.Methods: PubMed, Scopus, ...
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Background: About 20% of patients with coronavirus disease2019 (COVID-19) present with mucocutaneous eruptions. Earlyskin or dermatological manifestations can help pediatriciansprevent the spread of the disease by suspecting COVID-19 inasymptomatic or minimally symptomatic patients.Methods: PubMed, Scopus, Embase, Google Scholar, and theNottingham University website were searched on Sep. 1st, 2020,to retrieve studies regarding COVID-19-related mucocutaneousmanifestations in patients under the age of 18.Results: Data were extracted from 76 articles including 38,387 cases.Chilblain/pernio-like lesions were the most common dermatologicalmanifestation, followed by multisystem inflammatory syndrome inchildren (MIS-C)/Kawasaki-like syndrome. Most dermatologicalsigns were self-limited, presenting before, simultaneously with,or after other COVID-19 manifestations. In 40% of the affectedchildren, these signs were the sole presentation of COVID-19.Conclusion: During the COVID-19 pandemic, each newmucocutaneous event in children, especially acral lesions withvascular color, should be considered a possible indicator ofCOVID-19.
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.
Muhammed Mukhtar
Farideh Jowkar; Razieh Ahmadi Mahmoodabadi; Negin Fazelzadeh Haghighi
Archana Mavoori; Sneha Pamar; Sudha Bala
Abstract
Background: Secukinumab is a fully humanized IL-17A antagonist approved for managing moderate-to-severe plaque psoriasis as well as psoriatic arthritis. This study assessed the speed of action of secukinumab and the improvement in the quality of life in a series of patients.Methods: We aimed to assess ...
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Background: Secukinumab is a fully humanized IL-17A antagonist approved for managing moderate-to-severe plaque psoriasis as well as psoriatic arthritis. This study assessed the speed of action of secukinumab and the improvement in the quality of life in a series of patients.Methods: We aimed to assess changes in the PASI (Psoriasis Area Severity Index) and DLQI (Dermatology Life QualityIndex) following a course of secukinumab injections. Methods: This hospital-based study was conducted in the Department of Dermatology, Venereology and Leprosy of ESIC Medical College & Hospital, Hyderabad, India.Results: Starting from 8 weeks after initiation of treatment with secukinumab 300 mg, a clinically significant response was observed, with progressive reduction of skin disease indices. Twenty-four patients were included in the study, with a mean age of 42 years. The male to female ratio was 15:9. Thirteen (54.16%) patients achieved PASI 75 at eight weeks. At the end of 52 weeks, 20 (83.33%), 15 (62.5%), and 8 (33.33%) patients maintained PASI 75, PASI 90, and PASI 100, respectively.Conclusion: Secukinumab is a highly-efficacious, biologic therapy that provides rapid relief with a relatively favorable safety profile in patients with moderate-severe plaque psoriasis. In addition, secukinumab is a preferred treatment for patients with comorbid psoriatic arthritis or arthralgia symptoms due to its ability to arrest the progression of arthritic disease in the early course.
Indriana Pratiwi; Retno Widayati; Muslimin Muslimin
Abstract
Background: Vitamin C and long-pulsed Laser Nd:YAG 1064 nm can reduce the severity of acne scars by increasing the number and density of collagen fibers. Furthermore, applying vitamin C after the skin resurfaces can improve its penetration into the skin. This study aimed to prove the difference between ...
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Background: Vitamin C and long-pulsed Laser Nd:YAG 1064 nm can reduce the severity of acne scars by increasing the number and density of collagen fibers. Furthermore, applying vitamin C after the skin resurfaces can improve its penetration into the skin. This study aimed to prove the difference between the effectiveness of the long-pulsed Nd:YAG 1064 nm laser with 15% vitamin C (L-ascorbic acid) solution combination therapy and isolated long-pulsed Nd: YAG 1064 nm laser therapy in atrophic acne scars by assessing the decrease in Goodman and Baron scores.Methods: This study took the form of a double-blind, randomized controlled trial using a pretest-posttest comparison group design on patients with atrophy acne scars on the face. Both groups were assessed using the Goodman and Baron scores before and after therapy for three months. Subsequently, descriptive analysis andhypothesis testing were performed. Results: In the treatment group, the mean Goodman and Baron score decreased significantly after treatment to 13.9 ± 7.39 (P = 0.008), while in the control group, the mean score decreased significantly to 18.2 ± 9.34 (P = 0.007). Goodman and Baron Delta scores in the treatment group were significantly higher at 7.3 ± 2.78 compared with the control group at 3.1 ± 1.05 (P < 0.001).Conclusion: Long-pulsed Nd:YAG 1064 nm laser with 15% vitamin C solution (L-ascorbic acid) combination therapy is more effective in lowering the Goodman and Baron scores for atrophic acne scars than isolated long-pulsed Nd:YAG 1064 nm laser.
Hossein Mortazavi; Arileza Mortazavi; Anahita Rostami; Mohammadraza Javadi; Robabeh Abedini; Amir Teimourpour; Kheirolah Gholami; Ali Khamesipour
Abstract
Background: Little data on severe cutaneous adverse drug reactions (SCADRs) is available, especially in Iran. Therefore, there is a need for more studies in this field. We aimed to evaluate the clinical pictures and laboratory data of patients with SCADR in a tertiary dermatology center in Tehran, Iran.Methods: ...
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Background: Little data on severe cutaneous adverse drug reactions (SCADRs) is available, especially in Iran. Therefore, there is a need for more studies in this field. We aimed to evaluate the clinical pictures and laboratory data of patients with SCADR in a tertiary dermatology center in Tehran, Iran.Methods: In this retrospective study, patients with a clinical diagnosis of SCADR based on the World Health Organisation’s definition and histopathologic findings were included. Causality and preventability measures were assessed based on previous criteria, including the Naranjo score and the Schomock and Thronton scale.Results: Thirty-nine patients with a mean age of 43 ± 17 years participated in the study. SCADRs were more common in females than in males (2.9/1). SCADRs included Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), acute generalized exanthematous pustulosis (AGEP), and drug reactions with eosinophilia and systemic symptoms (DRESS). Thirty-one patients presented a Naranjo score of 5-8, indicating probable drug reactions. The remaining eight patients (with scores of 1-4) were determined as having possible drug eruptions. Regarding the category of culprit drugs, anticonvulsants (49%), antimalarials (15%), antibiotics (13%), and antihypertensives (10%) were themost frequent causes of SCADR, with lamotrigine being the single most common agent.Conclusion: The most frequent clinical presentation of SCADR was SJS/TEN, followed by AGEP and DRESS. The most frequent cause of SCADR was anticonvulsant drugs.
Nurona Azizah; Musthika Mashitah; Heri Kristianto
Abstract
Background: The management of third-degree burns primarily aims to enhance the re-epithelialization process. Any impairment in this process may cause delayed wound healing. Rosella calyx (Hibiscus sabdariffa L.) can act as an immunomodulator, possibly affecting the re-epithelialization process.Methods: ...
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Background: The management of third-degree burns primarily aims to enhance the re-epithelialization process. Any impairment in this process may cause delayed wound healing. Rosella calyx (Hibiscus sabdariffa L.) can act as an immunomodulator, possibly affecting the re-epithelialization process.Methods: Rats were randomized after adaptation for a week. Rats (n = 30) were induced with third-degree burns, and it was ensured that they met the criteria for third-degree burns. We divided them into six groups and administered treatment according to each group: 1) negative control group using cold cream only; 2) positive control using silver sulfadiazine (SSD) only; 3) treatment group using rosella calyx extract orally (250 mg/kg) + cold cream; 4) treatment group using rosella calyx extract topically only (250 mg/kg); 5) treatment group using rosella calyx extract orally (250 mg/kg) + SSD; and 6) treatment group using rosella calyx extract orally and topically (each 250 mg/kg). They were sacrificed on day 17 and then stained with hematoxylin and eosin. The variable studied was the re-epithelialization length (mm). Statistical analysis involved analysis of variance (ANOVA) and post hoc correction with P < 0.05 taken as significant.Results: Despite treatment using rosella calyx extract orally + topically showing the longest re-epithelialization, this group showed no significant difference compared with SSD treatment, indicating they may show a similar effect in the re-epithelialization process.Conclusion: Rosella calyx extract applied orally and topically may show a therapeutic effect in the re-epithelialization process. Further research needs to be conducted.
Caroline Oktarina; Danny Surya; Putu Martha Gerynda Sukma; Teguh Hopkop Putera Manurung; Sandra Widaty
Abstract
Background: Scabies is an infestation caused by Sarcoptes scabiei var. hominies, prevalent in children with poor nutritional status and hygiene, particularly in overcrowded communities. Indonesia has 14.5% cases of the double burden of malnutrition among school-aged children. As there has been no study ...
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Background: Scabies is an infestation caused by Sarcoptes scabiei var. hominies, prevalent in children with poor nutritional status and hygiene, particularly in overcrowded communities. Indonesia has 14.5% cases of the double burden of malnutrition among school-aged children. As there has been no study establishing the role of nutritional status in the occurrence of scabies, this study aims to investigate the association between body mass index (BMI) and height with scabies infestation in an Islamic boarding school in Indonesia.Methods: This was a cross-sectional study conducted in an Islamic boarding school in Indonesia with children aged 11-17 years old as participants. Physicians performed anthropometry measurements, and a dermatologist confirmed the diagnosis of scabies through history taking and physical examination. Logistic regression was used to analyze the association between BMI and height and the prevalence of scabies.Results: Of 287 subjects, 135 (47%) were diagnosed with scabies, with a male predominance (66.1%). Most of the subjects had normal weight (76.7%) while 20 (7%) were underweight, and 153 subjects (53.3%) had short stature. Male subjects were four times more likely to be infested by scabies (P < 0.001). Obese and short subjects were 4 and 1.67 times more likely to develop scabies, respectively.Conclusion: Poor nutritional status represented by BMI and height cannot be regarded as an independent risk factor for scabies, while environmental factors might be the most crucial factors in the development of scabies. A holistic approach addressing these factors should be implemented to eradicate scabies in addition to appropriate pharmacological management.
Kaliaperumal Karthikeyan; Iswarya Arumugam; Vijayasankar Palaniappan
Abstract
Porokeratosis is a heterogeneous group of keratinization disorderswith an autosomal dominant inheritance pattern. The etiology andpathogenesis of this disease have not been completely elucidated.The porokeratosis clinically presents with a characteristic prominentperipheral ridge and central dell. The ...
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Porokeratosis is a heterogeneous group of keratinization disorderswith an autosomal dominant inheritance pattern. The etiology andpathogenesis of this disease have not been completely elucidated.The porokeratosis clinically presents with a characteristic prominentperipheral ridge and central dell. The histological feature of theparakeratotic column known as ‘cornoid lamellae’ is a hallmarkfeature observed in the peripheral rim. Among the variousmorphological forms, linear porokeratosis is a rare variant withfour subtypes. When compared to other forms, the linear variantcarries an increased risk of malignancy, particularly squamouscell carcinoma, warranting a regular follow-up. Though there aremultiple treatment options, achieving complete clinical resolutionis difficult. We report an interesting case of linear porokeratosiswith generalized lesions in a 60-year-old male. The lesions weretypical and predominantly distributed in the extremities. Thebiopsy was diagnostic in our patient. This case is reported forits rare presentation and clinical interest.
Jaspriya Sandhu; Sunil Kumar Gupta; Shriya Garg; Sheerin Shah; Bhavna Garg
Abstract
Bowen’s disease (BD) is an in situ squamous cell carcinoma ofthe skin. Pigmented Bowen’s disease (pBD) is a rare variant,representing less than 2% of all BD cases. We report a case ofGiant pBD arising from seborrheic keratosis in a 65-year-old man.The dermoscopy showed a scaly surface, structureless ...
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Bowen’s disease (BD) is an in situ squamous cell carcinoma ofthe skin. Pigmented Bowen’s disease (pBD) is a rare variant,representing less than 2% of all BD cases. We report a case ofGiant pBD arising from seborrheic keratosis in a 65-year-old man.The dermoscopy showed a scaly surface, structureless brown togrey-black areas with dotted vessels, glomerular and reticulatevessels, and a few brown globules. Histopathology was classicalwith a “windblown appearance”; prominent melanophages wereseen in the dermis. Owing to the size and thickness of the plaque,a wide excision with a split-skin graft was done. The graft uptakewas good, and the patient was followed up on days 4 and 26post-surgery. We present our experience with the diagnosis andmanagement of this rare case of giant pBD. To the best of ourknowledge, such a case has not been previously reported.
Mohammad Ali Mapar; Simin Mansorian; Nader Pazyar; Mohammadreza Keshavarz; Atefeh Mansorian
Abstract
Background: Warts are among the most common skin diseases with various recommended treatments, including topical ablation, chemotherapy, and immunotherapy. However, given the unsatisfactory response rate, complications, and recurrence, effective treatment remains controversial. This study compared formalin ...
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Background: Warts are among the most common skin diseases with various recommended treatments, including topical ablation, chemotherapy, and immunotherapy. However, given the unsatisfactory response rate, complications, and recurrence, effective treatment remains controversial. This study compared formalin against an anti-wart compound containing salicylic acid and lactic acid.Methods: This clinical trial recruited 58 patients with wart lesions on hands and feet randomly divided into two groups of daily topical treatment: formalin 5% (n = 29) and anti-wart lotion containing salicylic acid 16.7% and lactic acid 16.7% in flexible collodion (n = 29) for eight weeks. Patient satisfaction and recovery were assessed and compared between the groups at weeks four and eight.Results: Patient satisfaction did not change significantly in either group (P > 0.05), and no significant difference was observed between the groups (P = 0.838). The number of wart lesions fell significantly after eight weeks in both groups (P < 0.001), with no significant difference between them (P = 0.225). There was no significant difference between the two methods in terms of side effects (P = 0.084).Conclusion: Both formalin and salicylic acid plus lactic acid lotion effectively treated plantar and common warts, and neither had any significant side effects. The treatment choice should be based on the patient’s age, the number of lesions, and the site affected.
Jaspriya Sandhu; Sunil Kumar Gupta; Navneet Kaur; Aditi Bansal; Bhavna Garg
Abstract
Acquired digital fibrokeratoma (ADFK) is a rare benign fibroustissue tumor that occurs over the extremities, predominantly inthe periungual area. We report a case of ADFK over the digitof the right hand presenting as a finger-like growth; the base ofthe lesion showed a collarette of scales. The lesion ...
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Acquired digital fibrokeratoma (ADFK) is a rare benign fibroustissue tumor that occurs over the extremities, predominantly inthe periungual area. We report a case of ADFK over the digitof the right hand presenting as a finger-like growth; the base ofthe lesion showed a collarette of scales. The lesion was excisedwith ablative CO2 laser. The histopathology was typical, showinghyperkeratosis and acanthosis. The core of the lesion had abundantcollagen fibers perpendicular to the long axis of the epithelium.There was good healing with minimal scarring; the patient wasfollowed up, and no recurrence was reported more than oneyear later. ADFK is a relatively rare tumor, with less than 150cases reported worldwide; we present a concise review of thepublished ADFK cases with their clinical and histopathologicalcharacteristics. To the best of our knowledge, this is the seventhsuch case to be reported from India.
Mohammad Ebrahimzadeh-Ardakani; Kazem Ansari; Hesan Pourgholamali; Zahra Sadri
Abstract
Background: Postpartum hair loss is one of the most common childbirth complications, sharing an association with certain clinical and disease-related factors. The aim of this study was to determine the frequency of postpartum hair loss and risk factors in women referring to Yazd primary healthcare clinics.Methods: ...
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Background: Postpartum hair loss is one of the most common childbirth complications, sharing an association with certain clinical and disease-related factors. The aim of this study was to determine the frequency of postpartum hair loss and risk factors in women referring to Yazd primary healthcare clinics.Methods: This descriptive cross-sectional study was conducted in 2016 in four dermatology clinics in Yazd, Iran. The statistical population included all women aged 17 to 48 years who had given birth during the previous six months and attended primary healthcare clinics. Cluster sampling was performed to select the participants; 329 women visiting four clinics in Yazd were examined for hair loss and its risk factors. Study data were analyzed using SPSS software (t-test, ANOVA, and chi-squared test).Results: The mean age of the participants was 29.29 ± 6.12 years. In this study, 68.4% of participants had postpartum hair loss. There was a statistically significant relationship between postpartum hair loss and variables such as anemia (P = 0.001), breastfeeding (P = 0.002), nocturnal feeding (P = 0.001), gestational diabetes (P = 0.019), history of hypothyroidism (P = 0.001), and stress before and during delivery (P = 0.001 for both).Conclusions: This study revealed that a history of hair loss, breastfeeding, gestational diabetes, and stress could affect postpartum hair loss. Therefore, these factors might be used as hair loss predictors in women undergoing pregnancy.
Vijayasankar Palaniappan; Gowtham Saravanan; Kaliaperumal Karthikeyan
Abstract
Cutaneous tuberculosis is an extrapulmonary form of tuberculosischaracterized by distinct clinical and histopathologicalpresentations. Tuberculous chancre, a form of primary inoculationtuberculosis, primarily affects individuals with no natural oracquired immunity against the tubercle bacilli. It is ...
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Cutaneous tuberculosis is an extrapulmonary form of tuberculosischaracterized by distinct clinical and histopathologicalpresentations. Tuberculous chancre, a form of primary inoculationtuberculosis, primarily affects individuals with no natural oracquired immunity against the tubercle bacilli. It is commonlyacquired after minor trauma or any traumatic procedures. Initially,it starts as a papule or nodule that gets ulcerated. The ulcer istypically painless, has undermined bluish margins, is friable innature, and heals with atrophic scarring. If left untreated, it canlead to various complications. The tuberculous chancre respondswell to antituberculous therapy. The emergence of resistant strainsand the AIDS epidemic led to a global resurgence of cutaneoustuberculosis in the last century. Hence, awareness of the clinicalmanifestations of cutaneous tuberculosis is necessary for its earlydiagnosis and management. We report a case of tuberculouschancre in a 45-year-old previously healthy male.
Rezvan Amiri; Ziba Omidvand; Saman Mohammadi; Maryam Khalili; Mahin Aflatoonian
Abstract
Background: Pityriasis versicolor is a recurrent non-inflammatory superficial fungal infection. Application of antifungal shampoo is a simple treatment modality for pityriasis versicolor that can be used on an extensive surface area. Currently, there is no study to evaluate the efficacy of climbazole ...
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Background: Pityriasis versicolor is a recurrent non-inflammatory superficial fungal infection. Application of antifungal shampoo is a simple treatment modality for pityriasis versicolor that can be used on an extensive surface area. Currently, there is no study to evaluate the efficacy of climbazole shampoo. In this study, the efficacy of 2% ketoconazole shampoo was compared to 2% climbazole shampoo in the dermatologic clinic of Afzalipour Hospital, Kerman, Iran.Methods: This triple-blind randomized clinical trial was performed on 60 patients diagnosed with pityriasis versicolor. Participants were categorized into groups A (ketoconazole shampoo) and B (climbazole shampoo) based on simple randomization. KOH smear was achieved from all participants at the baseline, four weeks after commencing treatment, and at three months follow up. Participants were instructed to apply shampoo three times a week for three weeks on all body surfaces and scalp for 10 minutes before rinsing. Evaluation of treatment was based on clinical improvement and results of KOH smears. Complete cure was defined as negative KOH smear and complete clinical improvement.Results: Seventy percent of the patients in the ketoconazole group and 43.3% of the patients in the climbazole group had negative smears four weeks after commencing treatment (P = 0.037). Complete clinical improvement at the three-month follow-up was 26.7% and 13.3% in the ketoconazole and climbazole groups, respectively (P = 0.402).Conclusion: In the present study, 2% ketoconazole shampoo had significantly greater efficacy in terms of mycological cure than climbazole shampoo among pityriasis versicolor patients.
Maryam Sadat Sadati; Ladan Dastgheib; Seyed Sajjad Tabei; Negin Fazelzadeh Haghighi; Maryam Hadibarhaghtalab
Abstract
Sneddon-Wilkinson disease, also known as subcorneal pustulardermatosis (SPD), is a relapsing pustular dermatosis of unknownetiology. The vesiculopustules typically present on the trunkand intertriginous areas. The mainstay of SPD treatment isdapsone; second-line therapies include corticosteroids and ...
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Sneddon-Wilkinson disease, also known as subcorneal pustulardermatosis (SPD), is a relapsing pustular dermatosis of unknownetiology. The vesiculopustules typically present on the trunkand intertriginous areas. The mainstay of SPD treatment isdapsone; second-line therapies include corticosteroids and otherimmunosuppressive drugs. Here, we report a case of recalcitrantsevere SPD that responded dramatically to adalimumab. Thepatient was a 30-year-old man who presented with generalizederythroderma and vesiculopustules on the trunk and extremities.In some pustules, the pus settled with gravity into the lowerhalf of the blister. He responded dramatically to a combinationof adalimumab (80 mg on day 1, 40 mg on day 7, and 40 mgbiweekly afterward) and prednisolone 50 mg daily. During followup,prednisolone was tapered to 5 mg daily over 2 months, andadalimumab was maintained biweekly; he is still in remissionafter 8 months. Thus, adalimumab can be used as an effectiveand easy-to-use treatment in refractory cases of SPD.
Muhammed Mukhtar
Raveendran Premjith; Kaliaperumal Karthikeyan; Vijayasankar Palaniappan
Setareh Ameri; Saman Ahmad Nasrollahi; Aniseh Samadi; Fatemeh Amiri; Solmaz Ahmadvand; Somayeh Yadangi; Mahsa Fattahi; Marzieh Ehsani; Alireza Firooz
Abstract
Background: Hand hygiene plays a vital role in controlling pathogenic microorganisms’ transmission and maintaining the interaction between skin microbiota and biometric parameters. This study evaluated the effects of hand cleansers including alcoholic gel, alcoholic pad, antibacterial, and simple ...
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Background: Hand hygiene plays a vital role in controlling pathogenic microorganisms’ transmission and maintaining the interaction between skin microbiota and biometric parameters. This study evaluated the effects of hand cleansers including alcoholic gel, alcoholic pad, antibacterial, and simple wipes on skin biometric parameters and microbiota.Methods: Samples were collected from the hands of 15 healthy office workers with a mean age of 37.70 ± 9.6 years. Then, the subjects were instructed to use cleansers in four following rounds, with a one-week washout period between the rounds. Sample collection was performed before, right after, and one hour after using the cleansers. Microbial isolates were investigated via standard microbiological techniques, and biometric measurements were made using the Cutometer® MPA 580. The obtained data were analyzed using the paired t-test and repeated measures ANOVA.Results: Overall, there were no significant differences between cleansers in reducing the total aerobic microbial count (TAMC). Also, there was an approximate return to the initial count of resident microbiota one hour after using the alcoholic pad. A significant difference was observed in decreasing the Staphylococcus aureus count using antibacterial wipes rather than simple wipes. Simple wipes had the most increasing effect on transepidermalwater loss (TEWL), showing a significant difference with the alcoholic gel. Furthermore, alcoholic gel caused a greater pH decrease in comparison to other products.Conclusion: Alcoholic cleaners are more effective than antibacterial and simple wipes due to maintaining the skin’s biometric parameters. An additional advantage is that alcoholic pads can preserve the resident microbiota.
Akshay Jain Salecha; Santh Kumar Bellamkonda; Haritha Samanthula; .Sujit Kumar Ponugoti; Anusha Jakkampudi
Abstract
Background: Psoriasis is a prevailing continual inflammatoryaffliction, carrying a considerable risk of cardiac diseases,sometimes even not traceable by conventional predisposingfactors. Detection of subclinical atherosclerosis in psoriasis byultrasonography is beneficial, and it has been solitarily ...
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Background: Psoriasis is a prevailing continual inflammatoryaffliction, carrying a considerable risk of cardiac diseases,sometimes even not traceable by conventional predisposingfactors. Detection of subclinical atherosclerosis in psoriasis byultrasonography is beneficial, and it has been solitarily exploredin carotid arteries. It was found to have a weak predictive value,and so the femoral arteries have now been contemplated. Thisstudy aims to determine subclinical atherosclerosis occurrenceby evaluating the femoral and carotid arteries’ intima-mediathickness (IMT) by ultrasonography in patients with psoriasis.Methods: The study was carried out in the departments ofdermatology and radiology at Dr. Pinnamaneni SiddharthaInstitute of Medical Sciences & Research Foundation for eightmonths. The sample size consisted of 30 chronic plaque psoriasiscases and 30 controls, matched for age and sex. Patients withcomorbidities were excluded. Femoral & carotid arteries wereassessed for IMT by ultrasonography.Results: In our study, the age range was 30–80 years, and a male(56.7%) preponderance was observed in cases and controls. Themean femoral artery and carotid artery IMTs were remarkablygreater in cases than in controls, with P-values < 0.001 and 0.04,respectively. The mean femoral artery IMT was significantly moreelevated (1.4 ± 0.63 mm) than the carotid artery IMT (1.0 ± 0.62mm) in cases (P = 0.01).Conclusion: Ultrasonographic screening of femoral artery IMTenhances the early discernment of subclinical atherosclerosis whencompared with carotid artery IMT. Thereby, it helps in the earlyidentification of cardiovascular disease in patients with psoriasis.Keywords: femoral artery, carotid artery, intima-media thickness,psoriasis, atherosclerosis
