Esmaili Nafiseh; Chams-Davatchi Cheyda; Daneshpazhooh Maryam; Ghiasi Maryam; Abedini Robabe; Mortazavi Hossein; Roghani Iman
Volume 15, Issue 2 , 2012, , Pages 33-37
Abstract
Background: Pemphigus vulgaris (PV) is an autoimmune bullous disorder that is fatal if left untreated. High dose systemic corticosteroids are the basis of therapy. The addition of immunosuppressive agents has improved the disease outcome and reduced the required corticosteroid dose and related toxicity. ...
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Background: Pemphigus vulgaris (PV) is an autoimmune bullous disorder that is fatal if left untreated. High dose systemic corticosteroids are the basis of therapy. The addition of immunosuppressive agents has improved the disease outcome and reduced the required corticosteroid dose and related toxicity. Mycophenolate mofetil is increasingly used as a steroid-sparing agent in immunotherapy of PV. Herein, we tried to appraise the efficacy of mycophenolate mofetil and topical clobetasol in the control of the major relapses of pemphigus vulgaris. Method: Seventeen patients with severe relapse of pemphigus vulgaris were included in this study. All patients had complete remission on/off therapy before this period of recurrence. The patients were treated with 2g/day mycophenolate mofetil and 25-35g/day topical clobetasol propionate ointment. All patients were monitored for the side effects of therapy. Result: The patients were followed for a mean period of 12.7 months. The average length of time from initiating mycophenolate to 50% control (partial remission), which occurred in all patients, was 6±1.17 weeks. Fifteen patients achieved complete remission averagely at week 20.8±7.70. The average duration of followup after complete disease control was 8 months (ranging from 2-13.5 months). Three patients were free of lesions for more than 12 months and 10 for more than 6 months. No important mycophenolate mofetil related complication was observed during treatment. Conclusion: The combination of mycophenolate mofetil and topical corticosteroid can be used to control PV relapses and taper-off corticosteroid.
Hallaji Zahra; Ghanadan Alireza; Akhyani Maryam; Esmaili Nafiseh; Khezri Somayeh; Mirzaeipour Mehdi
Volume 15, Issue 1 , 2012, , Pages 22-25
Abstract
Sweet’s syndrome and erythema nodosum are rarely seen together. Herein, we report a case of concurrent Sweet’s syndrome and erythema nodosum and review previous cases.
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Sweet’s syndrome and erythema nodosum are rarely seen together. Herein, we report a case of concurrent Sweet’s syndrome and erythema nodosum and review previous cases.
Barzegari Massoume; Valikhani Mahin; Esmaili Nafiseh; Naraghi Zahra; Nikoo Azita; Kamyab Kambiz; Ghanadan Ali; Tamizifar Banafshe
Volume 11, Issue 2 , 2008, , Pages 64-66
Abstract
Background: Pemphigus vulgaris (PV) is an autoimmune blistering disease, caused by autoantibodies against desmoglein (Dsg) 3 and / or Dsg1 which induce the loss of adhesion between keratinocytes. Nikolsky's sign is the ability to induce peripheral extension of a blister as a consequence of applying lateral ...
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Background: Pemphigus vulgaris (PV) is an autoimmune blistering disease, caused by autoantibodies against desmoglein (Dsg) 3 and / or Dsg1 which induce the loss of adhesion between keratinocytes. Nikolsky's sign is the ability to induce peripheral extension of a blister as a consequence of applying lateral pressure to the border of an intact blister. If the weakening of the intercellular adhesion is present but not marked, then the damage may be demonstrated only microscopically (microscopic Nikolsky’s sign and can increase the sensitivity of the histopathological studies. Methods: We studied 40 patients and divided them randomly into two groups (A, B). Group A were subjected to the tangential pressure over the perilesional skin before a biopsy specimen was taken from that site; group B patients were subjected to a biopsy without the tangential pressure technique. Results: Histopathological changes of pemphigus vulgaris were present in 30% of the patients in group A and 5% of the patients in group B. They were not statistically different. The presence of microscopic Nikolsky’s sign was significantly higher in patients with generalized disease. Conclusion: Microscopic Nikolsky sign can increase the sensitivity of histologic diagnosis of PV.
Esmaili Nafiseh; Hallaji Zahra; Ehsani Amirhoushang; Tork Ali Naser; Robati RezaMahmood; Toosi Siavash; Zahrian Fatemeh; Maarefat Afsaneh
Volume 10, Issue 2 , 2007, , Pages 100-104
Abstract
Background and aim: Psoriasis is one of the most common inflammatory skin disorders with a genetic background. Several treatment modalities have been used, including systemic and bath PUVA. The aim of this study was to evaluate the efficacy of systemic and bath PUVA in the treatment of psoriasis in Razi ...
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Background and aim: Psoriasis is one of the most common inflammatory skin disorders with a genetic background. Several treatment modalities have been used, including systemic and bath PUVA. The aim of this study was to evaluate the efficacy of systemic and bath PUVA in the treatment of psoriasis in Razi Hospital.Materials and methods: This retrospective database study was done in Razi Hospital and the records of 390 psoriatic patients referred to phototherapy unit in 1999-2003 were studied. One hundred and forty nine patients were treated with systemic and 238 patients with bath PUVA.Results: The most common form of psoriasis was the plaque type and the majority of patients were male. Complete remission of disease was achieved in 20.1% of systemic PUVA and 17.2% of bath PUVA patients, usually after 20-29 sessions of phototherapy. The mean cumulative UVA dose for complete remission was 233.46 and 108.79 J/cm2 in systemic and bath PUVA groups, respectively. Relapse occurred in 33.3% and 17.07% of patients achieving complete remission in systemic and bath PUVA groups, respectively. Erythema was the most common side effect in both groups.Conclusion: Both systemic and bath PUVA are efficacious in the treatment of psoriasis. The total UVA dose needed for complete clearance was higher in systemic PUVA and relapse occurred more frequently in this group.
Ghaninejad Hayedeh; Esmaili Nafiseh; Ghiasi Maryam
Volume 10, Issue 2 , 2007, , Pages 105-110
Abstract
Background and aim: Psoriasis is a chronic inflammatory dermatosis that affects 0.6% to 4.8% of the population. Phototherapy is commonly used in the treatment of this disease. According to the results of previous studies that showed difference in minimal erythema dose between different body sites, it ...
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Background and aim: Psoriasis is a chronic inflammatory dermatosis that affects 0.6% to 4.8% of the population. Phototherapy is commonly used in the treatment of this disease. According to the results of previous studies that showed difference in minimal erythema dose between different body sites, it seems that the responses of psoriatic lesions are also different in various body sites. Our objective was to compare the response of psoriatic lesions to phototherapy in various body sites.Materials and methods: Forty patients with generalized chronic plaque-type psoriasis were enrolled in this study. All patients were examined prior and during phototherapy course every 10 sessions. In each patient time of clearance of psoriatic lesions at trunk, upper and lower extremities were recorded separately.Results: At the end of phototherapy course the lesions of the trunk were cleared completely in 32 patients, and remained partially in 8 patients. The lesions of the upper limbs were cleared completely in 37 patients, and remained partially in 3 patients. The lesions of the lower limbs were cleared completely in 22 patients, and remained partially in 16 patients. Incomplete responses were significantly higher on the lower limbs than the trunk and upper limbs.Conclusion: Therapeutic response of psoriatic lesions to phototherapy is lower on the lower limbsthan the trunk and upper limbs.