Dermatology and Cosmetics
Year:2011 | Volume:1 | Issue:4|Papers Count:11

Background and Aim: Treatment of cutaneous leishmaniasis, especially when caused by L. tropica, is challenging. Meglumine antimoniate (Glucantime®) is used as the standard treatment, but multiple injectiond are necessary. The objective of this study was to compare the efficacy of weekly intralesional injections with twice weekly injections of Glucantime for the treatment of anthroponotic cutaneous leishmaniasis (ACL).Methods: This randomized open clinical trial was conducted, in Bam, Kerman province, Iran. 96 eligible patients according to inclusion and exclusion criteria who were willing to participate were included. The included patients were randomly assigned into two groups, one group treated with weekly intralesional injections of Glucantime® and the other group treated with intralesional Glucantime® twice a week. Type and size of each lesion (induration, ulcer and scar) were recorded weekly. Complete healing was defined as complete re-epithelialization and absence of induration in all lesions and was considered as the primary outcome measure.Results: A total of 48 patients completed the study; complete cure was seen in 24 of 27 (89%) patients who received weekly intralesional MA with a mean duration of healing equals to 70±10 days. Complete cure was seen in 24 of 31 (77%) patients who received intralesional MA twice a week, the mean duration of healing in the latter group was 58±5 days. There was no significant difference between the two groups (P=0.23).Conclusion: It seems that the efficacy of intralesional injections of Glucantime® once a week is similar to efficacy of twice a week Glucantime® injections.

Background and Aim: As a blistering agent, mustard gas causes a variety of disorders in different body organs, including the skin, such as altrations in DNA and clinical manifestations like pruritus. TGF-β1 molecule is a cytokine with anti-cell growth and inflammation suppression effects in skin inflammation. The aim of this study was to determine TGF-β1 gene exprtession in victims exposed to mustard gas and the correlation with the severity of their pruritus.Methods: 17 victims exposed to mustard gas, 17 patients with chronic contact dermatitis and 10 healthy individuals were included in the study. The assessment of TGF-β1 expression in their skin samples was conducted by semi-quantitative RT-PCR followed by immunohistochemistry and classification of patients was done by pruritus severity scoring system (0-3).Results: There was a significant decrease in TGF-β1 gene expression in mustard gas exposed victims comparing to chronic contact dermatitis group and the control group (P<0.05). In addition, in the absence of TGF-β1 expression, the severity of pruritus in the patient group significantly increased (P<0.05).Conclusion: TGF-β1 has a significant role in chronic inflammatory skin lesions caused by mustard gas.

Background and Aim: The correlation between diseases and psychiatric problems had been evaluated recently. The aim of this study was to determine the prevalence of skin diseases in patients in psychiatric department of Yahya-Nejad Hospital in Babol, North of Iran, in 2008.Methods: This cross sectional study was performed on 250 patients hospitalized in psychiatric department of Yahya-Nejad Hospital in Babol. They were examined by a dermatologist and laboratory examinations (skin smear and biopsy) were done if needed. Then a questionnaire including information about sex, age, job, past medical history and history of addiction, major stress, general appearance, psycological problems, previous and new dermatological diseases and treatment protocols was completed for every patient. Data were analyzed by SPSS 11 and P<0.05 was significant.Results: Among two hundred and fifty patients (109 male and 141 female) with psychological problems, 166 patients had dermatologic diseases. Sixty six were male and 100 cases were female. Major depression and obsessive-compulsive disorders had highest frequency in psychologic disorders. Seventy patients had treated their skin disorders.There was a significant relationship between stressors in the last six months with eczema, lichen simplex chronicus, acne, and rosacea. Correlations between schizophrenia and herpes simplex labialis (P=0.02), and PTSD with pediculosis were significant (P=0.004).Conclusion: Dermatological disorders are associated with a variety of psychological problems that can affect patients. Increased understanding of biopsychosocial approches and laision among physicians, psychiatrists and dermatologists can be very useful and highly beneficial.

Background and Aim: Melasma is an acquired symmetrical brown hyperpigmentation of the face or neck. Melasma has been shown to have a significant emotional and psychologic distress on affected patients. Although this pigmentary disorder is more prevalent among women of reproductive age, the effect of melasma on quality of life in this population is unknown. The aim of this study was to evaluate health-related quality of life in patients with melasma attending to dermatology clinics in Kerman city, IranMethods: A cross-sectional study was carried out by clinical examination and questionnaire on 200 patients with melasma. Melasma area and severity index (MASI), Dermatology Life Quality Index (DLQI) and Melasma Quality of Life Scale (MELASQOL) were used to assess melasma severity and quality of life.Results: There were 200 women with mean age 31.86±6.42 years old (range: 18-55 years). The mean score of DLQI and MELASQOL were 6.90±4.48 and 40.24±14.95, respectively. In 113 (56.5%) patients, melasma had very large effect on their quality of life. There was a significant correlation between the scores of quality of life questionnaires and MASI (P<0.001). In DLQI scale the most frequent impairment was related to emotional well-being and based on MELASQOL questionnaire, embarrassment due to skin appearance had an important impact on quality of life.Conclusion: This study revealed that physicians must consider the devastating psychosocial impact of pigmentary imperfections in addition to pharmacological and physical treatment.

Background and Aim: Chronic renal failure is a clinical state which results in declining the kidney function. Chronic renal failure has numerous cutaneous manifestations, when the process of hemodialysis begins, new changes may appear as a result. The aim of this study was to assess the prevalence of cutaneous problems among patients with chronic renal failure undergoing hemodialysis in Bandar Abbas, Iran.Methods: In this cross-sectional study, 60 patients with chronic renal failure under hemodialysis in Shahid Mohammadi Hospital Dialysis Center were examined by a dermatologist. The data were gathered and analyzed by SPSS software (version 16) using descriptive statistics, t and chi2 tests. P less than 0.05 was considered significant.Results: The most common skin findings were dry skin (78.3%) followed by pallor (71.7%) and pruritus (58.3%). Other common cutaneous manifestations were half-half nail (35%) idiopathic guttate hypomelanosis (33.3%), yellowish skin color change (31.7%), subungal hyperkeratosis (30%( onycholysis (20%), beau's line (15%), cherry angioma (15%), skin hyperpigmentation (15%) and purpura (13.3%).Conclusion: Chronic renal failure is associated with various cutaneous manifestations caused by hemodiaysis or the disease itself. The most common ones are dry skin and pallor. The early diagnosis of cutaneous changes may decrease the morbidity and eventually lead to quality of life improvement in these patients.

Background and Aim: Pruritus is usually caused by a primary skin disorder or a systemic disease. Causes of groin pruritus are fungi, eczema, bacterial diseases, neurodermatitis, scabies and many other skin disorders. This study was performed to find the common causes of groin pruritus in female patients that referred to dermatology and gynecology clinics of Yahya-Nejad hospital in Babol.Methods: This descriptive study was performed on patients with groin pruritus from the begining of winter 2006 until the end of autumn 2007. Other information including name, age, height, weight, previous drug consumption, simultaneous infection in partner or other members of the family, duration of infection, underlying disease and result of examination were recorded in a questionnaire for each patient.Results: 115 patients were studied. The average age of patients was 41.2 years (15-75 years old). The highest disease frequency was seen in 48 cases (41.7%) in summer. Most cases (33 patients [28.7%]) were between 46-55 years of age. Most of patients (28.7%) had a BMI from 25 to 29.9 (over weigh). The most common causes of groin pruritus in all seasons, ages and BMIs were tinea cruris in 55 cases (47.8%) and seborrheic dermatitis in 29 cases (25.1%).Conclusion: Considering common causes of groin pruritus, season and patient’s weight can be helpful in diagnosis and early treatment of groin pruritus.

N-acetylcysteine (NAC) is the acetylated metabolite of cysteine and is approved by the Food and Drug Administration (FDA) for treating acetaminophen toxicity. By boosting glutathione, NAC acts as an antioxidant and through replenishing glutathione, it can also prevent paracetamol toxicity. From the other hand, NAC has mucolytic and antiinflammatory effects and also is a glutamate precursor and therefore can be used in a variety of diseases. Regarding the various pharmacological effects of NAC and its low rate of adverse events, NAC has attracted increasing interest for a range of indications during the recent years. Here, the possible applications of this drug in dermatology are reviewed.

Pseudo-Kaposi sarcoma (PKS) or acroangiodermatitis is a benign angioproliferative disease which shares many clinical and histopathological features with Kaposi sarcoma. Clinical presentations include violaceous macules, papules or plaques in the lower extrimities, which is usually associated with chronic venous insufficiency or congenital or acquired arteriovenous malformations. Its pathogenesis is not well recognized yet but the ischemia due to venous insufficiency or arteriovenous malformation is considered to play a role. The diagnosis is made through the histopathologic examination of biopsy specimens. Different treatment modalities have been suggested including conservative treatment or correction of vascular abnormalities. This paper introduces a 28-year old man with a brown linear plaque in a scar of 3-month duration due to trauma on the anterior of left thigh. A biopsy was performed and the histopathologic examination confirmed the clinical diagnosis of Pseudo-kaposi sarcoma.