Iranian Journal of Dermatology
Year:2000 | Volume:4 | Issue:4 (12)|Papers Count:13

Background: Palmoplantar eczema is a common clinical problem involving 2% of the population. There are many treatment modalities for palmoplantar eczema, each with specific local and systemic side effects. Objective: To evaluate methoxsalen bath in the treatment of palmoplantar eczema Patients & Methods: In a randomized, double-blind, placebo controlled clinical trial, 60 patients with palmoplantar eczema referred to skin clinics of Isfahan University in 1376-78 were divided in two equal groups. One group received PUVA-bath and the other one received placebo-bath. Hands or feet or both were soaked for 15 minutes in warm water containing 0.0001 % 8-methoxypsoralen or placebo. Then the skin was exposed to sun for 30 minutes. This was performed 4 times a week up to a total of 25 treatments. Results: Excellent or good therapeutic effects were achieved in 86.7% of PUV A bath group but only in 6.7% of placebo (P value=0). No phototoxic reactions were observed. Conclusion: PUV A-bath is a safe, cheap, effective and comfortable method in the management of palmoplantar eczema.      

Background: Beta thalassemia major (BTM) is a genetic disorder which is common in Kerman province of Iran. New methods of care have increased their survival. Objective: The objective of this descriptive study was to assess the frequency of skin and mucosal complications of BTM patients. Patients & Methods: All BTM pantients referred to Kerman - Darman Hospital in 1377 (150 cases) were evaluated. Derma tologic signs & symptoms were diagnosed by physical examination and serum ferritin levels were measured. Results: Skin hyperpigmentation (65.3%), mucosal hyperpigmentation (41.3%), coarse nail (34%) and coarse hair (20.7%) were the most common signs. They were related to the age and serum ferritin levels but sex of patients and dose of desferral had no significant relation with skin complications. Conclusion: Skin and mucosal lesions are common in BTM. An exact exam and control of serum ferritin level with desferral is recommended to prevent skin complications.      

Background: Nevus spilus can produce considerable disfigurement. There is no specific and successful treatment for this nevus. Objective: The purpose of this study was to evaluate the efficacy of CO2 laser in the treatment of nevus spilus. Patients & Methods: This quaslexperimental clinical trial was performed on 47 patients with spilus nevus in Al-Zahra Hospital in Isfahan. The diagnosis of nevus spilus was based an clincal and biopsy findings. The efficacy of treatment was evaluated based on tolerability, side effects, improvement according to patient and physician judgment and comparison of photographies, after one year of follow up. The laser used was Sonic LS 500 (made in Germany) with power of 3 watts, duration of 0.25 seconds and spot size of 3 millimeters. Results: 45 of the patients were female and 2 were male. The mean age of them was 20 years. All the lesions were on the face. Two patients were withdrawn due to inefficacy or infection of test site treatment. In 43 of the 45 remaining patients (95.5%), the treated site healed uneventfully. Recurrence of nevus spilus was seen in a single patient one year after treatment. Conclusion: CO2 laser is an effective therapy for nevus spilus.      

Background: Determination of the prevalence of diseases is an important step in health programs. Objective: To determine the prevalence of skin diseases in primary school students in Ahwaz Patients & Methods: This cross -sectional study was done in March and April1995 (Esfand 1373, Farvardin 1374) in Ahwaz. 3000 male and 3000 female primary school students were examined for the presence of skin disease by a physician. This sample comprised 5 percent of total primary school students of Ahwaz. Diagnosis was made on clinical findings, laboratory examinations and skin biopsy, if needed.  Results: The most common skin diseases were: pityriasis alba, acne, freckle, keratosis pilaris, pediculosis capitis, chicken pox, wart, petigo, herpes simplex and leishmaniasis. The most common diseases in girls were ace and pediculosis capitis and in boys were acne and warts. Also the prevalence of diseases was related to the economic status of students. Conclusion: Skin diseases are common in primary school students in Ahwaz. The prevalence of certain skin diseases was related to the sex and economic status of the students.      

Background: Psoriasis is a common and genetically determined skin disease which is frequent throughout the world. Objective: To perform a descriptive clinical study of 200 cases of psoriasis in Ahwaz Patients & Methods: This study was performed from November 1997 to April 1999 on 200 psoriatic patients attended a private skin clinic in Ahwaz. Data were collected from patients and entered in questionnaires. Results: 56% of the patients were female and 44% were male. The age of onset was in the 1 st, 2nd, 3rd and 4th decades in 24.2%, 33.5%, 18.5% and 10%, respectively. Their age was in the 1st, 2nd, 3rd, and 4th decades in 23.5%,28.5%,17.5% and 14%, respectively. Only few cases referred with later ages of onset. In 40% of the cases the disease started from the scalp. 9% of the patients reported positive Koebner phenomenon. A positive family history for psoriasis was found in 25%. Nail involvement was detected in 39% of the patients. Conclusion: Psoriasis in Ahwaz shows a similar pattern to the other parts of world.      

Background: Most of patients with bullous pemphigoid are at old age and its differentiation from other bullous diseases is important. There is no report of it in Iran. Objective: This study was done in order to determine clinical and paraclinical features, natural course and response to treatment in patients, with bullous pemphigoid admitted in Loghman Hakim Hospital in 1992-1997. Patients & Methods: This descriptive study was done retrospectively by reviewing the existing files of 17 bullous pemphigoid patients admitted in the skin diseases ward of Loghman Hakim Hospital in Tehran in 1992-1997. The diagnosis was confirmed by histopathological examination in all of the patients. Results: The age range of the patients was 19-80 years, most of them were in the 6th - 8th decades. 58.8% of the patients were female. Initial lesions were bullous in 53%, eczematous in 29.4% and erythematous or urticarial in 17.6%.53% of patients were complaining of pruritus. Mucosal involvement was seen in 47%, all in the oral mucosa; only in one of the patients genital area was also involved. No malignancy was seen. 52% of the patients responded to oral prednisolone alone. None of the patients died from the disease. Conclusion: Iranian bullous pemphigoid patients show similar epidemiologic and clinical features to other parts of world.      

What shall we do when we have done everything we could for the diagnosis and treatment of a patient, but were not successful? What shall we do when there is no definite treatment for a patient? What shall we do when we have no diagnosis or treatment for a patient? Some useful suggestions are presented here to get rid of these situations.      

Apocrine nevus is a rare benign tumor of which only 9 cases have been reported in the literature. The apocrine nevus is seen mostly in the areas where the apocine glands are normally distributed such as axillae, head and neck. Our case was a 16 - year old girl who referred with a verrucous erythematous plaque over right parietal side of the scalp. The patient had the plaque since birth with partial growth after puberty. Histopathologic study showed mature apocrine glands located in the reticular and papillary dermis with epidermal papillomatosis and acanthosis.      

Plexiform neurofibroma is a rare variant but pathognomonic of van Recklinghausen disease. We report an uncommon presentation of neurofibromatosis type I in a girl. This 11- year old girl had multiple plexiform neurofibromas on her left hand, and also several Lisch's nodules. Classification and clinical features are discussed briefly with emphasis on the possibility this condition may not be given sufficient consideration.