Iranian Journal of Dermatology
Year:2002 | Volume:5 | Issue:2|Papers Count:14

Background: Pain and pruritus are two common symptoms in dermatology that are transmitted with unmyelinated C fibers via substance P. Topical capsaicin is effective due to depletion of nerve endings from substance P. Objective: The efficacy and side effects of capsaicin gel in painful and pruritic skin disorders was compared to placebo. Patients & Methods: In a controlled clinical trial, 40 patients (21 patients with postherpetic neuralgia, 10 with lichen simplex chronicus, and 9 with notalgia paresthetica), with the mean age of 48 years were randomly treated with 0.075% capsaicin gel or placebo q.i.d. for 4 weeks. The severity of symptoms and side effects were assessed every two weeks and recurrence was assessed also two months after treatment. Results: 31 cases (77%) completed their 4 weeks treatment period. According to Visual Analogue Score system, the mean of symptom severity decreased from 7.6 (±2.4) before treatment to 0.9 (±0.9) after treatment in capsaicin group and decreased from 6.3 (±2.3) to 5.0 (P<0.05). (±3.2) in placebo group Conclusion: Capsaicin gel is effective in painful and pruritic skin disorders and has tolerable side effects..

Background: Localized and extensive clinical subtypes of alopecia areata (AA) including alopecia totalis and alopecia universalis differ in genetic and immunologic aspects. Objective: Comparison of epidemiologic aspects of localized and extensive subtypes of AA. Patients & Methods: In a prospective descriptive study, 180 patients suffering from AA attending the skin clinics of Razi Hospital in Tehran in 6-month period were studied. The epidemiological aspects of the disease including age at onset, duration, family history, and mental stress were compared in the localized and extensive subtypes of AA. Results: The age at onset was 13/2 years in localized and 19/3 years in extensive AA (P<0.05). The duration of disease was remarkably longer in the extensive form (42.5 months vs. 17.5 months in localized AA). The role of mental stress was mentioned in 55.6% of cases with extensive form and 27.8% of cases with localized AA (P<0.05).There was no relation between family history of AA and the clinical subtype of disease. Conclusion: Extensive AA begins at a younger age, has longer course, and stronger relation with stress.

Background: So far seven types of the genus malassezia have been known. Except for one kind, the rest are normal flora of human skin which, under certain circumstances, cause or trigger eleven diseases. One of the side effects of topical and systemic steroid is steroid acne. Objective: This study was conducted to evaluate the association of pityrosporum ovale (malassezia) and steroid acne. Patients & Methods: Skin smears were prepared by comedo ne extractor from 20 patients with steroid acne and 12 acne patients without history of steroid usage, referred to dermatology clinic of Qaem Hospital and checked for the presence of malassezia. The reports of 2+ or more were considered as positive. The skin smears were positive in 80 percent of patients with steroid acne, and 66 percent of control group patients (P<0.05). 16 patients of steroid acne group responded well to antifungal drugs. Conclusion: Considering the clinical symp toms of steroid acne, positive skin smears and clear response of the patients to antifungal drugs, some of the steroid acne lesions are pityrosporum folliculitis.

Background: Pruritic of dermatoses pregnancy are important and common dermatoses during pregnancy. Objective: The purpose of this study was to determine the incidence and specificity or nonspecificity of pruritic dermatoses of pregnancy and their effects on health of mother and fetus, during a period of one year. Patients & Methods: The data were gathered by questionnaires completed by midwives in two antenatal clinics in Shiraz from October 1999 to October 2000. The pregnant patients with pruritic dermatoses were referred to dermatology out-patient clinic and evaluated according their physical history, to examination and laboratory workups. Results: Twenty five patients out of 9500 pregnant women had pruritic lesions, so the incidence rate was 0.26%. Pruritic urticarial papules and plaques of pregnancy and eczema were the most common dermatoses. One mortality and two morbidities in neonates of these mothers were observed. Conclusion: of Because dermatoses pregnancy are common and important diseases which can affect the health of both mother and fetus, further research in this field IS necessary.

Background: Pilomatricoma, the most common hair follicle turnor, has a wide variety of clinicopathological characteristics and is often misdiagnosed. Objective: The aim of this study was to explain the clinical and histological spectrum of turnor in order to help for its better diagnisis. Patients & Methods: In a retrospective descriptive study, the clinical and histological features of pilomatricoma were reviewed. The files and histologi9 sections of all biopsy specimens examined in Hamadan Sina ; Hospital between 1992 and 1999 were I analyzed. Results: Among 4000 biopsy specimens, 22 cases of pilomatricoma were found. 59.3% of the lesions were located on upper extremities. The lesion developed in second decade of life in 36.5 percent of the patients. Shadow cells, calcification, ossification and granulomatous reaction were detected in 100, 50, 9 and 45.5 percent of specimens, respectively. The accuracy of clinical diagnosis compared with pathologic findings was 36.5 percent. Conclusion: Pilomatricoma was the final diagnosis in 0.55 percent of all biopsy examined in Hamadan Sina specImens Hospital between the years 1992 to 1999. It should be included in differential diagnosis of skin tumors.

Cryotherapy is a simple, safe and effective method for many benign and malignant skin diseases. If applied with an appropriate technique, the results will be very satisfactory and the complications will be very low. Herewith we will discuss cryotherapy and its applications in dermatology and review the advantages technique. and disadvantages of this

Epidennal changes including hyperkeratosis and epidermal verrucous changes, papillomatosis, secondary infection, recurrent erysipelas and ulceration are complications of chronic lymphedema. Elephantiasis is a tenn used for these significant changes. Xanthoma may also develop in lymphedematous areas. Lymphangiosarcoma is a rare complication of chronic lymphedema. Nodular fibrosis is mentioned as a rare complication of lymphedema of legs and only two cases have been reported in the literature. This article presents a case of multiple lesions of nodular fibrosis on both legs after 40 years history of chronic lymphedema.

Syringoma is a benign tumor arising from intra-epidennal ducts of eccrine sweat glands. It usually presents as small translucent papules on eyelids and upper cheeks. The case which is presented, is a rare fonn of syringoma that occurred in a linear fashion on the trunk. Dennatologists should be aware of such form of syringoma to differentiate it from other similar lesions. This 23 year-old man with one year history of flesh-colored to red papules on the left side of this chest, with a distribution following Blashko lines, without any pruritus or burning sensation, presented to the skin clinic of Razi hospital 1380. On histopathologic In examination of the lesions, islands and epithelial strands with differentiation to eccrine gland ducts were observed. Also some duct-like structures similar to tad pole and comma-shaped structures were seen in the dennis, all of which were consistent with the diagnosis of syringoma.