Iranian Journal of Dermatology
Year:2005 | Volume:8 | Issue:3|Papers Count:13

Background: Eczema is one of the most widely spread inflammatory skin disorders. Contact dermatitis is an eczematous dermatitis that is produced as a result of contact with a substance in the environment. The substance can act as an irritant or allergen. Every country has allergens particular to itself. Objective: Determining the frequency of skin allergens in patients with contact dermatitis in Tehran. Patients and Methods: In this cross-sectional descriptive study, all the data about the patients with chronic contact dermatitis who were visited in a dermatology clinic in Tehran from the year 1993 to 2003 and patch tested with 23 allergens of European Standard Series (ESS) were analyzed. Results: In this study 222 patients were surveryed. The mean age of the patients was 33.5 Years(SD=13.8). 66.5% of the patients were female. The most common site of involvement (49%) was their hands.The mean duration of the disease was 54 months (SD=62). Clinical diagnosis included: 59% allergic contact dermatitis, 24% irritant dermatitis, 10% atopic dermatitis, and 7% other types of dermatitis. One-hundred and forty five (65.3%) of them had at least one positive reaction. The most common allergens were: nickle sulfate 22.6%, cobalt chloride 14.5%, and fragrance mix 13.6%. Conclusion: Nickel was the most common contact allergen among the patients surveyed.

Background: Vitiligo is a relatively common acquired depigmentary disorder affecting approximately 1 % of general population. PUVA therapy is the most effective modality and commonly used as the primary treatment of generalized vitiligo. Objective: To evaluate the synergistic effect of topical calcipotriol and oral methoxalene plus PUVA in treatment of generalized vitiligo. Patients and Methods: In this clinical trial, 47 patients with generalized vitiligo(<40% involvement of skin surface area) were randomly assigned to two treatment groups. Both groups were treated with systemic PUVA three times weekly. One group was also treated with topical calcipotriol (0.005%). Patients were evaluated for treatment response and possible side effects. . Results: The mean response rate at the end of the study was 63.9%±24.1 in the calcipotriol and PUVA group and 60.6%±23 in the PUVA group (P<0.05). The number of PUVA sessions and the mean cumulative UVA dose for maximum response were 96.6±22.7 and 584.1± 118.1 J/cm2 in the calcipotriol and PUVA group and 116.3±26.1 and 685.1± 168.0 J/cm2 in the PUVA group (P<0.05). Conclusion: In patients with generalized vitiligo, of combination PUVA with ca1cipotriol is an effective and safe treatment. This method decreases number of PUV A sessions and UVA dosage compared to treatment alone and accelerates PUVA repigmentation.

Congenital diffuse melanosis is one of the rarest clinical manifestations of hereditary universal melanosis and only few cases have been reported all over the world. The presented case is a 54-year-old man who presented to us complaining of erythematous annular lesions on his face and neck since 8 months ago. Diffuse pigmentation of his skin took our attention. According to the patient, diffuse hyperpigmentation was present at birth and there was no obvious changes up to now. His mother and sister had similar hyperpigmentation. He had two sons with a similar hyperpigmentaion, but his daugher had normal skin pigmentation. All laboratory investigation causes of for the hyperpigmentaion were reported normal and investigation of secondary for causes hyperpigmentation not reveal any did abnormality. In histopathologic assay, the erythematous lesion was reported to be discoid lupus erythematosus and the diagnosis of lesion reported as hyperpigmented congenital diffuse melanosis.

Background: Mustard gas is a disabling chemical weapon and was widely used in First World War and Iraq-Iran war. Its toxic effects could be acute or chronic and they could particularly affects lungs, eyes and skin. Objective: To study the frequency of chronic complications of sulfur mustard gas in Iranian victims 14 to 20 years after exposure. Patients and Methods: This descriptive cross-sectional study was performed on 800 patients that were randomly selected from different provinces of Iran, who had been exposed to sulfur mustard gas during 1983 to 1988. These patients were clinically re evaluated in 2002-2003 and laboratory tests were performed if necessary. Results: The mean age of the patients at the time of study was 39.3 (±9.8) years. Three types of skin lesions were observed. Non specific lesions including 39.6% xerosis, 19% pigmentary disorders, 17.4% cherry angioma, 12.7% seborrheic dermatitis, 12.2% eczema (dermatitis ), 11.6% acneiform lesions, 7% tinea versicolor, 5.1 % urticaria, , 3.6% vitiligo, 2.5% alopecia areata, 2% psoriasis, and 1.3% aphthous stomatitis. Specific skin lesion called mustard scar was defined according to morphology, location, history and observed in 44 (5.5%) patients. Malignant neoplasms including basal cell carcinoma, Bowen"s disease, squamous cell carcinoma, mycosis fungoides and dermatofibrosarcoma protuberans occurred in 9 victims (1.1 %). Conclusion: Mustard gas can cause acute and late-onset skin lesions. Specific lesion of mustard gas called mustard scar is the most important finding of this study.

Background: Getting access to information about expansion and spread of skin diseases and determination of common types of them in any specific area has particular importance. There is no doubt that cultural, social, and genetic factors play an important role in the epidemiology of skin diseases. Objective: To determine the frequency of various skin diseases in patients referred to Sadooghi Hospital in Yazd in the summer of year 1999. Patients and Methods: This descriptive study was done on 1000 patients who referred to the skin clinic. Final clinical diagnoses of patients were classified according to ICD 10. Results: According to ICD 10, more than 60 diseases infectious were diagnosed among which diseases of skin were the commonest (23%) and viral diseases formed about one third of total infections. 19% of cases had dermatitis of which two third were contact dermatitis. 10.8% of cases had acne and 7.8% had melasma. In patients under 15 years of age infectious diseases and in patients 15-25 years of age acne were the most commonly found diseases. Cutaneous leishmaniasis, which is endemic in the study area was the most common parasitic skin , infection. Conclusion: Infectious diseases and dermatitis are among the most commonly diagnosed skin diseases in Yazd and need to be considered carefully make to a comprehensive plan to control.

Background: Autoimmune mechanisms are involved in the etiology of alopecia areata. It is also shown that selenium has some effects on regulation of autoimmune mechanisms. Objective: To compare the plasma level of selenium between those with and without alopecia areata. Patients and Methods: In this case-control study, 29 patients with alopecia areata referred to Razi hospital in Tehran, and 29 persons without this disease were selected consequently. Plasma level of selenium was determined and compared between the groups. Results: The mean age of cases was 24.9±l0.5 and of controls was 29.1± 10.5 years. In both groups 15 (51.7%) patients were male and 14 (48.3%) of them were female. The mean plasma selenium level in cases was significantly lower than what was observed in controls (62.1±13.3 g/L vs. 88.3± 13.2 g /L, P<0.0005). Conclusion: This study indicated that mean plasma selenium level in patients with alopecia areata was lower than those without this disorder. It is recommended to evaluate the effects of adding selenium to dietary regimen of patients with alopecia areata.

Background: monoclonal Cutaneous lymphomas are neoplasic proliferations of immune cells most frequently T or B cells that infiltrates skin. Development of new diagnostic methods, particularly those for immunophenotyping, have substantially changed classification of these neoplasms. These reasons prompted us to perform this study. Objective: To re-classify cutaneous lymphoma and peudolymphas in Mashhad. Patients and Methods: We reevaluated the specimens from a recent 10-year period filing in Emam Reza and Omid hospitals pathology archives and selected 46 cases diagnosed as any kind of skin lymphoid neoplasms. Then further histochemical and immunohistochemical staining were performed. Results: Forty-three cases "of definitely diagnosed lymphohematopoietic cutaneous disorders were composed of 26 (60.5%) cutaneous T cell lymphoma (CTCL), 16(14%) cutaneous B cell lymphoma,7 (16.3%) pseudolymphoma and 1 (2.2%) case of Hodgkin"s disease (secondary nvolvement). Conclusion: CTCLs were the most common lymphomas of the skin and mycosis fungoides was the common CTCL. most Immunohistochemical tecniques can be greatly helpful in diagnosis and classification of cutaneous lymphomas. However, routine microscopic evaluation still remains the principle method for diagnosis, especially when there is a close cooperation between dermatologists and pathologists.

Background: Highly variable results of topical immunotherapy with diphencyprone (DPC) in the treatment of alopecia areata have been reported so far. Objective: The purpose of this study was to evaluate the efficacy and tolerability of DPC in the treatment of severe and chronic alopecia areata. Patients and Methods: Twenty-eight patients (16 female and 12 male, 10-35 years old, mean age 25 years) with chronic and/or extensive alopecia areata were enrolled in an open-label clinical trial. After sensitization with 2% DPC, progressively higher concentrations beginning at 0.001% were applied weekly for 6 months to one side of the scalp. The maximum concentration of DPC was 2%. Results: Twenty-seven of 28 patients completed therapy. The overall response rate was 81.5% (22 cases). Complete response (90% -100% terminal hair re-growth) was obtained in 22.2% (6 cases) and partial response (10%-90% terminal hair re-growth) in 59.3% (16 cases) , and 18.5% (5 cases) showed no regrowth. In all patients an eczematous reaction consisting of erythema, itching, and scaling at the site of application was observed. Other observed side effects included occipital lymphadenopathy in 40.7% (11 cases), severe eczema /blister formation in 40.7% (11 cases) , hyperpigmentation in 18.5% (5 cases). Notably, partial recurrence was observed in 66.7% (18 cases) of these patients after 6 to 12 months of follow up. Conclusion: Topical DPC treatment for alopecia areata is an effective therapy with a relatively high relapse rate.

Background: can result in Hirsutism cosmetic and psychological problems in women. Because of diverse etiological factors, treatment with a single drug is not usually successful. On the other hand, treatment of hirsutism can be associated with adverse effects. Objective: To evaluate the efficacy of a herbal ointment consisted of Leguminosea spp. and Zingiberaceae spp. extracts in reduction of hair density in hirsute women. Patients and Methods: In an open clinical trial 10 hirsute women were treated with a herbal ointment 3 times a day for two weeks in three consecutive months. Pre- and posttreatment assessments of number, length, and diameter of hairs were done in individual patients. Paired t test was used for statistical analyses. Results: After three treatment courses the mean number of the hairs showed significant reduction in comparison with pre-treatment values. patients mentioned that Some treatment resulted in softer, thinner, and lighter hairs. Conclusions: The studied herbal ointment was effective in hair density reduction in hirsute patients. It was also a simple, inexpensive and safe treatment for hirsutism.

Although night sweating is a common outpatient complaint medical, literature on this Tuberculosis, subject is scarce. brucellosis and lymphoma are diseases in which night sweating is a dominant symptom, but these are infrequently found to be the cause of night sweats in modem practice. While diseases important these remain diagnostic considerations in patients with night sweats, other diagnoses to consider include immunodeficiency virsus human infection, gastroesophageal reflux disease, obstructive sleep apnea, hyperthyroidism, hypoglycemia, diseases. and several less common Antihypertensives, antipyretics, and other medications such as drugs of abuse including alcohol and heroin may cause night sweats. Serious of night sweats can be causes excluded with a thorough history taking, physical examination, appropriate and laboratory and imaging studies.

Chronic graft versus host disease (GVHD) remains the most common late complication of allogenic stem cell transplantation and the most frequent cause of morbidity and mortality in these patients. To control this condition, ImmunosuppreSlve drugs are usually administered at a high dose and for a long time, which may result in several side effects. Five clinically and patients with histopathologically established cGVHD (3 lichenoid, 1 sclerodermoid and 1 mixed lichenoid-sclerodermoid) , who failed to respond to conventional immunosuppressive therapy were treated with psoralen and UVA (PUVA). Treatment was administered in a standard protocol three times a week on nonconsecutive days and were continued at least for 12 weeks. All 3 lichenoid cases showed complete improvement. In the sclerodermoid case there was partial response and in the mixed type case the partial response of sclerodermoid lesion and complete response of lichenoid lesions were observed. With the exception of a slight increase in liver tranferases, no other adverse reactions occurred. In conclusion, PUVA can be a safe and effective therapy in conjunction with systemic agents for chronic GVHD especially in lichenoid form.