Iranian Journal of Dermatology
Year:2006 | Volume:9 | Issue:2 (36)|Papers Count:20

Background and aim: Chronic skin lesions are common late complications of sulfur mustard intoxication which would result in numerous complaints including pruritus, skin dryness and bum feeling. In chemical warfare injured veterans, pruritus is the most common complaint in chronic status with significant effects on patient's quality of life. This study has evaluated efficacy of topical phenol 1% and menthol 1% combination in treatment of pruritus in chemical warfare injured veterans in comparison with placebo.Materials and Methods: This randomizeu double blind clinical trial was done on chemical warfare injured veterans with mustard gas induced pruritus. Eighty patients were randomly divided to 2 equal groups, one group treated with phenol 1% and menthol 1% combination and other group with placebo for 6 weeks and the therapeutic effects were evaluated according to pruritus scores. Results: Pruritus score was significantly reduced in active group compared to placebo group (P=0.026).Conclusion: Phenol 1% and menthol 1% combination has significant therapeutic effect for mustard gas induced pruritus in chemical warfare injured veterans.

Background and aim: Acne vulgaris is a chronic disease of pilosebaceous units which most commonly affects younger people. There are many different treatment modalities; each affects some mechanisms of acne pathogenesis. Systemic antibiotics are one of the most popular methods of treatment. In this study the efficacy of oral erythromycin was compared with doxycyclin in the treatment of moderate to severe acne vulgaris.Materials and Methods: This study was planned and conducted as a double-blind clinical trial. Sixty eight patients with acne were divided into two groups. One group was treated with oral erythromycin with a dose of 19/dayand the other group received oral doxycyclin at a dose of 100 mg/day for 4 months. The clinical improvement was evaluated based on reduction in the number of lesions in each monthly visit. Adverse events were also recorded.Results: Both groups showed considerable improvement in the lesions of face and trunk wih no significant difference. There was also no significant difference between improvement in facial and truncal lesions in the patients treated with erythromycin but facial lesions significantly improved more than trucal ones in patients on doxycyclin.Conclusion: The efficacy of oral erythromycin and doxycyclin was not significantly different in the treatment of acne vulgaris and each of them can be used according to the clinical status of the patients.

Background and aim: Pyogenic granuloma is a small, red, benign vascular tumor usually occurring after penetrating injury in skin. Different therapies such as laser, surgery and electro surgery have been offered for its treatment. Each of these therapies has advantages and disadvantages. In this study, we evaluated the therapeutic effects of cryotherapy and electrocautery on pyogenic granuloma.Materials and Methods: This clinical trial was performed on 50 patients who had pyogenic granuloma. In 25 patients cryotherapy was used with liquid nitrogen every ten days for a maximum of 3 sessions. Electrocautery was done by another dermatologist, and the lesion was destroyed in one session. Patients were followed for one month after treatment. T test and X2 were used for data analysis.Results: The mean age of patients in cryotherapy group and in electrocautery group were 21.8±17/1 and 28/7±17/7 years, respectively (P>0.05). Number of treatment sessions were 2.2±0.8 in cryotherapy and 1/1±0.3 in electrocautery group (P<0.0001) Cure was observed in 100% of patients treated by electracautery method and in 77% treated by cryotherapy method (P=0.01).Conclusion: Electrocautery is more effective than cryotherapy, but treatment with cryotherapy also is very effective, and can be used mainly in children, pregnant women, large lesions and those who are afraid from electrocautery.

Background and aim: In spite of the existence of different types of treatment for cutaneous leishmaniasis, an efficient, safe and cheap treatment has not been found yet. There are some studies showing antiparasiticidal effect of direct current electricity both in vivo and in vitro. The objective of this study was to evaluate the effect of electrotherapy in treatment of cutaneous leishmaniasis.Materials and Methods: This trial was done on 16 patients referred to dermatology clinics of Mashhad University of Medical Sciences with cutaneous leishmaniasis. Twenty-seven lesions were treated in six weekly sessions for 10 minutes, by direct current electricity. The intensity ranged from 5 to 15 mA, and the voltage was kept below 40 volts. Ten lesions were left untreated as control group. At each session the size of induration was measured and recorded.Results: At the end of the trial, in the study group, the average of the induration size decreased 55±30%, however, in the control group the induration size increased 20±20% (P<0.05).Conclusion: Direct current electricity was effective in the treatment of cutaneous leishmaniasis to some extent. Further studies with alteration in method of this treatment are needed.

Background and aim: Pigmented purpuric dermatoses are a group of chronic and recurrent skin diseases resulting from lymphocyte-mediated leakage of erythrocytes. No effective treatment has been suggested for these conditions. This study was performed to evaluate the efficacy of oral pentoxiphylline in the treatment of pigmented purpuric dermatoses.Materials and Methods: Thirty-five patients with typical clinical lesions of pigmented purpuric dermatoses, in whom the disease was histopathologically confirmed, were entered into this trial after giving informed consent. They were randomly allocated into two groups. One group was treated with oral pentoxifylline at a dose of 400 mg three times a day and the other group was treated with an inert topical emollient two times a day for 8 weeks. After the end of treatment, the efficacy of the interventions was assessed based on the following definitions: complete remission=disappearance of all clinical signs and symptoms, partial remission=more than 50% reduction, minimal remission (disease persistence)= less than 50% reduction and ineffective treatment=no change in the clinical signs and symptoms.Results: At the end of the intervention period, no patient in the emollient-treated group showed improvement as well as 18 of 20 patients in the pentoxifylline-treated group (P>0.05). In the pentoxifylline-treated group, complete remission was observed in one patient with lichen aurous and in a case of Schamberg's disease. Four weeks after the end of treatment, the lesions reappeared in the patient with Schamberg's disease. None of the patients in either groups had drug side effects or showed disease progression.Conclusion: This trial did not show any statistically significant difference between pentoxifylline and placebo in the treatment of pigmented purpuric dermatoses.

Background and aim: Atopic dermatitis (AD) is a chronic, inflammatory, pruritic skin disease usually observed in patients with other allergies. Decreased selenium levels and improvement with selenium supplement are reported in AD. The aim of this study was to compare serum and whole blood selenium in children with AD and control group.Materials and Methods: In an age-sex matched case-control study, 46 children with AD (according to Rajka & Hanifin criteria) and 46 controls were evaluated. The severity of AD was determined based on SCORAD index. Serum and whole blood selenium levels were measured and compared between two groups by atomic absorption spectroscopy. Chi-square and t tests were used for data analysis and P<0.05 was considered as significant.Results: Forty-six patients with age of 2.57±2.6 years and 46 controls with age of 2.63 ±2.6 years, each consisting of 24 boys and 22 girls were included (P>0.05). Mean serum selenium in patients (72.58±16.5 ng/ml) was significantly lower than controls (84.8±15.6 ng/ml) (P=0.001) M. ean whole blood selenium in patients (88.07±19.0 ng/ml) was significantly lower than controls (99.38±19.3 ng/ml) (P<0.001). Low serum selenium levels (less than 63 ng/ml) were observed in 28.3% of patients and 10.9% of controls (P<0.05). Low whole blood selenium levels (defined as less than 75.5 ng/ml) were observed in 30.4% of patients and 15.2% of controls (P>0.05). No significant correlations were observed between serum and whole blood selenium and severity of AD.Conclusion: The results confirm other studies that showed low selenium levels in AD. Our findings suggest that low selenium level may be involved in the pathophysiology of AD in childhood, and indicate nutritional status especially selenium levels might be a potentially useful strategy for the recognition and treatment of these patients.

Background and aim: Acne is a chronic inflammatory disease of the pilosebaceous units. Its etiology is unknown. However, several studies have shown that some endocrinologic factors are involved in acne pathogenesis. The aim of this study was to assess some endocrionlogic indices in male patients with acne vulgaris and comparing them with normal controls.Materials and Methods: In this case-control study, 40 male patients with acne referred to Razi hospital during the first 9 months of 1382, and 20 age-matched healthy subjects were selected. Plasma level of insulin, fasting blood sugar (FBS), free testosterone and sex hormone binding globulin (SHBG) were determined and compared between the groups.Results: The mean FBS level was 89.8±13.3 mg/dl in patients with acne and 91.1±16.3 in controls (P=0.017). The mean free testosterone level in cases and controls were 24.8±12.0 and 21.4±10.8 nmol/L, respectively (P=0.029).Conclusion: In this study, the testosterone level in patients with acne was higher and the FBS level was lower than controls. It is recommended that these indices be taken into consideration in male patients with acne.

Background and aim: Melasma is an acquired, symmetric hyperpigmentation, specially in sun-exposed skin. Disorders of thyroid gland result from processes that stimulate the overproduction or underproduction of thyroid hormones. This study was performed to assess the association of melasma with thyroid disorders.Materials and Methods: This case-control study was performed on 45 non-pregnant women between 20-50 years with and without melasma. Thyroid hormones and autoantibodies including T3, T4, TSH, anti TPO and anti TG were measured by ELISA in both groups.Results: In patients with melasma, the frequency of thyroid disorders was 37.8% versus 11.1% in the control group (P=0.013, OR=4.8, 95% CI=1.60-14.7). The mean level of TSH, anti TPO and anti TG in control patients was lower than in patients but the difference was not significant.Conclusion: Melasma is associated with thyroid disorders specially hypothyroidism and autoimmune disorders.

Background and aim: Basal cell carcinoma (BCC) is the most common cancer in whites. The most important risk factor for developing BCC is solar ultraviolet (UV) irradiation. As the weather in most parts of Iran is mostly sunny, BCC is common. This study was performed to evaluate changes in the frequency of BCC in 1368-69 and 1378-79.Materials and Methods: This descriptive and retrospective study was performed as an existing data study and all files in department of pathology in Razi Hospital from 1368-69 and 1378-79 were assessed with regards of BCC frequency, patient age and gender as well as history of radiation and the collected data were compared.Results: A total of 1503 BCCs were studied, 507 were from 1368-69 and 996 from 1378-79 period. In the years 1368-69, relative frequency of BCC was 11.1%. On the other hand in years 1378-79 relative frequency of BCC was increased to 15.2%, which was not associated with gender. BCC occurrence showed a significant decrease in 20-30-year age group and a significant increase in over 60 years age group. Among histologic subtypes, nodular form showed an increase, which was statistically significant on face region (P<0.005), but was not linked to patient gender. In male patients significant decrease of BCC frequency on face and increase on head and neck areas was observed, but there was not any significant change in tumor location in female patients.Conclusion: During a 10-year period the frequency of BCC has increased significantly requiring more attention to develop educational programs regarding prevention, diagnosis and early treatment.

Background and aim: Malassezia species are part of the resident skin flora of humans. These yeasts are associated with various superficial diseases, including seborrheic dermatitis, atopic dermatitis, dandruff, and psoriasis. Various DNA-based molecular methods have been recently described to differentiate species of Malassezia. In this survey, a simple, reliable, and cost effective PCR-based method was applied for differentiation of Malassezia species isolated from pityriasis versicolor patients in Iran.Materials and Methods: In this study 83 clinical isolates from pityriasis versicolor patients were analyzed. A PCR-based technique using restriction enzyme digestion was applied for identification of Malassezia species.Results: The most frequently isolated species were M. globosa, followed by M.furfur, M. sympodialis, M. restricta and M.slooffiae. Species of M. packydermatis and M. obtusa were not seen.Conclusion: As M. sympodialis is the most prevalent species in the skin of healthy individuals, isolation of M. globosa as the dominant species from pityriasis versicolor lesions, suggests more virulent factors in this species.

Background and aim: Leishmaniasis is a zoonotic disease with wide clinical diversity caused by protozoan parasite belonging to the genus of Leishmania. Treatment of human leishmaniases is still based on pentavalent antimonials but their toxicity and emerging resistance are problematic. This study was performed to assess the effect of Mimosa tenuiflora extract on L. tropica promastigotes to find potential new therapeutic method against leishmaniasis.Materials and Methods: This study has been based on two in vitro methods: methyl thiazole tetrazolium (MTT) assay and counting parasites, using 10, 100, 500, 1000 micg/ml concentrations of plant extract.Results: Different concentrations of M. Tenuiflora extract have different effects on multiplication of Leishmania protozoa in culture medium. Concentration of 1000and 500 micg/ml suppressed multiplication of promastigotes but at a concentration of 100 micg/ml it accelerated growth of promastigotes.Conclusion: This finding suggested that M. tenuiflora extract contains both inhibitory and acceleratory effects on Leishmania growth in vitro.

Granulomatous lobular mastitis (GLM) is a rare and benign condition of unknown etiology, which has been described recently. It primary affects young parous women and usually presents with a unilateral and extra-areolar breast mass. The condition may clinically mimic breast cancer, sometimes leading to misdiagnosis resulting in unnecessary breast surgery.We report two cases of GLM associated with erythema nodosum and oligoarthritis, which were treated with systemic steroids and surgery. After one year of follow up, there were no recurrency.

Becker's naevus is an acquired persistent asymmetrical area of skin pigmentation, sometimes showing evidence of increased androgen sensitivity, and colocalizing with other developmental anomalies. We report a 30-year-old woman with clinical findings compatible with Becker's naevus on her right breast accompanied with hypoplasia of ipsilateral breast.

Lichen nitidus is an uncommon skin condition that is clinically characterized by the presence of pinpoint papules, which are usually asymptomatic, flesh colored, with a flat, shiny surface. The histopathologic feature of it is characteristic. We report a 30-year-old man with typical skin lesions of lichen nitidus confirmed with histopathology, who also had multiple palmar pits. Treatment with topical clobetasol propionate resulted in great improvement, flattening of palmar lesions and clearance of the forearn and wrist lesions. To our knowledge, the association of lichen nitidus with palmar pitting has not been reported before.