Iranian Journal of Dermatology
Year:2003 | Volume:6 | Issue:4 (24)|Papers Count:13

Background: The current treatments of recurrent aphthous stomatitis are not very effective and are not justified for long term using due to their potential side effects. Objective: To compare the efficacy of topical sucralfate mouthwash with topical tetracycline mouthwash in recurrent aphthous stomatitis. Patients & Methods: In a randomized matched clinical trial, 60 patients with recurrent aphthous stomatitis fulfilling our inclusion criteria, referred to skin clinics affiliated to Skin Research Center in Shahid Beheshti University of Medical Sciences in 1380-81 were assessed. The patients were randomly divided in two groups, matched for age and type of the ulcer. The case group (26 patients) used a mouthwash containing 1 gr sucralfate per 15 cc, and the control group (34 patients) used a mouthwash containing 250 mg tetracycline per 15 cc, four times a day and were assessed every 2 weeks. The data were ana1yzed by chi-square and t-tests (P<0.05). Results: There was no significant difference between two groups regarding the frequency, healing time and pain of the aphthous lesions. Patients were more satisfied with the sucralfate suspension than tetracycline suspension in the end of treatment period (P<0.03) and in the end of follow up period (P<0.04). No side effects were seen in two groups. Conclusion: Sucralfate suspension mouth wash can be considered equally effective as tetracycline mouthwash in treating recurrent aphthous stomatitis. It can be considered as a special modality for aphthous ulcer treatment due to lack of systemic toxicity and side effects even if accidentally swallowed or absorbed through mucosal surfaces.  

Background: Tinea versicolor is a superficial fungal infection caused by normal skin flora and treatable by topical and oral anti-fungal medications. Objective: To evaluate the clinical and paraclinical response and to compare possible side-effects of a single oral dose of fluconazole and ketoconazole in the treatment of tinea versicolor. Patients & Methods: In this clinical trial, sixty-six definite cases of tinea versicolor were divided in two groups using a simple randomization method. The first group consisted of 33 patients who were treated with a single oral dose of 300 mg of fluconazole. The second group also consisted of 33 patients who received ketoconazole 400 mg orally as a single dose. The patients were evaluated 2 weeks after treatment for therapeutic and paraclinical responses as well as possible side effects. Results: Clinical and paraclinical responses were 60.6% and 78.7% in the first group (fluconazole) and 33.3% and 51.5% in the second group (ketoconazole), respectively (P<0.05): There was no statistical difference as far as side-effects were considered (P>0.05). Conclusion: The therapeutic effect of fluconazole as a single oral dose was more than ketoconazole in the treatment of tinea versicolor.    

Background: Due to infections, cardiovascular involvement and renal insufficiency, patients with systemic lupus erythematosus live shorter than usual. Objective: To determine the mean survival rate of SLE patients. Patients and Methods: 62 SLE patients admitted in the hospitals of Kerman University of Medical Sciences from 1369 to 1380 were included in this study. The demographic variables which were effective on disease survival time evaluated. Results: Mean survival time, regardless of other descriptive variables, was 9.2±0.89 years. The cases who had skin lesions first, in comparison with those who had rheumatic signs at first, revealed lower survival rate and more morbidity. The mean survival rate of cases who received combination of corticosteroid corticosteroid and antimalarial drugs, drugs alone, and cyclophosphamide plus anticoagulants, were 12.0,9.5 and 8.5 years, respectively. Conclusion: The prognosis in SLE patients with early skin manifestations was poorer than those with early rheumatic presentation. Best prognosis was noted in patients who received systemic steroids in comparison to other treatment modalities.      

Background: Comedone formation has an essential role in pathophysiology of acne, therefore destroying of comedones and preventing of comedone formation is very important in acne treatment. Objective: To determine the effect of superficial peeling with 70% glycolic acid in the improvement of acne. Patients & Methods: In this open clinical trial without control group, 30 patients with acne referred to Razi Hospital in Tehran (mean age 18) years were treated with 70% glycolic acid and their clinical improvement was evaluated. Results: Mean numbers of comedones were 24.4± 15.2 and 2.6±5.9 in first & last visits respectively (P<0.005). Moreover, 18 patients (60%) and 12 patients (40%) had complete and relative improvement, respectively. The side effects of this treatment were minimum and transient. Conclusion: Superficial peeling with 70% glycolic acid is effective in treatment of mild acne.      

Background: Vitiligo is a common auto immune skin disease that may occur in association with other autoimmune disorders especially those of the endocrine system. Diabetes mellitus is a   common endocrine disease associated with vitiligo. Objective: To study the association of vitiligo and diabetes mellitus. Patients & Methods: In this descriptive cross-sectional study, 750 diabetic patients referred to Mashad Diabetes Center were studied in Shahrivar 1380. Results: thirty two (4.3%) of these patients suffered from vitiligo that mostly was of generalized type. The face was the most common site of involvement. Twenty two patients (68.7%) were female and 10 patients (31.3%) were male. Five percent of female and 3.3% of male diabetics suffered from vitiligo. 4.2% of NIDDM diabetics and 4.7% of IDDM diabetics suffered from vitiligo. Conclusion: Vitiligo was more common in NIDDM than IDDM because of the higher prevalence of NIDDM, but the association of vitiligo with IDDM was stronger. Vitiligo was more common in female than male diabetics.        

Background: Tinea pedis is probably the most common form of dermatophytosis in developed countries and it is one of the public health problems in the most societies. Moreover, wearing shoes, sweating and maceration are its predisposing factors. Objective: To evaluate the prevalence and determination of type of tinea pedis in the personnel of Hamedan Sina Hospital. Patients & Methods: In a descriptive cross-sectional study, 156 employees of Hamedan Sina Hospital were examined clinically and by fungal skin smears. Results: Ninety-three (59.6%) of patients were male and 63 (40.4%) were female. Seven patients (4.48%) suffered from tinea pedis and T. mentagrophytis (interdigital) was the main cause of infection. Conclusion: The prevalence of tinea pedis in this study was 4.48% which is lower than its prevalence in developed countries.      

The available treatment modalities for hypertrophic scars and keloids have very little success. Surgical treatment of these lesions without adjuvant therapy is also associated with high recurrence rate. Hyphertrophic scars and keloids are the results of a series of cellular and molecular changes which their identification can guide us toward new treatment modalities which may decrease the pathological factors, or help balancing the repair mechanism; thus inhibiting extensive scar formation. In this article, we have reviewed the latest treatment methods, as well as molecular and cellular reactions which lead to the formation of hypertrophic scars and keloids.      

We report a diabetic patient who developed skin lesions on her left forearm and ulnar nerve involvement following admission to the hospital and putting IV catheter for her treatment. Biopsy samples were taken from her skin lesions and ulnar nerve and with further evaluation after 2 months, the diagnosis of fungal infection due to zygomycetes and mucur was considered based on the presence of nonseptal hyphas with spreading to adjacent blood vessels. In specific staining, the sample was positive for fungal elements but its culture was negative. Clinical healing was observed after treatment with IV Amphotericin B. In general, in every diabetic or immunosupressed patient, even normal individuals with unusual infections without any response to common antibiotics, the possibility zygomycosis should be considered and histopathologic and fungologic evaluation should be done.      

LEOPARD syndrome is an autosomal dominant hereditary disease, which is characterized with cutaneous pigmented patches, electrocardiographic changes, ocular hypertelorism, retarded growth, pulmonic stenosis, genital abnormalities and congenital deafness. The gene of this disease has high penetrance but expression is varied and incomplete forms may be seen. We report a 23 year-old woman with mucocutaneous pigmented patches, congenital deafness, delayed puberty and ECG changes. It seems that this case is an incomplete form of LEOPARD syndrome.