Iranian Journal of Dermatology
Year:2005 | Volume:8 | Issue:2|Papers Count:15

Background: Tinea capitis is a relatively common fungal in children. infection Although several oral antifungal agents have been used in the treatment of tinea capitis, griseofulvin has been considered as the treatment of choice for a long time. Objective: To compare the therapeutic effects of fluconazole with griseofulvin on tinea capitis. Patients Methods: Through and randomized, single-blinded, clinical trial on 40 clinically suspected and mycologically confirmed tinea capitis cases, 19 cases received oral fluconazole for 4 weeks and 21 patients were treated with griseofulvin for 6 weeks. All patients were evaluated clinically and mycologically before receiving their treatment and 8 weeks after the begining of treatment. Results: The age range of the patients was from 1 to 16 years. Thirty-two cases were males. Mycology studies indicated that the causative agents were Trichophyton verrucosum in 16 cases, Trichophyton violaceum in 16 cases and Microporum canis in 8 cases. At the end of the eighth week of the begining of treatment, 15 cases were cured in the fluconazole group compared with 16 cases in the griseofulvin group (P>0.05). a Conclusion: It seems that griseofulvin could be still considered as the first choice drug in the treatment of tinea capitis and fluconazole could be used as an alternative drug.

Background: Tinea versicolor is a common superficial mycosis, which is caused by lipophilic yeasts, Malessezia furfur. It is a chronic and recurrent skin disease. It occurs most commonly in young post pubertal people and in hot and humid climates (north and south provinces of Iran). Objective: Comparison of effects of ketoconazole 2% shampoo (Shafa Lab) with selenium sulfide 2.5% shampoo on tinea versicolor. Patients and Methods: Two-hundred patients with tinea versicolor were divided in 2 groups, each consisted of 100patients, one group was treated with ketoconazole 2% shampoo and the other one with selenium sulfide 2.5% shampoo Results:We found out that ketoconazole 2% shampoo was more effective (89% cure rate) than selenium sulfide 2.5% shampoo(35% cure rate). Conclusion: It seems that ketoconazole 2% shampoo is more effective than selenium sulffide 2.5% shampoo in the treatment of tinea versicolor.

Background: Cutaneous leishmaniasis is an important skin parasitic disease. Ideal treatment is not found yet and seeking for proper drugs continues. Objective: Comparison of the efficacy of fluconazole with systemic Glucantime in patients with acute cutaneous leishmanisis in Ghaem Hospital in Mashhad in 2002 Patients and Methods: During one year of study, all patients with cutaneous leishmaniasis were divided to two groups. Thirty-one patients were treated with oral fluconazole (100 mg twice a day) for 6 weeks and patients treated with 29 were intramuscular Glucantime (20 mgSb/kg) for 21 days. Both groups were evaluated 3 and 6 weeks after onset of treatment. "T" test and chi-square test were used for statistical analyses and P<0.05 was considered as significant. Results: Six weeks after begining .of treatment, clinical cure, improvement and failure were observed in 4(12.9%) , 11 (35.5%) and 16(51.5%) of patients treated with fluconazole, respectively. These figures were 11(37.9%), 10(34.6%)and 8(21.5%) of patients treated with Glucantime, respectively (P>0.05). Conclusion: It seems that efficacy of fluconazole in acute cutaneous leishmaniasis is lower than Glucantime. A larger clinical trial is recommended.

Background: Phototherapy is an important modality in dermatology and the number of skin diseases which can be controlled with it IS mcreasmg. In order to start treatment, the first dose of phototherapy is determined by measurement of minimal erythema dose (MED) in each patient individually or according to patient"s skin type. Objective: To determine the relationship of skin type with MED in patients under UV phototherapy referred to Razi Hospital in Tehran Patients and Methods: In patients referred to Razi Hospital in 1381(2002-2003) for UVB phototherapy, skin type was determined according to Fitzpatrick"s classification and MED was measured using a UV-meter. Age, sex and the disease of the patients were also recorded. The data were analysed using one way ANOVA and Welch tests. Results: Eighty patients including 39 males and 41 females were studied. The mean age of the patients was 32 years (SD=15.8). Their diseases include psonasls, vitiligo, parapsoriasis, pityriasis lichenoides chronica, perforating disorder and patch stage mycosis fungoides. The mean of MED in 17patients with skin type Il was 111.8±39.2, in 42 patients with skin type III was 105.9±43.1 and in 21 patients with skin type IV was l14.3±39.2 mJ/cm2 , with no significant statistical difference. Conclusion: The first dose of phototherapy could not be determined based on skin type and measurement of MED is necessary in each patient.

Background: Pemphigus is a serious blistering disease with considerable mortality, which heavily burdens on health care system because of the long time hospitalization. It is rare in North America but is considered as the most common immunobullous disease in eastern countries such as Malaysia and China. Objective: The purpose of this study was to define the epidemiologic features. of pemphigus in north of Iran. Patients and Methods: One-hundred and twenty-six cases of pemphigus diagnosed based on clinicohistological findings that were hospitalized in Rasht, in north of Iran, between 1995-2001 were studied. Epidemiological data collected from their hospital records were entered in SPSS software and statistical analyses were performed by "t" test, chi-square and Pearson correlatron tests. Results: Pemphigus vulgaris was the most common type (83%), followed by foliaceous (6%) and vegetans (1%). The mean age of patients was 45.6 years, with 47.2 in vulgaris and 37.8 in foliaceous group (P<0.05). There was no sex difference in mean age in vulgaris group, whereas the mean age of foliaceous group was 30.2 for females and 51.8 years for males (P<0.05). Female: male ratio was 1.5:1, with 1.44: 1 for vulgaris and 1.85:1 for foliaceous groups, respectively. The oral mucosa was the first site of involvement in 63% of vulgaris cases, and 72.4% of them had widespread mucocutaneous disease at the time of hospitalization. Frequency of illness in spring (32%) was higher than other seasons. The mean time for 80% improvement of lesions in hospital was significantly higher in cases with widespread mucocutaneous lesions than cases with only skin or mucosal illness (P<0.05). Conclusion: These findings clearly demonstrate the need for continuous training of involved health workers (dermatologists, dentists, oto1aryngologists, general physicians) for early diagnosis and referral of disease, which not only could decrease the morbidity and mortality, complications rates for patients but also hospitalization costs for patients and health care system.

Background: Lichen planus (LP) is an idiopathic papulosquamous disorder which can show cutaneous or mucosal signs. It is caused by a cell mediated immune response to an antigen. A wide range of clinical manifestations has been reported. Objective: To detennine the sex and age frequency and clinical presentations of this disease in patients referred to Razi Hospital in Tehran. Patients and Methods: In this observational case series study, patients referred to Razi Hospital in Tehran from May to July 2003 were examined and clinically. or clinicopatho10gically confinned cases of LP were selected. Results: One-hundred and twenty patients had LP (52 females-68 males). The age range was 6-80 years and the mean age was 40/6 years. Sixty-seven of patients had cutaneous lesions, 20% had mucocutaneous and 13% had mucosal lesions. Hypertrophic LP was present in 22% and typical or classic LP was seen in 18%. Seven percent of patients had scalp involvement and oral LP was present in 33.3% of cases and the most common fonn was reticular. Genitallesions were present in 6% of cases mainly in male cases and as annular fonn. Six percent of patients had positive family history of LP. Conclusion: In this study LP was more common in male patients and in fourth decade of life. Hypertrophic LP and classic LP were the most common and reticular fonn was the most common fonn of oral LP. Genital lesions were mainly seen in male patients and as annular fonn.

Background: Geographic tongue IS an inflammatory disorder of unknown etiology that affects the epithelium of the tongue. It has been associated with several cutaneous diseases. Objective: To determine the prevalence of geographic tongue and its association with other cutaneous diseases in patients referred to the dermatology clinic of Razi Hospital. Patients and Methods: A cross-sectional study was performed on all patients referred to one of the dermatology clinics of Razi Hospital between February 21 and March 18, 1996 to determine the prevalence of geographic tongue and other diseases. Results: One-thousand and one-hundred and sixty referred patients were studied. The prevalence of geographic tongue was 6.2%. There was a statistically significant association between geographic tongue and seborrheic dermatitis (P=0.0053). Conclusion: Geographic tongue is associated with some cutaneous diseases. Detection of these associations could be a clue to the etiology and pathogenesis of geographic tongue.

Background: Cutaneous granulomatous dermatoses usually are a diagnostic challenge with tuberculosis (TB) on top ofthem. TB is a universal health problem and considered by WHO at the top of 6 common and dangerous infectious diseases. Objective: To determine the clinical, laboratory and histopathological findings in 45 patients with the diagnosis of cutaneous TB over a 10-year period in Ahwaz. Patients and Methods: This is an existing data study on the records of all patients with the diagnosis of TB admitted to Sina Hospital in Ahwaz from November 1990 to March 1999. Data on the age, localization, clinical features were extracted from hospital records. Results: The age range of patients was between 1-76 years. Twenty-eight cases were female and 17 cases were male. Twenty-three cases clinically diagnosed as were scrofuloderma (SFD), 18 cases as lupus vulgaris (LV), 1 case as erythema induratum, 1 case as TB gumma, 1 case as orificial TB and 1 case as populonecrotic tuberculide. The most common involved site was face and the least common sites of involvement were buttock and elbow. Six cases had positive family history. SFD was present in 12 females and 11males.The result of tuberculin test was positive in 15, negative in 17 and not available in 13patients. Histopathologically, 23 cases showed chronic disease without granulomatous caseation, showed nonspecific 18 cases inflammation and in 3 cases tubercle with caseation was observed. Concerning treatment, we found generally good clinical response with no failure in 32 patients who came for follow up. Conclusions: This study showed that in Ahwaz SFD was the most common form of cutaneous TB and the most frequent site of involvement was face.

Since the discovery of X-rays, the use of imaging technology has continued to play an important role in medicine. Technological advancements have led to the development of various imaging modalities, most of which have been used to image organs deep within the human body. More recently, attention has focused on the application of imaging technology for evaluation of the skin. A variety of techniques are currently being used to examine the skin and these include specialized photography, surface microscopy, ultrasound, laser Doppler perfusion imaging, confocal microscopy, magnetic resonance Imagmg and optical coherence tumography. These modalities can provide information that can assist in the management of skin problems. Although many of these techniques are still undergoing research, they are showing promise as useful clinical tools in dermatology. In this review article we discuss about each of these technologies in brief.

Pseudoporphyria is an uncommon bullous disease and with similar clinical histopathological porphyria findings to cutanea tarda, in the absence of detectable porphyrin elevation. We present a 34-year-old man with clinical and histological findings compatible with porphyria cutanea tarda, whose his urinary uroporphyrin was negative and we concluded that he was a case of pseudoporphyria. Concomitant active infection with hepatitis C virus was a unique finding in this patient.

Mal de Meleda (keratoderma plamoplantaris transgrediens) is a rare autosomal recessive form of palmoplantar keratoderma with hyperkeratosis of palms and soles, which appears soon after birth and progressively involves other areas (transgrediens) of the skin especially dorsal aspects of hands and feet. We report a 20- year-old woman with Mal de Meleda with some unusual clinical features, i.e. peculiar finger nail anomalies and pseudoainhum on all her fingers.

Mal de Meleda (keratoderma plamoplantaris transgrediens) is a rare autosomal recessive form of palmoplantar keratoderma with hyperkeratosis of palms and soles, which appears soon after birth and progressively involves other areas (transgrediens) of the skin especially dorsal aspects of hands and feet. We report a 20- year-old woman with Mal de Meleda with some unusual clinical features, i.e. peculiar finger nail anomalies and pseudoainhum on all her fingers.

Harlequin ichthyosis is one of the most severe congenital skin cornification disorders with an incidence rate of about I in 300,000 births and characteristic clinical features. We report two cases of harlequin ichthyosis (HI) or harlequin fetus (HF), which were products of consanguineous union. Clinical examination showed typical features of harlequin ichthyosis, with the presence of plaques with diamond-like configuration, external ear anomaly, severe ectropion and eclabium, and rigid semi flexion of limbs.