Iranian Journal Of Dermatology
Volume:11 Issue: 1, 2008

Narrow band Ultraviolet B (NBUVB) has been used successfully for the treatment of vitiligo. Recently, topical calcipotriol has also been used as immunotherapy or as a part of combination therapies. The aim of this study was to compare the clinical efficacy and safety of NBUVB and NBUVB plus topical calcipotriol in the treatment of generalized vitiligo. NBUVB phototherapy was given to 26 patients with generalized, symmetrical vitiligo three times weekly. Topical calcipotriol cream was only applied on the lesions located on one side of the body. Treatment was continued until cosmetically acceptable repigmentation occurred, but total cumulative dose of NBUVB did not increase from the mean of 113.4 ± 47.0 j/cm. The efficacy of treatment was evaluated by visually scoring the percentage of regimentation of the lesions at 12-session intervals by an investigator unaware of the side of calcipotriol application. The mean daily dose of NBUVB was 1.4 ± 0.6 j/cm. The median number of exposure for initial regimentation was 26.5 (range 14-38) on the side of combination therapy with calcipotriol and 25.3 (range 20-40) on the other side. After 24 sessions of treatment, 14 patients (53.9%) showed minimal to moderate improvement on the calcipotriol treated side as compared to 21 patients (80.8 %) on the other side. After 60 sessions of treatment, 16 patients (16.5 %) showed moderate to marked regimentation on the side of combination therapy with calcipotriol as compared to 19 patients (73 %) on the other side. These findings indicate that concurrent use of topical calcipotriol does not enhance the efficacy of NBUVB in the treatment of vitiligo.

Latanoprost, a prostaglandin F 2a analogue, is an intraocular pressure lowering drug used in the treatment of glaucoma. Increase in eyelash number, length, pigmentation, curvature is reported after using topical Latanoprost in these patients. The aim of this study was to evaluate the effect of Latanoprost ophthalmic solution on eyelash regrowth in patients with alopecia areata. Fifteen patients with alopecia areata and bilateral eyelash involvement, who showed excellent response to diphencyprone therapy, entered the study to be treated with Latanoprost ophthalmic solution. In each patient, one eye was randomly treated with Latanoprost daily over 3 months. To assess the eyelash changes, patients were followed up monthly. Ten patients completed the study. Two patients had significant eyelash regrowth of both eyes. One patient showed eyelash regrowth on upper eyelid of the eye treated with Latanoprost. In this study, Latanoprost was not effective in treatment of alopecia areata of eyelashes. It is advisable to evaluate the efficacy of higher concentration and/or more frequent application of the Latanoprost with an appropriate vehicle for the treatment of alopecia areata of eyelashes.

In addition to humoral immunity associated with anti-desmoglein antibodies, cellular immunity and mediators including cytokines are involved in the pathogenesis of pemphigus vulgaris. In this study we evaluated the level of IL-2, IFN-γ, TNF-α, IL-4, and IL-10 in the sera of patients with pemphigus vulgaris before and after treatment. A total number of 71 new patients with pemphigus vulgaris were included in the study. The above mentioned cytokines were measured in patients with a mild disease (20 bullae or less) and a severe disease (60 bullae or more) using ELISA method before and 4 weeks after treatment with 2 mg/kg/day prednisolone and 2mg/kg/day azathioprine. We also measured IL-4 and IL-10 in 69 mildly and 70 severely affected patients only at the beginning of the study. All patients had muco-cutaneous phenotype. Patients with a mild disease had mild mucosal involvement and patients with a severe disease had moderate to severe mucosal involvement. Serum levels of IL-2 and IFN-γ were also measured in 27 normal controls. In the total study population, the level of IL-2 decreased from 103.9 pg/ml to 82.79 pg/ml after treatment (p=0.05). Comparing cytokines between 2 groups (severe and mild), the level of IL-2 before treatment showed significantly lower figures in severe patients (147.27 versus 67.38, p=0.04). On the other hand, IFN-γ after treatment was significantly higher in severe patients (0.75 versus 0.42, p=0.04). Mean level of IL-2 is lower in severe pemphigus vulgaris patients than that of mild disease. This finding indicates that, in pemphigus vulgaris, IL-2 level negatively correlates with the severity of the disease and widespread underlying autoimmune process. The data also suggests that the level of IFN-γ directly correlates with the severity of the disease.

Trichophyton rubrum (T. rubrum) is the most common cause of dermatophytosis of skin and nail tissue. Strain identification in Trichophyton rubrum is important for identification of strain-related differences in infectivity potential or transmissibility and epidemiological studies. PCR typing could determine whether the original isolate is responsible for re-infection or a new strain has been acquired. A minipreparation method for DNA from dermatophytes was used. Tandemly repetitive subelements (TRS-1 & TRS-2) of NTS region at ribosomal DNA of 23 T.rubrum isolates were amplified and the PCR products were separated by electrophoresis in 2% agarose gel (200 mA, 140 V), visualized by staining with ethidium bromide, and photographed. On the basis of copy number of TRS-1 and TRS-2, 8 out of our 23 samples were type 2 & II, respectively. Six of them were type 3 & II, four isolates were type 1 & II, two isolates were type 4 & II, two isolates were type 1 & I and one isolate was type 5 & II. In this study, most of T. rubrum isolates were type 2 & II, dissimilar to European studies where type 1 & II has been the most common. The present study showed that 26.1% of Iranian isolates were type 1 in contrast with a previous study which has demonstrated a much lower prevalence in Asians (5%).

Atopic dermatitis is the most common chronic inflammatory dermatitis, due to immunological disorders. Patients with atopic dermatitis are prone to infectious diseases including bacterial infections. On the other hand, atopy may be protective against helminthes parasites. The objective of this study was to compare the frequency and clinical presentations of cutaneous leishmaniasis in atopic dermatitis patients with the control group in an outpatient clinic in Kerman. This was a case – control study done on 459 patients with atopic dermatitis, who were diagnosed based on Hanifin & Rajka criteria and 400 healthy subjects without immunosuppression as our control group. The frequency of leishmaniasis was investigated in both groups according to age, gender and residential area. Among 459 atopic dermatitis patients, 232 were female and 227 were male. Control group consisted of 232 males and 168 females. The mean age of the atopic dermatitis patients and the controls was 9.2 and 13.3 years, respectively (p<0.05%). Both groups were matched regarding residential area. Twenty eight (6.81%) patients with atopic dermatitis and 29 (7.2 %) control subjects were affected by cutaneous leishmaniasis (p>0.05%). There was no statistically significant difference in clinical presentations of leishmaniasis between two groups. In this study there was no significant relationship between leishmaniasis and atopic dermatitis. This finding can be due to the small sample size or the difference between case and control groups regarding age.

Genital infections with human papilloma virus (HPV) are the most common sexually transmitted disease in the United States. Several predisposing factors are known for this infection. So far, no studies on the risk factors and clinico-epidemiologic aspects of genital warts in Iran have been reported. So, we performed this study to evaluate epidemiologic aspects of anogenital warts in Mashhad, Iran. In this case-control study, 100 patients with genital warts who referred to the dermatology clinic of Imam-Reza hospital (August 2005 - August 2007) and 100 age, sex and marital status matched healthy controls were included. Clinical and epidemiologic data were recorded using designed questionnaire. Finally, chi-square and t-student tests were used for statistical analysis. Male to female ratio was 0.87. The majority of the patients aged 30-39 years. Glans of the penis and posterior fourchette were the most common sites of involvement. Positive history of sexual contacts and sexual transmitted diseases (STDs), use of condom, pregnancy, addiction, use of swimming pools and number of marriages were significantly different in two groups. Younger age, higher number of marriages, having several partners, non-traditional sexual behavior, pregnancy, use of swimming pools, refuse to use condoms, history of other STDs, immune suppression, use of immunosuppressive drugs and topical steroids were the main risk factors of anogenital warts in this study.

The future development of medicine will greatly depend on research, knowledge and clinical application of stem cells. In recent years, stem cells especially; skin stem cells have been very interesting and amazing targets for study and scientific application in the following fields: 1- Cell-based therapy; 2- Regenerative medicine and tissue engineering; 3- Gene therapy; 4- Therapeutic cloning; 5- More efficient new drugs with fewer side effects.

We report phakomatosis pigmentovascularis (PPV) detected in a 40- year-old male characterized by the presence of a port-wine stain in the background of aberrant Mongolian spots covering the back, nevus of Ota, ocular melanosis, epidermal nevus and a scaly patch with the diagnosis of discoid lupus erytematosus. These associations have not been reported yet

A 15-year-old boy presented with several months history of bilateral axillary lymph adenopathies which were ulcerated subsequently. He had received anti-tuberculosis therapy for more than six months based on suspicious diagnosis of scrofuloderma. Histopathologic examination confirmed the diagnosis of specific lesions of Hodgkin’s disease. These lesions were probably metastatic due to retrograde lymphatic spread from his axillary lymph nodes, as this way is the most common mode of Hodgkin’s disease spreading to the skin. The patient received chemotherapy regimen for Hodgkin’s disease and ulcers resolved remarkably.