فهرست مطالب

Iranian Journal Of Dermatology
Volume:16 Issue: 4, Winter 2013

  • تاریخ انتشار: 1393/01/25
  • تعداد عناوین: 9
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  • Jafar Tazval, Mohtasham Ghaffari, Reza M. Robati Page 121
    Background
    Skin cancers are among the most prevalent malignancies in Iran. According to statistics, it is the most common cancer in the population of Ilam, west of Iran. The present study aimed to assess threat appraisal of skin cancer among rural farmers of Ilam in 2013-2014.
    Method
    In this cross-sectional study, we used multistage random sampling. We collected the data through distribution of a researcher-developed questionnaire among 248 farmers from the rural areas of Ilam in June 2013. The items of the questionnaire were based on the protection motivation theory, and covered components included perceived vulnerability, perceived severity, and rewards.
    Result
    We found a generally lower perceived vulnerability and severity and higher rewards among the farmers; 14.5 and 30.6 % of the farmers displayed higher perceived vulnerability and severity, respectively. Only 15.7% of the farmers were low in extrinsic and intrinsic rewards for unprotected behaviours. We found 149 people (60.1%) had unacceptable levels of threat appraisal; 2 people (0.8 %) had borderline levels; and 97 people (39.1%) had acceptable levels. Also, there was a significant relationship between perceived vulnerability, severity, income, and education level of the participants (P<0.001), but an insignificant relationship was found between family size, threat appraisal (P<0.747), family size and perceived threat (P<0.247).
    Conclusion
    The overall findings of the present study indicated unacceptable levels of psychological perception about skin cancer in farmers, which highlights the importance of designing, implementation, and evaluation of educational interventions related to the issue.
    Keywords: farmers, protection motivation theory, skin cancer, threat appraisal
  • Farhad Handjani, Amir Kalafi Page 128
    Background
    Chronic skin diseases such as vitiligo and psoriasis can impair the quality of life in the patients with these diseases. The impact of chronic and/or severe skin diseases on the lives of family members of the affected patients has only recently been addressed. The tool used for this assessment is the Family Dermatology Life Quality Index (FDLQI). The aim of this study was to use the FDLQI to assess the impact of four skin diseases (pemphigus, psoriasis, vitiligo, and cutaneous leishmaniasis) on family members of the affected patients.
    Method
    Fifty healthy family members of 50 patients with pemphigus, psoriasis, vitiligo, and cutaneous leishmaniasis were included in this study. The patients had to have an extensive disease with disease duration of at least one month. One family member of each patient completed the 10- item Persian version of the FLDQI questionnaire. The score of this index ranged from 0 to 30.
    Result
    The mean duration and mean FDLQI score of the diseases were as follows: psoriasis (mean duration=4.1±2.7, mean FDLQI score=14.7±5.01), pemphigus (mean duration=3.6±2.3, mean FDLQI score=15.4±4.7), vitiligo (mean duration=5.1±4.05, mean FDLQI score=14.4±5.08) and cutaneous leishmaniasis (mean duration=0.62±0.23, mean FDLQI score=12.0±4.3). There was no significant difference among the groups (p=0.562). In addition, no strong correlation was observed between the mean duration of the disease and mean FDLQI scores for each condition (r=0.051, p=0.726).
    Conclusion
    This small-scale study demonstrated that although not statistically significant, inflammatory diseases like pemphigus had a higher FDLQI score when compared to non-inflammatory conditions like vitiligo and short-term conditions such as leishmaniasis.
    Keywords: cutaneous leishmaniasis, family dermatology life quality index, quality of life, pemphigus, psoriasis, skin disease, vitiligo
  • Maryam Yousefi, Leyla Nabaei, Hassan Ghasemnia, Ehsan Abolhasani, Rayhaneh Rahgoshai, Behrooz Barikbin Page 132
    Background
    Seborrheic keratosis is a common benign tumor and many modalities are used to treat it. No convincing data favors the therapeutic effect of calcipotriol on seborrheic keratosis. We aimed to assess the efficacy of calcipotriol in the treatment of this tumor.
    Method
    Eligible patients aged over 40 years with seborrheic keratosis (size: 5-15mm) were instructed to apply 50?g/g calcipotriol ointment twice a day for 12 weeks. The size of the tumor was measured at baseline and after the 12-week period. The size change and improvement were assessed.
    Result
    Thirty out of fifty screened patients were eligible for the study and completed the 12-week course of the study. The mean baseline size of the tumors was 9.30±2.95 mm that decreased to the mean size of 2.02±1.94 mm (P<0.05). The mean percent of improvement was 80.46±17.66% and 6 patients demonstrated 100% improvement. The mean percent of improvement revealed no difference between male and female participants. An intermediate negative correlation existed between the tumor size and the improvement. No serious side effects were reported by patients.
    Conclusion
    Our study concluded that calcipotriol might be effective and safe in the treatment of seborrheic keratosis tumors with slightly better outcomes in smaller tumors. Controlled studies with larger sample sizes should be performed in order to find the effect of calcipotriol on this dermatologic entity.
    Keywords: calcipotriol_seborrheic keratosis_topical administration_vitamin D analogues
  • Maryam Ghiasi, Vahide Lajevardi, Hossein Mortazavi, Maedeh Raiyati Damavandi Page 137
    Background
    Systemic isotretinoin is a very effective medication for the treatment of acne, but it has some side effects. One of its side effects is musculoskeletal problems such as increased levels of creatine phosphokinase (CPK), myalgia, and serious muscle damage such as rhabdomyolysis. The aim of this study was to evaluate the incidence of myalgia and its relationship with the elevation of serum CPK levels in patients treated with isotretinoin.
    Method
    This study was done on forty acne patients in Razi Hospital. Isotretinoin was administered at a dose of 0.25 mg/ kg in all patients. Serum CPK levels were measured before the treatment and every 2 months during treatment. On each visit, the patients were asked about muscular symptoms such as myalgia.
    Result
    Twenty-eight (70%) patients were female. The mean age of the patients was 22.6±5.4 years. The mean serum CPK level did not increase during treatment with isotretinoin. However, 2.5%, 36.8% and 31.5% of the patients had myalgia 2, 4, and 6 months after the initiation of isotretinoin, respectively. There was no significant difference in the mean CPK level of those who had myalgia after treatment with isotretinoin and those who were asymptomatic.
    Conclusion
    It seems that low dose isotretinoin does not induce the elevation of CPK, but can cause myalgia in some patients irrespective of the CPK level. Myalgia in patients under treatment with low dose isotretinoin is a benign phenomenon and is not an alarm for serious muscle damage. Therefore, routine measurement of the CPK level in patients receiving low dose isotretinoin is not recommended.
    Keywords: acne, creatine phosphokinase, isotretinoin, myalgia
  • Mohammad Javad Yazdanpanah, Reza Nourbakhsh, Fakhrozaman Pezeshkpoor, Mahnaz Banihashemi, Jamshid Baradaran, Moghadam Page 141
    Background
    Exfoliative dermatitis is a rare disorder with several etiologic factors. The frequency of different etiologies varies in the medical literatures. The purpose of this study was to reveal the demographic characteristic and etiologies of exfoliative dermatitis in our department.
    Method
    We reviewed the records of the patients who were admitted to the dermatology ward of Ghaem Hospital, Mashhad, Iran, with a diagnosis of exfoliative dermatitis in a twenty-year period (1982-2002). Age, gender, the cause of exfoliative dermatitis, and the most probable drug cause were studied.
    Result
    Fifty-nine cases were included in the study. Male-female ratio was 1.27:1. The mean age of the patients was 50.11±19.37. The most common causes were psoriasis (40.7%), drugs (18.6%) and lymphoma (18.6%). The most common drugs that caused exfoliative dermatitis were co-trimoxazole (27.27%), carbamazepine (18.18%), and gold salts (18.18%).
    Conclusion
    The most frequent of underlying cause of exfoliative dermatitis in our series was psoriasis. Co-trimoxazole was the most common drug that caused exfoliative dermatitis.
    Keywords: erythroderma, etiology, exfoliative dermatitis
  • Hossein Mortazavi, Nessa Aghazadeh, Maryam Ghiasi, Vahideh Lajevardi Page 144
    Retinoids are synthetic and natural analogues of vitamin A that have various effects on cellular differentiation, cellular proliferation, immune system, and embryonic development. The present study reviews the history of systemic retinoids in medicine, the structure of synthetic retinoids and their mechanisms. The main focus is on their biologic functions, clinical uses, and the adverse effects of isotretinoin, acitretin, and bexarotene representing the most commonly used first, second, and third generation systemic retinoids, respectively.
    Keywords: acitretin, bexarotene, etretinate, isotretinoin, retinoids
  • Mohammad Radmanesh, Nasibeh Sohrabian, Ramin Radmanesh Page 159
    The patients with universal vitiligo and residual pigmented patches usually do not benefit from available repigmenting methods and are better scheduled for depigmentation by medical, laser, and or freezing procedures. A 37-year-old lady with universal vitiligo and remaining pigmentation in the left anterior chest wall, both ventral forearms, and diffuse mottled depigmentation of the face was scheduled for facial depigmentation by 532 nm Q-switched Nd-YAG laser. All residual pigmented facial areas were treated uniformly. Two months after laser therapy, we paradoxically observed considerable repigmentation of the treated areas with only some remaining scattered and round depigmented patches. Through an unknown mechanism, a true reverse Koebner phenomenon with its resultant repigmentation rather than depigmentation was observed in our patient.
    Keywords: depigmentation, Q, switched Nd, YAG laser, repigmentation, reverse koebner phenomenon, vitiligo
  • Parviz Toossi, Sarah Ershadi, Ehsan Abolhasani Page 162
    Universal acquired melanosis is a rare cause of diffuse hyperpigmentation of skin and mucosa during childhood. There are only few reported case of this scarce syndrome in medical literature. We report the first case of universal acquires melanosis from Iran in a 4-year-old girl whose skin becomes darker after 2-month of age.
    Keywords: Carbon baby, hyperpigmentation, universal acquired melanosis
  • Mehdi Qeisari, Farahnaz Bidari Zerehpoosh, Fahmimeh Abdollahimajd, Sara Salajeghe Page 165
    A 77-year-old Iranian man was visited at the Dermatology Department of Loghman-e Hakim Hospital affiliated with Shahid Beheshti University of Medical Sciences on June 2012 with bilateral, symmetric, raised, violaceous and painless plaques on the nose (both ala nasi), from one year ago. The lesions were small at first and then grew gradually larger in size. Systemic symptoms such as fever, weight loss and night sweat were absent. He had no history of systemic disease, bite, trauma, vaccination, or medication. Past medical history was negative except for cataract in several years ago and he was in good health. He had a history of treatment with oral antibiotics without any improvement. Physical examination revealed bilateral, symmetric, indurated, violaceous, non-tender plaques on the nose (both ala nasi) with some scales and follicular accentuation without discharge (Figure 1). Other examinations were normal and laboratory tests revealed no abnormality. A skin biopsy was performed.