Iranian Journal Of Dermatology
Volume:18 Issue: 1, Spring 2015

Hirsutism, a common clinical condition, not only causes cosmetic concern but may also be a sign of underlying disease. Polycystic ovary syndrome (PCOS) is an important and common cause of hirsutism. In fact, many women with PCOS present as hirsutism. This study assessed young Kashmiri women presenting as hirsutism, for ultrasonographic evidence of polycystic ovaries (PCO), in addition to recording their clinical and hormonal profile. The purpose of this study was to determine the prevalence of polycystic ovary syndrome using ultrasonography, in young Kashmiri women presenting as hirsutism. In total, one hundred and seventy (170) consecutive young Kashmiri women presenting with chief complaint of hirsutism were assessed. A total of eighty (80) age matched non- hirsute females having normal menstrual cycles, served as controls. The ovaries were visualised by transabdominal ultrasonography (USG). The serum was analysed for luteinizing hormone (LH), follicle stimulating hormone (FSH), total testosterone (tT), prolactin (PRL) and thyroid stimulating hormone (TSH). The study showed prevalence of 61.18% PCOS in young Kashmiri women presenting as hirsutism. PCOS was diagnosed in 35.11% hirsute women with regular menses and ultrasonography was used to identify PCO in 90.35% patients. Biochemical hyperandrogenemia was present in 70.15% of the patients and the LH/FSH ratio increased in 81.73% of the patients. The results of this study show a high prevalence of PCOS in young Kashmiri women presenting as hirsutism and also highlights the fact that PCOS is not necessarily associated with menstrual disturbances. Therefore, all hirsute women, even with regular menses, should be evaluated for PCOS.

Psoriasis is a chronic immune-mediated skin disease with a genetic predisposition. Prolactin may contribute to psoriasis pathogenesis. However, there has been a debate over the serum level of prolactin in psoriatic patients. The aim of this study was to describe the role of serum prolactin in the pathogenesis of psoriasis The serum prolactin level was measured in 45 patients with psoriasis and in 45 sex- and age-matched healthy individuals using radioimmunoassay. The mean serum prolactin concentration was not different between psoriatic patients and healthy controls (320 ± 179.38 vs. 318.18 ± 191.78 mIU/L, respectively P = 0.95). There was no sexand age-related differences in serum prolactin between the two study groups. Hyperprolactinemia (serum prolactin >324 mIU/L in men, and >496 mIU/L for women) was observed in 11 patients with psoriasis and 12 healthy subjects, which showed no significant difference between the two groups (P = 0.81). The serum prolactin was not significantly correlated with the duration of the disease (r = -0.18, P = 0.24) or the PASI score (r = 0.10, P = 0.50). The possible role of pituitary-produced circulating prolactin in the disease process needs further investigations.

Malassezia spp. is an opportunistic dimorphic Basidiomycetous fungi associated with a variety of diseases including dandruff, atopic eczema, pityriasis versicolor, seborrheic dermatitis and folliculitis. It also causes systemic infections in immune compromised patients. The aim of this study was to evaluate the antimicrobial activity of nettle leaves (Urtica dioica), colocynths fruits (Citrullus colocynthis), green tea (Camellia sinensis), burdock root (Arctium lappa) extracts and ketoconazole against 26 isolates of Malassezia spp., isolated from patients with Malassezia infections. Twenty-six (26) Malassezia spp. identified by RFLPPCR, were isolated from patients with Malassezia infections. The antifungal activity was evaluated by micro broth dilution assay. M. globosa (50%), M. furfur (46%) and M. slooffiae (4%) were the isolated strains. There was no significant difference between the minimal inhibitory concentration (MIC) values for colocynth extracts and ketoconazole. Also, the antimicrobial activity of green tea and burdock extracts against Malassezia spp. was not significantly different (P>0.05). The minimal fungicidal concentration (MFC) values for green tea, colocynth extracts and ketoconazole against Malassezia spp. were the same (P>0.05). Further clinical studies are required to determine the efficacy of C. colocynthis ethanol extract, in the treatment of Malassezia skin disorders.

The ABO blood group antigens play a role in the pathophysiology of some diseases and several researches have investigated this relationship in the field of dermatology. In the present study, an attempt was made to find the distribution of blood types in patients with pemphigus vulgaris and chronic plaque type psoriasis. Fifty patients with chronic plaque type psoriasis, 50 patients with pemphigus vulgaris and 100 healthy persons as control group, were selected as the study population. ABO blood grouping was determined by the cell type tube test method, using standard commercial anti/A, anti/B and 5% suspension of red blood cells. Chi square test was used to compare the frequency of ABO blood groups in patients and control groups. Among the 50 patients with psoriasis, 21 (42%) had blood group O, 15 (30%) blood group A, 10 (20%) blood group B and 8 (4%) had blood group AB. Among the 50 patients in the pemphigus group, 22 (44%) had blood group O, 19 (38%) blood group A, 8 (16%) blood group B and 1 (2%) had blood group AB. The distribution of blood groups in patients with these two diseases was not significantly different from the control group. Despite some researches, which found associations between blood group antigens and psoriasis or pemphigus, this study did not find any such relationship.

Skin reflects the general health status and is not an exception in the process of aging. Intervention studies indicate that it is possible to delay skin aging and improve skin conditions through diet-based anti-aging strategies. The purpose of the current work was to review recent existing literature regarding the role of nutrition, for and against skin aging processes. This review provides updates on the effects of nutrition strategies on skin aging developed during 2008-2014. Databases such as the ISI web of science, PubMed, Scopus and Google Scholar were investigated. The most important role of nutrition on skin aging is by restricting the generation or activation of reactive oxygen species (ROS) which is considered as the main cause of extrinsic skin aging. Excess sugar in daily diet accelerates aging processes through the production of advanced glycation end products that inhibit proper repair of collagen fibers. Monounsaturated and omega-3 polyunsaturated fatty acids have inverse association with severe photoaging. Antioxidants such as vitamins C, A, E, carotenoids, flavonoids and botanical antioxidants such as resveratrol, curcumin and green tea polyphenols effectively decelerate this process. Zinc, selenium and copper are coenzymes of metallothioneins and glutathione that reduce intracellular oxidative stress and result in skin protection. The link between nutritional issues and skin aging is an interesting but conflicting subject that requires many interventional studies. Intracellular antioxidant mechanisms are the most effective protection against skin aging.

Kaposi sarcoma is a malignant disease that originates from the lymphatic system. Different epidemiological, clinical and histopathological variants of this neoplasm have been identified. Classic Kaposi sarcoma is one of the four main clinico-epidemiologic variants. Cutaneous lesions vary from pink patches to dark violet plaques, nodules or polyps, depending on clinical variant and stage. Kaposi sarcoma with elephantiasis is reported in the context of AIDS. An 82-year-old male presented with a 2-year history of progressive verrucous skin changes and non-pitting edema consistent with elephantiasis nostras verrucosa (ENV), secondary to Kaposi’s sarcoma. Past medical history, physical examination, lab tests and imaging ruled out common causes of ENV and anti-HIV antibody test was negative. Classic Kaposi sarcoma was confirmed on biopsy. To the best of our knowledge, this study reports the first case of elephantiasis nostras verrucosa in an HIV-negative patient with classic Kaposi sarcoma.

Bazex-Dupre-Christol (BDC) syndrome is clinically characterized by multiple basal cell carcinomas of the face that mainly occur during the second and third decade of life, follicular atrophoderma predominantly of the dorsum sides of the hands and feet and generalized hypotrichosis; sometimes with pili torti and trichorrhexis nodosa. Features commonly associated with BDC are milia, hypohidrosis and calcifying epithelial tumours. In this study, four members of one family with BDC syndrome, a mother and her three daughters were reported. The major clinical features of BDC were very typical in the mother and one of the daughters whereas only follicular atrophoderma, milia and hypotrichosis were present in the other two daughters. Bazex Dupre Christol Syndrome is a hereditary multiple basal cell carcinoma (BCC) syndrome whose pattern of inheritance is thought to be X-linked dominant, which implies that all daughters of affected mothers should be having this disease. In this case report, among the four daughters, only three were suffering from BDCS while one is totally asymptomatic. Based on the literature review, this appears to be the first report of a family with BDC from Pakistan.

The histiocytoses are a group of proliferative disorders of the monocyte-macrophage lineage that are neoplastic or reactive in nature. Based on immunophenotyping and electron microscopy, two main groups have been recognized namely 1) Langerhans cell histiocytosis (LCH) and 2) non- Langerhans cell histiocytosis (non-LCH). In this study, a fairly rare disease of the non-LCH group, generalized eruptive histiocytosis, has been reported.

Folate plays an important role in metabolism and its deficiency can lead to cardiovascular problems or carcinogenesis. Some studies show that narrow band UVB (NBUVB) causes folate deficiency by photolysis, while others have different opinions or even the contrary. With regard to paradoxes in this context, we decided to study the effect of NBUVB on folate levels in patients with dermatologic disorders.

Pemphigus foliaceus (PF) is an autoimmune blistering disease presenting in endemic and sporadic forms. The typical presentation is recurrent shallow erosions in a seborrheic distribution. PF has also been found in association with autoimmune diseases such as autoimmune thyroid disease (e.g. toxic nodular goiter and Hashimoto’s thyroiditis). In some patients, PF appears to be triggered by radioiodine therapy.