Iranian Journal Of Dermatology
Volume:19 Issue: 2, Summer 2016

Prolactin (PRL) appears to play a role in the pathogenesis of autoimmune diseases. Limited evidence showed an association between serum PRL levels and the activity of pemphigus vulgaris (PV). This study intends to determine PRL level changes in pemphigus patients during therapy and its correlation with disease type and severity.
In this cohort study, we measured serum PRL levels by enzyme-linked immunosorbent assay (ELISA) in newly diagnosed PV patients at three time points: before therapy initiation and after two and four months. Concomitantly, we estimated disease severity by the Pemphigus Disease Area Index (PDAI).
We examined 42 new cases of PV. Among 32 cases who completed the study, mean serum PRL levels at the three time points were 15.9±14.1 ng/mL (before treatment), 16.7±9.8 ng/ mL (2 months after initiation of treatment), and 15.2±9.2 ng/mL (4 months after initiation of treatment). Mean PDAI values were 19.3±12.8 (before treatment), 3.7±6.2 (2 months after initiation of treatment), and 0.6±1.5 (4 months after initiation of treatment). Although the disease activity decreased significantly (P The results suggest that no significant association exists between serum PRL concentrations and the severity of PV.

Recurrent aphthous stomatitis (RAS) is among the most common oral lesions and pain is often the chief complaint of patients. The main etiology of RAS is unknown but several predisposing factors have been suggested. This study aims to assess the correlation of blood types (ABO/Rh) with RAS.
We conducted this prospective screening study on 50 patients with RAS and 50 controls. Both groups received a questionnaire and underwent serum screening for detection of blood type (ABO/Rh). The collected data were analyzed by the independent t-, Fisher’s exact, and chi square tests. P There was no significant difference observed between cases and controls in terms of age (P=0.065), sex (P=1.000), blood type (ABO; P=0.531), and Rh (P=1.000).
Based on the results, blood type (ABO/Rh) is not a predisposing factor for RAS. However, future studies with larger sample sizes are recommended.

Approximately 0.77% to 2% of cutaneous ulcers and post-burn scars will develop malignant degeneration. When squamous cell carcinoma (SCC) emerges in a chronic scar or ulcer, it often is referred to as Marjolin’s ulcer (MU).
This cross-sectional study assessed demographic information and pathological features of MU in Razi Hospital during 2009 to 2014. We reviewed 5150 chronic scar/ulcer cases and found 30 MU cases.
Patients had an average age of 59.2±19.9 years. Most cases were males Among 30 cases of MU, well-differential SCC accounted for 43.3% of cases. Moderately-differentiated SCC comprised 13.3% of cases, whereas there was invasive SCC in 10% of MUs. Only 3.3% of patients showed poorly-differentiated SCC and 9 (30%) had undifferentiated SCC. The average latency between burn and malignancy was 32.4±18.5 years In the majority (90%) of cases, the initial injury was a burn. The lower and upper limbs comprised 53.3% and 26.7% of cases, respectively. There was one case with a history of melanoma. Among the 4 measured concurrent risk factors for malignancy, sun exposure was the most prevalent.
Since there is a high possibility of SCC formation in burn lesions and other identical lesions, rapid follow-up and appropriate treatment in acute burn lesions is necessary.

Treatment of a diabetic foot is a principal step in rehabilitative approaches to the complications of diabetes mellitus. Use of integrative educational courses for diabetic patients is dependent on several factors such as cultural entities of the population, patient perceptions of classes, and their previous trainings about diabetes and related complications. The aim of this study was to determine the efficacy of integrative programs to improve diabetic patients’ outcomes for wound care.
We included 100 patients with diabetic wounds from August, 2014–December, 2014. Resources in this study included educational classes, brochures, and pamphlets. We implemented the educational course for three months in 50 patients and compared the results with 50 controls who received no educational course. The educational course was conducted over a three-month period and we evaluated reduction of HbA1C, fasting blood sugar (FBS), 60-second Diabetic Foot Screen score, STONES (Size, Temperature, Os [bone], New areas of breakdown, Exudate, erythema, edema, Smell) and NERDSS (Non-healing wound, Exudative wound, Red and bleeding wound, Debries in the wound, Smell form the wound) parameters implemented for evaluation of infectious diabetic wounds.
We followed STONES and NERDS changes (positive to negative) in 42 (84%) patients from the intervention group and 21 (42%) control group patients (P=0.001). Reduction in the 60-second Diabetic Foot Screen score was 34 (68%) for the intervention group and 24 (48%) in the control group (P=0.03).
Possibly the use of interventional educational programs is effective in reduction of harm in patients with diabetic wounds, which will lead to decreased infections and better dynamic conditions.

Tinea incognito is a dermatophyte infection of the skin with an atypical presentation attributed to inappropriate treatment with immunosuppressive medications. In this report, we have presented the case of a middle-aged lady with tinea incognito that mimicked dermatitis herpetiformis. She had good response to antifungal treatments.

Gyrate atrophy (GA) is a rare, progressive metabolic choroid and retinal degeneration that results from a deficiency of the pyridoxal phosphate-dependent mitochondrial matrix enzyme ornithine aminotransferase. Here, we report the case of a 40-yearold woman who presented with a gradual decline in visual acuity since puberty, along with a history of high myopia and cataract surgery. She was admitted to the Dermatology Clinic with chief complaints of sparse hair on her scalp, eyelids, eyebrows and other areas of the body for the previous 5 years. Physical examination showed that scalp hair along with hair from other parts of her body were fine, straight, and sparse with areas of non-well defined alopecia. Hyperornithinemia was documented during laboratory evaluation of the patient.

Palmoplantar keratoderma of Sybert (PPK of Sybert) or Sybert’s keratoderma was first documented by Virginia Sybert in 1988. Due to the high degree of similarity, it was previously considered to be Greither’s keratoderma, an established entity at that time. Currently, clinical and ultrastructural studies distinguish between the two disorders. Sybert’s keratoderma is an extremely rare type of keratoderma with an autosomal dominant mode of inheritance caused by mutations to the keratin 1 gene along with severe bilateral involvement of the palms and soles with a tendency for proximal extension and natal cleft in the absence of systemic manifestation. To the best of our knowledge, there are less than 20 cases of PPK of Sybert reported in the literature. Here we discuss an extremely rare familial PPK of Sybert that has affected 4 family members. The cases presented with symmetrical, severe involvement of their palms, soles, and knees with the development of pseudoainhum and autoamputation of the fingers and/or toes.

The recent report, “Serum prolactin level in psoriasis”, is very interesting 1. Ghiasi et al. concluded that “it seems that while intracutaneous prolactin may contribute to the pathogenesis of psoriasis, the probable role of pituitary-produced circulating prolactin in the disease process needs further investigation .” There are some concerns on this report. First, although Ghiasi et al. have studied serum prolactin, they based their conclusion on intracutaneous prolactin. The serum prolactin is not the same as intracutaneous prolactin. The serum prolactin can be affected by several physiological and pathological factors. In fertile females, variations of baseline serum prolactin can be expected. Indeed, for psoriasis, there are previous reports on prolactin with controversial results. The difference in baseline pathophysiological conditions of psoriatic patients can be a good explanation for the different findings on prolactin levels in patients.