Iranian Journal Of Dermatology
Volume:26 Issue: 2, Spring 2023

Complications of chemotherapy most commonly involve highly proliferative cells, including the skin and its appendages and mucosa. This study evaluated mucocutaneous complications of chemotherapy in children with cancer. This descriptive cross-sectional study involved 92 children who received chemotherapy at the Pediatric Oncology Ward of Afzalipour Hospital, Kerman, Iran, between September 2018 and March 2019. Demographic and clinical features of the patients were collected by history, physical examination, and laboratory tests (biopsy, fungal and bacterial smears if necessary). Frequency and percentage were used for qualitative analysis. Mean ± standard deviation was used for quantitative analysis. The mean age of patients was 6.60 ± 3.70 years (range 1 to 16 years). More than half of the patients (55.4%) were males. The most common malignancy was acute lymphocytic lymphoma (ALL). More than half of the children (60%) had mucocutaneous complications due to chemotherapy; these were significantly more common in boys than girls (70.6% vs. 48.8%). The mean age of children with mucocutaneous complications (7.41 ± 3.98) was significantly higher than those without complications (5.33 ± 2.84). The most common mucocutaneous side effects were, in order, alopecia, mucositis, and skin infections. We found that side effects of chemotherapy weresignificantly more common in older children, boys, and childrenwith leukemia. Vincristine was the most common culprit.

Basal cell carcinoma (BCC), the most common human malignancy, can cause significant morbidity through extensive tissue destruction. This study aimed to determine the frequency and clinicopathological features of BCC in an Iranian population. Histopathological reports with a definitive diagnosis of BCC in all pathology centers of Sanandaj, Kurdistan province, during 2009–2019 were reviewed. Data on age, gender, site, size, and clinical and histopathological types of tumors were collected and analyzed using SPSS software. P-values < 0.05 were consideredsignificant. We found 832 BCC lesions in 779 patients, including 453 males and 326 females aged 65.36 ± 14.35 years and 62.77 ± 13.79 years, respectively. The mean tumor size was 14.52 ± 10.08 mm in men and 11.79 ± 7.89 mm in women. The most common location was the head (95.23%), with the nose representing the most involved area. Males and females differed regarding age (P = 0.012), tumor size (P < 0.001), and the anatomical distribution of tumors on various parts of the head (P < 0.001). Ulcerative (58.36%) and nodular (54.45%) BCCs were the most frequent clinical and histopathological types, respectively, both in males and females, without a significant difference between the genders (P > 0.05). Our findings suggest that age, gender, and the tumor site in various head areas could be risk factors for BCC. Appropriate knowledge of BCC and its risk factors can help design prevention strategies and provide the necessary training for healthcare staff and the public to identify the disease in susceptible individuals.

Conventional topical treatments for male-pattern alopecia (MPA) have limited penetration into hair follicles and unwanted side effects, resulting in low patient compliance. We aimed to evaluate the efficacy and safety of niosomal kopexil 1% lotion compared with niosomal minoxidil 2% lotion in patients with MPA. We conducted a prospective, double-blind, randomized clinical trial at Afzalipour Hospital of Kerman University of Medical Sciences, Kerman, Iran. Thirty participants with MPA were randomized to apply 1 ml of niosomal minoxidil 2% lotion or niosomal kopexil 1% lotion twice a day for 24 weeks. We assessed the efficacy of treatments as the percentage of change in hair density in monthly sessions compared to the baseline using a dermatoscope; we also assessed patient satisfaction and side effects. Thirty participants were enrolled, 29 of whom completed the study. The mean change in hair density was significantly higher with niosomal kopexil compared with niosomal minoxidil (23.2 ± 1.3 and 14.2 ± 0.2, respectively). The hair density increased by 57.6 ± 3.7% and 25.6 ± 4.2% in the kopexil and minoxidil groups, respectively (P < 0.001). Patients reported significantly greater satisfaction with niosomal kopexil than with niosomal minoxidil (P < 0.001). No side effects were reported in either group. Despite the lower concentration, niosomal kopexil revealed significantly higher efficacy of treatment and satisfaction of patients compared to niosomal minoxidil.

During the recent coronavirus disease 2019 (COVID-19) pandemic, we witnessed an increased incidence of contact dermatitis in the hands and other body areas of healthcare workers secondary to using antiseptics and personal protective equipment. This study aimed to investigate the prevalence of skin lesions in healthcare workers in hospitals affiliated with Babol University of Medical Sciences during the COVID-19 pandemic. In a cross-sectional study, the healthcare workers of Ayatollah Rouhani, Shahid Yahya Nejad, and Shahid Beheshti hospitals in Babol, Iran, were asked to fill out information collection forms about cutaneous lesions during the COVID-19 pandemic. Three hundred healthcare workers were included in the study. Skin lesions were seen in 240 patients (80%), and the hands were the most common site of involvement (36.7%). Skin lesions in healthcare workers had no statistically significant relationship with the variables of age (P = 0.84), sex (P = 0.52), and COVID-19-dedicated wards (P = 0.16). However, skin lesions were more common in those with more working hours (P = 0.01) and increased handwashing frequency (P < 0.001). The present study showed a high prevalence of skin lesions among hospital healthcare workers during the COVID-19 pandemic. Therefore, preventive measures are recommended.

Granulomatous skin lesions are characterized by aggregation of activated histiocytes. Granulomatous skin lesions are classified as xanthomatous, necrobiotic, tuberculoid, sarcoidal, and foreign body types. This study evaluates the clinicopathological features of patients with granulomatous skin lesions. We conducted a cross-sectional study of 232 skin biopsies diagnosed as granulomatous skin lesions over ten years from patients referred to Afzalipour Hospital, Kerman, Iran. Demographics, clinical features of lesions, and pathological characteristics were recorded. Then, the correlation of the final diagnosis with the demographic and clinical features of the patients was assessed via the independent t-test and chi-squared test. Most patients were in their third decade of life, with a male-to-female ratio of 1.05 to 1. The most common types of granuloma were tuberculoid (60.3%), necrobiotic (12.5 %), and foreign body type (11.2%). Infectious disease was the most common cause of granulomatous lesions (64.2 %); leishmaniasis constituted approximately 96% of cases. The most common causes of noninfectious granulomatous skin diseases were foreign body granuloma (26.2%), granuloma annulare (23.2%), and xanthogranuloma (12.1%). There was a significant correlation between dermatologic disease type and disease duration (P = 0.024). In the current study, the most common type of granuloma was tuberculoid, followed by necrobiotic and foreign body type granulomas. Infectious diseases were the most common cause of granulomatous skin lesions. Furthermore, the most common granulomatous skin diseases were leishmaniasis, foreign body granuloma, and granuloma annulare. The least common granulomatous skin lesions were sporotrichosis and gout.

Proliferating trichilemmal tumors are rare, generally solitary, benign tumors arising from the hair’s outer root sheath with trichilemmal keratinization. These tumors are predominantly found on the head, neck, and face of elderly females; the inguinal region is a highly unusual site of involvement. Malignant change in this tumor is rare, histologically mimicking squamous cell carcinoma. Metastatic malignant proliferating trichilemmal tumor requires a high index of suspicion for diagnosis and accurate histopathological reporting for timely intervention. Here, we report the case of a 65-yearold man presenting with nodular-ulcerative lesions in the groin, clinically confused with hidradenitis suppurativa and histologically with squamous cell carcinoma. He was finally diagnosed with an inoperable metastatic stage of malignant proliferating trichilemmal tumor and was treated with palliative care. This case highlights the innocuous clinical appearance of such lesions that might delay the management of this fulminant tumor.

Pityriasis lichenoides chronica (PLC) is a chronic skin disorder with unknown etiology. This disorder still poses difficulty in diagnosis and treatment. Currently, there is no guideline established for the treatment of PLC. Most of the proposed therapy show transient or limited effects. Combination therapy is usually the best approach. A 40-year-old man presented with erythematous papules appearing recurrently in crops in the last nine months localized mainly to the trunk and proximal extremities. A complete response was not achieved with topical and systemic corticosteroids. The combination of narrowband UVB phototherapy and cyclosporine showed satisfying results following a short duration of therapy. A complete response was seen after eight sessions of narrowband UVB phototherapy. No side effects were observed. The combination therapy of phototherapy and cyclosporine is a potential choice that needs to be considered in the management of PLC.

Atopic dermatitis (AD) is a chronic allergic inflammation of the skin. Precise identification of the causative allergen is an important step in the successful treatment of patients with moderate to severe AD. Common diagnostic methods in allergy assess the presence or absence of allergen-specific sensitization, but none exhibits a complete clinical correlation. Component-resolved diagnostics (CRD) is a new precise method for identifying the culprit allergen. Here, we report the case of a nine-year-old boy with severe AD. He was polysensitized (based on a skin prick test), with a poor response to routine AD therapeutic measures and food elimination diets. He had experienced recurrent flares while under treatment. Skin biopsy confirmed AD. Systemic therapy with cyclosporine (200 mg per day) was initiated and caused significant symptom relief within eight weeks. However, he had a flare when the dose was decreased to 150 mg daily. The causative allergen was diagnosed based on CRD, and he was successfully treated by allergen immunotherapy. CRD can determine the causative allergen in selected polysensitized patients with AD with poor response to treatment. The application of allergen-specific immunotherapy in AD management is controversial, but highly sensitized patients could benefit from it once the diseasecausing allergen is identified.