فهرست مطالب amirreza hanifnia

Vitiligo involves 1% of the population and is equally seen in all races and in both genders. It is a multifactorial polygenic disorder, although various hypotheses have been proposed including autoimmunity, viral infection, biochemical, neural and oxidant/antioxidant theories (oxygen radical species), yet the exact mechanism of the disease has not been yet established.

To evaluate the prevalence of ocular findings in patients with vitiligo and reveal risk factors or possible associations that might increase the risk of ocular manifestations.
Patients and

In this cross-sectional study, 92 patients previously diagnosed as cutaneous vitiligo referred to the dermatology clinic of Rassoul Akram Hospital from April 2007 to September 2008, were examined for ocular abnormalities. The data of the patients including age, gender, duration of vitiligo, positive family history, association with autoimmune diseases, and anatomic distribution of depigmented macules were recorded. Next, an ophthalmologist at the hospital’s ophthalmology clinic examined the patients to detect depigmentation of eyelids, poliosis and signs of uveitis as well as signs of retinal atrophy or hypopigmentation by a direct ophthalmoscope. Corneal sensation and intraocular pressure (IOP) were evaluated to rule out infection and glaucoma in patients with uveitis. All recorded data were analyzed by the Social Sciences Statistical Software (SPSS version 15) using Chi-square tests and t-test.

This cross-sectional study included 92 patients (47 male and 45 female) with mean age of 32.1 ± 13.16 years (ranging from nine to 61 years of age). Mean duration of vitiligo was 10.84 ± 10.17 years. The most common distribution of the lesions was on the upper limbs (60.8%) and the least was on the genital region (10.8%). Positive family history was found in 26 (28.3%) patients. Diabetes and Hypothyroidism were found in 10 (10.86%) and 9 (9.87%) patients, respectively. Ocular problems were discovered in 19 (20.7%) patients with mean age of 41.26 ± 10.7 years, including uveitis in 10 (10.9%), optic atrophy in 4 (4.3%) and retinal hypopigmentation in 5 (5.4%) patients. Mean age of cases with positive ocular findings was significantly higher than those without ocular findings (29.6 ± 12.7 years, P < 0.0001). Mean duration of vitiligo was significantly longer in patients with positive ocular findings than in those without ocular problems (8.84 ± 9.08 years, P < 0.0001). No statistical correlation was found between sex and ocular findings (P > 0.05). Ocular findings were statistically more in patients with positive family history of vitiligo (P = 0.001) and with associated autoimmune diseases (P = 0.01). No significant association was found between anatomical distribution of depigmented macules and ocular findings (P > 0.05).

Ocular findings are important and assessable in patients with vitiligo. Older age and duration of vitiligo can increase the risk of ocular abnormalities and patients with positive family history and autoimmune disorders should be prioritized for screening.

Palmoplantar pustulosis is a chronic dermatosis of palms and soles, which is associated with a high recurrence rate and resistance to treatment. Various treatments with different success rates have been used.The purpose of this study was to evaluate the efficacy of local bath PUVA in the treatment of palmoplantar pustulosis.

In this retrospective study, patients with palmoplantar pustulosis who were treated with local bath PUVA in Phototherapy clinic of Razi Hospital between 2005 and 2009 were evaluated for the therapeutic efficacy of local bath PUVA. Data were analyzed using t and chi-square tests.

Ninety-five patients with a mean age of 44.17 years included in this study. 49.5% of patients were males and 50.5% were females. Mean treatment cessions of patients were 42.5 sessions and mean cumulative dose was 251.8 J/cm2. In 16.8% of cases have very good response was observed. Good, moderate and poor responses were observed in 35.8%, 29.5% and 9.5% of cases, respectively. Treatment failure was observed in 8.4% of patients. Mean cumulative dose in patients with very good response was significantly higher than other response groups, (P=0.016). Mean number of treatment sessions was also significantly higher in that group with comparison with other groups, (P<0.05). Twenty percent of patients withdrawed from the study because of complications. However all complications recovered completely and no long term complications was observed.

This study demonstrated that local bath PUVA is an effective safe treatment for the treatment of palmoplantar pustulosis.

Cicatricial alopecia is characterized by permanent destruction of the pilosebaceous unit, leading to irreversible hair loss, and has primary and secondary types. Primary type, based on predominant inflammatory infiltration in histology, is divided to neutrophilic, lymphocytic and mix types. Decalvans folliculitis, dissecting cellulitis and acne keloidalis are 3 subtypes of neutrophilic group. In this study frequency of each subtype and the distribution of age, gender and duration of disease have been reviewed.

This retrospective study was performed on patients with clinical diagnosis of cicatricial alopecia and histologic confirmation referred to Razi hospital in Tehran in 2005-2009.

Of 135 patients with mean (mean±SD) age of 32±10.6 years, 71.9% were male and 28.1% were female. The diagnoses included decalvans folliulitis (72.6%) with mean age of 31.89 years, dissecting cellulitis (25.0%) with mean age of 32.4 years and acne keloidalis (1.5%) with mean age of 52 years. The mean duration of disease was 4.2±3.9 years (4.08 years in male and 4.7 years in female). The mean duration of disease in decalvans folliulitis was 4.7, in dissecting cellulitis was 1.9 and in acne keloidalis was 17.5 years.

Neutrophilic scarring alopecia is more common in men and in the third decade of age and the most common type is decalvans folliulitis.

Alopecia areata is a non-scarring hair disorder. Trace elements imbalance (like zinc) has been reported as its triggering factor. In this study we compared serum zinc level in alopecia areata patients with normal values.

Twenty-three female and 19 male patients with alopecia areata were recruited and their serum zinc levels were assessed using absorption spectrometery. Chi squared, t and ANOVA tests were used for statistical analysis.

Sixteen patients with more extensive and prolonged disease, had serum zinc level lower than normal (70 µg/dL). The means of serum zinc levels in patients and normal population were 81.88 µg/dL and 83.5 µg/dL, respectively. This difference was not significant (P=0.668). The means of serum zinc level in different types of alopecia areata were not significantly different (P>0.05). There was an association between serum zinc level and disease duration (P=0.022).

Patients with more severe forms of alopecia areata had lower serum zinc level than other forms of the disease.