mahin aflatoonian

FFA usually has a gradual subtle course and might be overlooked by physicians or misdiagnosed with other types of hair loss including androgenetic alopecia, traction alopecia, and other types of patterned alopecia. In this study, we described clinicopathological features of patients with FFA referring for skin biopsy.

This is a retrospective cross-sectional study on 26 patients with a diagnosis of FFA based on clinicopathological features. Firstly, the demographic and clinical features of patients were extracted from an electronic database. Then, skin biopsy specimens were reviewed regarding the presence or absence of hair follicles, site and severity of infiltrations, and presence of fibrosis.

Most of the patients were over fifty years of age (57.7%) with a mean age of 50.73 ± 10.03 years. Frontal region involvement was observed in all of the cases. Eyebrow hair loss was observed in 38.5% of cases. The most frequent clinical findings were the absence of vellus hairs in frontotemporal regions (96.2%) and perifollicular erythema (92.3%). The most common pathological features were involvement of the vellus hairs (84.6%), replacement of follicular epithelium with fibrous sheath (80.8%), and destruction of sebaceous glands (69.2%). Peri-infundibular and peri-bulbar interface changes were observed in 50% and 61.5% of skin biopsies, respectively. Perifollicular fibrosis was demonstrated in half of the skin biopsies.

FFA is most commonly observed in females after the 5th decade of life. The absence of vellus hairs and the replacement of follicular epithelium with fibrous sheath are the most common clinical and pathological features of the disease, respectively.

Alopecia areata is a non-cicatricial alopecia that profoundly affects patients’ quality of life. In this study, we evaluated the influence of demographic and clinical features of alopecia areata patients on their quality of life. This cross-sectional study was performed on alopecia areata patients at the Dermatology Clinic of Afzalipour Hospital, Kerman. Firstly, demographic features and clinical data were collected. Then, the severity of alopecia areata [based on the severity of alopecia tool (SALT) score] and quality of life of the patients [using dermatology life quality index (DLQI) and child dermatology life quality index (CDLQI)] were calculated. Finally, the impacts of the patient’sdemographic and clinical features on quality of life were evaluated via multivariate logistic regression. One hundred and thirty-five patients with alopecia areata were enrolled in the study. The mean SALT score was 6.63 ± 6.34 (range 2–64). Mean DLQI scores for mild and moderate cases of AA were 7.4 and 12.5, respectively (P = 0.57). Females had significantly higher DLQI scores compared to males. Furthermore, patients with negative family history of alopecia areata had significantly higher DLQI scores than patients with positive family history (P = 0.03). We found no significant difference in quality of life between patients with different alopecia areata severities. However, females and patients with a negative family history of alopecia experienced significantly greater negative impacts on quality of life than males and those with a positive family history.

The association of cherry angioma with metabolic syndrome and fatty liver has been proposed in a few studies. This study evaluated the prevalence of cherry angiomas in patients with type II diabetes mellitus compared with healthy adults. This cross-sectional study was conducted on 100 patients with type II diabetes mellitus and 100 age and sex-matched healthy adults. Demographic features of the participants and the location and number of the lesions were recorded. Data were analyzed by SPSS 16. Mean ± standard deviation and frequency were used for quantitative analysis. The chi-squared test and independent t-test were utilized to evaluate the association of qualitative and quantitative data with the number of cherry angiomas, respectively. Cherry angiomas were more prevalent in the diabetes group (47%) than in controls (30%) (P = 0.013). Lesions in diabetic patients were more prevalent in females than males (P = 0.042). Furthermore, the number of lesions in the diabetes group significantly increased parallel to aging (P = 0.004). In the present study, significantly more cherry angiomas were observed in patients with type II diabetes mellitus than in healthy controls. Furthermore, the number of lesions was higher in females and elderly subjects in the diabetes group.

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.

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.

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.

Hyperhomocysteinemia and vitamin D deficiency may be involved in the pathogenesis of vitiligo. This study compared the serum levels of vitamin D, homocysteine, vitamin B12, and folic acid between vitiligo-affected children and healthy children.

Using a case-control design, 30 children with vitiligo and 30 age and sex-matched healthy children were enrolled from April 2018 to August 2020. Serum levels of vitamin D, homocysteine, vitamin B12, and folic acid were analyzed in both groups during the same season of the year. Additionally, the association between serum levels of these factors with demographic and clinical features of the children (collected by interview and physical examination) was evaluated. Data were analyzed using the independent T-test, Fisher’s exact test, and chi-squared test.

The vitiligo group had significantly lower vitamin D and folic acid serum levels compared with the control group [95% CI -19.87 to -2.96 and -4.15 to -4.18, respectively]. Among patients, the vitamin D level was negatively correlated with age (r = -0.459, P = 0.011) and disease duration (r = -0.373, P = 0.042). Moreover, there was a significant association between vitiligo activity and serum homocysteine levels (P = 0.027).

Routine measurement of vitamin D and folic acid serum levels might be suggested, especially in children with long-standing disease. Monitoring the homocysteine level may be beneficial, particularly in children with progressive vitiligo.

Infantile hemangioma is the most common type of vascular tumor in childhood. Risk factors for hemangioma include female gender, low birth weight, prematurity, higher maternal age, and multiple gestations. In this study, for the first time in Kerman, we describe and compare demographic features of infants with hemangiomatous lesions treated with two different systemic beta-blockers (atenolol or propranolol), examining their efficacy and adverse effects. Forty-one infants with hemangiomatous lesions admitted to the pediatric dermatology ward of Afzalipour Hospital from 2011 to 2017 were enrolled in this study. Demographic features of infants and their mothers and clinical features and complications of hemangiomatous lesions were recorded. Also, we compared the efficacy and adverse effects of treatment protocols with two betablockers (atenolol and propranolol). Most infants were female (70.7%), and 9.7% were premature. The majority of the lesions were superficial (53.7%) and located in the head and neck area (82.9%). Multiple hemangiomas were recorded in 4.8% of the cases. The most common complication was ulceration (29.3%). Two out of 18 patients treated with propranolol had a complete response rate. Adverse effects were observed more frequently with propranolol (26.8%) than with atenolol (14.6%). In our study, female gender and low birth weight were significantly more common in infantile hemangioma patients than in the normal population. Also, mothers of children with hemangioma had a significantly greater number of miscarriages than the average population. Propranolol and atenolol had no significant difference in efficacy and adverse effects.

Treatment failure of antimony drugs for anthroponotic cutaneous leishmaniasis (ACL) is rising. Recognizing predictive factors of unresponsiveness to treatment can substantially influence better ACL management. The goal of this study was to investigate predictive factors associated with treatment failure in ACL in Kerman, southeast Iran.

This case-control study was conducted retrospectively on 2,128 ACL cases in Kerman over ten years from 2011 to 2020. The case group included patients whose lesions failed to resolve after one treatment course. The control group included those whose lesions were cured after one treatment course.

Treatment failure was observed in 13.5% of cases (10.7% of systemic therapy and 16.7% of local therapy). No significant difference was reported between the type of treatment and treatment failure. The association of treatment failure with winter-onset (P = 0.001, OR = 1.39, CI = 1.23–1.56), face (P = 0.001, OR = 1.86, CI = 1.38–2.49), ulceration (P = 0.01, OR = 0.51, CI = 0.30– 0.85), small diameter (P = 0.005, OR = 0.57, CI = 0.38-0.84) and long duration of lesions (P = 0.01, OR = 1.57, CI = 1.11–2.21) was validated by multivariate logistic regression analysis.

Efficient detection and timely management of ACL cases are essential to reduce resistant cases, as lesions lasting longer than four months show poor response to treatment. Furthermore, early treatment of facial lesions with systemic therapy is suggested to optimize results and reduce the risk of disfiguring scars. Further surveys are required to determine the reason behind more treatment failure in winter-onset lesions.

Atopic dermatitis is a chronic relapsing inflammatoryskin disease that has possible associations with other diseases suchas allergic conditions, autoimmune skin diseases, and systemicdiseases. We evaluated the prevalence of alopecia areata andthyroid autoimmunity in children with atopic dermatitis. This was a cross-sectional study on 124 children(62 children with atopic dermatitis and 62 healthy children).Demographic features of the participants and duration of diseasein children with atopic dermatitis were recorded. Antithyroidperoxidase and thyroid stimulating hormone were evaluated inboth groups. Odds ratio (OR) and 95% confidence interval (CI)were calculated to estimate relative risk. The chi-squared testand analysis of variance test (ANOVA) were used to evaluatethe association of thyroid autoimmunity with the demographicand clinical features of patients. Thyroid autoimmunity was only detected in atopicdermatitis children and not in the control group, and the differencewas statistically significant [OR = 4.32, 95% CI = 2.15–10.81,P = 0.04). Furthermore, overt thyroid disease was significantlymore common in the atopic dermatitis group compared withthe control group (OR = 4.46, 95% CI = 1.15–17.24, P = 0.03). Apersonal history of alopecia areata was also significantly morecommon in the atopic dermatitis group (OR = 4.46, CI = 1.17–15.29,P = 0.030). In addition, there was no significant difference betweenthyroid autoimmunity and overt thyroid disease in the patients’severity of atopic dermatitis and demographic features (P > 0.05). Patients with atopic dermatitis had a significantlyhigher percentage of thyroid autoimmunity, overt thyroid disease,and alopecia areata than the control group.

The increased prevalence of metabolic syndrome has been established in chronic inflammatory skin diseases. Patients with metabolic syndrome have a higher mortality rate due to cardiovascular disease and malignancy. In this study, the prevalence of metabolic syndrome was evaluated in lichen planus patients compared with a control group in Kerman, southeast Iran. This was a cross-sectional study on 90 patients with lichen planus and 90 healthy participants from the Dermatology Clinic of Afzalipour Hospital, Kerman, Iran. Demographic features of the patients and clinical features of the lesions were recorded. Then, parameters of metabolic syndrome were evaluated in both groups. The independent t-test and chi-squared test were used to compare quantitative and qualitative variables, respectively. There was no significant difference in demographic features of the participants between the two groups. Metabolic syndrome was significantly more prevalent in the lichen planus group (62.6%) than in the control group (14.4%) (P = 0.001). Metabolic syndrome parameter values (except waist circumference) were significantly higher in the lichen planus group than in the control group. Lichen planus patients with metabolic syndrome had a significantly higher percentage of mucosal involvement (66.1%) than lichen planus patients without metabolic syndrome (44.1%). Lichen planus patients with metabolic syndrome were significantly older than those without metabolic syndrome. This study observed a higher prevalence of metabolic syndrome in lichen planus patients relative to controls. Furthermore, lichen planus patients with metabolic syndrome had significantly higher age, mucosal involvement, and body mass index than lichen planus patients without metabolic syndrome.

Basal cell carcinoma is the most common skin cancer, constituting nearly 80% of non-melanoma skin cancers. In this study, for the first time in Kerman, the clinicopathological features of basal cell carcinoma in patients referred to Afzalipour Hospital were evaluated. This is a retrospective, cross-sectional study on 145 skin biopsy samples with a diagnosis of basal cell carcinoma in Afzalipour Hospital, Kerman. Demographic features of patients and clinical and pathologic types of basal cell carcinoma were recorded. Then, the correlation between clinical or histological types with demographic features was evaluated using the chi-squared test. Ninety-four (64.8%) of the cases were male, and the mean age of the patients was 68.12 ± 14.54 (min = 15, max = 101) years. The most and the least common sites of involvement were the nose (35.9%) and trunk (0.7%), respectively. The most common clinical (76.5%) and pathological subtypes (71.03%) were nodular. The least common clinical (6.3%) and pathological types (2.1%) were morpheaform. There was no significant correlation between histopathological or clinical types with demographic features including age and sex. Furthermore, there was no significant correlation between sex and the site of the involvement or age of the patients. In this study, most patients were between 60-79 years of age, and the male-to-female ratio was 1.8 to 1. Nodular and morpheaform types were the most and the least common pathological and clinical types, respectively.

Bullous diseases are classified as autoimmune blistering diseases, hereditary blistering disorders, and blistering diseases secondary to inflammation and physical trauma. This study evaluated clinicopathological features of patients with bullous diseases.

This is a retrospective cross-sectional study of 88 patients with vesiculobullous diseases referred to the dermatology clinic of Afzalipour hospital in Kerman, Iran. Demographic features of the patients, type of lesions, differential diagnosis, and pathological features (site of skin biopsy, final pathological diagnosis, type of inflammatory cells, and direct immunofluorescence results) were recorded. Data were analyzed by chi-square test and independent t-test.

Eighty-eight patients (59.1% females and 40.9% males) were evaluated. The mean age of patients was 45.09 ± 20.48 years. Autoimmune blistering diseases, hereditary bullous diseases, and blisters secondary to inflammation and trauma were observed in 79.5%, 11.4%, 6.8%, and 2.3% of the cases, respectively. The most common diseases were pemphigus vulgaris (29.5%) and bullous pemphigoid (21.6%). There was a significant correlation between the type of the disease and the age of patients (P-value = 0.001) and the duration of the disease (0.047).

The most common autoimmune blistering diseases, hereditary bullous diseases, and blisters secondary to inflammation and trauma were pemphigus vulgaris, epidermolysis bullosa, lichen planus, and diabetic bullae/friction blister, respectively

Vitiligo is an autoimmune pigmentary skin disease. Recently, the association of chronic inflammatory conditions with metabolic syndrome (MS) and oxidative stress has been demonstrated in skin diseases such as lichen planus and psoriasis. In this study, the prevalence of MS in patients with vitiligo was compared to the control group.

This case-control study included 65 patients with vitiligo and 65 healthy participants in the control group who have referred to the dermatologic clinic in the Afzalipour Hospital of Kerman University of Medical Sciences, Iran. Demographic features and laboratory data of participants were collected and analyzed by SPSS 16 using chi-square and independent t tests.

There was no significant difference between the two groups in terms of age, gender, and body mass index (BMI). The mean values of MS parameters were not significant between the two groups. Systolic hypertension (HTN) was significantly higher in the vitiligo group than in the control group (P=0.03). Increasing the length of the disease by one year increased the chance of MS occurrence by 7%.

In the current study, systolic HTN was significantly higher in vitiligo patients compared to the control group. MS was also more common in vitiligo patients than in the control group, but the result was not statistically significant.

Seborrheic keratosis is a benign epidermal proliferation, which is highly common in sun-exposed areas. This study evaluated the clinicopathological characteristics of seborrheic keratosis lesions in patients referred to the Afzalipour Hospital, Kerman, Iran.

This retrospective cross-sectional study investigated ninety-nine skin biopsies of seborrheic keratosis lesions. The patients’ demographic features and the clinical and pathological features of the lesions were recorded. Then the correlation between pathological subtypes and demographics and clinical features was evaluated. Independent t-test and chi-square tests were used to assess the correlation between quantitative and qualitative data, respectively.

A majority of the patients were female (56.6%) in the sixth decade of their lives (33.3%). The lesions were more frequent in sun-exposed areas (65.6%). The most common pathological subtypes were acanthotic (47.5%), hyperkeratotic (27.3%), and adenoid (14.1%), and horn cyst (75.8%) and squamous eddies (5.1%) were the most and the least prevalent pathological features, respectively. Moreover, no significant correlation was noticed between pathological subtypes with the patients’ age or sun-exposed areas (P = 0.257 & P = 0.05, respectively)

The most common pathological subtype in this study was the acanthotic type. There was no correlation between pathological subtypes and the patients’ demographic features. The most common clinicopathological correlation was associated with the sun-protected lesions.

Pityriasis versicolor is a recurrent non-inflammatory superficial fungal infection. Application of antifungal shampoo is a simple treatment modality for pityriasis versicolor that can be used on an extensive surface area. Currently, there is no study to evaluate the efficacy of climbazole shampoo. In this study, the efficacy of 2% ketoconazole shampoo was compared to 2% climbazole shampoo in the dermatologic clinic of Afzalipour Hospital, Kerman, Iran. This triple-blind randomized clinical trial was performed on 60 patients diagnosed with pityriasis versicolor. Participants were categorized into groups A (ketoconazole shampoo) and B (climbazole shampoo) based on simple randomization. KOH smear was achieved from all participants at the baseline, four weeks after commencing treatment, and at three months follow up. Participants were instructed to apply shampoo three times a week for three weeks on all body surfaces and scalp for 10 minutes before rinsing. Evaluation of treatment was based on clinical improvement and results of KOH smears. Complete cure was defined as negative KOH smear and complete clinical improvement. Seventy percent of the patients in the ketoconazole group and 43.3% of the patients in the climbazole group had negative smears four weeks after commencing treatment (P = 0.037). Complete clinical improvement at the three-month follow-up was 26.7% and 13.3% in the ketoconazole and climbazole groups, respectively (P = 0.402). In the present study, 2% ketoconazole shampoo had significantly greater efficacy in terms of mycological cure than climbazole shampoo among pityriasis versicolor patients.

Care of patients with skin diseases may lead to high financial costs and burden on health system for societies and family members. In this study, we decided to evaluate the costs of treatments of patients admitted in the dermatology ward of Afzalipour Hospital, Kerman.

This is a retrospective, cross-sectional study performed from 2011 to 2017 on patients admitted in the dermatologic ward of Afzalipour Hospital. Demographic features of patients, duration of admission, cost of treatment, number and type of prescribed drugs as well as the patients’ and insurance organizations’ shares of the cost were recorded.

In this study, 940 patients were evaluated for six years. The mean age of the patients was 38.05±22.35 years and most of them were female. The mean duration of admission was 8.42±2.54 days. The insurance companies’ and patients’ shares of the fees were 93.8% and 6.2%, respectively. The highest costs belonged to prescribed drugs (37.9%) and hoteling (30.3%). The most common prescribed drugs were antihistamines (33.1%), topical steroids (27.7%) and systemic steroids (24.5%). The mean number of prescribed drugs in each admission was 6.30±4.02 (range
0-20). Patients suffering from Erythema and urticaria had the total highest costs of admission (81,360,000 Iran Rials).

In this study, the most frequent skin diseases were infectious and papulosquamous diseases. The highest and lowest cost of admission belonged to prescribed drugs and consultations, respectively. Also, the highest cost of admission belonged to patients with erythema and urticaria.

Atopic dermatitis is a common skin disease in children. Severe pruritus and eczematous lesions may interfere with the quality of life of the patients.

This study was designed to assess the validity and reliability of the Persian version of the children’s dermatology life quality index questionnaire.

After obtaining final acceptance by the first developers of the questionnaire for developing a Persian version, it was distributed to 100 children affected with atopic dermatitis aged 5 to 15 years. We analyzed data by SPSS18. Then, we evaluated the validity and reliability of the questionnaire by Kaiser criterion and Cronbach’s alpha.

Questions number 1 (itching) and 6 (sports activities) achieved the highest and the lowest scores, respectively. Cronbach’s alpha was assessed as 0.87, demonstrating good reliability. Inter-item correlation coefficients ranged from 0.24 to 0.69. A one-factor structure was achieved by Kaiser criterion and scree plot.

Our study demonstrated good reliability and validity of the Persian version of the children’s dermatology Life Quality Index Questionnaire. There was a significant positive relationship between the severity of the disease and the score of quality of life. However, there was no relationship between the quality of life and the demographic features of the participants.

Atopic dermatitis is the most common inflammatory skin disease in children. Severe itching may lead to an impaired quality of life in the patients. In this study, we evaluated the validity and reliability of Persian version of a questionnaire regarding the infants’ dermatitis quality of life in children suffering from atopic dermatitis. When the original authors approved of the Persian version of the questionnaire, the parents completed the questionnaire for their 98 children with atopic dermatitis aged less than four years. We analyzed the data by SPSS 16. Cronbach’s alpha and inter-item and calculated the correlations to evaluate the reliability and validity via Kaiser criterion and scree plot. The calculated mean score of questionnaire was 9.65±5.41. The first (itching and scratching) and eight questions (treatment problems) obtained the highest and lowest scores, respectively. There was a strong, positive correlation between the severity of the disease and the quality of life score in the patients. Cronbach’s alpha was calculated as 0.88 which is a sign of good internal consistency of the items. The inter-item correlative coefficients varied between -0.004 to 0.87. We used Kaiser’s criterion and scree plot to evaluate the validity and achieve a two-factor solution. Persian version of infants’ dermatitis quality of life index questionnaire was valid and reliable.

Combination of benzoyl peroxide (BPO) with topical antibiotics can lead to higherefficacy and less bacterial resistance, but it in turn increases adverse effects such as skinirritability and dryness. In this study, the efficacy of combination therapy of niosomal BPO 1%and clindamycin (CL) 1% is compared with niosomal CL in acne vulgaris.

This is a double-blind clinical trial study on 100 patients with acne vulgaris inAfzalipour hospital in Kerman. Patients were randomly divided into 2 groups (case and control).The case group received niosomal combination of BPO 1% and CL 1%.The control groupreceived niosomal CL1%. The efficacy of treatment protocols was evaluated in 2nd, 4th, 8thand 12th weeks of treatment by counting lesions (severity and grading acne lesions) and qualityof life (QoL). Furthermore, side effect were evaluated at each treatment visits.

The reduction in mean percentage of acne lesions in case group (treated with BPO 1%and CL1%) (64.21%) was higher than control group (treated with niosomal CL 1%) (59.04%),but the statistical difference was not significant. Sum of excellent and good results were foundin 80% and 76.1% of case and control groups, respectively (P = 0.377). Also adding BPO to thetreatment formulation in case group did not increase adverse effects, as statistical differencebetween 2 groups was not significant.

Combination of niosomal BPO 1% and CL 1% in treatment of acne vulgaris showedhigher efficacy with no increase in adverse effects in comparison with niosomal CL 1%, but thestatistical difference was not significant.

Basal cell carcinoma (BCC) is classified into BCC1 or low risk (nodular, superficial type) and BCC2 or high risk (micronodular, morpheaform, infiltrative, and basosquamous types) based on clinical behavior. This study attempts to evaluate immunohistochemical (IHC) findings and clinical features associated with local aggressiveness and recurrence in BCC lesions. This is a cross-sectional descriptive study conducted on 42 paraffin blocks (22 BCC1, 20 in BCC2) at Pathology Department of Afzalipour Teaching Hospital. First, demographic features of the patients were recorded and pathology blocks were classified by two dermatopathologists based on histopathological types of BCC1 and BCC2. Then, primary monoclonal antibodies including CD10, CD1a, SMA, Ki67, CD34, and P53 were utilized for IHC study. We compared BCC1 and BCC2 according to IHC markers, demographic features of patients, and tumoral features. The mean number of Langerhans cells (LCs) within epidermis above tumor mass was 14+1.92 and 4.7±1.23 in BCC1 and BCC2, respectively; these results show a significant difference between the two groups (P=0.001). P53 was positive in 41.13±6.39% and 74.5 ±6.26% of the tumor cells in BCC1 and BCC2 groups, which was statistically significant (P=0.001). Also, the mean number of blood vessels was 14.40±1.30 and 21.40±1.97 in BCC1 and BCC2, that was statistically significant (P=0.005).  Higher numbers of angiogenesis (SMA positive) and positive P53 were observed in BCC2 than BCC1. Also, more active positive CD1a cells were observed in BCC1 compared to BCC2.

Lichen planus (LP) is a common inflammatory skin disease. Pathogenesis of LP includes two possible mechanisms; related or unrelated to antigen. Regarding different clinical features of cutaneous and mucosal types of LP, for the first time, we decided to perform a qualitative and quantitative study of immune cells in different types of cutaneous LP and in comparison with normal skin. A total of 88 specimens (60 cases of cutaneous LP, 28 cases of normal skin) were selected from 2016 to 2017 in Kerman, Iran. Evaluation of immune cells was carried out based on qualitative and quantitative analysis. These findings were statistically calculated by descriptive statistical tests including frequency and mean ± standard deviation. Quantitative data were analyzed by independent t-test, chi-square, and analysis of variance (ANOVA). Data were analyzed using SPSS16 (SPSS Inc., Chicago, IL, USA). A p value less than 0.05 was considered statistically significant. Our study demonstrated that the mean number of immune cells was significantly higher in lichen planus group in comparison with the control group. Number and staining intensity of Langerhans cells (LCs) in the LP group were significantly greater in epidermal than dermal region. Mastocytes were located mostly within the deep dermis in the LP group. Hypertrophic and atrophic LP had the highest and the lowest number of immune cells (i.e., mastocytes, LCs, and CD3 positive cells), respectively, with a significant difference. Our study demonstrated that immune cells were seen in larger numbers in the hypertrophic type of cutaneous LP which is consistent with the chronicity of this disease.

Leishmaniasis is a common parasitic disease classified to acute and chronic types based on the duration of the disease. The acute lesion is presented as ulcerated papule and nodule that heal after a few months with an atrophic scar. The chronic form of cutaneous leishmaniasis is a nonhealing lesion that is persistent for more than one year. Here, we describe a chronic case of leishmaniasis developed after a head injury, similar to a keloidal scar.

PHACES syndrome (Posterior Fossa Malformations, Hemangioma, Arterial Anomalies, Cardiac Defects and Coarctation of the Aorta, Eye Abnormalities, and Sternal Abnormalities or Ventral Developmental Defects) is a rare neurocutaneous syndrome, which characteristic feature is large segmental hemangioma. Extracutaneous involvement is an important cause of morbidity in this syndrome.
Described below is an infant with large hemangiomatous lesions on the right side of the face, suprasternal notch, midline sternal defect and supraumbilical raphe. Based on the new consensus on the diagnostic criteria of PHACES syndrome, a definitive diagnosis of PHACES syndrome has been corroborated. Accordingly, our patient was analyzed with regards to other clinical features through magnetic resonance imaging of the head, neck and abdomen, all of which were normal. In echocardiography, the patient showed atrial septal defect, in addition to ipsilateral conductive hearing loss, contralateral cataract and Horner’s syndrome, which was reported only in very few cases. The clinical presentation of the present case was different from most previous reported ones, as segmental hemangioma in PHACES syndrome was, for the most part, located on the left side of the face and ocular involvement was predominantly reported ipsilateral to hemangiomatous lesion.

Goltz syndrome or focal dermal hypoplasia is a rare syndrome with mesoectodermal hypoplasia. This syndrome is an X-linked dominant disorder with involvement of the cutaneous, ocular, dental and skeletal systems. The most significant feature of this disease is connective tissue dysplasia. Here, we report a 30-year old woman who presented with congenital unilateral linear atrophic areas on her trunk, back, and upper and lower extremities. She has 3 daughters, 2 of whom had the same skin lesions that were consistent with Goltz syndrome. Skin lesions in the younger daughter were more severe than her older sister and mother. The younger daughter had multiple bone deformities in the form of clinodactyly and lobster-claw malformation. She also had nail dystrophy of her fingers and umbilical herniation. The older daughter only had syndactyly and skin atrophic lesions.