seyyede zeinab azimi

The recent coronavirus (COVID-19) is a rapidly spreading multisystemic disease with a broad spectrum of cutaneous manifestations. Recently, DNA-based/RNA-based vaccines, inactivated vaccines, and non-replicating viral vector vaccines have been manufactured to reduce viral transmission and attenuate the morbidity and mortality of COVID-19. The neurotropic virus of varicella-zoster can reactivate spontaneously or in response to a trigger such as trauma, fever, or immunosuppression. Recently, COVID-19 infection was assumed as a potential trigger as well. Up to now, 91 cases of herpes zoster have been reported after COVID-19 vaccinations. The present study reported a case of a 69-year-old woman from Iran. She had received an Astra Zeneca COVID-19 vaccine 5 days before the skin eruption. A clinical diagnosis of herpes zoster infection was confirmed by a polymerase chain reaction (PCR) test for varicella zoster DNA. Oral acyclovir 800 mg five times a day together with gabapentin 300 mg every night resulted in the resolution of the lesions in 2 weeks with no sequelae. The present study then discussed the potential contribution of vaccination against COVID-19 and the reactivation of the varicella-zoster virus.

Cutaneous angiosarcoma is a rare tumor of the head and neck region, most commonly affecting the elderly male. Its presentation varies from a small plaque to multifocal nodules. Differentiating this tumor from other conditions, such as hemangiomas, Kaposi sarcoma, squamous cell carcinoma, and rosacea, is sometimes difficult. Herein, we present a case of a 73-year-old male with a small oozing lesion on the scalp for more than two months. He had a history of scalp irradiation for tinea capitis in his childhood. Also, he experienced multiple basal cell carcinomas on his scalp a few years ago. Skin biopsy revealed infiltrations of malignant neoplastic lesions composed of proliferated pleomorphic tumoral cells with hyperchromatic nuclei and some epithelioid features arranged as sheets and irregularly shaped vascular spaces mostly devoid of red blood cells. Neoplastic cells were diffuse and strongly positive for D2-40, CD31, CD34, and Ki67 but negative for C-myc and CK. Cutaneous angiosarcoma should be considered in the differential diagnoses of scalp lesions, particularly in older men.

Uremic pruritus or chronic kidney disease?associated pruritus (CKD?aP) is a frequent compromising symptom in end?stage renal disease. Despite the little attention paid to drugs used among hemodialysis (HD) patients, investigating medications used in this population of patients and examining the status of CKD?aP may lead to the identification of medications that improve or worsen the pruritus condition. We aimed to assess the role of underlying diseases?related drugs on CKD?aP in HD patients.

We performed a case ? control study on HD patients aged over 18 years old. The  emographic data and clinical parameters including HD parameters, drug history, dermatologic assessments, and laboratory examination were assessed.

We compared 128 patients with CKD?aP as cases and 109 patients without CKD?aP as controls. Cases were on the longer course of dialysis (44.69 ± 43.24 months for cases vs. 38.87 ± 50.73 months for controls; P = 0.02). In multiple analyses of variables related to CKD?aP, backward LR logistic regression revealed that only  torvastatin (P = 0.036) was considered to be a predictive factor associated with  KD?aP. Thus, the use of atorvastatin reduced the index of CKD?aP (95% confidence interval: 0.256–0.954, odd’s Ratio = 0.494).

Atorvastatin was associated with decreased frequencies of CKD?aP among HD patients in our study. This knowledge may guide further clinical trials to evaluate atorvastatin’s immunomodulatory and  nti?inflammatory effects on the CKD?aP in HD populations. Key words: Amiodarone, atorvastatin, chronic kidney disease, hemodialysis, pruritus, valsartan Address for correspondence: Dr. Narges Alizadeh, Department of Dermatology, Skin Research Center, Razi  ospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. E?mail: narges.alizadeh7@gmail.com Submitted: 20?Jul?2021; Revised: 05?Mar?2022; Accepted: 20?Jun?2022; Published: 25-Nov-2022Access this article online Quick Response Code: Website: www.jmsjournal.net DOI: 10.4103/jrms.jrms_633_21 How to cite this article: Azimi SZ, Alizadeh N, Ramezanzadeh E, Monfared A, Leili EK. The impact of underlying diseases

The relationship between body mass index (BMI) and the severity of psoriasis is of debate. We investigated the relationship between BMI and psoriasis area and severity index (PASI) in Northern Iran. In this prospective, observational descriptive study, 190 patients with chronic plaque-type psoriasis were included from January 2015 to 2017. None of the patients used systemic therapy for psoriasis during the last month. There was a slight female predominance in our study (n=116; 61.1%). The mean age of our patients was 28.88 ± 18.17 (mean ± standard deviation) years. We found a positive correlation between BMI and PASI in the groups of psoriatic patients who had normal weight or were overweight (r = 0.369, P=0.006 and r=0.287, P=0.019, respectively). In the final logistic regression model, it was shown that in cases with BMI<18.5, the mean PASI score was lower in comparison with those with normal BMI (OR = 0.074, CI: 0.009, 0.636). A relationship between BMI and PASI was only seen in psoriatic patients who had normal weight or were overweight. To reduce the effect of factors such as systemic treatments, it is suggested to evaluate the relationship between BMI and PASI score as soon as the diagnosis of psoriasis is confirmed.

Psoriasis is a chronic disease that may affect patients’ quality of life. We investigated the quality of life (QoL) and its related factors in psoriasis patients.
In this cross-sectional study, 123 patients with psoriasis vulgaris were enrolled, who were at the age of 18-55 years. The QoL was assessed by the psoriasis disability index (PDI) questionnaire. The stress associated with psoriasis was evaluated by the psoriasis life stress inventory (PLSI) questionnaire. The severity of the disease (SoD) was measured based on the psoriasis area and severity index (PASI) score.
In this study, the mean age of the patients was 40.77 ± 0.73 years, and the mean duration of the disease was 8.7 ± 8.23 years. The average PASI score was 11.06, and the average PDI score was 11.98. The average PDI and PASI scores of smoker patients were significantly more than those of non-smokers (P = 0.017). There was a strong relationship between all parts of QoL and PLSI scores, as well as between PASI and PLSI (P < 0.05).
Psoriasis reduced our patients’ quality of life. Thus, it is recommended that the QoL in psoriatic patients be evaluated. Stress management and psychological supporting methods are necessary for these patients.

Psoriasis is a common chronic inflammatory skin disease, which is gradually being recognized as a systemic inflammatory disorder. Psoriasis and obesity are strongly linked, but there is not enough data whether obese psoriatic patients present differently from non-obese psoriatic patients. To compare the phenotype, clinical features, severity, baseline comorbidities and laboratory findings among psoriatic patients with/without obesity all the psoriatic patients, from three centers, who were receiving systemic therapy were included in the study. Patients were divided into two groups: those with obesity and those without obesity. We included 497 patients: 154 (31%) patients were obese and 343 (69%) were non-obese. Obese patients had more comorbidities, particularly hyperlipidemia, followed by hypertension and diabetes. Fasting blood sugar and serum lipids were significantly higher among obese subjects. Given the differences between obese patients and non-obese patients, the former group should be followed and managed more closely and with specific attention..

We reported two cases of immunocompetent patients with a rare form of AIDS-associated Kaposi sarcoma (KS), without visceral involvement, presenting with an unusual clinical and histopathological picture called telangiectatic and lymphangioma-like KS respectively. Dermatologists and pathologists need to be aware of this uncommon described variant to avoid the potential for misdiagnosis.

Bowen's disease (BD) is an epidermal in-situ squamous cell carcinoma (SCC). Most Human Papilloma Viruses (HPV)-positive lesions in Bowen's disease are localized to the genital region or distal extremities (periungual sites) in which HPV type-16 is frequently detected. Patient was a 64-year-old construction worker for whom we detected 2 erythematous psoriasiform reticular scaly plaques on peri-umbilical and medial knee. Biopsy established the diagnosis of Bowen's disease and polymerase chain reaction assay showed HPV-6, -18 co-infection. Patient was referred for surgical excision.

Statins improve prognosis in patients with coronary heart diseases by decreasing the incidence of vascular events. Excess prevalence of hyperhomocysteinemia, an independent risk factor of cardiovascular diseases, has been observed in stable renal transplant recipients (RTRs).
The objective of our study was to evaluate the association between atorvastatin administration and plasma total homocysteine (tHcy) levels in RTRs.
Patients and We performed a retrospective cross-sectional study in 148 cyclosporine A (CsA) treated stable RTRs. We compared tHcy level and other demographic and clinical variables in RTRs with and without atorvastatin. 58.1% of the 148 RTRs were treated with atorvastatin (20-40 mg/day). Mean tHcy levels were lower in patients treated with atorvastatin compared to nonusers (14.80 ± 5.13 µmol/l versus 16.95 ± 7.87 µmol/l, P = 0.04). The comparison of 85 patients treated with atorvastatin and 61 non-users revealed that those subjects with atorvastatin were older, with higher estimated creatinine clearance and elevated body mass index (BMI). They were more likely to have higher systolic blood pressure and CsA trough level (C0). The association between lower tHcy levels and atorvastatin use was confirmed in the multivariate regression model (P = 0.004). However tHcy levels were independently and negatively associated with serum folate (P = 0.0001) and vitamin B12 levels (P = 0.001) and positively with serum BUN (P = 0.001) and diastolic blood pressure (P = 0.024) as well.
These data support the association between lower tHcy levels and atorvastatin administration in RTRs. Further clinical trials are recommended to clarify homocysteine lowering effect of atorvastatin.

Chronic suppurative otitis media (CSOM) is considered one of the most common causes of acquired hearing impairment in developing countries. CSOM is a multifactorial persistent inflammatory disease of the middle ear. A distinct pathophysiologic mechanism linking allergic rhinitis (AR) and CSOM remains to evolve. The purpose of this study was to investigate the association between AR and CSOM in adults.This was a case-control study. The subjects were 62 adults (23 male, 39 female) with established CSOM and 61 healthy controls.CSOM was diagnosed when there was a history of chronic (persisting for at least 3 months) otorrhea, accumulation of mucopurulent exudates in the external auditory canal or middle ear and/or perforated tympanic membrane on otoscopy. All participants were evaluated for the presence of AR by clinical evaluation of allergic symptoms, and underwent a skin-prick test for 23 common regional allergens. Statistical analysis was performed using SPSS version 16. The prevalence of clinical rhinitis (allergic and non-allergic) was significantly higher among the cases compared with controls (62.5% vs. 37.5%, P=0.02). The prevalence of AR (proven by positive skin-prick test) was also significantly higher among affected adults than controls (24.6% and 13.8%, respectively). Adjusting for age, a logistic regression model showed that there was a significant difference between the two groups. Patients with AR and non-AR were at 3.27- (95% CI=1.15–9.29; P=0.036) and 2.57-(95% CI=1.01–6.57; P=0.048) fold increased risk of developing CSOM, respectively, compared with healthy individuals. The study showed a higher prevalence of AR in CSOM patients than in controls. It may be valuable to evaluate and control this factor in these patients.