فهرست مطالب

Iranian Journal Of Dermatology
Volume:23 Issue: 4, Winter 2020

  • تاریخ انتشار: 1400/01/15
  • تعداد عناوین: 9
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  • Akbar Mokhtarpour Neilagh, Farzam Alizadeh, Mehdi Aghazadeh Barenji, Shahin Behrouz Sharif, Amin Sedokani * Pages 132-136
    Background
    Vitiligo is an acquired disorder characterized by the selective destruction of melanocytes, culminating in white macules on the skin. It usually begins at an early age; however, late-onset vitiligo also may occur. The disease burden arising from the psychological effects, especially during childhood, highlights the importance of epidemiological studies of this disease and investigations of differences of disease features between earlyonset and late-onset forms.
    Methods
    A total of 234 vitiligo patients were included in this study and divided into two groups considering the age of onset. The disease characteristics and clinicopathological features of the patients were obtained and compared using written questionnaires.
    Results
    Overall, 25.6% of patients were early-onset and the mean of age in this group was 18.86 years compared with 37.14 years in the late-onset group. The most frequent involvement sites for the early-onset and late-onset groups were the eyelid and hand, respectively. A significant difference was observed between the groups regarding thyroid disorder as a comorbid disease.
    Conclusion
    Marked differences in clinical features were present between patients with early-onset and late-onset vitiligo. Females were more prevalent in the early-onset group and the frequency of thyroid disorder was less relative to the late-onset group. Further studies with different age cut-offs for categorizing early and late-onset vitiligo seem necessary.
    Keywords: Vitiligo, Thyroid, Autoimmune Disease
  • Hiader Kadhim Alrubaye, Khalil Ismail Alhamdi, Jamal Ahmed Abdel Barry, Majid Hameed Alabbood * Pages 137-141
    Background
    Psoriasis is a chronic, recurrent, inflammatory, and proliferative disease. Previous studies have demonstrated that patients with psoriasis may have an increased risk of developingcoronary artery disease. High serum lipid levels have been suggested in the pathogenesis of this phenomenon. Accumulating evidence suggests that apolipoprotein B is superior to other lipidparameters in predicting atherosclerotic cardiovascular disease. This study aimed to examine the differences in the lipid profile and apolipoprotein A-I and apolipoprotein B levels between psoriatic patients and healthy subjects.
    Methods
    This was a case-control, cross-sectional study. A total of 93 psoriatic patients and 113 healthy individuals were enrolled. This study was conducted at the outpatient department of dermatology in Alsader Teaching Hospital, Basra, Iraq. The serum level of total cholesterol (TC), triglyceride (TG), very lowdensity lipoprotein cholesterol (VLDL-C), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A-I and apolipoprotein B were measured.
    Results
    The psoriatic patients had significantly higher levels of TC, TG, VLDL-C, LDL-C, and apolipoprotein B compared with the control group.
    Conclusion
    Lipid profile values were significantly higher among patients with psoriasis than normal controls. Early screening and treatment of hyperlipidemia in these patients are advisable toprevent atherosclerosis and its complications. Apolipoprotein B may serve as a marker for dyslipidemia and CVD in patients with psoriasis.
    Keywords: Psoriasis, apolipoprotein, Hyperlipidemia
  • Amruta P. Dhotre, Sudhir P. Singh *, Bhushan Madke, Adarshlata Singh, Sugat Jawade Pages 142-149
    Background
    Idiopathic guttate hypomelanosis (IGH) is characterized by discrete, multiple, round-to-oval hypopigmented macules of approximately 2-5 mm diameter, especially on the forearms and pretibial area,which increase in number with aging. Recent focus has been on therapeutic wounding, which stimulates melanocytes from the periphery and surrounding hair follicles to proliferate, migrate, and repigment the lesions. This study aimed to evaluate and compare the efficacy of trichloroacetic (TCA) 50% application and dermabrasion in IGH patients.
    Methods
    Twenty patients of IGH were enrolled after considering various inclusion and exclusion criteria. IGH lesions over the right side were treated with trichloroacetic acid (TCA) 50% witha cotton-tipped applicator. IGH lesions over the left side were treated with dermabrasion.
    Results
    Of the 153 macules in 20 patients, all 81 macules in the dermabrasion group showed some repigmentation, whereas 7 (9.7%) out of 72 macules treated with 50% TCA Touch™ showedno improvement. At the end of 3 months, repigmentation up to 25%, between 25–50%, and between 51–75% was seen in 18.5%, 66.7%, and 14.8% of lesions treated with dermabrasion, respectively. This is while TCA 50% touch-treated macules showed up to 25% and between 25–50% repigmentation in 48.6% and 41.7% of instances, respectively.
    Conclusion
    The analysis suggested that both dermabrasion and TCA 50% Touch are effective in the treatment of IGH. Dermabrasion proved to be more effective than TCA peel and can be tried before or with the medical line of therapy in the treatment of IGH.
    Keywords: hypomelanosis, dermabrasion, Wound, trichloroacetic acid
  • Nasim Niknezhad, Behnaz Hamedani *, Abbas Zamanian, Reza Mahmoud Robati, Elnaz Hamedani Pages 150-154
    Introduction
    Acne vulgaris affects individuals of all ages, and isotretinoin is the most effective treatment available for this disease. However, serious adverse effects, including the possibility of depression and suicide, could limit its use. This study aimed to investigate the frequency of depression in patients with acne vulgaris treated with oral isotretinoin.
    Materials and Methods
    Forty acne vulgaris patients treated with oral isotretinoin and 40 age- and sex-matched controls treated with a systemic antibiotic (doxycycline 100-200 mg/day) and atopical retinoid were enrolled in this study. The depression score was measured based on Beck’s Depression Inventory (BDI) in both groups before and after two months of treatment.
    Result
    The BDI score and the rate of depression were not significantly different between the two groups after the twomonth treatment period. Moreover, we did not find any significant change in BDI score in each group after treatment (P > 0.05).
    Conclusion
    Our study showed that short-course oral isotretinoin therapy does not increase the depression rate among acne vulgaris patients. It should be noted that oral isotretinoin causesa significant clinical improvement in patients with moderate to severe acne vulgaris, which could be associated with a decrease in depression scores.
    Keywords: depression, Acne Vulgaris, Isotretinoin
  • Sonal Agarwala, Shashikant Malkud * Pages 155-162
    Background
    Vitiligo is an acquired condition resulting from the progressive loss of melanocytes. It may be associated with disorders of pigmented tissues of the eyes and ears, and withdisorders of the endocrine organs. 
    Aim
    To study the clinico-demographic profile of vitiligo patientsand its association with endocrine disorders and audiological and ocular abnormalities. 
    Materials and Methods
    This was a case-control study conducted at a tertiary care hospital; 261 vitiligo patients were enrolled together with 100 age- and gender-matched healthy individuals without vitiligo as the controls. A detailed history and clinical examination, including audiological and ocular examination, was undertaken; blood investigations like random blood sugar, thyroid function tests, and serum cortisol levels were requested for all subjects.
    Results
    Vitiligo vulgaris was the most common type of disease detected in 146 (55.93%) patients, followed by focal vitiligo in59 (22.60%), mucosal vitiligo in 31 (11.87%), acrofacial vitiligo in 16 (6.13%), segmental vitiligo in 8 (3.06%), and universal vitiligo in one (0.38%) patient. Endocrine disorders were noted in 40 (15.32%) patients, which included hypothyroidism in 27, hyperthyroidism in 5, and diabetes in 8 patients. Sensorineural hypoacusis andocular abnormalities were noted in 56 (21.45%) and 49 (18.77%) vitiligo patients respectively. The association of hypothyroidism, sensorineural hypoacusis, and ocular abnormalities with vitiligowas statistically significant.
    Conclusion
    Vitiligo is not limited to cutaneous melanocytes; it also affects pigment cells throughout the body. Patients with increased age, prolonged duration of disease, and greater bodysurface area involvement are at increased risk for systemic associations. A thorough clinical evaluation seems necessary for all vitiligo patients.
    Keywords: Hypothyroidism, hyperthyroidism, hypoacusis, Vitiligo
  • Mohammad Abdalla *, Mohammad Nayaf, Sura Hussein Pages 163-167
    Background
    Vitiligo is a skin disease caused by the destruction of melanocytes of the epidermis, leading to well-defined white patches that are often distributed symmetrically. The presentstudy aimed to determine the correlation relationship between the α-MSH and vitamin D serum levels among Iraqi vitiligo patients. 
    Materials and Methods
    This study was done on outpatients who attended the Dermatology and Venereology Consulting Clinic of Salah-Al Deen General Hospital from November 2017 to March 2018. One hundred and ninety individuals were stratified into 110 cases of vitiligo and 80 healthy controls. Serum assays for α-MSH and vitamin D levels were sent for all subjects.
    Results
    Vitiligo patients had significantly lower α-MSH levels and vitamin D levels than the controls (P ≤ 0.01). There was a significant, positive correlation between α-MSH and vitamin D levels in vitiligo patients overall (r = 0.236; P ≤ 0.01), though this correlation was negative within the male and female subgroups (r = -0.392 and -0.661, respectively; P ≤ 0.01).
    Conclusion
    Compared to normal controls, vitiligo patients had significantly lower levels of α-MSH and vitamin D. These findings may back the normalization of both α-MSH and vitamin D levels in vitiligo patients as an important step toward disease recovery.
    Keywords: Vitiligo, Vitamin D, α-MSH
  • Leili Amani, Fatemeh Fadaei, Mohammadreza Shams Ardakani, Mehran Mirabzadeh Ardakani, Seyede Nargess Sadati Lamardi, Laila Shirbeigi * Pages 168-175
    Background

    Skin conditions are among the most common health problems worldwide and are associated with immense psychological, social, and financial burdens. Atopic dermatitis, alopecia, eczema, diabetic ulcers, and abscesses are common acute or chronic conditions, which are increasing dramatically in prevalence due to industrialization and unhealthy lifestyle habits. The use of complementary and alternative medicine to treat skin diseases has been increasing in recent years.

    Methods

    This review focuses on proposed skin conditions for leech therapy as mentioned by Avicenna, a great Iranian philosopher and physician (980-1037 AD)in the Canon of Medicine. Electronic databases including PubMed, Scopus, and Google Scholar were searched for clinical studies on treatment protocols in this book to compare them with recent clinical trials involving leech therapy.

    Results

    Investigation of traditional Iranian medicine literature can lead to the identification of natural medicines for the management of skin problems. Leech saliva contains anti-coagulative, antiaggregative, and vasodilatory components.

    Conclusions

    In addition to the annelid’s mechanical ability to extract blood, leeches can contribute to patients’ health while posing minimal risks.

    Keywords: skin disease, traditional medicine, eczema, Alopecia, Abscess
  • Mouna Rkhami, Ghassen Gader *, Ahmed Maatoug, Bilel Loukil, Mohamed Badri, Ihsèn Zammel Pages 176-180

    Proliferating trichilemmal tumor (PTT) is a rare cutaneous tumor that mainly occurs in the scalp, eyelids, neck, and face of elderly women. In most cases, it is a unique, large, multi-lobulated, cystic lesion originating from a hair follicle. These tumors are mostly benign and are characterized by trichilemmal keratinization. However, in rare cases, they may be aggressive with a propensityfor distant metastasis.We report the case of a 69-year-old male patient, who presentedwith as welling on his forehead that had rapidly increased in size over the past year. CT scan and magnetic resonance imaging (MRI) showed a tumor located on the cranial vault, associatedwith an intracranial extension. Chest X-ray and CT scan found a tumor in the right lung. The patient underwent surgery for the removal of the tumor. The histological examination confirmedthe diagnosis of malignant PTT (MPTT). To the best of our knowledge, only a few cases of MPTT have been published. Furthermore, only one case of MPTT of the scalp with endocranial extension and lung metastasis has been eported to date.Through this case, we discuss the prognostic factors and the management of this aggressive lesion.

    Keywords: Metastases, dermatology, neurosurgery, cranial vault tumor