[Study of medical malpractice complaints in the field of dermatology and cosmetic, in the coroner's office of forensic medicine, province of Tehran, during 2002 to 2010]

Today, despite numerous advances in medical sciences, the number of complaints against physicians shows an increasing trend. Studying the causes of these complaints and identify contributing factors may reduce medical litigation. The aim of this study was to assess the reasons of complaints in the field of dermatology and cosmetic. In this retrospective cross-sectional study, we investigated the medical malpractice records related to dermatology and cosmetics, registered in the office of Forensic Medicine, province of Tehran from 2002 to 2010. In 63.4%, 35.3%, and 1.2% of cases, verdicts of malpractice, acquittal and closing the file without a verdict, were issued; respectively. The most common types of negligence were related to improvidence [63.4%], lack of proficiency [27%], and disregarding of governmental provisions [5.7%]. Most frequent causes of complaints were related to scar and darkening of skin after laser therapy [24.4%], dissatisfaction of hair transplantation [19.5%], and complications after injection of filler gels, botollonium toxin, etc [15.8%]. Most plaintiffs were women, in their 20s, with a highschool diploma and were housewives. The most frequent age range of the physicians was 30-39 years old and most of them were male. Considering medical ethics and professionalism, good communication between physicians, medical personnel and patient including his entourage, full examination, adequate explanations about therapeutic procedures and possible complications, lack of exaggerating the results of therapy, continuous study and updating medical knowledge, improvement of medical skills and experiments, refrain from dealing with procedures that did not pass its training courses, properly selected patient, take informed concept and innocence may reduce the number of complaints

[ review of acute and chronic skin complications of sulfur mustard exposure]

Sulfur mustard [SM] or mustard gas is a chemical weapon which for the first time was employed during world war I; later on it was used by Iraqi military forces against Iranian army and civilians [1980-88]. This agent injured over 100000 Iranians and one-third of them are still suffering from it complications. SM is an alkylating agent with cytotoxic, mutagenic and vesicating properties, which targets the skin, eyes and respiratory systems. In this study we review the acute and chronic effects of SM on the skin. We obtained information of this paper from a search of PubMed. Google, Iran Medex, Irandoc and SID until beginning of 2011. the most common acute effects of SM on skin were: pruritus and burning [26%-96.8%], pain [25%-77.4%], erythema [20.6%-83.9%], hyperpigmentation [20%-83.9%], and vesicle and bulla [15.4%-80.6%]. The most common chronic effects were: pruritus [24.7%-94.7%], burning [9.9%-52.1%], scar [4.5%-70%], hyperpigmentation [5.9%-55%], hypopigmentation [3.2%-40%], xerosis [2.1%-43.7%] and cherry angioma [12.2%-70.5%]. After passing more than 20 years of the end of the Iraq-Iran war, the victims still suffer from many skin complications of SM and some of them such as itching and dry skin have negative effects on the performance and quality of their life. Up to now, serious skin complications like malignant skin tumors have been rare and a longer time may be required to establish. Therefore further follow-up is needed to detect and treat any kind of skin cancers promptly

frequency of skin diseases among Hajj pilgrims in skin clinic of Iran in Saudi Arabia, 1993 and 1999

Skin diseases among pilgrims are considered to be one of the possible health problems. Data supporting this observation are scanty. The aim of this study was to report the most common skin diseases seen in Hajj season. Data regarding skin diseases were collected from piligrims whom were examined and diagnosed clinically at the skin clinics of Iran in Saudi Arabia in 1993 and 1999. During the Hajj season in 1999, 362 patients were seen. The most common groups of diseases were eczemas of different types and related conditions [35.9%], mechanical and thermal injury [17.6%] and infections [16.5%], accounted for more than 70% of cases. During Hajj season in 1993, 560 patients were seen. The most common groups of diseases were infections [19.3%], eczema and related conditions [18.6%] and disorders of skin appendages [16.4%], accounted for bout 54.2% of observed skin diseases. The finding of these most common skin disorders is important in training programmes and delivery of service for care of pilgrims, because they are preventable, easily diagnosed and curable in the majority of patients

Cutaneous manifestations of primary immunodeficiency diseases in children

Primary immunodeficiency diseases [PIDs] are rare but include severe conditions found predominantly in children, Most PIDs have cutaneous manifestations that may be important as early diagnostic features. The purpose of this study was to determine the frequency and nature of cutaneous alterations associated with PIDs. This article is a cross-sectional study at the department of allergy and clinical immunology of children's medical center conducted between December 5, 2001 and April 20, 2002. The subjects included pediatric patients with a diagnosis of PID and dermatological diagnoses were made by a dermatologist. Two hundred and ten patients were studied They consisted of 68 cases of humoral deficiency, 22 cases of cellular and combined deficiencies, 57 cases of phagocytic defects and 63 cases of other PIDs. In 67 cases [31.8%] the cutaneous alterations preceded and were the basis for clinical immunological diagnosis. Overall cutaneous alterations were infections in 99 cases and eczematous dermatitis in 27 cases. Our findings support the results of other studies that most PIDs have cutaneous features which being their typical aspects are highly suggestive for the diagnosis of PIDs

Papillon-lefe'vre syndrome: neutrophil motility and killing defect in a child with recurrent severe infections

A case of palmoplantar hyperkeratosis with periodontosis and a history of recurrent severe pyoderma, pneumonia and multiple liver abscesses is described in a 12 year old girl. The patient demonstrated neutrophil dysfunction characterized by decreased random migration and chemotaxis and defective bactericidal activity. The exact immunopathological mechanism for susceptibility to infections in Papillon-Lefe'vre syndrome patients still remains to be determined. However, the mode of clinical presentation, laboratory findings and response to retinoid treatment, all support the speculation of Papillon-Lefe'vre syndrome as a primary immunologic disease with a variable defect in neutrophil motility and bactericidal activity. The pattern of clinical presentations as skin and periodontal lesions alone or with susceptibility to infection in other sites will change accordingly