[ effect of isotretinoin on plasma homocysteine concentration of patients with acne vulgaris]

Isotretinoin [ISO] revolutionized the treatment of acne since 1980s and there after, severe forms of acne have been treated more effectively, with less residual cosmetic or psychological damage. The use of Isotretinoin is associated with significant side-effects such as mucocutaneous involvement, dyslipidemia and increased liver enzymes. The aim of study was the evaluation of homocysteine [Hey] levels and the responsible vitamins for its metabolism in patients with moderate to severe acne vulgaris undergone ISO treatment. Forty-seven [n=47] patients with acne, prepared with liver function tests, folate, vitamin B12, homocysteine and serum lipids evaluations. Hey was evaluated before [Value 1] and on the 2[nd] month [value 2] of treatment with Isotretinoin [0.5 mg/kg/day], by HPLC methods. Hey levels [value 1: 11.8 +/- 5.3 micro mol/L vs. value 2: 13.6 +/- 7.4 micro mol/L; P<0.001] were statically significantly increased in patients treated with ISO. In addition, lipids and liver enzymes increased in mentioned group. However, there was no significant correlation between Hey levels, vitamins and liver enzymes. Elevated Hey levels in patients after 2 months on ISO treatment might be resulted from liver function disturbances. Folate supplementation along with frequent evaluations of Hey serum levels are strongly reconnnened for the prevention of a premature occlusive disease

[Dermatologic manifestations of patients on chronic hemodialysis referring to University Hospitals]

Dermatologic diseases are common in patient with chronic renal failure, [CRF], being managed with hemodialysis. This study was done to determine the different patterns of skin involvement in these patients. We examined 215 patients on hemodialysis in four hemodialysis centers in Tehran in 2006. Of 215 patients, [122 men and 93 women], with the mean age of 56.4 +/- 16.2 years [range, 17 to 86 years], 202 [94%] had at least one type of dermatologic disease. They had been on dialysis from at least 1 year to 27 years. The most common dermatologic disease was xerosis, [59.1%]. There was a significant relation between the patients' age and solar elastosis [P=0.01], splinter hemorrhage [P=0.018], and longitudinal ridging [P=0.01]. Also, the relationship between the duration of hemodialysis and yellow discoloration, xerosis, and koilonychia were statistically significant, [P=0.047, 0.019, and 0.01, respectively]. A significant association was found between the patients' job and folicullitis [p= 0.01], and between the underlying disease resulting in CRF and folliculitis or furunculosis [P= 0.039]. As dermatologic diseases are very common in patients with chronic renal failure, referral to a dermatologist for optimal management will improve the quality of life in these patients