Neurological symptoms in psoriasis patients under treatment with infliximab

Objective: To study the neurological symptoms of psoriasis patients who used infliximab. Methods: We studied psoriasis patients who used infliximab in two referral general hospitals in Tehran from January 2013 to January 2014. We completed neurological symptoms checklists by questioning the patients. Results: Sixty patients with psoriasis were included in this study. Among them, 3 patients had sensory symptoms as side effect and one patient showed motor symptoms as side effect. There was no statistically significant difference between age, gender, and session count with the sensory and motor side effects ( P > 0.05). Conclusions: Neurological symptoms can be detected among 6% of patients under treatment with infliximab and there is no significant association between symptoms and gender, duration of drug use as well as age.

Comparing pulsed-dye laser with cryotherapy in the treatment of common warts

No modality has been identified as the treatment of chice for treating common warts. Cryothearpy and pulsed-dye laser [PDL] are among common modalities for treating these lesions. The aim of this study was to compare pulsed dye laser with cryotherapy in terms of efficacy and complications. Of a total of 46 patients enrolled in this study, 7 patients withdrew the study, 20 patients underwent cryotherapy and 19 patients underwent PDL. Patients underwent a maximum of 4 therapeutic sessions at 3-week intervals in both groups. They were assessed for the remission rate [complete and partial], side effects and recurrence rate in each session and 1 month after termination of the treatments. At the end of the study complete remission was achieved in 37.8% of patients in cryotherapy group and in 52.3% of patients in PDL group. This difference wasn't statistically significant [P=0.229], though after first and second sessions of treatment complete and excellent partial remission occurred more in PDL group with significant difference [P=0.007 and P=0.021]. Pain and bulla formation occurred statistically higher in cryotherapy group [P=0.002 and P=0.001]. Other complications were rare in both groups. In terms of efficacy, we couldn't demonstrate the superiority of pulseddye laser therapy to cryotherapy in treating common warts. Both methods were safe for long-term complications but PDL was much safer for short-term complications

randomized comparative study between three times and five times weekly phototherapy with nbuvb for treating chronic plaque type psoriasis

Psoriasis is a chronic inflammatory skin disease that is estimated to affect 0.6% to 4.8% of the general population. The optimum number of NB-UVB phototherapy sessions is yet to be determined. The aim of this study was to compare therapeutic effects of NB-UVB in treating chronic plaque type psoriasis three times weekly vs. five times weekly. This study was designed as a single-blinded randomized controlled trial. Patients with chronic plaque type psoriasis who were candidates for phototherapy were randomized in two groups, one group received NB-UVB three times a week [group A] while the other group received the same treatment five times a week [group B]. Patients' PASI score was determined before commencing the study and after 12 weeks of treatment. At the end of the study, response rate, PASI score of patients and total dose of UVB per patient were determined. A total of 47 patients were enrolled. Thirty two patients [19 in group A, 13 in group B] completed the study. Total response rate was 71.9% after 12 weeks of treatment [23 out of 32 patients] while nine patients [28.1%] had no response. Response rate was 78.9% [15 out of 19] in group A Vs. 61.5% [8 out of 13 patients] in group B [p>0.05]. Total UVB dose received, treatment sessions, erythema and final PASI score was lower in group A [p>0.05]. With similar therapeutic effects, it seems that three times a week regimen may be superior to five times a week for its lower total UVB dose received and higher safety profile

Cutaneous manifestations in patients with rheumatoid arthritis

Rheumatoid arthritis [RA] is a chronic inflammatory joint disease with different extra-articular manifestations. Among those extra-articular manifestations, there are significant cutaneous manifestations which may result in first admission to a dermatologist. In this article some specific and non-specific skin lesions of RA such as rheumatoid nodules, exacerbated nodules, rheumatoid vasculitis, Bywaters, pyoderma gangrenosum and neutrophilic rheumatoid dermatoses are discussed. Some of these lesions such as rheumatoid nodules are very common and some others are very rare

Keratoderma palmoplantaris transgrediens [Mal de Meleda]: a case report

Mal de Meleda [keratoderma palmoplantaris transgrediens] is a rare autosomal recessive form of palmoplantar keratoderma with hyperkeratosis of palms and soles, which appears soon after birth and progressively involves other areas [transgrediens] of the skin especially dorsal aspects of hands and feet. We report a 20-year-old woman with Mal de Meleda with some unusual clinical features, i.e. peculiar finger nail anomalies and pseudoainhum on all her fingers

comparison between systemic PUVA therapy alone and combined with topical calciporiol in the treatment of generalized vitiligo

Vitiligo is a relatively common acquired depigmentary disorder affecting approximately 1% of general population. PUVA therapy is the most effective modality and commonly used as the primary treatment of generalized vitiligo. To evaluate the synergistic effect of topical calcipotriol and oral methoxalene plus PUVA in treatment of generalized vitiligo. In this clinical trial, 47 patients with generalized vitiligo [<40% involvement of skin surface area] were randomly assigned to two treatment groups. Both groups were treated with systemic PUVA three times weekly. One group was also treated with topical calcipotriol [0.005%]. Patients were evaluated for treatment response and possible side effects. The mean response rate at the end of the study was 63.9% +/- 24.1 in the calcipotriol and PUVA group and 60.6% +/- 23 in the PUVA group [P>0.05]. The number of PUVA sessions and the mean cumulative UVA dose for maximum response were 96. 6 +/- 22.7 and 584.1 +/- 118.1 J/cm [2] in the calcipotriol and PUVA group and 116.3 +/- 26.1 and 685.1 +/- 168.0 J/cm [2] in the PUVA group [P<0.05]. In patients with generalized vitiligo, combination of PUVA with calcipotriol is an effective and safe treatment. This method decreases number of PUVA sessions and UVA dosage compared to PUVA treatment alone and accelerates repigmentation

Skin and diabetes

Diabetes mellitus is the most prevalent endocrine disease that is recognized by hyperglycemia due to a defect in insulin synthesis [type I], insulin function or both [type II].To review the common skin manifestations of diabetes we have performed an extensive search in the literature, with an emphasis on the recent articles. Skin manifestations of diabetes are presented in four main categories as follows: 1-manifestations due to diabetes such as necrobiosis lipoidica and diabetic dermopathy, 2-skin infections, 3-manifestations due to diabetes complications such as diabetic ulcer, and 4-skin reactions to diabetes treatment. Cutaneous manifestations occur in about two thirds of diabetic patients and may take place as a result of microvascular complications, wound healing defect and/or other unknown mechanisms. Generally, cutaneous manifestations in diabetes happen after the background of diabetic process has presented but sometimes they occur long time before the diagnosis of diabetes