[Efficacy and safety of topical or oral methoxsalen plus ultraviolet A in the treatment of vitiligo]

Vitiligo is a common skin disorder that presents as depigmented patchs and associated with psychosocial morbidity. Photochemotherapy with methoxsalen plus ultraviolet A [PUVA] is an effective and commonly used modality in treatment of vitiligo and is available in Khorasan Province since more than ten years ago. This uncontrolled clinical trial included patients with vitiligo referred to phototherapy center in Emam Reza Hospital in Mashhad during 1998-1999. Treatment was done topically on patients with involvement less than 2% of the body area and systemic in cases with involvement more than that. Data including improvement rate and side effects were analyzed by PSS software version 11.5. One-hundred and thirty-five patients, 79 female and 56 male, were enrolled. One-hundred and twenty-six patients were treated systemically and 9 patients underwent topical therapy. Complete [100%] repigmentation was observed in one patient. Repigmentation of 80-99%, 60-79%, 40-59%, 20-39% and less than 20% were observed in 53, 43, 12, 6 and 20 patients; respectively. Results were significantly better in generalized vitiligo, face involvement, and cases whom received more than 200 treatment sessions, but there was not significant relationship between improvement and patients' age, family history, the first involved area, beginning time of repigmentation, the observed interval between initiation of treatment and disorder appearance, and skin type. Common side effects were pruritus [69.6%], erythema [52.6%], nausea and vomiting [28.9%], and headache [17.8%]. PUVA therapy is an effective and safe treatment in patients with vitiligo, and has good results in nonsegmental vitiligo and facial involvement

Accuracy rate for clinical diagnosis of dermatofibroma in patients referred to dermatology and pathology department of Emam Reza hospital

Considering its typical clinical manifestation, Dermatofibroma [DF] can be clinically diagnosed in most cases. It has been nevertheless, common practice to rely on pathologic diagnoses. We decided to estimate the rate of correct clinical diagnosis and also the relative importance of other lesions in differential diagnosis of DF. We studied archived biopsies in Dermatology and Pathology Department of Emam Reza hospitals from 1984 until 1 2004 and Dermatofibroma cases were selected, then slides were reviewed. Demographic and other relevant data such as age, sex, etc were gathered and analysed. Eighty two of 127 clinically diagnosed dermatofibroma cases were confirmed by histologic examination [positive predictive value 64.5%]. The most common histological diagnosis in the remaining 45 cases were nodular hidradenoma [7 cases] and comedon and epidermal cyst [11 cases collectively]. In addition, 32 cases of histologically diagnosed dermatofibroma were found with different clinical diagnosis. According to our data, the sensitivity of clinical diagnosis was 72%. It was also found that the lesion is more common in females [57%] and in extremities [58%]. It often appears as a nodular [72%] lesion measuring 5 to 15 millimeters. Histopathologic examination is important for diagnosis of Dermatofibroma. According to our data, the probabilities of false positive and false negatives were 35.5% and 28%, respectively, which is equivalent to 64.5% positive predictive value [PPV]

evaluation of [sun protection factor] SPF accuracy of some sunscreens

The prevalence of photo-aging and skin cancers has been increasing in many parts of the world. To reduce cutaneous photodamage and skin carcinogenesis, primary prevention that an integral component of it is the use of sunscreens is recommended. The aim of this study was assessment of SPF accuracy in some Iranian sunscreens. Among healthy individuals with skin types I to III, 25 volunteers enrolled, but finally ten persons for two sunscreens "X" and "Y" completed the study. Candidates were tested during three days using phototherapy UV 800 K with UV B lamps, UV skin-tester and UV-meter [Waldman Company, Germany]. Minimal erythemal dose in unprotected areas of the skin [MEDup] was initially measured and then in protected areas [MEDp] was determined, according to the MEDup amount and national sunscreens' SPF label [SPF30]. Volunteer was exposed to his own MEDp and also 85% of it, after 24 hours, the two areas were examined for erythema. The final test result declared "correct", for the tested cream, if the accuracy of the SPF was confirmed in at least 90% of volunteers. The accuracy of test was confirmed according to SPF assessment standard protocol. All the candidates were male with mean age of 33.5 +/- 8.51 yrs. The MED mean was 73/09 +/- 15/6 mj/cm2. Final results declared "correct" for both products. In addition, the standard lotion test result was correct for all candidates. According to the results, we can assure people and physicians about reliability of labeled SPF, at least in some of the national products

[ assessment of the awareness of senior students about the effects of sunlight on the skin and necessity and methods of sun protection]

Nearly ninety percent [90%] of skin cancers occur in sun exposed areas. In this study the awareness of senior students of Mashhad University [Ferdowsi] about the effects of sunlight on the skin plus necessity and methods of sun protection is evaluated. In this descriptive study in 2004 at Mashhad University [Ferdowsi], 802 senior students of 9 majors enrolled. This study was approved by the local committee of Medical Ethics. The standard questionnaires including 24 questions distributed among students. The students divided into groups according to their score in the 24 awareness questions: weak [score

Frequency of different skin cancers in Qaem Hospital, Mashhad, from 1975 to 1995: a cross-sectional study

Skin cancer is the most common malignancy in the world, and carries a high rate of morbidity but low rate of mortality with the exception of malignant melanoma, which has a high mortality rate. In recent decades, incidence of skin cancers has been increased. The most important risk factors are sunlight and skin type. This study was performed to evaluate the demographic characteristics of skin cancers in Mashhad. This cross-sectional study was performed on 2786 cases of skin cancer from the archive of the pathology department of Qaem hospital in a twenty-year period [1975-1995]. Sex, age and localization of lesions in all registered cases were studied. Frequency of three common skin cancers in 2786 cases were basal cell carcinoma [BCC] 1606 [57.7%], squamous cell carcinoma [SCC] 562 [20.3%], malignant melanoma [MM] 122 [4.5%] and skin metastasis 96 cases [3.5%]. Ratio of BCC/SCC was 2.85/1. BCC, SCC and MM were more common in men, and BCC, SCC, MM and skin sarcoma were most commonly observed in the sixth decade. Median of age in BCC, SCC and MM was 54 +/- 15.9, 56 +/- 15.4 and 53 +/- 14.7 years; respectively. Ninety-three percent of BCC and 74% of SCC lesions were located on head and neck region and lower limb was the most common site of melanoma and skin sarcoma. Frequency of BCC, SCC and skin metastasis was similar to reports from other countries, but ratio of malignant melanoma to non-melanoma skin cancers [NMSC] was 50% lower than other studies. The median age in BCC was 54 years, which was lower than other studies. The most common sites of NMSC were in sun exposed areas which can emphasize the role of sunlight in the etiology of skin cancers

Survery of cutaneous complications after renal transplantation in Emam Reza [PH] and Qaem Hospitals, Mashhad

Renal transplantation is an appropriate treatment for end stage renal disease and helps prolongation of patients survival with better quality, but immunosuppressive drugs that are used for inhibition of rejection after transplantation may cause some adverse effects in other organs such as the skin. Apparently, early recognition of those side effects and their appropriate management can reduce morbidity and mortality. This study was designed to study cutaneous complications in renal transplantation recipients. In this descriptive study cutaneous side effects in one hundred kidney transplant patients who were admitted to transplantation clinics of Qaem and Emam Reza hospital of Mashhad during a six-month period [April to September 2003] were studied. Sixty-five patients were males and 35 cases were females. The mean age was 36 years [SD=14]. Totally, cutaneous manifestations were observed in 88% of patients. In a descending order they included hypertrichosis, cushinoid appearance, gingival hyperplasia, steroid acne, common warts, herpes simplex infection, superficial fungal infection, candidiasis, actinic keratosis, porokeratosis, lymphoma, stria, telangiectasia and sebaceous hyperplasia. Early recognition of these complications and appropriate treatment of them can reduce probable mortality and morbidity