595nm pulsed dye laser: an alternative to treat basal cell carcinomas

Basal cell carcinoma [BCC] is the most common cutaneous malignancy. Proffered treatment for these lesions is surgery. Based on patient's age, drug allergies, and place of lesions, surgery may not be the best option, and alternative treatments should be considered. Pulsed dye laser [PDL] may be a good alternative therapy. The aim of the present study was to determine the effectiveness and safety of this laser in the treatment of BCCs in Iranian patients. Patients with definite diagnosis of BCC enrolled in the study. For each patient, one lesion proved to be superficial, or nodular BCC via histopathology was treated with PDL for four sessions and after the last session, re-biopsy was done to determine any remnant of tumor. All patients were followed for 6 to 13 months to capture any recurrence of as soon as possible. A total of 12 patients including eight male and four female were selected. All patients completed the study in accordance to the treatment protocol. All patients cleared clinically resulting flat hypo pigmented scar, but in pathology, two patients showed remnants of tumor and were referred for surgery. No side effects, but mild erythema and irritation were noted in all patients. No recurrences were found during the follow up period. It seems that PDL may be an effective alternative therapy for some subtypes of BCCs with acceptable safety profile. Further studies with larger sample sizes are required to support this opinion

epidemiologic study on basal cell carcinoma and its related risk factors in patients referred to Razi hospital tumor clinic in autumn 2005-2006

Basal cell carcinoma [BCC] is the most common cutaneous malignancy UV light is an important risk factor for BCC, as well as X-ray and other ionizing radiations. The aim of this study was evaluation and risk factor assessment of BCC cases referred to Razi hospital tumor clinic. Patients referred from general clinics with skin biopsies consistent with Basal Cell Carcinoma were enrolled. A questionnaire including epidemiologic data, risk factor exposure and specification of skin lesions was completed for each patient. From October 2005 to October 2006, a total of 476 patients with cutaneous malignancy referred to Tumor clinic of Razi hospital. Of them, 367 patients had BCC. 215 were male [58%] and 152 were female [42%]. Mean age of patients was 62 [ +/- 12.7] and 62 [ +/- 13.4] years for men and women, respectively. The most common risk factors for BCC were radiotherapy and chronic sun exposure. The most common tumor sites were scalp, nose and ears. Of different clinico-pathologic types, nodulo-ulcerative type was the most common. It seems that radiotherapy is an important risk factor in Iranian BCC patients and it is useful to have a screening program for case finding and treating patients in early stages

Tinea faciei: a report of 22 cases referred to Razi Skin Hospital in 2004

Tinea faciei is an uncommon fungal infection, which infects glabrous skin of the face. All species of dermatophytes can produce this disease. The objective of this study was to determine the frequency of various dermatophyte species that produce tinea faciei and frequency of correct primary diagnosis in this disease in patients referred to Razi Hospital in Tehran. Materials and In this cross-sectional study, 22 patients with tinea faciei referred to Razi Hospital from April 2004 to March 2005 were evaluated considering species of dermatophyte and the accuracy of primary diagnosis. The most common species was Trichophyton tonsurans that was the causative agent in 10 patients. Fifteen patients had been admitted in other centers before coming to Razi Hospital and in 86% of them tinea faciei had been misdiagnosed. Clinical presentation of tinea faciei may be atypical in many cases and can lead to incorrect diagnosis. Therefore tinea faciei should be considered as a differential diagnosis in any localized erythematous lesion on the face

[Disappearing vermilion: report of 14 cases]

Sometimes we see patients with disappearing vermilion totally or in some parts. It seems that the marginal skin has advanced to the lip surface with the same color. It occurs mainly in lower lip. The majority of patients had history of recurrent herpes labialis on their lips, in the same location as disappearing vermilion. Disappearing vermilion is not accompanied by any change in consistency of labial skin. There is no symptom and most patients are unaware of it. Sometimes they refer to the physician for other reasons. Rarely patients, particularly women, complain of the disease. We collected a series of 14 cases of disappearing vermilion to evaluate this disease

Erythromelanosis follicularis faciei

Erythromelanosis follicularis faciei is not uncommon. Erythromelanosis follicularis is characterized by the triad of brown pigmentation, erythema and follicular papules on the face and neck. It is considered a rare, but actually underreported disease. Young adult males are principally involved. Only 11 females are yet reported. We observed 60 patients with this condition [during a 2-year period from September 1994, in Razi Hospital and a private office, with special attention to the distribution of lesions, the age at onset, family history, sex, the presence of keratosis pilaris and the skin phenotype. 17 cases were females. The age range was from 4 to 37 years old and the age of onset of disease was in the second decade in the majority of patients. Two pairs of siblings were among our cases. Keratosis pilaris was a frequent finding. Erythromelanosis follicularis faciei, especially its milder forms, is not rare: It is rather missed or underreported by physicians. It seems this condition is ameliorated or cleared by increasing age, a suggestion that must be proved by further studies