Immunohlstochemical study of COX-2 in melanocytic skin lesions

Background: cyclooxygenase-2 [cox-2] is involved in pathogenesis of various skin tumors including malignant melanoma; however, there is not enough information about cox-2 expression in benign melanocytic lesions. In the present study we compared the expression levels of cox-2 in malignant melanoma and benign melanocytic lesions

Methods: In this analytical study, 42 malignant melanoma from all 4 subtypes and 38 benign melanocytic lesions including dysplastic nevus, Spitz nevus and atypical nevus were evaluated for cox-2 expression using immunohistochemistry staining and intensity of cell staining [quantitatively and qualitatively]

Results: Malignant melanoma compared to benign melanocytic lesions had significantly higher levels of staining [p<0.00l], and much more intense coloration [p<0.00l] and higher overall staining score [p<0.001]

Regarding the cox-2 staining between malignant melanoma subtypes, all four subtypes mostly had staining intensity over 60%. Also in terms of quality, the most intense staining was in the ALM, and LM and NM had moderate staining intensity. With increasing depth of involvement, cox-2 staining increases. Intensity of cell staining was also higher in cases with tumor depth of 2-4 mm

Conclusion: The results indicate the effectiveness of cox-2 in differentiating between malignant melanoma and benign melanocytic lesions, cox-2 expression correlated with the depth of invasion. Although cox-2 alone cannot be used to differentiate melanoma from benign lesions, it can be helpful in combination with other methods, in determining the prognosis and future targeted therapies

Descriptive study of primary cicatricial alopecia in patients referred to the skin clinic of Sina hospital in Tabriz- [1997-2004]

Cicatrical alopecia refers to lesions associated with permanent destruction of hair follicles. Several diseases such as folliculitis decalvans, lichenplanopilaris [LPP] and discoid lupus erythematosus [DLE] may result in cicatricial alopecia. Since cicatricial alopecia is scarring and affects both the appearance and psychosocial behaviours of the patients and also it can be an alarming sign of some systemic diseases, making an early diagnosis and proper treatment can prevent progression and further complications. The aim of this study was to determine the epidemiologic and clinicopathologic characteristics of cicatricial alopecia. A total of 100 patients with cicatricial alopecia were selected from those referred to the skin clinic of Sina hospital in Tabriz for further assessment from 1997 to 2004. Their disease was pathologically proven. All epidermiologic and clinicopathologic data were obtained through questionnaires. The results were analysed by means of descriptive statistical methods. Fifty-two of hundred patients were male and 48 were female. The highest incidence rate was found in 3[rd], 4[th] and 5[th] decades of life. The underlying diseases in descending order were: 30% [24 male, 6 female] had folliculitis decalvans, 25% [10 male and 15 female] had DLE, 18 [6 male, 12 female] pseudopelade of Brocq, 14% [4 male and 10 female] had LPP, 8% [4 male, 4 female] had morphea and 5 [4 male, 1 female] had keloidalis folliculitis. From a histo-pathologic point of view, lymphocytic cicatricial alopecia was more common among middle aged women [65%] whereas the neutrophilic type was more prevalent among middle aged men [35%]. The ratio of lymphocytic to neutrophilic cicatricial alopecias was 2/1. Considering the high incidence of cicatricial alopecia, early stage diagnosis by biopsy and proper treatment will reduce further progression and especially alleviate psychosocial disturbances