Refractory port wine stains [PWS]: long pulsed alexandrite laser as an option

Port wine stains [PWS] are congenital vascular malformations. Pulsed dye laser [PDL] is the treatment of choice till now, although many lesions do not respond completely. One of possible options is long pulsed alexandrite laser. Some literatures confirmed its efficacy. The aim of the present study is to determine the efficacy of this laser as an option in treating refractory PWS in Iranian patients. Patients with refractory PWS lesions that did not respond to at least six PDL sessions were included if they had no history of Isotretinoin consumption in past year, history of keloid or hypertrophic scar formation, active infection in laser site and if they were not pregnant. All patients signed an informed consent. Alexandrite laser with fluencies from 36-40J/Cm[2], 12 mm spot size, 3 ms pulse duration and dynamic cooling device tuned to 50/50 ms was used in three successive sessions to treat lesions. All patients photographed before each session and after 8 weeks from the last sessions. Then, pictures were rated by two blinded dermatologist rater to determine degree of response based of visual analog scaling from score 1[below 25% response] to score 4 [more than 75% response]. A total of 20 patients comprised of 12 males and 8 females with mean age of 23 years were included. 35% [7 patients] had score of 1, 35% [7 patients] had score of 2, 25% [5 patients] had score of 3 while one patient [5%] reached score 4. No serious side effect was observed. There was no significant relationship with age, gender and size of lesions and response rate. It seems that considering a conservative approach, long pulsed alexandrite laser may be an effective option in treating refractory PWS lesions. Although future studies with higher sample size using higher fluences are required to confirm these results

Patterns of admissions to a referral skin hospital in Iran

Inpatient therapy in dermatology offers a number of advantages in several ways i.e. careful monitoring of patients' conditions, improvement of their skin lesions under the supervision of trained staff, absence of domestic pressure and increasing the quality of patients' life index. The objective of this study was to describe the patterns of admission for patients with dermatological diseases in Iran. In this retrospective study, data were collected by completing a questionnaire for 481 patients admitted to Razi skin hospital in Tehran during 18 months. The mean age of admitted patients was 44.03 years +/- 19.15. Bullous diseases [39.92%], psoriasis [20.79%], dermatitis [9.56%] and neoplasms [6.65%] were found as the most common reasons for admission. The mean duration of hospitalization was 22.79 days and neoplasms had the highest mean hospitalization period. Patient's admission patterns differ from country to country and there should be prioritizing plans to reach better results

Comparison of the frequency of anti Human T Lymphotropic Virus 1 antibodies in patients with mycosis fungoides and normal controls

Studies concerning the relation between mycosis fungoides [MF] and its leukemic form Sezary syndrome [SS] and infection with human T lymphotropic virus 1 [HTLV 1] have yielded different findings. The objective of this study is to determine the frequency of HTLV 1 infection in MF patients. In a case-control study, 150 clinically and histopathologically confirmed MF patients and 150 normal individuals were evaluated and compared for the HTLV 1 infection. Sera of the participants were taken and evaluated by ELISA method. Positive results were confirmed by Western blot. HTLV 1 infection was detected in 3 of 150 MF patients and 2 of normal participants. This study shows no association between HTLV 1 infection and MF in Iranian patients

[Coexistence of sezary syndrome with kaposi's sarcoma: report of a case with concurrent generalized dermatophyte infection]

Immunosuppression is known to be associated with increased rate of malignancies and widespread dermatophytosis in the patients with sezary syndrome and this may account for the occurrence of Kaposi's sarcoma and generalized dermatophytosis in patients in this report. Herein, we report a 58-year-old farmer man, who admitted with two months history of severely pruritic skin lesions, which progressed to erythroderma. Concurrently some vascular lesions were observed on glans penis off the patient suggestive of Kaposi's sarcoma. Leukocytosis with eosinophilia [20%] and atypical lymphocytosis [More than 10%] were present. Microscopic examination of biopsy of erythrodermic skin lesions on trunk revealed pautrier micro abscess with dermal lymphocytic infiltration and cellular atypia, and the peripheral blood sample showing sezary cells and high ratio of CD4/CD8 [45] lymphocyte were in favor of diagnosis of sezary syndrome. The pathologic evaluation of the vascular lesion of glans penis proved the diagnosis of Kaposi's sarcoma. During the progression of disease, the patient was invaded by generalized dermatophyte infection. KOH smear of annular skin lesion showed mycelia of dermatophyte and culture proved trichophytonrubrum to be the pathogenic agent