[Therapeutic effect of cryotherapy in facial lentigo and junctional nevus]

Superficial pigmented lesions are the most common complaint in dermatology. This study was done to assess the therapeutic effect of cryotherapy in facial lentigo and junctional nevus. In this descriptive study, 100 cases of flat-pigmented lesions with diameters up to 2 mm and after taking a photograph with USB microscope M2 [Scalar] treated with one freeze thaw cycle with liquid nitrogen through an applicator for 2 second in Imam Reza hospital, Mashhad, Iran during 2004-05. The patients were visited 3 times again through 3 successive months. According to the decrease in color of the lesion, patients were divided into 4 groups: sever pigmentation, no response, partial [>50% color loss] and complete response [<50% color loss]. Data were analyzed using SPSS-11.5 and Wilcoxon test. 96% of our patients were female and 4% were male. Mean age was 30 +/- 11.7 years. Based on Fitzpatrick criteria fifteen patients had type 2, fifty had type 3 and 35 had type 4 skin color. After the period of 3 months follow up, 6% of the patients completely healed, 58% had partial response, 31%with no response and 5% develop hyperpigmentation. Response in patients with type 2 Fitzpatrick skin color was clinically better than type 3 and 4 but this difference was not significant. Cryotherapy is considered as a simple, cost effective and safe therapeutic regiment in treating of 64% facial pigmental lesions

Markel cell carcinoma on mustard Gas scar: a case report

Merkel cell carcinoma [MCC] is a rare primary neuroendocrine carcinoma of the skin in elderly individuals, on sun exposed areas of the body, with the head and neck being the most common sites. Excessive ultraviolet exposure may play an etiologic role in the development of it. Exposure to mustard gas can cause skin reactions and increase risk of skin neoplasms and probably MCC. The Aim of this study was to report this interesting case and review the published literature on MCC. In this article a 60 year old man with a history of exposure to chemical warfare sulphur Mustard gas in Iraq-Iran conflict and development of a hemorrhagic nodular mass with a duration of 3 months on his scalp, that based on histology, immunohistochemical staining and was diagnosed as MCC is presented. This was the first reported case of Merkel cell carcinoma in Iran exposed to sulphur Mustard gas. Sulphur Mustard gas can be an etiologic factor for this tumour

[ study of hematologic, hepatic and renal side effects of intramuscular injection of meglumine antimoniate [glucantime] on patients with cutaneous leishmaniasis]

Cutaneous leishmaniasis is an endemic disease in many countries that is caused by different species of Leishmania. Nowadays, standard medication for leishmaniasis is pentavalent antimony compounds that are used intramuscular or intralesional. Though, they are drugs of choice, there are limitations such as hematologic, hepatic, renal and cardiac side effects. This study reviewed hematological, hepatic, and renal side effects of glucantim. The present work was a pre- and post- treatment study on 35 patients with cutaneous leishmaniasis referred to Dermatology Department, Imam Reza Hospital, Mashhad. Their disease was confirmed by direct smear. The patients were treated with intramuscular glucantime 60mg/kg daily for 20 days. Complete blood count [CBC, diff], serum glutamic oxaloacetic transaminase [SGOT], serum glutamic pyruvic transaminase [SGPT], blood urea nitrogen [BUN], creatinine[Cr] were evaluted at 3 times: before treatment, on the 20[th] day of treatment course [last day of injection], and a month after the end of treatment. Demographic, laboratory and treatment results, and drug complications were recorded in a questionnaire. Data were analyzed by descriptive statistics. Of 35 patients in this study, 26 completed the course. Red blood cell count, hemoglobin and hematocrit levels significantly reduced [P<0.05], but no significant difference was shown in white blood cell and platelet count. The increase of serum SGOT and SGPT levels were considerable [P<0.05]. Elevated serum levels of Cr and BUN observed in 11.5% and 34.6% of patients, respectively; and renal side effects were more common in females than in males [64% in females VS 10% in males]. Systemic glucantime is associated with hematologic, hepatic, and renal side effects. Therefore, evaluation of hematologic, hepatic and renal statement in patients receiving glucantim, before and during treatment is suggested

[Psoriasis and infestation with Malassezia]

Psoriasis is a chronic proliferative condition of the skin. Its accurate pathogenesis has not been known yet but interactions between genes and environmental factors have been implicated in its initiation. Although several reports have associated this lipophilic yeast with development of skin lesions in Psoriasis, the definite role of this lipophilic yeast in psoriasis is still undetermined. Our aim was to investigate the correlation between Malassezia and psoriasis. In this six-month's case-control study, a sample was obtained from cutaneous lesions of 50 psoriatic patients and 50 healthy volunteers as control group for evaluation of Malassezia infestation. Data were collected by use of questionnaires and analysed by SPSS software and using statistical tests of X[2] and Mann-whitney. There is no difference between Malassezia infestation in scalp lesions of psoriatic and healthy persons [P=0.86]. Malassezia infestation in psoriatic patients with scalp involvement was more than those without scalp involvement, but this relationship was not statistically significiant [P=0.069]. There is an inverse significant relationship between scalp infestation with Malassezia and chronicity of psoriasis [P=0.04]. Infestation with Malassezia in body skin of psoriatic patients was less than normal persons [P< 0.000]. It seems that Malassezia has an initiating role in inducing immune mechanism involved in pathogenesis of scalp psoriasis by Malassezia, but with chronicity and formation of dry and hyperkeratotic plaques, the environment will be inappropriate for Malassezia, so Malassezia infestation decreases with chronicity of disease

[Prevalence of depression in vitiligo patients]

Vitiligo is a acquired skin disease with prevalence of 1% in the community. In spite of existing different options in its treatment, commonly the course is progressive and the prognosis is unpredictable. In our community with a negative attitude of people to the disease, great burdens of social and familial problems are caused to the patient and these may bring about Psychological disorders. The object of this study is to evaluate the prevalence and severity of depression in vitiligo patients and comparison with normal population according to Hamilton Rating Score for Depression. This is a cross-sectional descriptive Analytical study. 52 vitiligo patients presenting to dermatology clinic of Imam Reza Hospital agreed to participate in this study. The dissemination and extent of their skin disease was determined and their demographic identification recorded. Then, the 24 item questionnaire of HRSD completed. The same was performed for the control group, which were healthy in general and dermatology examination and the same as examination group in demographic identification. In the vitiligo patient group 24 patients [46.2%] and in the control group 3 [5.8%] were depressed. Mean depression score in the vitiligo patients was 17.48 and in the control 5.6. 7.6% of vitiligo patients had a history of suicidal attempt. Also, in vitiligo patients no significant statistical relationship was found between depression score and age, sex, marital state, extent of skin involvement with vitiligo, expose or non-expose skin lesions, and history of consullation with psychiatrist [P> 0.05]. High prevalence of depression in these patients is indicator of an insistent need to collaboration of psychiatrists with dermatologists in the management of this disease

Prevalence of pediculosis capitis in primary shcool girls in mashhad city

Introduction: Pediculosis capitis persists as a health problem in many countries and children are the mostly involved group. There are few studies about it's prevalence and distribution in our community. Our aim was to evaluate the prevalence of pediculosis capitis in a part of society and to detect its relation with age and socio- economic level

Material and Methods: This study was done in primary schools of different areas of Mashhad in 2001-2002. 769 girls between 7 to 12 years of age were examined with random sampling method . The results of examination and information about the age, socio-economic level and clinical signs and symptoms were recorded by use of a questionaire, then our collected data were analysed by using statistical tables

Results: 59 cases of 769 students had pediculosis capitis [Prevalence = 7.6%]. The most common age of infestation was 8 and it was significantly more common in low socio-economic classes than high socio - economic classes. [72/88%, 1/6% respectively]. Most of the cases were in the group of moderate severity [49.2%]. Occiput was the most commonly infested area, and itching was seen in 39% of cases as a major

Conclution: symptom pediculosis capitis is an important health problem in our primary school students specially in low social classes, it seems necessany to examine students by trained people to find infested students

[ study of HTLV-1 seropositivity in vitiligo]

Introduction: Human T-lymphotropic virus type-1 [HTLV-1] is a retrovirus. Its relation to adult I-cell leukemia/lymphoma [ATLL] and HTLV- 1 associated myelopathy/tropical spastic paraparesis [HAM/TSP] has been established. Its relation to other diseases such as uveitis has also been considered. Khorassan, Iran is an endemic area for HTLV-1 [2.3%]. Vitiligo is a relatively common skin disease; autoimmune mechanisms have a causative role in its appearance. Former reports showed that 5% of patients with vitiligo have iritis and 8% of those with idiopathic uveitis have vitiligo. Regarding the association of both vitiligo and HTLV-1 with autoimmune diseases such as idiopathic uveitis, there appears to be a relation between vitiligo and HTLV-1

Methods and Materials: In this study, performed in the spring of 2001, 76 patients with vitiligo were chosen for HTLV-1 serologic testing using ELISA. They had received photochemotherapy in the Dermatology Clinic of Imam Reza Hospital, Mashhad University Medical School

Results: According to the laboratory results, seventy-six ELISA test samples were negative

Conclusion: Regarding previous studies indicating the prevalence of HTLV-1 infection in Mashhad to be 23% and according to the results of this study, there is no significant association between HTLV- 1 infection and vitiligo. If any, it might be weak and not remarkable. For further study of this subject, it is suggested that an investigation of greater sample size be carried out

[Evaluation of the therapeutic effect of dexamethasone rinse [0.1%] on oral lesions of pemphigus and erosive lichen planus]

Introduction: pemphigus vulgaris and lichen planus are one of the important skin diseases which involve oral mucosae, the patients often suffer from extensive and diffuse ulcers in their oral cavity which are refractory to the routine treatment. Mainstay of treatment in these patients is systemic use of corticosteroids which can be associated with side effects such as Hypertension, Hyperglycemia, Osteoporosis, etc. The aim of this study was to evaluate the effects of topical corticosteroid therapy added to systemic therapy to accelerate healing of oral lesions and decreasing systemic use of corticosteroids

Materials and Methods: in this study after synthesis of dexamethasone 0.1% mouth wash [ DM ] [ in Pharmacology School of Mashhad University of Medical Sciences, ], its therapeutic effects on 20 patients with oral lesions of pemphigus vulgaris and erosive lichen planus were evaluated and compared with routine treatment methods

Results: statistical analysis revealed that DM could decrease the pain of oral lesions in pemphigus significantly [P=0.02] and fulfilled patient's demands, but this effect was not significant for lichen planus lesions . DM could not reduce ulcers duration in any of the diseases

Conclusion: since reduction of pain as well as burning of oral lesions could indicate inflammation decrease and initiation of healing, doing additional studies with higher concentration of this mouthwash or longer time use is recommended

Psoriatic arthritis in 300 psoriatic patients in Imam Reza Hospital, Mashhad University of Medical Sciences

In order to study the prevalence of psoriatic arthritis in Imam Reza Hospital and determine the effects of factors like age, sex, familial history, type of skin involvement, nail involvement and duration of disease on psoriatic arthritis, 300 psoriatic patients over a period of 4 years were admitted and examined in the Department of Dermatology and Rheumatology in Imam Reza Teaching Hospital, [MUMS]. A special form was designed for collecting needed data [data collection sheet]. Statistical analysis was done on these data. In the studied population, the prevalence of psoritaic arthritis was 16.6%. The most common involved joints were the wrist and fingers [52%]. Asymmetrical peripheral oligoarthritis was the most prevalent type of joint involvement. Most of the patients were between the 3rd and 4th decades of life. Familial history was positive in 20% of psoriatic patients and 18% of psoriatic arthritis. From a clinical point of view 78% of psoriatic arthritis patients had psoriasis vulgaris. Nail involvement in this group was seen in 72%. Nail pitting was present in 68%. In general, the vulgaris type was seen in 89.2% and nail involvement in only 42.8%. In conclusion, psoriatic arthritis was present in 16.6% of 300 patients with psoriasis. It is recommended that joint and spine exams be performed in all cases of psoriasis, especially those with nail involvement