C-reactive protein serum level in patients with psoriasis before and after treatment with narrow-band ultraviolet B.

BACKGROUND:: C-reactive protein is an inflammatory biomarker and its level increases in the serum of psoriatic patients. Its level is also associated with Psoriasis Area and Severity Index score. OBJECTIVE:: The aim of this study was to assess the decrement of serum C-reactive protein level with narrow-band ultraviolet B (NB-UVB) therapy. METHODS:: C-reactive protein serum levels in psoriasis patients were measured before and after treatment with NB-UVB and the data were analyzed in relation to the Psoriasis Area and Severity Index score improvement. RESULTS:: Baseline C-reactive protein levels among psoriatic patients were higher than normal. These levels decreased significantly after treatment (P<0.001). At the beginning of the study, patients with higher levels of C-reactive protein also had more extensive and severe skin involvement. The highest decrease in C-reactive protein was observed in patients who responded better to the treatment and achieved a higher Psoriasis Area and Severity Index 75%. There was an association between baseline Psoriasis Area and Severity Index scores and C-reactive protein levels. CONCLUSION:: Patients with moderate to severe plaque-type psoriasis had active systemic inflammation, which was demonstrated by increased levels of C-reactive protein. Furthermore, skin disease severity was correlated with C-reactive protein levels. Phototherapy healed the psoriatic skin lesions and reduced inflammation, while decreasing C-reactive protein levels.

C-reactive protein serum level in patients with psoriasis before and after treatment with narrow-band ultraviolet B

Abstract: Background: C-reactive protein is an inflammatory biomarker and its level increases in the serum of psoriatic patients. Its level is also associated with Psoriasis Area and Severity Index score. Objective: The aim of this study was to assess the decrement of serum C-reactive protein level with narrow-band ultraviolet B (NB-UVB) therapy. Methods: C-reactive protein serum levels in psoriasis patients were measured before and after treatment with NB-UVB and the data were analyzed in relation to the Psoriasis Area and Severity Index score improvement. Results: Baseline C-reactive protein levels among psoriatic patients were higher than normal. These levels decreased significantly after treatment (P<0.001). At the beginning of the study, patients with higher levels of C-reactive protein also had more extensive and severe skin involvement. The highest decrease in C-reactive protein was observed in patients who responded better to the treatment and achieved a higher Psoriasis Area and Severity Index 75%. There was an association between baseline Psoriasis Area and Severity Index scores and C-reactive protein levels. Conclusion: Patients with moderate to severe plaque-type psoriasis had active systemic inflammation, which was demonstrated by increased levels of C-reactive protein. Furthermore, skin disease severity was correlated with C-reactive protein levels. Phototherapy healed the psoriatic skin lesions and reduced inflammation, while decreasing C-reactive protein levels.

Associations between cardiovascular risk factors and psoriasis in Iran.

BACKGROUND: Psoriasis is a common chronic inflammatory skin disease. There is overwhelming evidence on the higher risk of cardiovascular diseases in patients with psoriasis as a result of hyperlipidemia, which is more common in these patients. OBJECTIVES: The aim of this study was to elucidate the association between the cardiovascular risk factors and psoriasis. METHODS: In a cross-sectional study, 55 patients with psoriasis and 55 matched (sex and age) controls were entered the study at the Department of Dermatology between March 2011 and March 2013. Blood samples were obtained following 14 hours fasting status and serum levels of triglyceride, cholesterol, high-density lipoprotein, and low-density lipoprotein were determined using standard laboratory methods, and other variables such as sex, age, smoking, alcohol consumption, and the type of disease were recorded. RESULTS: Our findings showed that levels of triglyceride, low-density lipoprotein, and smoking were significantly higher in psoriatic patients when compared with controls, whereas the level of high-density lipoprotein and cholesterol was not significantly different between two groups. Body mass index of psoriatic patients was not significantly higher than controls. Patients with psoriasis also had an increased prevalence of hypertension. CONCLUSION: Our findings further verify lipid abnormalities in psoriatic patients. Psoriasis is associated with higher rate of hypertension, which may be resulted in increasing the risk of cardiovascular diseases in these patients. Thus, serum lipid profile and blood pressure in all patients with psoriasis, regardless of disease severity, deserve consideration to be checked.

Drug-induced skin reactions: a 2-year study.

BACKGROUND: The aim of this study was to analyze the clinical characteristics of patients with adverse cutaneous drug reactions, which occur when a medicinal product results in cutaneous morbidity. METHODS: The study included 308 patients who were diagnosed as having an adverse cutaneous drug reaction during the study period (2007-2009). In 84 cases, histopathologic examination of skin biopsies were also performed. RESULTS: Patients with drug reactions were found to be more commonly female (63%) than male (37%). Beta-lactam antibiotics were found to be the most frequent cause of adverse cutaneous drug reactions (42.7%), followed by non-steroidal anti-inflammatory drugs (16.5%). Acute urticaria was the most common clinical presentation (59.2%) followed by fixed drug eruptions (18.5%), and maculopapular eruptions (14.9%). CONCLUSION: Adverse cutaneous drug reactions in our study population were mainly induced by beta-lactam antibiotics and non-steroidal anti-inflammatory drugs. The most common forms of cutaneous adverse drug reactions were found to be acute urticaria, fixed drug eruptions, and maculopapular rashes.

Should variation of serum lipid levels be considered a risk factor for the development of basal cell carcinoma?

BACKGROUND: Basal cell carcinoma (BCC) is the most common cutaneous neoplasm in human beings. Ultraviolet radiation is one of the most important predisposing factors for BCC. Although some recent investigations have shown a high serum level of phospholipids in actinic keratosis and BCC, this subject is still debated and needs approval. This study aimed to evaluate the association between serum lipid level and development of cutaneous BCC. MATERIALS AND METHODS: In this case-control study, lipid profile including triglyceride (TG), Cholesterol (CHOL), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) were measured in 30 patients with BCC and 30 healthy controls. Data were analyzed by descriptive statistical tests including t tests and Chi square test. RESULTS: This study shows that the mean age of the case and control groups were 63.93 ± 12.09 and 61.57 ± 21.1 years (mean ± SD), respectively. The average amount of triglyceride, cholesterol, HDL and LDL in the BCC patients were 139.73 ± 69.11 mg/dl, 179.20 ± 43.42 mg/dl, 39.40 ± 9.30 mg/dl and 110.70 ± 34.13 mg/dl, respectively, whereas these amounts in the control group were 141.83 ± 80.41 mg/dl, 173.60 ± 96.32 mg/dl, 36.97 ± 6.35 mg/dl, 110.70 ± 34.13 mg/dl and 104.87 ± 30.85 mg/dl, respectively. No significant difference was found in the lipid profile of the case and control groups (P > 0.05%). CONCLUSION: This study shows that the serum lipid levels in patients with BCC has no significant difference in comparison with the control group and, therefore, relevance between BCC and serum lipid level is not proven. Further studies with a larger sample size are necessary for evaluating this subject.

Association between family history and herpes zoster: a case-control study.

BACKGROUND: There are many risk factors besides age and immune suppression for herpes zoster. Family history as a risk factor is suggested in some recent studies. The aim of this study was to evaluate the association between herpes zoster and family history. METHODS: This case-control study was undertaken in Farshchian Hospital, Hamadan, Iran. "Case group" included patients with confirmed diagnosis of herpes zoster. "Control group" was chosen among other dermatologic patients or their companions without any history of herpes zoster. Immune deficiency was the main excluding criteria. Information about age, gender, dermatome involved (only in patient group), history of chronic dermatologic or systemic diseases and family history of herpes zoster was asked using special questionnaires. RESULTS: Case and control groups included 217 and 200 participants respectively. Mean age of cases and controls was 49.08±15.59 and 49.96±15.54 years old respectively (P=0.936). 53.5% of cases and 54.5% of controls were women (P=0.845). Most frequent dermatomes involved in patients were thoracic (85/217; 39.25%) and cervical dermatomes (55/217; 25.3%). Frequency of herpes zoster in first-degree blood relatives in cases and controls was 65/217 (30%) and 16/200 (8%) respectively (OR=4.91; 95% CI: 2.73, 8.85; P=0.001). CONCLUSIONS: Our findings indicated a significantly higher proportion of patients with family history of herpes zoster comparing to controls. This study confirms family history as a risk factor for herpes zoster. Therefore, the old patients with positive family history of herpes zoster may be appropriate candidates for vaccination with Zostavax. However, more evidence based on large cohort studies in needed to confirm our findings.

Clinico-epidemiological and mycological aspects of tinea incognito in Iran: A 16-year study.

BACKGROUND: Tinea incognito is a dermatophytic infection in which topical or systemic steroids have modified the clinical appearance of the mycosis and mimicking other skin diseases. OBJECTIVES: A large retrospective study was carried out to identify the clinical aspects and type of dermatophytes involved in tinea incognito cases in Iran during 1993-2008. PATIENTS: Out of 6325 subjects suspected to have dermatophytoses, 56 patients (29 males, 27 females, mean age 32.6 years) were affected with tinea incognito. METHODS: The causative agents were identified macroscopically and microscopically after the clinical samples were subjected to potassium hydroxide examination and culture isolation. RESULTS: The most common type of infection was tinea corporis (32.1%), which significantly affected male patients. The prevalence of the other tineas in decreasing order was as follows: tinea faciei (26.8%), tinea cruris (14.3%), tinea manuum (12.5%), tinea pedis (8.9%), and tinea capitis (5.4%). The clinical features were to some extent diverse, ranging from eczema-like, seborrhoeic dermatitis-like, pyoderma-like and folliculitis to alopecia on scalp, trunk and limbs. Trichophyton verrucosum was the most frequently isolated species representing 33.9% of isolates, followed by T.mentagrophytes (28.6%), T. rubrum (12.5%), Epidermophyton floccosum (10.7%), Microsporum canis (8.9%), T. violaceum (3.6%), and T. schoenleinii (1.8%). CONCLUSION: To the best of our knowledge, this is the first broad investigation dealing with tinea incognito in Iran. The etiological agents of tinea incognito in Iran are consistent with those of the general population.

Pachydermodactyly, a new case from Iran.

Pachydermodactyly (PDD) is a rare form of benign digital fibromatosis involving the proximal portion of lateral sides of fingers. It is characterized by asymptomatic and symmetrical soft tissue swellings of the radial and ulnar aspects of proximal PIP joints of second to fifth fingers. Herein we report a 15-year-old boy with this condition.