Serum levels of lead and selenium in patients with premature graying of the hair.

BACKGROUND: The exact etiology of premature hair graying (PHG) remains unknown; however, oxidative stress is shown to be involved. Selenium, as an antioxidant, is widely known for its antiaging potentials. Moreover, PGH is more prevalent among addicts and because Lead is a common impurity found in illegal drug. AIMS: We evaluated the serum levels of lead and selenium in patients with PHG and compared it with a control group. PATIENTS/METHODS: In this cross-sectional study, 60 patients referred to Dermatology Clinic of Imam-Reza Hospital of Mashhad, Iran in 2015 were evaluated in two groups with and without PHG. Demographic information and disease characteristics, skin phenotype, and family history of PHG were recorded. Furthermore, 5 mL of brachial blood was drawn for measuring selenium and lead levels. RESULTS: The mean patients' age was 28.1 ± 4.8 years. Age, sex, occupation, and skin phenotype in individuals with and without PHG were not significantly different (P > .05) but family history of PHG was significantly higher in the patients with PHG (P = .001). Similarly, the number of white hairs was significantly higher (P < .001), and the age of onset of hair graying was significantly lower in patients with PHG (P < .001). Serum levels of selenium and lead were not significantly different between two groups (P < .05). However, the serum levels of lead in the patients with PHG were slightly higher. CONCLUSIONS: The results of this study showed that there was no significant difference in lead and selenium serum levels in patients with and without PHG.

Outcomes of Surgical Excision and Brachytherapy in Intractable Keloids.

BACKGROUND: Keloids as unusual scars are injury remnants characterized by bizarre cosmetics and painful itching. This study assessed outcomes of surgical excision and brachytherapy in intractable keloids. METHODS: Six patients with 10 keloid lesions were followed up. Surgical excision was done with 1-2 mm margin, and then radiotherapy was undertaken in 3 divided fractions on days 0, 1 and 2 after surgery. Scar improvement was evaluated by patients and observer with scar assessment scale (POSAS). RESULTS: Median age of patients was 38.3±6.4, while 40% were male and 60% were female. The mean primary size of the lesion before brachytherapy was 325.18±426.16 mm2 and the median size was 153.48 mm2. The mean primary size of the lesions with recurrence before brachytherapy was 150.50±124.78 mm2. The clinical improvement of the scars with POSAS scoring by the observer was 17.1±3.2 and by the patients was 20.8±11.5. In 5 patients who were evaluated, two keloid lesions showed recurrence (20%), and 8 lesions had no recurrence (80%). No patients reported side effects, but only one patient, a 43 years old woman with 5 keloid lesions, suffered wound infection and local dehiscence of the wound, followed by the second session of brachytherapy. The average time of relapse was 26.3±0.9 months. CONCLUSION: The use of surgical resection in combination with brachytherapy was demonstrated as a modality for treatment of refractory keloid scars that can be recommended to surgeons who deal with these patients.

The activity and tissue distribution of thioredoxin reductase in basal cell carcinoma.

PURPOSE: Basal cell carcinoma (BCC) is the most prevalent cancer worldwide. Different mechanisms are proposed to be involved in its pathogenesis such as oxidative stress. Oxidative stress, which is the consequence of the disruption of redox balance in favor of oxidants, is involved in the initiation or progression of many tumors. Thioredoxin reductase (TrxR) is a key enzyme of the thioredoxin (Trx) system, containing Trx and TrxR and NADPH, which is one of the main cellular oxidoreductases with an essential role in cellular health and survival through providing and maintaining redox balance. Therefore, we aimed to study and compare the activity and tissue distribution of TrxR in tumoral tissue and its healthy margin in patients with BCC. METHODS: After biopsy and taking samples from 18 patients, TrxR activity was measured using a commercial kit and its tissue distribution was assessed immunohistochemically. RESULTS: Both the activity and tissue distribution of TrxR in tumoral tissues were significantly higher compared to their healthy margins. Regarding the tissue distribution, this significant increase in TrxR in tumoral tissues was documented based on both staining intensity and abundance of positive cells in immunohistochemistry. CONCLUSIONS: Based on these results, it is concluded that TrxR is involved in the pathogenesis of BCC; however, more investigations are required to clarify whether this increase is a consequence of BCC or it is an initiating mechanism.

Effect of oral photochemotherapy (8-methoxypsoralen + UVA) on the electrophysiologic function of retina.

CONTEXT: Since we had observed electroretinographic (ERG) abnormalities in some patients undergoing photochemotherapy with normal eye examination, we decided to investigate the effects of this therapy on retinal function. OBJECTIVE: To investigate the effects of oral photochemotherapy (8-methoxypsoralen + Ultraviolet-A) on electrophysiologic function of retina. MATERIALS AND METHODS: Patients with vitiligo, psoriasis or eczema were enrolled. Patients with any abnormal eye exam or a positive drug or family history for retinal disease were excluded. Baseline standard ERG was provided with the RETIport32 device. The second ERG was performed 6 months after the first and at least 1 week after the last photochemotherapy session (mean number of sessions: 45 ± 11). The outcome measures were changes in rod response, standard combined response, single-flash cone response, 30-Hz flicker (N1-P1) and oscillatory potentials amplitudes. RESULTS: Forty patients were enrolled; 20 of them (mean age: 31.1 ± 12 years) completed the study. The mean rod response b-wave amplitude decreased from 88.9 ± 47.5 to 86.4 ± 36.6 and standard combined response b-wave amplitude decreased from 266.52 to 261.85 µV (p = 0.422 and p = 0.968, respectively) and the standard combined response a-wave amplitude increased from 155.4 ± 40.0 at baseline to 165.1 ± 48.4 in the follow-up ERG (p = 0.092). The mean single-flash cone response a-wave amplitude decreased insignificantly in the follow-up ERG trace (34.5 ± 13.7 and 29 ± 15.4, respectively, p = 0.242). The mean single-flash cone response b-wave amplitude showed an insignificant increase (p = 0.087). The amplitudes of 30-Hz flicker wave and oscillatory potentials did not change significantly in the follow-up ERG (p = 0.551 and p = 0.739, respectively). CONCLUSION: Since no significant change in ERG traces was observed, oral photochemotherapy seems safe for retinal electrophysiologic function.

The Effects of Aloe Vera Cream on Split-thickness Skin Graft Donor Site Management: A Randomized, Blinded, Placebo-controlled Study .

UNLABELLED:  Purpose. Split-thickness skin graft donor site management is an important patient comfort issue. The present study examined the effects of aloe vera cream compared to placebo cream and gauze dressing on the rates of wound healing and infection at the donor site. METHODS: Forty-five patients were enrolled in this randomized clinical trial and divided into three groups: control (without topical agent), placebo (base cream without aloe vera), and aloe vera cream groups. All patients underwent split-thickness skin grafting for various reasons, and the skin graft donor site wounds were covered with single-layer gauze without any topical agent, with aloe vera, or with placebo cream. The donor sites were assessed daily postoperatively until complete healing was achieved. RESULTS: Mean time to complete re-epithelization was 17 ± 8.6, 9.7 ± 2.9, and 8.8 ± 2.8 days for control, aloe vera, and placebo groups, respectively. Mean wound healing time in the control group was significantly different from the aloe vera and placebo groups (P < 0.005). The healing rate was not statistically different between aloe vera and placebo groups. CONCLUSION: This study showed a significantly shorter wound care time for skin graft donor sites in patients who were treated with aloe vera and placebo creams. The moist maintenance effect of these creams may contribute to wound healing.