Iranian Journal Of Dermatology
Volume:18 Issue: 2, summer 2015

Androgenetic alopecia (AGA) is a non-scarring alopecia which consists of miniaturization of the terminal hair under the influence of androgens. Some scholars have reported an association between AGA and coronary artery disease (CAD), probably due to alterations in CAD risk factors. However, this association is not supported by other studies, thus rendering the subject open to discussion. A total of 100 women were enrolled in this study: 50 diagnosed with AGA based on physical examination and 50 agematched controls. BMI as well as serum total cholesterol, highdensity lipoprotein (HDL-C), low-density lipoprotein (LDL-C), and triglyceride were measured. The mean BMI was 25.3±3.5 kg/m2 in the AGA group and 24.2±3.4 kg/m2 in the control group (P=0.11). The mean level of triglyceride, total cholesterol, HDL-C, and LDL-C in the AGA group was 141.7±55.4 mg/dl, 194.9±35.8 mg/dl, 41.1±12.3 mg/ dl, and 129.7±32.6 mg/dl, respectively. These figures showed no significant difference in the control group (P=0.10) It seems that a diagnosis of AGA in female patients is not linked to increased serum lipids.

Vitiligo is a hypopigmentation disorder of the skin that is associated with depression and an impaired quality of life. There has been conflicting reports on the association between the disease and the serum levels of homocysteine, vitamin B12, and folic acid.In this study,serum levels of homocysteine, vitamin B12, and folic acid were evaluated in patients with vitiligo. Thirty patients with vitiligo and 30 age- and sex-matched healthy controls were recruited. Venous blood samples wereobtained from the study subjects and the levels of homocysteine, vitamin B12, and folic acid were measured. Data were analyzedusing non-parametric statistical tests. No significant differences were found in the levels of serum homocysteine, vitamin B12, and folic acid between vitiligo patients and healthy controls. Moreover, there were no associations between these factors and age, body weight, gender,as well as the extent, duration, and type of vitiligo. It seems that vitiligo is not related to serum levels of homocysteine, vitamin B12, and folic acid.

It seems that there are similar associated diseases in psoriasis and Lewis (b) negative phenotypes such as diabetes mellitus, cardiovascular events, and metabolic syndrome. Therefore, we decided to evaluate the frequency of Lewis henotypes in patients with chronic plaque type psoriasis. A limited number of studies have been previously conducted in this regard. Fifty patients and 100 age and gender matched control subjects were selected as the study population. Two milliliter of venous blood was collected from each subject to find out the Lewis phenotype and in subjects with the Le (a-b-) henotype, saliva was collected to determine the secretory status. All individuals with the Le (a-b-) phenotype were typed as non-secretor in their saliva by the hemagglutination inhibition assay; therefore, in this study, Lewis (b) positive individuals were considered as secretor and Lewis (b) negative as non-secretor phenotypes. There was a significant difference in the secretory status or Lewis phenotypes between the two groups. ABH on-secretory status Le (a-b-) and Le (a+b-) together or Lewis b negative phenotypes were found in 78% (39 of 50) of the patients and 26% (26 out of 100) of the healthy controls (P<0.0001). The Le (a-b-) phenotype regardless of the secretory status was found in 14 patients with psoriasis (28.0%) and five healthy controls (5.0%), indicating a statistically significant difference (P≤0.0001). Individuals with Lewis b negative phenotypes or non-secretors are at risk of developing psoriasis. Inheriting Le/b antigen may have a protective role in patients with psoriasis.

Genital warts, the most common sexually transmitted disease (STD), are caused by human papillomavirus (HPV). Few studies have been performed on Iranian women with genital warts or cervix cancer but there isno documented data about genital warts and HPV genotyping in Iranian men. In this study, we determined HPV genotypes in 108 male and females with anogenital warts in an STD clinic in Tehran. In this cross sectional study, HPV genotypes were determined by the PCR method in 108 males and females with anogenital warts who were visited at an STD clinic in Tehran within January–June 2012. Age, sex, number of sexual partners, education level, and marital status were recorded in the questionnaires. We determined HPV genotypes in 108 patients including 36 men and 72 women. The mean age of the patients was 31.5±12.3 years. The most common type was type 6 (62%). Other common genotypes were 11 (28.7%), 18 (15.7%), 16 (14.8%), 31 (4.6%), 33 (0.9%), 51 (0.9%), 56 (0.9%), and 66 (0.09%). We found that genotypes 16 (P=0.003) and 31 (P=0.013) were more prevalent in the patients with a higher number of sexual partners. In addition, there was a statistically significant association between the number of sexual partners and multi type HPV infection (P=0.045). Genotypes 16 (P=0.036) and 11 (P=0.039) were significantly associated with the female gender. Our results showed that HPV 6 was the most prevalent HPV type followed by HPV 11, 18, and 16.

Some studies have reported a correlation between adnexal tumors and human papilloma virus (HPV) infection. We performed this study to determine the incidence of HPV infection in adnexal tumor samples to further clarify any potential link between HPV and the pathogenesis of adnexal tumors. A total of 65 formalin-fixed, paraffin-embedded, tissue samples with a histopathologically confirmed diagnosis of adnexal tumors, obtained between 2006 and 2011, were retrieved and evaluated by polymerase chain reaction (PCR) for the presence of different types of HPV. The samples included 29 sebaceous gland tumors, 18 sweet gland tumors, and 18 follicular epithelium tumors. The HPV DNA was only detected in four out of 18 sweet gland tumors (22.2%), i.e. in 6.2% of all evaluated tumors. HPV-6 and HPV-54 were detected in one and three samples, respectively. Considering the low rate of HPV in adnexal tumors, the probability of an association between HPV and adnexal tumor seems slim.

Verrucous hemangiomas (VH) are uncommon, congenital vascular malformations of the cutaneous and subcutaneous tissues that spare the deeper subfacial structures. VH usually presents at birth and slowly grows with age. It usually presents as hyperkeratotic, scattered, bluish-red plaques or nodules of various sizes. Although the lesions mostly have a linear pattern, serpiginous and reticulate forms can occur that are unusual. We present a case of a 27-year-old male with linear angiomatouslesions over his right leg.

Parameatal urethral cysts are a rare benign condition usually seen in males. They are usually asymptomatic but may produce symptoms like difficulty in micturition, pain during intercourse, urinary retention and distortion of the urinary stream. We report a case of parameatal urethral cyst in a 17 year old male presenting as a spherical clear fluid filled cystic lesion measuring about 0.8 cm in diameter at the external urethral meatus, causing distortion of the urinary stream and poor cosmesis. Complete surgical excision of the cyst was done and no recurrence was observed at 6 months of follow-up.

Juvenile xanthogranuloma (JXG) is an uncommon histiocytic cutaneous lesion. It is a type of non-Langerhans cell histiocytosis(WHO Class IIb). The mean age of onset is 2 years of age. The adult form of JXG is relatively rare. The most common affectedarea is the face or the scalp and most of the lesions are less than 5 mm in diameter. This lesion tends to show a self-limited course over several months to years. However, large size JXG can have an atypical course or create cosmetic problems. Therefore,excision is considered in such lesions. We report an adult form of JXG that presented as an asymptomatic solitary tumor witha rapid growth on the nose of a 16-year-old boy. Routine microscopic histopathological evaluation of the patient’s skin biopsy showed numerous eosinophils and Touton giant cells. Immunohistochemical evaluation was positive for CD68 and factor XIIIa. We performed extended excision to prevent recurrence and the tumor did not recur after resection.

Nevus comedonicus is an uncommon variant of adnexal hamartoma and is considered a rare subtype of epidermal nevi. It was first described in 1895 by Kofmann who used the term “comedo-nevus”. It manifests as a group of closely dilated follicular openings with dark keratin plugs resembling comedones. Both unilateral and bilateral distributions are seen. The face is the most commonly affected site followed by the neck, the trunk, and the upper arms. We report a case of a 25-year-old male who presented with linear keratotic papules which on histopathology was confirmed to be nevus comedonicus. Our case was interesting because of its large size and of its multidermatomal involvement affecting the chest, back, and arms.

‘En coup de sabre’ is a form of localized scleroderma (also known as morphea) characterized by sclerotic lesions distributed in a linear, band-like fashion on the frontoparietal scalp and forehead. In some cases, skin lesions may extend to thenose, cheek, upper lip, chin, and neck. Herein, we describe a unique case of en coup de sabre in a 32-year-old female which has not been reported before to the best of our knowledge.