r .yaghoobi

Pretibial epidermolysis bullosa is a rare variant of hereditary epidermolysis bullosa characterized by the delayed onset of lesions and their localization. We present two cases, a 35-year-old woman and a 21-year-old man. They clinically had pruritus, nodular prurigo-like or lichenified lesions, violaceous scarring, milia, nail dystrophy and in one case albopapuloid lesions on the trunk. Physical signs of disease were first noticed between 3 and 9 years of age. Histologic examination showed a subepidermal blister with milia formation, and a mild mixed inflammatory infiltrate. These patients represent an nusual, poorly recognized form of dystrophic epidermolysis bullosa with features that resemble a variety of acquired dermatoses.

The incidence of oral cancers is different worldwide.

To evaluate the rate of oral cancers in Khouzestan Province.

The data were collected from the pathologic reports of pathology laboratories all around the province, during the time period of 1992-2002.

Among the total received specimens, 305 cases of oral cancers were detected. One hundred ninety-three cases (63.2%) were male and 112 cases (36.8%) were female. Male to female ratio was 1.7 and mean age was 55.04±16.60 years. Squamous cell carcinoma was the most common malignancy (75% of total), and then standed the nasopharyngeal carcinoma (10.8%) and lymphoma (7.5%). The most common sites were lower lip (29.2%), tongue (19%) and nasopharynx (15.7%).

Regardless of some minor differences, most of our findings were similar to other previous studies.

Plexiform neurofibroma is a rare variant but pathognomonic of von Recklinghausen disease. We report an uncommon presentation of neurofibromatosis type I in a girl. This 11-year old girl had multiple plexiform neurofibromas on her left hand, and also several Lisch’s nodules. Classification and clinical features are discussed briefly with emphasis on the possibility this condition may not be given sufficient consideration.

Systemic lupus erythematosus (SLE) is an autoimmune disease in which cutaneous lesions occur in 72%-85% of patients.

This study was conducted to determine the pattern and incidence of skin lesions in SLE patients in Ahwaz.

Thirty patients with SLE fulfilling the clinical and laboratory criteria of the American Rheumatism Association who were admitted in Sina Hospital in Ahwaz from December 1989 to September 1999, were studied.

Skin findings included: Malar rash (70%), mucosal lesions (70%), non-cicatricial diffuse alopecia (63.3%), nonspecific skin rash (56.6%), photosensitivity (53.3%), nail involvement (40%), pigmentary changes (33.3%), dry skin and edema of extremities (16.6%), Raynaud’s phenomenon, discoid eruption, bullous lesions (13.3%), periorbital edema, urticaria, palmar erythema, scarring alopecia and cutaneous vasculitis (10%), chillblain and psoriasiform lesions (6.6%) and livedo reticularis (3%).

Skin changes are prominent in SLE and may provide helpful diagnostic information. A different clinical pattern from previous reports was noted in our patients.

Pemphigus is an autoimmune disease characterized with intra-epidermal cleavage.

The aim of this study was to examine the clinical and epidemiologic features of pemphigus in Khouzestan province, southwest Iran. Patients and

All new cases of pemphigus admitted in the department of dermatology, Sina Hospital, Ahwaz University from October 1990 to September 1999 were studied. The diagnosis of pemphigus was based on clinical and histological findings.

One hundred-eleven pemphigus patients represented 4.7% of 2358 patients admitted to this department in this period. The most common presentation was pemphigus vulgaris (81.98%), followed by pemphigus foliaceous (18.02%). Pemphigus was observed more common in women (62 of 111; 55.86%) than in men (49 of 111; 44.14%). The mean age of all variants of pemphigus and in both sex at the time of diagnosis was 42.5 years. The lag time between the onset of illness and final diagnosis in pemphigus vulgaris and pemphigus foliaceous were 4 and 9 months, respectively. In pemphigus vulgaris patients, the onset of lesions were 54.65% and 45.34% from mucous membranes (Mainly oral cavity) and skin in 54.65% and 45.35% of cases, respectively. In all of pemphigus foliaceous patients, the onset of lesions was from the skin. The mortality was 6.30%, more in pemphigus foliaceous than vulgaris.

This study showed that pemphigus is relatively common in Khouzestan province, compared with other regions. Pemphigus vulgaris is the most common variant and mortality was higher in pemphigus foliaceous.

A 37-year-old woman with Klippel-Trenaunay syndrome who developed malignant melanoma on the limb affected the vascular malformation, is reported. The observation and nature of this association or coincidence is discussed.

Mycetoma is a chronic, progressive, and destructive disease primarily caused by actinomycetes. This is a report of 4 cases of actinomycotic mycetomas studied in our hospital during the last five years. The patients included 2 men, 56 and 42 years old, and 2 women, 31 and 52 years old, from Khuzestan province located in the south west of Iran. Clinically all patients presented with mycetoma syndrome (Subcutaneous swelling, sinus tracts and granules) with a duration of 3 to 20 years. The lesions were located on the foot in 3 cases and on the hand in one of them. The diagnosis was based on clinical, histopathological and mycological studies. The etiologic agents were Nocardia spp, sterptomyces spp. and actinomyces spp. and one of cultures was negative. All of them were treated with trimethoprime-sulfamethoxazole (TMP-SMZ) plus streptomycin sulfate for several months. We were able to obtain clinical cure in one case and clinical improvement in 2 cases. Early diagnosis favored an efficient therapy and the most effective therapy was combination of TMP-SMZ with streptomycin sulfate.

Helicobacter pylori is probably the commonest bacterial infection worldwide and is now accepted as the cause of gastritis, peptic ulcer, gastric carcinoma, and gastric lymphoma. In the last few years, besides the local gasteroduodenal tissue damage, an association between H.pylori and various extra-intestinal pathologies had been described. Recent studies have suggested that H.pylori infection may be associated with various skin disorders such as idiopathic chronic urticaria, Raynaud’s phenomenon, systemic sclerosis, rosacea, Sweet’s syndrome, Henoch-Schonlein purpura, psoriasis, and atopic dermatitis. In this paper we review the current knowledge on Helicobacter pylori infection and its relevance for skin diseases especially its clinical pathophysiological aspects.

Trichoadenoma is a rare skin tumor first described by Nikolowski. There are variable clinical features and tumors have been diagnosed as cysts, basal cell epithelioma and seborrheic keratosis. The microscopic feature mainly consists of numerous cysts surrounded by eosinophilic cells. Trichoadenoma is benign and treatment is by simple excision. We report a case of trichoadenoma on the nose of a 46-year-old man present for 2 years.

Cutaneous leishmaniasis is a parasitic infection prevalent in many areas. The parasitic agent is usually transmitted by Phlebotomous sp. Lip leishmaniasis is a type of cutaneous leishmaniasis, which has rarely been reported. In a retrospective study performed in Ahwaz, center of Khuzestan province, southwest of Iran, 2861 patients were detected during 1986-1996. Seventeen of these patients (0.59%) had lower or upper lip leishmaniasis. The patients, age ranged from 3 months to 40 years. Duration of infection was 2 to 4 months. Eleven patients had only lip lesions whereas 6 patients had one or more skin lesions elsewhere. The appearance of lesions differed from nodules to crusted ulcers, usually observed on the vermilion border. Most of the cases failed to respond to topical or systemic antibiotic therapy. The diagnosis was based on the demonstration of Leishman bodies in Giemsa stained smears.