جستجوی مقالات مرتبط با کلیدواژه "ضایعات پوستی" در نشریات گروه "پزشکی"

Immunosuppressive drugs that are widely used to prevent acute and chronic organ rejections, predispose organ transplant patients to a variety of diseases including skin problems. This study aimed to determine the prevalence of skin lesions and to investigate their association with demographic characteristics in renal transplant patients.

This cross-sectional study was performed on 100 patients who were referred to the nephrology clinic of Baqiyatallah Hospital, Tehran, Iran and underwent kidney transplantation within a year (from the first working day of the Iranian Hijri calendar in April 2015 until the last working day in March 2016). Patients were referred to a dermatologist in case of any skin lesions. Patients' data were collected in a researcher-made questionnaire and were analyzed using SPSS software, version 18. The p values less than 5% were considered to be significant.

The mean and standard deviation (SD) of the patients' age was 50/4±11/8 years.  The average time of incidence of skin lesion after transplantation has been 8/1 ± 5/7 weeks. The most common types of non-melanoma cancers were squamous cell carcinoma (2%) and Kaposi's sarcoma (4%) and there was no significant difference between men and women (p>0.05). Sixty-six percent of the patients had skin infections and the most common skin infections were wart (34%) and tinea versicolor (11%). The relative frequency of skin infections was significantly higher in male patients than in females (p=0.004). Considering all other confounding variables including smoking, hypertension, diabetes and other infectious diseases, the only noteworthy finding was the higher relative frequency of tinea versicolor in diabetic compared with non-diabetic patients (p=0.046).

This study showed that skin complications including various neoplastic (Sarcoma and Carcinoma), infectious (fungal and viral), and other (Acne and Hypertrichosis) diseases are common in patients with kidney transplantation who are taking immunosuppressive drugs. Informing these patients and medical staff about skin problems leads to an early referral of patients and increases their life expectancy and improves their quality of life.

Dermoscopy is an important in-vivo, non-invasive diagnostic technique that allows inspection of morphological features that are not visible with bare eyes. It has an important role in enhancing the diagnostic accuracy of skin lesions. The aim of this study is evaluation of the use of dermoscopy in diagnose of malignant skin lesions and premalignant skin lesions.

This prospective observational study conducted on 240 patients with clinical diagnosis of malignant or pre-malignant skin lesions. All the patients were evaluated with dermoscopy and histopathology. Dermoscopic results were compared with histopathologic findings as the gold standard for diagnosis of skin lesions.

Of the 240 skin lesions, 69 (28.8%) were benign, 75 (31.3%) were pre malignant and 96 (40.0%) were malignant. The concordance between dermoscopic results and histopathological findings was 75.4%. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of dermoscopy in diagnosis of malignant lesions were 85.42%, 70.59%, 79.27%, 80.40%, 77.42% and 79.27% respectively, p < 0.0001. These items for pre-malignant lesions were 66.67%, 70.59%, 71.43%, 65.75% and 68.54% respectively.

The sensitivity and specificity of dermoscopy in diagnosis of skin lesions were high, therefore this real-time non-invasive technique can be introduced as a routine diagnostic tool in dermatological examination and can minimize unnecessary invasive biopsy.

Diabetes mellitus (DM) is the most common of the endocrine disorders characterized by hyperglycemia. Diabetes mellitus affects every organ of the body including the skin. Skin lesions have negative impact on quality of life of diabetic patients and it is also very frustrating for both patients and their physicians. The pathophysiologic mechanisms of skin lesions are mainly unknown.The aim of this study was to evaluate the frequency of skin manifestations in this patients. A cross sectional study was performed on 700 patients attending to the diabetes clinic. The Institute ethical clearance was obtained before the start of the study.A complete cutaneous examination was done in all cases. A detailed dermatological examination was carried out by a consultant dermatologist and cutaneous findings were recorded. Relevant microbiologic and histopathological investigations were done whenever they were necessary to diagnose the cutaneous disorders.Statistical analysis was carried out by using t- test and Chi-square test. Seven hundred patients(73% women and 27% men)were enrolled in the study.Diabetic skin manifestations were detected in 94.5% of diabetic patients.The most common skin lesions were cherry angioma (37%),skin tag (32%) and eczema (32.8%).Our study showed a significant difference between the involvement by skin lesions and duration of diabetes (P=0.05) and age of patients (P=0.03) but it didn,t show any significant difference between the involvement of skin lesions and HbA1C Our study showed that the skin lesions are common in DM patients and the duration of diabetes and age are positively correlated with skin lesions. For these reasons, education and special attention to medical staff and patients and searching approach to early diagnosis and treatment of skin lesions seem to be necessary.

Mucocutaneous lesions in the oral cavity have similar clinical features andhistopathological examination of the lesions is important for reaching a correct diagnosis. The aim of this study was to assess the concordance between clinical and histopathological diagnoses in mucocutaneous lesions of the oral cavity during 10 years (2003-2012) in Babol Dental School. In this retrospective study, records related to 150 patients with mucocutaneous lesions were analyzed in Babol Dental School from 2003 to 2012. Patient's data including age, gender, location of lesions, first, second and third clinical diagnosis that listed and histopathological diagnosis were recorded. Data analysis was done by SPSS software and Kappa and Mac Nemars tests. Present study showed that in 132 cases (88%) with oral mucocutaneous lesions, there was agreement between clinical and histopathological diagnoses. This concordance was 96.4% about lichen planus. Regardless of a case of lupus that clinically was not diagnosed, the highest percentage of inconcordance was found about lichenoid reaction in 53.3% of cases. In order to reach a more accurate diagnosis of mucocutaneous lesions, clinical and histopathological features of lesions is needed.

Lipoid proteinosis is a rare metabolic autosomal recessive disorder. Clinical manifestations of this disease are attributed to deposition of hyaline material in dermis and other organs which is a consequence of genetic mutations. Hoarseness of voice، beaded papules on the eyelid margins، acneiform scars، waxy papules and warty papules are common clinical manifestations of this disorder. Other manifestations include speech disorder، photosensitivity، recurrent salivary gland inflammation، loss of eyelashes، alopecia of scalp and pruritus. Case report: A 17 year old boy developed hoarseness of voice and mucocutaneous lesions since infancy. Skin lesions included acneiform scars on the face، waxy papules and warty papules on the elbows and buttocks، and also beaded papules on the eyelid margins. The tongue of the patient gradually enlarged and some papules appeared on the tongue and mouth angles. The patient was not able to protrude his tongue out of the mouth. Histopathologic examination revealed deposition of pink amorphous (hyaline) material in the dermis and around skin appendages. Diagnosis of lipoid proteinosis is based on its clinical manifestations and histopathological findings. Once hoarseness of voice in infancy، which is among the most common and earliest manifestations of the disease، is detected، lipoid proteinosis should be considered as an important differential diagnosis.

Many mucocutaneous lesions of the oral cavity have similar clinical features and therefore the histpathologic findings are very important in correct diagnosis and differential diagnosis of each lesion. The aim of this study was to assess the agreement between clinical and histopathologic diagnoses in mucocutaneous lesions of the oral cavity during 30 years (1979-2009) in Mashhad dental School. In this retrospective study, a total of 334 patients with mucocutaneus lesions were analyzed in Mashhad dental school from1979 to 2009. Patient's data including age, gender, location, clinical diagnosis and histopathologic diagnosis were recorded. Data were analyzed through SPSS 11.5 Software. In this study, there was an agreement between clinical and histopathologic diagnoses in 295 subjects (77.5%) with oral mucocutaneus lesions. All subjects with pemphigoid and white spongy nevus showed total agreement between clinical and histopathologic diagnoses. Atrophic and pigmenteted lichen planus also showed the highest percentage of agreement in lichen planus groups. In mucocutaneous lesions, clinical, radiographic, and histopathologic findings are necessary for definitive diagnosis of mucocutaneous lesions.

Illicit drug abuse is a major problem all over the world. The United Nations estimates that 5% of the world population (aged 15-64 years) use illicit drugs at least once a year (annual prevalence). Many adverse effects of the illicit drugs arise on skin and therefore dermatologists and general practitioners should be aware of these changes. This study aimed at evaluating the skin lesions in substance-dependent patients. In a descriptive setting, 66 substance-dependent patients were evaluated during a 16-month period in Tabriz Sina and Razi Hospitals and Sheikholraeis Clinic. Diagnosis of drug abuse was based on DSM-IV criteria. Thorough history taking about the type of illicit drug and the major route of use, as well as a complete physical examination emphasizing the skin lesions were done by a dermatologist. Accordingly, frequency of skin lesions was determined. Sixty six male drug abusers with a mean age of 32.8±8.1 (18-55) years were recruited. The mean duration of drug abuse was 56.3±41.4 (3-204) months. Inhalation (87.9%), oral consumption (13.6%) and intravenous injections (4.5%) were the main routes of drug abuse, respectively. Opiate (63.3%), crystal (24.2%), hashish (21.2%), heroin (19.7%) and crack (12.1%) were the main substances used in the studied population, respectively. The main skin lesions were acne (21.2%), cicatricial lesions (21.2%), atrophic glossitis (18.2%), nicotinic stomatitis (13.6%), burn (9.1%), mycotic glossitis (9.1%), crusted skin lesions (7.6%) and pruritus (7.6%). According to our results, many skin lesions are not characteristic for non intravenous drug abusers. Further studies with larger sample size and in different drugs are recommended.

Acrodermatitis enteropathica is a rare autosomal recessive disorder.The serum zinc levels are usually low in these patients‚ but cases with normal serum zinc level have been reported. The clinical manifestations include skin lesions‚ in particular in periorificial areas‚ and extremities ‚diarrhea and alopecia. These clinical signs may occur together only in 20% of the cases. Other manifestations of the disease are behavior and mood changes ‚failure to thrive‚ susceptibility to infection‚ nail changes and delayed wound healing. Case report: Here we report a case of acrodermatitis enteropathica with a normal serum zinc level. The patient was an 11 month old infant who was reffered to Bassat Hospital with well defined erythematous ‚erosions and crusted skin lesions in perioral‚ perianal ‚ buttocks‚ external genitalia and extremities from 4 months ago. The patient had history of irritability and infrequent episodes of diarrhea. Lab work up revealed a normal serum zinc level of 67µg/dl (Reference range: 60-121 µg/dl). 2 weeks after zinc supplementation‚ the skin lesions improved. Diagnosis of acrodermatitis enteropathica is based on clinical manifestations and this diagnosis is confirmed with a low serum zinc level. But in rare cases with normal serum zinc level and relevant clinical signs ‚we recommend a short term clinical trial of zinc supplementation. Improvement of the skin lesions and other symptoms confirms the diagnosis.

Part of linear polarized light that illuminates skin is backscattered by the superficial layers and rapidly depolarized by collagen fibers and Particles of light scatterer in skin. It is possible to distinguish such superficially backscattered light from the total reflected light. Method and Material: For this purpose, two images are obtained by a system that includes a linear polarizer in front of the camera (analyzer) and a linear polarizer in front of the light source. First image is Ipar that acquire when the passing axis of analyzer is parallel to the passing axis of polarizer. Second image is Iper that acquire when the passing axis of analyzer is perpendicular to the passing axis of polarizer. Image Pol= (Ipar- Iper)/ (Ipar+ Iper) that is based on the polarization ratio is created. It is shown that we can achieve a lower border error percentage in extracting lesion from dermoscopy images using Pol image. Also qualitative Interpretation of Pol image is useful for assessment of skin lesions and review of treatment process.

Introduction & Leishmaniasis is a major worldwide health problem throughout the world and in Iran as well. Skin lesions are mostly healing but nonhealing cases have also increased recently. T-helper type1 (Th1) responses induction helps the patients to resist against the disease while T-helper type2 (Th2) responses cause susceptibility to disease. With the assessment of IL-5, IL-10, IL-12, and IL-18 cytokines secreted from peripheral blood mononuclear cells (PBMC) in leishmaniasis healing and nonhealing patients, their role in curing leishmaniasis was surveyed. Cytokines secreted from PBMCs of 60 healing and nonhealing patients and also control group referred to Ab-o-Bargh number1 clinic and Mashhad Qaem hospital during 2007 were evaluated Elisa commercial kits after stimulation by leishmania antigen and mitogen in vitro. Healing patients PBMCs secreted IL-12 (236.55±38.00 pg/ml) more than non healing patients (p<0.05) while in nonhealing patients IL-5 (52.14±65.21 pg/ml) and IL-10 (30.19±18.73 pg/ml) secreted more than healing patients (p<0.005). Also IL-18 secreted significantly higher in nonhealing patients compared with healing patients (p=0.003). According to the results It can be concluded that IL-12 is secreted more in healing patients than nonhealing patients but IL-18, which causes the increase of IL-12 secretion and the activation of Th1 cells during IL-12 secretion decrease, secrets more in nonhealing patients, induces Th2 responses and results in disease progression.

Diabetes mellitus (DM) is a clinically and genitically heterogeneous group of disorders characterized by abnormally high levels of glucose in blood. The skin is involved both in the effects of acute metabolic changes and in the chronic degenerative compilications of diabetes. Skin lesions are frequently observed in diabetic patients and it is generally stated that about 30% of these patients have cutaneous disorders. The aim of this study was to assess the prevalence of skin lesion in patients with diabetes mellitus referring to dermatology and diabetes clinic of Sina hospital in Tabriz. This descriptive-analytical study was conducted on diabetic patients with skin lesion who referr e d to diabetic and dermatology clinic of Sina hospital of Tabriz during 2003. Data collecting instrument was a questionnaire which included some variables such as age, sex, job, type of diabetes, its duration, control of blood glucose, receiving regular treatment, type of lesion. The questionnaire was filled out for each patient with skin lesion individally. Skin lesions due to burn were excluded from our study. The data were analyzed by SPSS using Chi-aquare and Fisher test. From a total of 500 patients, 80 patients (16%) had skin lesions. 57.5% of these patients was male and 91.2% had type II DM. Mean age of the patients with skin lesion was 56.86±1.54 years and mean diabetes duration was 10.87±0.82 years. Patients over 50 years had the most skin lesion. The most common type of skin lesion in the diabetic patients were 30 cases of necrotic ulcer (6%) and 22 cases of diabetic dermopathy (4.4%) respectively. Other skin lesions such as infection, sclerodermoid, punched out lesions, neuropathic ulcer, diabetic bulla, dermatitis and lichen planus were not common. 97.5% of diabetic patients with skin lesion had poor control of blood glucose. Twelve percent of the patients had some kind of diabetic foot ulcer (Neuropathic Necrotic, punched out and cellulitis ulcer altogether) of which 21.6% underwent amputation. The results showed that rate of skin lesions in diabetic patients is decreased. compared to the past. This may be due to increase of knowledge and attitude of patients regarding diabetes and its complications.

Chemical weapons, which their history dates back to the first world war, refer to any factor that has direct toxic effects on human being, animals and plants. Iraqi regime used chemical weapons and various poisons during the imposed war against Iran of which mustard and nervous gases are examples that their effects are seen in victims even after passing many years. This descriptive cross – sectional study was carried out in2001-2002 to evaluate skin manifestations in 95 chemically wounded combatants of Lorestan province whom were exposed to the chemical weapons during the war. Data was collected by clinical examination and information recorded in a questionnaire. All of the studied cases with mean age of 39.26 years old had skin manifestations among which the most common symptoms were itching, burning, dry skin, scaling. From view point of lesions, the most common signs were erythema (81%), excoriation (87.9%) and pruritic papules (49.5%). Final diagnosis in 78% of the patients was chronic dermatitis and in 7.7% of them was seborrhoeic dermatitis and in 8.8% both chronic and seborrhoeic dermatitis were observed. During exposure to chemical gases only 37.9% of these combatants had used special masks and 40% had properly worn special clothes to protect themselves which covered their body completely, but rest of them had either used protection instruments improperly or had not used them at all. Most of the lesions were in trunk, lower extremities, abdomen, head and neck. 78% of the cases had multiple lesions. Regarding the results of this study all of the chemical wounded combatants of Lorestan province suffer from different degrees of skin lesions, although more than half of them were not aware of kind and nature of the chemical gases, but it is suggested to do further studies on long-term effects of these chemical gases.

The traditional classification of dermatologic diseases is based on etiology and clinical appearance, however, regional approach could be an appropriate alternatrive in clinical or research affairs. The present study was conducted in a dermatologic clinic in Razi hospital, Tehran to determine the frequency of cutaneous lesions of groin area and proposed the importance of a regional approach. This cross sectional study was performed on 3401 patients referring consecutively. Diagnosis was made by clinical and paraclinical studies, if necessary biopsy was also taken. Meanwhile, sex, age and body mass index were all recorded. Of 3401 patients, 3.9% had cutaneous lesions of groin area. Dermatophytosis, erythrasma, and seborrheic dermatitis were reported in 17.2, 14.9, and 14.9% of individuals. Lesions had shown significant differences according to the sex, and type of lesions. Cutaneous lesions of groin area are relatively common. Further regional approach studies are strongly recommended.

Considering the prevalence of skin lesions and drug eruptions in intensive care units and the absence of research about it, we decided to study skin lesions of patients admitted in intensive care unit.

In this descriptive study all patients admitted in intensive care units of Al-Zahra Hospital in Isfahan in 1376-78 were observed and examined by a resident in Dermatology. Skin biopsy and bacterial and fungal smears were done in selected cases. Data were collected, entered in SPSS and analyzed by ANOVA, Chi-square and Discriminant methods.

197 of a total of 406 patients had skin lesions. Skin lesions were most frequent in the age range of 21-40 years (37%) and least frequent in age groups under 10 years (2.5%) and over 80 years (3%). 116 of patients (58.9%) were male and 81 (41.1%) were female. The most common skin lesions were hemorrhagic cutaneous lesions (23.4%) and steroid acne (22.8%). The rarest was toxic epidermal necrolysis (0.5%). The most common causes of hospitalization were intracranial and subarachnoid hemorrhage (11.2% each).

Skin lesions are common in patients admitted in ICUs. Frequent and continuous examinations of these patients are recommended in order to prevent and treat them promptly.

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.

Here are our meditation on the art of attracting, keeping, and helping patients. It contains some sections including “Be professional”, “Be reassuring”, “Be confident”, “Be informative”, “Be smart” and “Be responsive”.