skin diseases

Skin diseases can have a profound negative impact on the lives of adolescents, leading to emotional distress, social isolation, and reduced self-esteem. This study aimed to investigate the relationship between family leisure, mindfulness, and quality of life in adolescents with skin diseases. In this descriptive-correlational study, the statistical population included all adolescents with skin diseases who referred to hospitals and specialized skin centers in Babol city in 2023. A total of 206 adolescents were selected as the sample. The tools used in this study included the Teenagers' Quality of Life (T-QoL) Questionnaire to assess quality of life, the Family Leisure Scale to measure family leisure, and the Five Facet Mindfulness Questionnaire (FFMQ) to evaluate mindfulness. The data were analyzed using the Pearson correlation coefficient and stepwise regression. The study included 206 adolescents with an average age of 16.25 years. The sample was fairly evenly split between genders, with slightly more females (51.46%) than males (48.54%). The results showed that family leisure had a positive and significant relationship with quality of life (P < 0.001). Mindfulness also had a positive and significant relationship with quality of life (P < 0.001). Family leisure and mindfulness predicted 27.0% of the variance in quality of life in adolescents with skin diseases, with mindfulness having a greater influence on predicting their quality of life. The study found that both family leisure and mindfulness positively impact the quality of life of adolescents with skin diseases. However, mindfulness appears to have a stronger influence on their well-being. The researchers suggest incorporating these activities into clinical interventions and therapeutic approaches to improve the overall health and well-being of these adolescents.

Skin diseases are alarmingly prevalent and significantly burden public health. This study aimed to investigate the economic burden arising from skin diseases among patients in the dermatology department.  

This cross-sectional study was conducted on 362 patients with skin diseases referred to Razi Educational and Medical Center, Guilan University of Medical Sciences, Rasht, Iran. Data of patients was recorded, and the economic burden, hospitalization cost, and disability-adjusted life year (DALY) were calculated based on the visual analog scale (VAS), time trade-off method (TTO), and TTO-10 years.  

The mean hospitalization days was 25.56±1.81 and pemphigus was the most prevalent skin disease (20.71%), followed by dermatitis and psoriasis (11.32% and 11.04%, respectively). The mean total hospitalization cost was 600,025±400,023 Rials, resulting in a total cost of absence from work of 80,404,000±305,000 Rials. The analysis of DALY and economic burden revealed that the highest costs were associated with the TTO method for both DALY and hospitalization. The length of stay showed a significant association with hospital cost, economic burden, and DALY.  

Economic burden of skin diseases in Guilan province, Iran, was influenced by hospital stay length and disease severity. While it might not be high compared to the global average, the study highlights significant costs associated with skin diseases.

Demodex spp., a cosmopolitan mite, can exist as a commensal or parasitic organism. This study aimed to investigate the prevalence of Demodex spp. infestation in patients with common skin diseases and explore the potential association between demodicosis and these conditions in Urmia, northwest Iran.

A total of 246 patients attending the Skin Polyclinic of Iranian Urmia Taleghani Hospital were enrolled in the study. Samples were taken from the nose wings, cheeks, and forehead regions of the face area of the persons using the standard superficial skin biopsy method.

Demodicosis was detected in 43 (16.3%) patients, with 42 cases attributed to D. folliculorum and 1 case to D. brevis infestation. The highest positivity was found in the 31‒50 (21.4%) and 51‒72 (22.2%) age groups. In the rela tionship between demodicosis and skin diseases, Demodex spp. was found in 13 (32.5%) of 40 patients who had skin disease; 6 of these patients with rosacea (42.9%) and 7 with eczema (29.2%). Mite infestation was found in 6 (37.5%) of 16 patients who had hemodialysis due to renal insufficiency. Furthermore, 46.7% of positive patients reported using common goods. The prevalence of demodicosis was similar among patients residing in villages (17.2%) and cities (17.6%).

This study sheds light on the potential association between Demodex infestation and common skin diseas es such as rosacea and eczema in Urmia, Iran. Therefore, there is a pressing need to augment research endeavors on de modicosis.

Diet plays a critical role in the maintenance of various physiological functions in cutaneous structures. Inadequacy of a well-balanced diet gives rise to a constellation of skin manifestations, which are frequently mild and non-specific; hence, overlooked or misdiagnosed. However, it can lead to serious complications. This group of dermatoses affects both developing and developed countries. Children, in particular, are more prone due to increased demand for nutrients for growth and development, as well as negligence or inability to provide by the caretaker. The dermatologist might be the first physician to come across such patients since cutaneous features are more apparent. Hence, a strong clinical suspicion for multiple micro- or macronutrient deficiencies should be maintained since many conditions may have overlapping presentations such as xerosis, periorificial and intertriginous dermatitis, photo-distributed dermatitis, seborrheic dermatitis-like lesions, follicular hyperkeratosis, intracutaneous hemorrhages, impaired wound healing, pigmentary changes, and others including mucosal manifestations and hair and nail changes. This review article discussed an approach to nutritional dermatoses in the pediatric age group to aid in accurate diagnosis and timely treatment.

Based on research, acne vulgaris is associated with a high prevalence of attention deficit hyperactivity disorder (ADHD).

This study investigates the comorbidity of ADHD and acne vulgaris in individuals with acne vulgaris who were referred to the Razi Dermatology Specialist Clinic and Beesat Clinic of Guilan University of Medical Sciences, Rasht City, Iran, in 2021.

This case-control study includes 85 individuals with acne vulgaris and 85 without acne vulgaris. The Conners’ adult ADHD rating scales (CAARS) were used to evaluate ADHD symptoms. The study data were analyzed with SPSS software, version 24 at a significant level of <0.05.

The Mean±SD age of the study participants was 35.12±13.19 years, and 64.1% of them (n=109) were women. Of the total participants, 7.6% had ADHD, and the frequency of ADHD in individuals with acne vulgaris compared to controls was 8.2% vs 7.1%, and this difference was not significant (P=0.773). The frequency of ADHD and the mean score of ADHD in individuals with acne vulgaris were higher in those aged ≤30, women, and severe types of acne, but this difference between the two groups was not statistically significant (P>0.05).

Our findings showed no statistically significant difference between subjects with acne vulgaris and the control group in the score and frequency of ADHD. Also, we found no statistically significant difference in the score and the frequency of ADHD based on the severity of acne vulgaris.

With the emergence of the coronavirus disease 2019 (COVID-19) pandemic, many people were affected worldwide.This study evaluated patients’ characteristics and skin diseases at a Dermatology Emergency Unit (DEU) of a university skin hospital in Tehran, Iran, during the COVID-19 pandemic. We also compared the results with those of a previous study performed at the same DEU in 2017. The data of all patients presented to the DEU during the first four months of the pandemic in Iran (February to June 2020) were studied, and variables such as age, sex, complaints, and finaldiagnosis were collected. A total of 3,745 patients (50.3% male) were studied. Infections (32.4%), dermatitis (20.5%), and urticaria (16.8%) were the most prevalent diagnoses in both genders. Infections were significantly more frequent in males (P < 0.001), while urticaria was more common in females (P < 0.001). The highest number of visits occurred between 12:00–18:00 (34.0%) and most patients were between 18–44 years old (48.8%). With the growing number of COVID-19 cases, the DEU of our skin hospital was involved as part of the medical community in screening COVID-19 patients. Compared to the previous study, the general framework of common causes of DEU visits was very similar to that of the non-pandemic era, although a significant increase in the proportion of dermatitis cases was observed. Likewise, the proportion of non-skin complaints was significantly higher, reflecting the public concern about the COVID-19 pandemic.

Aplasia cutis congenita (ACC) is a rare condition regarded as a congenital absence of the epidermis, dermis, and in some cases, subcutaneous tissues in the newborn. The pathogenic mechanism is unclear, although the condition has been described as a result of the disrupted development or degeneration of skin in utero. ACC may be observed with fetus papyraceous (FP).

We report a case of an 8-hour-old newborn female with bilateral symmetrically distributed, stellate type of truncal ACC at birth. She was the survivor twin as the other fetus died at 13wk+3d gestation. This condition describes ACC with FP. Physical examination showed otherwise normal and managed with no other congenital abnormalities. The newborn was treated with antibacterial ointment and antibiotics, and lesions resolved spontaneously within 5 days, leaving scars.

This report explained a newborn with type V cutis aplasia congentia in whom the detection was approved based on the revision of antenatal history and clinical features. The protocol outcome revealed that the topical and systemic antibiotic and washing with normal saline could be an effective treatment for the healing of ACC lesions. Follow-up after 3 months indicated that the skin lesion completely healed, leaving a very small atrophic scar, and no further lesion management was required.

In the age of development and efflorescence, Islamic medicine was founded on the principle of four temperaments; therefore, the prevalence of various diseases and their treatment methods were carried out based on the view mentioned above, namely,  temperament balance loss. According to available resources, it is clear that the recognition and treatment of some dermatoses, such as warts, were affected by this view. Warts are a common dermatosis that is discussed from various aspects and problems based on the four temperaments as perceived by doctors in Islamic civilization.  Despite the big misunderstanding in identifying the origin of this disease, mainly due to the lack of required technology and lack of accurate tools, Muslim physicians, unbelievably, were able to accurately examine and explain the type and location of their occurrence. Furthermore, the physicians could adopt appropriate treatment based on their type, extent of infection, and location. It is important to keep in mind that, with some advancements in technology and medicines, most of the treatments and medications that were widely used until the end of the 20th century can be modified to work in modern medicine.

Vitiligo is the most common cause of skin depigmentation, which relates to a wide range of psychological disorders. Stigma is defined as a negative attitude towards oneself that results from one's perception of being different from the general population. In this study, we have evaluated the quality of life and stigmatization degree among vitiligo patients. In this cross-sectional study, 323 patients with vitiligo referred to Razi Hospital, Tehran, Iran, were evaluated. All patients were asked to fill out a questionnaire containing age, gender, marital status, educational level, employment status, duration of vitiligo, location of lesions, history of underlying diseases, history of previous treatments, as well as history of depression or suicide. Quality of life and stigmatization among patients were assessed by DLQI (dermatology life quality index) and FSQ (feeling stigmatization questionnaire) questionnaires. The prevalence of moderate and severe stigmatization were 49.8 % and 13.3%, respectively. Women were significantly more stigmatized than men. The presence of vitiligo lesions on the face, hands, or forearms, previous topical and oral treatments, and prior depressive disorders were significantly associated with an increased sense of stigma. Patients with thigh or trunk lesions faced less stigmatization. Additionally, stigmatization was meaningfully related to the level of quality of life impairment. In the present study, 63% of patients with vitiligo experienced moderate to severe stigmatization levels related to gender, lesion site, history of prior treatments, and depression. Moreover, there was a significant correlation between the level of stigma sensation and the life quality disturbance.

Sa’fe disease is one of the skin diseases that has caught the attention of physicians of the Islamic ages. An ulcer on the head with small and scattered pimples has been regarded as the most significant symptom of this disease, sometimes making the patient’s face red. Generally, the condition is classified into two categories, dry and wet, with specific symptoms and treatments. The most significant signs of this disease include dry ulcers on the scalp and much dandruff, sometimes leading to baldness. The general treatment of this disease, which primarily affects the head and sometimes the face, includes blood collection in leprosy, cupping and leech therapy, regular washing with medicines and preparation of all kinds of poultices and oral medication. It should be noted that it is more common on the head and sometimes on the face. This disease is more prevalent in children than adults. Accordingly, this study was conducted to explain Sa’fe condition and mention the various symptoms and treatments stated in Islamic medical sources to remove this disease using the library method.

To the best of our knowledge, we are reporting the first case of psoriasis vulgaris in which the lesions became extensive with marked itching and resistance to traditional lines of treatment after the use of tramadol. Thus, tramadol may be a new drug exacerbating psoriasis vulgaris that should be avoided. Tramadol increases the severity of psoriasis vulgaris and induces marked itching in these patients.

Skin and soft tissue infections are important causes of outpatient visits to medical clinics or hos-pitals. This study aimed to review the literature for the accuracy of Clinical Resource Efficiency Support Team(CREST) guideline in management of cellulitis in emergency department.

Studies that had evaluatedcellulitis patients using the CREST guideline were quarried in Scopus, Web of Science, and PubMed database,from 2005 to the end of 2020. The quality of the studies was evaluated using Scottish Intercollegiate GuidelineNetwork (SIGN) checklist for cohort studies. Pooled area under the receiver operating characteristic curve (AU-ROC) of CREST guideline regarding the rate of hospital stay more than 24 hours, rate of revisit, and appropriate-ness of antimicrobial treatment in management of cellulitis in emergency department was evaluated.

Seven studies evaluating a total of 1640 adult cellulitis patients were finally entered to the study. In evaluation ofthe rate of the appropriate treatment versus over-treatment, the pooled AUROC was estimated to be 0.38 (95%confidence interval (CI): 0.06 – 0.82), indicating low accuracy (AUROC lower than 0.5) of guideline for antimicro-bial choice. CREST II patients had a significantly lower odds ratio (OR) of revisiting the Emergency Department,OR=0.21 (95% CI: 0.009 – 0.47). Pooled AUROC value of 0.86 (CI95%: 0.84 – 0.89) showed accuracy of the CRESTclassification in prediction of being hospitalized more or less than 24 hours.

CREST classificationshows good accuracy in determining the duration of hospitalization or observation in ED but it could lead toinevitable over/under treatment with empirical antimicrobial agents.

Psoriasis is a relatively common inflammatory skin disease characterized by red, scaly plaques in different parts of the body. Although the etiology of the disease is not fully understood, psychological stress is mentioned as a potential factor in developing the disease.

In this study, in response to the lack of sufficient information obtained from assessing the influence of psoriasis on mental health, an attempt has been made to evaluate the prevalence of mental health problems in a sample of patients with psoriasis.

This study was conducted following an applied, descriptive-correlational study design. A total of 104 patients with psoriasis were selected using the census sampling method. Data were collected using the standardized Symptom Checklist-90 (SCL-90) questionnaire. This self-administering questionnaire contains 90 items. The reliability and validity of the questionnaire were confirmed.

The mean score of mental health was 177.51±69.35, which indicates moderate psychiatric disorders. The positive symptom distress index (PSDI) was 0.22±0.08. There was a significant association between all dimensions of mental health and the total score of mental health with gender (P < 0.05). Also, a significant association was found between paranoid ideation and marital status (P = 0.024). There was no significant association between obsessive-compulsive, anxiety, and the total score of mental health with income level (P > 0.05), but there was a significant association between other dimensions of mental health and income level (P < 0.05).

Although in the present study, psychiatric disorders in patients with psoriasis were moderate, psychological counseling and psychiatric consultation are key to reduce the consequences of the disease and its progression.

 Seborrheic keratosis (SK) is one of the most common non-cancerous lesions that appears on the sun-exposure areas of the body and highly prevalent among the middle-aged population. It is the result of the hyperproliferation of keratinocytes. The clinical changes in SK lesions such as sudden growth, color changes, and ulcerations are accompanied by malignancies.

 This study presents a rare case of giant SK on the flank part with rapid enlargement. The manifestations were in favor of malignancy and the patient underwent biopsy and total excision with a good outcome.

 Giant SK is a rare type of SK that has various similarities with malignant masses and requires further investigation.

Psoriasis is a kind of common, chronic, and exacerbating skin diseases. It does not have any certain treatment but it can be controlled. Different treatments have been used to control the disease, from positional steroids in mild cases to methotrexate in severe cases, all of which have multiple side effects. The aim of the present study was to investigate the effects of Florabile, derived from Iranian Traditional Medicine, on reducing the severity of psoriasis rashes.

In a semi-experimental study, 25 patients aged 20 to 50 years with mild to moderate psoriasis and patients whose bodies were involved below than 20 percent were participated for a 30-days experimental period. They diluted Florabile syrup containing three spoons (each spoon with an approximate volume of 15 cc) with a glass of water (250 cc), and consumed one hour before lunch daily. Results were scored using the Psoriasis Area Severity Index (PASI) at the beginning and at the end of the study, and then evaluated by two dermatologists.

Consuming the medicine meaningfully reduced inflammation of the rashes, scaling, plaque, percentage of involvement, and PASI score (P < 0.050).

Findings show significant positive effect of Florabile syrup on reducing the severity of psoriasis rashes.

Folliculitis is a common skin disease, usually benign, which causes inflammation and eventual infections of hair follicles. They may have an infectious etiology, mainly due to the bacteria Staphylococcus aureus; it also occurs due to localized irritation, such as in areas of skin friction and for long periods of immersion in water, as in athletes and workers who are continuously exposed to the aquatic environment. Herein, we report on two fishermen, from fluvial and maritime environments, who presented with chronic aseptic folliculitis associated with daily immersion of their lower extremities while exercising the profession and that regressed when there was a decrease in their contact with water.