فهرست مطالب

Dermatology - Volume:21 Issue:4, 2019
  • Volume:21 Issue:4, 2019
  • تاریخ انتشار: 1397/12/25
  • تعداد عناوین: 7
|
  • Alireza Firooz, Farhad Handjani, Vahideh Lajevardi, Parvin Mansouri, Mansour Nassiri, Kashani, Yasaman Norouzi Pages 105-123
    Urticaria is a common and challenging skin disorder. Diagnosis and treatment of urticaria is not limited to the field of dermatology. General physicians, allergologists and clinical immunologists are also commonly involved in the management of patients with urticaria.
    Iranian Society of Dermatology developed a clinical practice guideline concerning diagnosis and treatment of urticaria that was published in 2015. The current guideline is an update to the previous one and includes findings related to this subject which has been published in the medical literature from 2015 to August 2018.
    Keywords: urticaria, diagnosis, treatment, antihistamines, clinical guideline
  • Venkataram Mysore, Shashikant Malkud, B Anitha Pages 124-127
    Background
    A rippled type of pigmentation is observed on the arms, forearms, and bony prominences, more commonly in women with a history of chronic rubbing. The terminology (commonly referred to as frictional melanosis) and its relation with cutaneous amyloidosis has been debated.
    Materials and Methods
    Twenty one patients with pigmented skin lesions with manifestations suggestive of frictional melanosis were included in the study. Detailed history, clinical and histopathological examination were conducted on all patients.
    Results
    Brownish black macules without rippling were the most prevalent type of presentation. Arm was the most common site of involvement followed by forearm. Histopathology showed basal layer pigmentation, acanthotic epidermis, condensation of collagen and pigmentary incontinence in the dermis. Only six patients showed amyloid deposition on Congo red stain.
    Conclusion
    Amyloid can be demonstrated by Congo red stain in certain cases only, called frictional amyloidosis. Other cases, in whom amyloid cannot be observed may be termed frictional melanosis.
    Keywords: friction, melanosis, amyloidosis, Congo red
  • Mahnaz Banihashemi, Yalda Nahidi, Naser Tayyebi Meibodi, Lida Jarrahi, Fatemeh Livani, Sahar Seifnia Pages 128-131
    Background
    Pemphigus vulgaris (PV) is a rare autoimmune blistering disease of the skin and mucous membranes. Because vitamin D deficiency is associated with many immune disorders, we compared the levels of vitamin D between PV patients and healthy controls.
    Methods
    Vitamin D level of 20 patients with PV was compared with 20 healthy individuals matched for age, gender, hours spent in the sun, body mass index (BMI) and daily vitamin D intake at the same time interval. The severity of the disease was estimated according to ABSIS score. The serum level of 25-hydroxyvitamin D (25OHD) was measured by a commercial ELISA test.
    Results
    Vitamin D deficiency in the pemphigus vulgaris group (75%) was higher than healthy controls (45%) (P = 0.053). Mean level of vitamin D in PV patients was significantly lower than healthy controls, and was in the range of vitamin deficiency (P ? 0.05). No significant relationship was observed between the severity of the PV disease and vitamin D levels (P > 0.05).
    Conclusions
    Based on the results of the present study, the mean level of vitamin D in patients with PV was significantly lower than healthy people. Based on our findings and given the important role of vitamin D in preventing inflammatory and autoimmune diseases, vitamin D deficiency can be considered as a factor triggering the onset of PV.
    Keywords: pemphigus vulgaris, vitamin D, autoimmune disease
  • Yalda Nahidi, Naser Tayyebi Meibodi, Pooran Layegh, Sara Sharifi Pages 132-137
    Background
    Lichen planus (LP) is a chronic inflammatory disease involving the skin, mucous membranes and appendages. Like other chronic inflammatory diseases, it may be associated with metabolic disorders and dyslipidemia. Due to the discrepancies in the results of previous studies and lack of a similar study on an Iranian population, we decided to investigate and compare the serum lipid levels of LP patients and normal healthy subjects.
    Methods
    In this case-control study, 71 patients with lichen planus confirmed by clinical and pathological examination who referred to dermatology clinic were recruited; further included were 71 subjects selected from attendants without any skin diseases matched for age, gender and BMI.with patients; the well-being of the healthy subjects was confirmed by laboratory tests, physical examination and medical history..After filling the questionnaire, triglyceride, cholesterol, HDL and LDL levels were measured for patients and healthy subjects..The collected data were then analyzed.
    Results
    Mean age of patients in the case group was 40.63 ± 11.41 years, 50.6% of whom were men, while 49.4% were women. Cholesterol, triglyceride and LDL levels in patients were significantly higher than the control group; it was only regarding HDL levels that no significant difference was observed between the two groups. HDL and triglyceride levels were significantly higher in patients with generalized disease. There was a recognizable correlation between elevated levels of LDL and cholesterol and disease duration.
    Conclusions
    In this study, a disrupted lipid profile was observed in LP patients, which can be associated with disease severity. This study proposes measuring lipid serum levels prior to commencing the treatment in all known cases of lichen planus so as to preclude cardiovascular diseases if there is a problem with the lipid profile.
    Keywords: lichen planus, dyslipidemia, cholesterol, triglyceride, HDL, LDL
  • Zohreh Maghami, Mozhdeh Sepaskhah, Ebrahim Moghimi Sarani, Zahra Bagheri, Mohammad Maghami Pages 138-141
    Background
    Vitiligo is a common pigmentary disorder affecting mental health, and alexithymia is a trait associated with multiple cutaneous disorders. This study was conducted to compare vitiligo patients and controls as concerns alexithymia.
    Methods
    Fifty-two patients with vitiligo and 61 non-vitiligo individuals were recruited. They completed Toronto alexithymia score-20 questionnaire. Independent sample t-test and Chi-square tests were used for comparing numerical and categorical variables, respectively. P value ? 0.05 was considered statistically significant.
    Results
    Twenty vitiligo patients were alexithymic, while 14 were borderline alexithymic. Thirteen, 16, and 32 control people were alexithymic, borderline alexithymic and non-alexithymic, respectively (p value: 0.096). Although alexithymia and borderline alexithymia were not significantly more prevalent in vitiligo patients (p value: 0.57), they were more likely to be high alexithymic (TAS ? 61) compared with the control group (p value: 0.02). Comparisons with the controls, patients obtained significantly higher scores associated with subscales of difficulty in identifying feelings (DIF) and difficulty in describing feelings (DDF) (p value: 0.002 and 0.02 respectively). Patients with lower education obtained higher alexithymia scores (p value: 0.009).
    Conclusion
    High alexithymia and higher DIF and DDF subscales are more prevalent in vitiligo patients in comparison with control population. Patients with lower levels of education are more alexithymic.
    Keywords: alexithymia, vitiligo, psychology, comorbidity
  • Ossama Abbas, Mazen Kurban Pages 142-146
    Background
    Angiolymphoid hyperplasia with eosinophilia (ALHE) is characterized by irregularly-shaped blood vessels with an inflammatory infiltrate. While absent from normal skin, plasmacytoid dendritic cells (pDCs) infiltrate the skin upon injury and during several infectious, inflammatory, and neoplastic entities. In addition to providing anti-viral resistance, pDCs link the innate and adaptive immune responses. In Kimura’s disease (KD), pDCs have been reported to occur. Here, we investigate pDCs in ALHE.
    Methods
    Five ALHE and comparable 4 KD cases were immunohistochemically tested for pDC occurrence and type I IFN production using anti-BDCA-2 and anti- myxovirus protein A (MxA) antibodies, respectively. A semiquantitative scoring system was used.
    Results
    Plasmacytoid dendritic cells were present in all ALHE and KD cases with no statistically significant differences, while MxA expression was weak and patchy in most ALHE and KD cases.
    Conclusions
    pDCs are recruited into the lesions of ALHE. Despite the diminished ability to produce type I IFNs, the consistent presence of pDCs in all ALHE cases is in favor of some role of these cells in ALHE pathogenesis.
    Keywords: angiolymphoid hyperplasia with eosinophilia, plasmacytoid dendritic cells, Kimura’s disease, interferon
  • Nasrin Saki, Fatemeh Rahmanian, Soraya Saki Pages 147-148
    CLINICAL PRESENTATION
    A 16 year old girl was referred to dermatology clinic with bilateral blue gray hyperpigmented patches on her cheeks since birth. Upon close physical examination, scleral blue-gray hyperpigmentation was observed in both her eyes (Figure 1). She also had a blanchable red patch with poorly defined borders on her right cheek (Figure 2). Ophthalmology consultation further revealed an increased intraocular pressure with optic nerve damage. She had neither systemic problems nor a history of a similar condition in her family.