Iranian Journal Of Dermatology
Volume:26 Issue: 3, Summer 2023

Psoriasis is a chronic inflammatory skin disease with extensive systemic effects. The role of sex hormones in the pathogenesis of psoriasis remains unknown. Therefore, in this study, the level of sex hormones in male chronic plaque psoriasis patients was evaluated. This study was descriptive-analytic of the cross-sectional type, done with a total population of 60, including 30 patients with chronic plaque psoriasis and 30 healthy subjects in the control group. Serum levels of testosterone, estradiol, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) were measured in patients and the control group who did not have psoriasis. The two groups were matched based on the grouped matching technique. The two groups were matched for age (34 ± 9 years) and BMI (30 ± 3 kg/m2), and the effects of these two variables on hormonal levels were eliminated. According to the results of the Kolmogorov-Smirnov test, the data had a normal distribution. The independent t-test and Pearson correlation coefficient were used for data analysis. A P-value less than 0.05 was considered significant. The levels of LH and FSH were significantly higher in the patient group than in the healthy group (P = 0.01 and P < 0.001, respectively). Testosterone and estradiol serum levels were lower in the patient group than in the healthy group (P < 0.001). Our study suggests that male patients with chronic plaque psoriasis have higher levels of LH and FSH and lower levels of testosterone and estradiol than the general male population.

Pemphigus vulgaris (PV) is a rare autoimmune disease characterized by the development of flaccid blisters on the skin and mucous membranes. Detection of anti-desmoglein (Dsg) 1 and anti- Dsg3 antibodies are frequently used for diagnosing the disease and evaluating disease activity. Recently, the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) were introduced as new biomarkers indicating inflammation in autoimmune and autoinflammatory diseases. We aimed to evaluate the possible associations of NLP, PLR, and MPV with pemphigus disease severity and anti-Dsg1/3 levels. Thirty-three newly diagnosed cases of PV and 33 age and sex-matched controls were included in this study. A complete blood count (CBC) was obtained from the participants to evaluate NLP, PLR, and MPV. Serological anti-Dsg1/3 and Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) were assessed in patients based on ELISA assay and clinical examination, respectively. The median (interquartile range) NLR and PLR values in patients were 2.50 (1.94–6.59) and 90.30 (71.60–196.80), respectively, compared with 1.69 (1.45–2.30) and 56.00 (50.00–85.00) in controls. The NLR and PLR were significantly higher in patients than in controls (P < 0.001 for both). However, no significant difference regarding MPV levels was detected. Neither the ABSIS nor the anti- Dsg1/3 levels correlated with the studied inflammatory markers. Our study revealed that NLR and PLR are elevated in patients with PV but do not correlate with disease activity (evaluated by the ABSIS) or anti-Dsg1/3 levels. These laboratory parameters can be considered inflammatory markers of PV but cannot predict the disease activity.

Cellulite is a cosmetic problem, especially in women. We compared the safety and efficacy of a herbal anti-cellulite lotion with a placebo in a randomized, double-blind, right-left comparison clinical trial. Ten healthy women (22-58 years) with cellulite (grades 2-4) participated in this study. The anti-cellulite lotion and placebo were applied twice daily on the thighs and buttocks for two months. Treated areas were photographed, and the thigh circumference, subcutaneous fat thickness, and dermal echo density were assessed and compared before and after the treatment. The satisfaction of the participants was also assessed. A comparable improvement in cellulite grade was detected by a blinded dermatologist on both treatment sides. Cellulite improved much in one participant, improved in six, and did not change in three participants. The dermis thickness increased compared with placebo after two months (P = 0.046). A significant reduction was observed in subcutaneous fat thickness on the treated side (P = 0.03). However, the decrease was not significant on the placebo site. There was an increase in the echo density of the dermis in the treatment site, though it was not statistically significant. Both products were well tolerated, and none of the participants experienced skin burning or itching. The studied anti-cellulite lotion reduced the thickness of subcutaneous fat and increased the dermis thickness without serious adverse effects.

Multiple studies indicate the correlation between lichen planus (LP) and certain systemic disorders. Data suggest an increased incidence of dyslipidemia with LP. Abnormal lipid levels are major risk factors for developing atherosclerotic changes and cardiovascular disorders (CVD). Non-high-density lipoprotein cholesterol (non-HDL-C) is a reliable marker for cardiovascular events. If non-HDL-C levels are raised in LP patients, it would mean that these individuals are high-risk patients and should be investigated periodically. We aimed to find non-HDL-C serum levels in cases of lichen planus and compare them with controls. We compared lipid profiles between 100 cases of LP and 50 healthy controls. Non-HDL-C levels were significantly higher in cases than controls (P = 0.002). The non-HDL-C level was elevated in 67% of LP cases, compared to 42% of controls. We demonstrated higher levels of non-HDL-C in LP patients than in controls, confirming the increased risk of CVDs in LP patients.

Alopecia areata is a non-cicatricial alopecia that profoundly affects patients’ quality of life. In this study, we evaluated the influence of demographic and clinical features of alopecia areata patients on their quality of life. This cross-sectional study was performed on alopecia areata patients at the Dermatology Clinic of Afzalipour Hospital, Kerman. Firstly, demographic features and clinical data were collected. Then, the severity of alopecia areata [based on the severity of alopecia tool (SALT) score] and quality of life of the patients [using dermatology life quality index (DLQI) and child dermatology life quality index (CDLQI)] were calculated. Finally, the impacts of the patient’sdemographic and clinical features on quality of life were evaluated via multivariate logistic regression. One hundred and thirty-five patients with alopecia areata were enrolled in the study. The mean SALT score was 6.63 ± 6.34 (range 2–64). Mean DLQI scores for mild and moderate cases of AA were 7.4 and 12.5, respectively (P = 0.57). Females had significantly higher DLQI scores compared to males. Furthermore, patients with negative family history of alopecia areata had significantly higher DLQI scores than patients with positive family history (P = 0.03). We found no significant difference in quality of life between patients with different alopecia areata severities. However, females and patients with a negative family history of alopecia experienced significantly greater negative impacts on quality of life than males and those with a positive family history.

The association of cherry angioma with metabolic syndrome and fatty liver has been proposed in a few studies. This study evaluated the prevalence of cherry angiomas in patients with type II diabetes mellitus compared with healthy adults. This cross-sectional study was conducted on 100 patients with type II diabetes mellitus and 100 age and sex-matched healthy adults. Demographic features of the participants and the location and number of the lesions were recorded. Data were analyzed by SPSS 16. Mean ± standard deviation and frequency were used for quantitative analysis. The chi-squared test and independent t-test were utilized to evaluate the association of qualitative and quantitative data with the number of cherry angiomas, respectively. Cherry angiomas were more prevalent in the diabetes group (47%) than in controls (30%) (P = 0.013). Lesions in diabetic patients were more prevalent in females than males (P = 0.042). Furthermore, the number of lesions in the diabetes group significantly increased parallel to aging (P = 0.004). In the present study, significantly more cherry angiomas were observed in patients with type II diabetes mellitus than in healthy controls. Furthermore, the number of lesions was higher in females and elderly subjects in the diabetes group.

Since December 2019, coronavirus disease 2019 (COVID-19) has been considered a major health issue. Even in the initial days of the pandemic, dermatologists faced several challenges in preventing, diagnosing, and treating COVID-19. Like other physicians, dermatologists encountered several ethical issues. Dermatologists have served a significant role as front liners, focusing on the cutaneous manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The COVID-19 pandemic affected medical practice significantly. Due to the health emergencies caused by SARS-CoV-2, medical students’ education, patients’ prioritization, care, and cosmetic procedures were affected. Additionally, new strategies were devised to reduce the risk of transmission. This review article examines the effects of the COVID-19 pandemic on dermatology practice. We reviewed 33 articles following a search of the PubMed and Google Scholar databases for articles studying how COVID-19 affected dermatology practice.

B-cell lymphomas represent most non-Hodgkin lymphomas (NHLs) arising within lymph nodes, and about 27% of patients have extranodal involvement. Primary cutaneous lymphoma is defined as malignant lymphoma limited to the skin at diagnosis. Diffuse large B-cell lymphoma (DLBCL) is the most common form of NHL, accounting for over one-third of all lymphomas. Primary cutaneous diffuse large B-cell lymphoma (PCDLBCL) is a type of non-Hodgkin’s lymphoma with skin involvement as the first and only site of involvement. Primary cutaneous diffuse large B-cell lymphoma typically presents as a rapid-growing, red or bluish nodule or tumor on the legs, though around 10–15% of patients present with lesions elsewhere. This case report illustrates a rare manifestation of PCDLBCL presenting as a non-healing, rapidly progressive ulcer in the groin area diagnosed based on histopathology and immunohistochemical expression. The patient was treated successfully with systemic chemotherapy. This report could have implications for clinicians to consider the diagnosis of PCDLBCL in patients with unusual, non-healing, chronic ulcers, especially in the elderly, despite the anatomic site of the lesions.

Dermatofibrosarcoma protuberans (DFSP) is a malignant, slowgrowing, locally aggressive tumor of the skin with a high rate of recurrence. It is a very uncommon malignant skin tumor, especially in the head and neck area (10-15% of cases). This case report discusses a rare case of scalp DFSP.

Cutaneous angiosarcoma is a rare tumor of the head and neck region, most commonly affecting the elderly male. Its presentation varies from a small plaque to multifocal nodules. Differentiating this tumor from other conditions, such as hemangiomas, Kaposi sarcoma, squamous cell carcinoma, and rosacea, is sometimes difficult. Herein, we present a case of a 73-year-old male with a small oozing lesion on the scalp for more than two months. He had a history of scalp irradiation for tinea capitis in his childhood. Also, he experienced multiple basal cell carcinomas on his scalp a few years ago. Skin biopsy revealed infiltrations of malignant neoplastic lesions composed of proliferated pleomorphic tumoral cells with hyperchromatic nuclei and some epithelioid features arranged as sheets and irregularly shaped vascular spaces mostly devoid of red blood cells. Neoplastic cells were diffuse and strongly positive for D2-40, CD31, CD34, and Ki67 but negative for C-myc and CK. Cutaneous angiosarcoma should be considered in the differential diagnoses of scalp lesions, particularly in older men.

Primary cutaneous diffuse large B‐cell lymphoma-leg type (PCDLBCL‐LT) is a rare malignant disease seen in older adults, especially women. In this case report, we discuss a 78-year-old man who developed erythematous indurated plaques on his left shin for about three months. The patient did not report pruritus, weight loss, night sweats, fever, or chills. There was no lymphadenopathy, splenomegaly, or hepatomegaly on the physical examination. A local tissue biopsy was taken from the plaques, confirming the diagnosis of PCDLBCL‐LT via immunohistochemistry. The patient was referred to an oncologist to begin additional evaluation and treatment. According to the literature, chemotherapy with or without adjuvant radiotherapy is the first treatment choice for PCDLBCL‐LT. Monotherapy with rituximab could be considered in some patients with this condition, but the disease may relapse in a short period.