فهرست مطالب

Dermatology - Volume:27 Issue: 1, Winter 2024

Iranian Journal Of Dermatology
Volume:27 Issue: 1, Winter 2024

  • تاریخ انتشار: 1402/12/11
  • تعداد عناوین: 10
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  • Alireza Ghanadan, Reza Shirkoohi, Reza Shahsiah, Samira Alihosseini, Reza Amiri, Nika Kianfar, Shahriar Hadadi Abianeh, Elham Sabbagh, Behzad Khodaei, Maryam Nasimi * Pages 1-5
    Background
    NRAS and BRAF mutations are commonly reported in melanoma with various frequencies in different countries. However, their correlation with the development of malignant melanoma and tumor prognosis has not previously been studied in the Iranian population. This study determined the prevalence of these mutations and their association with tumor-related factors.
    Methods
    This cross-sectional study involved 50 patients admitted to two dermatology hospitals with a definitive diagnosis of melanoma (primary or metastatic) who received surgery as a selective therapeutic option. The genomics of the BRAF and NRAS mutations were determined with the real-time PCR technique.
    Results
    BRAF and NRAS mutations were presented in 30% and 26% of patients, respectively. The NRAS mutation correlated with mitosis (P = 0.026), while the BRAF mutation correlated with visceral involvement (P = 0.023). None of the mutations correlated with gender, age, melanoma type (primary vs. metastasis), ulcer, microsatellitosis, and lymph node involvement.
    Conclusion
    BRAF and NRAS mutations demonstrated relatively high prevalence in Iranian patients with melanoma, which may be valuable prognostic tools in predicting tumor prognosis and metastasis.
    Keywords: Mutation, BRAF, NRAS, Melanoma, skin neoplasms
  • Maryam Aghaei, Shahrzad Aghaei, Fariba Iraji, Mohammad-Ali Nilforoushzadeh, Sayed Mohsen Hosseini, Zabihollah Shahmoradi, Seyed Hossein Hejazi * Pages 6-12
    Background
    Vitiligo is an autoimmune disease of the skin that affects both sexes and people of any age. The genetic and environmental factors are involved in the vitiligo etiology. Helicobacter pylori (H. pylori) has an important role in vitiligo progression. Therefore, the present study evaluated H. pylori seropositivity in vitiligo patients compared to healthy individuals.
    Method
    H. pylori infection was investigated in 210 vitiligo patients and 127 sex- and age-matched healthy controls using Enzyme- Linked Immunosorbent Assay (ELISA) test. The data was analyzed using SPSS software version 20.0, and the groups were compared using T-test and ANOVA tests. P < 0.05 was considered statistically significant.
    Results
    Vitiligo patients had higher median levels of IgG (29.68 ± 28.28 RU/mL) than (19.08 ± 20.12 RU/mL) in healthy controls (P < 0.000). Moreover, there was no significant difference between groups based on the level of IgM (P < 0.207). In the vitiligo group, IgG or IgM means were different compared to age (P < 0.33)/ (P < 0.017) and early symptoms (P < 0.00) (P < 0.02), respectively. Unlike IgG, there was a significant difference between the mean level of IgM, the onset age of vitiligo (P < 0.022), and the duration of the disease (P < 0.05). Moreover, males and females with vitiligo had a higher seropositivity to H. pylori antibodies than the control group.
    Conclusion
    Vitiligo was found to be significantly associated with H. pylori in Iranian patients. Therefore, it seemed probable that H. pylori had an important role in the initiation or progression of disease activity in vitiligo.
    Keywords: Vitiligo, Helicobacter pylori, Seropositivity, Enzyme-Linked Immunosorbent Assay (ELISA)
  • Lotfollah Afzali, Shima Rahmati, Reza Zargarsaleh, Babak Alavi-Farzaneh, Mehdi Banitalebi * Pages 13-20
    Background
    Wound healing in grade II burns is one of the treatment priorities. Advances in new sciences, such as stem cell therapy, biological scaffolds, and growth factors, have renewed hopes in this area. The present study aimed to assess the impact of ADSCs encapsulated in PRP/Chitosan-based gel and PRP/Chitosan cell-free gel on the healing of grade-II burn wounds in rats as compared to the control group.
    Methods
    Thirty rats were randomly assigned to one of three groups. Following adipose stem cell extraction, a deep grade II burn was induced in the back of the rats using a standardized catheter. The first group served as a control and received simply routine treatments. The second group received a gel based on PRP/Chitosan and ADSCs, and the third group received a gel free of PRP/Chitosan cells. The results were based on response to treatment, observable granulation tissue formation, or epithelialization at 7, 14, 21, and 28 days after treatment.
    Results
    The findings revealed that the use of a cell-based PRP/ Chitosan scaffold or cell-free PRP/Chitosan scaffold reduced the rate of necrosis and inflammation and increased the rate of epithelialization, granulation, and neovascularization compared to the control group (P < 0.05). Moreover, the use of stem cells in scaffolds resulted in greater wound healing than the cell-free scaffolds group (P < 0.05).
    Conclusion
    Due to their porosity and the improved efficacy of stem cells placed in them, PRP/Chitosan scaffolds could have a positive impact on healing and speed up the wound healing process.
    Keywords: Stem Cell, therapy, Biological, Scaffolds, Burns
  • Reza Robati, Farahnaz Bidari Zerehpoosh, Azadeh Rakhshan, Mona Gorji, Zahra Razzaghi, Mostafa Rezaei-Tavirani, Sareh Salarinejad * Pages 21-27
    Background
    Amyloidosis is a rare disease characterized by the extracellular deposition of a misfolded protein in multiple organs. Cutaneous amyloidosis (CA) is diagnosed by detecting amyloid deposition in the skin. Lichen amyloidosis (LA) and macular amyloidosis (MA) without visceral involvement are two of its more prevalent types.
    Methods
    This case-control study was conducted to evaluate C4d staining in amyloidosis to determine whether it could be used as a diagnostic tool for amyloidosis. Moreover, the results of C4d expression in amyloidosis with colloid bodies in lichen planus (LP) were compared. Therefore, 41 cases of CA and 43 cases of LP were selected. All samples were stained with C4d immunostain.
    Results
    12 of 41 cases of CA had apple green birefringence; however, all of them were positive for C4d, the same as the LP group. The CA group had 100% C4d and 29% Congo red sensitivities (P < 0.05). C4d had 100% sensitivity for colloid bodies in LP. Therefore, the C4d stain could serve as a new IHC marker for highlighting the colloid bodies.
    Conclusion
    C4d immunohistochemical (IHC) staining could be a very valuable ancillary tool for diagnosing amyloidosis, although it did not differentiate amyloid deposition from colloid bodies of LP.
    Keywords: Lichen Planus, cutaneous amyloidosis, C4d, Congo red, Amyloid, colloid body
  • Mohnish Sekar, Arun Inamadar *, Ajit Janagond Pages 28-34
    Background
    Atopic dermatitis (AD) is a prevalent, chronic, inflammatory skin disorder that primarily affects children, with just a few cases persisting into adulthood. Many theories exist to ascertain the relationship between atopic dermatitis and systemic inflammation. Neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and Mean platelet volume (MPV) are biomarkers of systemic inflammation, which in turn are related to atopic dermatitis. The present study aimed to assess the association between atopic dermatitis and NLR, PLR, and MPV values by calculating NLR, PLR, and MPV ratio and correlating their levels with the disease duration and severity of AD in pediatric atopic dermatitis.
    Methods
    This cross-sectional study included 165 pediatric atopic dermatitis patients who met the clinical confirmation criteria of the U.K. working party. The patients with co-existing conditions such as molluscum contagiosum, impetigo, hand-foot and-mouth disease, and eczema herpeticum were excluded. The mean ± SD values of NLR, PLR, and MPV were compared after the severity groups were classified using SCOR Atopic Dermatitis (SCORAD). The association of SCORAD and disease duration with NLR, PLR, and MPV levels was evaluated.
    Results
    Significant differences were noted between severity groups based on NLR, PLR, and MPV values. PLR and NLR had a positive correlation with the SCORAD score, whereas MPV was negatively correlated. In addition, NLR had a positive correlation with disease duration. PLR exhibited a higher diagnostic accuracy in predicting high SCORAD with a 100% sensitivity and specificity cut-off value of > 172.
    Conclusion
    NLR, PLR, and MPV were cost-effective, feasible, andwidely available tests to detect systemic inflammation in AD with high sensitivity and specificity.
    Keywords: Dermatitis, atopic, platelet lymphocyte ratio, neutrophil lymphocyte ratio, Mean platelet volume
  • Warood Albadri, Shiva Marri, M Kavya, Bhargavi Uttmani, Arun Inamadar * Pages 35-48

    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.

    Keywords: nutrition, Skin Diseases, nutritional deficiencies, Pediatric
  • Armaghan Gharehaghaji Zare *, Saeedeh Rahimi, Shiva Mohajeri Pages 49-53

    We report a 19-year-old woman, born of a consanguineous marriage but without a positive history in the family, diagnosed histologically and clinically with this disease. All the previous treatments were unsuccessful; we started acitretin, and she responded excellently to treatment. Although the improvement in thickness and hyperhidrosis was noteworthy, and the patient was satisfied with the treatment, as we expected, there was not an acceptable result with the erythema.

    Keywords: Greither, Keratoderma, Palmoplantar, acitretin
  • Reem Diab, Mohammad Shahidi Dadras, Azadeh Rakhshan, Ali Kaddah, Parsa Heydarifakher, Fahimeh Abdollahimajd * Pages 54-57

    Colorectal cancer is a fatal disease that is continuously increasing. Herein, we report a 36-year-old man with a seven-month history of colon adenocarcinoma, who presented with a painless, exophytic, bilateral scrotal mass that resembled lymphangioma in shape. The histopathological examination revealed metastatic adenocarcinoma, which was morphologically compatible with large bowel origin. To the best of our knowledge, cutaneous metastasis mimicking lymphangioma has rarely been described in the literature. Early diagnosis of cutaneous metastasis is very important and can improve the disease prognosis. A cutaneous metastasis should be considered when encountering any new painless exophytic lesions mimicking lymphangioma.

    Keywords: Metastasis, colonic neoplasms, Chemotherapy, Lymphangioma, Cutaneous manifestation
  • Ananya Reddy, Malcolm Pinto *, Santhosh Pai, Spandana Hegde, Manjunath Shenoy Pages 58-61

    Psoriasis is a chronic inflammatory disorder, which affects the skin, nails, and joints. Psoriasis can be associated with systemic diseases such as diabetes mellitus, metabolic syndrome, renal diseases, and cardiovascular diseases.Renal involvement among patients with psoriasis has been increasingly reported. These disorders include conditions such as IgA nephropathy, membranoproliferative glomerulonephritis, secondary renal amyloidosis, and C3 glomerulonephritis. The various clinical and laboratory features that need consideration to rule out underlying renal disease in such patients include hypertension, edema of bilateral lower limbs, microscopic hematuria, and proteinuria.Herein, we present a case of a 49-year-old patient with chronic plaque psoriasis, who was diagnosed with nephrotic syndrome 8 years after the onset of psoriasis. Immunohistochemical analysis of the renal biopsy samples revealed membrane nephropathy with M-type phospholipase PLA 2R positivity.Due to the concurrent presence of severe psoriasis lesions, oral corticosteroid was deferred, and the patient was treated with oral Tacrolimus 4 mg per day for membranous nephropathy, which resulted in significant improvement of cutaneous lesions.

    Keywords: Psoriasis, PLA 2R, nephropathy, Tacrolimus
  • Nasrin Saki, Seyedeh Yasamin Parvar, Saba Fazel, Fatemehsadat Pezeshkian * Pages 62-66

    Genital warts are epithelial tissues infected with human papillomaviruses, the most prevalent sexually transmitted disease worldwide. Topical treatments focus on removing warts rather than eliminating the virus. Curcumin, as a therapeutic option, has been shown to have antiviral activity in treating a variety of skin diseases, including vitiligo and psoriasis. The present study compared the effectiveness of cryotherapy plus oral curcumin to cryotherapy alone in treating genital warts. This randomized, double-blinded, placebo-controlled trial was performed on patients diagnosed with genital warts, who were divided into two groups. Patients underwent 5-7 sessions of cryotherapy plus oral curcumin or placebo. Outcome measures included the number of warts, the visual analog scale (VAS), and the Persian version of the Dermatology Life Quality Index (DLQI). The data were analyzed using SPSS software, version 21.Twenty-seven patients with a mean age of 34.3 ± 10.3 years were included in each group. The median number of genital warts, DLQI, and VAS improved significantly in both groups. The effect of curcumin was more prominent in a short period, although it was not statistically significant compared to the placebo group. Using curcumin as an adjuvant drug in conjunction with cryotherapy was shown to be ineffective in treating genital warts. According to The Dermatology Life Quality Index, clinical improvement was observed; however, it was not statistically significant. Further studies should be carried out with higher doses of oral curcumin or topical vaginal creams containing curcumin to determine the role of curcumin in treating genital warts.

    Keywords: Genital warts, curcumin, HPV, Cryotherapy, Clinical trial