Iranian Journal Of Dermatology
Volume:12 Issue: 3, Autumn 2009

Ingrown toe nail (IGTN) is a painful condition in which the distal-lateral corner of the nail grows into its surrounding soft tissue leading to inflammation and infection. Failure of conservative therapy is an indication for surgical interventions. The aim of this study is to compare matricectomy by curettage with chemical matricectomy with phenol 88% in terms of post procedure remission and complications. A number of 18 patients with IGTN were selected and divided randomly into 9-subject groups. The first group underwent matricectomy by curettage and the second underwent chemical matricectomy with phenol 88%. Patients were assessed after 2, 7 days and 1, 4 months after surgery for pain, oozing, soft tissue inflammation, cellulitis or purulent discharge and recurrence in both of the groups and the results were statistically compared. On the third post procedure day, pain and oozing discharge occurred less in curettage group with significant difference (P = 0.016 and 0.009). In our next visit, one week after procedure, there was no significant difference in recovery and post procedure complications (P = 0.475). In our visit, 4 weeks after procedure, all cases in both groups were completely healed for all parameters and no complication was found. Curettage partial matricectomy is superior to phenol matricectomy in achieving earlier release of post procedure symptoms and complete recovery.

Psoriasis vulgaris is a common chronic and inflammatory disease of skin that its etiology is not completely known. However, it seems that genetic and environmental factors play a role in this disease. In vitro studies show that prolactin as a neurohormone has an etiologic effect on psoriasis. This study aimed to compare serum prolactin levels in psoriatic patients with control group. Prolactin level in serum was measured with ELISA method in 30 patients with psoriasis vulgaris and in 30 healthy persons as control group, which they had been matched with a view to age and sex. Mean serum prolactin level in psoriatic patients was not significantly higher than control group. However, there was statistically significant relation between severity of disease and serum prolactin levels (r= 0.521, p=0.003). Positive relation between severity of psoriasis vulgaris and serum prolactin levels may suggest that prolactin is an index that shows severity of disease.

Dandruff especially with itching and inflammation is a common complaint among patients in the clinic and its treatment is much challenging. Chemical anti fungal substances used in antidandruff shampoos are common treatments. The aim of this study was to compare the clinical efficacy of two of these anti dandruff substances, climbazole and piroctone olamine in the treatment of dandruff and seborrheic dermatitis in shampoos with herbal extracts. One hundred and twenty men with scalp dandruff of the same severity, between 20-30 years old and in the same occupational condition in terms of sun exposure or environmental pollution were selected and divided randomly into two 60-subject groups. After each shampoo was applied 3 times a week for 5 weeks one in group 1 and the other in group 2, patients were assessed for existence of itching and redness of scalp and reduction in dandruff and results were compared between two groups. Itching and redness were completely cured in both groups after treatment. Dandruff was completely cured in 80% of patients and reduced in 20% of patients in climbazole group (p < 0.001), though completely cured in 55% of patients and reduced in 45% of patients in piroctone olamine group (p < 0.001). Climbazole was over piroctone olamine in reduction of dandruff with significant difference (p < 0.01). Both shampoos containing climbazole or piroctone olamine beside herbal extracts are effective in the reduction of dandruff and relief of other seborrheic dermatitis symptoms but climbazole seems to be more effective than piroctone olamine in the treatment of dandruff.

Ingrown toenails are a common condition which, when recurrent and painful, are often treated surgically. This study proposes a new simple surgical technique for ingrown toenails with good results. We selected 150 patients with 185 affected toes who were surgically treated by our techniques carried out from April 1995 to March 2004. This technique consisted of marginal nail elevation combined with surgical excision of the granulation tissue. To fix the nail margin on the toe, we have done one bite suture by Nylon 3-0 and remove it after 3 weeks. Recurrence occurred only in 1.08% (2 of 185 toenails), and only one toe required further surgical treatment. Failure of technique in overall is 1.7% and successful surgical treatment is over 98%. This study shows higher cure rate, shorter postoperative pain, lower risk of postoperative infection, and remarkable cosmetic result without any deformity because we excise the granulation tissue and elevate margin of nail over the skin with this simple technique. Therefore, this technique could be considered as an alternative method of ingrown toenail treatment.

The etiology of urticaria is recognized only in a minority of cases. Allergies to a wide variety of agents have been suspected, as well as hyper reactivity to food additives or drugs. Recently, autoimmune reaction to immunoglobulin E (IgE) and later to high-affinity IgE receptors on mast cells has been reported. The aim of this study was to show elevated serum IgE levels in the patients with chronic idiopathic urticaria (CIU) so that the underlying disease and the cause of CIU may be atopic condition or an occult disease with raised serum IgE. Altogether, 57 patients (30 women and 27 men, with an age range from 14 to 75 years; mean age of 35.86 years), who suffered from chronic urticaria with a duration of 3 months to 8 years were included in this study and serum IgE level was assessed. Thirty three patients had elevated serum IgE levels. The range of IgE levels were 114-3280 U (geometric mean greater than 100 ku/l) and mean IgE level was 411.39 U. Although the causes of CIU are often not clear, at least one causes of CIU may be atopy or other diseases that may be hidden and show elevated serum IgE. The patients present with CIU along with elevated serum IgE, should be investigated for atopy or other diseases that may be associated with elevated serum IgE.

Necrobiosis lipoidica diabeticorum (NLD) is a rare chronic and granulomatous skin disorder that affects 0.3% of diabetic patients. Although the etiology and pathogenesis of NLD is still contraversial, it is thought that microangipathy has an important role. The legs are the most common site for NLD, but involvement of other areas such as the abdomen, upper extremities and scalp have been reported. We present a case of scalp and leg NLD which was diagnosed on the clinical and histopathological basis.

Syringoma is a benign adnexal tumor originated from the intraepidermal portion of eccrine sweat duct. They commonly present as soft, flesh colored to slightly yellow dermal papules on the lower eyelids of healthy individuals. It usually occurs in the peri-pubertal period. There are a few reports of its widespread distribution as eruptive syringoma in the literature. Treatment of this benign condition is cosmetic only in both localized and eruptive form. Herein, a case of a 29 year old female with one year history of eruptive syringomas is presented.

Blue rubber bleb nevus syndrome is a sporadic disease with widely distributed dark blue papules and nodules and soft skin-colored compressible protuberances (rubber blebs) as well as large vascular malformations. Gasterointestinal lesions are documented by upper endoscopy and colonoscopy; hemorrhages from these lesions create irondeficinecy anemia. Other sites of visceral involvement are less common. We report a 20-year-old male with multiple blue venous nodules on the face, neck, trunk and limbs with occasional bleeding. In addition, he had similar lesions in buccal mucosa and genitalia. Endoscopic examination revealed blue nodular lesions in gastrointestinal tract. Lab tests showed iron deficiency anemia.

A 21-year-old man was referred to dermatology clinic for skin biopsy. He presented to neurology center with behavioral changes with cognition and memory disorders. He had two episodes of genealized tonic clonic seizure and series of myoclonc jerks in his limbs and face especially after awakening since several months ago. In neurological examination, he had mini mental score as 13; with some degree of bradykinesia, limb rigidity and dysartheria. He had leaved school because of inability to learning. His sister had died 5 months ago from the same disease. We performed biopsy from his right axillary skin. Histopathological examination revealed multiple intracytoplasmic homogenous pale basophilic globi in apocrine glands acini which were showing PAS positive reactivity in special staining. Reminder of epidermis and mid reticular dermis was unremarkable.