فصلنامه پوست و زیبایی
سال سوم شماره 2 (پیاپی 10، تابستان 1391)

Onychomycosis is the fungal infection of nails. Patient’s immune system has an important role in initiation of onychomycosis. One of the causes of the increased prevalence of onychomycosis is the increasing number of patients with local or general immune system disorders. In hormonal disorders such as diabetes mellitus, Cushing's syndrome and hypothyroidism; superficial vascular disorders and individuals with immune deficiency, onychomycosis prevalent. The aim of this study was to investigate onychomycosis in individuals with underlying diseases who referred to Razi hospital in Tehran. In this cross-sectional study, nail specimens of 250 patients who have nail dystrophy with an underlying disease whom were referred to mycological laboratory of Razi hospital in 2010-11 were evaluated with direct microscopy and culture on Sabouraud dextrose agar and Sabouraud dextrose agar containing chloramphenicol and cyclohexamide. For differential diagnosis of fungi, complementary tests were used. Eighty-nine (35.6%) of 250 individuals with underlying diseases and nail dystrophy, were affected with onychomycosis. Among these pateints, 52 (58.4%) cases had yeast infection, 19 (21.3%) had dermatophyte infection, and 18 (20.2%) had saprophyte infection. Diabetes mellitus (37.1%), cardiovascular diseases (14.7%), pemphigus (9%), psoriasis (7.9%), hypothyroidism (6.7%) and chronic eczema (5.6%) were the most common underlying diseases observed in patients with onychomycosis. Onychomycosis is common in hormonal disorders like diabetes mellitus and hypo-thyroidism; superficial vascular disorders and individual who suffer immunodeficiency.

The cosmetic surgery is a method to create a feeling of ideal self through which one’s pain of being undesirable or lack of self-love is removed. This multidimensional concept depends on many factors such as personality traits and defensive styles of people. The purpose of this study was to investigate the relationship between personality traits and defensive styles in the candidates of the cosmetic surgery. In this cross-sectional research, which was designed to assess correlations between personality traits and defensive stydles the questionnaires wwere implemented to each individual. With available sampling, 80 patients referred to the cosmetic and skin clinics of the city of Yazd for cosmetic surgery were asked to voluntarily participate in this research and complete questionairres. 80 patients, who were not seeking for cosmetic surgery, were chosen from the same clinics as the control group. Patients seeking for cosmetic surgery achieved lower scores in agreeableness trait and used more irrational and immature styles to overcome conflicts. There was a relationship between personality traits and defensive styles of volunteers of the cosmetic surgery, in the sense that the higher the scores in positive personality traits, the higher was the use of mature defensive styles and vice versa. Motivation for the cosmetic surgery has its roots in a combination of psychological, emotional, and personal factors. Traits and characteristics of volunteers of cosmetic surgery had a direct relation to defensive styles of these people. Therefore, psychological counseling is advised before cosmetic surgery for adjustment of more effective mechanisms.

Psoriasis is a chronic inflammatory dermatosis that affects 0.6% to 4.8% of the general population. Our aim was to compare the effect of narrow band UVB (NB-UVB) on normal flora of cutaneous plaques and normal skin in psoriatic patients. Twenty psoriatic patients without any contraindication of phototherapy were enrolled in this study. Samples from psoriatic lesions and adjacent normal skin, before and after phototherapy with NB-UVB were taken. Patients were treated with NB-UVB three times weekly until complete remission. Finally, quantity of normal cutaneous flora on normal and involved skin, before and after treatment was compared. The mean±SD of the NB-UVB sessions and the mean cumulative dose were 26.35±4.95 and 2.05±0.57 J/cm2, respectively. The number of Staphylococcus epidermidis, S. aureus and diphtheroids on psoriatic plaques reduced after phototherapy.Conclusuion: The quantity of normal cutaneous flora on normal skin is less than psoriatic plaques, and it reduced on normal and involved skin after phototherapy.

Pruritus is a major symptom of dermatologic diseases and a common symptom of systemic diseases. Severity of itch cannot be measured objectively. It’s usually determined to using a Visual Analogue Scale (VAS). But none of them can determine the effect of pruritus on patient's quality of life. So in the present study we sought to translate and develop a validated reliable Farsi version of pruritus specific quality of life instrument, ItchyQoL.

ItchyQoL questionnaire was translated to Farsi by two bilingual people, and then it was back-translated to English by two other bilinguals. These two questionnaires were matched and revised and the final Farsi questionnaire was established. Forty four patients with dermatologic pruritus filled the questionnaire at the baseline and 72 hours later, and the structural reliability and validity of it was analyzed.

The questionnaire had internal consistency and reproducibility. The questionnaire reliability was also analyzed by test-retest which was significant. Construct validity was analyzed by examining the relationship between intensity and frequency of itching with the total score in the three main axis symptoms, which was significant in all except the dysfunction axis.

The Farsi version of ItchyQoL questionnaire has favorable reliability and validity.

Basal cell carcinoma (BCC) is the most common type of malignancy that rarely causes death but results in cosmetic problems and is associated with high treatment cost. Clinical characteristics of this cancer are related to the host and environmental factors. Theses factors are specific for each area and may change over the time. The aim of this study was to find clinical characteristics of BCC in Kermanshah city. This cross-sectional study was done on 119 histopathologically documented BCC cases in Haj Dayi skin clinic in Kermanshah in 2009. Demographic data of patients and characteristics of the lesions including their number, location, size and clinical type were recorded. Data were analyzed using ANOVA and chi squared tests. The patients had a total number of 171 BCC lesions. Nodular type encompassed 158 (92.4%) lesions and was the most common clinical form. Pigmented subtype included one third of lesions and was significantly more common in male patients with moderate brown skin and following radiotherapy (P<0.05). The nose was the most common area of involvement and actinic keratosis was the most common associated skin lesion. In this study, the most common clinical and pathological type of BCC was nodular type. It was observed in old patients, those with outdoor jobs and was associated with actinic keratosis. Educational and screening programs for prevention, early detection and diagnosis, and appropriate treatment for high-risk individuals are suggested.

Cicatricial alopecia is characterized by permanent destruction of the pilosebaceous unit, leading to irreversible hair loss, and has primary and secondary types. Primary type, based on predominant inflammatory infiltration in histology, is divided to neutrophilic, lymphocytic and mix types. Decalvans folliculitis, dissecting cellulitis and acne keloidalis are 3 subtypes of neutrophilic group. In this study frequency of each subtype and the distribution of age, gender and duration of disease have been reviewed.

This retrospective study was performed on patients with clinical diagnosis of cicatricial alopecia and histologic confirmation referred to Razi hospital in Tehran in 2005-2009.

Of 135 patients with mean (mean±SD) age of 32±10.6 years, 71.9% were male and 28.1% were female. The diagnoses included decalvans folliulitis (72.6%) with mean age of 31.89 years, dissecting cellulitis (25.0%) with mean age of 32.4 years and acne keloidalis (1.5%) with mean age of 52 years. The mean duration of disease was 4.2±3.9 years (4.08 years in male and 4.7 years in female). The mean duration of disease in decalvans folliulitis was 4.7, in dissecting cellulitis was 1.9 and in acne keloidalis was 17.5 years.

Neutrophilic scarring alopecia is more common in men and in the third decade of age and the most common type is decalvans folliulitis.

Dermatophytes are keratinophilic fungi that cause infection in the skin, hair and nails. Dermatophytic infections are one of the important health problems in the world that related to social and economic life of communities. This cross-sectional study was conducted on all suspected patients in the medical mycology laboratory of Afzalipoor Faculty in Kerman from March 2007 to March 2011. For each patient after obtaining the detailed history, direct smear, staining and culture on specific media were performed. Out of 1800 referred cases, 166 patients were positive for dermatophytosis. The highest prevalence of infection was in the under 10 years old (28.31%), men and women were also involved equally. The most common agents of the cutaneous infection were Trichophyton mentagrophytes (45.78%) and T. verrucosum (18.1%). The most common infections were tinea manuum (35.54%), tinea capitis (16.87), and the least common one was tinea faciei (4.82%). It is necessary to increase the level of community health in order to prevent this dermatophytosis.