Dermatology and Cosmetic

Effect of different preservatives during freezing process on infectivity of Leishmania major in mice model

Esmaeil Fallah

Background and Aim: Leishmanization (LZ) is an effective tool to prevent cutaneous leishmaniasis. Standardization of Leishmania is the main drawback of LZ. The aim of this study was to assess the effect of various preservatives on the infectivity of Leishmania.

Methods: L.major harvested at different stages of growth logarithmic, early and late stationary phases were frozen using various preservatives of saccharose, glycerol, trehalose, glucose, sorbitol, and dimethyl sulfoxide (DMSO). The harvested parasites were inoculated into BALB/c mice before and after freezing. The infectivity of the parasites was checked. IFA test was used to assess the rate of metacyclic parasite.

Results: The ratio of live Leishmania in different growth stages and various preservatives were 89.0% to 98.2%. The lesion development in groups of mice which received Leishmania in sacarose + glycerol or DMSO was started from 3^rd week and at 5^th week all the mice showed lesion. The group of mice which were inoculated with early or late stationary phases in saccharose + glucose, saccharose + glycerol, glycerol 15% or DMSO showed lesion from 4^th to 5^th week and in 100% showed lesions at 8^th week. The rate of metacyclic parasites increases from log phase to early and late stationary phases.

Conclusion: There was a correlation between percent of live parasite and the rate of lesion development in BALB/c mice. Saccharose 22.5% + Glyserol 22.5% were the most appropriate preservative to freeze L. major. IFA test is used to detect metacyclic Leishmania. A correlation was seen between the rate of lesion development in BALB/c mice and IFA positivity.

Comparison of pediatric-onset psoriasis with adult-onset psoriasis

Vahide Lajevardi

Background and Aim: Psoriasis is a chronic papulosquamous disorder, which affects about 2% of the population. Psoriasis is relatively common in childhood: more than 10% of cases start before the age of 10. Tha aim of this study was to compare the clinical characteristics between pediatric-onset and adult-onset psoriasis in Iranian patients.

Methods: In 2006 and 2007, clinical data were collected from all patients with psoriasis diagnosis referred to Razi Hospital. They were categorized into two groups: pediatric-onset psoriasis patients and adult-onset psoriasis patients. Clinical variables such as number of patients, gender, age of onset, family history, and stress as a precipitating factor, the first site of involvement, clinical type and involved sites were compared between the two group.

Results: From total of 162 patients, 50 patients (33.2%) were considered as pediatric-onset group. The percentage of males in the pediatric-onset group was 48% compared with 58.9% in the adult-onset group. In the pediatric-onset group positive family history was 20% and in the adult-onset group was 12.5%. Stress as a precipitating factor was nearly the same in both groups. Plaque type psoriasis was the most common clinical presentation and the head and neck was the most common site of involvement in both groups.

Conclusion: Our findings, similar to previous studies showed that the involvement of female gender, family history and the onset of psoriasis on the scalp in children were more than adults.

Quality of life in patients with common pigmentation disorders in Kashan

Rezvan Talaee

Background and Aim: Quality of life is a broad concept that reflects an individual’s perspective on the level of life satisfaction experienced in a variety of situations including housing, recreation, environmental conditions, health and job. In this way it is a subjective measure that is affected by factors well beyond health status. To evaluate quality of life in patients with common pigmentation disorders such as vitiligo, melasma, and freckles refer to dermatologic clinics of Kashan University of medical sciences during 2010 and 2011.

Methods: In this cross sectional study, 142 patients with pigmentation disorders, older than 18 years old filled out Dermatology Life Quality Index (DLQI) questionnaire. DLQI questionnaire includes 10 questions regarding feelings, daily activities, leisure, job and education, personal relationship and treatment. Scoring was performed according to Finlay's guidelines. The data were analyzed with t, ANOVA and Pearson correlation tests. The higher the score, the greater the impairment of quality of life.

Results: The mean DLQI score was 5.64 (±5.03). The mean DLQI score in vitiligo was higher than other diseases. In this study score of quality of life in women, patients younger than 25 years old, patients with lesions on exposed areas, and single patients was higher than others, but there was not any significant relationship between quality of life and duration of disease, job, education level and place of residence.

Conclusion: This study showed that skin pigmentation disorders had a significant impact on all aspects of the quality of life, especially on socio-psychological aspect. Therefore, dermatologists should pay attention to the psychological effects of those diseases and try to decrease their extensions and disfigurating effects by various treatment modalities.

Efficacy of local bath PUVA in the treatment of palmoplantar pustulosis

Amirreza Hanifnia

Background and Aim: Palmoplantar pustulosis is a chronic dermatosis of palms and soles, which is associated with a high recurrence rate and resistance to treatment. Various treatments with different success rates have been used.The purpose of this study was to evaluate the efficacy of local bath PUVA in the treatment of palmoplantar pustulosis.

Methods: In this retrospective study, patients with palmoplantar pustulosis who were treated with local bath PUVA in Phototherapy clinic of Razi Hospital between 2005 and 2009 were evaluated for the therapeutic efficacy of local bath PUVA. Data were analyzed using t and chi-square tests.

Results: Ninety-five patients with a mean age of 44.17 years included in this study. 49.5% of patients were males and 50.5% were females. Mean treatment cessions of patients were 42.5 sessions and mean cumulative dose was 251.8 J/cm2. In 16.8% of cases have very good response was observed. Good, moderate and poor responses were observed in 35.8%, 29.5% and 9.5% of cases, respectively. Treatment failure was observed in 8.4% of patients. Mean cumulative dose in patients with very good response was significantly higher than other response groups, (P=0.016). Mean number of treatment sessions was also significantly higher in that group with comparison with other groups, (P<0.05). Twenty percent of patients withdrawed from the study because of complications. However all complications recovered completely and no long term complications was observed.

Conclusion: This study demonstrated that local bath PUVA is an effective safe treatment for the treatment of palmoplantar pustulosis.

Frequency of kerion complications

Iman Ahrari

Background and Aim: Tinea capitis is one of the most common fungal infections in dermatology. Although the new medications and development in social health have reduced its incidence, it is still common in Iran, especially in rural areas. The aim of this study was to describe the frequency of complications of kerion.

Methods: Eighteen affected patients, who were hospitalized in dermatology ward because of kerion, in a 10-year period, were revisited and according to their medical documents, data collection forms were filled.

Results: 61.1% of the patients were younger than 10 years of age and 77.7% were male. The mean disease duration from the onset of symptoms to the time of correct diagnosis and management was 16.9 days. The frequency of scar and alopecia was equal in all groups and occurred in 100% of patients. Two patients also suffered from isolation due to scarring alopecia. Various types of medications, made no difference in the prognosis and resultant scarring alopecia.

Conclusion: The frequency and types of sequela showed no relationship with age, type of medication and duration from the onset of disease and correct management. Scar and alopecia occurred in all patients. Further investigations on the new treatment modalities are required to reduce scar formation.

Hair evaluation methods and approach to the patients with hair loss

Mohsen Taherkhani

Hair loss can be viewed a problem from different perspectives: as a disease, a disorder which affects appearance of an individual, and its psychological effects. Therefore, it is crucial to determine the causes and types of hair loss. This review summarized hair loss evaluation methods with significant emphasis on their clinical aspects. According to relevant literature reviews, the major approaches to hair loss are taking medical history, primary investigations and detailed hair examination. Although several invasive and non-invasive, clinical and paraclinical examinations can be used for hair loss assessment, it is generally accepted that using clinical evaluation methods and physical examinations are more efficient. In conclusion, diagnosing hair loss is complex and sometimes time-consuming process. However, precise hair examination may lead to the suspicion of an endocrine disorder.

Evidence-based clinical guidelines for treatment: Vitiligo

Alireza Firooz

Clinical practice guidelines are the most important and valid guidelines for treatment of diseases, and are developed through experts consensus on a subject, considering the highest available evidence (systematic reviews, metaanalyses, and randomized controlled trials). We briefly review the latest evidence-based guideline for the treatment of vitiligo provided by European Dermatology Forum.