Dermatology and Cosmetic

The association between irritant contact dermatitis of hand and obsessive compulsive disorder in women: a case control study

Hossein Kavoussi, MD

Background and Aim: Irritant contact dermatitis of hands is a chronic and recurrent cutaneous disorder following the contact with detergents and chemicals. Obsessive compulsive disorder is highly frequent among dermatologic patients, and may be presented with signs of irritant contact dermatitis of hands. The aim of this study was to assess the frequency and relationship between obsessive compulsive disorder and irritant contact dermatitis, among women with chronic and recurrent irritant contact of hands dermatitis in Haj Daie Dermatology Clinic in Kermanshah.
Methods: This case-control analytic study was carried out on 139 females with irritant contact dermatitis of hands and 102 female patients without any history of irritant contact dermatitis of hands. Obsessive compulsive disorder was determined based on the clinical interview using DSM-IV-TR (SCID) by a psychiatrist. Data analysis was performed using chi-square and z-test.
Results: The mean age in the case group was 28.2±8.4 and in the control group was 28.4±6.3 years. Fifty-eight (41.7%) of hand dermatitis patients and 5 (4.9%) of control group had obsessive compulsive disorder (P<0.05). Obsessive compulsive disorder was seen in 29 and 14 patients with moderate and severe irritant contact dermatitis, respectively.
Conclusion: Obsessive compulsive disorder is common in irritant contact dermatitis of hands. Psychiatric evaluation in female patients with chronic irritant contact dermatitis of hands especially moderate and severe forms is suggested.

Relationship between systemic isotretinoin and induction of depression in acne vulgaris patients

Maryam Sadat Sadati, MD

Background and Aim: Acne is one of the most common skin diseases. One of the best treatments is systemic isotretinoin. Some studies link its use with depression, psychiatric problems and suicide, but it is still a matter of debate. So, this study was designed to determine the frequency of depression in acne patients, treated with isotretinoin.
Methods: Fifty-nine acne patients between 16 -30 years old were included. The patients received 0.5-1 mg/kg/day isotretinoin for 16 weeks. At the beginning and at the end of study, the Beck questionnaire was completed by the patients and the results were analyzed.
Results: The mean score of the Beck questionnaire was 13.19 at the beginning of the study and 14.80 after 4 months of treatment with isotretinoin (P=0.0001).
Conclusion: The results of this study showed that isotretinoin may have a small, but still noticeable increase in depression scores of acne patients. However, it is important to consider that various other parameters, such as individual’s psychological status at the time of completing the questionnaire, might influence the results. So, further studies with more patients and longer durations, and the use of other pertinent questionnaires, are recommended.

General health indices in university students uffered from seborrheic dermatitis

Hamidreza Mohajerani, PhD

Background and Aim: Seborrheic dermatitis is a chronic dermatitis that has been observed in both neonates and adults. It has been reported following stress, decreasing of mental and somatic energy, tiredness, insomnia, excitability, depression, etc. All of mentioned effects have adverse effects on health activity and result in body weakness. The aim of this study was evaluating general health indices of Arak Islamic Azad university students that suffered from seborrheic dermatitis using Goldberg scale.
Methods: Three hundred and eighteen students were randomly selected and examined, among them 101 students who suffered from seborrheic dermatitis completed the General Health Questionnaire and then the data were statistically described and analyzed.
Results: Forty-one percent of students with seborrheic dermatitis had body symptoms. Anxiety, communicative act failure and depression were observed in 48%, 65% and 31% of patients, respectively.
Conclusion: The findings of this study indicated the strong relationship between seborrheic dermatitis and communicative act failure.

Oral sulfasalazine in the treatment of patients with refractory alopecia areata

Abbas Karimi

Background and Aim: Alopecia Areata is a chronic inflammatory disease which involves hair follicles. The aim of this study was to assess the efficacy of oral sulfasalazine in the treatment of recalcitrant alopecia areata.
Methods: Patients with refractory alopecia areata who were eligible for the study, after providing informed consent were treated with oral sulfasalazine for 6 months. After completion of treatment, regrowth of vellus and terminal hairs were determined based on clinical examination and comparing the new photographs with the baseline ones.
Results: Sixteen patients were enrolled in the present study but only 5 patients completed it. No response was seen in 3 patients. After 4 months, 55-60% response to treatment was observed in 1 patient, but the disease relapsed at the end of fourth month. In 1 patient, 15% hair regrowth was observed but treatment was discontinued after the second month due to side effects. Side effects were observed in 2 patients.
Conclusion: Since only refractory alopecia areata patients had been enrolled to the study, the results could not be generalized to all patients with alopecia areata. Therapeutic response in the patients with alopecia areata is disappointing and any poor treatment response or failure of treatment in refractory cases of the disease cannot rule out the efficacy of the drug in the milder forms of the alopecia areata.

Efficacy of pulsed dye laser (PDL) in the treatment of xanthelasma palpebrarum

Fatemeh Gholamali, MD

Background and Aim: Xanthelasma is a benign condition considered which is mainly as a cosmetic problem. There are many destructive treatment options that may result in scar formation and dyspigmentation such as cryotherapy and electro-cauthery. According to these side effects finding a non-invasive solution could be important. At this study we aimed to evaluate the effect of PDL laser in the treatment xanthalasma.
Methods: Patients with bilateral palpebral xanthelasma having normal serum lipid profile were eligible for the study if they had no history of a collagen vascular disease or dermatologic disorders that were associated with Koebner phenomenon. All patients had two separate pulsed dye laser (PDL) treatment sessions, with a four-week gap in between and were photographed before every laser treatment session and four weeks after the second session. Visual analogue scale (VAS) scoring system was used to determine effect of treatment by two academic dermatologists blinded to the study as the referees. Mean healing score by the two referees considered as final score.
Results: Nine patients with a mean age (±standard deviation) of 38.0 (±9.2) years were included. All patients were female. The commonest site of lesions was upper lid, and final resolution score for all patients was less than 25%. There were no significant differences between viewpoints of the two referees. There were no major post operative complications. Patients followed for six months after the end of the treatment and there was no adverse effect.
Conclusion: The present study failed to demonstrate therapeutic efficacy of PDL in the treatment of xanthelasma. PDL with limited session numbers could not be considered as an alternative treatment for xanthelasma palpebrarum.

Pharmacological effects of medicinal plants on skin

Zohreh Bakhtiyari, MSc

Skin is one of the most sensitive parts of the body and is important to maintain the beauty of man. Herbal products have fewer side effects than chemicals and have pharmacological effects on the skin, so are used in cosmetic preparations. Books, articles and electronic databases including ISI Web of Science, PubMed, Magiran and IranMedex were searched to identify plants with positive effects on the skin, regardless of adverse effects and their interactions. A number of plants which were used in the treatment of skin diseases and their effects had been established, were chosen and reviewed. Avocado, thyme, aloe vera, chamomile, almond, licorice, calendula, olive and yarrow were included in this review. There are many herbs that have a role in the prevention and treatment of skin diseases, and are used in either traditional medicine or the preparation of cosmetics. The effects of a number of them have been scientifically proved and this information for the production of cosmetic and pharmaceutical products can be used.

Generalized dermatophytosis in a patient with congenital ichthyosis

Zeinab Aryanian, MD

Ichthyosis is defined as a group of diseases with keratinization disorder and diffuse scaling with highly variable degree of involvement. According to our knowledge, coincidence of ichthyosis and dermatophytosis, which both are very common disorders, is a very rare event. We report a young man with congenital ichthyosis that histological analysis of his skin biopsies and direct smear revealed PAS positive fungi. He had used topical steroids for generalized scaling erythematous patches and plaques for long time.