Journal of

---

Background and Aim: Vitiligo is a common skin disorder that presents as depigmented patchs and associated with psychosocial morbidity. Photochemotherapy with methoxsalen plus ultraviolet A (PUVA) is an effective and commonly used modality in treatment of vitiligo and is available in Khorasan Province since more than ten years ago.
Methods: This uncontrolled clinical trial included patients with vitiligo referred to phototherapy center in Emam Reza Hospital in Mashhad during 1998-1999. Treatment was done topically on patients with involvement less than 2% of the body area and systemic in cases with involvement more than that. Data including improvement rate and side effects were analyzed by SPSS software version 11.5.
Results: One-hundred and thirty-five patients, 79 female and 56 male, were enrolled.  One-hundred and twenty-six patients were treated systemically and 9 patients underwent topical therapy. Complete (100%) repigmentation was observed in one patient. Repigmentation of 80-99%, 60-79%, 40-59%, 20-39% and less than 20% were observed in 53, 43, 12, 6 and 20 patients respectively. Results were significantly better in generalized vitiligo, face involvement, and cases whom recieved more than 200 treatment sessions, but there was not significant relationship between improvement and patients' age, family history, the first involved area, beginning time of repigmentation, the observed interval between initiation of treatment and disorder appearance, and skin type. Common side effects were pruritus (69.6%), erythema (52.6%), nausea and vomiting (28.9%), and headache (17.8%).
Conclusion: PUVA therapy is an effective and safe treatment in patients with vitiligo, and has good results in nonsegmental vitiligo and facial involvement.

---

Background and Aim: Pruritus is one of the most disabling complications in patients with chronic renal failure that have negative effect on patients' quality of life. The aim of this study was to determine the frequency of the uremic pruritus and its associated factors in hemodialysis patients referred to the dialysis centers in Golestan Province.

Methods: In this cross-sectional study, all 375 patients referred to eight dialysis centers in Golestan Province were selected via census sampling method. Data were gathered by using demogeraphic and Yosipovitch pruritus questionnaires. Data analysis was performed using SPSS software through conducting t and chi square tests.

Results: The mean ± standard deviation of patients' age was 48.36 ± 13.27 years and 51.2% of patients were male. One hundred and eighty one (48.3%) patients had uremic pruritus. The lowest and highest frequency of pruritus among surveyed centers were 37.9% and 57.1%, respectively. 60.2 % of patients had localized pruritus and the most common location was back (68.8 %). There was a statistically significant correlation between uremic pruritus with number of dialysis session (P<0.001) and serum level of phosphorus (P<0.001). 

Conclusion: The results indicated that uremic pruritus is still one of the most common problems in hemodialysis patients. Therefore it seems necessary providing ways to eliminating or reducing the problem.

---

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.

---

Background and Aim: Unwanted hair growth (hirsutism) is a cosmetic problem, which has been resulted in a large number of researches regarding its treatment. Patient satisfaction after treatment using hair removal lasers has been different. The aim of this study was to investigate the satisfactaion rates of the patients with hirsutism after being treated with a diode laser. Methods: In this study satisfaction rates of 50 women with hirsutism were evaluated based on an audio-visual evaluation in Haj Daii clinic in Kermanshah, Iran. Results: Fifty patients with a maen±standard deviation age of 32.5±9.2 years were categorized in three groups in accordance with their skin phototypes. Patient satisfaction after using laser diode hair removal with 25-40 J/cm2 was 74.6%. The most common side effect was transient post laser erythema (28.3%). The highest satisfaction rate was obtained in patients who were taking hormone regulating drugs (85.0%). The lowest satisfaction was obtained in patients with irregular menstrual cycle who were not taking any hormon drugs (73.3%). There was a direct correlation between the number of laser sessions and patients satisfaction (r=0.51, P<0.05). Conclusion: Findings of the present study showed that diode laser is an effective method in treatment of hirsute patients and patients satisfaction rates are good.

---

Background and Aim: Internal evaluation is one of the most effective educational assessment processes. Due to involvement of all educational department stake-holders, this evaluation has high efficacy and enforcement. Appropriate use of the findings of such evaluations improve educational quality. The aim of this study was to evaluate various aspects of education, research and facilities at the Department of Dermatology, Kermanshah University of Medical Sciences, Iran.

Methods: In this cross-sectional study, objectives, organizational status, management and authority, faculty members, students, teaching-learning strategies, educational equipments, theses and sabbaticals, and graduates of the Department of Dermatology, Kermanshah University of Medical Sciences were evaluated. Questionnaires were designed, and obtained data were analyzed by IBM SPSS Statistics (IBM Corp., Armonk, NY, USA) version 22.

Results: Most of evaluated components were satisfying. Learning-teaching strategy was the most satisfying factor with an average satisfaction rate of 87.5%, and the graduates issues was the least satisfying factor with an average satisfaction rate of 66.7%.

Conclusion: Planning and proceedings at the  department and medical school levels according to feedbacks based on the results of this study not only could improve educational quality at the department, but also may help obtaining  approval for initiating a dermatology residency program.