Journal of

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Sulfur mustard (SM) or mustard gas is a chemical weapon which for the first time was employed during world war I later on it was used by Iraqi military forces against Iranian army and civilians (1980-88). This agent injured over 100000 Iranians and one-third of them are still suffering from its complications. SM is an alkylating agent with cytotoxic, mutagenic and vesicating properties, which targets the skin, eyes and respiratory systems. In this study we review the acute and chronic effects of SM on the skin. We obtained information of this paper from a search of PubMed. Google, Iran Medex, Irandoc and SID until beginning of 2011. The most common acute effects of SM on skin were: pruritus and burning (26%-96.8%), pain (25%-77.4%), erythema (20.6%-83.9%), hyperpigmentation (20%-83.9%), and vesicle and bulla (15.4%-80.6%). The most common chronic effects were: pruritus (24.7%-94.7%), burning (9.9%-52.1%), scar (4.5%-70%), hyperpigmentation (5.9%-55%), hypopigmentation (3.2%-40%), xerosis (2.1%-43.7%) and cherry angioma (12.2%-70.5%). After passing more than 20 years of the end of the Iraq-Iran war, the victims still suffer from many skin complications of SM and some of them such as itching and dry skin have negative effects on the performance and quality of their life. Up to now, serious skin complications like malignant skin tumors have been rare and a longer time may be required to establish. Therefore further follow-up is needed to detect and treat any kind of skin cancers promptly.

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Background and Aim: Today, despite numerous advances in medical sciences, the number of complaints against physicians shows an increasing trend. Studying the causes of these complaints and identify contributing factors may reduce medical litigation. The aim of this study was to assess the reasons of complaints in the field of dermatology and cosmetic.
Methods: In this retrospective cross-sectional study, we investigated the medical malpractice records related to dermatology and cosmetics, registered in the office of Forensic Medicine, province of Tehran from 2002 to 2010.
Results: In 63.4%, 35.3%, and 1.2% of cases, verdicts of malpractice, acquittal and closing the file without a verdict, were issued respectively. The most common types of negligence were related to improvidence (63.4%), lack of proficiency (27%), and disregarding of governmental provisions (5.7%). Most frequent causes of complaints were related to scar and darkening of skin after laser therapy (24.4%), dissatisfaction of hair transplantation (19.5%), and complications after injection of filler gels, botollonium toxin, etc (15.8%). Most plaintiffs were women, in their 20s, with a highschool diploma and were housewives. The most frequent age range of the physicians was 30-39 years old and most of them were male.
Conclusion: Considering medical ethics and professionalism, good communication between physician, medical personnel and patient including his entourage, full examination, adequate explanations about therapeutic procedures and possible complications, lack of exaggerating the results of therapy, continuous study and updating medical knowledge, improvement of medical skills and experiments, refrain from dealing with procedures that did not pass its training courses, properly selected patient, take informed concept and innocence may reduce the number of complaints.

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Background and Aim: Non-Melanoma Skin Cancer (NMSC), including squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) is the most common cancer in Iran. This study aimed to infer implicit information in the cases of NMSC patients referred to the Cancer Institute of Tehran.

Methods: A number of 865 cases of NMSC related to 2007-2015 years were selected from the archives of Cancer Institute using simple random sampling method. Initially, epidemiological variables, were extracted and after preprocessing of the data, descriptive statistics were used to classify and graphic display of information.

Results: The mean age for patients was identified 65 years and the highest and lowest numbers of cases were in age groups of 69-60 and 19-10 years respectively. The incidence of SCC was higher than BCC in the first four age decades and this trend was reversed in the next decades. About 56% of cases were BCC and 44% were SCC and frequency of NMSC in men was 2/33 times more than women. The head/neck and trunk were the highest and lowest involved positions. The disease had relapsed at least twice in 32% of cases. The disease history showed that most of patients were previously affected by kinds of cancers, cardiovascular or metabolic diseases. The occupation of 114 patients was found to be as high-risk jobs. Most patients were referred to Cancer Institute from northern and western parts of the country.

Conclusion: Along with other studies, we found more cases of BCC than SCC, involvement of patients over 60 years at the head-neck and a previous history of cancer. But against other studies, SCC cases was found more in the first four decades of life than BCC cases, feet affected twice than hands and the locality of most cases was found in high latitudes. Patient records are potential resources that can help management of the diseases.

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Background and Aim: Patients' complaints against doctors and medical malpractice is one of the most serious and challenging issues in the medical profession. Due to the importance of this issue and the lack of sufficient information about skin and beauty complaints in the medical system. The purpose of this study is to investigate and identify skin and beauty complaints referred to the Tehran Medical System Organization. 

Methods: In this descriptive-analytical and retrospective study, all cases of complaints of medical malpractice in the field of dermatology in the medical system of Tehran province from 2014 to 2019 were reviewed and after collecting information, the data were analyzed using SPSS statistical software (SPSS Statistics 25).

Results: Of the total cases, 1.6% were related to skin and beauty. Most of the plaintiffs were female (79.8%) and single (59.6%). The attending physicians were mostly male (79.8%) and general practitioner (48.1%). The most common type was private medical center (95.2%). The most common complaints were treatment complications (36.7%), most of which were related to the side effects of Botox or fat injections (15.4%) and then laser complications (12.5%). The most common type of negligence was carelessness (30%) and 20.7% of cases were declared negligent. The highest percentage of verdicts was written reprimand and inclusion in the file (42.3%).

Conclusion: Physicians should avoid engaging in unrelated disciplines and unscientific practices. Reducing financial relationships and emphasizing the physician's proper interaction with the patient and adhering to a professional commitment are helpful in preventing complaints.

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Background and Aim: Androgenetic alopecia is a type of androgen and genetic dependent hair loss and although it is more of a beauty issue, but in recent years studies have shown that this type of alopecia is associated with underlying disorders such as coronary artery disease. The aim of this study was to evaluate the frequency of androgenetic alopecia in hospitalized patients and its relationship with the history of coronary heart disease and its risk factors.

Methods: In this cross-sectional descriptive-analytic study, 250 patients (125 women and 125 men) admitted to Shahid Mostafa Khomeini Hospital in Tehran from October to December 2020 were examined and after examination and data collection, the data were analyzed using SPSS statistical software SPSS Statistics 25 version.

Results: The prevalence of alopecia was generally 46.8% in hospitalized patients, 61.6% in men and 32% in women. The prevalence of coronary heart disease in hospitalized patients was 25.6%, 34.4% in men and 16.8% in women. In patients with alopecia, the frequency of history of coronary heart disease was 39.31%, the history of hypertension was 20.8%, history of hyperlipidemia was 17.2%, history of diabetes was 14.4% and the smoking history was 15.6%. All of these factors were significantly associated with alopecia, except for smoking.

Conclusion: According to the results of this study, the frequency of androgenetic alopecia in patients admitted to the hospital is common and its prevalence in men is more than twice that of women. History of coronary heart disease and its risk factors in patients with alopecia are high, and have a significant relationship with it. This can be important and help in screening and early diagnosis of coronary heart disease and its subsequent prevention.