Journal of

Background and Aim: Adverse drug reactions are inevitable outcomes of drug therapy, which may cause mortality and morbidity for those whom are treated in this way. Cutanous adverse drug reactions are abserved in 2% to 3% of inpatients but only 2% of them are considered serious and may cause death. The aim of this study was to determine the cause and clinical forms of adverse drug reactions referred to department of dermatology.

Methods: This cross-sectional study that was done on patients with diagnosis of cutanous adverse drug reactions in 2007 and 2009. All patients suspected with diagnosis of adverse drug reactions were examined by an experienced dermatologist for determination of different kinds of clinical manifestations.

Results: During the study period, 308 patients were recruited. Cutanous adverse drug reactions were found to be more frequent in females (63%) than in males (37%). Betalactam antibiotics were found to be the most frequent cause of adverse cutaneous drug reactions (42.7%), followed by non-steroidal anti-inflammatory drugs (16.5%). Acute urticaria was the most frequent observed drug reaction (59.2%) followed by fixed drug eruption (18.5%) and maculopapular rashes (14.9%).

Conclusion: In this study adverse cutaneous drug reactions was mainly induced by betalactam antibiotics and non-steroidal anti-inflammatory drugs. The most common forms of cutaneous adverse drug reactions were found to be: acute urticaria, fixed drug eruption and maculopapular rashes.

Background and Aim: Hirsutism is defined as the presence of terminal hairs in androgen dependent areas like upper lip, cheeks, chin, breasts, lower area of abdomen and thigh in women. The aim of this study was to determine the etiologic factors and clinical features of hirsutism in premenopausal women.

Methods: In this cross-sectional study, 180 premenopausal women with hirsutism who were admitted at a referral dermatologic clinic in a 1-year period were investigated. After taking full medical history and performing physical examinations, a transabdominal ultrasonography of the ovaries, and laboratory evaluation including early morning total and free serum testosterone, prolactin, dehydroepiandrosterone sulfate, FSH, LH and 17-hydroxyprogestron in all patients were performed.

Results: The most common causes of hirsutism were idiopathic (51.1%), polycystic ovarian syndrome (37.7%), hyperprolactinemia (4.4%), adrenal hyperplasia (3.8%), and drug-induced (2.8%). Hirsutism was mild in 93 (51.6%) patients, moderate in 78 (43.3%) patients and severe in 9  (5%) patients. Family history of hirsutism was present in 100 patients. Clinical conditions associated with hirsutism were: acne (58.3%), obesity (55.5%), menstrual irregularity (38.8%), androgenic alopecia (17.7%) and acanthosis negricans (8.4%).

Conclusion: Idiopathic hirsutism and polycystic ovary syndrome were the most common causes of the hirsutism in premenopausal women. Obesity also had a significant role in hirsutism occurrence.

Background and Aim: Hand, foot, and mouth disease (HFMD) is a common contagious infectious disease. Because of the current limited knowledge about the etiology of this disease and its associated complications, especially nails lesions, we conducted this study to determine the prevalence of the nail disorders in children with HFMD.

Methods: In this cross-sectional study, 84 children whom were referred to Bo Ali Sina Hospital in Sari, in 2013 and 2014, and were diagnosed as HFMD, were recruited using a census sampling method. Diagnosis of HFMD was made by a dermatologist or a pediatrician based on the clinical findings. Then, the skin lesions were recorded and the nails of all HFMD patients were examined to detect any nail disorder (onychomadesis, transverse ridging, etc.). Nail examinations were repeated fortnightly up to 8 weeks after the first visit. During this follow-up period, through using a questionnaire, the type of the nail lesions and their relationship with HFMD were recorded.

Results: The mean±standard deviation (SD) age of the patients was 38.2±19.5 months, and 58.3% of the patients were male. At the time of HFMD diagnosis, 30 (35.7%) patients had hand and nail involvement. Thirty-one cases (36.9%) had toenails involvement. Onychomadesis frequency was higher 4 weeks after initiation of the disease in comparison with 2 weeks after the onset of illness (15.5% vs. 1.2%, P<0.001) and 6 weeks after the beginning of the disease compared to 4 weeks after the disease onset (29.8% vs. 15.5%, P=0.001) the frequency of nail involvement at 8 weeks after the disease onset compared to 6 weeks after the beginning of HFMD was decreased (17.9% vs. 29.8%, P=0.007).

Conclusion: It is necessary to take measures for early detection and treatment of involved nails in HFMD. Periodic follow-up visits is recommended too.