Tehran University Medical Journal

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Background: Acne is one of the most common skin diseases especially in adolescence. Different studies have reported unequal rates of facial acne prevalence in different countries and populations. Only a few cases of acne in the trunk area (back and chest) have been reported in literature. Although our clinical experience shows lower prevalence of truncal acne in comparison with facial acne, a community based study is needed to support this experience.

Methods: A total number of 1001 high school students, selected randomly from 5 out of 20 education-ministry subdivisions of Tehran, were included. In each area two high schools (one for boys and one for girls) with almost 100 students per high school were selected. Demographic data, family history and clinical findings were recorded in the questionnaires. Consensus Conference on Acne Classification was used for acne grading.

Results: One thousand one high school students, 503 girls and 498 boys ,were included. Prevalence of acne was 91.1% for face (95%CI: 83-99%), 93.4% in boys and 88.6% in girls. It was 53.4% for back (95%CI: 46-62.2%), 58.5% in boys and 36.9% in girls. Whereas for chest the prevalence was 36% (95%CI: 27-45%), 34.9% in boys and 36.9% in girls. Mean age of the students with truncal acne was 16.1 years where as 15.9 in others. This difference was significant (P<0.05). Positive family history was higher in students with truncal acne (P<0.001).

Conclusion: Truncal acne is less prevalent than facial acne. Acne on the back is significantly higher in boys than girls (P=0.002). Severe forms of acne in back may be more prevalent in boys. Positive family history can increase the risk of truncal acne.

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Background: Since the systemic steroids are introduced in Pemphigus Vulgaris treatment, the prognosis of disease improved significantly. This study was designed to evaluate determining factors in the prognosis of pemphigus vulgaris in Iranian patients.

Methods: In this study, 119 patients with documented pemphigus vulgaris who had presented to Razi Hospital from 2001 until 2003 were included. These patients had presented for the first time and treated with prednisolone and Azathioprine. Morality rate, minor and major relapses and duration of first remission had been defined as prognostic criteria and correlation between them and other demographic variables and disease characteristics were investigated.

Results: The majority of patients (84.1%) were followed for more than one year. The major recurrence and minor recurrence occurred in 28(23.5%) and 65(54.6%) of patients respectively, no case of mortality was observed. In patients who received treatment six months or less after onset of disease the frequency of major recurrence was less than the others. 18(17.8%) vs. 12(41.4%), (p=0.009). Duration of primary remission more than one year was detected in most of the patients (64.7%). In patients with less than 10 initial cutaneous lesions, period of primary remission was longer than the other patients. (p=0.009). Shorter duration of primary remission were noted in older patients (age>50) in comparison with younger patients (age≤50, p=0.04).

Conclusions: Male gender, old age, interval more than 6 months between onsets of symptoms to initial treatment and more than 10 skin lesions on admission, are associated with poor prognosis of pemphigus vulgaris.

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800x600 Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Psoriasis is a chronic, inflammatory disease of the skin. Recently, nicotinic cholinergic receptors have been demonstrated on keratinocytes, stimulating calcium influx and accelerating cell differentiation. Therefore, smoking and nicotine seem to influence inflammatory processes in psoriatic skin. The aim of this study was to determine the frequency of cigarette smoking as an independent risk factor in patients with psoriasis who attended the department of dermatology at Razi Hospital in Rasht during the years 2008 and 2009.
Methods : In this descriptive-inferential study, we recruited 96 patients with psoriasis vulgaris and 96 individuals as the controls. The participants were adjusted for sex, age and body mass index. The collected data related to smoking status, duration of smoking habit, smoking intensity, pack-year smoking history, and passively exposure to smoking were documented in a researcher-devised questionnaire. Subsequently, the data were analyzed by descriptive and inferential statistics such as χ², t-test and Mann-Whitney U test by SPSS software.
Results : The smoking rate was 33.3% in the patients and 19.4% in the controls. Pack-year history, regarded as the intensity and duration (years) of smoking, significantly increased the risk of psoriasis vulgaris (P<0.05, OR=2.07, 95% CI=1.17-3.68). Being a passive smoker did not make significant differences between the cases and the controls.
Conclusion: Our study demonstrated that psoriasis vulgaris had a relationship with duration and intensity of cigarette smoking and revealed the importance of smoking cessation, particularly among patients with psoriasis.

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Background: Surgery is one of the best choices for the treatment of hydatidosis. The use of effective scolicidal agents during surgery for hydatid cyst is essential to prevent the secondary infection. Up to now no effective and safe agent has been identified for this purpose. Berberis vulgaris called “Zereshk” in Persian has been traditionally used as herbal remedy for the treatment of complaints and it is widely cultivated in Iran. Many studies have shown that it has antibacterial, antifungal and antiparasitic effect. Methods: In this study the scolicidal effect of Berberis vulgaris aqueous and hydro-alcohol extract for different concentrations (for aqueous: 0.5, 1, 2 and 4 mg/ml and for hydro-alcohol: 0.25, 0.5, 1 and 2 mg/ml) at different exposure times (5, 15 and 30 minutes) was evaluated. For this purpose, we obtained liver hydatid-cysts from a slaughter house. Viability of protoscolices was assessed by 0.1% eosin staining. Normal saline and hypertonic saline were used as negative and positive controls respectively. Results: All the different concentrations of Berberis vulgaris aqueous and hydro-alcoholic extracts had scolicidal effect. An aqueous extract with 4mg/ml concentration acted as positive control and we observed to lead to the death of 100% of protoscolices in the first 5 minutes. The least scolicidal effect (12.3%) was observed in an aqueous extract with 0.5 mg/ml concentration.The scolicidal activity of hydro-alcoholic extract with concentration of 2 mg/ml was 100% after 5 min of application, which was the same as positive control group. We noticed a significant increase in protoscolicidal activity with an increase in concentration in the two extracts of Berberis vulgaris (P<0.001). Conclusion: It is important to mention that all the concentration levels and exposure times applied in this experiment are relatively low, since scolitical activity in both of the extracts is at its highest in this low spectrum. For further experiments, we suggest that the stability of cyst fluid in both of the extracts should be assessed. Therefore, after In vivo examination and additional experiments, it may be used as a suitable and effec-tive scolicidal in surgery.

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Background: Acne vulgaris is self-limiting, multifactorial disease involving sebaceous glands. Omeprazole is a proton pump inhibitor with in vitro antibacterial effects against staphylococcus aureus and anti-androgen that can be potential treatment of acne vulgaris. This study was designed to evaluate the efficacy of oral omeprazole and erythromycin 4% compared to doxycycline combination therapy in the treatment of acne vulgaris. Methods: In this clinical trial study, patients with moderate acne were referred to Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Science, Iran, during August 2014 until November 2015 and were randomized into two groups receiving topical erythromycin 4% plus omeprazole (34 patients) or doxycycline (35 patients) for 3 months. Moderate acne, lack of sensitivity to proton pump inhibitors, lack of warfarin, phenytoin, diazepam consumption, lack of active liver or kidney disease, being older than 12 years, were considered as inclusion criteria. Pregnant or lactating patients, patients with drug allergy history, patients taking oral contraceptives, acne topical medications (including retinoids) or systemic treatment within 30 days of study, patients with oligomenorrhea, hirsutism, acne conglobata, acne fulminant or body acne alone were excluded from the study. All patients were tested for Helicobacter pylori test at the beginning of the study. Results: Both inflammatory and non-inflammatory lesions decreased in both groups with negative correlation with age (P< 0.05). There was no significant correlation between positive Helicobacter pylori test and inflammatory or non-inflammatory lesion reduction (P= 0.794, P= 0.514). Also, patient satisfaction and rate of total drug side effects was not different between two treatment groups. Rate of skin reactions was 20.58% in omeprazole treated group and 11.42% in doxycycline group. For side effects, other than skin it was 2.94% versus 14.28% respectively. Conclusion: Omeprazole could be suggested as an alternative for doxycycline in the treatment of patients with moderate acne vulgaris especially in non-inflammatory lesions.