Z Hallaji; Sh Shams Davatchi; M Vali Khani; N Ghandi; M Kar Bakhsh Davari; M Hedayati; AR Firooz
Volume 9, Issue 3 , 2006, , Pages 204-210
Abstract
Background and aim: Azathioprine is the most widely used immunosuppressive agent as an adjunct to corticosteroids in the treatment of pemphigus vulgaris (PV). Thiopurine methyl transferase (TPMT) is a key enzyme in azathioprine metabolism and a genetic polymorphism controls its activity in human tissue. ...
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Background and aim: Azathioprine is the most widely used immunosuppressive agent as an adjunct to corticosteroids in the treatment of pemphigus vulgaris (PV). Thiopurine methyl transferase (TPMT) is a key enzyme in azathioprine metabolism and a genetic polymorphism controls its activity in human tissue. TPMT activity can provide a rational basis to determine suitable dose of azathioprine, theoretically. The aim of this study was to evaluate the clinical relevancy of this hypothesis in PV patients.Materials and Methods: In this cross sectional study in Razi Hospital, the activity of TPMT in the red blood cells of 52 PV patients who received azathioprine for at least 12 months and 29 PV patients who did not receive this drug was measured and correlated to the clinical response and side effects observed.Results:The mean of TPMT activity was not significantly different in patients with unfavourable response, comparing to patients with favorable response to azathioprine (P=0.087). No relationship was observed between total dose of corticosteroid and TPMT activity (r=0.089, P=0.583). There was no difference between the mean of TPMT activity in patients receiving azathioprine and those not receiving this drug (P=0.36).Conclusion: A direct relationship was not observed between TPMT activity and clinical efficacy and side effects in PV patients under treatment with azathioprine. Larger prospective studies in more homogenous patients are needed to evaluate the clinical relevance of TPMT polymorphism and to determine accurate azathioprine dosing guidelines based on TPMT activity.
Z Pour Pak; AR Firooz; L Sedighi Pour; A Afrooz; Gh.A Afrooz; B Ghobari; A Kazem Nejad
Volume 9, Issue 3 , 2006, , Pages 233-241
Abstract
Background and aim: Atopic dermatitis (AD) is a chronic disorder that is most common in early childhood. Both immunological and psychological factors are important in AD pathogenesis and should therefore be taken into account. The aim of this study was to compare behavioral characteristics of 30 infants ...
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Background and aim: Atopic dermatitis (AD) is a chronic disorder that is most common in early childhood. Both immunological and psychological factors are important in AD pathogenesis and should therefore be taken into account. The aim of this study was to compare behavioral characteristics of 30 infants (3-12 month-old) with AD with 40 controls.Materials and Methods: The infants with the definite diagnosis of atopic dermatitis referring to Children Medical Center and Center for Research & Training in Skin Diseases & Leprosy were included in the study. The severity of atopic dermatitis was determined by SCORAD criteria. For assessing behavioral characteristics Infant Behavior Questionnarie (IBQ) for measuring 11 scales of behavioral characteristics was used. Questionnaires were filled by the researchers with the cooperation of the patents or the child care givers.Results: The AD group showed significantly higher scores in perceptual sensitivity, soothability and high pleasure, but not other characteristics.Conclusion: Infants with AD tend to have higher perceptual sensitivity to the environment around them and show more pleasure and excitement when subjected to an intense, rapid, novel or incogruit stimuli compared with non atopic infants.
A Kouhkan; Z Pour Pak; R Safar Ali Zadeh; Sh Teimourian; AR Firooz
Volume 9, Issue 2 , 2006, , Pages 143-149
Abstract
Background and aim: Atopic dermatitis (AD) is a chronic, inflammatory, pruritic skin disease usually observed in patients with other allergies. Decreased selenium levels and improvement with selenium supplement are reported in AD. The aim of this study was to compare serum and whole blood selenium in ...
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Background and aim: Atopic dermatitis (AD) is a chronic, inflammatory, pruritic skin disease usually observed in patients with other allergies. Decreased selenium levels and improvement with selenium supplement are reported in AD. The aim of this study was to compare serum and whole blood selenium in children with AD and control group.Materials and Methods: In an age-sex matched case-control study, 46 children with AD (according to Rajka & Hanifin criteria) and 46 controls were evaluated. The severity of AD was determined based on SCORAD index. Serum and whole blood selenium levels were measured and compared between two groups by atomic absorption spectroscopy. Chi-square and t tests were used for data analysis and P<0.05 was considered as significant.Results: Forty-six patients with age of 2.57±2.6 years and 46 controls with age of 2.63±2.6 years, each consisting of 24 boys and 22 girls were included (P>0.05). Mean serum selenium in patients (72.58±16.5 ng/ml) was significantly lower than controls (84.8±15.6 ng/ml) (P=0.0001). Mean whole blood selenium in patients (88.07±19.0 ng/ml) was significantly lower than controls (99.38±19.3 ng/ml)(P<0.001). Low serum selenium levels (less than 63 ng/ml) were observed in 28.3% of patients and 10.9% of controls (P<0.05). Low whole blood selenium levels (defined as less than 75.5 ng/ml) were observed in 30.4% of patients and 15.2% of controls (P>0.05). No significant correlations were observed between serum and whole blood selenium and severity of AD.Conclusion: The results confirm other studies that showed low selenium levels in AD. Our findings suggest that low selenium level may be involved in the pathophysiology of AD in childhood, and indicate nutritional status especially selenium levels might be a potentially useful strategy for the recognition and treatment of these patients.
MA Nilforoush Zadeh; G Sadeghian; F Jafari; AR Firooz; Sh Moradi; R Derakhshan
Volume 9, Issue 1 , 2006, , Pages 35-39
N Naderi; M Mahdavi Mazdeh; AR Firooz; M Heydari Seraj
Volume 8, Issue 6 , 2006, , Pages 489-495
Abstract
Background and aim: New modalities in the treatment of end-stage renal disease (ESRD) patients have increased their life expectancy and quality of life. A wide range of cutaneous manifestations are seen in ESRD patients. This study was conducted to determine the prevalence of cutaneous manifestations ...
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Background and aim: New modalities in the treatment of end-stage renal disease (ESRD) patients have increased their life expectancy and quality of life. A wide range of cutaneous manifestations are seen in ESRD patients. This study was conducted to determine the prevalence of cutaneous manifestations in ESRD patients on maintenance hemodialysis in the dialysis department of Imam Khomeini hospital.Materials and Methods: One hundred and four hemodialysis patients on maintenance hemodialysis in April, May, and June 2003 were interviewed and examined for skin problems.Results: Almost all patients had at least one cutaneous lesion. The most common cutaneous findings were changes in skin color and nail disorders (79.8%). The other common cutaneous manifestations were xerosis (74%) and pruritus (51%). Xerosis was more common in those patients with serum calcium level greater than 9.3 gr/dl (P<0.05). Hyperpigmentation was more frequent in patients with urine volume<500 ml (P<0.05) and in those who were more than 24 months on continuous hemodialysis (P<0.05). Pruritus was more common in those patients with a history of drinking alcohol (P<0.05). Nail involvement was seen in all 14 patients who were positive for HCV Ab, but was absent in those 5 patients who were positive for HBs Ag.Conclusion: Cutaneous manifestations are very common in ESRD patients on maintenance hemodialysis.
MA Nilforoush Zadeh; F Jafari; N Ansari; Z Nilforoushan; AR Firooz
Volume 8, Issue 5 , 2005, , Pages 340-346
H Seirafi; F Farnaghi; AR Firooz; S Mostafa; Y Sedaghat
Volume 8, Issue 5 , 2005, , Pages 347-352
AR Khatami; AR Firooz; Z Ghorbani; F Gorouhi; A Komeili
Volume 8, suppl , 2005, , Pages 34-37
Abstract
Several skin conditions have been reported to occur on epidermal nevi, but it seems that co-occurrence of a vascular lesion and an epidermal nevus is a very rare phenomenon. Herein, a 17- year- old female patient who had presented with skin lesions on her thigh since 4 years ago has been reported. The ...
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Several skin conditions have been reported to occur on epidermal nevi, but it seems that co-occurrence of a vascular lesion and an epidermal nevus is a very rare phenomenon. Herein, a 17- year- old female patient who had presented with skin lesions on her thigh since 4 years ago has been reported. The lesions were two oval plaques consisted of multiple brown- tinted, hyperkereratotic papules that surrounded several dark red papules. One of the lesions was totally excised and the specimen was sent for histopathologic evalution. Routine light microscopic examination of the slides revealed histopathologic features of both epidermal nevus and angiokeratoma. The clinical presentation of this case suggested the co- occurrence of an epidermal nevus and angiokeratoma, which was confirmed after histopathological study.
SM Davoudi; AA Karimi Zarchi; S Ghafouri Manesh; AR Firooz; M Nasiri Kashani; Y Dowlati
Volume 8, Issue 3 , 2005, , Pages 166-170
Abstract
Background: Eczema is one of the most widely spread inflammatory skin disorders contact dermatitis is an eczematous dermatitis that is produced as a result of contact with a substance in the environment. The substance can act as an irritant or allergen. Every country has allergen particular to itself. ...
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Background: Eczema is one of the most widely spread inflammatory skin disorders contact dermatitis is an eczematous dermatitis that is produced as a result of contact with a substance in the environment. The substance can act as an irritant or allergen. Every country has allergen particular to itself. Objective: Determining the frequency of skin allergens in patients with contact dermatitis in Tehran. Patients and Methods: In this cross-sectional descriptive study, all the data about the patients with chronic contact dermatitis who were visited in a dermatology clinic in Tehran from the year 1993 to 2003 and patch tested with 23 allergens of European standard series (ESS) were analyzed. Results: In this study 222 patients were surveyed. The mean age of the patients was 33.5 years (SD=13.8). 66.5% of the patients were female. The most common site of involvement (49%) was their hands. The mean duration of the disease was 54 months (SD=62). Clinical diagnosis included: 59% allergic contact dermatitis, 24% irritant dermatitis, 10% atopic dermatitis, and 7% other types of dermatitis. 145 (65.3%) of them had at least one positive reaction. The most common allergens were: Nickle sulfate 22.6%, cobalt chloride 14.5%, and fragrance mix 13.6%. Conclusion: Nickel was the most common contact allergen among the patients surveyed.
N Farsi; AR Firooz; M Rashighi Firoozabadi
Volume 8, Issue 1 , 2004, , Pages 66-69
Abstract
Pigmented Bowens disease is an in situ squamous cell carcinoma, which is seldom reported in white patients. Herein we report a 20-year-old woman with type III skin, who had this lesion on the fourth finger of her right hand, similar to superficial malignant melanoma, clinically. Although dermoscopic ...
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Pigmented Bowens disease is an in situ squamous cell carcinoma, which is seldom reported in white patients. Herein we report a 20-year-old woman with type III skin, who had this lesion on the fourth finger of her right hand, similar to superficial malignant melanoma, clinically. Although dermoscopic evaluation could be helpful, correct diagnosis of non-melanotic origin is done by histological examination. In spite of its rarity, pigmented Bowens disease should be considered in the differential diagnosis of malignant melanoma.
AR Firooz; AR Khatami; A Khamesipour; M Nassiri Kashani; MA Nilforoushzadeh; F Behnia; HR Pazoki Toroudi; Y Dowlati
Volume 7, Issue 4 , 2004, , Pages 209-218
Abstract
Background: Several treatment modalities have been used for cutaneous leishmaniasis (CL) with various results. In vitro and in vivo studies have shown inhibitory effects of zinc sulfate (ZnSO4) on Leishmania parasites. Objective: To compare the efficacy of intralesional injections of 2% ZnSO4 solution ...
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Background: Several treatment modalities have been used for cutaneous leishmaniasis (CL) with various results. In vitro and in vivo studies have shown inhibitory effects of zinc sulfate (ZnSO4) on Leishmania parasites. Objective: To compare the efficacy of intralesional injections of 2% ZnSO4 solution with meglumine antimonate (Glucantime) in the treatment of acute Old World CL. Patients and Methods: Seventy-two patients with CL with a duration of less than 8 weeks were recruited in a randomized, double-blind, clinical trial in Isfahan province – an area endemic for Leishmania major – after giving written informed consent. They were treated with 6 weekly intralesional injections of either 2% sterile ZnSO4 solution or Glucantime prepared in identical vials. The primary outcome measure was complete re-epithelialization of CL lesions. Results: Among 36 patients with 53 lesions treated with ZnSO4 and 36 patients with 53 lesions treated with Glucantime, 13 patients with 19 lesions and 22 patients with 31 lesions completed the trial, respectively. Inadequacy of treatment was the main reason for drop-out in 12 (33.3%) and 2 (5.5%) patients in ZnSO4 and Glucantime groups, respectively (P<0.05). Complete re-epithelialization was observed in 2 (10.5%) and 19 (61.3%) lesions 1 week after the end of treatment in the ZnSO4 and Glucantime groups, respectively (P<0.05). Conclusion: A six-week course of weekly intralesional injections of 2% ZnSO4 solution was less effective than Glucantime in the treatment of acute Old World CL.
M Karimzadegan Nia; A Miramin Mohamadi; AR Firooz; MR Shidfar
Volume 7, Issue 2 , 2004, , Pages 95-100
Abstract
Background: At present time, the diagnosis of onychomycosis is based on clinical signs, direct exam and fungal culture, whereas Pathologic methods have shown to be more sensitive than other methods. Objective: Evaluation of pathologic methods in the diagnosis of onychomycosis in comparison to direct ...
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Background: At present time, the diagnosis of onychomycosis is based on clinical signs, direct exam and fungal culture, whereas Pathologic methods have shown to be more sensitive than other methods. Objective: Evaluation of pathologic methods in the diagnosis of onychomycosis in comparison to direct smear and culture. Patients and Methods: A nail sample was cut form 96 suspected onychomycosis patients by nail clipper. Then it was divided to four pats, and one part was stored. One part was fixed in 4% formalin and examined pathologically (PATH-PAS method). Another part was cultured in mycosil agar and Sabour and Dextrose Agar media and kept in room temperature for 4 weeks. Another part was directly examined by 10% KOH. The results of each method were recorded separately without knowing the results of others. Clinical signs with at least one positive result were considered as onychomycosis and the sensitivity of these methods were compared. Results: The most sensitive method was the combination of PATH-PAS and direct smear (98%). There was no significant difference between the sensitivity of smear and pathological method, where as PATH-PAS and culture differed significantly. Conclusion: PATH-PAS is a simple and very sensitive method in the diagnosis of onychomycosis.
AR Firooz; AR Khatami
Volume 7, Issue 2 , 2004, , Pages 101-111
Abstract
Physicians’ daily need for valid information about diseases, their limited time for finding this information, the inadequacy of traditional sources (E.g. textbooks) to address this matter, the disparity between physicians diagnostic skills and clinical judgment (Which increase with experience) ...
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Physicians’ daily need for valid information about diseases, their limited time for finding this information, the inadequacy of traditional sources (E.g. textbooks) to address this matter, the disparity between physicians diagnostic skills and clinical judgment (Which increase with experience) and their up to date knowledge and clinical performance (Which decline by time), as well as dramatic development in the field of information technology that provides easy access to an uncountable number of data resources, all have resulted in the consideration of evidence-based medicine (EBM) as an appropriate approach to solve these problems. EBM is defined as: “The conscientious, explicit, and judicious use of current best evidence in making clinical decisions about the care of individual patients”. The full-blown practice of EBM comprises five steps: Step 1) Asking a well-built clinical question; step 2) Tracking down the best evidence which answer that question; step 3) Critically appraising that evidence for its validity, importance, and applicability; step 4) Integrating the critical appraisal with the clinical expertise and with the patients unique values and circumstances; and step 5) Evaluating our effectiveness and efficiency in executing steps 1-4 and seeking ways to improve them for next time.
F Farnaghi; H Seirafi; AR Firooz; F Jamshidi
Volume 7, Issue 1 , 2003, , Pages 19-23
Abstract
Background: Psoriatic arthropathy is a seronegative arthropathy seen in some patients with psoriasis, a self-limited and genetically determined skin disease. Objective: To determine the prevalence and risk factors of arthropathy in patients with psoriasis. Patients and Methods: In a prospective, cross-sectional ...
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Background: Psoriatic arthropathy is a seronegative arthropathy seen in some patients with psoriasis, a self-limited and genetically determined skin disease. Objective: To determine the prevalence and risk factors of arthropathy in patients with psoriasis. Patients and Methods: In a prospective, cross-sectional study, psoriatic patients referred to Razi Skin Hospital in Tehran, Iran in 2002 were evaluated for the presence of arthropathy, and were referred to a rheumatologist for confirmation of arthropathy. The relationship between and nail involvement were evaluated using chi-square and t tests. Results: Among 320 patients with psoriasis, 29 (9.1%) had joint diseases. The most common was asymmetric polyarthritis. Patients with joint diseases had more nail involvement (96.5% vs. 73.1%, P<0.05) and higher mean PASI scores (24.33±10.35 vs. 10.70±8.44, P<0.05) than those without arthropathy, but the age and sex distribution of two groups were not significantly different. Conclusion: The prevalence of joint diseases in psoriatic patients in this study was similar to other reports. Nail involvement and more extensive disease are risk factors for joint diseases in these patients.
M Nasiri Kashani; AR Firooz
Volume 6, Issue 1 , 2002, , Pages 32-42
Abstract
Contact dermatitis is an inflammatory skin disease due to contact with different substances and caused by two mechanisms: Allergy and irritation. Contact dermatitis is a common skin disease and the most common occupational dermatosis. Differentiating between allergic and irritant contact dermatitis is ...
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Contact dermatitis is an inflammatory skin disease due to contact with different substances and caused by two mechanisms: Allergy and irritation. Contact dermatitis is a common skin disease and the most common occupational dermatosis. Differentiating between allergic and irritant contact dermatitis is essential in the identification of etiologic factor(s) and hence, its control and prognosis. This differentiation can be done only by patch test. Unfortunately, this simple, safe and useful test is always neglected. We review the basics of patch test, the method of performance, reading and interpretation of its results, possible side effects and results of studies done with patch test in different countries.
AR Firooz; M Rashighi Firoozabadi; B Ghazi Saidi; Y Dowlati
Volume 4, Issue 3 , 2001, , Pages 11-17
Abstract
Background: Alopecia areata (AA) is a common disease with an unknown etiology. It is a chronic disease with causes severe disfigurement. So it may significantly affect the patients’ quality of life (QOL). This study was designed to evaluate illness perception and QOL in patients with AA. Patients ...
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Background: Alopecia areata (AA) is a common disease with an unknown etiology. It is a chronic disease with causes severe disfigurement. So it may significantly affect the patients’ quality of life (QOL). This study was designed to evaluate illness perception and QOL in patients with AA. Patients and Methods: A questionnaire consisting of 28 questions about causes, course and the impact on QOL were given to patients with AA older than 12 years attending a private skin clinic in 1999 in Tehran. The questions were asked as closed questions and the patients answered them anonymously as “I agree”, “I do not know” and “I disagree”. Only questionnaires with more than 80% of questions answered were analyzed. The role of age, sex, duration, previous treatment, education, severity and family history of AA were assessed. Results: 80 patients (42 male and 38 female) with a mean age of 27.5±9.3 years and disease duration of 7.8±7.7 years entered the study. 60 of them had AA and 20 had alopecia totalis/universalis (AT/AU). 77% of patients believed on the role of stress as the cause of disease, more in older patients and shorter duration. 17% believed on the role of genetic background, more in patients with positive family history of AA or longer duration of disease. AA had a pronounced effect on QOL of 58% of patients, more in younger patients. 51% of patients considered their disease as severe, more in younger patients or severe disease. Only 58% of patients considered their treatments effective and 49% of them believed it will improve with praying. Conclusion: AA may considerably affect various aspects of patients’ lives. The knowledge of patients about the causes and course of this disease is very limited. Physicians should spend more time on the education of patients.
N Bouzari; AR Firooz; H Tabatabai; Y Dowlati
Volume 4, Issue 3 , 2001, , Pages 24-29
Abstract
Background: Minoxidil is currently an approved treatment for androgenetic alopecia. Topical tretinoin can enhance skin absorption of minoxidil. Objective: This study has been done in order to determine the efficacy and safety of the solution of 0.5% minoxidil+0.05% tretinoin compared to 2% minoxidil ...
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Background: Minoxidil is currently an approved treatment for androgenetic alopecia. Topical tretinoin can enhance skin absorption of minoxidil. Objective: This study has been done in order to determine the efficacy and safety of the solution of 0.5% minoxidil+0.05% tretinoin compared to 2% minoxidil in androgenetic alopecia in men. Patients and Methods: In a randomized, double-blind, parallel-group, controlled study, 117 male patients with androgenetic alopecia, 18-40 years old, Hamilton grades of 2-5 and duration of alopecia less than 10 years were evaluated. These patients were divided in two groups randomly, one group received a solution containing 0.5% minoxidil and 0.05% tretinoin and another group received 2% minoxidil for at least 4 months. The patients used 1ml of the solution twice daily. 2 and 4 months after treatment, the patients were evaluated for efficacy (Patients, idea about improvement of hair loss, hair regrowth and wash test) and safety (Erythema, scaling and pruritus). The quantitative data were analyzed by ANOVA and the qualitative data were analyzed by qui-squared test. Results: There were no significant differences between two groups regarding the age, duration and grade of hair loss. After 4 months of treatment, the percentage of patients reporting improvement in hair loss and hair regrowth were 81.6% and 56% in minoxidil 2% group and 65.4% and 59.6% in minoxidil+tretinoin group, respectively (P>0.05 for all). At the same time, the numbers of hairs in wash test were 156 in minoxidil 2% group and 149 in minoxidil+tretinoin group (P>0.05). Conclusion: There was no significant difference in efficacy and safety of 4 months treatment with the solution of 0.5% minoxidil and 0.05% tretinoin compared to the solution of 2% minoxidil in the treatment of androgenetic alopecia in men.
H Riahi Dehkordi; AR Firooz
Volume 2, Issue 4 , 1999, , Pages 22-30
Abstract
Systemic drugs have been used widely in the treatment of many skin diseases. Although dermatologists are familiar with the guidelines of selecting appropriate patients and prescribing systemic drugs, their knowledge about the side effects and significant interactions of systemic drugs used in dermatology ...
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Systemic drugs have been used widely in the treatment of many skin diseases. Although dermatologists are familiar with the guidelines of selecting appropriate patients and prescribing systemic drugs, their knowledge about the side effects and significant interactions of systemic drugs used in dermatology is more limited. So a short review on important drug interactions seems to be useful. Some of the most significant drug interactions in dermatology are reviewed.
AR Firooz
Volume 2, Issue 3 , 1999, , Pages 43-45
Abstract
Systemic drugs are used in the treatment of several skin diseases. In order to obtain best therapeutic results and prevent side effects, the patients should be carefully screened before and thoroughly evaluated during treatment. In this article guidelines for selection and follow up of patients receiving ...
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Systemic drugs are used in the treatment of several skin diseases. In order to obtain best therapeutic results and prevent side effects, the patients should be carefully screened before and thoroughly evaluated during treatment. In this article guidelines for selection and follow up of patients receiving systemic drugs for their skin diseases are presented. These drugs include azathioprine, anti-malarials, spironolactone, PUVA, dapson, retinoids, cyclosporin, cyclophosphamide, gold, colchicine, corticosteroids, and methotrexate.
A Miramin Mohammadi; AR Firooz
Volume 2, Issue 1 , 1998, , Pages 27-32
Abstract
During 12 months survey on 33 patients with onychomycosis, only one of them showed infection due to scopulariopsis brevicalis. The case was a 38-year-old male with great toe nail lesion which was diagnosed as Trichophyton rubrum based on smear and culture. The patient was treated with 3 weekly pulses ...
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During 12 months survey on 33 patients with onychomycosis, only one of them showed infection due to scopulariopsis brevicalis. The case was a 38-year-old male with great toe nail lesion which was diagnosed as Trichophyton rubrum based on smear and culture. The patient was treated with 3 weekly pulses of itraconazole, 200mg twice daily during 3 months and showed marked clinical improvement. But 6 months after treatment the case relapsed and this time smear and culture showed infection due to Scopulariopsis brevicalis.
P Sepehri; AR Firooz; Y Dowlati
Volume 1, 3-4 , 1998, , Pages 43-46
Abstract
A 47-year-old man with 3 years history of a pruritic plaque, 1×3 cm on his left leg attended a dermatology clinic. An incisional biopsy was done with the differential diagnoses of: 1) Hypertrophic lichen planus, 2) Lichen simplex chronicus, 3) Psoriasis, 4) Bowen's disease. A diagnosis of “Fibroepithelioma” ...
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A 47-year-old man with 3 years history of a pruritic plaque, 1×3 cm on his left leg attended a dermatology clinic. An incisional biopsy was done with the differential diagnoses of: 1) Hypertrophic lichen planus, 2) Lichen simplex chronicus, 3) Psoriasis, 4) Bowen's disease. A diagnosis of “Fibroepithelioma” was suggested by histopathologist who was not compatible with clinical diagnosis. Careful review of slide showed that the specimen had been cut horizontally in the laboratory, which had misled the pathologist. By vertical sectioning the block and doing another biopsy, the diagnosis of hypertrophic lichen planus was confirmed. The patient was treated with intralesional triamcinolone injection and 4 weeks later the lesion was completely healed with residual hyperpigmentation.
