Alireza Khatami; Pegeen Walsh
Abstract
The World Health Organization characterized the outbreak of the coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), as a pandemic on March 11, 2020. According to official reports, over 12,300,000 individuals have caught the disease globally ...
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The World Health Organization characterized the outbreak of the coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), as a pandemic on March 11, 2020. According to official reports, over 12,300,000 individuals have caught the disease globally over the past six months. Like many other professions, the disease has affected private and academic dermatology practices around the world. The disease has diverse and extensive skin manifestations with implications for dermatology education and research. Some other issues that may concern dermatologists during the pandemic include ethics pertaining to the optimal use of scarce resources like certain drugs and personal protective equipment as well as surcharging patients and the potential of increasing the size of the preexisting health inequity gap. Considering all these issues, discussing the ethical aspects of dermatology, i.e., dermatoethics, during this pandemic is critical. Herein, we review the four basic biomedical ethics principles of autonomy, beneficence, non-maleficence, and justice in the context of the COVID-19 pandemic.
Kamyab Kambiz; Firooz Alireza; Kohsari Laleh Montaser; Noorian Negin; Khorshid Hamidreza Khorram; Khatami Alireza; Estarabadi Ali Rajabi
Volume 19, Issue 3 , 2016, , Pages 86-88
Abstract
Background: In 10-30% of the cases with sarcoidosis, skin lesions appear solely without any systemic signs or symptoms. BTNL2 gene, which is a member of the immunoglobulin gene super family and is associated with CD86 and CD80 co-stimulatory receptors, is identified to play an important role in the establishment ...
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Background: In 10-30% of the cases with sarcoidosis, skin lesions appear solely without any systemic signs or symptoms. BTNL2 gene, which is a member of the immunoglobulin gene super family and is associated with CD86 and CD80 co-stimulatory receptors, is identified to play an important role in the establishment of sarcoidosis. We aimed to evaluate the role of this gene in patients with skin sarcoidosis in comparison with skin sarcoidal reaction patients and those with normal skin. Methods: The nucleotide sequence of rs2076530 allele in exon 5 of BTNL2 gene was compared among the paraffin-embedded blocks of 34 patients with a histologic diagnosis of sarcoidosis, 14 patients with skin sarcoidal reaction (tattoo, foreign body), and 27 patients with normal skin (excised during cosmetic surgery) using polymerase chain reaction. Results: There was no statistically significant difference in the frequency of 3 genotypes of AA, AG, and GG in rs2076530 allele among skin sarcoidosis, skin sarcoidal reaction, and normal skin. Conclusion: The expression of rs2076530 allele of BTNL2 gene in skin sarcoidosis or sarcoidal reaction does not differ with its expression in the normal skin.
Firooz Alireza; Hallaji Zahra; Khatami Alireza; Lajevardi Vahideh; Mansouri Parvin; Pedram Mehryan; Zohreh Mozafari; Mansour Nassiri-Kashani; Reza Robati; Hassan Seirafi
Volume 18, Issue 3 , 2015, , Pages 81-96
Abstract
Urticaria is a common and challenging skin disorder. Diagnosis and treatment of urticaria is not limited to the field of dermatology. General physicians, allergologists and clinical immunologists are also commonly involved in the management of patients with urticaria.One of the missions of the Iranian ...
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Urticaria is a common and challenging skin disorder. Diagnosis and treatment of urticaria is not limited to the field of dermatology. General physicians, allergologists and clinical immunologists are also commonly involved in the management of patients with urticaria.One of the missions of the Iranian Society of Dermatology is to develop strategies in order to provide the best possible management for patients suffering from dermatological conditions. To accomplish this mission, the Society assigned a committee to search and critically appraise the recent research evidence and available guidelines to develop a clinical practice guideline concerning diagnosis and treatment of urticaria.
Nassiri-Kashani Mansour; Nassiri-Kashani Mohammad Hassan; Khatami Alireza; Ghafari Mostafa; Firooz Alireza; Dowlati Yahya
Volume 17, Issue 2 , 2014, , Pages 49-53
Abstract
Background: Job-related allergic contact dermatitis (ACD) mayprolong the disease duration, increase disabilities, and decreasethe patient’s quality of life. The aim of this study was to determinecommon allergens causing ACD, investigating certain featuresof the disease and evaluating its relation ...
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Background: Job-related allergic contact dermatitis (ACD) mayprolong the disease duration, increase disabilities, and decreasethe patient’s quality of life. The aim of this study was to determinecommon allergens causing ACD, investigating certain featuresof the disease and evaluating its relation to the patients’ jobs.Method: In this cross-sectional study, relevant data was obtainedfrom patch test clinics at the Center for Research and Trainingin Skin Diseases and Leprosy, Tehran University of MedicalSciences, and two private dermatology clinics in Tehran, Iran.Nine hundred and forty six patients from different regions of Iranwith a probable diagnosis of ACD were recruited into the study.Patch testing was used as the gold standard test to differentiateACD from other differential diagnoses.Result: Of 946 studied patients with a probable diagnosis ofACD, 649 (68.6%) cases were females. The mean age ± standarddeviation (SD) of the patients was 31.9 ± 12.3 years. Five hundredand twenty eight (55.7%) cases had positive patch test results toat least one tested allergen. Comparing job-related and non jobrelatedACD patients revealed that while there was a significantdifference in the mean age of the two group (30.6 ± 11.3 vs.32.7 ± 12.9 years in job-related and non-job-related groups,respectively) (P=0.016), there were no significant differences inthe gender distribution, number of positive patch tests, frequencyof allergens, reaction time, and severity of reactions between thetwo groups. Nickel sulphate and cobalt chloride were the twomost common allergens in both groups.Conclusion: Job-related patients were younger and most of themwere female compared to non job-related patients. However,other characteristics were not different between the two groups.
Khatami Alireza; Firooz MSPH Alireza
Volume 11, Issue 2 , 2008, , Pages 76-85
Abstract
In a number of important clinical issues such as evaluation of the efficacy or effectiveness of therapeutic or preventive interventions as well as for comparing the harms of interventions, randomized controlled trials (RCTs) provide the highest levels of evidence, either directly or indirectly. It is ...
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In a number of important clinical issues such as evaluation of the efficacy or effectiveness of therapeutic or preventive interventions as well as for comparing the harms of interventions, randomized controlled trials (RCTs) provide the highest levels of evidence, either directly or indirectly. It is obvious that critical appraisal of these studies to assess their validity and precision is of paramount importance. The aim of this review is to provide the readership an outline about different types of RCTs, the importance of proper appraisal of RCTs, an overview of the most important factors that have an influence on the validity of an RCT and a strategy for systematic evaluation of those factors, and to introduce some useful methods for improving design, implementation and reporting of RCTs as well as some tools that are used for the evaluation of these studies. It is expected that after reading this review, the reader obtains some knowledge about different phases and types of RCTs, as well as being enabled to evaluate the four major factors: randomization sequence generation, randomization concealment, blinding and intention to treat analysis that affect the validity of an RCT.
Abbas Rasi; Leyla Tajziehchi; Alireza Khatami
Volume 9, suppl.1 , 2006, , Pages 3-3
Abstract
The case, who discribed here is a 66-year-old man with one year history of asymptomatic, keratotic papules with a linear distribution on the skin of his right palm near the wrist. On histopathological examination cornoid lamella-like parakeratotic columns above eccrine sweat ducts were observed. The ...
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The case, who discribed here is a 66-year-old man with one year history of asymptomatic, keratotic papules with a linear distribution on the skin of his right palm near the wrist. On histopathological examination cornoid lamella-like parakeratotic columns above eccrine sweat ducts were observed. The acrosyringium was also dilated. He had been followed up for predominantly sensory polyneuropathy by neurologist from 6 years before. Endocrinologic evaluation revealed hyperthyroidism. In this article, we present a new case of Porokeratotic Eccrine Ostial and Dermal Duct Nevus (PEODDN) where the palmar skin was the primary site of presentation. The present case is consistent with the tarda variant of PEODDN, as the onset of lesions was around the age of 65 years.
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.
A Rasi; H Ansarin; AR Khatami
Volume 8, Issue 4 , 2005, , Pages 299-306
Abstract
Adjuvant high dose IVIgs are being used increasingly in a range of immune-mediated and auto-immune diseases. Although numerous immunomodulatory mechanisms have been suggested, the exact mechanisms of action are poorly understood. The efficacy of IVIg in certain diseases has been proven in clinical trials, ...
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Adjuvant high dose IVIgs are being used increasingly in a range of immune-mediated and auto-immune diseases. Although numerous immunomodulatory mechanisms have been suggested, the exact mechanisms of action are poorly understood. The efficacy of IVIg in certain diseases has been proven in clinical trials, in so far as IVIg is approved as the therapy of choice for Kawasaki syndrome and idiopathic thrombocytopenic purpura. IVIg treatment has been shown to be safe, without many drug-related adverse effects, including systemic immunosuppression, that are related to corticosteriods and other immunosuppressive agents. Current dermatologic uses of IVIg are increasing, which calls for adequately controlled clinical trials. This review evaluates the current published data on the use of IVIg therapy in the treatment of autoimmune diseases and discusses current opinion concerning its potential immunomodulating mechanisms, the industrial preparation and safety features of this biologic agent.
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.
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.
