Amirhoushang Ehsani; Alireza Firooz; Arezou Jam Manesh; Amirali Jahanshahi; Elnaz Khosravani; vahide Lajevardi; Parvin Mansouri; Mansour Nassiri Kashani; Reza M Robati; Zahra Saffarian
Abstract
Urticaria is a frequent and difficult-to-treat skin condition, described as temporary erythematous, raised, and itchy skin lesions (wheals) brought on by dilated blood vessels, elevated local blood flow, and increased vascular permeability. It can occur alone or in conjunction with angioedema. Urticaria ...
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Urticaria is a frequent and difficult-to-treat skin condition, described as temporary erythematous, raised, and itchy skin lesions (wheals) brought on by dilated blood vessels, elevated local blood flow, and increased vascular permeability. It can occur alone or in conjunction with angioedema. Urticaria can be diagnosed and treated in fields other than dermatology; patients often visit general physicians, internal medicine specialists, allergologists, and clinical immunologists. In 2018, the Iranian Society of Dermatology produced a clinical practice guideline on diagnosing and managing urticaria. To update the guideline, the Guideline Development Committee conducted an exhaustive search of scientific papers published on the topic from April 2018 to the end of August 2022, and the new guideline was developed. Finally, the updated guideline was critiqued by members of the Dermatology Board Certificate Examination Panel and chairs of dermatology departments in Iran, and it was improved using their feedback.
Firooz Alireza; Handjani Farhad; Lajevardi Vahideh; Mansouri Parvin; Nassiri-Kashani Mansour; Norouzi Yasaman
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. Iranian Society of Dermatology developed ...
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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. Iranian Society of Dermatology developed a clinical practice guideline concerning diagnosis and treatment of urticaria that was published in 2015. The current guideline is an update to the previous one and includes findings related to this subject which has been published in the medical literature from 2015 to August 2018.
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.
Banihashemi Mahnaz; Pezeshkpoor Fakhrozaman; Hadis Yousefzadeh; Fatemeh Livani; Gholamreza Ghandeharian
Volume 17, Issue 4 , 2014, , Pages 126-129
Abstract
Background: The diagnosis of herpes simplex virus may requirevirological confirmation. Tzanck smear is an old, rapid, costeffective but nonspecific method that has been recently re-evaluatedas a method for the diagnosis of herpes virus infection. This studywas conducted to compare Tzanck smear and viral ...
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Background: The diagnosis of herpes simplex virus may requirevirological confirmation. Tzanck smear is an old, rapid, costeffective but nonspecific method that has been recently re-evaluatedas a method for the diagnosis of herpes virus infection. This studywas conducted to compare Tzanck smear and viral culture in thediagnosis of herpes simplex virus infection in patients clinicallysuspected to be infected with this virus.Method: Materials obtained from a fresh vesicle were used toprepare Tzanck smears and viral cultures.Result: In this study, 40 (71.4%) of the 56 samples were culturepositive while Tzanck smears were positive in 36 (64.3%) patients.We found that the sensitivity and specificity of the Tzanck testwas 90% and 100% respectively when compared to cell culture.Moreover, the positive predictive value (PPV) and negativepredictive value (NPV) of the Tzanck test was 100% and 80%,respectively.Conclusion: The Tzanck smear has its limitations but is still asuitable rapid, easy, and cost effective diagnostic method forherpes simplex virus infections, especially when viral cultureor other virological methods are not available.
Anchal Jindal; Rushikesh Shah; Neela Patel
Volume 17, Issue 3 , 2014, , Pages 96-100
Abstract
Background: Immunobullous diseases are morphologically heterogeneous and the differentiation between various subtypes is essential for proper treatment and prognosis. The aim of our study was to analyze and correlate clinical, histopathological, and immunofluorescence findings in ...
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Background: Immunobullous diseases are morphologically heterogeneous and the differentiation between various subtypes is essential for proper treatment and prognosis. The aim of our study was to analyze and correlate clinical, histopathological, and immunofluorescence findings in autoimmune bullous diseases.Method: A cross-sectional study was conducted over a period of two years (2010-2012) after receiving the ethics committee approval. Sixty patients who met the inclusion criteria of immunobullous disease were included in the study. Skin biopsy for histopathological and direct immunofluorescence (DIF) examination was taken. DIF was also done in a few of the cases using the salt-split technique. The final diagnosis was based on clinical, histopathological, and DIFfindings.Result: Sixty cases with a clinical diagnosis of autoimmune bullous diseases were evaluated. In 95% of the cases, the histopathological diagnosis was consistent with the clinical diagnosis and in 75% of the cases, the DIF diagnosis was consistent with the clinical diagnosis. A positive relationship was seen between clinical and DIF findings with r = 0.67 and between histopathologic and DIF findings with r = 0.76. DIF positivity was seen in 100% of the cases of bullous pemphigoid (BP), 100% of the cases of pemphigus foliaceus, and 94.7% of the cases of pemphigus vulgaris which was statistically significant with P < 0.05.Conclusion: Our study provides evidence-based guidance for the diagnosis and classification of various immunobullous disorders. DIF test should be done in conjunction with histopathology tomake a definite diagnosis and minimize both false-positive and false-negative results.
Barzegari Massoume; Valikhani Mahin; Esmaili Nafiseh; Naraghi Zahra; Nikoo Azita; Kamyab Kambiz; Ghanadan Ali; Tamizifar Banafshe
Volume 11, Issue 2 , 2008, , Pages 64-66
Abstract
Background: Pemphigus vulgaris (PV) is an autoimmune blistering disease, caused by autoantibodies against desmoglein (Dsg) 3 and / or Dsg1 which induce the loss of adhesion between keratinocytes. Nikolsky's sign is the ability to induce peripheral extension of a blister as a consequence of applying lateral ...
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Background: Pemphigus vulgaris (PV) is an autoimmune blistering disease, caused by autoantibodies against desmoglein (Dsg) 3 and / or Dsg1 which induce the loss of adhesion between keratinocytes. Nikolsky's sign is the ability to induce peripheral extension of a blister as a consequence of applying lateral pressure to the border of an intact blister. If the weakening of the intercellular adhesion is present but not marked, then the damage may be demonstrated only microscopically (microscopic Nikolsky’s sign and can increase the sensitivity of the histopathological studies. Methods: We studied 40 patients and divided them randomly into two groups (A, B). Group A were subjected to the tangential pressure over the perilesional skin before a biopsy specimen was taken from that site; group B patients were subjected to a biopsy without the tangential pressure technique. Results: Histopathological changes of pemphigus vulgaris were present in 30% of the patients in group A and 5% of the patients in group B. They were not statistically different. The presence of microscopic Nikolsky’s sign was significantly higher in patients with generalized disease. Conclusion: Microscopic Nikolsky sign can increase the sensitivity of histologic diagnosis of PV.
Samadi Zaynab; Gorouhi Farzam; Davari Parastoo; Firooz Alireza
Volume 9, Issue 4 , 2006, , Pages 335-342
Abstract
Background and aim: Pemphigus vulgaris (PV) is the most common blistering disease in Iran and many other Asian countries with a relatively high incidence and involvement of both skin and mucous membrances in majority of patients. The aim of this study was to assess the opinions of Asian experts on the ...
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Background and aim: Pemphigus vulgaris (PV) is the most common blistering disease in Iran and many other Asian countries with a relatively high incidence and involvement of both skin and mucous membrances in majority of patients. The aim of this study was to assess the opinions of Asian experts on the diagnosis and management of PV. Materials and Methods: A questinnaire-based mailed/emailed survey was conducted. The questionnaire was sent to 29 dermatologists from different countries of Asia (23 from Iran and 6 from India, Kuwait, Turkey and Bangladesh) who are in charge of the treatment of autoimmune blistering disorders with at least 5 years experience in this field who visit at least five new PV patients annually. Questions incluced duration of experience, number of patients treated and diagnostic and treatment approaches for PV. Descriptive data were reported using SPSS 11.5 and some data are reported as mean±SD. Results: All 29 physicians participated in the survey. Among them, 79.3% visit their patients within 6 months after the onset of symptoms. Diagnosis of PV is confirmed by histologic and direct immunofluorescence examinations by 65.5% of physicians. All of them initiate the treatment with corticosteroids (48.3% with a dose of at least 2 mg/kg/day prednisolone) and 89.7% add adjuvant immunosuppressors at the same time. Of the adjuvant agents used, azathioprine is used by 82.8% of physicians. Conclusion: Different trends in diagnostic techniques and treatment options for PV among the experienced authorities emphasize the urgent need for large-scale controlled trials to reach consensus standards in this field. In addition, regional and worldwide consensus meetings to consider all regional and genetic similarities and differences are highly recommended.
MT Noor Bala; N Poursina
Volume 8, Issue 3 , 2005, , Pages 190-194
Abstract
Background: Getting access to information about expansion and spread of skin diseases and determination of common types of them in any specific area has particular importance. There is no doubt that cultural, social and genetic factors by an important role in the epidemiology of skin diseases. Objective: ...
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Background: Getting access to information about expansion and spread of skin diseases and determination of common types of them in any specific area has particular importance. There is no doubt that cultural, social and genetic factors by an important role in the epidemiology of skin diseases. Objective: To determine the frequency of various skin diseases in patients referred to Sadooghi hospital in Yazd in the summer of year 1999. Patients and Methods: This descriptive study was done on 1000 patients who referred to the skin clinic. Final clinical diagnosis of patients were classified according to ICD 10. Results: According to ICD 10, more than 60 diseases were diagnosed among which infectious diseases of skin were the commonest (23%) and viral diseases formed about one third of total infections. 19% of cases had dermatitis of which 2 third were contact dermatitis. 10.8% of cases had acne and 7.8% had melasma. In patients under 15 years of age infectious diseases and in patients 15-25 years of age acne were the most commonly found diseases. Cutaneous leishmaniasis, which is endemic in the study area, was the most common parasitic skin infection. Conclusion: Infectious diseases and dermatitis are among the most commonly diagnosed skin diseases in Yazd and need to be considered carefully to make a comprehensive plan to control.
F Fatemi; A Asilian; AA Forouz Mehr
Volume 8, Issue 2 , 2005, , Pages 128-139
Abstract
Since the discovery of X-rays, the use of imaging technology has continued to play an important role in medicine. Technological advancements have led to the development of various imaging modalities, most of which have been used to image organs deep within the human body. More recently, attention has ...
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Since the discovery of X-rays, the use of imaging technology has continued to play an important role in medicine. Technological advancements have led to the development of various imaging modalities, most of which have been used to image organs deep within the human body. More recently, attention has focused on the application of imaging technology for evaluation of the skin. A variety of techniques are currently being used to examine the skin and these include specialized photography, surface microscopy, ultrasound, laser Doppler perfusion imaging, confocal microscopy, magnetic resonance imaging and optical coherence tumography. These modalities can provide information hat can assist in the management of skin problems. Although many of these techniques are still undergoing research, they are showing promise as useful clinical tools in dermatology. In this review article we discuss about each of these technologies in brief.
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.
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.
A Zamanian; M Pilehvar
Volume 5, Issue 2 , 2002, , Pages 28-32
Abstract
Background: Pilomatricoma, the most common hair follicle tumor, has a wide variety of clinicopathological characteristics and is often misdiagnosed. Objective: The aim of this study was to explain the clinical and histological spectrum of tumor in order to help for its better diagnosis. Patients and ...
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Background: Pilomatricoma, the most common hair follicle tumor, has a wide variety of clinicopathological characteristics and is often misdiagnosed. Objective: The aim of this study was to explain the clinical and histological spectrum of tumor in order to help for its better diagnosis. Patients and Methods: In a retrospective descriptive study, the clinical and histological features of pilomatricoma were reviewed. The files and histologic sections of all biopsy specimens examined in Hamadan Sina Hospital between 1992 and 1999 were analyzed. Results: Among 4000 biopsy specimens, 22 cases of pilomatricoma were found. 59.3% of the lesions were located on upper extremities. The lesion developed in second decade of life in 36.5 percent of the patients. Shadow cells, calcifications, ossification and granulomatous reaction were detected in 100, 50, 9 and 45.5 percent of specimens, respectively. The accuracy of clinical diagnosis compared with pathologic findings was 36.5 percent. Conclusion: Pilomatricoma was the final diagnosis in 0.55 percent of all biopsy specimens examined in Hamadan Sina Hospital between the years 1992 to 1999. It should be included in differential diagnosis of skin tumors.
S Shamsaddini
Volume 3, Issue 4 , 2000, , Pages 38-42
Abstract
What shall we do when we have done everything we could for the diagnosis and treatment of a patient, but were not successful? What shall we do when there is no definite treatment for a patient? What shall we do when we have no diagnosis or treatment for a patient? Some useful suggestions are presented ...
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What shall we do when we have done everything we could for the diagnosis and treatment of a patient, but were not successful? What shall we do when there is no definite treatment for a patient? What shall we do when we have no diagnosis or treatment for a patient? Some useful suggestions are presented here to get rid of these situations.
