Iranian Journal of Dermatology

Abstract Background: Chronic lupoid leishmaniasis (CLL) is a chronicform of cutaneous leishmaniasis that is usually resistant to antileishmania agents and leishmania is not seen in the histologicsections. We used polymerase chain reaction (PCR) to detectleishmania DNA in CLL specimens.Method: This descriptive cross sectional study was done on20 paraffin embedded specimens of CLL cases referred to thedermatology clinic of Imam Reza Hospital, Mashhad, Iran.Patients’ information including age, sex, duration and location ofthe lesion was obtained and then skin specimens were reviewedhistopathologically and assessed for leishmania DNA using PCR.Result: Eleven male and 9 female patients with a mean age of17.95 years were included in our study. The

Abstract Background: Preexisting guidelines about clinical managementof cutaneous wounds are based on wound dressing and avoidingwater exposure for at least 48 hours. In this study, infectionrate in the patients who underwent melanocytic nevus surgerywith dressed dry wounds were compared with the patients whoallowed their wounds to become wet.Method: In a controlled randomized clinical trial study, theincidence rate of infection in facial melanocytic nevi surgery inthe wounds that became wet 24 hours after surgery (234 wounds)were compared with similar wounds that were kept dry for atleast for 48 hours (234 wounds).Result: The infection rate was 3.4 % (8 wounds) for the drywounds versus 2.6 % (6 wounds) for the wet wounds; comparisonof these two rates showed no statistically significant difference(P=0.548, odds ratio= 1.345, CI 95%: 0.459-3.939).Conclusion: The results of this study showed that it was safe toremove the dressing of the wounds within 24 hours after minorsurgery without concern about infections and allow wounds tobecome wet after 24 hours under normal circumstances.

Abstract Introduction: Acne is a common problem in adolescent and youngage groups, for which several risk factors have been suggested.One of the risk factors is smoking. In studies on the relationshipbetween smoking and acne, conflicting results have been obtained.Method: This study was conducted on 133 male patients whowere visited at the dermatology clinic of Imam Reza hospital dueto acne as the case group, and 133 healthy individuals withoutany skin diseases including acne among those accompanying thepatients as the control group. The case and the control groups wereage matched. For each patient who had the criteria for inclusionin the study, a questionnaire was completed and the necessaryinformation was collected and then analyzed statistically.Result: The questionnaires were filled for 133 patients with acneand 133 healthy controls. Twenty-nine patients with acne (21.8%)and 12 patients in the control group (9.1%) were smokers, and thedifference between them was significant (P = 0.004). The numberof cigarettes smoked per day was significantly different in thetwo groups (4.75 in the case group versus 1.88 in the controlgroup). No correlation was found between smoking and acnelocalization, severity of acne, the type of lesion, symptomaticor asymptomatic nature of acne and acne complications. In thecase group, the smokers developed acne at an older age thanthe non-smokers.Conclusion: Patients with acne were more likely to smoke thanpatients without acne; thus, smoking might be a factor affectingthe incidence of acne.

Abstract Background: Diaper rash is a common but non life threateningcondition during infancy. Different modalities of treatmentare suggested. Sucralfate acts as a physical barrier to irritantsand has antibacterial activities. Promising reports of the effectof topical sucralfate on wound epithelialization along with itsbacteriostatic properties led us to carry out a trial to evaluateits role as a topical agent in the treatment of diaper dermatitisand compare its efficacy with topical zinc oxide.Method: This double blind randomized clinical trial was conductedin Shariati hospital from April 2008 to September 2009. Sucralfateand zinc oxide were formulated as 20% ointments with the sameexcipients. All patients were randomly treated topically witheither sucralfate (N=25) or zinc oxide (N=21) for 7 days. Diaperseverity scores were obtained before treatment and at days 3, 5,7 by the authors.Result: A total of 46 infants (54.3% female and 45.7% male) withmean age of 4.4±6.5 months entered the study. The mean age,sex, frequency of diaper change (per day) and severity of diaperrash showed no statistically significant difference between twogroups. Sucralfate 20% ointment was significantly superior inhealing diaper dermatitis at days 5 and 7 (p < 0.05 and 0.01respectively) and showed a significantly shorter healing time(3.24+/-2.02 days) in comparison with zinc oxide 20% ointment(5.42+/-2.39 days) (P = 0.002).Conclusion: Since sucralfate in topical formulations acts as aphysical barrier with proved safety and no noticeable absorption,it may be used as a potential treatment for diaper dermatitis.

Abstract Background: Precancerous lesions are disorders that are highlylikely to become malignant. Early diagnosis of precancerous skinlesions helps to prevent skin cancers. The aim of this study wasclinicopathological assessment of precancerous skin lesions inpatients referred to the dermatology department of Imam Rezahospital.Method: Two hundred and nine patients who were diagnosed withprecancerous lesions and referred to the dermatology departmentof Imam Reza hospital from 1997 to 2007 were studied. Studyparameters included participants’ age, sex and occupation, typeof precancerous skin lesion, clinicopathological type of the lesionand location. The data was collected from the patients’ recordsin the dermatology department and their microscopic slides inthe pathology department.Result: The most common precancerous skin lesion was actinickeratosis (68.4%) followed by Bowen’s disease (7.2%). About67.5% of the patients were male with a mean age of 61.7 years.Moreover, 53.1% of the patients worked outdoors. The mostcommon site of the lesions was head and neck (83.3%) and 18.7%of lesions were associated with malignancy. The most commonpathological form of actinic keratosis was the proliferative type(28.9%).Conclusion: The results of this study showed that precancerousskin lesions were more prevalent in men aged over 50 years, insun-exposed areas and in occupations practiced outdoors. Inaddition to squamous cell carcinoma, these lesions could alsobe associated with basal cell carcinoma.

Abstract Intravesical instillation of Bacillus Calmette-Guerin (BCG) has
become an established adjuvant treatment for superficial bladder
carcinoma. This treatment is associated with a relatively high rate
of side effects which are mostly reversible spontaneously or can
be treated symptomatically. Serious systemic side effects are less
frequent. One of rare complications is granulomatous cutaneous
reaction. We report a 50-year-old man with disseminated papules
and plaques following intravesical BCG.  

Abstract Adrenocortical carcinoma is an uncommon and aggressivemalignancy. Despite a high frequency of metastasis, cutaneousmetastasis of adrenocortical carcinoma is rare with only isolatedcase reports. Its diagnosis can be challenging based solely onhistopathological findings. Yet, the clinical history in combinationwith an immunohistochemical panel consisting of inhibin,vimentin, chromogranin, synaptophysin, melan- A, neuron specificenolase and calretinin, can be useful in differentiating it fromother tumours with similar morphology. We report a case of a52-year-old female who presented with subcutaneous noduleson her abdominal wall which, on histopathology, proved to bemetastasis from adrenocortical carcinoma diagnosed one and ahalf years ago.

Abstract Carcinoma erysipeloides is a well-demarcated erythematousplaque resembling erysipelas. Malignant cells are predominantlywithin the dermal lymphatic vessels, with malignant thrombiinducedlymphatic obstructions causing the erysipeloid induration.Carcinoma erysipeloides, as the first manifestation of breastcancer, is very rare and accounts for about 2-5% of all cases.

Abstract Indeterminate cell histiocytosis is a very rare proliferative disorderof histiocytes which displays both langerhans cell histiocytosisand non langerhans cell histiocytosis immunophenotypic features.The majority of the patients develop multiple lesions which areclinically indistinguishable from generalized eruptive histiocytosis.We report a 14-year-old girl with multiple papules on the face,scalp and trunk.

Abstract Laser– assisted permanent hair removal iscommonly performed for the treatment of unwantedhair. This procedure is usually associated withpain and pain reduction has an important role inthe success of this treatment. A common methodof reducing pain is to use topical analgesics . Amixture of lidocaine and prilocaine (EMLA) is acommonly used and very effective topical anesthetic.Another agent is diclofenac gel. Diclofenac is anon-steroidal anti-inflammatory drug (NSAID) andis a potent inhibitor of inducible cyclo-oxygenase(COX-2) . Oral administration of this medicationcan result in adverse effects. There are no studieson its efficacy as a topical anesthetic in laser hairremoval.