Ghiasi Maryam; Daneshpazhooh Maryam; Balighi Kamran; Ghiasi Fatemeh
Volume 20, Issue 1 , 2017, , Pages 6-10
Abstract
Background: Intravenous immunoglobulin (IVIG) is used to treat many autoimmune and immunodeficiency disorders. The main indications of IVIG in dermatology include treatment for resistant autoimmune bullous diseases, Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). Although generally ...
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Background: Intravenous immunoglobulin (IVIG) is used to treat many autoimmune and immunodeficiency disorders. The main indications of IVIG in dermatology include treatment for resistant autoimmune bullous diseases, Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). Although generally welltolerated, various adverse effects can occur.Methods: We designed a retrospective study to investigate the adverse effects of IVIG in all patients who received this drug in Razi Hospital from 2005-2016. Information was gathered from patients’ medical records.Results: During the study period, 67 patients received 94 IVIG infusions. The most common underlying dermatologic disease was pemphigus vulgaris (54 patients). The most frequent adverse effect of IVIG therapy was an increase in blood pressure for 17 patients and in 21 infusions of IVIG. Other adverse reactions included fatigue and generalized weakness, fever, chills, tachycardia, dizziness, a decrease in blood pressure, headache, flushing, chest discomfort, hemolysis, leukopenia, and deep vein thrombosis.Conclusions: Adverse events associated with IVIG therapy are usually mild and self-limiting. The incidence of serious adverse events is low. Identification of risk factors and close monitoring of high risk patients are essential to decrease the occurrence of serious adverse events.
Balighi Kamran; Ghodsi Zahra; Iravani Masoud; Damavandi Maede Rayati; Goodarzi Azadeh; Lajevardi Vahide; Saburi Sara; Kashani Alireza Faghihi
Volume 19, Issue 75 , 2016, , Pages 21-24
Abstract
Background: Chronic graft versus host disease (cGVHD) is a major cutaneous complication of bone marrow transplantation (BMT). Although milder forms of this process may be associated with a lower incidence of tumor recurrences, it is mandatory to develop a more efficient and less harmful therapeutic approach.Methods: ...
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Background: Chronic graft versus host disease (cGVHD) is a major cutaneous complication of bone marrow transplantation (BMT). Although milder forms of this process may be associated with a lower incidence of tumor recurrences, it is mandatory to develop a more efficient and less harmful therapeutic approach.Methods: This case-series study enrolled 7 patients diagnosed with chronic mucocutaneous GVHD. We divided the patients into three major categories based on the type of skin lesions: sclerodermoid, lichenoid, and mixed. Patients received several packs of narrow band UVB (NBUVB) phototherapy. Each pack contained ten sessions of NBUVB (311 nm) with a duration of at least ten seconds and a fixed radiation dosage (6 mj/cm2) during the treatment.Results: There were 3 patients diagnosed with lichenoid skin lesions, 2 with sclerodermoid lesions, and 2 had mixed cGVHD lesions. During the follow up period one patient was excluded due to a lower respiratory tract infection. The mean response ratio was 42% with a mean satisfaction level of 5.5 out of 10. The lichenoid group had the best, most rapid response. There were no serious adverse effects reported.Conclusion: Narrow band UVB phototherapy is useful as an adjuvant therapeutic modality in cutaneous lichenoid and intraoral cGVHD with no serious adverse effects.
Balighi Kamran; Soori Tahereh; Fouladi Negar
Volume 16, Issue 3 , 2013, , Pages 105-108
Abstract
Background: Mucocutaneous manifestations may occur inevery stage of human immunodeficiency virus (HIV) infection.Some of them may be the first presentations. In this study, weevaluated the prevalence of dermatologic manifestations as thefirst presentations of HIV/AIDS in 25 Iranian patients.Method: In ...
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Background: Mucocutaneous manifestations may occur inevery stage of human immunodeficiency virus (HIV) infection.Some of them may be the first presentations. In this study, weevaluated the prevalence of dermatologic manifestations as thefirst presentations of HIV/AIDS in 25 Iranian patients.Method: In a cross sectional study, we evaluated 25 new casesof HIV infection whose HIV infections were diagnosed duringwork up for their recent dermatological problems. The type ofmucocutaneous manifestations and general information suchas age, sex, risk factors, dermatologic problem duration andeducational level was recorded in a questionnaire.Result: Warts (anogenital and generalized warts) were the mostcommon cutaneous manifestation in new HIV infected patients(36%) followed by psoriasis and cutaneous abscess.Conclusion: Some mucocutaneous diseases such as anogenital orgeneralized warts, psoriasis, and cutaneous abscess may presentas the first manifestation of HIV infection.
Ghandi Narges; Balighi Kamran; Ghiasi Maryam; Soori Tahereh; Kiani Pardis
Volume 15, Issue 3 , 2012, , Pages 74-79
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 ...
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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.
Balighi Kamran; Jamshidi Samaneh; Daneshpajooh Maryam; Lajevardi Vahideh; Aalami Harandi Sima; Ghassemi Hamed
Volume 14, Issue 3 , 2011, , Pages 95-99
Abstract
Background: Treatment of acne scars is a therapeutic challenge that may require multiple modalities. Subcision is a procedure that has been reported to be beneficial in the treatment of acne scars. Although subcision is a valuable method, its efficacy is mild to moderate due to the high recurrence rate. ...
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Background: Treatment of acne scars is a therapeutic challenge that may require multiple modalities. Subcision is a procedure that has been reported to be beneficial in the treatment of acne scars. Although subcision is a valuable method, its efficacy is mild to moderate due to the high recurrence rate. This study aimed to evaluate the novel complementary treatment of repeated suction sessions plus subcision at the recurrence period of subcised scars. Methods: The standard technique of subcision was applied to treat scars in 12 patients; then, one side of the face underwent repeated suctioning for 2 weeks. All patients completed treatment and the follow-up period. The patients’ and investigators’ assessments of improvement were both recorded. Results: According to patients and investigators, subcision plus suction showed 81% and 65% improvement after 3 month, respectively. Subcision alone, after 3 month, was associated with 62% and 33.3% improvement according to patients and investigators, respectively. The rate of response showed a significant difference with the use of repeated suctioning. The side-effects of local edema and bruising were all transient. Conclusion: Subcision plus frequent suctioning at the recurrence period of subcision appears to be a safe technique that increases the efficacy of subcision without considerable complications.
Ghodsi Seyyede Zahra; Bahar Babak; Balighi Kamran; Ranjkesh Mohammad Reza; Toosi Siavash
Volume 11, Issue 4 , 2008, , Pages 137-142
Abstract
Background: Chronic graft versus host disease (ch.GVHD) is the most frequent late complication after allogenic stem-cell transplantation. Systemic immunosuppressive agents are usually required to control the disease. Psoralen plus UVA (PUVA) has been used for the treatment of ch.GVHD with variable beneficial ...
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Background: Chronic graft versus host disease (ch.GVHD) is the most frequent late complication after allogenic stem-cell transplantation. Systemic immunosuppressive agents are usually required to control the disease. Psoralen plus UVA (PUVA) has been used for the treatment of ch.GVHD with variable beneficial effects. The objective of this study was to assess the efficacy and safety of a relatively lower dose of oral psoralen compared with previous reports, for the treatment of ch.GVHD patients with PUVA.Methods: Eleven patients who received allogenic bone marrow transplantation and had severe progressive ch.GVHD that was unresponsive to conventional immunosuppressive treatments were treated with oral 8-methoxypsoralen (0.2 mg/kg, up to 10 mg) two hours before exposure to UVA.Results: The patients received a median of 43 treatments (range: 18 to 72). Mean cumulative dose of UVA was 200.5 J/cm2 (range, 116.5-306.5 J/cm2). In four of the 11 patients, there was a complete resolution of cutaneous ch.GVHD and the remaining seven patients achieved partial response with PUVA treatment. Complete and partial remission was observed in four and six patients with lichenoid lesions, respectively, but all of the four patients with sclerodermoid GVHD showed partial response to PUVA treatment. We observed no side effects like phototoxicity, nausea and vomiting, and exacerbation of GVHD. Liver enzymes raised in five patients, causing no significant morbidity for them.Conclusion: Low-dose psoralen plus UVA can be a safe and effective therapy for chronic cutaneous GVHD. Although the number of treatments and total cumulative exposure to UVA was rather high in our study, we observed no phototoxic reaction or severe irreversible liver damage due to phototherapy, which may be because of a relatively lower dose of methoxsalen used in our patients. Psoralen plus UVA is effective particularly in lichenoid GVHD lesions but sclerodermoid lesions may also benefit from this therapy.
Balighi Kamran; Lajevardi Vahideh; Ghiasi Maryam; Farahani Farzaneh; Nikoo Azita
Volume 11, Issue 1 , 2008, , Pages 34-37
Abstract
We report phakomatosis pigmentovascularis (PPV) detected in a 40- year-old male characterized by the presence of a port-wine stain in the background of aberrant Mongolian spots covering the back, nevus of Ota, ocular melanosis, epidermal nevus and a scaly patch with the diagnosis of discoid lupus erytematosus. ...
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We report phakomatosis pigmentovascularis (PPV) detected in a 40- year-old male characterized by the presence of a port-wine stain in the background of aberrant Mongolian spots covering the back, nevus of Ota, ocular melanosis, epidermal nevus and a scaly patch with the diagnosis of discoid lupus erytematosus. These associations have not been reported yet.
Balighi Kamran; Lajevardi Vahideh; Moeineddin Fatemeh; Naraghi Zahra; Irvani Masoud
Volume 11, Issue 1 , 2008, , Pages 38-41
Abstract
A 15-year-old boy presented with several months history of bilateral axillary lymph adenopathies which were ulcerated subsequently. He had received anti-tuberculosis therapy for more than six months based on suspicious diagnosis of scrofuloderma. Histopathologic examination confirmed the diagnosis of ...
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A 15-year-old boy presented with several months history of bilateral axillary lymph adenopathies which were ulcerated subsequently. He had received anti-tuberculosis therapy for more than six months based on suspicious diagnosis of scrofuloderma. Histopathologic examination confirmed the diagnosis of specific lesions of Hodgkin’s disease. These lesions were probably metastatic due to retrograde lymphatic spread from his axillary lymph nodes, as this way is the most common mode of Hodgkin’s disease spreading to the skin. The patient received chemotherapy regimen for Hodgkin’s disease and ulcers resolved remarkably.
Balighi Kamran; Moslehi Homayun; Robati Reza Mahmoud; Robati Amin Mahmoud
Volume 10, Issue 4 , 2007, , Pages 271-277
Abstract
Background and aim: Subcision is a procedure that has been reported to be beneficial in treatment of acne scars. The objective of this trial was to assess the efficacy of subcision in the treatment of rolling acne scars and evaluate a novel subdermal filler" absorbable plain catgut suture" with subcision. ...
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Background and aim: Subcision is a procedure that has been reported to be beneficial in treatment of acne scars. The objective of this trial was to assess the efficacy of subcision in the treatment of rolling acne scars and evaluate a novel subdermal filler" absorbable plain catgut suture" with subcision. Materials and methods: 22 patients with rolling acne scars underwent subcision, 20 of whom completed treatment and follow-up period. One side of the face underwent subcision and another side subcision with subdermal implant. The patients and investigators' assessments of improvement were both recorded. Results: Subcision showed mild improvement in about 60% of patients and moderate improvement in about 40% of them. The rate of response showed no significant difference with the use of subdermal implant. The side effects of local edema, bruising, and infection were all transient. Conclusion: Subcision appears to be a safe method to correct the rolling acne scars with long term improvement. However, the subdermal implant led to no significant superior results.
Balighi Kamran; Lajevardi Vahideh; Moeineddin Fatemeh; Ghiassi Maryam; Arami Shabnam; Nikoo Azita; Mahdavi-nia Mostafa
Volume 10, Issue 4 , 2007, , Pages 338-344
Abstract
Atrichia with papular lesions (APL) is a rare, autosomal recessive syndrome with total alopecia in which mutations in the hairless gene have been shown to underlie the phenotype. We report here three cases, two 16 and 18 years old cousins and a 15 year-old-girl with a history of shedding of scalp, eyebrow ...
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Atrichia with papular lesions (APL) is a rare, autosomal recessive syndrome with total alopecia in which mutations in the hairless gene have been shown to underlie the phenotype. We report here three cases, two 16 and 18 years old cousins and a 15 year-old-girl with a history of shedding of scalp, eyebrow and eye lashes in infancy. Later in life they developed numerous erythematous papules on their limbs predominantly on the knees and elbows. According to their history, clinical presentation and pathologic findings, diagnosis of atrichia with papular lesions (APL) with some different features was postulated. Comparing to the known cases of APL with scalp, facial and truncal lesions, the cases presented here do not show such lesions in these sites.
Chams-Davatchi Cheyda; Balighi Kamran; Yazdanian Shideh; Nabaii Behruz
Volume 10, Issue 2 , 2007, , Pages 111-118
Abstract
Background and aim: Pemphigus vulgaris is an autoimmune vesiculobullous disorder. Prior to the advent of glucocorticoid therapy, it was often fatal. Now its mortality and morbidity is due to highdose glucocorticoid complications rather than the disease itself. This study was aimed to determine the effect ...
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Background and aim: Pemphigus vulgaris is an autoimmune vesiculobullous disorder. Prior to the advent of glucocorticoid therapy, it was often fatal. Now its mortality and morbidity is due to highdose glucocorticoid complications rather than the disease itself. This study was aimed to determine the effect of dapsone as a second adjuvant in the treatment of pemphigus vulgaris.Materials and methods: In this quasi-experimental open prospective study, 22 patients with moderate to severe pemphigus vulgaris were treated with prednisolone, azathioprine and dapsone. They were observed for 12-18 months.Results: Patients consisted of 10 females and 12 males with mean age of 41.71 years. The mean duration to reach to the maintenance dose of prednisolone (7.5 mg daily) was 13 months. No major relapse was observed but minor relapses were seen in 6 patients with mean prednisolone dose of 13.8 mg daily. Hemolysis was detected in only one patient and 4 patients had a little drop in hemoglobin level. We observed no other severe dapsone induced adverse reaction.Conclusion: These findings suggest that dapsone can be used as a second adjuvant for more rapid tapering of steroid dosage without significant flare of the disease.
Raziee Morteza; Balighi Kamran; Shabanzadeh-Dehkordi Hossein; Rabati Reza Mahmoud
Volume 9, Issue 4 , 2006, , Pages 308-312
Abstract
Background and aim: Solar lentigines are common sun-induced benign melanocytic proliferations that present a significant cosmetic problem for many middle- aged and elderly patients. The purpose of this study was to assess the efficacy of cryotherapy in comparison to trichloroacetic acid (TCA) 33% on ...
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Background and aim: Solar lentigines are common sun-induced benign melanocytic proliferations that present a significant cosmetic problem for many middle- aged and elderly patients. The purpose of this study was to assess the efficacy of cryotherapy in comparison to trichloroacetic acid (TCA) 33% on solar lentigines on the back of the hands (SLBH).Materials and Methods: Each hand of 33 patients with SLBH was treated randomly with either cryotherapy or TCA 33% solution. Photographs of the hands were taken prior to and two months following the treatment. Therapeutic response and side-effect were compared using chi-square test.Results: Twenty five patients completed the study. Cryotherapy was more likely to produce substantial lightening of the solar lentigines than TCA 33% solution (P=0.025) but was more painful and took longer to heal. Post inflammatory hyperpigmentation (PIH) was almost equal in two types of treatment. Statistically, better results were seen in lower Fitzpatrick's skin types (P<0.01).Conclusion: Cryotherapy appears to be superior to TCA 33% solution in the treatment of SLBH particularly in lower Fitzpatrick skin types. PIH is the major complication of both particularly in higher Fitzpatrick skin types. Generally, the major criterion for treatment of SLBH with cryotherapy or TCA is Fitzpatrick's skin type.
Espandar Ramin; Yazdanian Shideh; Balighi Kamran; Baghdadi Taghi; Tork Ali Naser
Volume 9, Issue 4 , 2006, , Pages 360-366
Abstract
The Proteus syndrome comprises an association of asymmetrical overgrowth of almost any part of the body, verrucous epidermal naevi, vascular malformations and lipoma-like subcutaneous hamartoma. Both sexes are affected with equal frequency and severity and it is not transmitted genetically. Here a 16-year-old ...
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The Proteus syndrome comprises an association of asymmetrical overgrowth of almost any part of the body, verrucous epidermal naevi, vascular malformations and lipoma-like subcutaneous hamartoma. Both sexes are affected with equal frequency and severity and it is not transmitted genetically. Here a 16-year-old man with asymmetric overgrowth of the extremities, macrodactyly, cerebriform hypertrophy of the soles and various skin and bony lesions is reported diagnosed as Proteus syndrome.
