Ali Asilian; Fariba Iraji; Saba Khalilian; Zabihollah Shahmoradi; Mina Saber
Abstract
Background: Psoriasis is an immune-mediated inflammatory disease with unclear pathophysiology. Although diverse medications have been applied, a paucity of knowledge is accessible regarding the use of corticosteroids for psoriasis management. We evaluated the efficacy of corticosteroid pulse therapy ...
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Background: Psoriasis is an immune-mediated inflammatory disease with unclear pathophysiology. Although diverse medications have been applied, a paucity of knowledge is accessible regarding the use of corticosteroids for psoriasis management. We evaluated the efficacy of corticosteroid pulse therapy in combination with methotrexate versus methotrexate alone for psoriasis treatment.Methods: This cohort study was conducted on 51 hospitalized patients with erythrodermic or pustular psoriasis who were assigned to one of the therapeutic interventions of subcutaneous methotrexate alone (n = 33) or in combination with betamethasone pulse therapy (n = 18). The first group was treated with weekly 15 mg subcutaneous methotrexate for six weeks, and the second group received a similar dose of methotrexate plus 3 mg oral betamethasone weekly. The patients were followed for six months and assessed regarding the disease remission, relapses, the interval between the medication and relapse incidence, and patient satisfaction with the regimens.Results: The studied groups were similar regarding gender (P = 0.296), age(P = 0.561), and the type of cutaneous lesions (P = 0.807). Six months follow-up of the two therapeutic interventions revealed insignificant differences in terms of early response to the treatment (P = 0.993), the incidence (P = 0.142) and frequency of relapses (P = 0.928), and the interval period between the treatment and relapse (P = 0.213). Besides, the patients’ treatment satisfaction did not differ between the groups (P = 0.453).Conclusion: Based on this study, combining methotrexate and lowdose corticosteroid pulse therapy does not lead to better outcomes than methotrexate alone for managing pustular and erythrodermic psoriasis. Further studies are strongly recommended.
Fariba Iraji; Fatemeh Mohaghegh; Atefeh Shajari; Parvin Rajabi; Samaneh Mozafarpoor
Abstract
Mycosis fungoides (MF) is the most common skin subtype of T-cell lymphoma. Its underlying cause is not yet clearly understood, and diagnosis might be difficult since MF presents itself with symptoms similar to some other dermatologic disorders. In the current case presentation, we report a 12-year-old ...
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Mycosis fungoides (MF) is the most common skin subtype of T-cell lymphoma. Its underlying cause is not yet clearly understood, and diagnosis might be difficult since MF presents itself with symptoms similar to some other dermatologic disorders. In the current case presentation, we report a 12-year-old female with concurrenthypopigmented and pigmented purpuric dermatosis-like lesions that underwent skin biopsies and immunohistochemistry study. Microscopic findings of hyperkeratosis and mild acanthosis in addition to epidermotropism of lymphocytes with perivascular and interstitial infiltration led us to the probable diagnosis of MF.Intraepidermal lymphocyte immunohistochemistry assessments were positive for CD3 and CD4 while negative for CD8 and CD7. The peripheral blood smear revealed a normal CD4 to CD8 ratio, and the number of Sézary cells detected was insufficient to diagnose Sézary syndrome. Therefore, the final diagnosis of MF was made for this young patient.
Amir Hossein Siadat; Siamak Rahmani; Fariba Iraji; Ali Asilian; Seyed Mohasen Hosseini; Mohammad Ali Nilfroushzadeh
Abstract
Background: Keratosis rubra pilaris is a common condition with an estimated percentage of 40% involvement in the population. This condition is inherited as an autosomal dominant trait and more commonly involves patients with dry skin. In the current study, we evaluated the efficacy ...
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Background: Keratosis rubra pilaris is a common condition with an estimated percentage of 40% involvement in the population. This condition is inherited as an autosomal dominant trait and more commonly involves patients with dry skin. In the current study, we evaluated the efficacy of intense pulsed light (IPL) plus ammonium lactate versus ammonium lactate alone in the treatment of keratosis pilaris.Methods: A total of 50 patches were selected in 10 patients. If there were two similar patches with the same color and same location, each of them was randomized to receive ammonium lactate (Kerapil cream®) or ammonium lactate (Kerapil cream®) +IPL. Treatment was performed for 3 months, and improvement was rated by physicians and patients one month and two months after the intervention.Results: The grade of improvement in the IPL + ammonium lactate was not significantly higher than ammonium lactate alone group as rated by blinded physicians at week 4 (P > 0.05). However, the score of improvement was also higher, as rated by the patients, in the IPL + ammonium lactate versus ammonium lactate alone (P < 0.05) at week 8.Conclusion: Our results demonstrated that addition of IPL to ammonium lactate could improve the clinical response of keratosis pilaris lesions.
