Farhad Malekzad; Mohammad Saeedi; Azin Ayatollahi
Volume 14, Issue 4 , 2011, , Pages 131-135
Abstract
Background: Lichen planus is a common inflammatory disease that can involve the skin, nails, mucous membrane, and hair follicles. There is a long list of topical and systemic therapies for its treatment. Methotrexarte has some characteristics that make it a good choice for generalized lichen planus. ...
Read More
Background: Lichen planus is a common inflammatory disease that can involve the skin, nails, mucous membrane, and hair follicles. There is a long list of topical and systemic therapies for its treatment. Methotrexarte has some characteristics that make it a good choice for generalized lichen planus. Aim: The goal of this study was to assess the effect of low dose methotrexate in generalized lichen planus. Method: Eighteen patients (8 male and 10 female, mean age: 51.1, range: 22-80, SD: 14.9) with generalized lichen planus were enrolled in the study. After basic evaluations, low dose methotrexate (7.5-10 mg weekly) initiated. The response rate was appraised after 2, 4 and 8 weeks. Six-month follow-up was done for evaluating the recurrence rate. Result: At the end of the 8th week, 75% of the patients had more than 75% improvement. After six months, no case of recurrence was reported. Adverse effects were limited to laboratory abnormalities in two patients (abnormal liver function tests in one case and decreased hemoglobin in the other case). Conclusion: Low dose methotrexate is a very good and safe treatment for generalized lichen planus, especially when there is concern regarding the steroids undesired effects or when the disease is resistant to corticosteroids.
Malekzad Farhad; Eshghi Gholamreza; Ebadi Atyeh; Younespour Shima
Volume 13, Issue 3 , 2010, , Pages 91-95
Abstract
Background: Alopecia areata is one of the most common human autoimmune disorders and its severe types are refractory to all conventional therapies. Corticosteroids have been used in severe alopecia areata since 1950s but there is concern over complications caused by high doses of corticosteroids. Methotrexate ...
Read More
Background: Alopecia areata is one of the most common human autoimmune disorders and its severe types are refractory to all conventional therapies. Corticosteroids have been used in severe alopecia areata since 1950s but there is concern over complications caused by high doses of corticosteroids. Methotrexate has been used as an adjunctive therapy in some autoimmune disorders and has been proposed to be effective in the treatment of severe alopecia areata both as a monotherapy and in combination with corticosteroids. Methods: In this study, 120 patients of intractable alopecia areata totalis and universalis with a mean duration of 3.27 ±1.60 years were studied. We treated them with methotrexate in combination with intravenous and low dose of prednisolone for one year. Methotrexate 10 mg per week was administered in combination with three monthly methylprednisolone and oral prednisolone 15 mg per day for one year. Response to the treatment was evaluated clinically and by serial photographs. Results: Sixty four patients (57.7%) gained total hair regrowth after treatment with no significant difference between alopecia totalis and universalis. Almost half of the patients (44.75%) remained disease free until the end of the one-year follow-up. Relapse occurred in 34 patients (56.25%); of them 20% were focal relapses. Nine patients out of 120 patients (7.5%) experienced severe adverse effects of the therapy. Conclusion: Our study suggested that methotrexate could be used as a safe and well tolerated adjunctive therapy for severe alopecia areata although careful monitoring of adverse effect is necessary. Furthermore, controlled prospective clinical trials are warranted to answer many of the questions regarding methotrexate therapy for severe alopecia areata.
Malekzad Farhad; Qeisari Mehdi; Nasiri Soheila; Rahmati-Roudsari Mohammad; Saeedi Marjan; Sarlak Mojdeh
Volume 12, Issue 1 , 2009, , Pages 9-12
Abstract
Background: An elevated homocysteine level is an independent risk factor for cardiovascular disorders. Psoriatic patients have an increased risk of cardiovascular diseases; In addition, hyperhomocysteinemia is a complication of methotrexate treatment. We undertook a study to evaluate the plasma levels ...
Read More
Background: An elevated homocysteine level is an independent risk factor for cardiovascular disorders. Psoriatic patients have an increased risk of cardiovascular diseases; In addition, hyperhomocysteinemia is a complication of methotrexate treatment. We undertook a study to evaluate the plasma levels of homocysteine, vitamin B12 and folate in patients with psoriasis before and after short-term low-dose methotrexate treatment. Methods: Twenty six patients with psoriasis were recruited. The plasma levels of homocysteine, vitamin B12 and folate were evaluated before and 8 weeks after methotrexate therapy (in the peak of methotrexate effect). Results: No significant difference was found between the plasma profile of homocysteine, vitamin B12 and folate before and after methotrexate treatment. Conclusion: In the short-term treatment of psoriasis, methotrexate does not increase homocysteine level.
M Farshchian; M Pilevar
Volume 4, Issue 1 , 2000, , Pages 26-30
Abstract
Background: Pityriasis rubra pilaris (PRP) is a rare skin disease characterized by follicular hyperkeratosis, perifollicular erythema with islands of normal skin scattered over the sheets of erythroderma, palmoplantar hyperkeratosis and pityriasis capitis with unknown etiology. Objective: This study ...
Read More
Background: Pityriasis rubra pilaris (PRP) is a rare skin disease characterized by follicular hyperkeratosis, perifollicular erythema with islands of normal skin scattered over the sheets of erythroderma, palmoplantar hyperkeratosis and pityriasis capitis with unknown etiology. Objective: This study has been done in order to determine the demographics, clinical and therapeutic aspects of PRP patients who were admitted to the dermatology ward of Sina Hospital in Hamadan in 1991-1999. Patients and Methods: This was a case series study, which the essential information was gathered by referring to the patients’ files. Then the obtained information was analyzed by SPSS software. Results: As PRP is a rare disease. Only 8 patients were identified. Five of them (61.5%) were men and 3 (37.5%) were women. The highest age of PRP patients was 66 years and the lowest was seven. The mean age of the patients was 32±19.4 years. None of the patients mentioned a positive family history. Six (75%) of the PRP patients suffered from Type I and two patients (25%) from Type III. Five patients (62.5%) were completely cured, all treated with retinoids, and three patients (37.5%) were partially cured, all treated with methotrexate. There was no case showing failure of the treatment. Conclusion: In this study the number of men was more than women. All of our patients suffered from Type 1 adult onset (Classic) or Type III juvenile onset. Retinoids showed more efficacy than methotrexate in the treatment of PRP.
