Original Article
Akshay Jain Salecha; Santh Kumar Bellamkonda; Haritha Samanthula; .Sujit Kumar Ponugoti; Anusha Jakkampudi
Abstract
Background: Psoriasis is a prevailing continual inflammatoryaffliction, carrying a considerable risk of cardiac diseases,sometimes even not traceable by conventional predisposingfactors. Detection of subclinical atherosclerosis in psoriasis byultrasonography is beneficial, and it has been solitarily ...
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Background: Psoriasis is a prevailing continual inflammatoryaffliction, carrying a considerable risk of cardiac diseases,sometimes even not traceable by conventional predisposingfactors. Detection of subclinical atherosclerosis in psoriasis byultrasonography is beneficial, and it has been solitarily exploredin carotid arteries. It was found to have a weak predictive value,and so the femoral arteries have now been contemplated. Thisstudy aims to determine subclinical atherosclerosis occurrenceby evaluating the femoral and carotid arteries’ intima-mediathickness (IMT) by ultrasonography in patients with psoriasis.Methods: The study was carried out in the departments ofdermatology and radiology at Dr. Pinnamaneni SiddharthaInstitute of Medical Sciences & Research Foundation for eightmonths. The sample size consisted of 30 chronic plaque psoriasiscases and 30 controls, matched for age and sex. Patients withcomorbidities were excluded. Femoral & carotid arteries wereassessed for IMT by ultrasonography.Results: In our study, the age range was 30–80 years, and a male(56.7%) preponderance was observed in cases and controls. Themean femoral artery and carotid artery IMTs were remarkablygreater in cases than in controls, with P-values < 0.001 and 0.04,respectively. The mean femoral artery IMT was significantly moreelevated (1.4 ± 0.63 mm) than the carotid artery IMT (1.0 ± 0.62mm) in cases (P = 0.01).Conclusion: Ultrasonographic screening of femoral artery IMTenhances the early discernment of subclinical atherosclerosis whencompared with carotid artery IMT. Thereby, it helps in the earlyidentification of cardiovascular disease in patients with psoriasis.Keywords: femoral artery, carotid artery, intima-media thickness,psoriasis, atherosclerosis
Original Article
Saeedeh Farajzadeh; Mahin Aflatoonian; Saman Mohammadi; Hamid Sharifi; Maryam Khalili
Abstract
Background: Hyperhomocysteinemia and vitamin D deficiency maybe involved in the pathogenesis of vitiligo. This study comparedthe serum levels of vitamin D, homocysteine, vitamin B12, andfolic acid between vitiligo-affected children and healthy children.Methods: Using a case-control design, 30 children ...
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Background: Hyperhomocysteinemia and vitamin D deficiency maybe involved in the pathogenesis of vitiligo. This study comparedthe serum levels of vitamin D, homocysteine, vitamin B12, andfolic acid between vitiligo-affected children and healthy children.Methods: Using a case-control design, 30 children with vitiligoand 30 age and sex-matched healthy children were enrolledfrom April 2018 to August 2020. Serum levels of vitamin D,homocysteine, vitamin B12, and folic acid were analyzed in bothgroups during the same season of the year. Additionally, theassociation between serum levels of these factors with demographicand clinical features of the children (collected by interview andphysical examination) was evaluated. Data were analyzed usingthe independent T-test, Fisher’s exact test, and chi-squared test.Results: The vitiligo group had significantly lower vitamin Dand folic acid serum levels compared with the control group[95% CI -19.87 to -2.96 and -4.15 to -4.18, respectively]. Amongpatients, the vitamin D level was negatively correlated with age(r = -0.459, P = 0.011) and disease duration (r = -0.373, P = 0.042).Moreover, there was a significant association between vitiligoactivity and serum homocysteine levels (P = 0.027).Conclusion: Routine measurement of vitamin D and folic acidserum levels might be suggested, especially in children withlong-standing disease. Monitoring the homocysteine level maybe beneficial, particularly in children with progressive vitiligo.
Original Article
Arunima Dhabal; Jayanta Kumar Barua; Kingshuk Chatterjee; Ananya Chandra; Sumana Khan; Manab Kumar Ghosh; Saswati Halder
Abstract
Background: Lichen planus (LP) is a chronic inflammatorydisorder involving the skin, mucosa, hair, and nails. Previousreports have shown a possible association between LP andmetabolic derangement, leading to increased cardiovascular riskamong these patients. Our study aimed to assess the prevalenceof ...
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Background: Lichen planus (LP) is a chronic inflammatorydisorder involving the skin, mucosa, hair, and nails. Previousreports have shown a possible association between LP andmetabolic derangement, leading to increased cardiovascular riskamong these patients. Our study aimed to assess the prevalenceof metabolic syndrome (MetS) and its components in LP patientsand to study their relationship with mucosal involvement in LP.Methods: We conducted a cross-sectional observational study of123 LP patients. Demographic and clinical data were obtained,and evaluation was done for the presence of abdominal obesity,hypertension, hyperglycemia, and dyslipidemia. MetS wasdiagnosed according to the modified National CholesterolEducation Program: Adult Treatment Panel III (NCEP-ATP III)criteria for the South Asian population. Data analysis was doneusing appropriate statistical methods.Results: The prevalence of MetS in LP patients was 31%. The meanage of LP patients having MetS was considerably higher thanthose without MetS (44.8 ± 13.6 vs. 33.3 ± 15.9 years; P = 0.0002).Although statistically insignificant, female patients and patients withmucosal involvement showed a higher prevalence of MetS. Centralobesity, hypertension, hyperglycemia, and hypertriglyceridemiawere more prevalent in mucosal LP patients than in those withoutmucosal lesions, with hyperglycemia having a significantly higherprevalence in mucosal LP (41% vs. 18%; P = 0.015).Conclusion: Incre ased age, female gender, and mucosalinvolvement are important predictors of concurrent metabolicderangement in LP patients. Thus, these patients should bescreened for the presence of MetS and its components.
Original Article
Maryam Khalili; Saman Mohammadi; Mohamadhosein Saeidi; Rezvan Amiri; Amireh Heshmatkhah; Simin Shamsi Meymandi; Mahin Aflatoonian
Abstract
Background: Treatment failure of antimony drugs for anthroponoticcutaneous leishmaniasis (ACL) is rising. Recognizing predictivefactors of unresponsiveness to treatment can substantiallyinfluence better ACL management. The goal of this study wasto investigate predictive factors associated with treatment ...
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Background: Treatment failure of antimony drugs for anthroponoticcutaneous leishmaniasis (ACL) is rising. Recognizing predictivefactors of unresponsiveness to treatment can substantiallyinfluence better ACL management. The goal of this study wasto investigate predictive factors associated with treatment failurein ACL in Kerman, southeast Iran.Methods: This case-control study was conducted retrospectivelyon 2,128 ACL cases in Kerman over ten years from 2011 to 2020.The case group included patients whose lesions failed to resolveafter one treatment course. The control group included thosewhose lesions were cured after one treatment course.Results: Treatment failure was observed in 13.5% of cases (10.7%of systemic therapy and 16.7% of local therapy). No significantdifference was reported between the type of treatment andtreatment failure. The association of treatment failure withwinter-onset (P = 0.001, OR = 1.39, CI = 1.23–1.56), face (P = 0.001,OR = 1.86, CI = 1.38–2.49), ulceration (P = 0.01, OR = 0.51, CI = 0.30–0.85), small diameter (P = 0.005, OR = 0.57, CI = 0.38-0.84) andlong duration of lesions (P = 0.01, OR = 1.57, CI = 1.11–2.21) wasvalidated by multivariate logistic regression analysis.Conclusion: Efficient detection and timely management of ACLcases are essential to reduce resistant cases, as lesions lastinglonger than four months show poor response to treatment.Furthermore, early treatment of facial lesions with systemictherapy is suggested to optimize results and reduce the risk ofdisfiguring scars. Further surveys are required to determine thereason behind more treatment failure in winter-onset lesions.
Original Article
Hossain Kawosi; Nader Salari; Arash Golpazir Sorkhe; Ibrahim Shakiba; Roya Safarpour; Masoud Mohammadi
Abstract
Background: Malignant melanoma is a prevalent, offensive, andfatal cancer in developed countries. Most of our information isrelated to studies conducted in western countries. This studyaims to evaluate demographic and clinical data of melanoma inthe Kermanshah province of Iran.Method: This was a descriptive ...
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Background: Malignant melanoma is a prevalent, offensive, andfatal cancer in developed countries. Most of our information isrelated to studies conducted in western countries. This studyaims to evaluate demographic and clinical data of melanoma inthe Kermanshah province of Iran.Method: This was a descriptive study on data available in theCancer Registry Center of Kermanshah, which includes 70patients during eight years from 2010–2017. Clinical recognitionof melanoma was based on American Joint Committee on Cancercriteria. Data were analyzed by SPSS 20 software and shown inArcGIS (Version 10.7).Results: Patients included 46 men (65.7%) and 24 women (34.3%)with a mean age of 60.49 ± 16.08. The general prevalence ofmelanoma was 4.4 in every 1,000,000 persons annually. Mostpatients had skin type III (65.7%), indoor jobs (61.4%), and livedin the city (67.1%). Also, 35.7% had a trauma history, 2.8% hadfamilial melanoma history, and 17.1% had other types of skincancer. Extremities (51.4%), acral lentiginous melanoma (50.1%),Clark IV (61.4%), and inguinal lymph nodes (14.3%) were themost prevalent location, clinical type, pathological level, andinvolved lymph nodes, respectively.Conclusion: Acral lentiginous melanoma and extremitiesinvolvement are prevalent in our region. Most patients go todoctors at an advanced level due to delays in referral, lack offollow-up by patients, lack of recognition at the initial care level,and lack of access to specialty centers. We recommend generalinstructions through media and holding special workshops forphysicians for better familiarity with melanoma.
Original Article
Mohammad Mahdi Parvizi; Farhad Handjani; Leila Ghahramani; Nasrin Shokrpour
Abstract
Background: Evidence shows that article titles might affectcitation metrics. This study aimed to evaluate the associationbetween selected citation metrics and the title characteristics indermatology journals.Methods: We enrolled 305 reviews and original articles publishedduring 2016 from four dermatology ...
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Background: Evidence shows that article titles might affectcitation metrics. This study aimed to evaluate the associationbetween selected citation metrics and the title characteristics indermatology journals.Methods: We enrolled 305 reviews and original articles publishedduring 2016 from four dermatology journals consisting of the“Journal of the American Academy of Dermatology,” “Journalof the European Academy of Dermatology and Venereology,”“Indian Journal of Dermatology, Venereology and Leprology,”and “International Journal of Dermatology” using a stratifiedand simple random sampling method. The list of articles wasextracted from Scopus; then, the title characteristics werereviewed. Moreover, we extracted the citation metrics, includingthe citation count, Field-Weighted Citation Impact (FWCI), andcitation benchmarking percentile of the articles until the end ofOctober 2021 using Scopus. For statistical analysis, we used Statasoftware version 14.2.Results: Overall, 239 (78.36%) original and 66 (21.64%) reviewarticles were included. The citation count and FWCI significantlyand positively correlated with the number of words, characters,and punctuation marks in the titles. By adjusting the covariates,linear logistic regression showed that the title length and thepresence of acronyms in the title were the most effective factorsin increasing the citation count and FWCI of the articles.Conclusion: Using longer titles and including acronyms in thetitles may help augment the citation of articles in dermatologyjournals.
Original Article
Samer A Dhaher; Ali M Yosif
Abstract
Background: Acne vulgaris is a common chronic inflammation ofpilosebaceous units with a multifactorial pathogenesis. Traditionaltreatment may have limited success with potential side effects.The long-pulsed neodymium-doped yttrium garnet (Nd:YAG)laser may be a desirable alternative.Methods: A prospective ...
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Background: Acne vulgaris is a common chronic inflammation ofpilosebaceous units with a multifactorial pathogenesis. Traditionaltreatment may have limited success with potential side effects.The long-pulsed neodymium-doped yttrium garnet (Nd:YAG)laser may be a desirable alternative.Methods: A prospective clinical trial was conducted on 61 acnepatients at the Department of Dermatology, Basrah TeachingHospital, from April 2019 to April 2020. Three treatments withlong-pulsed Nd:YAG were performed across two-weeks intervals(fluence 50 J/cm2, spot size 5 mm, pulse duration 15 ms, andfrequency 1.5 Hz). Patients were assessed at baseline and 2, 4,6, and 12 weeks later by counting the acne lesions and scoringthe response according to the percentage of lesions’ reduction.Results: Sixty-one patients completed the study (49 femalesand 12 males); the mean age was 18.7 ± 1.67 years. A significantreduction of acne lesions at the end of therapy was observedcompared to the baseline. The mean number of total lesions wasreduced from 84.2 ± 25.8 to 16 ± 23.3 (P < 0.05). Overall, 49 (80.3%)patients achieved an excellent response, 3 (4.9%) good, 1 (1.6%)moderate, and 8 patients (13.1%) showed a poor response. Thetreatment was well tolerated with insignificant adverse effects.Conclusion: Long-pulsed Nd:YAG laser is an effective and safemodality for treating acne vulgaris and may be considered analternative option for cases of recurrence after conventionaltreatment. However, more sessions are needed for severe cases.
Case Report
Sunil Gupta; Jaspriya Sandhu; Palvi Singla; Aditi Bansal; Bhavna Garg; Harpreet Kaur
Abstract
Rheumatoid vasculitis, an uncommon extraarticular manifestationof rheumatoid arthritis, usually develops in long-standing casesaffecting small-to-medium-sized vessels. It is a poor prognosticmarker when multiple systems are affected, skin and neurologicinvolvement being most frequent. Rheumatoid vasculitis ...
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Rheumatoid vasculitis, an uncommon extraarticular manifestationof rheumatoid arthritis, usually develops in long-standing casesaffecting small-to-medium-sized vessels. It is a poor prognosticmarker when multiple systems are affected, skin and neurologicinvolvement being most frequent. Rheumatoid vasculitis is seenmore commonly in seropositive and nodular rheumatoid arthritispatients who are male or smoke. Herein, we present the peculiarcase of a 48-year-old female with rapid onset, progressive, multipleulcers predominantly over the flexures. Differential diagnoses ofpyoderma gangrenosum, pyoderma vegetans, pemphigus vegetans,and vasculitis were considered, and the patient was evaluated. Oninvestigation, her rheumatoid factor titer was strongly positive;a skin biopsy revealed leukocytoclastic vasculitis. On clinical,serological, and histopathological correlation, a diagnosis ofrheumatoid vasculitis was made, responding well to high-doseprednisolone. On follow-up at six months, her skin lesions hadhealed well with moderate scarring; however, she developedsevere joint pain, warranting the initiation of disease-modifyingantirheumatic drugs. To the best of our knowledge, this is apreviously unreported clinical and morphological presentationof rheumatoid vasculitis.
Case Report
Anil Prakash Gosavi; Ravindranath Brahmadeo Chavan; Neelamkumari Bhatt; Nitika Deshmukh; Darshana Rajendra Kundale
Abstract
Bullous pemphigoid is the most common type of subepidermalautoimmune bullous disease. It usually affects older people;isolated cases among people younger than 65 have been reportedwith various presentations, usually more severe and active thanthose seen in the elderly. Toxic epidermal necrolysis (TEN) ...
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Bullous pemphigoid is the most common type of subepidermalautoimmune bullous disease. It usually affects older people;isolated cases among people younger than 65 have been reportedwith various presentations, usually more severe and active thanthose seen in the elderly. Toxic epidermal necrolysis (TEN) is apotentially life-threatening dermatologic disorder characterizedby widespread necrosis and bullous detachment of the epidermisand mucous membranes resulting in exfoliation and possiblesepsis. Various morphological variants of bullous pemphigoidhave been reported, with reports of the TEN-like variant ofbullous pemphigoid being scarce. In this study, we report a caseof bullous pemphigoid with TEN-like presentation in a middleagedfemale.
Case Report
Atieh Ebadi; Farhad Malekzad; Mohmmadreza Khorramizadeh; Ariana Kariminejad; Fahimeh Shahabipour; Reza M Robati
Abstract
Cutis laxa (CL) is a connective tissue disease thatis either inherited or acquired. It is characterized by redundant,pendulous, and inelastic skin. Loss of elasticity is a pathologicalfeature of some degenerative and inflammatory diseases. Matrixmetalloproteinases (MMPs) can cleave elastin fibers by ...
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Cutis laxa (CL) is a connective tissue disease thatis either inherited or acquired. It is characterized by redundant,pendulous, and inelastic skin. Loss of elasticity is a pathologicalfeature of some degenerative and inflammatory diseases. Matrixmetalloproteinases (MMPs) can cleave elastin fibers by damagingthe microfibrils and the elastin core, resulting in the loss ofelasticity.In this study, we report eight patientswith different types of cutis laxa along with the quantitativemeasurement of serum levels of MMP-2 and MMP-9.The cutis laxa patients showed various clinical andhistopathological findings, indicating the heterogeneity of thisrare skin connective tissue disease. The serum level of MMP-2and MMP-9 were elevated in these patients.Increased MMP-2 and MMP-9 might be associatedwith cutis laxa. However, our findings need to be validated inlarger clinical settings.
Letter to Editor
Muhammed Mukhtar
Quiz
Vijayasankar Palaniappan; Premjith Raveendran; Karthikeyan Kaliaperumal; Ramya Gandhi
Quiz
Nasrin Saki; Fatemeh Sari Aslani; Mohammad Javad Najafzadeh; Roya Radanfar; Seyed Ali Hosseini; Najmeh Ahramiyanpour
