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Background: Psoriasis as a common cutaneous inflammatory disease affect many aspects of patients' life. Disease registries render it possible to collect valuable data regarding a disease prevalence and burden as well as long‐term observations concerning possible therapeutic regimens. Methods: This registry was designed for the ongoing systematic data collection on patients with psoriasis at two referral dermatology centers in Iran. The pilot phase of the registry was used to identify possible obstacles in the application and execution of systematic registration. Results: A total of 281 patients were registered with the mean age of 42.02 years. The disease duration was 12.06 ± 10.90 years with the variety of clinical presentations. There was no significant difference between males and females in the age of disease onset (p = 0.53). Notably, 167 patients had children. Among them, 13 had children with psoriasis. The gender of the affected parent did not affect the possibility of psoriasis transmission to the child, and no significant difference was seen between the two sexes (P = 0.569). Regarding treatment, 99.4% of patients (n = 280) had used topical agents, 52.3% (n = 147) biologics, and 60.9% (n = 171) nonbiologic medications. Conclusion: Clinical trials report the efficacy and safety data regarding limited study populations in a restricted time window, and the results may differ from the general population. This highlights the importance of registry‐based studies for collecting and analyzing longitudinal information. In terms of long‐term disease complications such as malignancies, cardiovascular events, and serious adverse events, registry‐based studies will help clinicians better recognize and manage each disease. [ABSTRACT FROM AUTHOR]

This article discusses a pilot study that compared the effects of topical cetirizine 1% and topical diclofenac 3% with minoxidil as a conventional therapy for androgenic alopecia (AGA), or male/female pattern hair loss. AGA is a common condition that affects people of all races and ages, causing gradual hair thinning and loss. The study involved 33 male participants with AGA who were divided into three groups and received different treatments. The results showed that minoxidil had a significant improvement in hair growth, while cetirizine and diclofenac did not show significant improvements. However, cetirizine may be an option for those who do not respond to minoxidil, as it has fewer potential adverse effects. Further research is needed to fully understand the effects of topical cetirizine on AGA. [Extracted from the article]

Background: Pemphigus vulgaris (PV) is a rare immunobullous disease with a higher mortality rate than the general population. The aim of this study was to investigate P-wave duration and P-wave dispersion (PWD) in patients with PV as predictors of atrial fibrillation (AF). Materials and Methods: In this case-control study, the risk of AF development was determined by measuring maximum and minimum P-wave duration (P-max and P-min) and PWD in 45 PV patients and 45 healthy individuals. The incidence of metabolic syndrome was evaluated. Results: PWD and P-max values of the study group were significantly higher than those of the control group. No difference was observed between PWD with regards to disease duration and disease phenotype (p > 0.05). There was no significant difference regarding the prevalence of metabolic syndrome in PV patients compared with the control group. Conclusion: PWD and P-max, which are accepted as risk factors for AF development, were found to be higher in PV patients. Some components of metabolic syndrome were more prevalent in PV patients. It seems that there is an increased risk of CVD and AF in PV patients. [ABSTRACT FROM AUTHOR]

Considering the emergency approval of the Food and Drug Administration for widespread use of coronavirus disease 2019 (COVID‐19) vaccines, evaluating potential vaccine‐related adverse effects is critical as it will allow physicians to diagnose and manage these complications properly. In this descriptive cross‐sectional questionnaire‐based study, we evaluated the possible side effects of the COVID‐19 vaccine from June 1, 2021 to June 21, 2021. The Iranian population is generally vaccinated with AstraZeneca, Sputnik V, Sinopharm, and Bharat vaccines. The continuous and categorical variables were described and data analyzed by the SPSS software version 25. Cutaneous reactions occurred in 30% of individuals vaccinated against COVID‐19. The most common cutaneous complications were focal injection site reaction, exanthematous rash, and urticaria. There were infrequent cutaneous adverse events that included vesicular eruption, pernio‐like lesions, angioedema, erythema multiforme‐like eruption, and zoster. Acquainting physicians with COVID‐19 vaccine‐related cutaneous complications will assist them in detection and management. In addition, introducing these complications to individuals might improve acceptance of vaccine‐related adverse effects in the general population. [ABSTRACT FROM AUTHOR]

Byline: Nastaran. Namazi, Morteza. Ghassemipour, Azadeh. Rakhshan, Ata. Abbasi Synovial sarcoma is a type of malignancy which usually occurs near the joints of the arm, neck, or leg. It is [...]

Leukemia cutis is a cutaneous manifestation of leukemia. Herein, we present a rare cutaneous manifestation of leukemia cutis in a patient with myeloid leukemia m5, characterized by hyperpigmented red‐to‐brown patches on face and upper trunk. To our knowledge, hyperpigmented patches secondary to leukemia cutis is rarely described in the literature. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate metabolic syndrome prevalence in patients with Alopecia Areata compared to controls. Sixty eligible patients with Alopecia Areata and 60 healthy subjects frequency matched for age and sex attending to our referral dermatology clinics from 2015 to 2017 were enrolled. Prevalence of metabolic syndrome and its components were compared between the two groups. Metabolic syndrome was only seen in seven patients (11.67%) and four controls (6.67%) without a significant difference (P =.34). The clinical presentations of AA included patch type (38.33%), ophiasis (6.67%), alopecia totalis (16.67%), and alopecia universalis (38.33%). Presence of metabolic syndrome was significantly associated with abdominal circumference (OR: 1.10, 95% CI for OR: 1.02to 1.19). Although there was no significant association between Alopecia Areata and metabolic syndrome, some components of metabolic syndrome were more prevalent in these patients. It may be concluded Alopecia Areata patients are at a higher risk of developing metabolic syndrome in the future. Further studies with larger sample sizes are needed. [ABSTRACT FROM AUTHOR]

Inflammatory and autoimmune skin diseases such as vitiligo may be associated with systemic disorders, including endocrine and cardiovascular diseases, due to some similarities in the pathogenesis. It was aimed to evaluate metabolic syndrome and subclinical atherosclerosis in patients with vitiligo. Seventy patients with nonsegmental vitiligo and 70 age‐matched and gender‐matched healthy controls participated in the study. These participants were investigated for metabolic syndrome criteria. The mean intima‐media thickness of the common carotid artery (MIMT‐CCA) of the subjects was measured for assessment of subclinical atherosclerosis. Metabolic syndrome and subclinical atherosclerosis were significantly more frequent in vitiligo patients compared with the controls (P =.006 and P =.002, respectively). In addition, metabolic syndrome and subclinical atherosclerosis had positive, significant correlations with the severity and duration of vitiligo (P =.031 and r =.482; P <.01, respectively). Our study suggested that patients with vitiligo, especially those with more chronic and severe disease or concomitant metabolic syndrome, are at a higher risk of developing cardiovascular diseases. Therefore, early diagnosis and treatment of metabolic syndrome in patients with vitiligo to prevent cardiovascular complications were recommended. [ABSTRACT FROM AUTHOR]

COVID-19 pandemic had spread rapidly all around the world leading to variety of manifestations that ranged from being asymptomatic to death.1 While COVID-19 vaccination has played a very important role in ending this pandemic, adverse reactions are increasingly reported including cutaneous ones. The patient mentioned that she was infected with COVID-19 virus 1 month before vaccination. Skin biopsy from her thigh was done with differential diagnosis of urticarial vasculitis, COVID-19 rash, drug reaction and purpura annularis telangiectodes of majocchi. [Extracted from the article]

Vitiligo is a multifactorial skin disease with established role of genetics and autoimmunity in its pathogenesis. Vitamin D receptor (VDR) polymorphisms have been suggested to correlate with risk of vitiligo in some ethnic populations. On the other hand, cathelicidin, one of the innate immune system components, has a role in development of some chronic skin diseases and VDR regulates the expression of cathelicidin. We aimed to determine the plasma level of cathelicidin and its association with the VDR gene polymorphisms as well as plasma vitamin D level in patients with vitiligo. Ninety vitiligo patients and 90 non‐vitiligo controls participated in this study. Blood levels of 25(OH) vitamin D and cathelicidin were determined with ELISA. Genotyping for VDR polymorphisms (ApaI, TaqI, FokI and BsmI) was done with RFLP‐PCR method. Mean blood level of cathelicidin was significantly higher in vitiligo patients as compared to controls (P <.0001). Mean blood level of vitamin D was significantly lower in patients than controls (P =.01). Statistically significant differences were not observed for both genotype and allele frequencies of BsmI, ApaI and TaqI polymorphisms. There was a borderline increased risk of vitiligo in over‐dominant model of FokI polymorphism with OR = 1.8 and P =.051. Our findings was suggestive of the potential role of cathelicidin in the pathogenesis of vitiligo; however, future evaluations are needed to determine its precise mechanism. Genetic study of VDR gene polymorphism was suggestive of increased risk of vitiligo in association with a FokI polymorphism in Iranian population. [ABSTRACT FROM AUTHOR]

Increasing evidence on the association of MTHFR gene polymorphism and serum homocysteine levels with autoimmune diseases such as vitiligo has made the MTHFR gene a very interesting candidate to be evaluated in different ethnicities and populations. We aimed to evaluate the levels of serum homocysteine and vitamin B12 and their associations with MTHFR C677T polymorphism in the Iranian population. This case–control study included 104 patients with vitiligo and 100 age‐ and sex‐matched healthy control subjects. Serum vitamin B12 and homocysteine levels were measured by a chemiluminescence assay. Polymerase chain reaction‐restriction fragment length polymorphism (PCR‐RFLP) analysis was used for genotyping the polymorphism. The mean serum homocysteine levels were significantly higher in cases than controls and associated with disease activity (p <.001). Furthermore, the homozygous MTHFR C677T variant genotype was associated with vitiligo development (adjusted OR: 3.52, 95% CI: 1.09–11.32, p =.02) and elevated homocysteine level (p <.001). There was no association between serum vitamin B12 levels and the MTHFR C677T genotype. The homozygous variant MTHFR C677T may be considered as a risk factor for both elevated homocysteine levels and the development of vitiligo in the Iranian population. Although these results are not conclusive, they could elucidate the contribution of genetic and immune‐mediated inflammatory factors to the pathogenesis of vitiligo. [ABSTRACT FROM AUTHOR]

Background: Botulinum toxins‐A, as the most common non‐surgical method for facial rejuvenation, have been used broadly. Objective: Despite its significant aesthetic aspects, particular undesirable adverse effects could occur. Aim: The aim of this case report is to present the most serious side effects of botulinum toxin injections. Patients/Methods: A case report of a middle age woman with side effects of botulinum toxin injection with presentation of erythema and edema on the sites of injection and more further on the face and neck. The skin biopsies from both sides were obtained. On the skin biopsy the small vessel vasculitis on the site on injection and more further on the face and neck was performed as a result of injections. Results: Following Botulinum toxin‐A injection, various cutaneous reactions could occur. Some of these reactions such as edema and erythema may be self‐limited and has not serious impact on patients life but also some severe reactions like this case may occur which may alarm the life threatening side effects of injections. These reactions may be due to molecular patterns and exogenous proteins that have the potential for activating the immune cascade. Conclusion: Using the unapproved Botulinum toxin‐A should be discouraged due to their hazard of systemic reactions and clinicians should avoid administering the unlicensed products even by patients request or lack of the allergic reactions from previous injections. [ABSTRACT FROM AUTHOR]

Background: Microneedling and fractional lasers have been used in facial rejuvenation with acceptable results and low adverse effects. Aims: To compare the efficacy of microneedling with fractional Er:YAG in facial skin rejuvenation. Patients/Methods: This study was planned as a split‐face clinical trial. Volunteers were randomly allocated to receive three monthly treatments on each side of the face, one with fractional Er:YAG laser and one with microneedling. The assessments included investigating clinical outcomes by two blinded dermatologists accompanied by measuring skin biophysical characteristics including cutaneous resonance running time (CRRT) and transepidermal water loss (TEWL). Moreover, possible adverse effects, downtime, and patients' satisfaction were recorded at baseline, 1 month after each treatment, and 3 months after the last treatment session. The protocol was approved by the Iranian Registry of Clinical Trials (IRCT20160820029436N3). Results: Of the 32 selected volunteers, 24 subjects completed the study. The clinical assessment showed a significant improvement of the face appearance along with a significant reduction in dyschromia, and periorbital wrinkling (P‐value <.05), with both procedures without any considerable difference between two methods. Moreover, the patients showed substantial satisfaction with both modalities with no statistically significant difference. Mean TEWL and CRRT values also decreased significantly in both groups with no considerable difference. The downtime was significantly shorter in the microneedling‐treated side. There were no long‐lasting or severe adverse effects after treatment with both methods. Conclusion: Microneedling and fractional Er:YAG laser have comparable efficacy in facial rejuvenation, but little downtime of the former makes it preferable for many patients. [ABSTRACT FROM AUTHOR]

Impetigo herpetiformis (IH) is among rare dermatosis of pregnancy, which is currently considered as a form of generalized pustular psoriasis. It is diagnosed by characteristic lesions of erythematous patches and grouped pustules mostly in the third trimester of pregnancy and may have systemic associations. A variety of complications have been reported in the course of IH. Treatment of IH can be quite challenging, and a number of treatment options have been reported to be effective for the management. [ABSTRACT FROM AUTHOR]

Background: There is a great body of evidence indicating that some inflammatory skin diseases, such as psoriasis, are mediated by oxidative stress. Trace metals have been shown to be involved in oxidative stress response. Altered trace metal homeostasis in psoriasis has been studied. However, limited number of studies has focused on the involvement of metal binding proteins in psoriasis. Materials and Methods: In a case control-study, serum levels of Iron (Fe), Copper (Cu), Transferrin (Trf), and Ceruloplasmin (Cp) were measured in 40 psoriasis patients and matched healthy controls. The severity of the disease was measured using psoriasis area and severity index (PASI), and the association of severity based on PASI score and measured elements and proteins was investigated. Results: Forty patients with psoriasis (mild: 14 and moderate to severe: 26) and 40 healthy controls were included in this study. The serum Fe, Trf, and Cu/Cp levels of the patients with psoriasis were statistically lower compared with those of the controls; serum levels of Cp was elevated in patients with psoriasis compared to controls (P = 0.02). No significant difference was observed between the two groups regarding serum levels of Cu (P = 0.07). Conclusion: Cu/Cp ratio of the patients with psoriasis was statistically lower compared with those of the controls. [ABSTRACT FROM AUTHOR]

Not only the autoimmune nature of the disease, but also some of the immunosuppressive drugs used by these patients put them at a greater risk for infections ([1]). Coronavirus disease 2019 (COVID-19) pandemic has also affected these patients especially those taking systemic drugs or phototherapy. [Extracted from the article]

Two factors of oxidative stress and inflammatory processes are implicated in pathogenesis of acne vulgaris. Silymarin has antioxidant and anti‐inflammatory activities. This study was done to evaluate the effect of oral silymarin in the treatment of acne vulgaris compared to doxycycline and also their combination therapy. This randomized controlled trial was performed on 60 patients with acne vulgaris were divided into three groups of 20 patients, including: Silymarin (Group 1), Doxycycline (Group 2), and both compounds (Group 3). The patients' response was monitored every month and the lesions were evaluated using photography and two methods of Global Acne Grading system (GAGS) and Acne Severity Index (ASI). According to the results, the response to silymarin was not significantly different with doxycycline in the GAGS index (p =.260), but was lower in the ASI (p =.021). In this study, the synergistic effects of silymarin and doxycycline combination have been investigated in comparison with doxycycline. Although the improvement was more favorable in combination group, there was no statistically significant difference (p =.9 in ASI and p =.5 in GAGS). The results of our study suggest that although the silymarin monotherapy is not as effective as doxycycline for the treatment of acne vulgaris, it can be a therapeutic option. [ABSTRACT FROM AUTHOR]

Steroid pulse therapy has shown satisfactory efficacy and safety in treating pemphigus vulgaris (PV). However, there is a paucity of data about the efficacy and safety of methylprednisolone, despite its frequent administration. The aim of this study is to evaluate the efficacy and safety of steroid pulse therapy in treating PV. In this 10‐year retrospective cohort study, 312 patients with PV, who had received methylprednisolone pulse therapy, were included. Data of pulse therapy sessions, adjuvant medications, dosages, remission rates, complications, and mortalities were collected from all patients. A total of 276 patients out of 312 underwent the final follow‐up at least 6 months after the last session of pulse therapy. Complete remission off therapy was achieved in 83 patients (30%), and 152 patients (55%) had complete remission on therapy. About 29 (10.5%) patients had lesions of pemphigus at the time of the study follow‐up, and 26.8% of remained patients were on the minimal therapy. Methylprednisolone pulse therapy could be considered as an option for proper control of PV in severe cases. It might lead to shorter periods of hospitalization and reduce the need to take long‐term high‐dose oral steroid therapy. [ABSTRACT FROM AUTHOR]

The article presents three case studies of family members with facial papular lesions accompanied with frontotemporal scalp and eyebrow alopecia. It notes the mother, the sisters and her son were diagnosed with lichen planopilaris (LPP) and there were no signs of itching and erythema in the affected regions. The article adds that all the isotretinoin and Finastride and Facial lesions disappeared in all of them except the son, who did not not respond to hydroxychloroquine and isotretinoin.

Introduction: Melasma is one of the most common skin pigmentation disorders, which mostly affects the facial skin and has a considerable psychological impact on the patients. Melasma management has been one of the controversial issues in dermatology. We aimed to compare the combined treatment of the Er: YAG (erbium: yttrium-aluminum-garnet) laser plus hydroquinone (HQ) 4% with HQ 4% alone in the treatment of melasma. Methods: Twenty-nine patients were treated with the combined Er: YAG laser and HQ 4% on one side of the face with HQ 4% alone on the other side. Three sessions of the laser rat 4-week intervals. The outcome was calculated using the Melasma Area Severity Index (MASI). Results: The side that received the combined treatment (laser + HQ 4%) showed a statistically significant reduction in MASI compared to the side treated with HQ 4% alone. Conclusion: Our study suggests the superiority of the combination of the Er: YAG laser and HQ 4% in the treatment of melasma compared to HQ 4% alone., (Copyright © 2020 J Lasers Med Sci.)

Recently, advances in understanding the etiology of urticaria and updates of diagnostic and therapeutic management guidelines have drawn attention to chronic urticaria (CU) morbidity. The present study aimed to evaluate Iranian dermatologists' practice and real life management of CU patients. A total of 35 dermatologists and 443 patients were included in the study. Number of female patients was 321 (72.5%). Mean (standard deviation) age of the study patients was 38 (13) years and the median (inter quartile range) of disease duration was 12 (6-48) months. Severity of patients' symptoms was mild for 32.1%, moderate for 38.7%, severe for 18.8%, and 10.4% of them had no evident signs or symptoms. The most common diagnostic methods were physical examination (96.6%), differential blood count (83.5%), erythrocyte sedimentation rate (77.4%), and C-reactive protein (62.8%). The number of dermatologists prescribed nonsedating antihistamines (nsAH) in regular dose and high dose mono therapy were 26 (74%) and 6 (17%), respectively. About 66% of dermatologists were familiar with British Association of Dermatologists (BAD) guideline. The most common first-line treatment for CU by Iranian dermatologists was nonsedating antihistamines in regular or high doses. The real-life management of patients with CU in Iran was in accordance with the available practice guidelines., (© 2018 Wiley Periodicals, Inc.)

Botulinum toxin A injection is performed most frequently for facial rejuvenation all over the world. Some bizarre and severe side effects have been reported after botulinum toxin A injection. Herein, we present a case of vasculitis with panniculitis after a patient underwent a cosmetic procedure that included injection of purported botulinum toxin A.

Background: Prolactin (PRL) level is proposed to be associated with the severity of psoriasis although the previous studies reported different results., Objective: To find the association between PRL levels and severity of psoriasis before and after treatment. In addition, we aimed to find a difference in prolactin, thyroid stimulating hormone (TSH), thyroid hormones (T3 and T4), and cortisol levels between patients with psoriasis and normal controls., Methods: First, the levels of hormones were measured in 30 patients with psoriasis and 30 matched controls. The severity was assessed by psoriasis area and severity index (PASI). Then, patients were treated, and PASI was assessed every week until achieving PASI-75 response. At this time, the hormones were measured again and compared to the baseline., Results: No statistical significant difference was observed in the mean PRL, T3, T4, TSH, and cortisol levels between cases and controls. Comparing to the baseline, a significant decrease in PRL levels and a significant increase in T3 and serum cortisol levels were observed after treatment (P < 0.05), while the changes in other hormones were not significant., Conclusion: After treatment, PRL significantly decreased, and T3 and cortisol levels significantly increased. No correlation between hormone levels and improvement of PASI score existed.