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BACKGROUND Surgical management of hair loss has become an increasingly challenging procedure, when dealing with scar alopecia. We investigated the efficacy of hair transplantation in patients with head and neck scar alopecia. METHODS From 2016 to 2018 in Shiraz, Iran, all patients with scar alopecia in head and neck were evaluated for efficacy of follicular unit extraction (FUE), follicular unit transplantation (FUT) or a combination of two methods from donor sites in scalp and beard various hair-grafts were compared. RESULTS Fifty-six patients were enrolled. Most of them were between 31 and 40 yr old (48.3%) and male (71.4%). Trauma, burn, surgical excision of adjacent skin, radiotherapy and leishmaniasis were the registered causes. Scars were visible in scalp (39.3%), beard (28.6%), eyebrow (21.4%), and moustache (10.7%) regions. FUE (87.5%), FUT (10.7%) and a combination (1.8%) were the used methods. One-hair-grafts were used in eyebrows (100%), moustache (100%), beard (88%) and scalp (7.9%), while 2-hair-grafts in beard (6%) and scalp (47.4%) and 3-haired grafts in beard (6%) and scalp (44.7%) transplantations. CONCLUSION In head and neck scar alopecia, hair transplantation was selected based on type and depth of scar. FUE was targeted when huge grafts were not needed, including beard, moustache, and eyebrow, while FIT was used when extensive scars were present in scalp. One-hair-grafts were mostly applied for eyebrow, moustache and beard, 2-hair- and 3-hair- grafts for beard and scalp transplantation. These findings can be added to the literature when FUE, FIT, or their combination are targeted in hair restoration of scar alopecia in head and neck.

Purpose Vitiligo is an acquired hypopigmentation condition in which well-defined macules can develop virtually everywhere on the patients' skin. This analytic case-control study was conducted in Faghihi Hospital outpatient dermatology clinic, affiliated to Shiraz University of Medical Sciences, southern Iran from June to September 2019. Furthermore, we studied the relationship of hypertension with activity, age of onset, duration, affected body surface area and type of vitiligo. Patients and methods In the current case-control study, 166 individuals were enrolled in total (the case group was comprised of 83 vitiligo patients and 83 individuals actedas control group). The case group was made up of vitiligo patients (both segmental and non-segmental) between 20 and 50 years of age, no prior history of systemic disease and other hypopigmentation disorders, while individuals with any form of dermatologic findings were excluded from the control group. Individuals aged younger than 20 years old or older than 50, having a dermatologic disease other than vitiligo, being afflicted with the diseases which may lead to secondary hypertension, pregnancy, taking substances, and medication which can lead to hypertension were chosen as the exclusion criteria in this study. Results Data obtained from our study revealed that vitiligo patients had a higher prevalence of essential hypertension diagnosis than the control group (P=0.040). Also, no significant relationship was found between patients' age at the first lesion appearance (P=0.856), duration of vitiligo involvement (P=0.497), and percentage of vitiligo involvement (P=0.681) with hypertension. Conclusion According to our results, vitiligo patients were more susceptible to hypertension while no association could be found between characteristics of the disease and rise in blood pressure.

Background: Acne vulgaris is a common inflammatory disease of the pilosebaceous follicle thataffects many teenagers and young people. There is an obvious need for topical treatments with goodtolerability and efficacy for the management of acne lesions. Objective: This study determined the therapeutic efficacy of topical sodium hypochlorite solution(0.005%) in the treatment of mild to moderate acne lesions. Methods: This placebo-controlled randomized controlled trial compared 0.005% sodium hypochloriteto placebo administered topically on each side of the patients’ faces 3 times a day for 1 month. Thenumbers of papules and pustules were recorded at baseline, 1, 2 and 4 weeks after initiation. Results: The total number of papules and pustules decreased after topical application of sodiumhypochlorite 0.005% for 1 month. Conclusions: Topical sodium hypochlorite solution (0.005%) can be effective in the treatment of mildto moderate acne, and its clinical efficacy was evaluated between the male and female groups andbetween the hormonal and non-hormonal ones. Trial registration: Our study was registered in the Iranian Registry of Clinical Trials (IRCT) with thecode number IRCT20200701047976N1.

Background: Cutaneous Squamous Cell Carcinoma (cSCC) is an invasive primary cutaneous malignancy and the second common cancer among whites. Objectives: To define the frequency and epidemiologic features of cSCC. Methods: This study was carried out on 311 patients referred to the Department of Dermatology at Faghihi Hospital of Shiraz, Southwest Iran, between 2015 - 2016. cSCC was diagnosed by pathologists using the standard criteria. The reports were collected along with general information such as age, sex, location, type, and depth of invasion; then it was analyzed by using the statistical software known as SPSS version 23.0 and Minitab software version 18. Chi-square test was used to evaluate the statistical significance. A P value lower than 0.05 was considered as significant. Results: The age range of patients was 21 - 95 years old with an average age of 67.63. The sex ratio (male to female) was 2.87 for the total number of cases. The most common stage was well differentiation 97 (31.2%). The most frequent tumor thickness was between two to four millimeters and the most frequent lesion locations were the nose and then the scalp. Conclusions: The frequency of cSCC increased over the years in regards to patients that were referred to the Faghihi Hospital. This results along with other data which are available from other hospitals and medical centers confirm that the frequency of cSCC is increasing in Iran and plan for management of cSCC is essential, nationally.

Contact dermatitis is a common complication in prosthetic limb users. There are no effective, available and cheap treatments for skin problems of these patients. In traditional Iranian medicine, henna (Lawsonia inermis L.) is a plant that has anti-inflammatory, antimicrobial and skin-enhancing properties, all of which are beneficial for people with artificial limbs. The aim of this study was to assess the efficacy of a topical henna preparation in management of contact dermatitis in patients using lower limb prosthetics.The current randomized, double-blind, placebo-controlled clinical trial was conducted on ninety-five participants with lower extremity amputation using limb prosthetics, aged 12-70 years who complained of contact dermatitis. They were randomly assigned to receive either two weeks of topical henna preparation every night as the intervention group, or topical placebo as the control group. Participants were instructed to spread henna preparation on the surfaces of the amputated limb that were in contact with the prosthesis. Severity of contact dermatitis symptoms was set as the primary outcome measure. Edema, papules and erythema were evaluated by a physician using standard color atlas. Secondary outcomes included symptoms such as burning, itching, pain, thickness and skin sweating evaluated by a self-administered questionnaire.A significant improvement was observed in the symptoms of contact dermatitis including skin edema, itching, sweating, skin thinning and pain (p-value0.05) in the henna group compared to the placebo group. Skin burning decreased more in the henna group compared to the placebo group, but this was not statistically significant (p-value = 0.052). Moreover, skin redness significantly increased in the henna group (p-value = 0.001).Topical formulation of henna might be a complementary choice for improving contact dermatitis in patients using lower limb prosthetics.

Background Altered levels of sex hormones have been observed in many autoimmune disorders, but there is no considerable data about pemphigus. The aim of this study is to compare serum total and free prolactin and dehydroepiandrosterone sulfate (DHEAS) levels between patients with pemphigus and healthy controls and to determine the correlation of these hormones with disease severity. Methods This study included 52 newly diagnosed cases of pemphigus and 57 healthy controls. Serum prolactin (total and free) and DHEAS were measured in all subjects. Data analyses were performed using JMP, Version 7. Results Pemphigus patients had significantly higher levels of total and free serum prolactin (both P = 0.01) and lower levels of DHEAS (P = 0.005) than healthy controls. A significant association was found between severity of pemphigus and total prolactin levels (r = 0.40, P = 0.003). Conclusions The patients with pemphigus had higher total and free prolactin and lower DHEAS concentrations, and patients with more severe disease had higher levels of serum total prolactin. These new data may suggest a potential role for sex hormones in the pathogenesis of pemphigus disease and provide new insights for the better management of this chronic and life-threatening disease.

The long-term planning approach with its central aim of changing the urban form using zoning regulations and improving transportation may no longer be the only conceivable solution. Participants in planning and land development processes formulating plans today are predominantly land developers, entrepreneurs, and landlords. However, community groups are increasingly active participants, providing a counterbalance to the profit-driven agenda of corporations. Explores that landscape for current smart city development.

Background: Pulse therapy is a type of systemic management in which large amounts of medications are administered to patients in short time and intervals (e.g. weekly) to get the stronger effects of medication sooner and avoid long term use of them. Objective: To determine how therapy-resistant dermatology diseases respond to oral minipulse steroids . Methods: Articles with Mesh terms "pulse therapy", "dermatology" and "steroid" were searched in PubMed database .we chose case reports and clinical randomized controlled trials on oral steroid minipulse therapies of dermatology diseases. Results: Most articles and case reports mentioned the successful treatment of refractory diseases like lichen planus, vitiligo and alopecia areata with oral mini -pulse steroids. Conclusions: Oral mini pulse has stronger beneficial effects and fewer side effects than daily systemic corticosteroids. Since it is administered twice weekly , patient compliance will be better. Therefore, oral corticosteroids minipulse can be a good alternative to daily systemic corticosteroids in dermatologic diseases. Egyptian Dermatology Online Journal Vol. 10 No 2: 1, December 2014 2 http://www.edoj.org.eg Introduction Corticosteroids have been used in dermatology since a long time ago. Pulse therapy is a type of systemic management in which large amounts of medications are administered to patients in short time and intervals (e.g. weekly) to get the stronger effects of medication sooner and avoid long term use of them [1]. Pulse steroid therapy was firstly used in a patient with renal allograft in 1969 [2]. Oral mini pulse (OMP) is a type of pulse steroid therapy which is given orally in intervals to patients[1]. It is more comfortable for patients to comply with than daily systemic steroid therapy [3]. Pasricha et al. [4] used OMP in the treatment vitiligo for the first time and later it was used in other dermatological conditions such as lichen planus, alopecia areata, nail dystrophy, infantile periocular hemangioma and etc. Our article is a short review about the clinical use of oral minipulse steroid in the treatment of different dermatological diseases to determine how therapy-resistant cases respond to oral steroid pulse therapy till now. Methods: We searched the PubMed data bank using the following MESH-terms: pulse therapy, steroid, dermatology. We limited our search for clinical trials and case reports on treating dermatologic refractory cases with only oral mini pulse steroids. We didn't have access to the most full articles so we used abstract forms of the articles. There were 7 case reports and 17 original articles found on oral minipulse therapy and dermatology diseases.

Skin aging has received tremendous attention in recent years by both scientists and the lay public. This article reviews the evidence that homocysteine, an intermediary sulfhydryl-containing amino acid implicated in atherosclerosis, can accelerate skin aging and the aging of internal organs (universal aging).

Background. Uremic pruritus (UP) is still a common tormenting symptom among patients on hemodialysis (HD). The pathogenesis of UP is complex and not fully clarified. Some preliminary studies indicate that UP is a systemic inflammatory disease with a deranged balance of T helper (TH) cell differentiation toward TH1 predominance. The aim of this study was to further elucidate the potential contribution of TH1 cytokines to the pathogenesis of UP. Methods. In this study, 112 HD patients were screened for UP. After meeting the required criteria, 31 HD patients with UP were included in the study as case group and 30 age- and sex-matched HD patients without UP were enrolled as controls. The serum levels of interleukin (IL)-2 and interferon-c (as TH1 cytokines), IL-4 (as a TH-2 cytokine), high-sensitive C-reactive protein (as an inflammatory marker), parathyroid hormone, calcium, phosphate, albumin and ferritin were measured in all patients. Moreover, blood variables including hemoglobin and mean corpuscular volume were also determined. The correlations of measured factors with UP severity were determined as well. Results. Except for the serum levels of IL-2, which were significantly higher in HD patients with itch versus those without it [0.544 6 0.126 (U/mL) versus 0.318 6 0.145 (U/mL); P < 0.0001], no statistically significant difference was observed in the levels of each of the above-mentioned factors between the two groups. Additionally, no correlation was detected between the levels of measured factors and UP severity. Conclusions. The results of our study, for the first time, point to the potential important role of IL-2 in UP and further support the notion of TH1 overactivity in its pathogenesis. Our study paves the way for further studies focusing on the contribution of IL-2 to the UP, such as the experimental use of anti-IL-2 receptor antibodies.

Background Pemphigus vulgaris (PV) is a blistering autoimmune bullous disease that is usually fatal without proper treatment. There are no clear treatment guidelines for PV at this time. Purpose We suggest a standard treatment regimen for patients with PV based on the success of our treatment. Methods A retrospective chart review of 18 patients with PV was conducted to assess response to a similar approach using mycophenolate mofetil (MMF) and prednisone. Diagnosis was confirmed through routine histology, direct immunofluorescence, and indirect immunofluorescence, and patients were followed up for a total average of 35.2 months. Results We achieved complete disease control in 89% of patients using our treatment algorithm. Fourteen of 18 patients achieved complete disease control on therapy with prednisone and MMF. Three of the 4 patients who did not achieve control on MMF and prednisone went on to receive rituximab therapy, and two of those patients achieved disease control on rituximab. The average length of time from initiating therapy to 75% clearance of lesions was 4.5 months. Three of 18 patients were able to discontinue therapy after an average of 3 years and have remained in complete remission for more than 1 year. Limitations This was a retrospective chart review with a small patient sample size. Conclusions The combination therapy of MMF and prednisone is an effective treatment regimen to achieve rapid and complete control of PV. For those patients who fail treatment with MMF and prednisone, rituximab is an efficacious alternative therapy.

Statins are competitive inhibitors of 3-hydroxy-3-methylyglutaryl-coenzyme A reductase and reduce low-density lipoprotein-C levels. Statins are well-tolerated drugs used for prevention of atherosclerosis and cardiovascular events. Statins possess anti-inflammatory, immunomodulatory, antioxidant, metabolic, and possible anticancer effects. Statins are reported to be effective against psoriasis, dermatitis, graft-versus-host disease, uremic pruritus, vitiligo, and hirsutism. Topical forms of statins are employed in the treatment of acne, seborrhea, rosacea, and rhinophyma. Animal studies show the beneficial effect of statins against contact dermatitis and wound healing. They have promising anti-HIV effects as well. This article succinctly reviews the various cellular and molecular effects of statins, their applications in cutaneous medicine and their side effects.

Fetal wound healing occurs rapidly and without scar formation early in gestation. Studying the mechanisms of scarless repair can lead to novel scar-preventive approaches. In fetal wounds, collagen is deposited early and is fine and reticular with less cross-linking. Several important differences of fetal vs. postgestational wound-healing response have been determined, such as the presence of less inflammation, higher hyaluronic acid concentration and a greater ratio of collagen type III to type I. Compared with typical wounds, there are also altered ratios of signaling molecules, such as higher ratios of transforming growth factor (TGF)-β3 to TGF-β1 and -β2, and matrix metalloproteinases to tissue inhibitors of metalloproteinases. Furthermore, fetal fibroblasts do not exhibit TGF-β1-induced collagen production compared with their mature counterparts. Patterning genes (homeobox genes) involved in organogenesis are more active in the fetal period and are believed to be the "first domino" in the fetal cutaneous wound repair regulatory cascade. The recommended scar-preventive agents, such as Scarguard MD®, silicone gel and sheet, Seprafilm® Bioresorbable Membrane, topical hyaluronan, onion extract, oral tamoxifen and 585-nm pulsed dye laser are reviewed in this study. Despite the lack of supporting evidence, there is a widespread false presumption that the acceleration of healing with the widely assumed scar-preventive commercial agents is associated with decreased scar formation. Humans are erroneously inclined to make a negative correlation between the healing rate and the degree of scar formation, while such a correlation does not exist in reality. Despite the importance of scar prevention, no FDA-approved therapy for this purpose is available in the 21st century, which reflects the important challenges, such as the presence of redundant pathways, that these approaches are facing.

Tinea versicolor is a superficial fungal infection of the skin caused by Malassezia yeasts. Tinea versicolor is a common disease and has a high rate of recurrence.This is a prospective, double-blind, randomized, placebo-controlled clinical trial in Faghihi Hospital Dermatology Department. Participants were older than 10 years with a clinical diagnosis of tinea versicolor and positive KOH preparation, and were divided in two groups: active and control (32 individuals in each). They were randomized to receive either nitric oxide (NO)-liberating cream as the active group and placebo as a control. Creams were applied twice daily on the affected sites for 10 days.Sixty-four patients were entered into the study (31 male and 33 female). No significant difference was found between the two groups in terms of severity, age and sex distribution. There was significant improvement with acidified nitrite cream in the active group after 10 days (p = 0.000).NO is an important cytotoxic effector in immune defense against fungi that are too large to phagocyte. This study shows the efficacy of an exogenous NO-releasing cream in treating tinea versicolor.

Background Despite the improvement of health standards, head lice infestation remains a problem worldwide. In addition, there is increasing evidence that head lice are becoming resistant to common pediculocides. Aim To test the potential effectiveness of thiabendazole, a potent and broad-spectrum antiparasitic and scabicidal agent, for the treatment of pediculosis capitis. Methods Twenty-three female patients, aged 7–12 years, who had active head lice infestation, were treated with oral thiabendazole, 20 mg/kg twice daily for 1 day, with repeat treatment after 10 days. Results On the 11th day, meticulous hair examination showed that 21 patients had responded to treatment [91%; 95% confidence interval (CI), 71–98%], with 14 showing complete responsiveness (61%; 95% CI, 40–78%). The only adverse reactions observed were nausea and mild dizziness, which occurred in four patients, three of whom took the drug on an empty stomach. Conclusions Thiabendazole may be a promising treatment for head lice infestation. The primary action of this drug seems to be the inhibition of parasite microtubule polymerization by binding to β-tubulin. In addition, thiabendazole may interfere with the synaptic transmission of lice through its probable cholinergic effect. As pediculosis capitis is a very communicable disease, the unresponsiveness to thiabendazole could largely be attributed to new infestations during the drug-free interval. Therefore, massive and simultaneous rather than individual and isolated treatments should be used to achieve the epidemiologic control of this ectoparasitosis. As this is a preliminary study, the performance of double-blind, randomized controlled trials on this subject is warranted. Thiabendazole, either alone or in combination with other agents, may prove to be of particular use in areas in which head lice show resistance to common pediculocides.

A continuous update of building information is necessary in today’s urban planning. Digital images acquired by remote sensing platforms at appropriate spatial and temporal resolutions provide an excellent data source to achieve this. In particular, high-resolution satellite images are often used to retrieve objects such as rooftops using feature extraction. However, high-resolution images acquired over built-up areas are associated with noises such as shadows that reduce the accuracy of feature extraction. Feature extraction heavily relies on the reflectance purity of objects, which is difficult to perfect in complex urban landscapes. An attempt was made to increase the reflectance purity of building rooftops affected by shadows. In addition to the multispectral (MS) image, derivatives thereof namely, normalized difference vegetation index and principle component (PC) images were incorporated in generating the probability image. This hybrid probability image generation ensured that the effect of shadows on rooftop extraction, particularly on light-colored roofs, is largely eliminated. The PC image was also used for image segmentation, which further increased the accuracy compared to segmentation performed on an MS image. Results show that the presented method can achieve higher rooftop extraction accuracy (70.4%) in vegetation-rich urban areas compared to traditional methods.

Introduction: Alopecia areata (AA) is a common type of hair loss with an autoimmune basis. As the role of homocysteine (Hcys), folate, and CRP has been considered in some autoimmune diseases. Objectives: To evaluate homocysteine, folate and CRP level in AA. Methods: This study was performed on 29 patients who had AA for at least 6 months affecting more than 20% of scalp, and 32 healthy controls. Levels of serum Hcys, blood high-sensitivity CRP, and RBC folate were measured in all subjects. Results: The mean level of RBC folate was significantly lower in the patient group than that in controls (P < 0.001). Also, the level of RBC folate was significantly lower in patients with extensive forms of disease (alopecia totalis/alopecia universalis) in comparison with more localized form (patchy hair loss) (P < 0.05). Patients with higher "Severity of Alopecia Total" (SALT) score had lower RBC folate, as well. Serum Hcys and blood high-sensitivity CRP levels did not show a significant difference in two groups. Conclusion: Patients with alopecia areata have lower level of RBC folate which is in negative correlation with both severity and extension of AA.

Sirs,Vitiligo is a common, recalcitrant, psychologically devastating skin disorder with a complex and enigmatic etiopathogenesis (1). Autoimmune, autocytotoxic and neurogenic phenomena are consider...

Background: Nicotinamide (NA), the active form of vitamin-B3, is hypothesized to have positive effects on the process of wound healing; it has anti-inflammatory, antioxidant, and immunomodulatory properties, as well as an epithelization inducing action. Objectives: In the present study, we aimed to determine the effects of topical administration of NA on skin wounds, based on histomorphometrical and pathological criteria. Materials and Methods: In this study, 36 male Sprague-Dawley rats (220 ± 20 g each), with 1 cm2 circular full-thickness wounds on their backs were divided into three groups (n = 12): NA group, was treated daily with a Nicotinamide 2% gel , untreated group (control), and base group, which were treated with the vehicle (base) of the gel (carboxymethylcellulose). Skin biopsies were prepared for microscopic analyses. Inflammation, granulation tissue formation, ulceration, epithelization, wound closure rate, fibroblast proliferation, collagen synthesis, and vascularization were studied criteria. Results: The results revealed that besides improving the wound healing by its anti-inflammatory, antioxidant, and epithelization inducing effects, NA also improved tissue regeneration through the increment of fibroblast proliferation, collagen synthesis, and vascularization. Conclusions: In spite of the few reported side effects, NA can be introduced as an effective agent on the wound healing process, an adjuvant therapy and possibly a treatment by itself. However, its chemical characteristics, as well as possible adverse effects warrants further research.

An infrastructure system is inherently complex, with layers of both defined and subtle interfaces with other infrastructure systems and human users. High availability is desired, which implies stringent requirements on reliability and safety. Reliability analysis typically starts at component or sub-system level and aggregates through the system functional hierarchy. Because of the system complexity, incorporating occurrences of all possible interactions and scenarios is not always practical and failure data is often limited. Moreover, there are unobserved events among the sub-systems distributing either randomly or with temporal trend. To facilitate reliability analysis amid the complex environment and uncertain data, this paper proposes a general framework on modelling and aggregating reliability for complex systems with distinctive statistical approaches. The underlying principles will be illustrated and the suitability of the proposed techniques with respect to the data available will be discussed. This study contributes to the assurance of life-long productivity of infrastructure systems.

With rapid development in product globalization and just-in-time production over the last two decades, area-specific reliable, responsive and customer- oriented rail freight services are in demand and are of increasing interest. Having a proper understanding of underlying factors in the evaluation of the quality of rail freight services is a key challenge in the short-term and long-term regional and metropolitan freight mobility planning, particularly within the context of a competitive rail freight market as in Australia. Among the fundamental attributes of rail freight services, transit time and reliability/punctuality are of utmost importance, which also tend to be inevitably correlated. This paper discusses the potential opportunities for service improvement in the Australian non-bulk interstate network through managing the underlying factors. The paper also addresses the conditions under which these factors can be combined to enhance the utilisation and efficiency of rail freight services in the national rail infrastructure.

Background. Alopecia areata (AA) is a chronic inflammatory disease of the hair follicle. The exact pathogenesis of AA remains unknown, although recent studies support a T-cell mediated autoimmune process. On the other hand, some studies have proposed that the renin-angiotensin-aldosterone system (RAAS) may play a role in autoimmunity. Therefore, we assessed serum activity of angiotensin converting enzyme (ACE), a component of this system, in AA. Methods. ACE activity was measured in the sera of 19 patients with AA and 16 healthy control subjects. In addition, the relationship between severity and duration of the disease and ACE activity was evaluated. Results. Serum ACE activity was higher in the patient group (55.81 U/L) compared to the control group (46.41 U/L), but the difference was not statistically significant (P=0.085). Also, there was no correlation between ACE activity and severity (P=0.13) and duration of disease (P=0.25) in the patient group. Conclusion. The increased serum ACE activity found in this study may demonstrate local involvement of the RAAS in the pathogenesis of AA. Assessment of ACE in a study with a larger sample size as well as in tissue samples is recommended in order to further evaluate the possible role of RAAS in AA.

A 45-year-old woman from Afghanistan presented with a 1-year history of multiple itching and stinging lesions on both right and left auricular and periauricular areas. Skin examination revealed about eight superficial erythematous nodules, ranging from 0.2 to 1.2 cm in diameter, on both ears, as well as on the preauricular and retroauricular areas (Fig. 1). Figure 1. Multiple erythematous nodules and papules on the left auricular and periauricular areas Download figure to PowerPoint Examination of a lesional skin biopsy specimen revealed vascular proliferation and dense dermal infiltration by lymphocytes, eosinophils, and mast cells. The vascular component consisted of thick- and thin-walled blood vessels lined by plump endothelial cells with large nuclei and abundant eosinophilic cytoplasm. No lymphoid follicles were identified (Fig. 2). Figure 2. Diffuse dermal infiltration by lymphocytes and eosinophils and vascular proliferation (hematoxylin and eosin, (a) × 150, (b) × 250) Download figure to PowerPoint The patient's medical history was remarkable for the gradual development of generalized edema starting 4 months after the appearance of the skin lesions. Laboratory investigation revealed the presence of massive proteinuria (11 g/day; normal

In a free viewpoint video system, the scene is captured by a number of cameras and it would be desirable to optimize the configuration of cameras, such as their location or orientation, to improve the rendering quality. This paper introduces a mathematical representation of the multi-camera geometry, called the correspondence field (CF), which can be used to quantify the suitability of a camera configuration for a given arrangement of objects in the scene. The correspondence field describes the spatial topology of the intersecting rays of cameras, arranged as a number of layers or surfaces in the field of view of cameras. The paper derives the topology of CF for certain camera arrangements and analyzes the impact of changes in camera location or orientation on this topology. It demonstrates that CF can be used to find the optimum camera configuration for a given objective. It also presents simulation results of this method using our light field simulator.

The 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins), atorvastatin, cerivastatin, fluvastatin, pravastatin, lovastatin and simvastatin, reduce atherogenesis and cardiovascular morbidity. Besides, there is growing evidence that statins have immunomodulatory activities. Statins downregulate the expression of adhesion molecules, intercellular adhesion molecule-1 (ICAM-1), monocyte chemotactic protein-1 (MAC-1) and lymphocyte function-associated antigen-1 (LFA-1), on leucocytes and endothelial cells and, through binding to LFA-1, interfere with ICAM-1–LFA-1 interaction, which is crucial for activation of lymphocytes by antigen-presenting cells, ingress of leucocytes into the inflammation sites and immunologic cytotoxicity. Statins inhibit the inducible expression of major histocompatibility complex class II in several cell types including macrophages and downregulate the expression of T-helper-1 (Th1) chemokine receptors on T cells, leading further to inhibition of activation of lymphocytes and their infiltration into the inflammation sites. Statins block the induction of inducible nitric oxide synthase and the expression of several proinflammatory cytokines such as tumour necrosis factor-α and interferon-γ in macrophages and possess antioxidant effects. These agents inhibit the proliferation of immunocytes and the activation of natural killer cells. Regarding the above facts and in view of their safety and inexpensiveness, statins may prove invaluable in the treatment of a multiplicity of dermatologic disorders, especially those characterized by ingress of activated leucocytes into the skin, such as alopecia areata, vitiligo, lichen planus, subacute cutaneous lupus erythematosus, erythema multiforme, psoriasis, bullous pemphigoid, systemic sclerosis, mycosis fungoides, toxic epidermal necrolysis and Behcet's disease.

Chronic idiopathic urticaria (CIU), a debilitating condition, is defined as having urticaria for at least 6 weeks without any obvious cause. Antihistamines and steroids are popular treatments, but other alternatives have been evaluated. Mesalazine may be effective in CIU according to its anti-inflammatory properties via inhibition of 5-lipoxygenase, cycloxygenases, nuclear factor-kappa B activation, T lymphocyte proliferation and antigen stimulated histamine release.Mesalazine was administered to 33 patients with CIU, starting at 500 mg/day with weekly incremental dosing to a total of 1 g/day. The patients' dermatology life quality index (DLQI) and symptom scores were recorded before and after 8 weeks of treatment. Screening laboratory tests before and during treatment period were performed.Mesalazine induced a statistically significant decrease in DLQI in 22 (66%) of 33 patients. It is also effective in reducing symptom score in at least half of the patients. The success of treatment was not related to age, sex, drug history and atopy, but was related to duration of the disease in reverse.Mesalazine seems to be a safe and effective therapy for CIU in reducing DLQI and symptoms.

A 60-year-old, otherwise healthy, male farmer presented to our Dermatology Department with a large ulcer on his lower right leg. The lesion had started as a small papule 6 months before, which became eroded and transformed into a rather rapidly progressive ulcer. On careful inspection, numerous larvae were found moving within the wound. The larvae were analyzed and found to be Lucilia sericata (the green bottle blowfly). The lesion was diagnosed histopathologically as squamous cell carcinoma. The myiasis was treated by submerging the wound in a dilute permanganate potassium solution.

Background There is ample evidence for involvement of macrophage migration inhibitory factor (MIF) in autoimmune and inflammatory diseases. Objective The aim of this study was to determine whether MIF levels were raised in the sera of patients with pemphigus vulgaris (PV). Methods Serum MIF levels were measured using ELISA method in 22 patients with active PV and 21 age- and sex-matched healthy controls and the results were compared with each other. Results The mean serum MIF levels was significantly higher in PV patients than in control subjects (11.99 ± 1.63 pg/m vs. 1.83 ± 0.22 pg/ml; P-value = 0.0001). Conclusions Elevated MIF levels in the sera of PV patients could participate in disease induction by activation of T cells as well as induction of autoantibody production by B cells. Given that MIF counter-regulates the effects of steroids, MIF antagonists may prove to be very effective, novel steroid-sparing agents for this life-threatening conundrum.

Psoriasis is an inflammatory disorder characterized by a T helper cell type 1 cytokine pattern. Interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), interleukin-2 (IL-2) and interleukin-1 (IL-1) are predominantly ex-pressed in this disorder. This immunological pathway is stimulated by interleukin-12 (IL-12) released from activated dendritic cells and by exposure of T cells to type 1 cytokines during maturation.

Background Skin tags are common benign lesion occurring mainly on the neck and major flexures as a small soft pedunculated protrusion. This study evaluate insulin and insulin-like growth factor-I (IGF-I) in non-diabetic ones. Methods and materials A case–control study was conducted in non-diabetic persons. Comparing insulin and IGF-I between matched cases (n = 40) and controls (n = 40) by radioimmunoassay test. Cases and controls were recruited from patients consecutively seen at an academic outpatient dermatology clinic. Results The insulin level in patients with skin tags was significantly higher than controls (P = 0.00) but IGF-I level was not significantly different (P = 0.43). Conclusion These results show an increased insulin level in non-diabetics ones and overall importance of insulin effect in pathogenesis of skin tags.

Calcium is one of the most important intracellular messengers in human brain. Studies show that there is a relationship between altered Ca2+-homeostasis, especially elevation of intracellular calcium, and formation of the hallmark pathological lesions of Alzheimer's disease. Additionally, Ca2+ is crucial for normal function of the skin, and an abnormal rise in intracellular Ca2+ can consequently lead to the development of two skin disorders: Darier and Hailey-Hailey diseases. As these mutated genes are also highly expressed in the brain and these patients are reported to experience some neuropsychiatric problems, we have hypothesized that patients with these dermatologic diseases may be more prone to the development of Alzheimer's disease. Further investigation may give us clues to find novel therapeutic targets and agents for modulation of intracellular calcium in neurons.

The tumescent anesthetic technique offers both anesthesia and vasoconstriction. A solution of 0.1% lidocaine, 1:1000,000 epinephrine, and 10 mEq/l of sodium bicarbonate is injected into the subcutaneous tissue until it becomes quite firm. A dual level of tumescent anesthetic infiltration expedites hair grafting or strip harvesting for hair transplantation, facilitates the placement of the correct incisional angle of instruments inserted into the donor site, reduces bleeding, and increases the exit angle of the hairs, thereby promoting increased survivorship of hair shafts and bulbs [2, 3]. However, despite the use of this technique, bleeding from the recipient sites frequently occurs, which makes transplantation of the harvested follicles difficult. Tranexamic acid is a synthetic derivative of the amino acid lysine that exerts its antifibrinolytic effect through the reversible blockade of lysine-binding sites on plasminogen molecules. Tranexamic acid is useful in a wide range of hemorrhagic conditions. The drug reduces postoperative blood loss in a number of surgery types such as cardiac surgery with cardiopulmonary bypass, orthotopic liver transplantation, and transurethral prostatic surgery. Tranexamic acid decreases the blood loss from upper gastrointestinal bleeding, menorrhagia, placental bleeding, traumatic hyphema, postpartum hemorrhage, and conisation of the cervix. Tranexamic acid significantly reduced mean blood loss after oral surgery for patients with hemophilia and was effective as a mouthwash for dental patients receiving oral anticoagulants. Systemically administered tranexamic acid is well tolerated. Nausea and diarrhea are the most common adverse events. Increased risk of thrombosis with the drug has not been demonstrated in clinical trials [1]. The antifibrinolytic property of tranexamic acid could be elegantly used for the reduction of bleeding at hair transplantation recipient sites. The addition of one 500-mg (5 ml) ampule of tranexamic acid to the tumescent anesthetic solution can significantly speed and ease the transplantation of the harvested follicles into the recipient sites while decreasing the stress of the operation.