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Amyloidosis cutis dyschromica (ACD) is a rare pigmentary disorder with about 50 cases having been reported in the English literature. Only one case of ACD has been reported from Iran. We present three patients who presented with generalized hyper- and hypopigmented patches, sparing face, hands, and feet in all three cases. The presence of amorphous eosinophilic deposits in the papillary dermis confirmed the diagnosis of ACD; the deposits were stained by crystal violet in the histopathological examination of the lesions. In all three cases, similar lesions were present in some of the family members. ACD should be considered in the differential diagnosis of diffuse hyperpigmentation studded with hypopigmentation, especially when beginning in childhood.

A 30-year-old woman, presented with erythematous scaling plaques on her trunk with severe pruritus and a burning sensation that began 3 months prior to her visit. She had a history of a thermal burn in that area, three years prior. Topical corticosteroid application for 3 months had no positive effects. Skin biopsy was done and scabies mites were found.

Autoimmune progesterone dermatitis (APD) is a rare disorder characterized by periodic skin lesions that erupt during the luteal phase of the menstrual cycle. Clinical manifestations of APD is caused by an unusual allergy to progesterone and has a wide range of clinical manifestations from eczema and urticaria to angioedema and erythema multiforme. A 46-year-old woman described recurrent, round erythematous plaques on the lower lip, both forearms and buttocks. These skin eruptions waxed and waned for 10 months, reoccurring 3-4 days before menstruation. Based on her medical history and physical examination, APD was suspected and the progesterone challenge test showed positive results. After treatment with oral prednisolone (30 mg/day) before menstruation, the severity of eruptions decreased dramatically but recurrence did not cease completely.

Byline: Bahia. Jahromi, Mahsa. Razeghi, Ladan. Dastgheib, Arezou. Fazelzadeh, Amir. Miri, Sina. Vakili, Sedigheh. Foruhari, Soudabeh. Sabetian Objectives: Genital wart is a sexually transmitted disease caused by human papillomavirus (HPV) [...]

For centuries, Hirudo medicinalis (medicinal leech) has been used as a remedy to treat many discomforts, such as muscle and joint pain. Nowadays, using leech in reconstructive surgery, microsurgery, wound and flap healing, venous insufficiency, varicosities and many other disorders has increased. In this study, we report a 45 year old female patient with six pruritic papules on her legs since10 months ago that appeared about 4 weeks after one session of leech application. Skin biopsy was performed on one of the papules, and in histopathology, superficial ulceration with a dense superficial and deep inflammatory infiltrate within the dermis composed of lymphocytes and eosinophils detected that considering history of leech application at this site, these constellation of data was compatible with the diagnosis of cutaneous lymphoid hyperplasia induced by leeches and the patient was cured by a topical steroid and cryotherapy. [ABSTRACT FROM AUTHOR]

Objective: Cassia fistula L. fruit extract has been traditionally used in the treatment of pemphigus vulgaris (PV) lesions in Iran. The aim of this study was to determine the efficacy of C. fistula fruit gel on healing time of PV lesions in a clinical setting. Materials and Methods: This was a randomized, double-blind placebo-controlled clinical trial that was performed in dermatology ward at Saadi hospital, affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. Right- or left- sided lesions of PV patients on standard systemic treatment were randomized for treatment with either C. fistula fruit gel or placebo prescribed twice daily. The largest diameter of each lesion was measured at the baseline (day 0) and on days 10 and 20. Epithelialization Index (EI), as outcome measure was calculated and compared between the two groups. Results: The present study comprised 20 patients, with overall 82 cutaneous lesions including 41 lesions in the C. fistula fruit gel group and 41 lesions in the placebo group. The EI in the C. fistula fruit gel group was significantly higher than that of the placebo group both on day 10 (65±28vs 30±34; p=0.001) and at the end of the study (91±22 vs 69±49; p=0.003). Conclusion: Topical application of C. fistula fruit gel can be considered as an effective adjuvant therapy in treatment of PV. [ABSTRACT FROM AUTHOR]

Objective: As a rare autoimmune disease, pemphigus vulgaris has a poor prognosis especially in lack of proper medical support. This blistering disease involves both the skin and mucus membranes. The challenge is improving the healing process of skin lesions of which, superimposed infections are among the main causes of the disease mortality. Accordingly, we aimed to assess the treatment options suggested by traditional Persian medicine (TPM) and compare them with current findings. Materials and Methods: We studied the main clinical and pharmaceutical textbooks of TPM (Kitāb al-hāwīfī al-tibb, the Canon of Medicine, Eksir-e-Aazam, Tuhfat al-mu'minīn, Makhzan al-adviyah (focusing on the skin chapter and respective herbal remedies for the inflamed skin and ulcers. Additionally, scientific databases such as PubMed, Science direct, Scopus, and Google Scholar were searched for the current pharmacological evidence. In the studied books, the term "hot ulcers" was found close to what is known as "Pemphigus vulgaris". Results: Reported medicinal herbs possess anti-inflammatory, antioxidant, wound healing, and antibacterial activities reported by recent studies. Therefore, they could be introduced as novel natural remedies for pemphigoid wounds. Conclusion: Taken as a whole, the review of traditional remedies for hot ulcers in Persian medical and pharmaceutical literature may open a new window toward developing new topical treatments for this disease. [ABSTRACT FROM AUTHOR]

Diaper dermatitis is a common disorder. Coriandrum sativum is a herbal remedy with anti-inflammatory, analgesic, anti-microbial and anti-oxidant activities effects. In this non- randomised clinical trial which was performed on 58 infants with diaper dermatitis referred to Faghihi Hospital, Shiraz University of Medical Sciences, the efficacy and safety of topical Coriandrum extract cream is compared with hydrocortisone ointment. Coriandrum sativum extract cream was administered for 37 (intervention group) and hydrocortisone 1% ointment for 21 (control group) patients. Patients were examined on days 3 and 10. Chi-square test was applied for statistical analysis. The results demonstrated a statistically significant difference in the cure rate (20 (54.1%) for the intervention group versus 19 (90.5%) for the control group) (P-value = 0.005) and side effects (10 (27%) for the intervention group versus 0 (0%) for control group) (P-value = 0.009) both in favor of hydrocortisone. This trial failed to confirm the efficacy of Coriandrum sativum in the treatment of diaper dermatitis; however, it seems that if soothing compounds are used in combination with Coriandrum sativum to reduce the mild irritation, Coriandrum extract can be an alternative treatment for diaper dermatitis. [ABSTRACT FROM AUTHOR]

Objective: Pemphigus is a rare autoimmune disease that may be fatal without proper medical intervention. It is a blistering disease that involves both the skin and mucus membranes, in which the most important causes of death comprise superimposed opportunistic infections and complications of long-term high-dose corticosteroid therapy or prolonged consumption of immune suppressant drugs. Skin lesions are the most important sources of infection, and any local treatment decreasing the healing time of lesions and reducing the total dosage of drugs is favorable. Materials and Methods: Here, we review the probable mechanism of action of a traditional formulary of Cassia fistula (C. fistula) fruit extract in almond oil as a new topical medication for reducing the duration of treatment of pemphigus vulgaris erosions. Results: C. fistula fruit oil has lupeol, anthraquinone compounds as rhein and flavonoids. Previous in vitro and animal studies on C. fistula fruit have demonstrated wound healing, antioxidative, anti-leukotrienes, antiinflammatory, antibacterial and antifungal effects of this plant. Conclusion: It is hypothesized that C. fistula L. can be a botanical therapeutic choice for treatment of pemphigus erosions. [ABSTRACT FROM AUTHOR]

Introduction: To investigate the therapeutic efficacy of tacrolimus compared with azathioprine in the treatment of pemphigus vulgaris. Methods: About 23 patients received prednisolone and azathioprine, and 23 patients prednisolone and tacrolimus for 6 months. Pemphigus activity scores, the time that new bulla formation stopped, the time corticosteroid was tapered, cumulative steroid dosage and medication side effects were analyzed. Results: In the control group, the new bulla formation was ceased after a mean ± SD of 11.8 ± 4.7 days, and steroid tapering was done after a mean ± SD of 28.3 ± 5.45 days. Of the 23 patients receiving prednisolone and tacrolimus, the new bulla formation was ceased after a mean ± SD of 12.9 ± 5.26 days, and steroid tapering was done after a mean ± SD of 28.2 ± 5.39 days. About 8.6% of patients did not reach remission in each group. In patients receiving azathioprine, life-threatening side effects were seen in 1 (4.7%), moderate side effects in 2 (9.5%) and mild side effects in 1 (4.7%). In patients receiving tacrolimus, moderate side effect was seen in 1 (5%) and mild in 1 (5%). Conclusion: Tacrolimus effects are comparable to azathioprine as pemphigus vulgaris adjuvant treatment, also it has less severe side effects. Trial registration No. IRCT2012073010450N1 available at [ABSTRACT FROM AUTHOR]

Background and Aim: Pityriasis versicolor (PV) is a fungal infection of the skin that is caused by Malassezia species in tropical and subtropical areas. Various treatments such as ketoconazole 2% shampoo are effective in the treatment of PV. In this study, the therapeutic effects of ketoconazole 2% shampoo and Octopirox 1% shampoo on PV were compared. Methods: Fourty-two patients participated in the study. Twenty-five patients were treated using Octopirox 1% shampoo and 17 patients were treated by ketoconazole 2% shampoo. Each shampoo was administered for 5 minutes after daily showers for three weeks. At the end of the treatment period, patients were evaluated on the basis of the results KOH test and clinical examinations. Results: At the end of the treatment period in ketoconazole 2% shampoo group, 64.7% of patients were cured. In Octopirox 1% shampoo group, 44% of patients were cured. The detected difference was not statistically significant (P=0.187). Conclusion: Both shampoos were effective in eliminating the symptoms, but ketoconazole 2% shampoo was more effective in improving the associated hyperpigmentation and erythema than Octopirox 2% shampoo. No side effects were observed in either group. [ABSTRACT FROM AUTHOR]

Background: 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. Methods: 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. Results: 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. Conclusions: Mesalazine seems to be a safe and effective therapy for CIU in reducing DLQI and symptoms. [ABSTRACT FROM AUTHOR]

Androgenic alopecia as a physiologic process and benign prostatic hyperplasia (BPH) as a pathologic process in the older population are androgen-dependent processes influenced by 5-alpha reductase enzyme which converts testosterone to dihydrotestosterone. This cross sectional study was done to evaluate the relationship between androgenic alopecia and BPH. 150 men older than 50 years old, who presented to the free prostate screening clinic, were included. They were asked about urinary symptoms. PSA level, prostate volume with sonography and alopecia grading using Hamilton-Norwood classification (grade I to VII) were evaluated. Analysis was done by SPSS statistical method. 59.6% of men had mild alopecia (grade I, II, III), 34.1% had moderate alopecia (grade IV, V) and 6.3% had severe alopecia (grade VI, VII).The mean PSA level was 1.37 ± 1.48 ng/ml. The minimum PSA level was 0.1 ng/ml, and the maximum level was 6.8 ng/ml. The mean prostate volume was 37.85 ± 21.85cc. The minimum prostate size was 10 ml, and the maximum volume was 173 ml. The mean international prostate symptom score (IPSS) was 7.6 ± 6.11 with the minimum score 0 and the maximum score 27. However, no relationship between these parameters and androgenic alopecia was detected. This study showed that there is no relationship between androgenic alopecia, PSA level, IPSS, and prostate volume. Occurrence of alopecia in younger age and a positive family history correlated with a higher grade of alopecia. [ABSTRACT FROM AUTHOR]

Objectives: Pemphigus vulgaris is a rare autoimmune disease with poor prognosis and risk of mortality. No proper medical interventions have been proposed for this blistering disease, which involves both the skin and mucous membranes. Skin lesions are one of the most important sources of infection. Use of local treatments can decrease the healing time of lesions and reduce the need for high doses of drugs. Apart from conventional therapeutic approaches, traditional Iranian medicine may be of great benefit for the treatment of this condition. Accordingly, major clinical and pharmaceutical textbooks of traditional Iranian medicine, focusing on skin diseases and respective herbal remedies for inflamed skin and ulcers, were studied in this paper. Material and Methods: Scientific databases including PubMed, Science Direct, Scopus and Google Scholar were searched for finding pharmacological evidence on the use of medicinal herbs. Results: The term "hot ulcer" was found connotatively close to what is now known as "Pemphigus vulgaris". The reported medicinal herbs possessed anti-inflammatory, antioxidant and wound healing properties, as well as antibacterial and antifungal activities mentioned in recent studies. Therefore, they can be introduced as natural remedies for Pemphigus vulgaris. Conclusion: Review of traditional remedies for hot ulcers in Iranian medical and pharmaceutical literature may open new horizons for the topical treatment of this disease. [ABSTRACT FROM AUTHOR]

Background: Genetic diversity in human leukocyte antigen (HLA) alleles across populations is a significant risk factor for drug-induced severe cutaneous adverse reactions (SCARs), e.g., carbamazepine (CBZ)- and lamotrigine (LTG)-induced Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). The present study aimed to investigate the frequency of different HLA alleles in Iranian patients with CBZ- and LTG-induced SJS/TEN., Methods: A case-control study was conducted from 2011 to 2018 at various hospitals affiliated with Shiraz University of Medical Sciences (Shiraz, Iran). A total of 31 patients receiving anticonvulsant drugs (CZB or LTG) were recruited and divided into two groups. The drug-induced group (n=14) included hospitalized patients due to CBZ- or LTG-induced SJS/TEN. The drug-tolerant group (n=17) included individuals receiving CBZ or LTG for at least three months with no adverse effects. In addition, 46 healthy individuals (control group) were recruited. The frequency of HLA-A, -B, and -DRB1 alleles in patients with CZB- or LTG-induced SJS/TEN was investigated. HLA typing was performed using the allele-specific polymerase chain reaction method. The Chi square test and Fisher's exact test were used to determine a potential association between SJS/TEN and HLA alleles. P<0.05 was considered statistically significant., Results: CBZ- or LTG-induced SJS/TEN was not significantly associated with HLA alleles. However, HLA-DRB1*01 showed a significantly higher frequency in patients with CBZ-induced SJS/TEN than the CBZ-tolerant patients (30% vs. 9%, P=0.07)., Conclusion: Overall, no significant association was found between CBZ- or LTG-induced SJS/TEN and HLA alleles. Further large-scale studies are required to substantiate our findings., Competing Interests: None declared., (Copyright: © Iranian Journal of Medical Sciences.)