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Key Clinical Message: Rituximab which is established as a main treatment for pemphigus vulgaris can be a potential causative factor for development of psoriasis in some patients. It is preferred to avoid using rituximab in patients who had a history of psoriasis. Acquainting medical doctors about rituximab‐related cutaneous complications will help them in detection and management. Rituximab is a human/murine monoclonal antibody targeting the CD20 antigen on B‐lymphocytes surface. Although it is used as promising treatment for pemphigus, nowadays it is also a new therapy for other autoimmune diseases including systemic lupus erythematosus and rheumatoid arthritis, and others like non‐Hodgkin's lymphoma. Although there is increasing evidence regarding the safety and effectiveness of rituximab in these diseases, many cutaneous adverse effects have been reported. Here, we describe a 48‐years‐old patient affected with pemphigus vulgaris who developed psoriatic lesions on her on scalp, trunk, and extremities, 4 months after the second course of rituximab. [ABSTRACT FROM AUTHOR]

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]

Byline: Soheila. Nasiri, Afsaneh. Sadeghzadeh-Bazargan, Reza. Robati, Hamid. Haghighatkhah, Shima. YounespourBackground: Lichen planus is an idiopathic and chronic inflammatory disease that affects the skin and the mucous membranes, and has [...]

The risk of herpes zoster (HZ) increases with age and declining immune function. Increased oxidative stress and inflammatory conditions may cause a negative impact on the immune responses. The present study aimed to assess the levels of oxidative/inflammatory stress biomarkers in HZ patients compared with the controls. This case‐control study included 43 HZ patients and 47 age‐matched controls. Melatonin (MLT), Indole‐dioxygenase (IDO), Interleukin‐18 (IL‐18), Interleukin‐6 (IL‐6), ferritin, C‐reactive protein (hsCRP), and total homocysteine (tHcy) levels were measured and compared in both groups. The significant high levels of IDO, IL‐18, IL‐6, ferritin, hsCRP, and tHcy, as well as low levels of MLT were found in HZ patients compared with the controls (P < 0.001); these significant differences were also associated with rash and pain severity (P < 0.001). The final logistic regression model with the area under the curve (0.99; 95% confidence interval [CI], 0.98‐1.00) showed the association of HZ with decreased level of MLT (odds ratio [OR], 0.95; 95% CI, 0.92‐0.98; P = 0.007) and increased levels of tHcy (OR, 1.53; 95% CI, 1.06‐2.19; P = 0.02). The findings showed increased inflammation‐associated oxidative stress in HZ patients. Elevated tHcy levels and reduced MLT levels may be associated with the manifestation of HZ. More investigations are required to confirm the results. [ABSTRACT FROM AUTHOR]

Byline: Soheila. Nasiri, Reza. Robati, Afsaneh. Marefat, Marjan. Saeedi, Nima. Sarrafi-rad Sir, Leishmania infection is caused by the protozoan leishmania and transmitted by the bite of infected phlebotomine sand flies. [...]

Background/aim: Acute unintentional and deliberate poisoning by medications and chemicals is a frequent emergency, especially in Iran. This study aimed to evaluate the frequency and character of skin findings occurring in patients with acute intentional and aunintentional poisoning. Materials and methods: This prospective observational study was performed at the Loghman Hakim Hospital Poison Center over a period of 6 months from April 2016 to September 2016. Data including patient demographics, cause of poisoning, and level of consciousness were collected. Pediatric patients (under the age of 13) and patients who died in the first hours of admission were excluded from the study. Results: The most common cause of toxicity-related admission in our patients was methadone overdose. The most common skin finding in these patients was xerosis. According to our results, there was an association between tramadol poisoning and self-induced lesions. Shin hyperpigmentation was found to be significantly more frequent in patients with lead poisoning. Conclusion: Further study is recommended to shed light on the possible association of drug poisoning and skin lesions. [ABSTRACT FROM AUTHOR]

Background: Non-Melanoma Skin Cancer (NMSC), the most prevalent types being Squamous Cell Carcinoma (SCC) and Basal Cell Carcinoma (BCC), is the most common type of malignancy in human beings. These neoplasms are more frequent in the elderly and fair skinned people and mainly occur on sun-exposed sites of the body. Ultraviolet B (UVB) has a well-known effect in induction and promotion of growth of these cancers. The p53 tumor suppressor gene is believed to be an early target in UV-induced skin carcinogenesis. Aggregates of keratinocytes with p53 protein overexpression are frequently identified in normal human skin and are more prevalent in chronically sun-exposed skin, and have been proposed to play a role in skin cancer pathogenesis. The aim of this study was to clarify the potential role of P53 in the development of NMSC. Methods: Immunohistochemical evaluation of p53 expression in peri-lesional skin of 90 cases of SCC, BCC and melanocytic nevi was performed. Results: The well-delineated compact type of p53 clone, but not the strong dispersed type, was significantly more predominant in SCCs in comparison with BCCs and melanocytic nevi (P value=0.001). The size of p53 clones was also significantly greater in SCCs compared to the BCCs (P=0.003) and melanocytic nevi (P=0.001). There was no significant difference between these neoplasms regarding the frequency of P53 clones (P=0.86). Conclusion: This study suggests the possible relationship of epidermal p53 clones with the pathogenesis of SCC. [ABSTRACT FROM AUTHOR]

Pemphigus vulgaris (PV) is considered a chronic disease with a potentially fatal outcome. Studies have suggested that environmental factors and personal habits play an important role in the pathogenesis of PV, but more studies are required to elaborate their connection to the disease. The goal of this multicenter case-control study was to determine some of the environmental factors related to PV. Cases (n = 99) were patients with PV, and controls (n = 198) were individuals who did not have PV. Data about demographics, history, clinical findings, occupational exposures to pesticides, smoking status, number of births (parity), herpes simplex virus (HSV) infection, and fast food consumption were collected using a structured questionnaire. Chi-square and logistic regression analyses were used for data analysis. Univariate logistic regression analysis indicated that the statistically significant factors related to PV were infection with HSV in recent weeks (odds ratio [OR], 3.35; 95% confidence interval [CI], 1.75-6.43), parity (OR, 0.50; 95% CI, 0.39-0.63), and lack of occupational exposure to pesticides (OR, 0.36; 95% CI, 0.21-0.60). Multivariate analysis revealed that significant factors were cessation of smoking (adjusted odds ratio [AOR], 4.36; 95% CI, 1.50-12.66), HSV infection (AOR, 2.91; 95% CI, 1.47-5.75), and lack of occupational exposure to pesticides (AOR, 0.35; 95% CI, 0.20-0.63).The findings indicated that cessation of smoking and HSV infection in recent weeks are risk factors for PV, while lack of occupational exposure to pesticides and increasing parity (a greater number of births) are protective factors against PV. [ABSTRACT FROM AUTHOR]