Mohammad Javad Nazemi, Marjan Saeedi, Maryam Yousefi, Behrooz Barikbin, Zahra S Naraghi, Zahra Asadi KaniInternational journal of dermatology 05/2012; · 1.18 Impact Factor
Article: Direct immunofluorescence of plucked hair for evaluation of immunologic remission in pemphigus vulgaris.Maryam Daneshpazhooh, Zahra S Naraghi, Ali Ramezani, Alireza Ghanadan, Nafiseh Esmaili, Cheyda Chams-Davatchi[show abstract] [hide abstract]
ABSTRACT: Negative direct immunofluorescence (DIF) is a predictor of immunologic remission in pemphigus vulgaris. Recently, it has been shown that plucked hair can be used as substrate for DIF in the diagnosis of pemphigus. We sought to compare hair DIF in patients with pemphigus vulgaris in clinical remission with conventional DIF for the assessment of immunologic remission. A total of 55 patients with pemphigus vulgaris fulfilling the following inclusion criteria were enrolled: absence of any lesion and daily prednisolone dosage equal or less than 10 mg without adjuvant drug in the preceding 6 months. Biopsy specimen and plucked hair were processed for DIF. Intercellular deposition of IgG and/or C3 was considered positive. Conventional DIF and hair DIF were positive in 28 (50.9%) and 36 (65.5%) patients, respectively. Hair DIF had a sensitivity of 0.79 (95% confidence interval [CI] 0.59-0.92), a specificity of 0.48 (95% CI 0.29-0.68), a positive predictive value of 0.61 (95% CI 0.44-0.77), and a negative predictive value of 0.68 (95% CI 0.43-0.87). Small sample size is the main limitation of this study. The sensitivity of hair DIF was not high enough to allow us to suggest it as a substitute for conventional DIF. On the other hand, one cannot disregard positive cases of hair DIF in the setting of negative biopsy DIF. As hair plucking is less invasive than biopsy, the following approach could be suggested: hair DIF may be repeated in patients in clinical remission until negative; then conventional DIF should be performed, too. The physician can decide to stop treatment only when DIF assays on both substrates are negative.Journal of the American Academy of Dermatology 06/2011; 65(6):e173-7. · 3.99 Impact Factor
Article: Desmoglein ELISA in the diagnosis of pemphigus and its correlation with the severity of pemphigus vulgaris.Hossein Mortazavi, Majid Shahdi, Ali Akbar Amirzargar, Zahra S Naraghi, Mahin Valikhani, Maryam Daneshpazhooh, Amir Vasheghani-Farahani, Mojtaba Sedaghat, Cheyda Chams-Davatchi[show abstract] [hide abstract]
ABSTRACT: Anti-desmoglein 3 and 1 autoantibodies are involved in the pathogenesis of pemphigus diseases. Our objective was to assess the value of ELISA in the diagnosis of pemphigus and its correlation with the severity of pemphigus vulgaris. Based on clinical presentation and histopathologic confirmation for the diagnosis of the pemphigus, 38 patients took part in the study. Sera of the patients were tested by desmoglein 1 and desmoglein 3 ELISA. Also, direct immunofluorescence was performed for all patients which revealed positive results in 36 patients (94.7%). ELISA was positive in 37 of 38 pemphigus patients (Sensitivity: 97.3%). The relationship between desmoglein 1 index values and skin severity was statistically significant (p<0.05). Desmoglein 3 index values increased with oral severity although this was not statistically significant. Iranian patients similar to Indian patients had higher positive anti-desmoglein 1 autoantibodies. Desmoglein-ELISA test is appropriate in the diagnosis of pemphigus. Desmoglein 1 index value is statistically correlated with the severity of pemphigus vulgaris.Iranian journal of allergy, asthma, and immunology 03/2009; 8(1):53-6. · 0.51 Impact Factor
Article: Erosions on a prolapsed uterine in an old woman: an unusual manifestation of pemphigus vulgaris.Ali Ramezani, Narges Ghandi, Maryam Akhyani, Maryam Daneshpazhooh, Zahra S Naraghi, Cheyda Chams-Davatchi[show abstract] [hide abstract]
ABSTRACT: Vaginal involvement in pemphigus vulgaris has previously been described. In all those cases a pelvic examination was needed to explore the lesions. We describe a patient with pemphigus vulgaris who had pemphigus erosions on a prolapsed uterus (i.e., on the everted surface of vagina). The patient had widespread lesions of pemphigus in other mucosal and cutaneous sites. Biopsy, antibodies against desmoglein 1 and 3, and direct and indirect immunofluorescence were confirming. The erosions on the prolapsed uterus were resistant to treatment; other mucosal and cutaneous lesions responded rapidly to prednisolone and azathioprine. After lowering the dose of prednisolone the patient was referred to a gynecologist for a vaginal hysterectomy. This case was unique because her vaginal lesions could be easily examined and followed.Dermatology online journal 01/2009; 15(9):9.
International journal of dermatology 11/2008; 47(10):1092-4. · 1.18 Impact Factor