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ABSTRACT: Narrowband ultraviolet B (NB-UVB) phototherapy is an effective treatment for psoriasis.
To compare the effects of three and five times weekly NB-UVB phototherapy in the treatment of chronic plaque psoriasis. Methods: Sixty-five patients with chronic plaque psoriasis were allocated to receive three or five times weekly NB-UVB, starting at low dose.
Among the patients who completed the study, clearance was achieved in 18 out of 23 patients (78%) in the three times weekly group and in 15 out of 22 patients (68%) in the five times weekly group. The difference was not statistically significant (P=0.44). No statistically significant differences were found between the two groups in the number of treatments (P=0.95), cumulative UVB dose (P=0.51), and rate of side-effects. Length of the treatment period was significantly shorter in the five times weekly group (P<0.001). At the end of treatment, the mean psoriasis area and severity index score was lower in the three times weekly group (P=0.02).
We recommend three times weekly NB-UVB for chronic plaque psoriasis; however, the more rapid clearance of psoriasis with five times weekly phototherapy may justify using this method in some patients.
Photodermatology Photoimmunology and Photomedicine 02/2010; 26(1):10-5. · 1.30 Impact Factor
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ABSTRACT: Cheek augmentation improves the appearance of patients with flat malar eminences, creating a more youthful image. Autologous adipose tissue has been demonstrated to be a safe injectable filling material for malar augmentation.
Before proceeding to fat transplantation, a rapidly absorbable substance such as normal saline is injected into the cheek with a fine needle to enhance the malar eminence.
This method helps the surgeon to determine the location and amount of fat to be injected. Patients can also see a simulation of the final results.
A temporary malar augmentation could be performed before a potentially permanent procedure, particularly when the surgeon or patient is hesitant about the aesthetic results.
International journal of dermatology 04/2009; 48(3):310-1. · 1.18 Impact Factor
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ABSTRACT: To evaluate the clinical outcome and complications of intravitreal injections of triamcinolone acetonide in patients undergoing pars plana vitrectomy for treatment of diabetic nonclearing vitreous hemorrhage.
This prospective, randomized clinical trial study included 72 consecutive patients (72 eyes) who underwent pars plana vitrectomy for treatment of diabetic nonclearing vitreous hemorrhage. 38 patients received an intravitreal injection of 4 mg (0.1 cc) of triamcinolone acetonide at the end of surgery. Main outcome measures were rate of recurrent early vitreous hemorrhage, reoperation, intraocular pressure, visual acuity, and incidence of cataract formation. Mean follow-up time was 6 months.
Rate of early rebleeding and reoperation were lower in patients taking intravitreal triamcinolone (P = 0.003 and 0.03, respectively). Visual acuity 6 months after operation was better in study group (P < 0.001). Mean intraocular pressure was higher 1 day and 1 week after procedure in study group compared with control group (P < 0.001 and 0.002, respectively); however, in other times its differences were not significant. No significant difference in rate of nuclear sclerosis and cortical cataract formation and other complication was noted between the two groups. However, there was a significantly increased rate of posterior subcapsular progression in a dose dependent manner in the study group versus control (P = 0.011).
The present clinical study suggests that intravitreal injection of triamcinolone acetonide is effective in the prevention of rebleeding in eyes undergoing pars plana vitrectomy for treatment of diabetic vitreous hemorrhage.
Retina (Philadelphia, Pa.) 07/2008; 28(9):1241-6. · 2.93 Impact Factor
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Dermatologic Surgery 12/2007; 33(11):1392-4 discussion 1394-5. · 1.80 Impact Factor
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ABSTRACT: Pemphigus vulgaris is characterized by the presence of autoantibodies to desmogleins. Multiple relapses and remission may occur during the course of the disease. The goal of this study was to determine whether direct immunofluorescence study has any value in detecting immunological remission of pemphigus vulgaris.
Fifty-seven patients with pemphigus vulgaris who were in clinical remission for at least 3 months, while taking prednisolone 5-7.5 mg/day, were recruited retrospectively for the study. Direct immunofluorescence study had been performed in all patients after a period of at least 3 months in clinical remission. Treatment had been discontinued in all patients with negative results of direct immunofluorescence.
Of 57 patients who were in clinical remission, 24 patients (42%) had negative and 33 patients (58%) had positive results of direct immunofluorescence. Eleven patients (46%) with negative results of direct immunofluorescence relapsed within the first year of the follow-up period. Nine patients with negative direct immunofluorescence had a history of more than 6 months of clinical remission before direct immunofluorescence study. Among them, two patients (22%) relapsed. None of four patients with history of more than 12 months of clinical remission before a negative direct immunofluorescence study relapsed.
Negative direct immunofluorescence is an indicator of immunological remission in patients with pemphigus vulgaris after 6-12 months in clinical remission.
International Journal of Dermatology 12/2006; 45(11):1308-11. · 1.14 Impact Factor
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ABSTRACT: A 70-year-old man presents with multiple asymptomatic, yellow to skin-colored firm papules scattered on the scalp; the lesions had been present for about 30 years. Histological findings are consistent with the diagnosis of steatocystoma. We review the English-language literature of the published cases of localized forms of steatocystoma multiplex.
Dermatology online journal 02/2005; 11(1):22.
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ABSTRACT: Computer-aided dermoscopy using artificial neural networks has been reported to be an accurate tool for the evaluation of pigmented skin lesions. We set out to determine the sensitivity and specificity of a computer-aided dermoscopy system for diagnosis of melanoma in Iranian patients.
We studied 122 pigmented skin lesions which were referred for diagnostic evaluation or cosmetic reasons. Each lesion was examined by two clinicians with naked eyes and all of their clinical diagnostic considerations were recorded. The lesions were analyzed using a microDERM dermoscopy unit. The output value of the software for each lesion was a score between 0 and 10. All of the lesions were excised and examined histologically.
Histopathological examination revealed melanoma in six lesions. Considering only the most likely clinical diagnosis, sensitivity and specificity of clinical examination for diagnosis of melanoma were 83% and 96%, respectively. Considering all clinical diagnostic considerations, the sensitivity and specificity were 100% and 89%. Choosing a cut-off point of 7.88 for dermoscopy score, the sensitivity and specificity of the score for diagnosis of melanoma were 83% and 96%, respectively. Setting the cut-off point at 7.34, the sensitivity and specificity were 100% and 90%.
The diagnostic accuracy of the dermoscopy system was at the level of clinical examination by dermatologists with naked eyes. This system may represent a useful tool for screening of melanoma, particularly at centers not experienced in the field of pigmented skin lesions.
BMC Dermatology 02/2005; 5:8.
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ABSTRACT: Syringomas are benign adnexal tumors derived from the intraepidermal portion of eccrine sweat ducts. Usually, they present as soft, flesh-colored to slightly yellow dermal papules on the lower eyelids of healthy individuals. We report an 18-year-old man with rare presentation of eruptive syringomas involving his trunk and extremities, with linear arrangement on the arms and forearms. A biopsy obtained from the lesions of the dorsum of the hands showed eccrine syringoma with a lymphocytic inflammatory infiltration around superficial blood vessels and eccrine ducts. We used the 585-nm and 595-nm pulsed dye laser for treatment of inflammatory lesions of forearm and trunk with no success.
Dermatology online journal 02/2005; 11(2):13.
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ABSTRACT: The association of alopecia areata (AA) with nuchal nevus flammeus (NNF) has been demonstrated by previous studies.
The aim of this study was to investigate whether AA is associated with NNF. Methods: 199 AA patients and 215 controls without AA were examined for the presence of NNF.
35 patients (17.6%) in the AA group had NNF. In the control group, 20 patients (9.3%) had NNF (odds ratio = 2.08, 95% confidence interval 1.43-2.73; p = 0.013). A statistically significant association was found between the presence of NNF and duration of the AA (p < 0.001). The presence of NNF was associated with severity of AA (p < 0.001).
The results of our study suggest a link between NNF and AA especially in severer and more chronic forms.
Dermatology 01/2005; 211(4):334-7. · 2.05 Impact Factor
