Current Issue : October - December Volume : 2016 Issue Number : 4 Articles : 6 Articles
Background: Etanercept, a soluble tumor necrosis factor receptor, and acitretin have been shown to be effective in\ntreating psoriasis. Acitretin is widely used in Korea. However, the combination of etanercept plus acitretin has not\nbeen evaluated among Korean patients with psoriasis. The objective of this study was to investigate the efficacy\nand safety of combination therapy with etanercept and acitretin in patients with moderate to severe plaque\npsoriasis.\nMethods: Sixty patients with psoriasis were randomized to receive etanercept 50 mg twice weekly (BIW) for\n12 weeks followed by etanercept 25 mg BIW for 12 weeks (ETN-ETN); etanercept 25 mg BIW plus acitretin 10 mg\ntwice daily (BID) for 24 weeks (ETN-ACT); or acitretin 10 mg BID for 24 weeks (ACT). The primary efficacy\nmeasurement was the proportion of patients achieving 75 % improvement in Psoriasis Area and Severity Index\n(PASI 75) at week 24. Secondary end points included 50 % improvement in PASI (PASI 50) at week 24 and clear/\nalmost-clear by Physician Global Assessment (PGA) at each visit through week 24.\nResults: The proportions of patients achieving PASI 75, PASI 50, and PGA clear/almost-clear at week 24 in the ETNETN\n(52.4, 71.4, and 52.4 %, respectively) and ETN-ACT groups (57.9, 84.2, and 52.6 %, respectively) were higher than\nin the ACT group (22.2, 44.4, and 16.7 %, respectively). The incidence of adverse events was similar across all arms.\nThis was an open-label study with a small number of patients.\nConclusion: In Korean patients with moderate to severe plaque psoriasis, etanercept alone or in combination with\nacitretin was more effective than acitretin. All treatments were well tolerated throughout the study...
Background: Allergic contact dermatitis is a common disorder in adults and children alike and appears to be on the\nincrease. The purpose of this study was to determine the sensitization trends in Iranian children with contact dermatitis.\nMethods: The result of 109 patch tests performed using the 24 allergens of the European Standard Series in patients\nbelow 18 years old from September 2007 to March 2009 were recorded and analyzed. The tests were evaluated at 48\nand 72 h after performing.\nResults: The study population consisted of 72 (66.1 %) females and 37 (33.9 %) males. Hands were the most commonly\naffected anatomic site. In the final evaluation of the tests on day three, 51 (46.8 %) individuals showed a positive reaction\nto at least one allergen. Females were significantly more likely to show a positive response to at least one allergen\n(p-value = 0.031, odds ratio: 2.46). The most common allergens were nickel sulfate, cobalt, methylisothiazolinone, and\ncolophony with 21 (19.3 %), 11 (10.1 %), 7 (6.4 %), and 6 (5.5 %) positive reactions, respectively. Contact allergy to nickel\nsulfate was more common in females than males (23.6 % vs. 10.8 %). There was no statistically significant relationship\nbetween personal or family history of atopy and a positive reaction to patch testing. The clinical and practical relevance\nwere assessed for nickel and cobalt with a clinical current relevance in 11 (52.3 %) and 4 (36.4 %), respectively.\nConclusions: Nickel sulfate, cobalt, methylisothiazolinone, and colophony are the most common allergens responsible for\ninduction of allergic contact dermatitis in Iranian children and adolescents. Females tended to show more positive\nreactions to allergens....
Covering the entire human body, the skin is considered to be one of the most important organs,\nsince it is the first line of protection against chemical and biological external agents. Although the\nskin protects tissues and organs against external aggression, it can still be unbalanced by various\nskin diseases, such as psoriasis. This non-contagious inflammatory dermatosis is characterized by\nthe occurrence of erythematous lesions of various sizes covered with whitish scales. This scaling\nof the skin is the result of a rapid renewal of the epidermis, occurring over five to seven days instead\nof 28 days. Psoriasis vulgaris, or plaque psoriasis, is the most common form of this disease\nand is therefore commonly referred to by the term ââ?¬Å?psoriasisââ?¬Â. This work is a review of the literature\non plaque psoriasis, aiming at a better comprehension of the pathology at the histological\nlevel, but also to understand the genetic and environmental factors associated with this inflammatory\ndermatosis....
Background: Nail changes associated with ageing are common in the elderly and include characteristic\nmodifications of color, contour, growth, surface, thickness and histology. No cutaneous examination\nis complete without a careful clinical evaluation of the nails. Objective: The aim of\npresent work is to assess the frequency of senile nail changes and disorders in Iraqi people above\n50 years old compared with control age group (20 - 30 years old). Patients and methods: This\ncase-controlled, cross-sectional study was performed in the outpatient clinic of Dermatology and\nVenereology Department at the Kufa College of Medicine Teaching Hospital in Najaf Province in\nthe period from September 2010 to April 2011. The study included 200 subjects, of which 100 patients\nwere above 50 years old (study group), and the other 100 subjects were from 20 - 30 years\nold (control group). A detailed history from each subject was recorded to detect the onset, duration\nand progression of nail changes and/or disorders, their occupation and any environmental\nexposure. A careful examination of the nails was carried out to assess the type of nail changes, site\nand symmetry. Any patient with systemic disease, dermatological disease or with suspected drug\nintake was excluded from the study. Results: The present work has shown that many nail changes\nwere more frequent among older age individuals than younger age group with significant statistical\ndifference (p = 0.043 - 0.000) like dull opaque appearance, rough lusterlessness, longitudinal ridging,\naltered thickness, ragged cuticle, altered contour, subungual hyperkeratosis and scaling nail\nfolds. Chromonychia was not statistically significant (14% of study group versus 16% of the control)\nwith p = 0.692. Longitudinal melanonychia was significantly higher in the study group (6% versus\n0% of the control) with p = 0.013, while punctate leukonychia was significantly higher in the control\ngroup (16% versus 4% of study group) with p = 0.005. Conclusion: Some changes of the nail are significantly\ncorrelated with advanced age like dull opaque nails, rough lusterlessness, longitudinal\nridging. Therefore, these signs can be regarded as indicative of ageing of healthy Iraqi people....
Background: Autoimmune diseases are a vast array of organ-specific as well as systemic diseases,\nwhose pathogenesis results from the activation of B and T lymphocytes reacting against antigens\nof the bodyâ��s own tissues (defined as self). Objective: To record skin tumors and infections in all\nautoimmune diseases gathered together in a one pathological state, compared with renal transplant\nrecipients and normal control. Patients and Methods: Four hundred patients with different\nautoimmune diseases were examined. Fifty patients with pemphigus (15 males, 35 females) are\naged from 20 - 70 (41.23 �± 3.89) years. Fifty patients with systemic lupus erythematosus (50 females)\nare aged from 17 - 45 (30.58 �± 10.08) years. One hundred patients with vitiligo (59 males,\n41 females) are aged from 9 - 71 (42.89 �± 5.28) years. One hundred patients with alopecia areata\n(42 males, 58 females) are aged from 7 - 52 (38.67 �± 9.52) years. One hundred patients with psoriasis\n(56 males, 44 females) are aged from 7 - 71 (47.36 �± 8.62) years were evaluated. One hundred\ntwenty kidney transplant recipientsâ�� (101 males, 19 females) ages ranged from 14 - 70 (45.43\n�± 4.63) years. All patients were examined thoroughly for any cutaneous manifestations and tumors\nand the findings were compared with the general population as a control group, which consisted\nof 500 healthy control individuals whose ages ranged from 20 - 71 (44.53 �± 11.48) years.\nThis case series, descriptive, controlled study was performed in Baghdad Teaching Hospital from\nJune 2014 to October 2015. Results: In renal transplant recipients, the findings were observed as\nfollow herpetic infection in 30(25%), bacterial 12(10%) while fungal 24(20%) patients. These infections\nappeared early in the course of immunosuppression. While the tumors were noticed, the\nbenign tumors were the commonest manifestations, which included viral warts in 45(37.5%) followed\nby actinic keratosis 15(12.5%), seborrheic keratosis 14(11.6%), sebaceous hyperplasia 13(10.8%) and keratoacanthoma 1(0.8%). While the malignant tumors were basal cell carcinoma\n4(3.3%) followed by squamous cell carcinoma 3(2.5%), and kaposiâ��s sarcoma 4(3.3%), Bowenâ��s\ndisease 1(0.8%). These malignancy usually appeared late in the course of immunosuppression. In\npemphigus, viral warts were observed in 4(8%) cases; fungal infection was seen in 4(8%) cases\nand bacterial infections in 2(4%) of cases and herpetic infection in only 1(2%) of case; no tumors\nwere found in all patients. In vitiligo, viral warts were observed in 2(2%) cases, while seborrhic\nkeratosis and sebaceous hyperplasia were observed in 1(1%) case; herpetic and fungal infections\nwere seen in 3(3%) of cases while bacterial infections were recorded in 2(2%) of cases but no tumors\nwere found in all patients. In alopecia areata viral warts were observed in 9(9%) of cases,\nsebaceous hyperplasia in 1(1%) case, herpetic and bacterial in 3(3%) of cases and fungal in 4(4%)\nof cases; no tumors were found in all patients. In systemic lupus erythymatosus (SLE) viral warts\nwere observed in 4(8%) of cases, herpetic infection in 12(12%) of cases, fungal infection in\n10(20%) of cases, bacterial infection in 3(3%) of cases and sebaceous hyperplasia in only 1(2%)\nof case, but no tumors were seen. In psoriasis, viral warts were observed in 14(14%) of cases,\nherpetic infection in 10(10%) of cases, bacterial infection in 3(3%) of cases, fungal infection in\n2(2%) of cases, sebaceous hyperplasia in 2(2%) of cases and seborrhiec hyperkeratosis in 1(1%)\ncase, while no tumors were demonstrated. In healthy control individuals, herpetic infection was\npresent in 36(7.2%) and viral warts in 52(10.4%) individuals, fungal infection in 29(5.8%) of individuals\nand regarding tumors solar keratosis was present in 24(4.8%); basal cell carcinoma and\nsquamous cell carcinoma were present in 2(0.4%) individuals of each. Conclusions: Patients with\nautoimmune diseases were protected against infections and tumors while kidney transplant recipients\nhad no such protection although all these groups were on prolonged immunosuppression....
Background: Cutaneous Leishmaniasis (CL) is an endemic disease in many countries and caused\nby different species of Leishmania parasite. It results in a deformed scar after a relatively long period.\nMany therapies have been tried in treatment of this disease. Objective: To compare the effect\nof oral zinc sulfate and oral ketoconazole singly and in combination in the treatment of acute cutaneous\nleishmaniasis. Patients and Methods: This single, blinded, therapeutic, controlled study\nwas conducted in the Department of Dermatology, Baghdad Teaching Hospital, Baghdad, Iraq,\nduring the period, January 2015 to July 2015. Seventy-five patients with acute CL were enrolled in\nthis study. The total numbers of lesions were 327, and the duration of lesions ranged from 4 to 12\n(6.9 �± 0.7) weeks. The diagnosis was confirmed by smear and histopathology. Patients were divided\ninto three groups: 24 patients in Group A were treated with oral zinc sulfate capsules 10\nmg/kg/day for 6 weeks; 24 patients in Group B were treated with ketoconazole tablets 200 mg\ntwice daily for 6 weeks and 27 patients in Group C were treated orally with a combination of zinc\nsulfate and ketoconazole for 6 weeks. All patients were seen regularly every 2 weeks for 6 weeks\nof treatment period, then monthly for the next three months as follow up period. Healing of the lesions\nwas assessed by using Sharquieâ��s modified Leishmania score to assess the objective response\nto the topical or systemic therapy. Results...
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