Do clinical severity scores correlate with the quality of life in children with psoriasis? A cross-sectional study of Iranian pediatric patients.

BACKGROUND: Psoriasis is a common chronic dermatosis that can negatively affect patients' lives. AIM: To obtain more insight about how having psoriasis and how the various clinical and physical characteristics of the disease impact the health-related quality of life (HRQoL) of pediatric patients. METHODS: A retrospective cross-sectional study was designed with 40 pediatric patients with psoriasis. HRQoL was evaluated using the Children Dermatology Life Quality Index (CDLQI). RESULTS: A total of 40 patients enrolled in this study. The mean age of participants was 12.42 ± 7.1 years (age range: 4-16 years), 21 males (52.5%), and 19 females (47.5%). The mean Psoriasis Area Severity Index (PASI) score was 8.03 ± 9.31 with a range of 0.4-25. Mean CDLQI score was 18.87 ± 8.15, indicating a considerable burden on health-related QoL. There was a strong positive correlation between CDLQI and PASI scores (p < .001, r: .653). CONCLUSION: The negative effect of psoriasis on HRQoL in pediatrics was confirmed, and a strong correlation between disease severity scores and HRQoL in children with psoriasis was found in this study. Taking HRQoL indices into account while managing adolescent patients will improve our insight into the patient's experience and may provide better patient adherence to treatment.

Comparison of the efficacy and safety of 308-nm excimer laser with intralesional corticosteroids for the treatment of alopecia areata: A randomized controlled study.

BACKGROUND: Corticosteroids have been the mainstay of treatment for alopecia areata (AA). Recently, the 308-nm excimer laser has been proposed for treating AA. OBJECTIVES: To compare the efficacy and safety of excimer laser with intralesional corticosteroid (ILCS) in AA. METHODS: Patients with at least two alopecic patches were randomly assigned to receive weekly excimer laser treatments or monthly injections of ILCS. Photographs and trichoscopy images were examined at baseline, the last treatment session, and after one month of follow-up. The hair regrowth score was evaluated on a 6-point scale. RESULTS: Sixteen patients with 99 alopecic patches completed the study. At the last treatment session, the mean score of hair regrowth for the laser was significantly lower than the ILCS (p = 0.003). However, after a month of follow-up, the difference was not statistically significant (p = 0.148). Positive response in hair regrowth (≥50%) was achieved in 47% of laser-treated patches and 66% in ILCS-treated ones. Four (25%) and 8 (50%) patients experienced severe adverse events of laser and ILCS, respectively. CONCLUSIONS: The excimer laser was safe and effective in AA. The effect of laser on hair regrowth might be delayed as compared with ILCS.

Cutaneous granular cell tumor: A case series, review, and update.

Background: Granular cell tumor (GCT) or Abrikossoff's tumor is an uncommon neuro-derived tumor in which Schwann cells are found and express S-100 protein. Often, it is a benign lesion. Histopathologically, there are granular cell infiltrations through the entire dermis without necrosis which are periodic acid Schiff (PAS) stain positive and reactive with S-100. The aim of this study is the clinicopathological evaluation of GCT. Material and Methods: In this paper, we described the experience of 6 patients with a GCT in different locations (4 cases in the skin and 2 cases in the mucosa), for example, a case with a tumor in the abdomen and a keloidal-like presentation with a highly sclerotic pattern (an uncommon pathological feature). Another case developed a lesion secondary to physical trauma. Result: In one case, the presence of a lesion in the lower lip associated with actinic damage secondary to chronic sun exposure resulted in misdiagnosis with actinic cheilitis and squamous cell carcinoma. Conclusion: Histopathologically, there were granular cell infiltrations through the entire dermis without necrosis which are PAS-positive and reactive with S-100.

Multiple firm nodules in a young woman: an unusual presentation of sarcoidosis.

A 27-year-old woman presented to the dermatology department with a 1-year history of multiple asymptomatic violaceous lesions on her upper and lower extremities, trunk and abdomen. The lesions were firm on palpation. She had no other associated symptoms and the rest of the examination was unremarkable. An incisional biopsy showed multiple confluent granulomas composed of histiocytes devoid of necrosis surrounded by a rim of lymphocytes extending to the subcutaneous fat consistent with the diagnosis of subcutaneous sarcoidosis. The serum ACE assay was elevated at 134 IU/L. Other blood tests including complete blood count, renal and liver function tests, serum calcium and phosphate were within normal ranges and chest X-ray was unremarkable. Complete remission was achieved with an intralesional triamcinolone injection (10 mg/mL) for a few sessions. Subcutaneous sarcoidosis is a rare variation and its diagnosis requires a high index of suspicion.

Serum and tissue angiotensin-converting enzyme in patients with alopecia areata.

BACKGROUND: Alopecia areata is an immune-dependent disorder characterized by the interaction of T-lymphocytes with follicular antigens. Recent studies have shown the existence of a local renin-angiotensin system in the skin, where angiotensin-converting enzyme (ACE) plays a role in autoimmunity and inflammation. AIM: The objective of this study was to evaluate serum and tissue ACE activity in patients with alopecia areata. METHODS: This case-control study was conducted on patients with alopecia areata and healthy controls. Serum and tissue ACE activity were assessed and compared between the two groups. RESULTS: Twenty-five alopecia areata patients (60% male, mean age 32.1 ± 9.9 years) and 24 controls (50% male, mean age 37.4 ± 8.8 years) were included. Mean serum ACE activity was 52.1 ± 9 U/L in cases and 55.3 ± 14.7 U/L in controls (P = 0.37). Tissue ACE activity was significantly lower in cases in all parts of the skin i.e. epidermis (P = 0.016), follicular epithelium (P = 0.004), and endothelium (P = 0.037). Among cases, serum ACE activity was significantly higher in patients with more severe disease (P = 0.030), nonpatchy alopecia areata (alopecia universalis; ophiasis, patchy and ophiasis, diffuse) (P = 0.029), and with nail involvement (P = 0.027). LIMITATIONS: The sample size was too small to draw definite conclusions. Further, most of the patients had only mild or moderate alopecia areata. CONCLUSION: Unlike in some other inflammatory diseases, the tissue level of ACE seems to be significantly lower in alopecia areata compared to normal controls. Serum ACE was significantly higher in patients with more severe disease.

Segmental pigmentation disorder: A rare form of cutaneous dyspigmentation.

BACKGROUND: Segmental pigmentation disorder (SegPD) is a rare type of cutaneous dyspigmentation. This hereditary disorder, first described some 20 years ago, is characterized by hypo and hyperpigmented patches on the trunk, extremities and less likely on the face and neck. These lesions are considered as a type of checkerboard pattern. CASE PRESENTATION: Herein, we present a 26-year-old male who presented with hyperpigmented patches on his trunk, neck and upper extremities. Considering the clinical and histopathological findings, the diagnosis of SegPD was confirmed. CONCLUSION: SegPD is a somewhat neglected entity which should be considered in differential diagnosis of pigmentation disorders.