Assessment of Uric Acid Level in the Saliva of Patients with Oral Lichen Planus.

OBJECTIVE: The aim of this study was to evaluate the level of uric acid (UA) in saliva, which is considered to be an antioxidant defense biomarker against oxidative stress in patients with oral lichen planus (OLP). SUBJECTS AND METHODS: In this case-control study, 25 OLP patients were included. The reticular form of OLP was verified by a clinical examination with Wickham striae, and other types (erosive, atrophic, ulcerative) were confirmed by histopathological assessment. Thirty healthy individuals matched for age and gender were selected as the control group. In both groups, the Navazesh technique was used to collect the unstimulated saliva. Then, the amount of UA was measured using a Cobas Mira autoanalyzer with a wavelength of 546 nm. The Student t test was used to analyze the data assuming a significance level at <0.05. RESULTS: Of the 25 patients, the most common type of OLP was erosive (n = 11, 44%), and the most common site of OLP was seen as bilateral in the buccal mucosa (n = 12, 48%). The mean level of salivary UA was significantly lower in the patients with OLP (2.10 ± 0.19 mg/dL) in comparison with the control group (4.80 ± 0.29 mg/dL; p < 0.001). CONCLUSION: In this study, OLP was associated with a decrease in UA levels in the saliva. Salivary UA as a biomarker could be used for monitoring and treating OLP.

Is There a Relation between ABO Blood Groups and Clinical Outcome in Patients with Pemphigoid? A Case-Control Study.

Background. Relationship between blood groups and dermatologic diseases remains controversial and was not yet fully elucidated nor explained clearly. The aim of this study was to examine if any relation exists between different types of pemphigoid diseases and ABO blood group. Methods. In this case-control study, 159 pemphigoid patients and 152 healthy matched-controls were evaluated. All blood group (including Rh status) data for the study was obtained from the hospital medical records. Statistical comparisons were completed with chi-square test and logistic regression. Results. Blood group "O" was found in 32.9% of patients and 38.2% of control group. Blood group "A" was found among 30.8% of patients and 34.2% of control group, while group "B" was reported in 27.4% of cases and 21.1% of controls and "AB" was identified among 8.9% of patients and 6.6% of control group. 84.9% of patients were Rh positive, while in the control group 86.2% of patients were Rh positive. No significant differences were found regarding ABO blood groups (P = 0.46) or Rh (P = 0.76) between pemphigoid patients and control group. Also, older females had the higher risk of developing bullous pemphigoid. Conclusion. We found no relationship between ABO blood groups and pemphigoid disease.

Evaluation of Salivary Secretor Status of Blood Group Antigens in Patients with Oral Lichen Planus.

OBJECTIVE: To investigate the relationship between secretion or nonsecretion of blood group antigens into the saliva and oral lichen planus (OLP). SUBJECTS AND METHODS: In this study, 30 patients (women: 22, men: 8) with OLP were examined as the case group and 30 subjects without OLP matched for age and gender as the control group. Diagnosis of OLP was confirmed by clinical and histopathological examinations according to WHO criteria. The control group was randomly selected from healthy individuals without pathological oral changes seeking dental treatment. In both groups, blood group type was determined by hemagglutination, and unstimulated saliva was collected using the Navazesh technique. Establishment of salivary secretor status was carried out using the Wiener agglutination test. The data were analyzed using a Χ2 test, Fisher's exact test, and logistic regression. RESULTS: The patients with OLP (cases), including 22 (36.7%) women and 8 (13.3%) men with a mean age of 51 ± 14.16 years, were compared with healthy subjects (controls), comprised of 25 (41.7%) women and 5 (8.3%) men with a mean age of 50.7 ± 13.56 years. A large majority of the people examined in both groups were secretors of blood group A. On the other hand, most OLP patients were blood group B. In the case group, 25 subjects (84.4%) were secretors and 5 (16.6%) were nonsecretors. In the control group, 24 subjects (80.0%) were secretors and 6 (20.0%) were nonsecretors. There was no significant difference between the case and control groups for secretor status (p = 0.73). CONCLUSION: The present study did not indicate a significant difference in salivary secretor status between OLP patients compared to controls.

A novel homozygous LMNA mutation (p.Met540Ile) causes mandibuloacral dysplasia type A.

Mandibuloacral dysplasia with type A lipodystrophy (MADA) is a rare genetic disorder inherited in an autosomal recessive fashion characterized by hypoplasia of the mandible and clavicles, acroosteolysis and lipodystrophy due to mutations in the LMNA or ZMPSTE24 genes. In the current study, we have investigated a consanguineous family clinically diagnosed with mandibuloacral dysplasia type A having an affected child for the LMNA gene alteration(s). Mother is now 15weeks pregnant, seeking advice on the health of her fetus. Peripheral blood was obtained from all family members after informed consent was achieved. Genomic DNA was isolated. The sequence of the LMNA gene, including all exons and intron boundaries was analyzed by PCR and Sanger sequencing. Chorionic villus was collected from the placenta to reveal the condition of the fetus. Molecular analysis ascertained a homozygous mutation c.1620G>A (p.M540I) in the proband and heterozygous alteration in the family. Genomic DNA isolated from the CVS was amplified using specific primers for identified deleterious mutation and analyzed by Sanger sequencing. Two pathogenic mutations c.1620G>A and c.1698C>T were identified in the fetus. Genetic counseling as well as justified rapid and sensitive genetic testing can provide reassurance for the families to prevent the high burden of genetic disorders. We have also applied several online tools including PolyPhen2, MUpro, SIFT, PoPMuSiC, Project HOPE and Mutation Taster to predict the impact of p.Met540Ile substitution as a hotspot region within LMNA. All tools showed reduction in the stability of the protein structure. We conclude that p.M540I mutation may causes disease in the homozygous state.

Considerable variation among Iranian dermatologists in the dosing and monitoring of methotrexate for treating psoriasis.

BACKGROUND: Methotrexate (MTX) is a risky medication requiring careful attention to dosing and monitoring. Dosing and monitoring practices are not well characterized. AIMS: The aim of this study was to assess variation in the dosing and monitoring of methotrexate among Iranian dermatologists. METHODS: A questionnaire was administered to forty experts in psoriasis concerning the use of MTX. RESULTS: Among the 39 responding dermatologists (15 women, 24 men), 54% saw fewer than 10 psoriatic patients per week, 23% 10-20 patients, and 23% more than 20 patients. About half of the dermatologists treat their patients with an initial MTX dose of <7.5 mg/week (range 5-17.5 mg/week), an average dose of <10 mg/week (range 5-25 mg/week), and a maximum dose of <20 mg/week (range 7.550 ­ mg/week) with 71.8% prescribing the medication orally and 28.2% intramuscularly. Subcutaneous injection was preferred by none of the dermatologists as a usual route of administration. Nearly 5% of the dermatologists believe that liver biopsy should be performed prior to treatment with MTX in all patients, and another 5% consider this procedure prior to treatment only in patients with risk factors. About 44 and 33% of the dermatologists do the liver biopsy after 1.0-1.5 g and 3.54 g total cumulative doses, respectively. CONCLUSION: After more than a half century, there are still noticeable controversies on the manner of using MTX in treating psoriasis among Iranian dermatologists. A national guideline may help standardize treatment practices.

Erythema nodosum in the course of Crimean-Congo haemorrhagic fever.

Crimean-Congo haemorrhagic fever is an emerging zoonosis with a wide geographic distribution and protean clinical manifestations. The main pathogenesis of this infection has not been elucidated. Erythema nodosum is an immunologically-mediated dermatologic disease and the most common form of panniculitis that has been associated with many infections and inflammatory disorders. We describe a case of Crimean-Congo haemorrhagic fever with severe bleeding diathesis and hepatic failure that was successfully treated with oral ribavirin. The patient presented with erythema nodosum in the course of disease. Crimean-Congo haemorrhagic fever and erythema nodosum have not been reported to occur together. We present the first reported case of erythema nodosum associated with this emerging viral infection. Furthermore, it may influence our opinion about pathogenesis and immunologic mechanisms of this disease.

A comparison study of the efficacy and side effects of different light sources in hair removal.

Unwanted hairs are a common problem in which different light sources were developed as the treatment of choice. Alexandrite laser, diode laser, and intense pulsed light (IPL) were clinically used for this purpose with long-term scarce comparative results. The objective of the study was to compare the clinical efficacy, complications, and long-term hair reduction of alexandrite laser, diode laser, and IPL. Clinical trials on 232 persons using diode, alexandrite, laser and IPL were conducted. The number of sessions to reach optimal result varied between 3 and 7. Then the side effects were evaluated. Six months after the last session, optimal hair reduction was observed with no significant differences between the light sources, but a hair reduction was found to be higher using the diode laser. Side effects were observed with all light sources but more frequently with diode. Our findings indicate that all three light sources tested have similar effects on hair removal and in Iranian patients, using lower wavelengths minimizes the side effects.