Cutaneous adverse reactions of COVID-19 vaccines: A systematic review.

Numerous vaccines are under clinical development and implementation for the prevention of severe course and lethal outcomes of coronavirus disease 2019 (COVID-19). This systematic review aims to summarize and integrated the findings of studies regarding cutaneous side effects of COVID-19 vaccines. This systematic review conducted by searching the scientific databases of PubMed, Scopus, Science direct, and Web of knowledge from the beginning of the COVID-19 to May 10, 2021. Articles were reviewed and analyzed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Seventeen studies on cutaneous side effects of COVID-19 vaccines were included after the screening of search results based on to the eligibility criteria. The results showed that the most common injection site reactions and delayed large local reactions, arising from all vaccine types, were redness/erythema (39%), followed by: itchiness (28%), urticarial rash (17%) on the neck, upper limbs, and trunk, morbilliform eruptions (6.5%), Pityriasis rosea (3%), swelling, and burning, and so forth. Most cutaneous reactions occurred in women (84%), and middle-aged people, after the first dose of vaccine, with the onset ranged from 1 to 21 days after vaccination. In addition, cutaneous reactions were generally self-limiting, and needed little or no therapeutic intervention, that were not regarded as a barrier to injecting a second dose. In conclusion, severe cutaneous side effects are very rare and approved vaccines have satisfactory safety profiles. Therefore, mild or moderate cutaneous reactions should not discourage people from vaccination. In certain groups such as patients with allergies and a history of local injection reactions, pre-vaccination counseling and assurance, also use of appropriate medications may be helpful. However, more studies are needed to investigate the side effect profile of all COVID-19 vaccines.

Treatment of recalcitrant vitiligo by autologous non-cultured and trypsinized melanocyte grafting in the west of Iran.

BACKGROUND: Vitiligo is a common disease with a high burden, and its recalcitrant type is unresponsive to current medical treatments. Autologous non-cultured and trypsinized melanocyte grafting, which is a simple and experience-based procedure, has been suggested for the treatment of vitiligo. OBJECTIVE: To assess autologous non-cultured and trypsinised melanocyte grafting in recalcitrant vitiligo. METHODS: This clinical trial was done on 28 patients (20 females and 8 males). After demarcation and preparation of both donor and recipient sites, both sites were shaved by a curette. The materials harvested from the donor site were trypsinized and centrifuged. The resulting suspension was mixed with hyaluronic acid gel and was spread over the shaved recipient area. RESULTS: Twenty-eight patients with a total of 108 lesions and a mean age of 25.93 ± 7.11 years were included in the present study. Generalized vitiligo (57.1%) was the most common clinical type and the face and neck regions (38%) were the most frequent treated sites. Good to excellent repigmentation was seen in the face and neck, trunk, upper extremity, and genitals in 31 (57.4%), 11 (20.4%), 9 (16.7%) and 3 (5.5%) patients, respectively. Face and neck showed significantly better results (p < 0.05). STUDY LIMITATIONS: Low sample size and single-center study. CONCLUSION: Autologous non-cultured and trypsinized melanocyte grafting is a safe method with satisfactory outcomes in recalcitrant vitiligo. Appropriate training of physicians and proper use of specialists' experiences can be effective in increasing the improvement rate.

Treatment of recalcitrant vitiligo by autologous non-cultured and trypsinized melanocyte grafting in the west of Iran

Abstract Background Vitiligo is a common disease with a high burden, and its recalcitrant type is unresponsive to current medical treatments. Autologous non-cultured and trypsinized melanocyte grafting, which is a simple and experience-based procedure, has been suggested for the treatment of vitiligo. Objective To assess autologous non-cultured and trypsinised melanocyte grafting in recalcitrant vitiligo. Methods This clinical trial was done on 28 patients (20 females and 8 males). After demarcation and preparation of both donor and recipient sites, both sites were shaved by a curette. The materials harvested from the donor site were trypsinized and centrifuged. The resulting suspension was mixed with hyaluronic acid gel and was spread over the shaved recipient area. Results Twenty-eight patients with a total of 108 lesions and a mean age of 25.93 ± 7.11 years were included in the present study. Generalized vitiligo (57.1%) was the most common clinical type and the face and neck regions (38%) were the most frequent treated sites. Good to excellent repigmentation was seen in the face and neck, trunk, upper extremity, and genitals in 31 (57.4%), 11 (20.4%), 9 (16.7%) and 3 (5.5%) patients, respectively. Face and neck showed significantly better results (p < 0.05). Study limitations Low sample size and single-center study. Conclusion Autologous non-cultured and trypsinized melanocyte grafting is a safe method with satisfactory outcomes in recalcitrant vitiligo. Appropriate training of physicians and proper use of specialists' experiences can be effective in increasing the improvement rate.

Characteristics of telogen effluvium in COVID-19 in western Iran (2020)

Abstract Background: Although COVID-19 pandemic significantly induces mortality, many of the patients who recovered present other medical problems such as alopecias. Telogen effluvium is a common alopecia that is usually related to previous events such as acute febrile diseases, including COVID-19. Objective: To evaluate the characteristics of telogen effluvium in COVID-19. Method: This cross-sectional study was carried out on 526 patients with documented telogen effluvium that recovered from COVID-19. Demographic data, concurrent alopecia, associated diseases, and COVID-19 severity were recorded. Data were analyzed by appropriate statistical methods. Results: The mean age of the 526 patients (410 females, 116 males) was 30.97±9.592 years, with 7.65 ± 1.739 weeks of mean time of alopecia onset. Vitamin D deficiency (24.3%), androgenetic alopecia (78.2%), and grade III COVID-19 severity were the most common findings. Alopecia onset was significantly earlier in the younger age group, females, in hypothyroidism, and more severe coronavirus infection. Higher grade coronavirus infection was significantly seen in males, higher ages, earlier onset, and androgenic alopecia. Study limitations: Performing a single-center study and considering limited variables. Conclusion: Although Coronavirus 2 infection can be an important factor in telogen effluvium induction, other factors such as associated diseases, drug intake and emotional stress may also be involved. In the cases of early onset of alopecia, concomitant diseases such as hypothyroidism and severe coronavirus infection can occur, thus, the presence of various factors in telogen effluvium induction should be considered.

Comparison of Demographic and Clinicopathological Characteristics of Basal Cell Carcinoma on the Nose and Other Sites of the Face: A Cross-Sectional Study.

INTRODUCTION: The clinicopathological characteristics of basal cell carcinoma (BCC) in different areas of the face, including the nose, are important and may be different. Accurate recognition of these characteristics may be necessary for the planning and selection of appropriate treatment. MATERIALS AND METHODS: This cross-sectional study was conducted on 328 patients (131 females and 197 males) with 371 documented facial BCC in the West of Iran within 2013-2018. The demographic and clinicopathological data of the patients in the nose area were compared with other sites of the face by appropriate statistical methods. RESULTS: Out of 371 lesions, 38.8% of the cases were on the nose, 75.8% were primary lesions, 97.8% had no perineural invasion, 89.2% were nodular, and 65.8% were of nodular clinical and pathologic type, which were the most common variables of patients. It was revealed that early-onset (P<0.001), smaller size (P<0.001), high-risk pathologic type (P=0.01), and recurrent lesions (P=0.013) were significantly higher in the nasal BCC. However, there was no significant difference between BCC in the nose and other sites of the face in terms of gender (P=0.654), high-risk clinical type (P=0.06), and perineural invasion (P=0.275). CONCLUSION: Considering the nasal site as an important cosmetic unit, more limitation of the nose in performing any procedure, and presence of the more risk factors in the nose than in other areas of the face, the definite treatment of nasal BCC requires special attention, expertise, and experience.

Characteristics of telogen effluvium in COVID-19 in western Iran (2020).

BACKGROUND: Although COVID-19 pandemic significantly induces mortality, many of the patients who recovered present other medical problems such as alopecias. Telogen effluvium is a common alopecia that is usually related to previous events such as acute febrile diseases, including COVID-19. OBJECTIVE: To evaluate the characteristics of telogen effluvium in COVID-19. METHOD: This cross-sectional study was carried out on 526 patients with documented telogen effluvium that recovered from COVID-19. Demographic data, concurrent alopecia, associated diseases, and COVID-19 severity were recorded. Data were analyzed by appropriate statistical methods. RESULTS: The mean age of the 526 patients (410 females, 116 males) was 30.97 ±â€¯9.592 years, with 7.65 ±â€¯1.739 weeks of mean time of alopecia onset. Vitamin D deficiency (24.3%), androgenetic alopecia (78.2%), and grade III COVID-19 severity were the most common findings. Alopecia onset was significantly earlier in the younger age group, females, in hypothyroidism, and more severe coronavirus infection. Higher grade coronavirus infection was significantly seen in males, higher ages, earlier onset, and androgenic alopecia. STUDY LIMITATIONS: Performing a single-center study and considering limited variables. CONCLUSION: Although Coronavirus 2 infection can be an important factor in telogen effluvium induction, other factors such as associated diseases, drug intake and emotional stress may also be involved. In the cases of early onset of alopecia, concomitant diseases such as hypothyroidism and severe coronavirus infection can occur, thus, the presence of various factors in telogen effluvium induction should be considered.

The effect of simplified autologous melanocyte and keratinocyte grafting on the treatment of refractory vitiligo.

INTRODUCTION: Vitiligo is a disease with a high prevalence and burden that has a negative impact on various aspects of life. Because most cases of vitiligo are not responsive to medical treatment, we performed simplified autologous melanocyte and keratinocyte grafting to treat refractory stable vitiligo. METHODS: This interventional study was carried out on 32 patients (16 females and 16 males). After local anesthesia at the donor site, we shaved the donor sites to harvest autologous melanocyte material. The harvested paste-like non-trypsinized material was spread over the abraded recipient area. Patient follow-up was performed to track the treatment outcome and possible complications. RESULTS: Out of 32 patients with 99 lesions, the generalized type accounted for 28 (87.5%) patients, and 46 (46.5%) lesions were seen in the upper extremity as the most common clinical type and site of involvement. Eighteen (18.2%) and 26 (26.3%) patches showed excellent and good re-pigmentation, respectively, and face areas showed significantly better re-pigmentation (p < 0.001). CONCLUSIONS: Simplified autologous melanocyte and keratinocyte grafting is a safe, simple, office-based, and low-cost procedure with a modest re-pigmentation outcome in refractory stable vitiligo. Moreover, the face area had a satisfactory outcome with this procedure.

Outcome of staged excision with pathologic margin control in high-risk basal cell carcinoma of the head region

Abstract Background: High-risk basal cell carcinoma involves a significant rate of basal cell carcinoma that requires Mohs micrographic surgery for definitive treatment. Staged excision with pathologic margin control is a simple, accessible, and curative procedure suggested for the treatment of high-risk basal cell carcinoma. Objective: To evaluate the results of staged excision of high-risk basal cell carcinoma in the head region. Methods: This interventional study was performed on patients with high-risk basal cell carcinoma, who underwent staged excision until the margins were free of tumor. Results: A total of 122 patients (47 females and 75 males) with mean age of 57.66 ± 9.13 years were recruited in this study. Nasal and nodular types were the most common of both clinical and pathologic forms, respectively. Further, 89.3 % of cases were cured by staged excision after four years of follow-up. There was a significant relationship between treatment outcomes and recurrent lesions, multiplicity of risk factors, long-standing disease, and pathologic type. There was also a significant association between the number of surgical excisions and multiplicity of risk factors, as well as recurrence, location, and size of basal cell carcinoma. Study limitations: Lack of magnetic resonance imaging assessment in cases of suspected perineural invasion. Conclusions: High-risk basal cell carcinoma had a high cure rate by staged excision. Patients with more risk factors and those with nasal and recurrent basal cell carcinoma required more staged excisions. Failure of treatment is more probable in patients with more risk factors, long-standing lesions, and high-risk pathologic and recurrent basal cell carcinomas.

Outcome of staged excision with pathologic margin control in high-risk basal cell carcinoma of the head region.

BACKGROUND: High-risk basal cell carcinoma involves a significant rate of basal cell carcinoma that requires Mohs micrographic surgery for definitive treatment. Staged excision with pathologic margin control is a simple, accessible, and curative procedure suggested for the treatment of high-risk basal cell carcinoma. OBJECTIVE: To evaluate the results of staged excision of high-risk basal cell carcinoma in the head region. METHODS: This interventional study was performed on patients with high-risk basal cell carcinoma, who underwent staged excision until the margins were free of tumor. RESULTS: A total of 122 patients (47 females and 75 males) with mean age of 57.66 ±â€¯9.13 years were recruited in this study. Nasal and nodular types were the most common of both clinical and pathologic forms, respectively. Further, 89.3 % of cases were cured by staged excision after four years of follow-up. There was a significant relationship between treatment outcomes and recurrent lesions, multiplicity of risk factors, long-standing disease, and pathologic type. There was also a significant association between the number of surgical excisions and multiplicity of risk factors, as well as recurrence, location, and size of basal cell carcinoma. STUDY LIMITATIONS: Lack of magnetic resonance imaging assessment in cases of suspected perineural invasion. CONCLUSIONS: High-risk basal cell carcinoma had a high cure rate by staged excision. Patients with more risk factors and those with nasal and recurrent basal cell carcinoma required more staged excisions. Failure of treatment is more probable in patients with more risk factors, long-standing lesions, and high-risk pathologic and recurrent basal cell carcinomas.

A comparison of effectiveness and cosmetic outcome of two methods for ingrown toenail: partial nail matricectomy using CO2 laser versus lateral nail fold excision.

BACKGROUND: Ingrown toenail (IGT) is a common nail disorder that causes discomfort and interferes with most activities. Most cases of IGT require procedural intervention. This study was performed to compare the treatment and cosmetic outcome of partial nail matricectomy (PNM) using CO2 laser versus lateral nail fold excision (LNFE). METHOD: This interventional study was performed on 127 patients with IGT that were randomized into two groups. Demographic data, clinical characteristics, and treatment results were recorded in both groups. RESULTS: Sixty-two patients with a mean age of 28.23 ± 11.34 years were subjected to PNM and 65 patients with a mean age of 28.92 ± 9.63 years to LNFE. The PNM versus LNFE groups had cure rates of 85.5% versus 78.5%, fair cosmetic outcomes of 67.9% versus 84.0%, and infection rates of 4.8% versus 3.1%. The mean time of pain duration, return to daily activity, and return to work were nearly 3, 4, and 13 days, respectively, in both groups. CONCLUSION: The treatment outcome was slightly better in the PNM group than in the LNFE group, and vice-versa for the cosmetic outcome. There were nearly similar outcomes in terms of the mean time of repair, pain duration, return to daily activity, and infection rate using both methods.

Evaluation of skin lesions in diabetic patients: a systematic review and meta-analysis.

BACKGROUD: Prevalence of skin lesions among diabetic patients is a major health concern. Therefore, this systematic review and meta-analysis study was conducted to determine the prevalence of skin lesions in diabetic patients. METHODS: To identify and select relevant articles, the SID, MagIran, IranMedex, IranDoc, Google Scholar, Cochrane, Embase, ScienceDirect, Scopus, PubMed, and Web of Science (WoS) databases were searched without a lower time limit and until April 2020. The random effects model was used to perform the analysis, and the heterogeneity of studies was assessed using the I2 index. Data were analyzed within the Comprehensive Meta-Analysis (Version 2) software. RESULTS: After evaluating the 22 final articles with a total sample size of 8406, the prevalence of skin lesions among diabetes patients were found as 70.3% (95% CI: 63-76.7%). Moreover, according to the meta-regression analysis, the effect of 'sample size' on th prevalence of skin lesions was significantly different in diabetes patients (p < 0.05). CONCLUSION: The results of this study show that skin lesions are common in diabetes patients. Therefore, appropriate policies needs to be adopted to improve the situation and to monitor patients and outcomes at all levels.

Well-Circumscribed Localized-Rhinophyma as a Very Rare Presentation of Rhinophyma.

INTRODUCTION: Rhinophyma is an uncommon subtype of rosacea, the clinical diagnosis of which is straightforward. However, localized, especially well-circumscribed, rhinophyma is a very rare condition, which requires a paraclinical assessment to be accurately diagnosed. CASE REPORT: We report a 48-year-old male patient who presented with a well-circumscribed and dark red tumoral mass of 28 mm in diameter and smooth consistency in the right nasal ala. The patient had no former and concomitant characteristic skin lesions on the other part of his face. Histopathology and immunohistochemistry assessments documented the diagnosis of rhinophyma. CONCLUSION: To the best of our knowledge, this is the first case report of well-circumscribed localized rhinophyma. This lesion can be treated by CO2 laser in a fast and efficient manner with esthetically satisfactory outcome and no significant complications.

Revision of a depressed scar across a relaxed skin tension line by punch elevation, filler injection, and fractional CO2 laser.

Revision of a depressed scar is more challenging because it does not follow the relaxed skin tension line (RSTL). Several measures have been suggested for revision of this type of scar, and they have a number of limitations, complications, advantages, and disadvantages. A 45-year-old woman presented with a depressed scar measuring approximately 45 × 2.5 mm across the chin area as a result of an accidental sharp trauma 17 years previously. She was subjected to several procedures to revise the scar, but none of them were satisfactory. In our method, multiple punches were created along the depressed scar after performing local anesthesia. Then the punched area was treated with fractional CO2 laser, and hyaluronic acid was finally injected into the treated area. Significant improvement was seen in the depressed scar during the 12-month postoperative follow-up. The advantages of our method are an easy and quick procedure, no need for very advanced equipment, and absence of any incision or downtime. However, a limitation of this procedure is that it is appropriate only for depressed scars with mild to moderate width and depth.

The Correlation of Acne with Anxiety after Rhinoplasty.

INTRODUCTION: Rhinoplasty is one of the most common cosmetic surgeries occasionally associated with complications, such as acne lesions. Anxiety reportedly leads to the emergence or exacerbation of acne lesions. MATERIALS AND METHODS: This cross-sectional study was conducted on 147 patients undergoing rhinoplasty. The patients were assigned into two groups of case (with acne lesions) and control (without acne lesions) entailing 52 (45 females, 7 males) and 95 (68 females, 27 males) subjects, respectively. The data were collected using an instrument entailing clinical and demographic data and the state-trait anxiety inventory developed by Spielberger. RESULTS: According to the results, 70.7% and 71.6% of the patients in the case and control groups were female, respectively. Regarding the education level, 61.5% and 68.4% of the case and control groups had academic education, respectively. Additionally, 61.5% and 42.1% of the subjects in the case and control groups were single with the mean ages of 25.06±5.077 and 27.45±5.909 years, respectively. , 73.1% of the case group indicated grade 2 acne mostly in the face (100%) appearing 1-4 weeks post-surgery (51.9%). The case group had higher mean scores of trait (46.92±12.53) and state (46.21±9.30) anxiety, trait (P=0.001) and state (P=0.019) anxiety severity, as well as the prevalence of cosmetic dissatisfaction (51.9%), compared to the control group. Furthermore, acne severity showed a direct correlation with the severity of trait anxiety (r=0.472, P=0.005) and state anxiety (r=0.443, P=0.013). CONCLUSION: As the findings indicated, anxiety could be a major factor in triggering or exacerbating acne lesions after rhinoplasty. The assessment of mental health before the surgery, proper selection of the cases seeking aesthetic surgery, provision of psychological support, lack of medical history of acne lesions, and successful cosmetic rhinoplasty could result in reducing the prevalence of acne lesions after cosmetic surgeries, especially rhinoplasty.

Clinico-mycological profile of tinea capitis and its comparative response to griseofulvin versus terbinafine.

BACKGROUND AND PURPOSE: Tinea capitis is the most common superficial mycosis in children. This disease is a contagious infection with worldwide distribution and is occasionally associated with permanent alopecia. The treatment of this infection usually requires the administration of appropriate oral antifungal agents. The current study was conducted to evaluate the clinico-mycological profile of tinea capitis and compare the efficiency of oral griseofulvin and terbinafine in the treatment of this disease. MATERIALS AND METHODS: This study was conducted on 69 patients, including 23 females (33.3%) and 46 males (66.7%), clinically suspected of tinea capitis. After the confirmation of tinea capitis diagnosis through direct examination, the subjects were randomly assigned into two groups of griseofulvin and terbinafine. Demographic data, clinical and mycological characteristics, and therapeutic outcome were recorded for both groups. RESULTS: According to the results, tinea capitis was more common in children younger than 15 years (73.9%), athletes (37.7%), and males (66.7%), and those with frontal involvement (34.8%), non-inflammatory type (68.1%), endothrix (69.6%), and Trichophyton tonsurans species (41.7%). The griseofulvin and terbinafine groups had the treatment success rates of 90.9% and 80.6%, respectively (P= 0.311). The griseofulvin group had a shorter therapeutic course than the terbinafine group (P=0.129). CONCLUSION: Although our findings demonstrated that both griseofulvin and terbinafine were effective in the treatment of tinea capitis, griseofulvin showed a little higher efficacy in this regard. Consideration of some variables, such as age, associated risk factors, clinical type, hair involvement pattern, and dominant pathogenic species, is important in the determination of the drugs.

Combination of CO2 laser therapy and curettage for sebaceous gland hyperplasia.

INTRODUCTION: Sebaceous hyperplasia (SH) is a common cutaneous disorder associated with cosmetic problems. Some optional treatments and various laser devices have been reported to be effective, but recurrence and cosmetic outcome have not been resolved. METHODS: This interventional study was performed on SH lesions. First, the lesions were treated with a CO2 laser, and then the shrunken lesions were removed with a fine, sharp curette. RESULTS: A total of 46 patients (32 females and 14 males, mean age 39.9 ± 5.7 years) with SH skin lesions varying in severity were included in this study. The mean time of repair was 11.5 ± 1.9 days; a shorter repair time was seen in females and for mild extension lesions (p < 0.001). A fair cosmetic outcome was seen in 76.1% of cases, with better results reported for females and for skin types II and III (p < 0.001). CONCLUSIONS: The method reported herein is an easy, rapid, and effective procedure for the complete removal of SH lesions with few complications in the majority of patients with numerous lesions and Fitzpatrick skin types II-IV. Cosmetic outcomes are better in females and skin types II and III.

Comparison of the risk factors and HPV types in males with anogenital warts with and without involvement of the urethral meatus in western Iran.

BACKGROUND: Human papillomavirus (HPV)-induced lesions rarely develop in the urethral meatus (UM); however, their eradication can be problematic. METHODS: A total of 22 patients with anogenital warts (AGWs) in the UM region and 22 patients with AGWs located at other anatomical sites were included in this cross-sectional study. The presence of human papillomavirus (HPV) types in biopsy samples was determined using the HPV Easy typing kit (GenID GmbH, Germany). RESULTS: Although the patients in the AGW group with involvement of the UM had a higher incidence of reported multiple sexual partners (63.6% vs. 40.9%), larger meatus size (81.8% vs. 36.4%), and more frequent anal (36.4% vs. 18.2%) or unprotected sexual contact (68.2% vs. 36.4%) than those in the AGW group without UM involvement, only the duration of lesions (p = 0.04) and meatus size (p = 0.004) were significantly different in both groups. Low-risk HPV types were found in 75.0% and 69.2% of patients in the AGW groups with and without UM involvement, respectively. CONCLUSION: We found that a larger UM size was more prone to the development of meatus AGWs; however, being married, delaying sexual debut, and avoidance of multiple sexual partners seemed to be associated with a decreased risk of development of AGWs, especially within the UM region.

Serum lipid profile and clinical characteristics of patients with xanthelasma palpebrarum.

BACKGROUND: Although many factors are involved in the etiology of xanthelasma palpebrum, lipid disorder is strongly associated with its induction. Xanthelasma palpebrum, the most common type of xanthoma, usually presents in middle-aged females and results in aesthetic problems. OBJECTIVE: To evaluate thelipid profile and important clinical aspects of xanthelasma palpebrum patients. METHODS: In this descriptive study, we enrolled 42xanthelasma palpebrumpatients, and 42 cases of non-inflammatory skin disorders as thecontrol group, matched for age and gender.The clinical characteristics of the patients and fasting serum lipid profile were recorded for both groups. The data obtained were analyzed using SPSS-16. RESULTS: Xanthelasma palpebrum was found more commonly in middle-aged females with disease onset of less than 1 year, and without significant familial history of xanthoma. Furthermore,xanthelasma lesionswere most often seen in the upper lid with mild extension and was rarely associated with systemic disease. There was no statistically significant difference between two groups regarding hypertriglyceridemia (p= 0.231) and hypercholesterolemia (p= 0.302). The mean serum levels of cholesterol (221.51±60.4 mg/dl), triglyceride (185.98±71.1 mg/dl) and VLDL (37.7±17.6 mg/dl) were significantly higher and themedian HDL (36.2 (31, 41) mg/dl) level was lower in thepatient group. CONCLUSION: In our study, hypercholesterolemia and hypertriglyceridemia did not reveal a significant difference between thepatient and control groups; however, mean serum values for cholesterol, triglyceride, VLDL and HDL showed a significant difference between the two groups. Therefore, in addition to lipid abnormality, other factors could be involved in the pathogenesis of xanthelasma palpebrum.

Serum lipid profile and clinical characteristics of patients with xanthelasma palpebrarum

Abstract: Background: Although many factors are involved in the etiology of xanthelasma palpebrum, lipid disorder is strongly associated with its induction. Xanthelasma palpebrum, the most common type of xanthoma, usually presents in middle-aged females and results in aesthetic problems. Objective: To evaluate thelipid profile and important clinical aspects of xanthelasma palpebrum patients. Methods: In this descriptive study, we enrolled 42xanthelasma palpebrumpatients, and 42 cases of non-inflammatory skin disorders as thecontrol group, matched for age and gender.The clinical characteristics of the patients and fasting serum lipid profile were recorded for both groups. The data obtained were analyzed using SPSS-16. Results: Xanthelasma palpebrum was found more commonly in middle-aged females with disease onset of less than 1 year, and without significant familial history of xanthoma. Furthermore,xanthelasma lesionswere most often seen in the upper lid with mild extension and was rarely associated with systemic disease. There was no statistically significant difference between two groups regarding hypertriglyceridemia (p= 0.231) and hypercholesterolemia (p= 0.302). The mean serum levels of cholesterol (221.51±60.4 mg/dl), triglyceride (185.98±71.1 mg/dl) and VLDL (37.7±17.6 mg/dl) were significantly higher and themedian HDL (36.2 (31, 41) mg/dl) level was lower in thepatient group. Conclusion: In our study, hypercholesterolemia and hypertriglyceridemia did not reveal a significant difference between thepatient and control groups; however, mean serum values for cholesterol, triglyceride, VLDL and HDL showed a significant difference between the two groups. Therefore, in addition to lipid abnormality, other factors could be involved in the pathogenesis of xanthelasma palpebrum.