Erythroderma: A clinical study of 97 cases

BACKGROUND: Erythroderma is a rare skin disorder that may be caused by a variety of underlying dermatoses, infections, systemic diseases and drugs. METHODS: We reviewed the clinical, laboratory and biopsy material of 97 patients diagnosed with erythroderma who were treated in our department over a 6-year period (1996 through 2002). RESULTS: The male-female ratio was 1.85:1. The mean age at diagnosis was 46.2 years. The most common causative factors were dermatoses (59.7%), followed by drug reactions (21.6%), malignancies (11.3%) and idiopathic causes (7.2%). Carbamazepine was the most common drug (57.1%). The best clinicopathologic correlation was found in cutaneous T-cell lymphoma and pityriasis rubra pilaris related erythroderma. Apart from scaling and erythema that were present in all patients, pruritus was the most common finding (97.5%), followed by fever (33.6%), lymphadenopathy (21.3%), edema (14.4%) and hyperkeratosis (7.2%). CONCLUSION: This study outlines that underlying etiologic factors of erythroderma may show geographic variations. Our series had a high percentage of erythroderma secondary to preexisting dermatoses and a low percentage of idiopathic cases. There was no HIV-infected patient among our series based on multiple serum antibody tests. The clinical features of erythroderma were identical, irrespective of the etiology. The onset of the disease was usually insidious except in drug-induced erythroderma, where it was acute. The group associated with the best prognosis was that related to drugs

Lichen planus and Hepatitis C: a case-control study

BACKGROUND: The association of lichen planus with hepatitis C (HCV) has been widely reported in the literature. However, there are wide geographical variations in the reported prevalence of HCV infection in patients with lichen planus. This study was conducted to determine the frequency of hepatitis C in Iranian patients with lichen planus at Razi hospital, Tehran. METHODS: During the years 1997 and 1998, 146 cases of lichen planus, 78 (53.1%) women and 69 (46.9%) men were diagnosed. They were diagnosed on the basis of the usual clinical features and, if necessary, typical histological findings. The patients were screened for the presence of anti-HCV antibodies by third generation ELISA and liver function tests. We used the results from screening of blood donors for anti HCV (carried out by Iranian Blood Transfusion Organization) for comparison as the control group. RESULTS: Anti-HCV antibodies were detected in seven cases (4.8%). This was significantly higher than that of the blood donors' antibodies (p < 0.001). The odds ratio was 50.37(21.45–112.24). A statistically significant association was demonstrated between erosive lichen planus and HCV infection. Liver function tests were not significantly different between HCV infected and non-infected patients. CONCLUSION: HCV apears to have an etiologic role for lichen planus in Iranian patients. On the other hand, liver function tests are not good screening means for HCV infection

Prevalence, Severity, and Severity Risk Factors of Acne in High School Pupils: A Community-Based Study

A cross-sectional, community-based study was performed to determine the prevalence and severity of acne vulgaris in adolescents and of factors influencing the acne severity risk. The presence of acne was clinically determined and the secondary outcome measures of family acne history and the relation of acne to nutrition habits, emotional stress, menstruation, and smoking were recorded in a questionnaire. A representative sample of 1,002 pupils aged 16±0.9 years was enrolled. The overall acne prevalence was 93.3, 94.4% for boys and 92.0% for girls. Moderate to severe acne was observed in 14%. The prevalence of moderate to severe acne was 19.9% in pupils with and 9.8% in those without a family history of acne (P<0.0005; OR: 2.3). Acne severity risk increased with the number of family members with acne history. A mother with acne history influenced the severity of acne the most. Increasing pubertal age, seborrhea, the premenstrual phase, mental stress, and sweet and oily foods were recognized as risk factors for moderate to severe acne. In contrast, gender, spicy foods, and smoking were not associated with acne severity. In conclusion, acne is a common disorder in Iranian adolescents, with a low rate of moderate to severe acne. A genetic background is suggested, with mother's acne history being the most important prognostic factor. Skin quality and certain nutrition habits may affect acne severity

Osteoporosis iIn Patients with Pemphigus Vulgaris before Steroid Therapy

Pemphigus Vulgaris (PV) is often complicated by osteoporosis. Although corticosteroid therapy undoubtedly plays a causative role, inflammation associated with PV may also contribute to osteoporosis. This study was designed to determine the prevalence of osteoporosis in patients with PV before corticosteroid therapy and to compare these findings with those reported previously in healthy volunteers. Newly diagnosed patients with PV, who had not received systemic corticosteroids, were enrolled.  Bone mineral density (BMD) was measured both in the lumbar spine (L1-L4) and hip region. Data were compared with those of a healthy Iranian population. The association between the disease duration and severity and BMD was evaluated. A total of 50 patients (27 women) with a mean age of 42.6±14.5 years were enrolled. Osteoporosis was seen in 7 (14%) patients, 3 (11.1%) women, 4 (17.4%) men, and in both genders it was more common when compared to the population of healthy Iranians (8.2% in women and 4.9% in men). Osteopenia was found in 26 (52%) patients, 13 women and 13 men. Although both osteopenia and osteoporosis were more common in severe disease, neither the duration nor the severity of PV showed a statistically significant association with osteopenia or osteoporosis. The presence of a higher than expected rate of osteoporosis in patients with PV argues for osteoporosis screening and efforts aimed at prevention and early initiation of treatment to prevent unnecessary morbidity

The relationship between trust in AI and trustworthy machine learning technologies

To build AI-based systems that users and the public can justifiably trust one needs to understand how machine learning technologies impact trust put in these services. To guide technology developments, this paper provides a systematic approach to relate social science concepts of trust with the technologies used in AI-based services and products. We conceive trust as discussed in the ABI (Ability, Benevolence, Integrity) framework and use a recently proposed mapping of ABI on qualities of technologies. We consider four categories of machine learning technologies, namely these for Fairness, Explainability, Auditability and Safety (FEAS) and discuss if and how these possess the required qualities. Trust can be impacted throughout the life cycle of AI-based systems, and we introduce the concept of Chain of Trust to discuss technological needs for trust in different stages of the life cycle. FEAS has obvious relations with known frameworks and therefore we relate FEAS to a variety of international Principled AI policy and technology frameworks that have emerged in recent years.Comment: This submission has been accepted in ACM FAT* 2020 Conferenc