Immunoglobulins assessment (IgE,G,A,M) in some Iraqi patients with acute and chronic urticaria

60 patients diagnosed as having urticaria were included in the study ; 30 patients were effected with acute urticaria and 30 patients were affected with chronic urticaria. In addition, 30 healthy adult volunteers were selected as control group .The patients and control groups sera were examined with enzyme linked immunosorbent assay ( ELISA) to detect total level IgE and radial immunodiffusion (RID) to detect levels of IgG , IgA and IgM . The total level of IgE in acute urticaria ( 1.45±0.13) IU/mL and chronic urticaria (2.12 ± 0.10) IU/mL patients were significantly higher than the control groups ( 0.85 ± 0.10)IU/mL (

Chronic ulcerative Cutaneous Vasculitis of the legs Clinical and histopathological study

Background: Cutaneous small vessel vasculitis characterized by necrosis and inflammation of upper dermal blood vessels. It presents with ulcers and systemic manifestations after extensive acute onset. Many patients have a form of cutaneous vasculitis that presents with chronic painful ulcerations & purpuras involving the ankles without systemic manifestations, with some similarity in clinical presentation to livedoid vasculopathy. Patients and Methods: Thirteen patients were seen in the Department of Dermatology and Venereology, Baghdad Teaching Hospital, for a period extending from January 2004 to March 2005. They were evaluated clinically, histopathologically and other laboratory studies. In addition, evaluation of the clinical response to prednisolone 0.5mg/kg/day and azathioprine150mg/day was done. Results: Thirteen patients were included in this study; eight females and five males, with male to female ratio of 1:1.6. Their ages ranged between 26-66 years with a mean ±SD of 42 ± 13.8 years. The duration of the disease ranged from 0.5 – 18 years with a mean ±SD of 38 ± 59.2 months.The clinical examination revealed multiple oval punched out ulcers, with an indurated base, and surrounded by a zone of erythema; affecting mainly the ankles and dorsa of feet. Histopathological evaluation showed upper dermal vessels' wall necrosis, fibrinoid deposition, obliteration of the lumen, extravasation of red blood cells, endothelial cells swelling with perivascular and vascular wall infiltration mainly by mononuclear cells.The treatment was started with prednisolone & azathioprine. The ulcers healed completely with residual hyperpigmentation - hypopigmentation, atrophy and scars within 10-15 weeks  Conclusions: Chronic ulcerative cutaneous vasculitis is often a neglected and misdiagnosed variant of vasulitis. Histologically it has vascuiltic features, and clinically looks like livedoid vasculopathy

Topical Methotrexate for Treatment of Psoriasis: Formulation and Clinical Implications.

Background: To test effectiveness and safety of topical methotrexate 0.5%gel and to introduce new formula of methotrexate gel using suitable media for delivery. Patients and Methods: The clinical work was performed at the Department of Dermatology and Venereology in Baghdad Teaching Hospital during the period from January 2008 to October 2008. While preparation of formula was performed in the laboratories of the Department of Pharmacology- College of Medicine-University of Baghdad. Patients were divided in to two groups according to the type of treatment, group (I) 32 patients treated with methotrexate 0.5% gel and group(II) (placebo group) included 33 patients treated with placebo gel. Results: A total of 65 patients with limited plaque psoriasis were included in this study. For the MTX group the mean PASI score before treatment was 7.07 while at 2, 4, 6 and 8 weeks treatment, it was decreased to 5.17, 3.93, 3.07 and 2.35 respectively. At eight weeks treatment 25(78%) patients achieved good response (reduction in PASI score 50%), while 5(15.6%) patients achieved partial response (reduction in PASI score 25-49%) and 2(6.25%) patients had poor response (reduction in PASI score< 25%). For placebo group the pretreatment mean PASI score was 7.12 and after 2, 4, 6 and 8 weeks treatment it became 6.32, 6.07, 5.99 and 6.2 respectively. Clinically the response of the patients to placebo gel at 8 weeks treatment was partial in 10(30.3%) patients and poor in 23(69.7%) patients while no patients achieved good response.  Conclusions: MTX 0.5% gel is effective treatment option for plaque psoriasis and also appears to be safe treatment since side effects were transient, limited and reduced with continuation of therapy