Evaluating the combined efficacy of oral isotretinoin and topical tacrolimus versus oral finasteride and topical tacrolimus in frontal fibrosing alopecia : a randomized controlled trial

Objective Treatment of frontal fibrosing alopecia (FFA) is complicated and challenging. In this study, we evaluated the efficacy of combining topical tacrolimus with isotretinoin versus finasteride in patients with FFA. Methodology Thirty-one patients with FFA were divided randomly into two groups. Therapeutic regimen of the first group (group A, n = 16) was isotretinoin and tacrolimus (Capsule isotretinoin 20 mg daily and topical tacrolimus 0.1% BD). The second group (group B, n = 15) was given finasteride and tacrolimus (Tablet finasteride 2.5 mg daily and topical tacrolimus 0.1% BD). Patients were treated and followed up periodically for 12 weeks. Evaluation of the treatment efficacy was based on Patient Global Assessment and Physician Global Assessment scales. Objective evaluation was based on improving the severity of skin lesions by viewing serial images taken from the affected areas. Results Physician Global Assessment (PGA) was significantly better in the group A as compared with the group B at 4 weeks (p = 0.038). Physician satisfaction in the group A was better than the group B at 12 weeks, but this was not statistically significant (p > 0.05). Patient Global Assessment and patient satisfaction in the group A was better than the group B at 8 and 12 weeks, but it was not statistically significant (p > 0.05). Conclusion Although both therapeutic regimens were effective in the treatment of FFA, treatment with tacrolimus and isotretinoin is significantly more effective than tacrolimus and finasteride

Occurrence of Mycosis Fungoides in an Iranian Chemical Victim of the Iran–Iraq War with a Long-term Follow-Up: A Case Report and Review of Literature

Mycosis fungoides (MF) is the most common form of cutaneous T-cell lymphoma. Persistent antigenic stimulation has been claimed to play a role in the development of this malignancy. We aimed to show the role of sulfur mustard in the pathogenesis of MF. A 45-year-old man with MF is introduced herein. He was a victim of chemical exposure in 1987 during the Iran–Iraq war. He developed skin lesions 3 years after exposure to sulfur mustard gas at the age of 21. Seven years after his exposure to sulfur mustard gas, a biopsy from the posterior distal part of his calf, which was injured and had bulla, revealed MF. Later, he developed more lesions on his extremities, trunk, and abdomen. On his previous admission, his left eyebrow was involved. A punch biopsy specimen was obtained from his eyebrow lesion, which rendered diffuse infiltration of atypical lymphocyte cells with some convoluted nuclei and scant cytoplasm admixed with lymphocytes, histiocytes, and mast cells compatible with the nodular stage of MF. At his last admission, a biopsy was obtained from the plaque lesions on his left thigh, and a TCR-γ gene rearrangement of the paraffin block of the plaque lesions revealed positive monoclonality. All the findings supported the MF diagnosis. We concluded that sulfur mustard could be a risk factor for MF development

Cutaneous manifestation in children with HIV/AIDS

The most recent studies have explained almost 2.3 million children are affected with HIV up to the end of 2009. Sub-Saharan Africa is the main region to at least 68% of the global total of HIV infection of 22.5 million. Despite providing competent healthcare services to prevent mother-to-child transmission which is the main way of infection to a newborn, an estimated 370,000 children were newly infected in 2009. Skin disorders are common and may even be the first manifestation of HIV in children. The most common skin illnesses are classified in four groups infections, inflammatory, neoplasm, and HAART related. In addition, unusual anatomical sites and disseminated skin lesions, increased frequency and severity, unexplained clinical presentation and rapid onset, and finally treatment failure may be the other specified skin conditions in HIV/AIDS children. CD4 count and viral load are two basic factors playing an almost important role in terms of type and severity of skin illness. The aim of this review was to show the common and crucial cutaneous finding among HIV/AIDS children via published articles with the same subject

A Comprehensive Review on HIV-Associated Dermatologic Manifestations: From Epidemiology to Clinical Management

Dermatological disorders are among the most prevalent manifestations of HIV infection/acquired immunodeficiency syndrome (AIDS). In this review, we aimed to characterize the various dermatologic presentations among HIV-infected patients with a detailed categorization of the mucocutaneous signs and symptoms, their etiopathogenic factors, and clinical management. In fact, cutaneous manifestations of HIV are quite various, ranging from AIDS-specific skin eruptions (xerosis, pruritic papular eruptions, eosinophilic folliculitis, and acne), opportunistic infections (herpes simplex, molluscum contagiosum, cutaneous leishmaniasis, bacillary angiomatosis, disseminated histoplasmosis, disseminated cryptococcosis, and zoster) to AIDS-related malignancies (Kaposi’s sarcoma, lymphoma, and nonmelanoma skin cancers) and antiretroviral therapy (ART)-associated drug eruptions. We tried to classify HIV-related cutaneous presentations which can help clinicians for a better understanding of the various specific and nonspecific features of AIDS-associated cutaneous manifestations and management of the condition