Papers by Ladan Dastgheib
Journal of The American Academy of Dermatology, May 1, 2010
Dermatology Online Journal, 2017
Dermatology Online Journal, 2018
Galen Medical Journal, Feb 19, 2015
Background: As an early and accurate diagnosis of all diseases, including skin disorders directly... more Background: As an early and accurate diagnosis of all diseases, including skin disorders directly influences the duration of treatment and its costs, which may be a significant burden, it is very important for physicians to be familiar with all types of diseases, especially those with a higher incidence in a given population. Considering the fact that disease patterns vary from region to region and there is no demographic data on patterns of skin diseases in Fars Province, we aimed to assess the frequency of skin diseases in admitted patients to Dermatology Ward of Shahid Faghihi Hospital. Materials and Methods: Medical records of 1450 patients, who completed a questionnaire during the years 2008 to 2011, were evaluated in this retrospective study. Demographic data and diagnoses of skin diseases were analyzed by SPSS software and classified according to International Classification of Diseases (ICD-10). Results: Pemphigus (12.5%), drug rash (11.7%) and eczema (10.5%) were the most common causes of referral to dermatology ward. The mean age of patients was 41.89±20.79 and the average length of hospitalization in this study was 9.34 days.Conclusion: High occurrence rate of Pemphigus and drug rash indicates that further study is required to root out underlying causes. Proper health policies should be implemented to manage these diseases.
PubMed, May 1, 2016
Background: The use of complementary and alternative medicine (CAM) has been increasing among pat... more Background: The use of complementary and alternative medicine (CAM) has been increasing among patients worldwide. The objective of this study was to assess CAM use and its related factors among Iranian dermatologic outpatients in Shiraz, Iran. Methods: This cross-sectional study was conducted in Shiraz, Iran. Six hundred dermatologic outpatients were randomly selected. We used a self-structured questionnaire with 14 items to assess CAM use and its related factors among our participants. We used descriptive statistics reported as mean±SD and frequency by Mann-Whitney U test, chi square and binary logistic regression tests for statistical analysis. Results: Among the 600 participants, 188 (31.3%) had used one of the CAM methods for resolving their dermatologic problems. The most frequent method used was herbal medicine (89.9%). The mean age and years of duration of the skin condition were significantly higher in patients using CAM compared to non-users (P=0.001 and 0.037, respectively). Patients with acne, alopecia, and hair loss significantly used CAM more than other diseases (OR: 2.48, CI 95%: 1.28-4.78) and (OR: 3.19, CI 95%: 1.62-6.27), respectively. There was a significant relationship between education and using CAM (P<0.001). Conclusion: Community member's behavior in CAM use without adequate knowledge may have a noticeable influence on each other. Since it is a prevalent matter, we should think of ways of educating the general population about CAM methods and its potential risks and benefits. We also should encourage our healthcare workers to communicate such materials with their patients.
Journal of Cutaneous Pathology, Mar 1, 2009
Proteinase‐activated receptor‐2 (PAR‐2) is a transmembrane G‐protein expressed in many normal tis... more Proteinase‐activated receptor‐2 (PAR‐2) is a transmembrane G‐protein expressed in many normal tissues and overexpressed in several cancer cell lines. It contributes to metastasis, promotes epidermal growth factor receptor proliferation, angiogenesis and tumor progression in many carcinomas. The purpose of this study was to investigate the expression of PAR‐2 in basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) in comparison with that of normal skin.Immunohistochemical (IHC) expression of PAR‐2 was examined using paraffin‐embedded sections from 30 BCCs, 30 SCCs and also 30 normal sun‐exposed skin specimens. PAR‐2 was expressed in all specimens of SCC and normal skin. In marked contrast, all BCC specimens had negative IHC staining. Given the important role of PAR‐2 in angiogenesis and metastasis, our finding can explain the far less aggressive behavior of BCC as compared with SCC.
Archives of Dermatological Research, Oct 16, 2019
Vitiligo is a skin disorder with melanocyte destruction and an autoimmune basis. Given the import... more Vitiligo is a skin disorder with melanocyte destruction and an autoimmune basis. Given the importance of cytokines in autoimmunity, we aimed to find the cytokine profile of innate and adaptive immunity in vitiligo patients, and correlate them with clinical parameters. The serum levels of innate immunity [interleukin(IL)-1α, IL-1β, IL-6, IL-8, IL-12, IL-15 and tumor necrosis factor (TNF)-α] and T helper(Th)1 [IL-2, interferon (IFN)-γ, TNF-β], Th2 (IL-4, IL-5, IL-10, IL-13) and Th17 (IL-17, IL-23) cytokines in 44 vitiligo patients were measured by multiplex cytokine assay and compared with 44 healthy subjects. All innate immunity (p < 0.04), Th1 (p < 0.01), Th2 (p < 0.05) and Th17 (p < 0.001) cytokines were higher in patients than controls. Total summation levels of innate immunity and adaptive immunity cytokines showed a remarkable up-regulation in the patients (p < 0.0001). The ratio of innate immunity to Th1 (p = 0.03), Th2 (p = 0.01) and Th17 (p = 0.03) cytokines was significantly higher in patients vs. controls. We found significant higher ratio of Th1 to Th2 cytokines and TNF-β elevated levels in patients with a family history of autoimmunity (p < 0.05). IL-4 and IL-13 (p < 0.04) levels were lower in patients with amelanotic hair. Increased IL-10 level was observed in patients with stable disease (p = 0.02). In conclusion, the profile of cytokines in patients showed a dominant role of innate immunity pro-inflammatory cytokines in vitiligo, which suggests the potential of targeting these cytokines for vitiligo treatment. While a higher ratio of Th1/Th2 cytokines was observed in the patients, association of decreased Th2 cytokines with disease complications suggests a protective role for Th2 pathway.
Australasian Journal of Dermatology, May 16, 2023
Pyoderma gangrenosum (PG) is a rare dermatological disease characterized by the rapid development... more Pyoderma gangrenosum (PG) is a rare dermatological disease characterized by the rapid development of painful skin ulcers. While systemic infliximab is considered a standard treatment for patients with PG, herein, we report our success with the use of intralesional infliximab in a 40‐year‐old woman with systemic lupus erythematosus (SLE) and PG.
Journal of Dermatological Treatment, Feb 20, 2014
Introduction: To investigate the therapeutic efficacy of tacrolimus compared with azathioprine in... more Introduction: To investigate the therapeutic efficacy of tacrolimus compared with azathioprine in the treatment of pemphigus vulgaris. Methods: About 23 patients received prednisolone and azathioprine, and 23 patients prednisolone and tacrolimus for 6 months. Pemphigus activity scores, the time that new bulla formation stopped, the time corticosteroid was tapered, cumulative steroid dosage and medication side effects were analyzed. Results: In the control group, the new bulla formation was ceased after a mean ± SD of 11.8 ± 4.7 days, and steroid tapering was done after a mean ± SD of 28.3 ± 5.45 days. Of the 23 patients receiving prednisolone and tacrolimus, the new bulla formation was ceased after a mean ± SD of 12.9 ± 5.26 days, and steroid tapering was done after a mean ± SD of 28.2 ± 5.39 days. About 8.6% of patients did not reach remission in each group. In patients receiving azathioprine, life-threatening side effects were seen in 1 (4.7%), moderate side effects in 2 (9.5%) and mild side effects in 1 (4.7%). In patients receiving tacrolimus, moderate side effect was seen in 1 (5%) and mild in 1 (5%). Conclusion: Tacrolimus effects are comparable to azathioprine as pemphigus vulgaris adjuvant treatment, also it has less severe side effects. Trial registration No. IRCT2012073010450N1
PubMed, 2023
Background: Genetic diversity in human leukocyte antigen (HLA) alleles across populations is a si... more Background: Genetic diversity in human leukocyte antigen (HLA) alleles across populations is a significant risk factor for drug-induced severe cutaneous adverse reactions (SCARs), e.g., carbamazepine (CBZ)- and lamotrigine (LTG)-induced Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). The present study aimed to investigate the frequency of different HLA alleles in Iranian patients with CBZ- and LTG-induced SJS/TEN. Methods: A case-control study was conducted from 2011 to 2018 at various hospitals affiliated with Shiraz University of Medical Sciences (Shiraz, Iran). A total of 31 patients receiving anticonvulsant drugs (CZB or LTG) were recruited and divided into two groups. The drug-induced group (n=14) included hospitalized patients due to CBZ- or LTG-induced SJS/TEN. The drug-tolerant group (n=17) included individuals receiving CBZ or LTG for at least three months with no adverse effects. In addition, 46 healthy individuals (control group) were recruited. The frequency of HLA-A, -B, and -DRB1 alleles in patients with CZB- or LTG-induced SJS/TEN was investigated. HLA typing was performed using the allele-specific polymerase chain reaction method. The Chi square test and Fisher's exact test were used to determine a potential association between SJS/TEN and HLA alleles. P<0.05 was considered statistically significant. Results: CBZ- or LTG-induced SJS/TEN was not significantly associated with HLA alleles. However, HLA-DRB1*01 showed a significantly higher frequency in patients with CBZ-induced SJS/TEN than the CBZ-tolerant patients (30% vs. 9%, P=0.07). Conclusion: Overall, no significant association was found between CBZ- or LTG-induced SJS/TEN and HLA alleles. Further large-scale studies are required to substantiate our findings.
Italian journal of dermatology and venereology, Apr 1, 2017
Pyoderma gangrenosum (PG) is an uncommon ulcerative cutaneous disease, without any well-known spe... more Pyoderma gangrenosum (PG) is an uncommon ulcerative cutaneous disease, without any well-known specific and effective treatment. Here we report two patients with severe recalcitrant perineal pyoderma gangrenosum, successfully treated with low dose systemic tacrolimus. Tacrolimus can be a safe effective drug in the management of recalcitrant PG.
Dermatology Research and Practice, 2012
Background. Lichen Planus is a chronic mucocutaneous disease of immunological basis and unknown e... more Background. Lichen Planus is a chronic mucocutaneous disease of immunological basis and unknown etiology. women with oral lichen planus may have concomitant manifestations in vulvovaginal areas. Objective. To determine the frequency and risk factors of genital involvement in a group of Iranian women affected by oral lichen planus. Methods. Thirty-six women with clinical and histopathological diagnosis of oral lichen planus were evaluated for demographic, historical, and clinical parameters of the oral disease. All the patients were referred for careful vulvovaginal examination, as well as histopathological assessment upon clinical indication. Results. Nineteen patients complained from genital symptoms but the number of women with the final diagnosis of genital lichen planus (n = 2) was too small to show any correlation with the parameters evaluated. Conclusion. In spite of low genital involvement possibly due to inadequate patient population, lack of follow-up visits, and contribution of genetic or ethnic factors, for conservative patient care, women with the oral lichen planus in particular those having some relevant genital symptoms, should preferably be referred for careful vulvovaginal examination. Multicenter cohort studies on women of different geographical regions or ethnicities who have genital lichen planus alone or in combination with other common sites are encouraged.
Medical Principles and Practice, 2010
postoperative irradiation was an effective and relatively safe choice for treatment of keloids. A... more postoperative irradiation was an effective and relatively safe choice for treatment of keloids. Although cryotherapy combined with intralesional steroids was associated with more side effects and higher relapse rates, it could be a good choice for small and newly formed keloids.
Iranian journal of public health, Jan 14, 2023
The Article is not available.
Dermatology Online Journal, 2019
Dermatology Online Journal || Case Presentation Figure 1. Case 1. A) Diffuse hyperpigmentation st... more Dermatology Online Journal || Case Presentation Figure 1. Case 1. A) Diffuse hyperpigmentation studded by hypopigmented macules over back. B) Sparing of dorsa of hands. C) Histopathology. Mild acanthosis, homogenous eosinophilic globular deposits in the papillary dermis (arrow) and melanophages in the upper dermis. H&E, 400×. D) Purple globules of amyloid in the papillary dermis. Crystal violet, 400×.
Journal of Complementary and Integrative Medicine, Dec 4, 2019
For centuries, Hirudo medicinalis (medicinal leech) has been used as a remedy to treat many disco... more For centuries, Hirudo medicinalis (medicinal leech) has been used as a remedy to treat many discomforts, such as muscle and joint pain. Nowadays, using leech in reconstructive surgery, microsurgery, wound and flap healing, venous insufficiency, varicosities and many other disorders has increased. In this study, we report a 45 year old female patient with six pruritic papules on her legs since10 months ago that appeared about 4 weeks after one session of leech application. Skin biopsy was performed on one of the papules, and in histopathology, superficial ulceration with a dense superficial and deep inflammatory infiltrate within the dermis composed of lymphocytes and eosinophils detected that considering history of leech application at this site, these constellation of data was compatible with the diagnosis of cutaneous lymphoid hyperplasia induced by leeches and the patient was cured by a topical steroid and cryotherapy.
Anais Brasileiros De Dermatologia, Apr 1, 2016
Pyogenic granuloma (PG) is a benign vascular lesion of the skin and mucous membranes, presenting ... more Pyogenic granuloma (PG) is a benign vascular lesion of the skin and mucous membranes, presenting as a solitary, red, pedunculated papule that bleeds easily and which appears to be a reactive vascular proliferation to minor injury. These lesions are more common in children and are mostly seen in exposed sites. Multiple disseminated PG is a rare condition. This report describes an infant with multiple, disseminated, pyogenic granulomas following burns from boiling milk. We reviewed literature published in English and found 9 cases. Six cases were provoked by hot milk, 2 by hot water, while the cause of the other case is unknown. Angiogiogenetic activity in milk may explain PG development in these patients.
Journal of Evidence-Based Complementary & Alternative Medicine, Apr 27, 2017
The objective of this study was to assess complementary and alternative medicine use and its rela... more The objective of this study was to assess complementary and alternative medicine use and its related factors among Iranian dermatology outpatients. In this cross-sectional study, a self-structured questionnaire was administered to 600 dermatology outpatients. Mann-Whitney U test, chi-square test, and binary logistic regression test were used. A total of 188 (31.3%) patients had used one of complementary and alternative medicine methods. The most frequent method used was herbal medicine (89.9%). The mean years of duration of the skin condition were significantly higher in complementary and alternative medicine users compared with nonusers (P ¼ .037). Patients with acne and alopecia significantly used more complementary and alternative medicine (odds ratio: 2.48 and 3.19, respectively). There was a significant relationship between education and using complementary and alternative medicine (P < .001). Complementary and alternative medicine use is prevalent among our patients and we should think of ways of educating general population about complementary and alternative medicine methods and their potential risks and benefits and encourage our health care workers to communicate these materials with their patients.
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Papers by Ladan Dastgheib