Background Acne vulgaris is a common chronic inflammatory disease of the pilosebaceous units asso... more Background Acne vulgaris is a common chronic inflammatory disease of the pilosebaceous units associated with longterm sequelae and complications. Currently, acne in women is classified into adolescent and postadolescent forms. However, comparative studies evaluating the clinical and laboratory parameters across various age groups in women with acne are lacking. The aim of the study is to compare the clinical and laboratory characteristics of different groups of women with acne vulgaris. Patients and methods Over 3 years (2018-2021), a cross-sectional study was carried out on 340 women with acne consulting the Dermatology and Venereology Outpatient Clinic, Basrah Teaching Hospital, Basrah, Iraq. Eligible patients were carefully evaluated and fully examined, emphasizing on signs of hyperandrogenism and scoring of acne severity. Hormonal assays of serum total testosterone (TST), dehydroepiandrosterone sulfate (DHEAS), luteinizing hormone (LH), follicular stimulating hormone (FSH), and serum prolactin (PRL) were done. Pelvic ultrasonography was performed to identify any pelvic pathology. The patients were classified according to their age of onset. Clinical and laboratory data were compared among groups. Results Three groups were recognized: 160 patients (47%) with adolescent acne (AA) (mean age SD: 17.2±1.6 years), 80 (23.5%) with early adult-onset acne (EA) (mean age SD: 21.4±1.2 years), and 100 (29.4%) with postadolescent acne (PA) (mean age SD: 28.7±2.9 years), which were further sub-grouped into late-onset acne (40 cases, 11.7%), and persistent acne (60 cases, 17.6%). The mean body mass index was normal in the AA group and overweight in the EA and PA groups. Moderate obesity was more frequent in PA (24%, p=0.03). While 78.5% of AA was mild to moderate acne, 77.5% of EA was moderate to moderately severe, and 72% of PA was moderately severe to severe. Clinical and biochemical markers of hyperandrogenism were seen in all groups, however, they were more frequent in PA and EA groups than in the AA group (p<005). Conclusion Clinical and biochemical hyperandrogenism were present in a significant proportion of women with acne; their prevalence was higher in post-adolescent acne than in adolescent acne. Acne that began between the ages of 20 and 25 was classified as "early adult-onset acne," and showed variable features of hyperandrogenism. A complete evaluation, regardless of age, for every female with acne, including a hormonal analysis and pelvic ultrasound examination to detect hormonal imbalances as early therapy, can help to prevent and reduce the risk of consequences.
Background: A combination treatment of cutaneous leishmaniasis (CL) that hastens the healing and ... more Background: A combination treatment of cutaneous leishmaniasis (CL) that hastens the healing and reduces the chance of scarring, especially in aesthetically receptive sites, is required. Objectives: To evaluate if a combination of intralesional sodium stibogluconate (SSG) injection and topical imiquimod 5% cream (IMI) accelerates healing and improves the quality of scars from CL. Patients and Methods: A prospective, placebo-controlled, randomized clinical trial was conducted at Basrah Teaching Hospital, Basrah, southern Iraq from 2017 to 2019 on a cohort of patients with CL. Eligible patients were injected intralesionally with sodium stibogluconate (SSG) weekly for six weeks and randomized to receive either topical imiquimod 5% cream (IMI group) or topical emollient cream (placebo group). The healing rate and scar quality were assessed at week six. Results: One hundred twenty-one patients completed the trial (66 [55%] males, mean age SD: 34.1 years). The clinical healing rate was significantly higher in the IMI group than in the placebo group (94% versus 74%, p <0.05). A high rate of scars was noticed in both groups (66.6% in the IMI group and 91.2% in the placebo group). However, superficial non-atrophic scars were more frequent in the IMI group (40% versus 26%), while deep atrophic scars were more evident in the placebo group than in the IMI group (65.2% versus 26.6%, p<0.05). Conclusions: Combined intralesional SSG plus topical imiquimod was beneficial in accelerating CL healing and improving scar quality, and should be considered when CL is located in aesthetically sensitive areas.
Background: A combination of azithromycin & isotretinoin has been used for treatment of Severe no... more Background: A combination of azithromycin & isotretinoin has been used for treatment of Severe nodulocystic acne before, however, an optimal scheduled doses regimen of such combination remained to be elucidated. Objectives: To evaluate the effectiveness, safety and tolerability of using a new combination of fixed low doses of isotretinoin and azithromycin in an alternative days regimen in treatment of severe nodulocystic acne in Iraqi patients. Patients and Methods: A prospective open-labeled clinical study in which 54 young adult and adolescent patients with severe nodulocystic acne were recruited for the study at the Department of Dermatology in Basra General Hospital during from May-October 2015. The patients were received a combination of fixed dose of isotretinoin 20 mg thrice weekly and 500 mg azithromycin given orally thrice weekly on alternating days and one day off for 12 weeks. The participants was assessed before, during and after treatment. The calculation of percentage ...
1Adult Endocrinologist. Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Univ... more 1Adult Endocrinologist. Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), University of Basrah, Basrah,Iraq. 2 Assistant Professor of Dermatology, University of Basrah, Basrah, Iraq. 3Professor of Medicine,Consultant Endocrinologist.Faiha Specialized Diabetes, Endocrine, and Metabolism Center (FDEMC), University of Basrah, Basrah, Iraq. *Corresponding Author E-mail: [email protected]
Background: Although female androgenetic alopecia (FAGA) occurs in genetically susceptible women,... more Background: Although female androgenetic alopecia (FAGA) occurs in genetically susceptible women, some trace elements may play an important role. Aim of the Study: This study aimed to evaluate serum and hair zinc and iron levels in patients with FAGA and to compare the findings with normal controls. Patients and Methods: A case-control study that was conducted at Dermatology Clinic in Basra General Hospital, Basra, Iraq. The participants were divided into two groups: The first group consisted of 27 women with FAGA and the second was age-matched 28 healthy women control group. The serum and hair zinc and iron assays were done for all participants. Results: Both hair and serum zinc levels in FAGA group were significantly lower than that in the control (103.4±25.5 ppm vs. 143.5±33.1 ppm for hair and 65.6±14.2 µg/dl vs. 128.4±41.4 µg/dl for serum). Hair iron level in FAGA was significantly lower than in control (17.9±3.8 ppm vs. 26.9±7.4 ppm, P>0.05). Serum iron level in FAGA group was lower than in the control, but it was not significant statistically (88.9±22.3 µg/dl vs. 100.9±18.9 µg/dl). Except for the hair iron, there was no significant correlation between zinc and iron concentrations in hair and serum with severity of alopecia. Conclusions: Zinc and iron levels in serum and hair were lower in FAGA compared to that of normal individuals indicating that trace elements might play an important role in the etiopathogenesis of FAGA.
Women with late onset acne may have to check for their own androgens levels in the blood otherwis... more Women with late onset acne may have to check for their own androgens levels in the blood otherwise the problem of acne will be not resolved. Many of these women with late onset acne have an abnormal elevation of androgens level in the circulation which is the most likely unrevealed hidden cause of their continuous suffering. Moreover ,treating of these women with anti androgenic medications may achieve a dramatic improvement of their acne may prevent the unwanted scars & pits.
Journal of Dermatology and Dermatologic Surgery, 2018
Background: Desloratadine, when combined with isotretinoin, had a favorable effect in the treatme... more Background: Desloratadine, when combined with isotretinoin, had a favorable effect in the treatment of moderate acne; however, its effect in severe nodulocystic acne remained to be elucidated. Aim of the Study: The aim of the study was to evaluate the effect of adding oral desloratadine to the combined azithromycin and isotretinoin regimen for severe acne. Patients and Methods: Patients were randomly classified into two groups: 1st (control) included 38 patients and received alternating isotretinoin and azithromycin orally and 2nd (intervention) group included 38 patients and received same regimen plus desloratadine 5 mg/day. Assessment was made at baseline, 4, 8, and 12 weeks of the trial. Results: In both groups, there was statistically significant reduction in count of inflammatory lesions at 12 weeks compared to baseline (59 ± 19–9 ± 7 for 2nd group and from 57 ± 18 to 21 ± 8 for control) (P < 0.05) and it was significantly higher in 2nd than in 1st control (P < 0.05). Significant reduction in non-inflammatory lesions count (from 18 ± 3 to 8 ± 2 and 18 ± 4 to11 ± 2 for 2nd and 1st group, respectively). At 12th week, 19 (50%) patients in the intervention and 12 (31.6%) of control groups were achieved excellent improvement (>80%). Conclusion: Oral desloratadine had antiacne properties, and when combined with azithromycin plus isotretinoin protocol, it significantly improves severe acne lesions and minimizes the adverse drug reactions.
Background: Low serum level of Vitamin D may have a potential role in the pathogenesis of female ... more Background: Low serum level of Vitamin D may have a potential role in the pathogenesis of female pattern hair loss (FPHL). Aims: To evaluate serum vitamin D level in Iraqi women with female pattern hair loss and compare it with normal healthy control. Settings and Design: A case-control study was carried out on 190 women: 95 patients with FPHL aged ≥15 years and 95 healthy agematched control. Methods and Material: The diagnosis and severity of FPHL were based on clinical examination and using Ludwig classification. All participants were investigated for vitamin D level and alkaline phosphatase. Data were collected and statistically analyzed. Results: The mean ± SD level for vitamin D was significantly lower in the FPHL group than control (13.8 ± 2.6 ng/mL vs 37.6 ± 4.7ng/mL, p < 0.001). Eighty-two patients (86.1%) of the FPHL group and 35 (36.9%) of the control group had a low vitamin D level (p < 0.001). Alkaline phosphatase level was significantly elevated in 77of FPHL compa...
Background and objectives: A wide arrays of skin lesions occurred in the setting of COVID-19 infe... more Background and objectives: A wide arrays of skin lesions occurred in the setting of COVID-19 infection. We aimed to estimate the incidence and types of skin lesions among hospitalized patients with COVID-19 infection. Methods: We conducted an observational cohort study on 369 hospitalized patients with COVID-19 infection at Basra Teaching Hospital for 3 months. We studied the incidence and types of skin lesions. Results: Among 369 hospitalized patients, skin lesions were developed in 5%. Of those who developed skin lesions, 33% were asymptomatic. Skin lesions were more frequent in young females (83.3%). The most frequent type of skin lesion was maculopapular 44.3% which occurred exclusively in the medical ward and half of them in asymptomatic patients. For pustular lesions, all were female, diabetic, in the ICU, in symptomatic patients with the highest levels of serum C-reactive proteins. Pseudo-chilblain lesions were reported only in younger female and half of patients were asympto...
Journal of Pakistan Association of Dermatology, 2020
Objective We aimed to assess the efficacy and safety of NB-UVB phototherapy in relieving uremic p... more Objective We aimed to assess the efficacy and safety of NB-UVB phototherapy in relieving uremic pruritus. Patients and Methods Over a period of 12 months, we recruited 17 patients with uremic pruritus having skin phototype III and more, aged from 21 to 67 years, 19(52.9%) females and 8(47.1%) male. They received NB-UVB, 2 sessions per week for 10 weeks. The response was assessed using 5-D itch scale. Results There was a 60.7±29.2% reduction of 5D-itch score compared to baseline (19.53±3 versus 7.59±5.8, p<0.001). The mean cumulative dose of NB-UVB for one patient was 24.99 joule/ cm 2 (1.25 ± 0.6 j/ cm 2 per session). At the end of the trial, according to 5-D itch score criteria, 82.4% of patients were considered as a responder (good in 47.1%, very good in 35.3%) and after the treatment at follow up for 8 weeks, 35.7% developed pruritus again. Transient erythema was observed in 2 patients (10.5%) on phototherapy. Conclusion In our population, with Fitzpatrick s skin phototypes...
Background: Burn hemangioma, also known as scalded pyogenic granuloma, is considered a variant of... more Background: Burn hemangioma, also known as scalded pyogenic granuloma, is considered a variant of pyogenic granuloma, but unlike the classic type it presents with rapid progression. Most patients are infants and young children with a history of burns caused by liquids. Objective: The present study aims to present all patients with burn hemangiomas treated at our institutions with a full clinical and histopathological assessment. Patients and Methods: This case series includes 34 cases that were treated during the period from 2016 to 2021. Results: A total of 34 patients (16 female/18 male, mean age of 17.6 years) were included. Two age groups presented: infants and children (n = 22, age range 0.5–8 years, 10 female/12 male), and adults (n = 11, age range 25–44 years, 6 female/6 male). Lesions appeared 1–2 weeks following predominantly second-degree burns, and multiple lesions predominated in infants and children. The lesions evolved to large lesions within weeks, and these appeared ...
Background: Although systemic treatment with oral azithromycin was considered as first line of th... more Background: Although systemic treatment with oral azithromycin was considered as first line of therapy for inflammatory papulopustular acne. Its beneficial effects on severe nodulocystic type was not well studied before Objectives: To evaluate the efficacy, safety and tolerability of azithromycin as monotherapy for treatment of severe nodulocystic acne . Patients and Methods: The study was a prospective clinical trial recruiting 49 patients with severe nodulocystic acne. Azithromycin 500mg was given orally thrice weekly for 12 weeks. Four weekly follow up were performed for 3 months to assess clinical response and report any adverse effects. Results: Compared to baseline, there was marked and significant reduction in the number of the inflammatory lesions at 12 weeks of treatment with the clearance of 87.05% of the papules, 90.5% of the pustules and 78.82% of the nodulocysts. At the end of the treatment there was a remarkable clearance of the inflammatory lesions in the majority of ...
Results: After 3 doses of ivermectin, there was a significant reduction in the total count of inf... more Results: After 3 doses of ivermectin, there was a significant reduction in the total count of inflammatory lesions compared to the base line (the mean was reduced from 51.6±27.4 to 21±14.7) (P<0.05). At the end of the two-month follow-up period, more reduction was observed in inflammatory lesions (mean was reduced to 9.3±7), and 62% of the patients showed excellent responses to the treatment (≥ 80% reduction in the lesions). Nausea was reported in 10%.
Tinea incognito is a variant of dermatophyte infection of the skin modified by an erroneously app... more Tinea incognito is a variant of dermatophyte infection of the skin modified by an erroneously applied topical or systemic steroid. Aim of the study: to describe the various clinic-epidemiological aspects of tinea incognito found among our patients. A prospective study was carried out in the Department of Dermatology, Basra Teaching Hospital, Basra, Iraq. The clinical diagnosis was confirmed by mycological tests. Clinical data were described in more detail and the lesions were classified according to the site, shape, and extent. Ninety cases of tinea incognito were seen, median age was 34years. The initial inaccurate diagnoses were eczema in 60 patients (67%), intertrigo in 16 (18 %) and psoriasis in 14 (15%) patients. The type of topical drugs applied was topical corticosteroid (potent and fluorinated) in most cases (54.4%), fixed drug combination creams in 36.6% and a topical calcineurin inhibitor in 5.5%. Commonly presented as acute eczema-like, on hands and trunk, discoid lupus e...
Background: Psoriasis has an increased likelihood of comorbidities compared with healthy controls... more Background: Psoriasis has an increased likelihood of comorbidities compared with healthy controls such as cardiovascular diseases and metabolic syndrome. Objectives: To investigate the risk factors that increases the incidence of cardiovascular diseases and metabolic syndrome in Iraqi patients with psoriasis. Patients & methods: a case-control prospective study enrolled 80 patients with psoriasis and 80 normal individuals as a control group. Psoriasis severity was assessed using PASI(psoriasis area severity index) score, in both groups, blood pressure, BMI(body mass index) & waist circumference were measured, laboratory tests including fasting blood sugar & lipid profile were done. For comparison between the 2 groups, Fisher s exact test were performed. Results: In psoriatic group, calculation of (BMI), showed that 19 (23.8%) were obese, 34 (42.5%) over weight, 27 (38.8%) normal weight. Thirty four patients (42.5%) had an elevated blood pressure, both were significantly correlated with the severity of psoriasis.44 (55%) have abnormal lipid profile, 17 (21.3%) elevated cholesterol, 17(21.3%) had raised LDL & 32 (40%) had low HDL. These were correlated with the severity of psoriasis. Eight (10%) patients had elevated VLDL & 13 (16.3 %) had elevated TG. Twelve (15%) patients had elevated FBS.33 (41.25%) patients were having Metabolic syndrome and the risk was increased with the duration of psoriasis. Comparing with the control group, psoriatic patients were at risk of developing hyperglycemia & hyperlipidemia with statistically significant elevation of fasting blood sugar, cholesterol, LDL, & reduced HDL. Conclusions: Compared with the control group, psoriatic patients in our population had an atherogenic lipid profile with increased prevalence of risk factors for cardiovascular diseases & metabolic syndrome & this was directly correlated with the severity and duration of the disease.
Background: A combination of azithromycin & isotretinoin has been used for treatment of Severe no... more Background: A combination of azithromycin & isotretinoin has been used for treatment of Severe nodulocystic acne before, however, an optimal scheduled doses regimen of such combination remained to be elucidated. Objectives: To evaluate the effectiveness, safety and tolerability of using a new combination of fixed low doses of isotretinoin and azithromycin in an alternative days regimen in treatment of severe nodulocystic acne in Iraqi patients. Patients and Methods: A prospective open-labeled clinical study in which 54 young adult and adolescent patients with severe nodulocystic acne were recruited for the study at the Department of Dermatology in Basra General Hospital during from May-October 2015. The patients were received a combination of fixed dose of isotretinoin 20 mg thrice weekly and 500 mg azithromycin given orally thrice weekly on alternating days and one day off for 12 weeks. The participants was assessed before, during and after treatment. The calculation of percentage and scoring of reduction of acne lesions was also carried out. Results: There was a marked reduction in the inflammatory lesions at the first 4 weeks of the treatment, with a significant clearance of 38.4% of the papular lesions, 63.5% of pustular and 43% of the nodular lesions. At the end of the study, there was a significant reduction in the number of the inflammatory lesions, with the clearance of 76% of the papules, 96% of the pustules and 86% of the nodules. The most frequent adverse effects reported was dryness of face and lips. Conclusion: Fixed dose of azithromycin 500 mg combined with isotretinoin 20 mg on alternating day regimen proved to be effective, safe & well tolerated regimen for treatment of severe nodulocystic acne with high score of patient satisfaction.
Background Acne vulgaris is a common chronic inflammatory disease of the pilosebaceous units asso... more Background Acne vulgaris is a common chronic inflammatory disease of the pilosebaceous units associated with longterm sequelae and complications. Currently, acne in women is classified into adolescent and postadolescent forms. However, comparative studies evaluating the clinical and laboratory parameters across various age groups in women with acne are lacking. The aim of the study is to compare the clinical and laboratory characteristics of different groups of women with acne vulgaris. Patients and methods Over 3 years (2018-2021), a cross-sectional study was carried out on 340 women with acne consulting the Dermatology and Venereology Outpatient Clinic, Basrah Teaching Hospital, Basrah, Iraq. Eligible patients were carefully evaluated and fully examined, emphasizing on signs of hyperandrogenism and scoring of acne severity. Hormonal assays of serum total testosterone (TST), dehydroepiandrosterone sulfate (DHEAS), luteinizing hormone (LH), follicular stimulating hormone (FSH), and serum prolactin (PRL) were done. Pelvic ultrasonography was performed to identify any pelvic pathology. The patients were classified according to their age of onset. Clinical and laboratory data were compared among groups. Results Three groups were recognized: 160 patients (47%) with adolescent acne (AA) (mean age SD: 17.2±1.6 years), 80 (23.5%) with early adult-onset acne (EA) (mean age SD: 21.4±1.2 years), and 100 (29.4%) with postadolescent acne (PA) (mean age SD: 28.7±2.9 years), which were further sub-grouped into late-onset acne (40 cases, 11.7%), and persistent acne (60 cases, 17.6%). The mean body mass index was normal in the AA group and overweight in the EA and PA groups. Moderate obesity was more frequent in PA (24%, p=0.03). While 78.5% of AA was mild to moderate acne, 77.5% of EA was moderate to moderately severe, and 72% of PA was moderately severe to severe. Clinical and biochemical markers of hyperandrogenism were seen in all groups, however, they were more frequent in PA and EA groups than in the AA group (p<005). Conclusion Clinical and biochemical hyperandrogenism were present in a significant proportion of women with acne; their prevalence was higher in post-adolescent acne than in adolescent acne. Acne that began between the ages of 20 and 25 was classified as "early adult-onset acne," and showed variable features of hyperandrogenism. A complete evaluation, regardless of age, for every female with acne, including a hormonal analysis and pelvic ultrasound examination to detect hormonal imbalances as early therapy, can help to prevent and reduce the risk of consequences.
Background: A combination treatment of cutaneous leishmaniasis (CL) that hastens the healing and ... more Background: A combination treatment of cutaneous leishmaniasis (CL) that hastens the healing and reduces the chance of scarring, especially in aesthetically receptive sites, is required. Objectives: To evaluate if a combination of intralesional sodium stibogluconate (SSG) injection and topical imiquimod 5% cream (IMI) accelerates healing and improves the quality of scars from CL. Patients and Methods: A prospective, placebo-controlled, randomized clinical trial was conducted at Basrah Teaching Hospital, Basrah, southern Iraq from 2017 to 2019 on a cohort of patients with CL. Eligible patients were injected intralesionally with sodium stibogluconate (SSG) weekly for six weeks and randomized to receive either topical imiquimod 5% cream (IMI group) or topical emollient cream (placebo group). The healing rate and scar quality were assessed at week six. Results: One hundred twenty-one patients completed the trial (66 [55%] males, mean age SD: 34.1 years). The clinical healing rate was significantly higher in the IMI group than in the placebo group (94% versus 74%, p <0.05). A high rate of scars was noticed in both groups (66.6% in the IMI group and 91.2% in the placebo group). However, superficial non-atrophic scars were more frequent in the IMI group (40% versus 26%), while deep atrophic scars were more evident in the placebo group than in the IMI group (65.2% versus 26.6%, p<0.05). Conclusions: Combined intralesional SSG plus topical imiquimod was beneficial in accelerating CL healing and improving scar quality, and should be considered when CL is located in aesthetically sensitive areas.
Background: A combination of azithromycin & isotretinoin has been used for treatment of Severe no... more Background: A combination of azithromycin & isotretinoin has been used for treatment of Severe nodulocystic acne before, however, an optimal scheduled doses regimen of such combination remained to be elucidated. Objectives: To evaluate the effectiveness, safety and tolerability of using a new combination of fixed low doses of isotretinoin and azithromycin in an alternative days regimen in treatment of severe nodulocystic acne in Iraqi patients. Patients and Methods: A prospective open-labeled clinical study in which 54 young adult and adolescent patients with severe nodulocystic acne were recruited for the study at the Department of Dermatology in Basra General Hospital during from May-October 2015. The patients were received a combination of fixed dose of isotretinoin 20 mg thrice weekly and 500 mg azithromycin given orally thrice weekly on alternating days and one day off for 12 weeks. The participants was assessed before, during and after treatment. The calculation of percentage ...
1Adult Endocrinologist. Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Univ... more 1Adult Endocrinologist. Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), University of Basrah, Basrah,Iraq. 2 Assistant Professor of Dermatology, University of Basrah, Basrah, Iraq. 3Professor of Medicine,Consultant Endocrinologist.Faiha Specialized Diabetes, Endocrine, and Metabolism Center (FDEMC), University of Basrah, Basrah, Iraq. *Corresponding Author E-mail: [email protected]
Background: Although female androgenetic alopecia (FAGA) occurs in genetically susceptible women,... more Background: Although female androgenetic alopecia (FAGA) occurs in genetically susceptible women, some trace elements may play an important role. Aim of the Study: This study aimed to evaluate serum and hair zinc and iron levels in patients with FAGA and to compare the findings with normal controls. Patients and Methods: A case-control study that was conducted at Dermatology Clinic in Basra General Hospital, Basra, Iraq. The participants were divided into two groups: The first group consisted of 27 women with FAGA and the second was age-matched 28 healthy women control group. The serum and hair zinc and iron assays were done for all participants. Results: Both hair and serum zinc levels in FAGA group were significantly lower than that in the control (103.4±25.5 ppm vs. 143.5±33.1 ppm for hair and 65.6±14.2 µg/dl vs. 128.4±41.4 µg/dl for serum). Hair iron level in FAGA was significantly lower than in control (17.9±3.8 ppm vs. 26.9±7.4 ppm, P>0.05). Serum iron level in FAGA group was lower than in the control, but it was not significant statistically (88.9±22.3 µg/dl vs. 100.9±18.9 µg/dl). Except for the hair iron, there was no significant correlation between zinc and iron concentrations in hair and serum with severity of alopecia. Conclusions: Zinc and iron levels in serum and hair were lower in FAGA compared to that of normal individuals indicating that trace elements might play an important role in the etiopathogenesis of FAGA.
Women with late onset acne may have to check for their own androgens levels in the blood otherwis... more Women with late onset acne may have to check for their own androgens levels in the blood otherwise the problem of acne will be not resolved. Many of these women with late onset acne have an abnormal elevation of androgens level in the circulation which is the most likely unrevealed hidden cause of their continuous suffering. Moreover ,treating of these women with anti androgenic medications may achieve a dramatic improvement of their acne may prevent the unwanted scars & pits.
Journal of Dermatology and Dermatologic Surgery, 2018
Background: Desloratadine, when combined with isotretinoin, had a favorable effect in the treatme... more Background: Desloratadine, when combined with isotretinoin, had a favorable effect in the treatment of moderate acne; however, its effect in severe nodulocystic acne remained to be elucidated. Aim of the Study: The aim of the study was to evaluate the effect of adding oral desloratadine to the combined azithromycin and isotretinoin regimen for severe acne. Patients and Methods: Patients were randomly classified into two groups: 1st (control) included 38 patients and received alternating isotretinoin and azithromycin orally and 2nd (intervention) group included 38 patients and received same regimen plus desloratadine 5 mg/day. Assessment was made at baseline, 4, 8, and 12 weeks of the trial. Results: In both groups, there was statistically significant reduction in count of inflammatory lesions at 12 weeks compared to baseline (59 ± 19–9 ± 7 for 2nd group and from 57 ± 18 to 21 ± 8 for control) (P < 0.05) and it was significantly higher in 2nd than in 1st control (P < 0.05). Significant reduction in non-inflammatory lesions count (from 18 ± 3 to 8 ± 2 and 18 ± 4 to11 ± 2 for 2nd and 1st group, respectively). At 12th week, 19 (50%) patients in the intervention and 12 (31.6%) of control groups were achieved excellent improvement (>80%). Conclusion: Oral desloratadine had antiacne properties, and when combined with azithromycin plus isotretinoin protocol, it significantly improves severe acne lesions and minimizes the adverse drug reactions.
Background: Low serum level of Vitamin D may have a potential role in the pathogenesis of female ... more Background: Low serum level of Vitamin D may have a potential role in the pathogenesis of female pattern hair loss (FPHL). Aims: To evaluate serum vitamin D level in Iraqi women with female pattern hair loss and compare it with normal healthy control. Settings and Design: A case-control study was carried out on 190 women: 95 patients with FPHL aged ≥15 years and 95 healthy agematched control. Methods and Material: The diagnosis and severity of FPHL were based on clinical examination and using Ludwig classification. All participants were investigated for vitamin D level and alkaline phosphatase. Data were collected and statistically analyzed. Results: The mean ± SD level for vitamin D was significantly lower in the FPHL group than control (13.8 ± 2.6 ng/mL vs 37.6 ± 4.7ng/mL, p < 0.001). Eighty-two patients (86.1%) of the FPHL group and 35 (36.9%) of the control group had a low vitamin D level (p < 0.001). Alkaline phosphatase level was significantly elevated in 77of FPHL compa...
Background and objectives: A wide arrays of skin lesions occurred in the setting of COVID-19 infe... more Background and objectives: A wide arrays of skin lesions occurred in the setting of COVID-19 infection. We aimed to estimate the incidence and types of skin lesions among hospitalized patients with COVID-19 infection. Methods: We conducted an observational cohort study on 369 hospitalized patients with COVID-19 infection at Basra Teaching Hospital for 3 months. We studied the incidence and types of skin lesions. Results: Among 369 hospitalized patients, skin lesions were developed in 5%. Of those who developed skin lesions, 33% were asymptomatic. Skin lesions were more frequent in young females (83.3%). The most frequent type of skin lesion was maculopapular 44.3% which occurred exclusively in the medical ward and half of them in asymptomatic patients. For pustular lesions, all were female, diabetic, in the ICU, in symptomatic patients with the highest levels of serum C-reactive proteins. Pseudo-chilblain lesions were reported only in younger female and half of patients were asympto...
Journal of Pakistan Association of Dermatology, 2020
Objective We aimed to assess the efficacy and safety of NB-UVB phototherapy in relieving uremic p... more Objective We aimed to assess the efficacy and safety of NB-UVB phototherapy in relieving uremic pruritus. Patients and Methods Over a period of 12 months, we recruited 17 patients with uremic pruritus having skin phototype III and more, aged from 21 to 67 years, 19(52.9%) females and 8(47.1%) male. They received NB-UVB, 2 sessions per week for 10 weeks. The response was assessed using 5-D itch scale. Results There was a 60.7±29.2% reduction of 5D-itch score compared to baseline (19.53±3 versus 7.59±5.8, p<0.001). The mean cumulative dose of NB-UVB for one patient was 24.99 joule/ cm 2 (1.25 ± 0.6 j/ cm 2 per session). At the end of the trial, according to 5-D itch score criteria, 82.4% of patients were considered as a responder (good in 47.1%, very good in 35.3%) and after the treatment at follow up for 8 weeks, 35.7% developed pruritus again. Transient erythema was observed in 2 patients (10.5%) on phototherapy. Conclusion In our population, with Fitzpatrick s skin phototypes...
Background: Burn hemangioma, also known as scalded pyogenic granuloma, is considered a variant of... more Background: Burn hemangioma, also known as scalded pyogenic granuloma, is considered a variant of pyogenic granuloma, but unlike the classic type it presents with rapid progression. Most patients are infants and young children with a history of burns caused by liquids. Objective: The present study aims to present all patients with burn hemangiomas treated at our institutions with a full clinical and histopathological assessment. Patients and Methods: This case series includes 34 cases that were treated during the period from 2016 to 2021. Results: A total of 34 patients (16 female/18 male, mean age of 17.6 years) were included. Two age groups presented: infants and children (n = 22, age range 0.5–8 years, 10 female/12 male), and adults (n = 11, age range 25–44 years, 6 female/6 male). Lesions appeared 1–2 weeks following predominantly second-degree burns, and multiple lesions predominated in infants and children. The lesions evolved to large lesions within weeks, and these appeared ...
Background: Although systemic treatment with oral azithromycin was considered as first line of th... more Background: Although systemic treatment with oral azithromycin was considered as first line of therapy for inflammatory papulopustular acne. Its beneficial effects on severe nodulocystic type was not well studied before Objectives: To evaluate the efficacy, safety and tolerability of azithromycin as monotherapy for treatment of severe nodulocystic acne . Patients and Methods: The study was a prospective clinical trial recruiting 49 patients with severe nodulocystic acne. Azithromycin 500mg was given orally thrice weekly for 12 weeks. Four weekly follow up were performed for 3 months to assess clinical response and report any adverse effects. Results: Compared to baseline, there was marked and significant reduction in the number of the inflammatory lesions at 12 weeks of treatment with the clearance of 87.05% of the papules, 90.5% of the pustules and 78.82% of the nodulocysts. At the end of the treatment there was a remarkable clearance of the inflammatory lesions in the majority of ...
Results: After 3 doses of ivermectin, there was a significant reduction in the total count of inf... more Results: After 3 doses of ivermectin, there was a significant reduction in the total count of inflammatory lesions compared to the base line (the mean was reduced from 51.6±27.4 to 21±14.7) (P<0.05). At the end of the two-month follow-up period, more reduction was observed in inflammatory lesions (mean was reduced to 9.3±7), and 62% of the patients showed excellent responses to the treatment (≥ 80% reduction in the lesions). Nausea was reported in 10%.
Tinea incognito is a variant of dermatophyte infection of the skin modified by an erroneously app... more Tinea incognito is a variant of dermatophyte infection of the skin modified by an erroneously applied topical or systemic steroid. Aim of the study: to describe the various clinic-epidemiological aspects of tinea incognito found among our patients. A prospective study was carried out in the Department of Dermatology, Basra Teaching Hospital, Basra, Iraq. The clinical diagnosis was confirmed by mycological tests. Clinical data were described in more detail and the lesions were classified according to the site, shape, and extent. Ninety cases of tinea incognito were seen, median age was 34years. The initial inaccurate diagnoses were eczema in 60 patients (67%), intertrigo in 16 (18 %) and psoriasis in 14 (15%) patients. The type of topical drugs applied was topical corticosteroid (potent and fluorinated) in most cases (54.4%), fixed drug combination creams in 36.6% and a topical calcineurin inhibitor in 5.5%. Commonly presented as acute eczema-like, on hands and trunk, discoid lupus e...
Background: Psoriasis has an increased likelihood of comorbidities compared with healthy controls... more Background: Psoriasis has an increased likelihood of comorbidities compared with healthy controls such as cardiovascular diseases and metabolic syndrome. Objectives: To investigate the risk factors that increases the incidence of cardiovascular diseases and metabolic syndrome in Iraqi patients with psoriasis. Patients & methods: a case-control prospective study enrolled 80 patients with psoriasis and 80 normal individuals as a control group. Psoriasis severity was assessed using PASI(psoriasis area severity index) score, in both groups, blood pressure, BMI(body mass index) & waist circumference were measured, laboratory tests including fasting blood sugar & lipid profile were done. For comparison between the 2 groups, Fisher s exact test were performed. Results: In psoriatic group, calculation of (BMI), showed that 19 (23.8%) were obese, 34 (42.5%) over weight, 27 (38.8%) normal weight. Thirty four patients (42.5%) had an elevated blood pressure, both were significantly correlated with the severity of psoriasis.44 (55%) have abnormal lipid profile, 17 (21.3%) elevated cholesterol, 17(21.3%) had raised LDL & 32 (40%) had low HDL. These were correlated with the severity of psoriasis. Eight (10%) patients had elevated VLDL & 13 (16.3 %) had elevated TG. Twelve (15%) patients had elevated FBS.33 (41.25%) patients were having Metabolic syndrome and the risk was increased with the duration of psoriasis. Comparing with the control group, psoriatic patients were at risk of developing hyperglycemia & hyperlipidemia with statistically significant elevation of fasting blood sugar, cholesterol, LDL, & reduced HDL. Conclusions: Compared with the control group, psoriatic patients in our population had an atherogenic lipid profile with increased prevalence of risk factors for cardiovascular diseases & metabolic syndrome & this was directly correlated with the severity and duration of the disease.
Background: A combination of azithromycin & isotretinoin has been used for treatment of Severe no... more Background: A combination of azithromycin & isotretinoin has been used for treatment of Severe nodulocystic acne before, however, an optimal scheduled doses regimen of such combination remained to be elucidated. Objectives: To evaluate the effectiveness, safety and tolerability of using a new combination of fixed low doses of isotretinoin and azithromycin in an alternative days regimen in treatment of severe nodulocystic acne in Iraqi patients. Patients and Methods: A prospective open-labeled clinical study in which 54 young adult and adolescent patients with severe nodulocystic acne were recruited for the study at the Department of Dermatology in Basra General Hospital during from May-October 2015. The patients were received a combination of fixed dose of isotretinoin 20 mg thrice weekly and 500 mg azithromycin given orally thrice weekly on alternating days and one day off for 12 weeks. The participants was assessed before, during and after treatment. The calculation of percentage and scoring of reduction of acne lesions was also carried out. Results: There was a marked reduction in the inflammatory lesions at the first 4 weeks of the treatment, with a significant clearance of 38.4% of the papular lesions, 63.5% of pustular and 43% of the nodular lesions. At the end of the study, there was a significant reduction in the number of the inflammatory lesions, with the clearance of 76% of the papules, 96% of the pustules and 86% of the nodules. The most frequent adverse effects reported was dryness of face and lips. Conclusion: Fixed dose of azithromycin 500 mg combined with isotretinoin 20 mg on alternating day regimen proved to be effective, safe & well tolerated regimen for treatment of severe nodulocystic acne with high score of patient satisfaction.
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