Publications by authors named "Farzam Gorouhi"

45 Publications

Cutaneous manifestations of COVID-19: a systematic review and analysis of individual patient-level data.

Dermatol Online J 2020 Dec 15;26(12). Epub 2020 Dec 15.

Department of Dermatology, The Permanente Medical Group, South Sacramento, CA Department of Dermatology, University of California, Davis, CA.

Distinctive patterns in the cutaneous manifestations of COVID-19 have been recently reported. We conducted a systematic review to identify case reports and case series characterizing cutaneous manifestations of confirmed COVID-19. Key demographic and clinical data from each case were extracted and analyzed. The primary outcome measure was risk factor analysis of skin related outcomes for severe COVID-19 disease. Seventy-one case reports and series comprising 144 cases of cutaneous involvement in COVID-19 were included. The most frequently occurring morphologies were: morbilliform (30.6%), varicelliform (18.8%), urticarial (13.2%), chilblains-like (12.5%), and acro-ischemic (9%). The median age of patients was 51 years (mean: 45.9, range: 0 to 91). Patients with chilblains-like eruptions had lower frequencies of extracutaneous COVID-19 symptoms (5/18, 27.8%, P<0.05) and were less likely to have severe COVID-19 disease (2/18, 11%, 95% CI 1.4% to 34.7%, P=0.02). Patients with livedoid and acro-ischemic morphologies had severe COVID-19 more frequently than those with other morphologies (17/21, 81%, 95% CI 58.0% to 94.5%, P<0.0001). The most frequently observed cutaneous manifestations of COVID-19 (morbilliform, varicelliform, and urticarial) are well-described patterns of viral exanthems. However, chilblains-like, livedoid, and acro-ischemic morphologies are not traditionally associated with viral infections and were significantly associated with severity of COVID-19 disease.
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December 2020

Novel mutation in patient with flexural and acral hyperpigmented reticulated macules presenting in adolescence.

JAAD Case Rep 2020 Apr 26;6(4):334-336. Epub 2020 Mar 26.

Department of Biochemistry and Molecular Medicine, University of California, Davis, Sacramento, California.

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http://dx.doi.org/10.1016/j.jdcr.2020.02.016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7109565PMC
April 2020

Pancreatic acinar cell carcinoma-induced panniculitis.

JAAD Case Rep 2018 Aug 15;4(7):719-721. Epub 2018 Aug 15.

Department of Dermatology, University of California, Davis, Sacramento, California.

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http://dx.doi.org/10.1016/j.jdcr.2018.05.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6098203PMC
August 2018

Generalized fixed drug eruption to piperacillin/tazobactam and review of literature.

Dermatol Online J 2018 Apr 15;24(4). Epub 2018 Apr 15.

University of California Davis, Sacramento, California.

Fixed drug eruption (FDE) is an adverse drug reaction characterized by the development of well-circumscribed, round, dusky erythematous macules and plaques on cutaneous or mucosal surfaces. The reaction occurs on the same mucosal or cutaneous site with subsequent exposures to the offending drug. Although FDE usually manifests as a single lesion, in rare instances, more than one lesion may arise and this is referred to as a generalized eruption. Herein, we present a 31year-old man with history of cystic fibrosis who developed a generalized fixed drug eruption to piperacillin/tazobactam (Zosyn, Pfizer). We discuss our patient's course and review causes and outcomes of generalized fixed drug eruptions in the literature.
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April 2018

Ultraviolet Radiation Inhibits Mammary Carcinogenesis in an ER-Negative Murine Model by a Mechanism Independent of Vitamin D.

Cancer Prev Res (Phila) 2018 07 10;11(7):383-392. Epub 2018 Apr 10.

Children's Hospital Oakland Research Institute, Oakland, California.

Three decades ago, the Garlands postulated that vitamin D produced in the skin by ultraviolet radiation (UVR)-induced conversion of 7-dehydrocholesterol to pre-D has anticancer effects, thus triggering more than 9,500 publications on D and cancer. Here, we report that UVR treatment of transgenic mice of the well-established C3(1)/SV40 Tag mammary cancer model significantly inhibits both autochthonous carcinogenesis and allograft tumor growth, but in contrast neither dietary nor topical D influences mammary carcinogenesis in this specific mouse model. Furthermore, UVR's inhibitory effects occur irrespective of whether or not the treatment increases circulating D in the mice. The inhibitory effect of UVR on autochthonous tumors occurs at or before the stage of ductal carcinoma in situ. Our studies indicate clearly that UVR can exert D-independent anticancer effects in C3(1)/SV40 Tag mice. Therefore, supplemental D may not mimic all possible beneficial effects of UVR, and uncovering non-D-mediated mechanisms of UVR tumor inhibition may lead to novel strategies for cancer prevention. .
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http://dx.doi.org/10.1158/1940-6207.CAPR-17-0195DOI Listing
July 2018

Prehospital hypertonic fluid resuscitation for trauma patients: A systematic review and meta-analysis.

J Trauma Acute Care Surg 2017 05;82(5):956-962

From the Division of Trauma, Acute Care Surgery, and Surgical Critical Care (C.D.C., F.G., E.S.S., J.M.G.), University of California Davis School of Medicine, Sacramento, California.

Background: Prehospital assessment of a patient's circulation status and appropriate resuscitation with intravenous fluids plays a critical role in patients with obvious hemorrhage or systolic blood pressure below 90 mm Hg.

Objectives: We assessed the efficacy and safety of prehospital administration of crystalloids or colloids to improve the survival rate of trauma patients with acceptable safety profile.

Data Sources: We searched SCOPUS, Embase, TRIP database, Cochrane Central Register of Controlled Trials, Ovid MEDLINE, and PubMed as per search protocol from January 1, 1900 to February 12, 2015.

Study Eligibility Criteria: All randomized controlled trials were considered.

Participants And Interventions: All patients had penetrating or blunt trauma, excluding traumatic brain or thermal injuries. At least one of the comparators should be a crystalloid or colloid.

Study Appraisal And Synthesis Methods: Detailed search strategy was developed and utilized. Duplicates were removed from the search results. We, the co-first authors (C.d.C. and F.G.), independently reviewed the article titles and abstracts to assess eligibility. Eligible articles were downloaded for full text review to determine inclusion in the review and analysis. We (C.d.C. and F.G.) performed a methodological quality assessment of each included article. The primary outcome was mortality. The secondary outcomes included adverse events, infections, multiple organ dysfunction score, and length of stay at the hospital. Heterogeneity was measured by I value. An I value greater than 50% was considered to be substantial heterogeneity. Fixed effect analysis and random effect analysis were performed when needed.

Results: A total of nine trials (3,490 patients) were included in the systematic review, and six trials were included in meta-analyses. There were no significant differences between hypertonic saline with dextran and lactated Ringer's solution in 1 day using two studies (2.91; 95% CI, 0.58-14.54; p = 0.19) and 28- to 30-day survival rates using another two studies (1.47; 95% CI, 0.30-7.18; p = 0.63). Adding dextran to hypertonic saline did not increase the survival rate (0.94; 95% CI, 0.65-1.34; p = 0.71). Overall, complications were comparable between all groups.

Limitations: The quality of some of the included studies is not optimal.

Conclusions And Implications Of Key Findings: There is no beneficial effect of hypertonic saline with or without dextran in general traumatic patients. Further trials to evaluate its benefit in patients with penetrating trauma requiring surgery are warranted.

Level Of Evidence: Systematic review and meta-analysis, level I.
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http://dx.doi.org/10.1097/TA.0000000000001409DOI Listing
May 2017

Combination therapy of autologous adipose mesenchymal stem cell-enriched, high-density lipoaspirate and topical timolol for healing chronic wounds.

J Tissue Eng Regen Med 2018 01 17;12(1):186-190. Epub 2017 Aug 17.

Department of Dermatology, University of California, Davis, Sacramento, CA, USA.

Chronic venous leg ulcers are profoundly debilitating and result in billions in health care expenditure. Thus, there is a quest for engineered and innovative approaches. Herein we present a 63-year-old patient with a 30 year history of venous stasis and left lower extremity ulcers, which have been refractory to standard of care, anticoagulation and venous stripping. The medial ulcer was treated with transplantation of autologous adipose mesenchymal stem cell (AMSC)-enriched, high-density lipoaspirate (HDL) on OASIS wound matrix and compression therapy. The lateral ulcer was treated as a control with standard debridement and compression therapy. Four weeks later, both ulcers received daily topical timolol. Three months later, the test ulcer was completely epithelized and remains healed for over 15 months. However, the control showed minimal signs of improvement. In companion studies in our laboratory, human AMSC were cultured in Minimum Essential Medium Eagle Alpha Modifications (MEMα) with fetal bovine serum (FBS). Timolol was administered to AMSC prior to treatment with epinephrine and 104 bacteria/ml heat-killed Staphylococcus aureus. The MEMα with FBS devoid of AMSC served as a background control. After 24 h, cell culture supernatants and protein lysates were collected to determine cytokine production. There was a statistical significant decrease in pro-inflammatory interleukin-6 and -8 induced by the bacteria (to model the wound environment) in AMSC in the presence of timolol compared with control (p < 0.5). This is the first case of a successful combination of autologous AMSC-enriched, HDL with topical timolol for the healing of chronic venous leg ulcers. Copyright © 2016 John Wiley & Sons, Ltd.
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http://dx.doi.org/10.1002/term.2390DOI Listing
January 2018

A critical review of personal statements submitted by dermatology residency applicants.

Dermatol Res Pract 2014 14;2014:934874. Epub 2014 Sep 14.

University of California, Davis, Sacramento, CA 95816, USA ; Department of Dermatology, University of California, Davis School of Medicine, 3301 C Street, Suite 1400, Sacramento, CA 95816, USA.

Background. A strong personal statement is deemed favorable in the overall application review process. However, research on the role of personal statements in the application process is lacking. Objective. To determine if personal statements from matched applicants differ from unmatched applicants. Methods. All dermatology residency applications (n = 332) submitted to UC Davis Dermatology in the year of 2012 were evaluated. Two investigators identified the characteristics and recurring themes of content present in the personal statements. Then, both investigators individually evaluated the content of these personal statements in order to determine if any of the defined themes was present. Chi-square, Fisher's exact, and reliability tests were used. Results. The following themes were emphasized more often by the matched applicants than the unmatched applicants as their reasons for going into dermatology are to study the cutaneous manifestations of systemic disease (33.8% versus 22.8%), to contribute to the literature gap (8.3% versus 1.1%), and to study the pathophysiology of skin diseases (8.3% versus 2.2%; P ≤ 0.05 for all). Conclusion. The prevalence of certain themes in personal statements of dermatology applicants differs according to match status; nevertheless, whether certain themes impact match outcome needs to be further elucidated.
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http://dx.doi.org/10.1155/2014/934874DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4197885PMC
October 2014

Evidence or experience: that is the question.

Am J Clin Dermatol 2014 Jul;15(3):147-8

Department of Dermatology, University of California, Davis, 3301 C St. Suite 1400, Sacramento, CA, 95816-3367, USA,

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http://dx.doi.org/10.1007/s40257-014-0082-8DOI Listing
July 2014

Dermatology residency selection criteria with an emphasis on program characteristics: a national program director survey.

Dermatol Res Pract 2014 17;2014:692760. Epub 2014 Mar 17.

Department of Dermatology, University of California, Davis, 3301 C Street, Sacramento, CA 95816, USA.

Background. Dermatology residency programs are relatively diverse in their resident selection process. The authors investigated the importance of 25 dermatology residency selection criteria focusing on differences in program directors' (PDs') perception based on specific program demographics. Methods. This cross-sectional nationwide observational survey utilized a 41-item questionnaire that was developed by literature search, brainstorming sessions, and online expert reviews. The data were analyzed utilizing the reliability test, two-step clustering, and K-means methods as well as other methods. The main purpose of this study was to investigate the differences in PDs' perception regarding the importance of the selection criteria based on program demographics. Results. Ninety-five out of 114 PDs (83.3%) responded to the survey. The top five criteria for dermatology residency selection were interview, letters of recommendation, United States Medical Licensing Examination Step I scores, medical school transcripts, and clinical rotations. The following criteria were preferentially ranked based on different program characteristics: "advanced degrees," "interest in academics," "reputation of undergraduate and medical school," "prior unsuccessful attempts to match," and "number of publications." Conclusions. Our survey provides up-to-date factual data on dermatology PDs' perception in this regard. Dermatology residency programs may find the reported data useful in further optimizing their residency selection process.
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http://dx.doi.org/10.1155/2014/692760DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3977115PMC
April 2014

Crosstalk between adrenergic and toll-like receptors in human mesenchymal stem cells and keratinocytes: a recipe for impaired wound healing.

Stem Cells Transl Med 2014 Jun 23;3(6):745-59. Epub 2014 Apr 23.

Department of Dermatology and Institute for Regenerative Cures, University of California, Davis, California, USA; Department of Biological Sciences, California State University, Sacramento, California, USA; Dermatology Service, Department of Veterans Affairs, Northern California Health Care System, Sacramento, California, USA

Previous studies demonstrate that skin wounds generate epinephrine (EPI) that can activate local adrenergic receptors (ARs), impairing healing. Bacterially derived activators of Toll-like receptors (TLRs) within the wound initiate inflammatory responses and can also impair healing. In this study, we examined the hypothesis that these two pathways crosstalk to one another, using EPI and macrophage-activating lipopeptide-2 (MALP2) to activate ARs and TLR2, respectively, in human bone marrow-derived mesenchymal stem cells (BM-MSCs) and neonatal keratinocytes (NHKs). BM-MSCs exposed to EPI significantly (p < .05) increased TLR2 message (sevenfold BM-MSCs), TLR2 protein (twofold), and myeloid differentiation factor 88 (MyD88) (fourfold). Conversely, activation of TLR2 by MALP2 in these cells increased β2-AR message (twofold in BM-MSCs, 2.7-fold in NHKs), β2-AR protein (2.5-fold), phosphorylation of β-AR-activated kinase (p-BARK, twofold), and induced release of EPI from both cell types (twofold). Treating cells with EPI and MALP2 together, as would be encountered in a wound, increased β2-AR and p-BARK protein expression (sixfold), impaired cell migration (BM-MSCs- 21%↓ and NHKs- 60%↓, p < .002), and resulted in a 10-fold (BM-MSCs) and 51-fold (NHKs) increase in release of IL-6 (p < .001) responses that were remarkably reduced by pretreatment with β2-AR antagonists. In vivo, EPI-stressed animals exhibited impaired healing, with elevated levels of TLR2, MyD88, and IL-6 in the wounds (p < .05) relative to nonstressed controls. Thus, our data describe a recipe for decreasing cell migration and exacerbating inflammation via novel crosstalk between the adrenergic and Toll-like receptor pathways in BM-MSCs and NHKs.
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http://dx.doi.org/10.5966/sctm.2013-0200DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4039457PMC
June 2014

Cutaneous and mucosal lichen planus: a comprehensive review of clinical subtypes, risk factors, diagnosis, and prognosis.

ScientificWorldJournal 2014 30;2014:742826. Epub 2014 Jan 30.

Department of Dermatology, University of California Davis, 3301 C Street, Sacramento, CA 95816, USA.

Lichen planus (LP) is a chronic inflammatory disorder that most often affects middle-aged adults. LP can involve the skin or mucous membranes including the oral, vulvovaginal, esophageal, laryngeal, and conjunctival mucosa. It has different variants based on the morphology of the lesions and the site of involvement. The literature suggests that certain presentations of the disease such as esophageal or ophthalmological involvement are underdiagnosed. The burden of the disease is higher in some variants including hypertrophic LP and erosive oral LP, which may have a more chronic pattern. LP can significantly affect the quality of life of patients as well. Drugs or contact allergens can cause lichenoid reactions as the main differential diagnosis of LP. LP is a T-cell mediated immunologic disease but the responsible antigen remains unidentified. In this paper, we review the history, epidemiology, and clinical subtypes of LP. We also review the histopathologic aspects of the disease, differential diagnoses, immunopathogenesis, and the clinical and genetic correlations.
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http://dx.doi.org/10.1155/2014/742826DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3929580PMC
January 2015

Epidermal growth factor-functionalized polymeric multilayer films: interplay between spatial location and bioavailability of EGF.

J Invest Dermatol 2014 Jun 3;134(6):1757-1760. Epub 2014 Jan 3.

Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, California, USA; Department of Ophthalmology & Vision Science, School of Medicine, University of California, Davis, Davis, California, USA. Electronic address:

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http://dx.doi.org/10.1038/jid.2014.7DOI Listing
June 2014

Catecholamine stress alters neutrophil trafficking and impairs wound healing by β2-adrenergic receptor-mediated upregulation of IL-6.

J Invest Dermatol 2014 03 11;134(3):809-817. Epub 2013 Oct 11.

Department of Dermatology, School of Medicine, University of California at Davis, Davis, California, USA; Dermatology Section, Department of Veterans Affairs, Northern California Health Care System, Mather, California, USA. Electronic address:

Stress-induced hormones can alter the inflammatory response to tissue injury; however, the precise mechanism by which epinephrine influences inflammatory response and wound healing is not well defined. Here we demonstrate that epinephrine alters the neutrophil (polymorphonuclear leukocyte (PMN))-dependent inflammatory response to a cutaneous wound. Using noninvasive real-time imaging of genetically tagged PMNs in a murine skin wound, chronic, epinephrine-mediated stress was modeled by sustained delivery of epinephrine. Prolonged systemic exposure of epinephrine resulted in persistent PMN trafficking to the wound site via an IL-6-mediated mechanism, and this in turn impaired wound repair. Further, we demonstrate that β2-adrenergic receptor-dependent activation of proinflammatory macrophages is critical for epinephrine-mediated IL-6 production. This study expands our current understanding of stress hormone-mediated impairment of wound healing and provides an important mechanistic link to explain how epinephrine stress exacerbates inflammation via increased number and lifetime of PMNs.
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http://dx.doi.org/10.1038/jid.2013.415DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4013292PMC
March 2014

Allergic contact dermatitis to metal allergens in Iran.

Int J Dermatol 2013 Dec 14;52(12):1513-8. Epub 2013 Mar 14.

Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran.

Background: Metallic allergens such as nickel are among the most common causes of allergic contact dermatitis (ACD), but frequencies of contact dermatitis to these allergens may vary in different areas.

Objectives: This study aimed to determine the frequencies of ACD caused by three common metallic allergens: nickel sulfate; potassium dichromate; and cobalt chloride.

Methods: Data for 1137 patients with clinical diagnoses of contact dermatitis and/or atopic dermatitis evaluated by patch testing in Iran during a 5-year period were retrospectively studied to establish the frequencies of hypersensitivity to these metallic allergens.

Results: A total of 313 patients (27.5%) gave positive patch test results for at least one metallic allergen. Allergy to nickel (229 cases, 20.0%) was the most commonly observed, followed by allergy to cobalt (90 cases, 8.0%) and allergy to chromium (70 cases, 6.2%). Nickel allergy was significantly more frequent in females and in subjects aged <40 years, whereas chromium hypersensitivity was more common in males and in subjects aged >40 years. Sensitivity to nickel or chromium was a risk factor for cobalt allergy.

Conclusions: Nickel was most commonly identified as a metallic allergen in Iran and tended to affect women aged <40 years. Regulations pertaining to nickel release may decrease the frequency of nickel hypersensitivity in Iran.
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http://dx.doi.org/10.1111/j.1365-4632.2012.05623.xDOI Listing
December 2013

Treatment of female pattern hair loss.

Skinmed 2012 Jul-Aug;10(4):218-27

Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Female pattern hair loss (FPHL) as a distinctive entity was first described about 30 years ago. The objective of this study was to perform a systematic review of all randomized controlled trials for treatment of FPHL. A preliminary search was carried out in several databases up to August 2008 to identify all randomized controlled trials on nonsurgical interventions for treatment of FPHL. Studies reporting fewer than 10 patients and non-English articles were excluded. Additionally, references of relevant articles and reviews were checked manually in search for additional sources. Among 238 citations found in the preliminary search, 12 fulfilled all criteria to be included in the systematic review. Topical minoxidil 1% to 5% for 24 to 48 weeks was shown to be effective in FPHL and its effect was not related to age or androgen level of patients. In addition, it may be effective in women with FPHL, both with and without hyperandrogenism, and in young and old premenopausal or postmenopausal. In patients with increased serum androgens, oral flutamide but not finasteride or cyproterone acetate was more effective than no treatment. Topical minoxidil is effective in patients with FPHL, with or without hyperandrogenism, but there is limited evidence for the efficacy of antiandrogens.
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October 2012

Pulsed dye laser treatment with different onset times for new surgical scars: a single-blind randomized controlled trial.

Lasers Med Sci 2012 Sep 8;27(5):1095-8. Epub 2012 Jan 8.

Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, 415 Taleghani Ave, Tehran, 14166, Iran.

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http://dx.doi.org/10.1007/s10103-011-1044-5DOI Listing
September 2012

Fox-Fordyce disease exacerbated by hyperhidrosis.

Pediatr Dermatol 2010 Mar-Apr;27(2):162-5

University of California, Davis, School of Medicine, CA, USA.

Fox-Fordyce disease is an uncommon disorder primarily affecting postpubertal females. It is characterized by intensely pruritic, papular eruptions in apocrine-gland bearing regions. Rarity and scant literature have resulted in a lack of definitive treatment options or pathognomonic diagnostic indicators. We report a 16-year-old boy with typical findings of Fox-Fordyce disease including numerous, grouped, rounded (1-3 mm), skin-colored papules confined to the axillary and periareolar areas, bilaterally. These lesions started before puberty, and were exacerbated by hyperhidrosis.
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http://dx.doi.org/10.1111/j.1525-1470.2010.01102.xDOI Listing
September 2010

Unwanted facial hair removal with laser treatment improves quality of life of patients.

J Cosmet Laser Ther 2010 Feb;12(1):7-9

Army University of Medical Sciences, Tehran, Iran.

Background: Unwanted facial hair can have adverse psychological effects on women and reduce their quality of life.

Objective: To assess the effects of unwanted facial hair removal with laser on improving quality of life.

Methods: In this study, 70 patients treated for unwanted facial hair by laser were assessed by Dermatology Life Quality Index (DLQI) questionnaire on admission and 3 months later after three sessions of laser treatment.

Results: The DLQI score before treatment was 9.42 +/- 5.99, which was reduced to 3.12 +/- 3.40 after laser treatment (p <0.05).

Conclusion: Unwanted facial hair removal with laser can improve the quality of life of patients.
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http://dx.doi.org/10.3109/14764170903449802DOI Listing
February 2010

Comparison of seropositivity of human T lymphotropic virus type 1 in mycosis fungoides patients and normal volunteers: a case-control study and review of literature.

Indian J Dermatol Venereol Leprol 2009 Jul-Aug;75(4):363-7

Razi Skin Hospital, Department of Dermatology and Center for Research & Training in Skin Diseases & Leprosy, Medical Sciences/University of Tehran, Tehran, Iran.

Background: There have been controversial reports about the possible association between mycosis fungoides (MF), its leukemic variant Siotazary syndrome (SS) and human T lymphotropic virus type 1 (HTLV-1) in different geographical regions.

Aims: The purpose of this study was to explore any association between MF and presence of HTLV-1 infection in Iran.

Methods: In a case-control setting, 150 clinically and histopathologically proven MF patients had been admitted to the tertiary referral skin center during a 10-year period and another 150 normal volunteers had been compared with each other for the presence of HTLV-1 infection. Enzyme-linked immunosorbent assay (ELISA) was used to detect antibodies against HTLV-1, and positive results were confirmed with western blotting.

Results: Only three MF patients had HTLV-1 infection, whereas two cases of normal subjects had the infection (P > 0.05). The only three seropositive MF patients were male and from North-Eastern Iran.

Conclusion: This study showed that MF does not correlate with HTLV-1 infection in Iran.
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http://dx.doi.org/10.4103/0378-6323.53131DOI Listing
March 2010

A neglected issue in interpretation of results of randomized controlled trials: informative censoring.

Dermatol Online J 2009 Jan 15;15(1):13. Epub 2009 Jan 15.

The presence of informative censoring is a commonly neglected issue that can lead to inaccurate results in randomized controlled trials. It is mandatory to perform an intention to treat analysis to minimize this source of error.
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January 2009

Comparison of long-pulsed alexandrite and Nd:YAG lasers, individually and in combination, for leg hair reduction: an assessor-blinded, randomized trial with 18 months of follow-up.

Arch Dermatol 2008 Oct;144(10):1323-7

Department of Dermatology, Baqiyatallah University of Medical Sciences, Tehran, Iran.

Objective: To compare the long-term effectiveness and safety of long-pulsed Nd:YAG and alexandrite lasers, individually and in combination, in long-term leg hair reduction.

Design: Randomized, single-center, within-participant, investigator-blinded, active-controlled clinical trial.

Setting: Private skin laser center.

Participants: Twenty individuals aged 16 to 50 years with skin phototypes III and IV.

Interventions: The medial and lateral sides of each participant's legs were randomly assigned to receive 1 of the following laser treatments: (1) long-pulsed 1064-nm Nd:YAG laser (12-mm spot size); (2) long-pulsed 755-nm alexandrite laser (12-mm spot size); (3) long-pulsed 755-nm alexandrite laser (18-mm spot size); and (4) a combination of long-pulsed 1064-nm Nd:YAG laser and long-pulsed 755-nm alexandrite laser (treatments 1 and 2). Identified areas were treated for a total of 4 sessions at 8-week intervals.

Main Outcome Measures: Hair reduction from baseline based on hair counting with digital photography by 2 blinded assessors, 8 and 18 months after the last treatment session.

Results: Fifteen participants completed the trial. The mean (SD) hair reduction 18 months after the last treatment, as measured by the assessors from digital photographs, were 75.9% (19.0%) for the 12-mm spot size alexandrite laser, 84.3% (12.4%) for the 18-mm spot size alexandrite laser, 73.6% (11.4%) for the Nd:YAG laser, and 77.8% (15.9%) for the combination therapy (analysis of variance, P > .05). The incidence of adverse effects (hyperpigmentation) and pain severity were significantly greater in areas that received combination therapy (P = .001).

Conclusions: After 18 months of follow-up, alexandrite and Nd:YAG lasers were efficacious for leg hair removal. Combination therapy did not have any additional benefit and caused more adverse effects.
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http://dx.doi.org/10.1001/archderm.144.10.1323DOI Listing
October 2008

Cutaneous leishmaniasis.

Lancet Infect Dis 2008 Aug;8(8):458; author reply 458-9

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http://dx.doi.org/10.1016/S1473-3099(08)70159-2DOI Listing
August 2008

A randomized investigator-blind trial of different passes of microdermabrasion therapy and their effects on skin biophysical characteristics.

Int J Dermatol 2008 May;47(5):508-13

Center for Research & Training in Skin Diseases and Leprosy, Medical Sciences, University of Tehran, Tehran, Iran.

Background: Microdermabrasion (MDA) is a safe, simple, and beneficial technique for superficial skin resurfacing. Despite its popular usage, few studies have assessed the efficacy of different MDA protocols applied at the present time. Objectives To assess the effects of MDA generally, as well as to compare the effects of two vs. three passes of MDA in each session for a total number of six therapeutic sessions on skin biophysical characteristics.

Methods: In this randomized, investigator-blind, split-face study, 10 patients underwent a series of six MDA treatments with an interval of 2 weeks. One side of the face was treated with two passes of MDA and the other side was treated with three passes, randomly. Stratum corneum hydration, sebum secretion, and skin pH measurements were obtained before and after the procedure on all sessions and also 1 and 4 weeks after the last treatment.

Results: After six sessions of MDA, a decrease in sebum content compared to baseline was shown at the end of treatment sessions, but no statistical difference was observed between two vs. three passes groups (-30.0 [interquartile range, IQR = 50.0] vs. -27.5 [IQR = 125.3], respectively, P = 0.58). Comparison of two treatment groups showed significant higher values of sebum content in the first follow-up after treatment with three passes of MDA. (64.0 [IQR = 52.0] for three passes vs. 45.0 [IQR = 46.0] for two passes, P = 0.04) A significant increase was observed in pH values at the end of treatment series, first and second follow-up after treatment with two passes of MDA.

Conclusions: MDA may have remarkable effects on skin barrier function changes resulting in skin clinical improvements (Cochrane Skin Group identifier: CSG No. 37).
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http://dx.doi.org/10.1111/j.1365-4632.2008.03583.xDOI Listing
May 2008

Corneal stability after discontinued soft contact lens wear.

Cont Lens Anterior Eye 2008 Jun 14;31(3):122-5. Epub 2008 Mar 14.

Farabi Eye Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Purpose: To determine the time needed to reach corneal stability after discontinued daily wear of soft contact lenses and to identify corneal topographic and pachymetric changes during this period.

Methods: We prospectively studied the eyes of 21 consecutive soft contact lens wearers evaluated for keratorefractive surgery. Each eye was examined once immediately after lens removal, 3 and 7 days later, and weekly thereafter. At each visit, manifest refraction, keratometry, corneal topography (EyeSys Corneal Analysis system, EyeSys Laboratories, Houston, TX) and pachymetry were performed. Incidence of associated corneal warpage and changes in corneal curvature and thickness during corneal stability time were determined.

Results: Of the 42 eyes examined, 26 corneas showed no significant change after the initial evaluation (stable group). The minimum stability time was 3 days in the remaining 16 eyes (unstable group), 7 of which had significant evidence of abnormal topography. Statistical analysis showed no significant differences between two groups regarding age, sex, duration of contact lens wear, and refractive and topographic measures. The mean central corneal thickness on the final visit was significantly different between two groups (P<0.05).

Conclusion: Contact lens induced corneal warpage may occur in a considerable proportion of soft contact lens wearers. A 2-week contact lens free period seems to be adequate for the cornea to stabilize; however, one cannot predict the minimum time needed for each individual patient. Repeating examinations to document corneal stability before refractive surgery may be a safer alternative.
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http://dx.doi.org/10.1016/j.clae.2008.02.001DOI Listing
June 2008

Giant bilateral becker nevus: a rare presentation.

Pediatr Dermatol 2008 Jan-Feb;25(1):47-51

Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran.

A 14-year-old boy had giant confluent brown patches that were bilaterally distributed on his back, chest, and upper arms, and partially covered by dark coarse hairs. A clinical diagnosis of Becker nevus was made and confirmed histopathologically. We report this patient for the rarity of presentation. Different clinical features of Becker nevi, associated findings, differential diagnoses, and treatment options are discussed.
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http://dx.doi.org/10.1111/j.1525-1470.2007.00581.xDOI Listing
April 2008

Respiratory rate within the first hour of ascent predicts subsequent acute mountain sickness severity.

Arch Iran Med 2008 Mar;11(2):152-6

Department of Neurology, Tehran University of Medical Sciences, Tehran, Iran.

Background: Altitude illness results from hypobaric hypoxia at altitudes higher than 2500 meters above sea level. To determine whether vital signs can be used as predictors for severe acute mountain sickness, we carried out a prospective observational study.

Methods: A cohort of 90 individuals (male/female ratio: 2; age: 13 - 65 years) in a mountain hotel's clinic at 3450 meters in Iran were studied from September through October 2006. Demographics and vital signs were measured during the first hour of ascent. The individuals were followed for acute mountain sickness symptoms including headache, dizziness, nausea or vomiting, insomnia, and fatigue. Lake Louise criteria were used to diagnose acute mountain sickness. Severe acute mountain sickness was considered if a score of equal or more than 5 was present. Significance was assigned to values of P<0.05.

Results: Acute mountain sickness was diagnosed in 34 (37.8%) participants after 24 hours of ascent. Severe acute mountain sickness was detected in 14 (15.6%) participants. A respiratory rate of 20 or more during the first hour of ascent was recorded for nine (64.3%) patients with severe acute mountain sickness and 15 (19.7%) individuals in the negative/mild acute mountain sickness group. This suggests an association between early high respiratory rates and risk of subsequent severe acute mountain sickness (P=0.001).

Conclusion: There is an association between a rise in the respiratory rate and susceptibility to acute mountain sickness. This can enable us to predict severe acute mountain sickness and prevent it. Furthermore, Tochal Mountain Hotel guests should be aware of the risk of acute mountain sickness and should be recommended to use prophylactic acetazolamide or dexamethasone before ascent.
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http://dx.doi.org/08112/AIM.006DOI Listing
March 2008

Treatment of traumatic tattoo with the Q-switched Nd:YAG laser.

J Cosmet Laser Ther 2007 Dec;9(4):253-5

Center for Research and Training in Skin Diseases and Leprosy, Medical Sciences / University of Tehran, Tehran, Iran.

Traumatic tattoos are undesirable tattoos caused by different foreign bodies such as fireworks' particles, sand, metals, glass, gunpowder, asphalt, dust, or petroleum products embedded forcefully in the dermis. We report the case of a 54-year-old man who presented with sand and asphalt tattooing on his face following a bomb explosion 15 years ago. Q-switched Nd:YAG laser at a wavelength of 1064 nm with a spot size of 4 mm and a fluence of 7.96 J/cm(2) were applied to treat the patient. The patient tolerated the treatment very well. Most of the blue dots became whitened immediately after the procedure and remained almost clear after a 6-month follow-up.
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http://dx.doi.org/10.1080/14764170701708263DOI Listing
December 2007