Pedram Alirezaei - Academia.edu (original) (raw)

Papers by Pedram Alirezaei

Biological Trace Element Research

Background Despite the exact etiopathogenesis of psoriasis remains unknown, the increasing or dec... more Background Despite the exact etiopathogenesis of psoriasis remains unknown, the increasing or decreasing of some trace elements and oxidative stress status are considered to play a role. In this study, the effect of Lactocare® synbiotic on the serum levels of trace elements including Zn, Cu, Mg, Na, Fe, P, Ca, and K in the patients with mild to moderate psoriasis was investigated. Methods Sixty-four patients with mild to moderate psoriasis were included. Patients were randomly divided into treatment (n═32) and control (n═32) groups. The treatment group received Lactocare® and the control group received a placebo (two times daily for 12 weeks). Eight patients from the intervention group and 18 patients from the control group discontinued the study because of the recent COVID-19 condition. For routine trace element analysis, the blood samples were collected from all patients at the baseline as well as week 12 post-treatment. The serum was then isolated and the serum levels of trace elements including Fe, K, Ca, Mg, P, Zn, Na, and Cu were measured using an automatic electrolyte analyzer. For confirmation of the effect of Lactocare® on the alteration of serum levels of trace elements, intra-group analysis was performed at two interval times: baseline and week 12 post-treatment. Results The serum levels of K, P, and Ca in the placebo group were significantly higher than that of the treatment group at baseline. Serum levels of Zn and Ca were significantly higher in the treatment group compared to the placebo group at week 12 post-treatment. Moreover, a significantly lower serum level of K, P, and Ca in the treatment group at the baseline compared to the placebo group was compensated on week 12 post-treatment. Intra-group analysis in the treatment group showed that the serum levels of Fe, Ca, Mg, P, Zn, and Na was significantly increased at week 12 post-treatment compared to baseline levels. Whereas, intra-group analysis in the control group showed only Ca has a significant difference between baseline and week 12 post-treatment. Conclusion The serum levels of Fe, Zn, P, Mg, Ca, and Na are increased significantly 12 weeks after oral administration of Lactocare® in psoriatic patients. The serum level of Fe and Cu is affected by sex at pre-and post-treatment. This study supports the concept that Lactocare® exerts beneficial effects in the gastrointestinal tract to improve mineral absorption in psoriatic patients.

$Research paper thumbnail of Comparison of the efficacy of fractional CO2 laser with microneedling in management of patients with atrophic acne scars: a single-blind clinical trial$

Journal of Dermatology and Cosmetic, Jan 10, 2021

پزشکی بالینی ابن سینا, Mar 1, 2019

Background and Objective: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are... more Background and Objective: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe and potentially life-threatening reactions. In spite of the low prevalence of these conditions, they are of utmost significance due to their catastrophic complications and mortality. The SJS and TEN are mostly caused by a reaction to a drug; however, in some cases, they result from infections. The aim of this study was to investigate the epidemiologic, etiologic, and clinical characteristics of the patients admitted to Sina Hospital in Hamadan, Iran, due to SJS and TEN during a 16-year period. Materials and Methods: This cross-sectional descriptive study was conducted on the patients with SJS and TEN admitted to Sina Hospital during the last 16 years (i.e., 2002-2018). The data analyzed in the present study included age, gender, causative drug, length of hospital stay, received treatment, and complications. Results: A total of 47 patients, consisting of 21 males and 26 females, were investigated in this study. Out of the 47 patients, 34, 9, and 4 cases were diagnosed with SJS, TEN, and SJS/TEN overlap, respectively. Regarding the etiology of these conditions, 45 cases (95.7%) were drug-related, while the remaining 2 cases were caused by reasons other than drugs. The most common causative drugs were antimicrobials (36.1%), followed by antiepileptics (27.6%) and nonsteroidal anti-inflammatory drug (17 %). Furthermore, there one case caused by reaction to allopurinol, and another case resulted from reactions to rabies vaccine. The remaining cases were either non-drug related or multi-drug related. The most common complications were infections (21.2%), followed by ocular problems (19.1%) and gastrointestinal bleeding (2.1%). Conclusion: As the findings indicated, antimicrobials were the most common causative drugs of SJS and TEN. The physicians should be aware of the clinical manifestations of SJS and TEN with regard to the severe complications of these conditions, including ocular damages, and their risk of mortality. Moreover, it is required to enhance public awareness regarding the avoidance of self-medication with antimicrobial drugs.

Dermatology Reports, Jun 25, 2020

Warty dyskeratoma is an uncommon benign skin lesion, which is mostly limited to the head or neck ... more Warty dyskeratoma is an uncommon benign skin lesion, which is mostly limited to the head or neck and is rarely seen in other areas of the skin or mucous membranes. Although it is clinically similar to many skin lesions, its distinctive histopathologic features help distinguish it from other identical lesions. Herein, we report a case of warty dyskeratoma in a very unusual site (lateral border of the tongue) in a 56-year-old woman.

Dermatology Research and Practice, Oct 7, 2022

Background. Attention to the administration of probiotics for the treatment of psoriasis has rece... more Background. Attention to the administration of probiotics for the treatment of psoriasis has recently increased. Aim. In the present study, improvements in dermatology life quality index (DLQI), psoriasis area severity index (PASI), and visual analogue scale (VAS) scores in the psoriasis patients receiving Lactocare ® probiotic were compared to psoriasis patients receiving placebo. Methods. A total of 52 psoriasis patients were included in this study and randomly divided into treatment and placebo (control) groups. e control group received topical hydrocortisone associated with placebo; in the treatment group, Lactocare ® was administrated orally associated with hydrocortisone. e mean of VAS, DLQI, and PSAI scores was recorded and evaluated pretreatment and post-treatment in both groups for 3 months. e mean of the scores in the control groups was compared to the treatment group. Intragroup analysis was preformed with a comparison of the mean of these scores at baseline 4-, 8-, and 12-weeks post-treatment. Results. In the treatment group, a signi cant decrease was seen in PASI, VAS, and DLQI scores compared to the control group on week 12 post-treatment. Conclusion. Oral administration of Lactocare ® probiotic (two times daily) associated with administration of topical hydrocortisone resulted in the improvement of PASI, DLQI, and VAS scores in the patients with psoriasis after 12 weeks of treatment. PASI reduction occurred in all patients who received probiotics.

پزشکی بالینی ابن سینا, Mar 1, 2017

Introduction: Parry-Romberg syndrome, a rare syndrome, is characterized by progressive atrophy af... more Introduction: Parry-Romberg syndrome, a rare syndrome, is characterized by progressive atrophy affecting one side of the face. This disease can include the skin, subcutaneous tissue, muscles, cartilage, and underlying bony structures. Case Presentation: A 27-year-old female was admitted to the outpatient clinic of dermatology of Farshchian Hospital, with chief complaint of asymmetric facial appearance. The asymmetry started at the age of 16 and developed over a period of 4 years, then stopped. A physical examination revealed that the right side of her face, especially her chin was smaller than the left side, and there was loss of subcutaneous fat, which was associated with skin tightness. There were no systemic symptoms of other illnesses or other signs. Conclusion: The disease is self-limiting, yet, can be associated with systemic involvement such as neurological disorders. Clinical symptoms are the keys of diagnosis. A muli-lateral approach is essential to control the disease.

KAUMS Journal, Dec 15, 2015

Background: Amyloidosis is an uncommon disorder characterized by deposition of insoluble patholog... more Background: Amyloidosis is an uncommon disorder characterized by deposition of insoluble pathologic amyloid fibrils in different tissues and has two main forms: systemic and localized. Primary systemic amyloidosis, as the most common type of systemic amyloidosis, is a clonal plasma cell disorder and ischemic stroke has been sporadically reported as its complication. Case Presentation: The patient was an 88-year-old man with reduced muscle force in his right side of the body, dysarthria on the morning of admission, and a history of skin lesions. Multiple ecchymotic skin lesions all over the body especially head and neck areas along with macroglossia were observed in skin and mucous membrane examination. Neurologic examination revealed hemiplegia of the right side and reduced but symmetric deep tendon reflexes, along with drowsiness and global aphasia. In brain computed tomography, extensive infarction of left cerebral hemisphere was observed and after skin biopsy, diagnosis of amyloidosis was confirmed. Due to massive infarction of one cerebral hemisphere and extensive skin lesions, the patient died ten days later. Conclusion: Extensive ischemic stroke may occur as a complication of primary systemic amyloidosis. Therefore, in every patient presenting with extensive ecchymotic skin lesions and stroke, this differential diagnosis should be considered. Moreover, the occurrence of ischemic stroke as the complication of primary systemic amyloidosis may lead to poor prognosis.

Avicenna Journal of Clinical Medicine

Background and Objective: Seborrheic dermatitis is a common inflammatory skin disease characteriz... more Background and Objective: Seborrheic dermatitis is a common inflammatory skin disease characterized by erythema, scaling, and pruritus. Antifungals are among the most commonly prescribed drugs for the treatment of this disease. In this regard, the present study investigated the efficacy of two medications including clotrimazole 1% and sertaconazole 2% in the treatment of adult seborrheic dermatitis. Materials and Methods: This double-blinded randomized clinical trial was performed on 100 patients over the age of 18 with seborrheic dermatitis referring to Farshchian hospital, Hamadan, Iran. Patients were randomly assigned to two groups. The participants in one group received sertaconazole twice a day for four weeks and another group received clotrimazole within this period of time. After two weeks, the patients were examined in terms of clinical symptoms and side effects of medications. Moreover, they were reexamined for recurrence of disease after the completion of treatment and four weeks later. Furthermore, the level of patients' satisfaction was evaluated four weeks after treatment. Results: Mean and standard deviation of Scoring Index 7.16±2.20 and 6.45±2.10 before treatment (P=0.184), 4.08 ± 1.82 and 2.78 ± 2.14 two weeks after treatment (P<0.001), and 2.62 ± 2.13 and 0.89 ± 1.09 four weeks after the end of treatment (P<0.001). Additionally, the relapse rate in clotrimazole and sertaconazole groups was found to be 32% and 21.7%, respectively. Furthermore, the complication rate was reported as 8% and 8.5% in clotrimazole group and sertaconazole group, respectively (P=0.220). Moreover, the rate of good satisfaction in clotrimazole and sertaconazole groups was reported as 38% and 71.1% (P<0.001), respectively. Conclusion: Based on the results of the study, the frequency of complications and recurrence of disease in patients treated with sertaconazole was comparable to treatment with clotrimazole. However, sertoconazole was found to be more effective and bring more satisfaction to patients.

Dermatology Research and Practice

Clinical, Cosmetic and Investigational Dermatology

Background: There are overlapping features in histopathologic characteristics of psoriasis and ch... more Background: There are overlapping features in histopathologic characteristics of psoriasis and chronic dermatitis, which sometimes make the correct diagnosis difficult. Objective: The aim of this study was to compare the histopathologic diagnostic features of psoriasis with chronic dermatitis quantitatively. Patients and methods: In this study, 30 patients with psoriasis and 30 patients with chronic dermatitis were included. Diagnosis of psoriasis or chronic dermatitis was based on clinicopathologic correlation. Photos of histopathologic slides were provided by LABOMED Digital Camera and LABOMED Microscope. Width and length of rete ridges, minimal thickness of suprapapillary plates, thickness of epidermis, thickness of hyperkeratotic layer, and minimal thickness of granular layer were determined using Pixel Pro software on micrometer scale. Results: Suprapapillary plates and granular layer were significantly thicker in patients with chronic dermatitis compared with patients with psoriasis. The rete ridges were longer and wider, the epidermis was thicker, and the parakeratotic layer was also thicker in patients with psoriasis compared with patients with chronic dermatitis, and the difference between these corresponding parameters in the two groups was statistically significant except for thickness of parakeratotic layer. Moreover, the mean ratio of minimal suprapapillary plate's thickness to epidermal thickness and the mean ratio of minimal granular layer's thickness to parakeratotic layer's thickness were significantly higher in patients with chronic dermatitis compared with those with psoriasis. Conclusion: Despite overlapping histopathologic features in psoriasis and chronic dermatitis, quantitative histopathologic criteria might be valuable for differentiation of these two conditions. Ratios of minimal suprapapillary plate's thickness to epidermal thickness and minimal granular layer's thickness to parakeratotic layer's thickness can be particularly helpful in this regard.

Journal of Dermatology and Cosmetic, May 10, 2021

Journal of Dermatology and Cosmetic, Oct 10, 2020

White sponge nevus is a rare benign autosomal dominant disorder with variable penetrance. It is c... more White sponge nevus is a rare benign autosomal dominant disorder with variable penetrance. It is characterized by asymptomatic white plaques affecting mainly the oral mucosa. Careful clinical and histopathological examination is indicated to exclude other more serious conditions presenting as oral white lesions. Herein, we present a new case of oral white sponge nevus in a 17-year-old Iranian male with no familial background.

KAUMS Journal, 2015

Journal of Dermatology and Cosmetic, 2019

Scientific Journal of Hamadan University of Medical Sciences, 2016

Introduction & Objective: Skin tag is a soft, small and pedunculated lesion that is usually l... more Introduction & Objective: Skin tag is a soft, small and pedunculated lesion that is usually located on the skin folds like neck and axilla. The relationship between skin tags and dyslipidemia has been reported in several studies. This study was conducted with the aim of comparing serum lipid levels in skin tag affected subjects with healthy individuals. Materials & Methods: In this case-control study, lipid profile (serum levels of total cholesterol, triglyceride, low density lipoprotein (LDL) and high density lipoprotein (HDL)) of skin tag affected patients presenting to dermatology clinic of Farshchian hospital (Hamadan, Iran) was compared with lipid profile of individuals presenting to the same clinic for the reasons other than skin tags. All the data collected were analyzed with SPSS16 software. Results: In this study, lipid profile of 49 skin tag affected individuals was compared with lipid profile of 49 individuals not affected by such lesion. Mean serum levels of total cholesterol, triglyceride, LDL and HDL were significantly higher in the affected group in comparison to control group (P<0.05). Conclusions: This study showed that the presence of skin tags could be related to increased levels of serum lipids. It is recommended that physicians consider the possibility of dyslipidemia in patients presenting with these skin lesions. (Sci J Hamadan Univ Med Sci 2016; 23 (1):34-39)

Acta medica Iranica, 2017

Dermatology Reports, 2020

Clinical, Cosmetic and Investigational Dermatology, 2020

The association of androgenetic alopecia (AGA) with cardiovascular risk factors including hyperte... more The association of androgenetic alopecia (AGA) with cardiovascular risk factors including hypertension, smoking and high body mass index (BMI) has been investigated in several studies. However, the results are discrepant. The aim of the present study was to evaluate the association of AGA with anthropometrics, blood pressure and lifestyle habits. Patients and Methods: In this case-control study, 256 men with AGA and 256 agematched healthy controls were evaluated. Systolic and diastolic blood pressures, as well as anthropometric indices were measured. Data on lifestyle habits including smoking, hookah use and alcohol consumption were also collected. Results: Patients with AGA had significantly lower BMI and lower waist to hip ratio as compared to controls (p = 0.012 and p = 0.002, respectively). Other anthropometrics as well as mean systolic and diastolic blood pressures were not significantly different between the two groups. There was no significant difference between patients and controls in terms of lifestyle habits. Patients with severe AGA (Norwood-Hamilton classification type IV-VII) had significantly higher systolic and diastolic blood pressures as compared to those with mild to moderate AGA (Norwood-Hamilton classification type II, III), but the mean age of the former group was also significantly higher (p < 0.001). Conclusion: In contrast to some previous studies, our findings did not show a significant association between certain cardiovascular risk factors (such as hypertension and smoking) and AGA. Although lower BMI and lower waist to hip ratio were observed in the patient group, these values were within normal limits and therefore not biologically significant.

Clinical, Cosmetic and Investigational Dermatology, 2018

Background: Malignant melanoma of the skin is a potentially lethal neoplasm that generally origin... more Background: Malignant melanoma of the skin is a potentially lethal neoplasm that generally originates from atypical melanocytes in the dermal-epidermal junction. When the neoplasm penetrates into the dermis, several variables can affect the extent of its spread, among which depth of invasion has the most important prognostic value. Mitotic rate is another prognostic factor that reflects the biological behavior of the neoplasm. Objective: This study was designed to evaluate the probable relationship between the depth of invasion of malignant melanoma and its mitotic rate. Materials and methods: This study was performed on 50 excisional biopsy specimens that had received the diagnosis of malignant melanoma histopathologically. Tumor characteristics including Breslow thickness, Clark level, T-stage, and tumor mitotic rate were recorded. Results: We observed that at higher Clark levels and higher T-stages, and the mean mitotic rate was significantly increased. Moreover, there was a positive and significant correlation between Breslow thickness and mitotic rate. We demonstrated that one unit increase in mitotic rate was correlated with 0.8 mm increase in Breslow thickness of the tumor. Conclusion: In malignant melanoma, mitotic activity may probably indicate the depth of tumor invasion. Therefore, in incisional biopsies where depth of invasion cannot be accurately determined, the mitotic activity may be used to estimate Breslow thickness, which is necessary for planning surgical management.