Journal of the Saudi Society of Dermatology & Dermatologic Surgery最新文献

Psoriasis is a chronic, noncontiguous, inflammatory, multisystem disease with predominantly skin and joint manifestations affecting approximately 2% of the population. There is a genetic predisposition to psoriasis and has tendency to wax and wane with flares related to systemic or environmental factors, including life stress events and infection.

Majority of patients with psoriasis have limited disease (5% body surface area involvement) and can be treated with topical agents, which generally provide a high efficacy-to-safety ratio.

To optimize the topical treatment of psoriasis in Saudi Arabia, the Saudi Society of Dermatology and Dermatologic surgery (SSDDS) have initiated a project to develop guidelines for the management of psoriasis. The guidelines are based on German and American one with subsequent discussion with experts in the field; they have been approved by a team of dermatology experts.

Granular cell tumor (GCT) is uncommon, mostly benign neoplasm that can affect any organ of the body; immunohistochemical studies showed that it has a Schwann cell origin through the positive identification of S-100 protein. GCT can affect both sexes and in any age, although it is most common in females and dark skinned population. The most common occurrence is during the fourth to sixth decades of life, very rarely it occurs as congenital disease. The common locations are the head and neck, the tongue is affected in 25% of cases but any internal organs can be affected such as larynx, bronchus, stomach, rectum, anus, biliary ducts, pancreas and soft tissues. Malignant GCT is extremely rare, it occurs in only 1–2% of cases. Multiple GCTs occur up to 10%. In children, only 20 cases have been reported in the literature.

This paper describes the case of a 6-year-old girl diagnosed with upper right arm granular cell tumor and the patient’s clinical evolution after tumor surgical removal.

Background

Pityriasis versicolor is a superficial fungal infection of the skin. Multiple modalities of therapy have been used including both topical and systemic agents, such as imidazoles, triazoles and allylamines.

Objective

To evaluate the effectiveness of topical 1% diclofenac gel in the treatment of pityriasis versicolor in comparison with topical clotrimazole cream and aqua rosa cream as a placebo control.

Patients and methods

This is a single-blinded, comparative therapeutic trial of topical 1% diclofenac gel in the treatment of pityriasis versicolor in comparison with topical 1% clotrimazole cream and aqua rosa cream as a placebo control group was conducted at the Department of Dermatology – Baghdad Teaching Hospital during November 2006–November 2008.

This study included 75 patients (39 males and 36 females). They were divided randomly into three groups, each containing 25 patients. Group A patients treated with diclofenac gel: include 15 (60%) males and 10 (40%) females. Their ages ranged from 15 to 44 (23.72 ± 6.52) years, while the duration of the disease ranged from 1 to 24 (4.28 ± 5.79) months. Group B patients treated with clotrimazole cream: composed of 13 (52%) males and 12 (48%) females, their ages ranged from 15 to 38 (22.56 ± 5.09) years, and the duration of the disease ranged from 1 to 18 (3.76 ± 3.98) months. Group C patients treated with aqua rosa cream: contain 11 (44%) males and 14 (56%) females, their ages ranged from 16 to 33 (23.68 ± 4.98) years and the duration of the disease ranged from 1 to 18 (3.26 ± 3.53) months. Detailed history, close clinical examination, skin scraping test and Wood’s light examination were done for all patients. Patients with immune suppression conditions or who received treatment during the last 2 months before the beginning of the study were excluded. Every patient was instructed to apply the drug twice daily for 1-month and to be seen every 2 weeks during the treatment and the follow up which is another 1-month. All patients were assessed clinically; skin scraping test and Wood’s light examination were done at each visit.

Results

The result of this study revealed that at the end of 4 weeks: in Group A 14 (56%) patients had complete improvement (P value = 0.00004), while in Group B 23 (92%) patients had complete improvement (P value <0.00000001) and no one achieved complete improvement in Group C. Mild side effects were recorded as itching in few patients, which do not need to discontinue the therapy.

Conclusion

Diclofenac gel proved to be an effective, new topical treatment for pityriasis versicolo