Background: Psoriasis is one of the most common skin diseases with prevalence rate of 1.4% to 2.9%. The scalp type of this disease is also common. This study was conducted to compare the efficacy and drug complications of single and combination regimens. Methods: Fifty-four patients with scalp psoriasis were randomly divided to 2 groups. In one group (n = 27) betamethasone and calcipotriol (B + C) were administered simultaneously and in the other group (n = 23) betamethasone was administered alone. Clinical status of patients before the treatment, baseline, and 8 weeks after treatment were compared in both groups based on TSS, IGA, and PGA scores. Results: The goal of this study was to evaluate Tss < 1, absence of disease based on IGA, and cleared disease according to PGA. The intensity of the clinical symptoms based on IGA was significantly better in the combination therapy group compared with the monotherapy group at the end of the treatment (P value of 0.04). Furthermore, patients of the calcipotriol group reached a better status compared to the control group (P value of 0.007). Comparison of the basic TSS and TSS at eight weeks showed a significant difference between the two groups after termination of the treatment (P = 0.004). Conclusions: It could be concluded that combination therapy is a reliable and low-complication method compared with the singledrug regimen and is more effective with better efficacy.
Background: Vitiligo involves 1% of the population and is equally seen in all races and in both genders. It is a multifactorial polygenic disorder, although various hypotheses have been proposed including autoimmunity, viral infection, biochemical, neural and oxidant/ antioxidant theories (oxygen radical species), yet the exact mechanism of the disease has not been yet established. Objectives: To evaluate the prevalence of ocular findings in patients with vitiligo and reveal risk factors or possible associations that might increase the risk of ocular manifestations. Patients and Methods: In this cross-sectional study, 92 patients previously diagnosed as cutaneous vitiligo referred to the dermatology clinic of Rassoul Akram Hospital from April 2007 to September 2008, were examined for ocular abnormalities. The data of the patients including age, gender, duration of vitiligo, positive family history, association with autoimmune diseases, and anatomic distribution of depigmented macules were recorded. Next, an ophthalmologist at the hospital's ophthalmology clinic examined the patients to detect depigmentation of eyelids, poliosis and signs of uveitis as well as signs of retinal atrophy or hypopigmentation by a direct ophthalmoscope. Corneal sensation and intraocular pressure (IOP) were evaluated to rule out infection and glaucoma in patients with uveitis. All recorded data were analyzed by the Social Sciences Statistical Software (SPSS version 15) using Chi-square tests and t-test. Results: This cross-sectional study included 92 patients (47 males and 45 females) with mean age of 32.1 ± 13.16 years (ranging from nine to 61 years of age). Mean duration of vitiligo was 10.84 ± 10.17 years. The most common distribution of the lesions was on the upper limbs (60.8%) and the least was on the genital region (10.8%). Positive family history was found in 26 (28.3%) patients. Diabetes and Hypothyroidism were found in 10 (10.86%) and 9 (9.87%) patients, respectively. Ocular problems were discovered in 19 (20.7%) patients with mean age of 41.26 ± 10.7 years, including uveitis in 10 (10.9%), optic atrophy in 4 (4.3%) and retinal hypopigmentation in 5 (5.4%) patients. Mean age of cases with positive ocular findings was significantly higher than those without ocular findings (29.6 ± 12.7 years, P < 0.0001). Mean duration of vitiligo was significantly longer in patients with positive ocular findings than in those without ocular problems (8.84 ± 9.08 years, P < 0.0001). No statistical correlation was found between sex and ocular findings (P > 0.05). Ocular findings were statistically more in patients with positive family history of vitiligo (P = 0.001) and with associated autoimmune diseases (P = 0.01). No significant association was found between anatomical distribution of depigmented macules and ocular findings (P > 0.05). Conclusions: Ocular findings are important and assessable in patients with vitiligo. Older age and duration of vitiligo can increase the risk of ocular abnormalities and patients with positive family history an...
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