Background: Polymorphisms of genes including tumor necrosis factor alpha (TNF-α) and Tumor necrosis factor receptor super family 1B (TNFRSF1B) may influence susceptibility to psoriasis as well as patients' biological responses. Aim of the study: To demonstrate the potential roles of TNF-α and TNFR1B, genes polymorphism {TNF-α -308 (G/A) and TNFR1B rs1061622 (T/C)} in susceptibility to psoriasis, elucidating their possible influence on patients' biological drug response and serum level. Subjects and methods: One hundred psoriatic patients and 100 apparently healthy individuals as a controls were included in this study. Restriction Fragment Length Polymorphism-Polymerase Chain Reaction (RFLP-PCR) was performed to evaluate different TNF-α and TNFR1B genes polymorphism. TNF-α and TNFR1B serum levels were assessed by enzyme linked immune sorbent assay. Results: Comparison between overall patients and controls revealed a higher serum level of TNF-α in patients than the controls with a highly significant difference (P<0.001). The risk of psoriasis was observed among people who had TNF-α-308 AA or GA genotypes, namely A allele-containing genotypes. Regarding the response to treatment it was revealed that the mutant homozygous genotype AA with higher frequency in non-responder (85.7%). The risk of non-response to biological drug was higher in people carrying AA genotype than in people carrying GG or GA genotypes. Concerning to serum level of tumor necrosis factor receptor super family member 1B (TNFRSF1B), Present study showed a highly significant difference between overall patients and controls. TNFSFR1B (rs1061622) SNP, CC and CT genotypes were dominant in controls and psoriatic patients, whereas the mutant TT genotype was dominant only in psoriatic patients. High risk of psoriasis in subjects had TT genotype than subjects carrying CC genotype. The response to treatment in the present study shows non-significant difference in the distribution of different genotypes of TNFSFR1B (rs1061622) polymorphism between responders and non-responders patients. Conclusion: These results may provide an additional evidence for association of TNF-α -308G/A and TNFRSF1B rs1061622, genes polymorphism to psoriasis susceptibility and disease severity and may serve as predictive and prognostic biomarkers.
Background: telogen effluvium is a form of non- scarring alopecia characterized by diffuse hair shedding, often of acute onset. It’s a reactive process caused by metabolic or hormonal stress or by medications. Generally, recovery is spontaneous within 6 months.Objectives: is to shed a light on the clinic- epidemiological aspects and most important causes of telogen effluvium in Iraqi women.Patients and methods: A total number of 100 female patients were seen in the period between March 2014 to March 2015 in the Dermatology Department of Baghdad Teachinhg Hospital / Medical City. Their ages ranged between 20 to 40 years old and the duration of their complaints ranged between 1 to 12 months. Their symptoms were excessive hair loss, diffuse shedding, scalp hair thinning and trichodynia. In all patients the diagnosis was confirmed by positive pull test, and the patients were questioned about all possible triggering factors.Results: In most of cases, 74%,the duration of illness was less than 6 months . all the patients complained of diffuse shedding , 12% had visibile scalp thinning and only 8% had trichodynia . In 32% of cases no underlying triggering factor was identified and 21% of cases had acute psychological distress.Conclusion: most of cases of telogen effluvium in Iraqi women were without clear underlying triggering factor, most patients were anxious about impending baldness, but significant hair thinning was present in only minority of patients.Searching for underlying iron diffeciency is important as 6% of patients had evidence of subcinical iron diffeciency on laboratory examinations.
Background: telogen effluvium is a form of non-scarring alopecia characterized by diffuse hair shedding, often of acute onset. It's a reactive process caused by metabolic or hormonal stress or by medications. Generally, recovery is spontaneous within 6 months. Objectives: is to shed a light on the clinic-epidemiological aspects and most important causes of telogen effluvium in Iraqi women. Patients and methods: A total number of 100 female patients were seen in the period between March 2014 to March 2015 in the Dermatology Department of Baghdad Teachinhg Hospital / Medical City. Their ages ranged between 20 to 40 years old and the duration of their complaints ranged between 1 to 12 months. Their symptoms were excessive hair loss, diffuse shedding, scalp hair thinning and trichodynia. In all patients the diagnosis was confirmed by positive pull test, and the patients were questioned about all possible triggering factors. Results: In most of cases, 74%,the duration of illness was less than 6 months. all the patients complained of diffuse shedding , 12% had visibile scalp thinning and only 8% had trichodynia. In 32% of cases no underlying triggering factor was identified and 21% of cases had acute psychological distress. Conclusion: most of cases of telogen effluvium in Iraqi women were without clear underlying triggering factor, most patients were anxious about impending baldness, but significant hair thinning was present in only minority of patients. Searching for underlying iron diffeciency is important as 6% of patients had evidence of subcinical iron diffeciency on laboratory examinations.
Background: Suffering from recurrent boils (furunclosis) is a common problem in our locality as it is noticed by many dermatologists especially in association with increasingly hot weather. The most common causative organisms are staphylococci. Objective: The aim of the study was to shed the light upon this problem and compare two systemic therapeutic agents for the prevention of recurrence, doxycycline and rifampicin. Patient and method: One hundred thirty-five (135) Patients with recurrent boils from Al-Yarmouk teaching hospital dermatology outpatient department were included in this study; age ranged from 10 to 64 years old and out of total patients 32 were males and 103 were females. Patients were assessed by full history and clinical examination done by dermatologist. An aspirate from the content of the boil was taken from 30 patients for bacteriological culture. The patients were treated by topical with or without systemic anti-staph antibiotics followed by a preventive protocol of doxycycline100mg twice daily for two months duration in 50 patients and rifampicin 600mg for ten days in the other 85 patients. Both groups used topical sodium fucidate 2% ointment twice daily in nostrils, axilla and perineum for ten days. All were followed up for 2 years to assess the recurrence after treatment. Results: Out of 135 patients treated, 3 (2.22%) patients defaulted from follow up (they were from doxycyclin group) and out of the remainder 132, only 9 (6.8%) patients had recurrence after treatment; 7 (14.89%) patients from the doxycycline group and 3(3.52%) patients from rifampicin group. Forty 40 (85.1%) patients responded well to doxycycline without recurrence for 2 years compared to 83 (97.65%) patients treated with Rifampicin with no recurrence during the 2 years of follow up. The noticed side effects were gastric upset in doxycycline and urine discoloration in rifampicin. Conclusion: Rifampicin regimen in prevention of recurrent boils significantly showed higher effectiveness in addition to more tolerable, easier, shorter course, and fewer side effects than doxycyclin.
Psoriasis is a common, chronic, immune mediated disorder.The disease is arising as a result of dysregulated interactions of the innate and adaptive immune system in the context of skin epithelium and connective tissue. The biological drug Etanercept(ETN) approved for use in treated psoriasis. ETN is tumor necrosis factor-α (TNF-α) inhibitor. In this study, 48 psoriatic patients were taken before and after treatment who attended to the Dermatology and Venereology Department in Baghdad Teaching Hospital during the period from December 2016 to September 2017and 50 samples were used as healthy control group. The results showed that most psoriatic patients 52.08 % were within the second and third decades 20-35 year, and the majority of psoriatic patients were males 62.5% and the ratio of male to female is 1.67:1. Moreover, the results demonstrated that the males were more expected psoriasis compare with females. Blood samples were collected and TNF-α was estimated in sera of all subjects by using Enzyme Linked Immunosorbent Assay (ELISA). The TNF-α mean levels in psoriatic patients before treatment was 189.5±26.0 ng/ml, and after treatment was 223.6±41.1 ng/ml compar with the healthy control group 93.5±2.4 ng/ml. The results showed significant differences between the studied groups.
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