The recent success of vitamin D and its analogues in the treatment of psoriasis has generated extensive research into the role of vitamin D and calcium in this hyperproliferative skin disease. This study aimed at studying the calcium serum level in patients suffering from psoriasis. In this case control studies, 98 hospitalized cases with psoriasis were compared with 100 patients who were hospitalized due to other diseases. Two groups were matched for age and gender. The type of psoriasis, age and sex of patients and serum calcium and albumin levels in two groups were documented in a especial questionnaire. Of all 98 patients with psoriasis, 37.2% were hypocalcemic and 63.7% had normal serum calcium. There was no hypercalcemia. In other group 9% were hypocalcemic, 89 and 2% were normocalcemic and hypercalcemic respectively. In 64.9% of hypocalcemic psoriatic patients, low serum albumin was noted. But all of control group had normal levels. Hypocalcemia is a risk factor of psoriasis. It is better to include dairy as calcium resource in daily diet of patients suffering from psoriasis.

Objectives: Extracorporeal shock wave lithotripsy (ESWL) is mainly an alternative for other therapeutic methods such as surgery and endourology to treat urinary tract calculus. Although it is safe and effective, it has undesirable effects on renal function. Diagnostic techniques such as color Doppler ultrasonography create a new attitude toward renal function. The aim of this study was to evaluate renal vascular resistance change before and after extracorporeal shock wave lithotripsy. Methods: During the present study, vascular resistive index (RI) of renal intralobar artery was measured before, 30 min, and 1 week after ESWL using Doppler ultrasonography. Results: Thirty minutes after ESWL, RI was significantly increased from primary value of 0.62 AE 0.05 to 0.66 AE 0.06 (p ¼ 0.0001). There was no correlation between increase of RI and patients' age. Following up the patients revealed that mean RI did not return to pretreatment level after 1 week (p < 0.05). The RI level in the old patients (3 patients who were 60 years or older) was higher than that of the younger ones (19 patients who were younger than 60 years) after 1 week (0.76 AE 0.05 vs. 0.64 AE 0.06). There was no meaningful relationship between ESWL voltage or number of shocks and RI variation before and after ESWL. Conclusion: Following ESWL, patients are at risk of renal tissue damage due to increase of primary RI level. Measuring RI variations using ultrasound techniques after ESWL may provide helpful information to clinical detection of renal tissue damage.

Introduction. Frontal fibrosing alopecia (FFA) is known as a lymphocytic primary cicatricial alopecia. The main characteristic of FFA is progressive frontotemporal hairline recession. The pathogenesis of FFA is not completely understood. Destructing the stem cells of the epithelial hair follicles causes permanent hair loss and seems to be the main cause of FFA. Studies have reported significantly decreased quality of life in patients with hair loss. On the other hand, late diagnosis and treatment of FFA can decrease the success rate of the treatment. In this regard, different topical and systemic therapies have been developed to resolve the symptoms; however, only a partial response to treatment is usually achieved. We conducted a systematic review of the literature to identify the effectiveness of the available treatment modalities used for FFA patients and the related outcomes. Methods. On April 2022, we made a wide systematic computer-assisted search of PubMed and Google Scholar databases, using “frontal fibrosing alopecia” and “treatment” keywords. We scanned 1,514 articles. All the studies concerning a therapeutic regimen for FFA were included. After removing duplicate studies, 50 studies containing the therapeutic regimen of 1,478 FFA patients were included in this review. Results. The 5-alpha-reductase inhibitors (oral finasteride/dutasteride) were the most used medications (usually prescribed as a combination therapy with other medications). Topical corticosteroids were the second commonly used medication for the treatment of FFA. Systemic corticosteroids seem to be ineffective in improving FFA progression. Oral isotretinoin (or alitretinoin) had the most promising effect on improving facial papules of FFA patients with a 92% rate of facial papule improvement. Conclusion. In our review, intralesional corticosteroid injection and 5-alpha-reductase inhibitors (finasteride/dutasteride) were reported as the most effective treatment modalities. Oral isotretinoin (or alitretinoin) is considered as the most promising treatment for improving facial papules in the context of FFA. However, it had minimal effects on hair regrowth or stabilization of hairline recession in FFA patients.

Developmental Dysplasia of the Hip (DDH) is a common congenital malformation. Avascular necrosis of femoral head is the major complication of both close and open reduction of the dislocated joint. Aim of this study was to determine the incidence and influencing factors in different types of a vascular necrosis of femoral head, following surgical treatment of developmental dysplasia of hip in 1-7 years patients. In this study, 120 patients aged from 1 to 7 years old with DDH who had been undergone open surgery, entered to the study. All of these patients followed up for at least 1 year. Surgery procedures divided to 4 groups: open reduction, open reduction+salter osteotomy, open reduction+femur shortening and open reduction+salter osteotomy+femur shortening. The presence of Avascular Necrosis (AVN) had been appraised. 27.5% of surgeries performed on male and 72.5 on female patients. 35.0% of DDH cases were unilateral and remaining was bilateral. 36 patients (30%) shows radiologic findings of AVN, although all of them placed at group I of Bucholz-Ogden classification. 40% of group A patients, 25% of group B, 14.3% of group C and 36.4% of group D patients developed this findings. Open reduction of DDH in older children is effective in the management of DDH and if all of the contrivance considered in the surgery, the rate of AVN would be low and mild (at least in short term follow ups).

Introduction: Mycosis fungoides (MF) is the most common variant of primary skin T-cell lymphoma. It typically manifests as an indolent cutaneous eruption with erythematous scaly patches or plaques. Due to the nonspecific pathological findings, it can be easily misdiagnosed with psoriasis. Case presentation: A 34-year-old woman was referred with a history of psoriasiform plaques for 12 years. Earlier, a diagnosis of psoriasis was made and medication with topical steroids were initiated, without any clinical improvement. During the visit, a skin biopsy was performed and a diagnosis of MF was confirmed and treatment with PUVA, prednisolon, methotrexate, topical ointment including ucerin, urea ad clobetasol were initiated. Significant improvement in all lesions were observed after one month of the treatment, and within a year, the disease improved dramatically after PUVA therapy. Conclusion: In refractory cases of psoriasiform plaques that are progressive and/or ulcerative in spite of optimal treatment, biopsy is required and a possible diagnosis of MF should be kept in mind.