BackgroundAlthough many factors are involved in the etiology of xanthelasma palpebrum, lipid disorder is strongly associated with its induction. Xanthelasma palpebrum, the most common type of xanthoma, usually presents in middle-aged females and results in aesthetic problems.ObjectiveTo evaluate thelipid profile and important clinical aspects of xanthelasma palpebrum patients.MethodsIn this descriptive study, we enrolled 42xanthelasma palpebrumpatients, and 42 cases of non-inflammatory skin disorders as thecontrol group, matched for age and gender.The clinical characteristics of the patients and fasting serum lipid profile were recorded for both groups. The data obtained were analyzed using SPSS-16.ResultsXanthelasma palpebrum was found more commonly in middle-aged females with disease onset of less than 1 year, and without significant familial history of xanthoma. Furthermore,xanthelasma lesionswere most often seen in the upper lid with mild extension and was rarely associated with systemic disease. There was no statistically significant difference between two groups regarding hypertriglyceridemia (p= 0.231) and hypercholesterolemia (p= 0.302). The mean serum levels of cholesterol (221.51±60.4 mg/dl), triglyceride (185.98±71.1 mg/dl) and VLDL (37.7±17.6 mg/dl) were significantly higher and themedian HDL (36.2 (31, 41) mg/dl) level was lower in thepatient group.ConclusionIn our study, hypercholesterolemia and hypertriglyceridemia did not reveal a significant difference between thepatient and control groups; however, mean serum values for cholesterol, triglyceride, VLDL and HDL showed a significant difference between the two groups. Therefore, in addition to lipid abnormality, other factors could be involved in the pathogenesis of xanthelasma palpebrum.

Background Although COVID-19 pandemic significantly induces mortality, many of the patients who recovered present with other medical problems such as alopecias. Telogen effluvium is a common alopecia that is usually related to previous events such as acute febrile diseases, including COVID-19. Objective To evaluate the characteristics of telogen effluvium in COVID-19. Method This cross-sectional study was carried out on 526 patients with documented telogen effluvium that recovered from COVID-19. Demographic data, concurrent alopecia, associated diseases, and COVID-19 severity were recorded. Data were analyzed by appropriate statistical methods. Results The mean age of the 526 patients (410 females, 116 males) was 30.97 ± 9.592 years, with 7.65 ± 1.739 weeks of mean time of alopecia onset. In our patients vitamin D deficiency (24.3%), androgenetic alopecia (78.2%), and grade III disease severity were the most common findings. Alopecia onset was significantly earlier in the younger age group, females, in hypothyroidism, and more severe coronavirus infection. Higher grade coronavirus infection was significantly seen in males, higher ages, earlier onset, and androgenic alopecia. Study limitations Performing a single-center study and considering limited variables. Conclusion Although Coronavirus 2 infection can be an important factor in telogen effluvium induction, other factors such as associated diseases, drug intake and emotional stress may also be involved. In the cases of early onset of alopecia, concomitant diseases such as hypothyroidism and severe coronavirus infections can occur, thus, the presence of various factors in telogen effluvium induction should be considered.

Background. Generalized fixed drug eruption is a specific variant of fixed drug eruption with multifocal lesions. Diagnosis of this drug reaction is straightforward, but occasionally recognition of the causative drug is not possible. This study was aimed at evaluating the clinical features and culprit drugs in generalized fixed drug eruptions in the west of Iran. Method. This cross-sectional study was carried out on 30 patients with criteria of generalized fixed drug eruption over 9 years. Demographic, clinical, and drug intake information were collected. Results. Out of 30 patients (17 females and 13 males) with the mean age of 26.67 ± 10.21 years, 28 (93.3%) and 2 (6.7%) cases had plaque and bullous clinical presentation, respectively. Upper limbs were the most common (90%) site of involvement. The antibiotic group, especially cotrimoxazole (26.1%), was reported to be the most common offending drug, but the causative drug was not determined in 7 (23.3%) patients. Conclusion. Many cases of generalized fixed drug eruption firstly presented as limited lesions and led to generalized lesion due to repeated intake of the causative drug. No causative drug was found in some patients, which might be associated with concurrent intake of several drugs, multiple FDE, and peculiarity of the patch test.

Background. Periorbital basal cell carcinoma (BCC) is considered a high risk case because it is associated with high rate of recurrence and complication. Superpulsed CO2 laser with intraoperative pathologic assessment could be an alternative and appropriate treatment for periocular lesions where Mohs micrographic surgery is not available. Objective. To evaluate the efficacy of superpulsed CO2 laser therapy with intraoperative pathologic assessment on periocular BCC involving eyelash line. Method. This follow-up study was performed on 20 patients with a total of 21 BCC lesions that were pathologically documented. Firstly, debulkation of tumoral mass was done by curettage. Then, irradiation and intraoperative pathologic evaluation were done by concurrent CO2 laser. The patients were followed up for a period of 36 months. Results. Out of 21 lesions, the nodular type accounted for 15 (71.4%) lesions, and 12 (57.1%) lesions were seen in the lower lid as the most common clinical type and site involvement. Twenty BCC lesions (95.2%) were treated after one session. Damage to eyelash was seen in 2 (10%) patients, but ectropion and other complications were not seen in any patient. Conclusion. Treatment with superpulsed CO2 laser and intraoperative pathologic evaluation for periorbital BCC lesions much close to conjunctiva could be an effective method with minimal complications without major danger of recurrence. This modality can be used with care in the inner canthus and high risk pathologic lesions.

Introduction: Ingrown toenail (IGT) is a common nail disorder that causes discomfort and interferes with most activities. Most cases of IGT require procedural intervention. This study was performed to compare the treatment and cosmetic outcome of partial nail matricectomy (PNM) using CO2 laser versus lateral nail fold excision (LNFE). Methods: This interventional study was performed on 127 patients with IGT that were randomized into two groups. Demographic data, clinical characteristics, and treatment results were recorded in both groups. Results: Sixty-two patients with a mean age of 28.23 ± 11.34 years were subjected to PNM and 65 patients with a mean age of 28.92 ± 9.63 years to LNFE. The PNM versus LNFE groups had cure rates of 85.5% versus 78.5%, fair cosmetic outcomes of 67.9% versus 84.0%, and infection rates of 4.8% versus 3.1%. The mean time of pain duration, return to daily activity, and return to work were nearly 3, 4, and 13 days, respectively, in both groups. Conclusions: The treatment outcome was slightly better in the PNM group than in the LNFE group, and vice-versa for the cosmetic outcome. There were nearly similar outcomes in terms of the mean time of repair, pain duration, return to daily activity, and infection rate using both methods.