Dermatology and Cosmetic

Efficacy of 0.05% isotretinoin gel in comparison with clindamycin 1% solution in the treatment of papulopustular acne: A randomized clinical trial

Hamideh Herizchi Qadim

Background and Aim: Acne vulgaris is a common disorder of adolescence which may lead to significant cosmetic and psychological problems. Different topical and systemic therapeutic modalities have been used to treat acne vulgaris. This study was designed to compare the efficacy of topical 0.05% isotretinoin gel with 1% clindamycin solution in the treatment of acne vulgaris.
Methods: In this randomized clinical trial, 60 patients with mild to moderate papulopustular acne vulgaris were randomly allocated into two groups of equal sizes. One group was treated with 0.05% isotretinoin gel every night. The other group was treated with 1% clindamycin solution twice daily. Both groups were followed every month for 3 months.
Results: The mean of total lesion count decreased significantly after treatment in comparison with its mean before the treatment in both groups (P<0.001). The mean of acne severity index significantly reduced after treatment in both groups (P<0.001). Satisfaction of patients in clindamycin group was higher (P<0.001).
Conclusion: Decrease in total lesion count and acne severity index in both treatment groups were statistically significant however, considering the minimal complications and satisfaction of patients in clindamycin group, 1% solution of clindamycin may be recommended in the treatment of papulopustular of acne vulgaris.

Comparison of free salivary testosterone versus free serum testosterone levels in patients with hirsutism and control group

Pouran Layegh

Background and Aim: Hirsutism is defined as male pattern hair growth in females which affects 10% of women. Our aim was to compare free salivary and free serum testosterone levels in women with hirsutism and healthy controls.
Methods: This study was a case-control study in which 30 hirsute women in child bearing age were recruited and compared with 10 healthy controls. For each patient, a questionnaire containing demographic, clinical and laboratory information was completed. The salivary and serum total and free testosterone plus free androgen index were measured by radioimmunoassay (RIA) method. The collected data were described and analyzed using SPSS software version 11.5. Significance level was determined at 0.05.
Results: No significant correlation was seen between salivary and serum free testosterone and in free androgen index with free testosteron in patients and control groups. Comparing the results between case and control groups, except for mean serum total testosterone level (P<0.05), the other results were not significantly different. No significant correlation was seen between hirsutism severity and free serum or salivary testosterone levels. Significant correlation was seen with total serum testosterone (P<0.001). Investigating correlations between these hormones with serum free androgen index, only salivary free testosterone was correlated with this index (r=0.01, P<0.05).
Conclusion: In our study, we find no correlation between free serum and salivary testosterone, so it seems that this evaluation method is not an appropriate alternative for serum evaluation of this hormone.

Effects of rhinoplasty on women’s body image

Hassan Baniasadi

Background and Aim: The women’s main purpose of cosmetic rhinoplasty is to have a nose that they think has a better harmony with their face, so they could reach to a more desirable body image. This study investigated the effects of cosmetic nose surgery on women`s body image.
Methods: Thirty women referred to the private clinics of cosmetic surgeons for nose cosmetic surgery were selected. The multidimensional body-self relations questionnaire developed by Cash (1998) was employed to measure the women`s body image. This questionnaire was filled out before and five months after rhinoplasty.
Results: Using paired t test, the analyses of the data demostrated that nose cosmetic rhinoplasty increased the levels of women`s satisfaction of their subjective body and subjective nose images (P=0.0001 and , respectively).
Conclusion: The findings of the present study showed that cosmetic nose surgery increases the of levels of women’s satisfaction of their body image and it causes the person to have higher satisfaction of her nose and body image.

Frequency of margin involvement after excision of skin basal cell carcinomas with 5 millimeter margins

Akram Ansar

Background and Aim: Skin basal cell carcinoma (BCC) is the most common cancer in human beings. Prevalence of this tumor has increased over the past decades. The standard treatment is complete excision, however some risks for recurrence still exist. The aim of this study was to determine the frequency of margin involvement in skin BCC as well as to investigate the demographic characteristics of the patients.
Methods: This study was conducted from April 2011 to April 2012 on the patients who had skin lesions suspected for BCC. The patients were undergone elliptical excision surgeries for removing their suspected lesions with 5-millimeter margins of clinically normal skin in Farchian Hospital, Hamadan, Iran. Following data were collected and recorded: age, sex, anatomical location, duration of the disease, primary clinical diagnosis, histopathologic type, and margin involvement.
Results: In total, 125 lesions from 115 patients were investigated (70 males, 45 females). The range of the ages of the patients were from 32 to 93 years, with a mean of 64.6 years. The most common histopathological type was nodular type (61.0%). Twenty percent of the excised lesions showed margin involvement. Risk factors for incomplete excision were older age and anatomical locations (ears and peri-ocular lesions). There was no statistically significant differences between sex, histological type, primary clinical diagnosis, and duration of the disease. In almost all cases, the clinical and histopathological diagnoses were similar.
Conclusion: To avoid repeated surgeries and to reduce the risk of incomplete excision for lesions on high risk locations, particularly in elderly, it is recommended that BCCs be excised with wide margins or Mohs micrographic surgery.

Demographic and clinical characteristics of parapsoriasis patients

Abbas Karimi

Background an Aim: parapsoriasis is a rare chronic idiopathic dermatosis which commonly manifests with round or oval scaling and itching erythematosus plaques on trunk and extremities. Considering the size of the lesions, parapsoriasis is divided into two groups: small plaque and large plaque. Study of demographic characteristics of this disease may help to identify the high risk groups who are more susceptible to cutaneous lymphoma with high mortality as well as proper allocation of health service resources.
Methods: In this retrospective cross-sectional study, affected parapsoriasis patients whom were referred to Razi Hospital in Tehran between April 2003 to March 2009 were studied. Three hundred and twenty patients were investigated for variables: age, sex, place of residence, location of the lesions and clinical subgroups according to the histopathology reports.
Results: 53.4% of patients were female. The disease was most commonly observed in age group of 20 to 50 years and the mean age of the patients was 43.3 years. Eighty-five percent of the patients were inhabitant of Tehran province. 88.1% of patients had large plaque lesions and 11.9% had small plaque lesions. The most common sites of lesions were on the trunk (53.4%) followed by the extremities (38.7%).
Conclusion: Based on these findings, it was determined that parapsoriasis most commonly affects middle-aged women. Involvement of trunks and extremities were most commonly observed. Large plaque type was the most common type.

Methods for skin biophysical analysis and imaging: A review (Part Ι)

Alireza Firooz

Skin is the largest organ of the integumentary system with multiples important functions. Due to its complex structure, the permeability skin status can be modified by different external and internal factors such as chemical and physical stresses, and several skin and systemic diseases. Today, different non-invasive methods are used to assess the skin barrier biophysical properties. The parameters such as transepidermal water loss, stratum corneum hydration, skin surface pH and skin surface lipids is essential for evaluation of the epidermal barrier status. Application of these methods is critical for evaluation of disease treatments, the effectiveness of topically applied drugs and cosmetic products. The aim of this article is to review application of several methods for skin biophysical and biomechanical properties in humans.

Evidence-based dermatology: Correct reporting of the outcome comparisons in clinical trials

Alireza Khatami

According to evidence-based medicine, randomized controlled clinical trials are a group of research designs which provides the highest level of clinical evidence, particularly regarding therapeutic or preventive interventions. Considering the dramatic increase in the number of published clinical trials in medical journals, the readership need to have knowledge about the problems that may occur during design and conduct of these studies, as well as about proper reporting of them. Due to importance of these studies in clinical medicine, several guidelines have been developed regarding designing, conducting and reporting clinical trials. One of the most important guidelines which has been developed to alleviate the problems in reporting randomized clinical trials is Consolidated Standards for Reporting Trials (CONSORT). In this article, some crucial points with regards to the report of the comparison of outcomes of interventions in randomized controlled trials will be reviewed briefly.