Dermatology and Cosmetic

Comparison of the efficacy of niosomal minoxidil with conventional minoxidil in the treatment of androgenetic alopecia: A randomized, controlled, double-blind clinical trial

Rezvan Amiri

Background and Aim: Androgenetic alopecia (AGA) is the most common type of alopecia in men. Currently, minoxidil is the only topical drug which has been approved by FDA for the treatment of AGA. However, its efficacy is restricted because of its low skin penetration. Since vesicular systems such as liposomes and niosomes have higher efficacy and lower adverse effects, this study was conducted to compare the efficacy of topical niosomal minoxidil with conventional minoxidil in the treatment of AGA. Methods: This study was a randomized, controlled double-blind clinical trial. Ninety male patients with AGA according to Hamilton criteria were enrolled into this trial. The participants applied the interversion to which they were allocated twice a day, and were evaluated monthly for 6 months by a physician and patients self-assessments. Results: Eighty-eight patients completed the trial. Mean increased hair count in niosomal minoxidil group and conventional minoxidil group in the last visit were 28.18±11.00 and 14.22±5.23, respectively (P<0.001). Moreover, evaluation of treatment response according to the patients self-assessments were 8.72±5.03 and 3.33±2.67 in niosomal and conventional minoxidil, respectively, which revealed more satisfaction in niosomal group (P=0.001). With the exception of two cases in niosomal minoxidil group whom were withdraw due to scalp itching and erthema no other adverse effect was observed in either group. Conclusion: In the present study, application of topical niosomal minoxidil revealed an increase in the hair count in comparison with conventional minoxidil solution. Application of this new formulation for the treatment of AGA may be recommended.

Safety assessment of 5 sunscreen products: Phase I controlled clinical trial

Saman Ahmad Nasrollahi

Background and Aim: Sunscreens are an important part of photoprotection strategy. They are exposed to strict safety evaluation using human subjects such as in vivo studies of skin irritation. Biophysical parameters measurements could be used as fast and noninvasive methods to measure any destructive effect of cosmetic formulations on skin application sites. Methods: Five sunscreens were selected from Iran's market to determine changes in Transepidermal Water Loss (TEWL), stratum corneum hydration, pH, melanin and hemoglobin contents by biometric assessments with MPA 580Cutometer®. Results: There was no significant change in skin pH, melanin and hemoglobin contents before and after sunscreen application. Significant change in TEWL and stratum corneum hydration after use of some sunscreens might be contributed by the occlusive and humectant ingredients which used in base cream. Conclusion: Application of the studied sunscreens on human volunteers has not shown any adverse effects and these formulations could be recommended to use.

ELISA sensitivity in detection of autoantibodies desmoglein 1 and 3 in saliva and serum of patient with pemphigus vulgaris

Maryam Koopaie

Background and Aim: Pemphigus vulgaris (PV) is the most common bullous autoimmune disease, which can cause mortality and morbidity in the patients who suffer from it. Researches to find reliable noninvasive laboratory tests to diagnose and monitor PV patients are being conducted.The aim of this study is to find the sensitivity of serum and salivary anti-DSG1 and anti-DSG3 antibodies in the diagnosis of PV by ELISA and to compare the results of serum and salivary autoantibodies with each other. Methods: In this case-control study, 40 newly diagnosed patients with PV were recruited. Forty healthy controls were also recruited to this study. The clinical diagnosis of PV was confirmed by histopathology and direct immunofluorescence (DIF). Demographic data, disease severity and phenotypes were recorded on the questionnaires, which were developed for this study. DSG1 and DSG3 ELISA test were performed on serum and salivary samples of patients and controls. Results: The mean±standard deviation age of patients, 43.37±11.94, with a range of 26 to 71 years. The sensitivities of serum anti-DSG3 and anti-DSG1 were 85% (34 cases had positive test results) and 90%, (36 cases had positive test results) respectively. The sensitivities of salivary anti-DSG3 and anti-DSG1 antibodies were accordingly 42.5% (17 cases had positive test results) and 60%, (24 cases had positive test results) respectively. Conclusion: While the sensitivities of serum ELISA in detection of anti-DSG1 and anti-DSG3 were significantly higher than those of salivary ELISA, since the levels of the latter are chnaging in parallel to those of serum ELISA, they might be used to monitor the disease activity.

Tattoo granuloma: A clinical and demographic survey of patients referred to Razi Hospital in Tehran

Pedram Nourmohammadpour

Background and Aim: Due to new popularity of cosmetic tattoos especially among women and its potential relationship with sarcoidosis, the present study was conducted to evaluate clinical presentation and some demographic data about tattoo granuloma, as part of non-infectious dermatologic granulomas. Methods: In this retrospective cross-sectional study, all patients with the histopathological diagnosis of non-infectious granulomatous lesions whom were admitted between at the dermatology clinics at Razi Hospital, Tehran, Iran between March 21, 2007 and March 20, 2012 were included. Results: A total of 1099 patients were included in the study. The commonest form of granuloma was foreign body granuloma in 511 (46.4%) of the patients and was followed by tattoo granuloma in 102 (9.2%) of the patients. All patients with tattoo granuloma were females whose ages were from 40 to 60 years. The mean±standard deviation age of the patients was 43±8.57 years. Twenty-six (25%) of patients with tattoo granuloma showed sarcoidal pattern, and one case (1%) showed caseouse pattern, after histopathological evaluation of biopsy specimens. Majority of the lesions were papular (32.3%) followed by nodular (24.5%) lesions. Conclusion: Tattoo granuloma is the second common form of non-infectious granulomas, and in one-quarter of cases has sarcoidal pattern. Considering this finding, it seems reasonable to evaluate these patients for sarcoidosis.

Comparison of viewpoints of dermatology medical students involved in teaching-learning process about two methods of learning: group discussion versus lecture

Mehran Heydari Seraj

Background and Aim: The World Federation for Medical Education developed standards for medical education and recommended medical schools to encourage their students to take active responsibility for their self-learning, and prepare them for lifelong learning. The purpose of this study was to compare the viewpoints of medical students about the effectiveness of their participation in two methods of teaching-learning process, group discussion versus lecture. Methods: This cross-sectional study was performed between the years 2011-2013 during which 19 one-month courses of dermatology for medical students were presented. In each course, attended by 5-7 students, 16 sessions of dermatology theory classes were planned. The first four sessions were completely presented by medical tutors and the next 12 sessions involved active student participation, 6 presented as group discussions and 6 aslecture presentation. At the end of each course the students’ perspective were asked by using a questionnaire evaluating the effectiveness of each method. Results: From 102 students that participated in this study the following results were attained: 94 students (92.15%) considered group discussion more efficient than conference presentation (2 students [1.96%]), 5 (4.9%) reported both methods were efficient and 1 student (0.98%) said that none of these two methods were useful. The reasons that students preferred group discussion were: studying the subject matters before class and mental readiness, active participation of all students, learning at a higher degree and better durability of the subject in mind, expression of key points by the medical teacher, restatement of subject matters and enthusiasm of the class in group discussion. Conclusion: Group discussion is a valuable technique in teaching-learning process which requires active participation of all students, leading to deeper understanding of the subject matters, self-learning and more attention to key points, it also makes the class more lively.

Diagnosis of skin cancer based on thermal model in infrared images

Fatemeh Valipoori Goodarzi

Background and Aim: Skin cancer is the most common type of cancer constitutes and 75% of all cancers in the world. Malignant melanoma is the most invasive and lethal form of skin cancer. The objective of this study was to evaluate infrared thermography in differentiation of benign and malignant skin lesions. Methods: This study was conducted on 120 patients (60 female, 60 male) with a lesion suspicious for melanoma and identifying the type of lesion (benign or malignant) based on thermal model using Fuzzy C-Means (FCM) clustering. In this imaging method, the difference on temperature responses between the normal and abnormal tissue was compared and data obtained was compared with biopsy results. Results: In 120 cases studied, 3 cases of skin cancer (2 male, 1 female) were found which all could be detected based on analysis of thermal images. Conclusion: At present, new methods for the detection of skin cancer, especially non-invasive diagnostic tools, have been discovered in several laboratories. The method presented in this paper could be considered as a non-invasive and cost effective method for the detection of skin cancer.

Sunscreen products: A double-edged sword in the prevention of skin cancer

Hamid Salehinia

Skin cancer is the most common cancer in humans worldwide. It is also the most common cancer in Iran. To achieve primary prevention in skin cancers, avoidance of direct sun exposure is recommended. Sunscreen use is one of the methods to reduce sun exposure. However, while using sunscreens has increased recently, the incidence rate of skin cancers has also increased. One of the reasons for observing this paradox may be caused by counterfit sunscreen products, in particular in Iran. The author imagines that this letter may result in proper decision making among health policy makers to tackle this problem.