Dermatology and Cosmetic

Editorial Note

alireza Firooz

Abstracts

Efficacy of combination of fractional CO2 laser and tranexamic 5% gel in the treatment of melasma

Mozhdeh Sepaskhah

Background and Aim: Melasma is a common disease affecting quality of life. Available treatments result in the gradual and partial clearance of melasma, and are accompanied with high risk of recurrence after discontinuing treatment. Tranexamic acid has been successfully evaluated in several studies. In addition, laser has been proposed as an enhanced drug delivery method. This study is designed to evaluate this enhancing effect.

Methods: Twenty-five patients with bilateral epidermal and mixed type melasma were recruited in the study and applied tranexamic 5% gel bilaterally on face two times a day and randomly underwent fractional CO2 laser treatment on one side of the face monthly. They were evaluated before starting treatment and then every 4 weeks by measuring modified melasma area severity index (mMASI) and melanin index by Dermacatch (Colorix, Switzerland). Also, quality of life was measured and compared in a subset of patients with MELAS QoL questionnaire before and after treatment. The results were analyzed by SPSS software version 18 and the results were compared by paired t test. Due to multiple comparisons, p value of 0.0125 was considered significant.

Results: The mMASI and melanin index were not significantly different between two sides in each follow up (P>0.0125). The mMASI and melanin index significantly decreased after treatment with tranexamic acid with or without fractional CO₂ laser (P<0.001 and P<0.001, respectively)

Conclusion: Although tranexamic acid 5% gel is effective in the treatment of melasma, however, our study did not show additive therapeutic effect by adding fractional CO₂ laser to it.

Skin complications of blood vessel donor limbs and their association with diabetes in patients undergoing coronary artery bypass grafting

Khatereh Zahedi

Background and Aim: According to the limited clinical observations and researches on cutaneous complications and hair growth changes of donor's site extremities, this study aimed to compare hair growth changes and cutaneous complications of donor's site extremity in patients who underwent coronary artery bypass graft between diabetic and non-diabetic patients.

Methods: Patients who attended the heart surgical clinic for routine follow-up 3-6 months after CABG (coronary artery bypass grafting) were evaluated. Their donor's sites in both extremities were compared with each other. Cutaneous changes were assessed and recorded by a dermatologist. After recording data, the incidence of these complications and the differences between diabetic and non-diabetic patients were evaluated.

Results: From the 97 participants of this study, 77 were male and 20 were female. Of these patients 29 were diabetic. Ten had hypertrichosis, 3 had hair loss in donor's site extremity, 16 had hyperpigmentation changes, 21 had itches, 26 had colloid scar changes, 3 had dermatitis, and 9 had wound site infection. In this study there was no statistically significant difference regarding the incidence of complications in diabetic patients compared to non-diabetic patients (P>0.05).

Conclusion: The cutaneous complications in this study were similar to previous studies and the only significant finding was the incidence of hypertrichosis in donor's site extremity. In order to determine the prevalence and persistence of the complications more accurately, further studies on larger populations including follow-up of complications are warranted.

The effect of group positive psychotherapy on social competence of women candidates for cosmetic rhinoplasty

Sheida Jabalameli

ackground and Aim: The purpose of this study was to determine the efficacy of group positive psychotherapy on social competence in women candidates for cosmetic rhinoplasty in Isfahan city.

Methods: The research design was a semi-experimental
pre-test-posttest, controlled study and available sampling method was used. From all women refered to relavant centers for cosmetic rhinoplasty in the third quarter (October, November and December) of 2018, 50 participants were selected. After filling social adequacy questionnaire, 30 individuals who obtained the lowest score, were selected and randomly divided into two experimental and control groups. Subsequently, positive group intervention was performed on the experimental group in 10 sessions of 2 hours based on the Rashid protocol (2015). Then the participants of both groups were asked to answer the questionnaire of social adequacy. Finally, the data were analyzed by SPSS-23 software in two descriptive and inferential sections.

Results: The results showed that group positive psychotherapy increased social competence on a general scale and its dimensions in women who were applicant for cosmetic surgery in the experimental group in post-test phase and these changes are statistically significant (P<0.01).

Conclusion: Positive psychotherapy can be used as an interventional and therapeutic method for women applying for rhinoplasty surgery to improve the social competence.

The effect of topical vitamin C solution on granulation tissue formation in burn wounds

Hamid Robat Sarpooshi

ackground and Aim: Different treatments have been tried for healing burn wounds each of which has had its own effects and complications. Therefore, researchers have attempted to develop methods for more rapid wound healing with fewer complications and greater patient satisfaction. This study investigated the effect of topical application of vitamin C solution on granulation tissue formation resulting from burn wounds.

Methods: Thirty patients hospitalized in the Burns Ward were divided into the control and intervention groups. The intervention group received topical application of vitamin C solution together with silver sulfadiazine ointment whereas only silver sulfadiazine ointment was used for the control group. Wound healing was observed and given scores on days 1, 3, 7 and 14 using the Bates-Jensen Wound Assessment Tool. The collected data was analyzed using SPSS 16.

Results: The results of repeated measures ANOVA showed that there were statistically significant between the two groups with respect to the mean scores for granulation tissue formation (P=0.004). Moreover, topical application of vitamin C significantly improved granulation tissue formation. As for intragroup effects also, the duration of the treatment had statistically significant effects on the mean score given for granulation tissue formation; i.e., there were significant differences between the mean scores given for days 1, 3, 7 and 17 (P=0.000; F=264.430).

Conclusion: This study showed that vitamin C has accelerating effect on wound healing.

Assessment of quality of life in hemodialysis patients with uremic pruritus from Iranian Medicine view

Seyedmajid Ghazanfari

Background and Aim: Pruritus is one of the most common problems of chronic kidney diseases. Different treatment modalities, while extending the life span of patients, can lead to changes in their lifestyle, health status and ultimately change their quality of life (QOL). Understanding the different aspects of patients' QOL leads to better services provided by health care teams to improve the patients' QOL. The aim of this study was to evaluate the quality of life of hemodialysis patients with uremic pruritus in Mashhad in 1396 with a view to Iranian Medicine.

Methods: This descriptive-analytical study was performed on 52 patients. Data collection was done by the World Health Organization QOL and researcher-made demographic Questionnaire and SPSS 16 software was used for data analysis.

Results: The mean age of patients was 51.73 years and mean duration of dialysis was 41.42 months. Total score of life quality was 56. The lowest and highest scores were seen in physical and environmental dimensions. There was an inverse significant relationship between some aspects of QOL with hemoglobin and creatinine and a direct significant relationship with age, diabetes, hypertension and hyperlipidemia (P<0.005).

Conclusion: Hemodialysis patients' QOL is lower than others and several factors can improve it. Special attention to the individual characteristics of hemodialysis patients can be helpful in predicting their basic needs.

Herbal remedies for treatment of urticaria in view of Iranian Medicine and evaluation of relevant evidence in conventional medicine

Ebrahim Khadem

Urticaria is a relatively common skin disease characterized by red or white itchy and transient swellings. In more severe cases, it can reduce level of consciousness and be life-threatening due to swelling of tongue or throat and airway obstruction
In conventional medicine, this disease is treated symptomatic and mainly by antihistamines. Studies have indicated that urticaria is similar to "shara" (a type of skin disease mentioned in Persian medicine) in terms of etiology, description, clinical symptoms and diagnosis. In Persian medicine (Iranian traditional medicine) litrature, efficacy of several medicinal plants for the treatment of "shara" has been explaind.

This study is a review on the effective herbal remedies in the treatment of urticaria based on search in Iranian medicine resources, and conventional medicine litrature. Data were extracted from Iranian medicine textbooks and scientific databases including Google scholar, Pub Med, Web of Science and Scopus. It was found that Iranian medicine scholars have used 48 different medicinal plants to treat and reduce the complications of urticaria and the recent scientific studies have proven antiinflammatory, antioxidant and immune-regulating properties in 45 of these plants.

Case report: leprosy in a family

Azin Ayatollahi

ntroduction: Leprosy is an infectious disease which primarily affect skin and peripheral nerves. Mycobacterium leprae and Mycobacterium lepromatosis that are the acid-fast bacillus are known to be cause of leprosy. Genetic factors and immunological function have some roles in susceptibility of developing leprosy. There are some cases of familial leprosy.

Case Report: Here in, we report a case of familial leprosy which in one member it was symptomatic and others were asymptomatic with positive skin smear for mycobacterium leprosy bacilli.

Conclusion: We recommend in addition to approach and manage lepromatous patients, their families be also evaluated.