Dermatology and Cosmetic

Editorial Note

Mansour Nassiri Kashani

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Evaluating the treatment history and its’ associated factors in psoriasis patients who received biologic treatment

Shahin Hamzelou

Background and aim: In the severe cases psoriasis, there is a need for biologic treatments which target the immunological responses contributing to the disease pathophysiology. There is no study in definite indications for the treatment choice and the time to start the biologic treatment in Iranian psoriasis patients.
Methods: We designed a cross-sectional study and evaluated all psoriasis patients who had received biologic treatment. After determining the patients who were eligible to participate in the study, their records were studied and analyzed.
Results: 50 patients with the mean age of 42.86 (SD=14.33) participated in the study. Twenty-five patients had received phototherapy for the treatment of psoriasis. All patients had received topical agents and 47 (94%) had received systemic treatment. Adalimumab was the most common biologic treatment used for the treatment of psoriasis patients (74%). 24% of patients had received Infliximab and 4% had received Etanercept.
Conclusion: 50 patients with the mean age of 42.86 (SD=14.33) participated in the study. Twenty-five patients had received phototherapy for the treatment of psoriasis. All patients had received topical agents and 47 (94%) had received systemic treatment. Adalimumab was the most common biologic treatment used for the treatment of psoriasis patients (74%). 24% of patients had received Infliximab and 4% had received Etanercept.

Investigating the relationship between melasma and SAHA

Shabnam Fahim

Background and Aim: Melasma is an acquired, chronic, and recurrent pigmentation disorder that usually affects sun-exposed skin areas. SAHA syndrome is also an acronym for four words: seborrhea, acne, hirsutism, and androgenic alopecia. Given the association of melasma with some components of SAHA syndrome, such as acne and hirsutism, this study was conducted to determine the relationship between melasma and SAHA syndrome.
Methods: This case-control study was conducted on 75 women with melasma as the case group and 75 women without melasma as the control group. Data were collected in the form of a questionnaire consisting of 28 questions and analyzed.
Results: In the case group, 32% had hirsutism and 70.7% had acne. In the control group, 10.7% had hirsutism and 26.7% had acne. There was a significant association between factors (history of melasma in first-degree relatives, history of hirsutism in first-degree relatives, acne, alopecia) and melasma. Among the case group, 5.3% had SAHA syndrome.
Conclusion: Considering that androgenic disorders are implicated in the etiology of SAHA syndrome and melasma, it seems that melasma lesions are more common in patients with SAHA syndrome.

Segmentation of skin lesions using the LSE method for heterogeneous dermoscopic images in color spaces

Abdolah Chalechale

Background and Aim: Image brightness heterogeneity is one of the major challenges in computer image processing that can lead to inaccurate results in image segmentation. Despite the existence of numerous segmentation methods, few studies have been conducted on the effect of brightness heterogeneity and the selection of the best color channels in segmentation. In this paper, different color spaces have been used for automatic detection of skin lesions.

Methods: In this study, the LSE (Level Set Evolution) segmentation method along with intensity smoothing has been used for computer recognition of skin lesions. First, the brightness heterogeneity is reduced and a more uniform image is created. Then, the proposed segmentation divides the image domain into distinct regions. This method results in more accurate recognition of skin lesions.
Results: The proposed method has been tested on 200 dermoscopic images from the known PH2 dataset using different color channels. The results show that this method performs better than other methods. Accuracy of 97%, sensitivity of 98%, specificity of 99% and Dice coefficient of 92% have been obtained.
Conclusion: This method has the ability to accurately isolate and diagnose lesions and can help doctors in the treatment process of skin lesions.

Pilot study of efficacy of injection of interferon-gamma (IFN-γ) on skin lesions caused by leishmania major in Balb /C mice

Ali Khamesipour

Background and Aim: Leishmaniasis is difficult to control and is not cost-effective in endemic areas. Antimony toxic compounds is the drug of choice, which drug resistance is increasing. Animal studies showed that interferon-gamma deficiency impairs the recovery of leishmaniasis. In this study, the therapeutic effects of subcutaneous injection of recombinant gamma interferon on leishmaniasis lesions in Balb/ C mice were evaluated.
Methods: 40 Balb/ C mice were infected with Leishmania major. After developing lesions, the therapeutic effects of interferon gamma alone or in combination with glucantime were investigated. Also, the standard treatment of glucantime and the control group without treatment were evaluated for comparison.
Results: The treatment groups (glucantime, gamma interferon, and gamma interferon-glucantime) had a significant difference (P<0.01) in terms of reduction in the footpad thickness compared to the control group. There was no significant difference in the mortality rate in the groups receiving gamma interferon and the group receiving standard glucantime treatment.
Conclusion: It seems that gamma interferon was effective in treating cutaneous leishmaniasis lesions in Balb/c mice alone and in combination with standard treatment and can be considered as an alternative treatment.

Polysaccharides and peptides with wound healing activity from fungi

Bahareh Nowruzi

Bacteria are natural sources of metabolites that exhibit diverse bioactive properties, including wound healing, antioxidative, antibacterial, antifungal, anti-inflammatory, antidiabetic, and anticancer activities. Two important groups of bacteria with wound healing potential are polysaccharides and peptides. In addition to cellulose, bacteria produce various polysaccharides (such as exopolysaccharides) with wound healing potential. The most common bacterial peptides used in wound healing studies are bacteriocins and lipopeptides. The aim of this article is to review recent literature on the potential of wound healing in vitro and in vivo by polysaccharides and peptides derived from bacteria (Actinobacteria, Bacteroides, Cyanobacteria, Firmicutes, and Proteobacteria). For this reason, a search was conducted in scientific research databases such as Web of Science, Google Scholar, Wiley, Elsevier, Taylor and Francis, BMC Springer and MDPI with the keywords polysaccharide, peptide, bacteriocins, lipopeptides, streptomyces, bacteria, lactic acid bacteria, cyanobacteria and wound healing. The overall results showed that polysaccharides and peptides and peptides derived from bacteria show wound healing power both in vitro and in vivo. In living models, including animals and humans, these metabolites have a positive effect on wound healing by inhibiting pathogens, antioxidant activity, modulating the inflammatory response, moisturizing the wound environment, promoting the proliferation and migration of fibroblasts and keratinocytes, increasing collagen synthesis, remodeling, epithelialization and angiogenesis. Therefore, peptides and polysaccharides derived from bacteria play a significant role in wound healing.

The role of inflammation in wound healing and pathological scarring; a glance to the function of macrophages

Mahmood Araghi

Impaired wound healing following significant tissue damage such as severe burns, trauma, or surgery can result in scarring and skin fibrosis. Pathological scarring leads to changes in the natural shape of the wound and, in addition to cosmetic problems, may be accompanied by pain and even limit the person's normal movement. The immune response plays a very important role in the wound healing process. Activation of immune cells and factors initiates the inflammatory process, facilitates wound cleansing, and tissue repair and regeneration. However, disruption of the immune system during the wound healing process leads to persistent inflammation and delayed healing, ultimately leading to the development of chronic wounds. The microenvironment of a chronic wound contains a large number of immune cells, including proinflammatory macrophages, and high expression of inflammatory mediators such as TNF-α and IL-1β is observed in it. Among them, macrophages, as innate immune cells, play a key role in promoting the immune response and activating adaptive immunity. These cells are also key factors in the transition from the inflammatory phase to the tissue repair phase. As a result, dysregulation of macrophage function will have consequences such as scarring. Therefore, knowledge of the exact mechanism of the inflammatory process during wound healing, the inflammatory and anti-inflammatory mediators produced, and the effect of macrophages on this process can promise the achievement of new strategies in scarless wound healing. Therefore, this article discusses the mechanism of the immune system during the inflammatory process, and the key role of macrophages in this process, as well as scar formation.

Polysaccharides and peptides with wound healing activity from bacteria

Bahareh Nowruzi