Journal of

Background and Aim: Hypertrophic scars are highly resistant to the treatment and have a high recurrence rate. Affected patients suffer from aesthetic and functional complications, which may influence their quality of life. Nowadays, various therapeutic modalities have been used in the treatment of hypertrophic scars, but patients' problems remain because of high recurrence rate. This study evaluated the efficacy of intralesional injection of botulinum toxin A in the treatment of hypertrophic scar lesions.

Methods: This randomised controlled trial was performed during 2014 and 2015. Each patient`s lesion was randomly allocated in ine of the two arms of the study: one half of the lesion received monthly 8 IU/cm³ of 200 IU/ml intralesional botulinum toxin A (Dysport, Ipsen Biopharma Ltd., UK) and the other half was injected with the same volume of normal saline. Injections were repeated three times. After 9 months, lesions were evaluated according to Vancouver scar scale.

Results: Twenty-one patients with a mean age of 27.2 years completed the study. In the intervention the mean lesions` pigmentation scale decrease to 0.73, vascularity to 0.9 and pliability to 0.98 (P<0.01), but there was no significant change in lesions height (P=0.32).

Conclusion: It seems that injection of botulinum toxin A in hypertrophic scar lesions acts as useful adjuvant for other treatment methods.

Background and Aim: Undesirable appearance of the scar tissue after aesthetic surgery can affect the outcomes and patient satisfaction. In recent years, early laser therapy had been encouraged to reduce the scar tissue formation. However, the available evidence regarding the outcomes of laser therapy utilizing combined lasers are limited. In the current study, the effects of combined laser therapy using pulsed dye laser (PDL) and fractional CO2 laser on the appearance of the scar tissue after aesthetic surgeries were investigated.

Methods: There were 15 patients enrolled in the current study including 13 mammoplasty and 2 abdominoplasty patients. In mammoplasty, each breast was randomly assigned to the laser therapy or control group. In abdominoplasty, split scar design was used. In laser therapy group, at the end of the third postoperative week, PDL 585 nm was radiated. Furthermore, at the end of the sixth week, fractional CO2 laser was radiated. The patients were followed for 6 months after the last laser therapy session. Visual analogue scale was used to rate the appearance of the scar tissues by 3 surgeons blinded to the treatment of scars. The appearance of the scars was determined as poor, fair, good or excellent. 

Results: VAS averaged 5.5±0.8 in laser therapy group and 4.8±0.8 in the control group. The difference was not statistically significant (P=0.057). There was no scar with excellent appearance in the current study. All of the scars were fair and good in the laser therapy group. In the control group, 13 scars were fair. The difference was not significant (P=0.227).

Conclusion: Early combined laser therapy using PDL and fractional CO2 laser was associated with improved appearance of the scar tissue in short-term follow up, however, the effects were not statistically significant.

Background and Aim: The most prevalent form of leishmaniasis is cutaneous leishmaniasis (CL), which manifests as a single ulcerative or nodular lesion that usually heals on its own. The aims of this study were to investigate the histopathologic and clinical features of CL patients.
 

Methods: This cross-sectional study was accomplished on 70 CL patients that referred to Razi dermatology hospital in Iran, over a five-year period from 2016 to 2020. Included patients were those who were diagnosed clinically suspected patients whom their disease was confirmed through histopathology examination.
 

Results: The age of patients ranged from 2 to 76 years with a mean of 42.26 ± 20.86 years. The majority of patients were men (54.3%). The plaque form lesions were the most frequent type (64.3%). Respecting lesion site, face, and upper limbs were more frequent with the abundances of 47.1% and 34.3%, respectively. All of the patients had evidence of cellulitis on ultrasound. The most prevalent change of epidermis was hyperkeratosis (42.8%). Regarding dermal histopathologic changes, infiltration of lymphocytes (61.4%), plasma cells (58.6%), and histiocytes (48.6%), as well as granuloma formation (54.3%) and leishman body presence (54.3%) were the dominant changes. Some patients had atypical forms of CL as six of them had lupoid cutaneous leishmaniasis (LCL) and five had sporotrichoid cutaneous leishmaniasis (SCL).
 

Conclusion: In this study, men and those who were in middle age were more susceptible to be infected, so it suggests considering them particularly in the preventive programs. Moreover, histopathological findings of CL, including LCL and SCL, are presented. These findings may be beneficial for dermatologists and dermatopathologists to differentiate them from other cutaneous diseases.