Journal of

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Background and Aim: Vitiligo is a common skin disorder that presents as depigmented patchs and associated with psychosocial morbidity. Photochemotherapy with methoxsalen plus ultraviolet A (PUVA) is an effective and commonly used modality in treatment of vitiligo and is available in Khorasan Province since more than ten years ago.
Methods: This uncontrolled clinical trial included patients with vitiligo referred to phototherapy center in Emam Reza Hospital in Mashhad during 1998-1999. Treatment was done topically on patients with involvement less than 2% of the body area and systemic in cases with involvement more than that. Data including improvement rate and side effects were analyzed by SPSS software version 11.5.
Results: One-hundred and thirty-five patients, 79 female and 56 male, were enrolled.  One-hundred and twenty-six patients were treated systemically and 9 patients underwent topical therapy. Complete (100%) repigmentation was observed in one patient. Repigmentation of 80-99%, 60-79%, 40-59%, 20-39% and less than 20% were observed in 53, 43, 12, 6 and 20 patients respectively. Results were significantly better in generalized vitiligo, face involvement, and cases whom recieved more than 200 treatment sessions, but there was not significant relationship between improvement and patients' age, family history, the first involved area, beginning time of repigmentation, the observed interval between initiation of treatment and disorder appearance, and skin type. Common side effects were pruritus (69.6%), erythema (52.6%), nausea and vomiting (28.9%), and headache (17.8%).
Conclusion: PUVA therapy is an effective and safe treatment in patients with vitiligo, and has good results in nonsegmental vitiligo and facial involvement.

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Malassezia species (previously Pityrosporum) are normal flora of human and warm-blooded animals skin. The genus Malassezia is now divided into 13 species. Most of the yeasts show an absolute requirement for long fatty acid chains and specific procedures are required for their isolation, conservation and identification. Under appropriate conditions, the fungi can cause various skin diseases. The aims of this review were to describe recent classification of genus Malassezia their virulence factors, and their association to dermatlogical diseases.

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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.

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Background and Aim: Hirsutism as a clinical presentation of hyperandrogenism has a negative impact on the mental health and quality of life. Therefore, determination of its prevalence and associated factors in communities are important. The aim of this study was to determine the prevalence of hirsutism and its associated factors in dormitory students of Semnan University of Medical Sciences in Semana, Iran.

Methods: In this cross-sectional study, all of the female students of Semnan University of Medical Sciences dormitory were given a questionnaire which consists of three parts. The first two sections was designed to collect the demographic data and medical history including past medical history, drug history, menstrual condition and familial history of hirsutism. The third section included the grading scale of Ferrimen-Gallwey, that contains images of various parts of the body and hair growth. Participants were asked to determine their hair growth on the pictures. Data was analyzed using IBM SPSS Statistics (IBM Corp., Armonk, NY, USA) version 19. Chi squared test was used for comparison of proportions in different groups.

Results: From 330 participants, 119 students (36.1%) complained from hirsutism. 105 (31.8%) patients had mild and 14 (4.3%) students had moderate hirsutism. There was a significant correlation between hirsutism and irregular menstrual cycles, positive familial history of hirsutism, congenital adrenal hyperplasia, polycystic ovary, hypothyroidism, use of danazol, and hoarseness (P<0.05).

Conclusion: This study showed a high prevalence of hirsutism in dormitory students of Semnan University of Medical Sciences. More clinical evaluation is suggested to determine various forms of hirsutism and the underlying conditions.

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Background and Aim: So far, the relationship between patient experiences and the quality of services provided to them has not been widely studied. However, evidence suggests that improving patient experiences can improve clinical outcomes. The aim of this study was to determine the satisfaction of parents of children referring to the pediatric clinic as well as the related factors.

Methods: This descriptive study was conducted using a pre-designed Press Ganey questionnaire in Persian language and through interviews with 207 parents of children who referred to the pediatric clinic of Razi Dermatology Hospital in 2018. 

Results: Of the 207 participants, 87 were fathers (42%) and 105 were mothers (50.7%). The remaining 15 had other relationships with the child. Overall satisfaction (recommending our clinic to others) was 62.8%. Also, 72.5% of the participants believed they would recommand their doctors. The lowest level of satisfaction was due to the lack of introduction of clinic staff and the difficulties in setting up an appointment. The factors that most closely correlate with the patient's overall satisfaction included respectively: the cheerfulness of the visit by the doctor, the confidence in the doctor, and the likelihood of recommending the doctor.

Conclusion: The relationship between a physician and a patient is significantly related to the quality of patients' experiences in the pediatric dermatology clinic. Families and patients, when evaluating their experiences, focused on clear language and doctor's sensitivity.