Journal of

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Background and Aim: Cutaneous leishmaniasis (CL) is endemic in Iran, where it is one of the most important health problems. Both anthroponotic CL (ACL) caused by L. tropica and zoonotic CL (ZCL) caused by L. major are reported. Antimoniate derivatives as the standard therapy for CL need multiple injections and are not easy to tolerate for the patients. This study was conducted in Mashhad to compare the efficacy of weekly versus twice a week intralesional injections of meglumine antimoniate (MA) in the treatment of ACL.
Methods: This randomised controlled trial was performed during 2006 to 2008 in Mashhad, Iran. Using computerized sequence of random numbers, participants were randomly allocated in the two arms of the study: one receiving weekly and the other receiving twice-a-week intralesional injections of MA. The lesion size, induration and healing rate were assessed, recorded and compared. Healing was defined as complete re-epithelialisation and disappearance of induration.
Results: A total of 252 suspected CL patients with 372 lesions were screened. 82 parasitologically proven cases with 121 lesions caused by L. tropica were included and 74 patients with 113 lesions completed the study. At 12^th week after initiation of treatment, complete healing was observed in 38 out of 44 lesions (86.4%) in the group which received weekly intralesional MA injection. The median time-to-heal in this group was 36 days (95% confidence interval [CI]: 32.0-39.9). Complete healing was recorded in 60 out of 69 lesions (86.9%) in the group which received twice a week intralesional injections of MA with a median time-to-heal of 25 days (95% CI: 20.9-29.1). While no significant difference was observed between the two groups in terms of complete healing rate (P=0.999), time-to-heal was significantly different between the 2 groups (P=0.003).
Conclusion: It seems that the effectiveness of twice-weekly intralesional injections of MA is similar to once-weekly regimen while the former regimen causes more rapid healing of lesions.

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Langerhans cell histiocytosis (LCH) is a proliferative disorder of langerhans cells and lymphocytes having different subtypes and a wide range of clinical manifestations and severity ranging from a unifocal self-limited disorder to multi-system involvement and even death. Along with clinical manifestations, diagnosis is made through existence of specific immunohistochemistry markers. Where treatment is necessary, different treatment modalities have been proposed though none have found to be optimal.This paper introduces a 23-year old girl with an extensive yellowish to red-brown maculopapular rash over her face accompanied with polyuria, polydipsia, and fatigue.

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Background and Aim: Atopic dermatitis (AD) is a chronic, relapsing, pruritic skin disease more common in infancy and childhood. Emollients, topical corticosteroids, and avoidance of irritating factors are the mainstay of its treatment, but fear of side effects has limited the use of topical corticosteroids. The objective of this study was to evaluate the safety and efficacy of topical tacrolimus 0.03% ointment in the treatment of AD.
Methods: In this randomized, double-blind, clinical trial, 76 patients with AD older than 2 years were randomly allocated in two groups and treated with either tacrolimus 0.03% ointment (Abu-Rayhan Co., Iran) or placebo, twice a day for 6 weeks. Responses to treatment were compared every 2 weeks using SCORAD.
Results: Twenty-nine patients in tacrolimus group and 26 in placebo group completed the trial. The reduction in SCORAD after 2 and 4 weeks in tacrolimus group was significantly higher than placebo group (P<0/05). The frequency of treatment-induced pruritus and burning sensation was similar in both groups but erythema was more observed in the placebo group (P<0/05).
Conclusion: Tacrolimus 0.03% ointment is more effective than placebo in the treatment of AD.

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Dermatology is a branch of medicine which is related to the diagnosis, treatment and prevention of the diseases and disorders that affect the skin and its appendages including hair, nail, sweat glands and mucosal surfaces of mouth and external genitalia. There are about 3000 clinical entities in the field of dermatology, which are very diverse in terms of their etiologies. Although some of these diseases are really prevalent and some others of them have high incidence rates and acknowledging that because of their visibility in many cases they are associated with stress, anxiety and impairment of patients' quality of lives, their resultant burden of disease at individual, familial and social levels are usually ignored. Herein, we provide some examples of the adverse public health and health economics effects of different dermatological diseases and disorders in different countries and populations. We also provide some reasons for this negligence and suggest some strategies to tackle this problem.

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Skin is the largest organ of the integumentary system with multiples important functions. Due to its complex structure, the permeability skin status can be modified by different external and internal factors such as chemical and physical stresses, and several skin and systemic diseases. Today, different non-invasive methods are used to assess the skin barrier biophysical properties. The parameters such as transepidermal water loss, stratum corneum hydration, skin surface pH and skin surface lipids is essential for evaluation of the epidermal barrier status. Application of these methods is critical for evaluation of disease treatments, the effectiveness of topically applied drugs and cosmetic products. The aim of this article is to review application of several methods for skin biophysical and biomechanical properties in humans.

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Great progress in optics, electronic engineering, and computer science provide an opportunity to diagnosis of skin diseases, estimating effectiveness of drugs and skin care products using non-invasive, non-destructive methods of analysis. Also many noninvasive methods using analytic devices are developed to assessment of the outcomes of dermatologic surgeries on malignant skin tumors. The aim of this article is to review advanced methods for skin analysis on human’s skin such as magnetic resonance imaging and time domain reflectometry. Many kind of interesting applications are defined for using these methods especially in cosmetic pressures.

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There are different ways to treat local obesity and cellulite including invasive and noninvasive methods. Due to the fact that noninvasive methods have significantly lower rates of adverse effects, they become more popular. One of these methods is acoustic wave therapy (AWT) or shock wave therapy (SWT). In addition to treating cellulite, SWT has been found useful for some other conditions. In this paper, we briefly introduce SWT and describe the protocol and results of treating cellulite and local obesity using Callactor® SC1 device (Storz Medical, Switzerland) in three females with normal body mass indices.

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Background and aim: In recent years, increasing demand for aesthetic treatments in Iran and the need for high-quality domestic products have encouraged several companies to produce botulinum toxin type A. This study aimed to evaluate and compare the clinical efficacy and safety of three such Iranian products.
Methods: In the first part of the study, the overall efficacy of the botulinum toxin type A products for treating glabellar lines was assessed in 230 participants who received one of the three Iranian formulations (mean age 42.69 ± 9.21 years), and compared with 230 participants who received the standard treatment (Dysport®) (mean age 42.50±9.79 years). Outcomes were evaluated on day 30 post-injection. In the second part, the comparative efficacy of the three domestic products during the same period and their safety profile up to month four post-injection were assessed.
Results: A clinically meaningful response (at least a two-grade improvement in glabellar line severity) was achieved in 68.6% of recipients of the Iranian products, compared with 52.8% of Dysport recipients, demonstrating a statistically significant superiority in equivalence studies (P<0.01). Among the three domestic products, only product No. 2 showed a significantly higher proportion of participants achieving ≥2-grade improvement (assessed by an independent physician). The type and frequency of adverse events (except for headache) were comparable to the standard drug monograph.
Conclusion: The findings indicate acceptable efficacy and safety of Iran-made botulinum toxin type A products compared with the reference product. Except for limited differences, the efficacy and safety profiles of the three formulations were generally similar up to day 30 post-injection.