Faezeh Roshanbakht, Nahid Hassanzadeh Nemati, Neda Attaran Kakhki,
Volume 16, Issue 1 (5-2025)
Abstract
Skin infections caused by pathogenic bacteria such as Staphylococcus aureus and Pseudomonas aeruginosa have become a serious challenge in the field of antibacterial therapies, especially in the context of antibiotic resistance. In this regard, the simultaneous use of classical antibiotic combinations with advanced nanostructures is considered a novel and effective approach. Narasin, an ionophore antibiotic of natural origin, has a high potential in inhibiting bacterial growth due to its ability to disrupt cell membrane function and ion transport. On the other hand, silica nanostructures, especially mesoporous silica nanoparticles, play an important role in enhancing antibacterial activity due to their properties such as biocompatibility, drug loading capability, controlled release, and production of reactive oxygen species.
Recent studies have shown that the combination of narasin with silica nanostructures enhances the synergistic antibacterial effects, increases drug stability, and improves penetration into bacterial biofilms. This combination has also been effective in reducing the dosage and systemic toxicity. Despite promising results in laboratory and animal models, challenges such as the assessment of cytotoxicity, precise release control, and the need for extensive clinical studies remain.
In this article, while comprehensively reviewing the properties and functions of narasin and silica nanostructures, the mechanisms of their combined effects on skin pathogenic bacteria are discussed and future prospects in the development of nanobiotechnological therapies are reviewed.
Azin Ayatollahi, Mahsa Fattahi,
Volume 16, Issue 1 (5-2025)
Abstract
Dermatophytes are keratinophilic fungi responsible for common and benign infections worldwide. However, in immunocompromised patients, they may lead to rare and severe diseases. Severe forms include widespread and/or invasive dermatophytosis, such as deep dermatophytosis and Majocchi’s granuloma. These cases have been reported in individuals with primary immunodeficiencies (such as autosomal recessive CARD9 deficiency) or acquired immunodeficiencies (such as solid organ transplantation, autoimmune diseases treated with immunosuppressive therapies, or HIV infection). The clinical manifestations of these infections are non-specific. Lymph node and organ involvement may also occur. Diagnosis requires mycological and histopathological evidence. There is no consensus on treatment. Systemic antifungal agents, such as terbinafine and azoles (e.g., itraconazole or posaconazole), are effective. However, the long-term outcome and management depend on the site and extent of the infection and the type of underlying immunodeficiency.
Farnaz Valizadeh,
Volume 16, Issue 1 (5-2025)
Abstract
Onychomycosis is one of the most common human fungal infections, affecting both fingernails and toenails and accounting for approximately 50% of all chronic nail disorders. It may be caused by various dermatophytes, yeasts (especially Candida spp.), and non-dermatophyte molds. Risk factors include advanced age, underlying conditions such as diabetes, immunosuppression, chronic moisture, and prolonged use of closed footwear. Accurate diagnosis requires clinical examination along with direct microscopy, culture, and, in advanced cases, molecular techniques. Treatment options include topical, systemic, or combined antifungal therapies, chosen based on the infection’s severity, causative agent, and patient status. Due to high recurrence rates, preventive measures and complete treatment follow-up are essential. This review provides a comprehensive overview of the epidemiology, clinical manifestations, etiologic agents, diagnostic methods, and therapeutic approaches to onychomycosis, highlighting current challenges in its management.
Azin Ayatollahi, Aliasgahr Ghaderi,
Volume 16, Issue 1 (5-2025)
Abstract
The indications for botulinum toxin have evolved tremendously since its introduction in 1989. This review highlights the potential of the use of BoNT based on the latest studies that indicate botulinum toxin injections may be beneficial as an alternative method of therapy in treating, among others, hyperhidrosis, hidradenitis suppurativa, Raynaud phenomenon, or anal fissure. Currently, there are numerous studies suggesting the effectiveness of botulinum toxin in the discussed diseases; however, it should be emphasized that the majority of evidence is based on low scientific quality publications and more clinical trials need to be conducted. Despite many favorable utilizations, the use of botulinum toxin is not without ramifications. To serve patients with relevant therapy and reduce related complications, dermatologists should be aware of both on- and off-label applications of botulinum toxin. Undoubtedly, a consensus on the treatment protocol for each indicator should be a topic of interest for practitioners to standardize all regimens with specific doses of BoNT.
Mansour Nassiri Kashani,
Volume 16, Issue 2 (7-2025)
Abstract
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Maryamsadat Sadati, Arefe Ferdowsi, Majid Akrami, Armin Gorjian, Mojgan Akbarzadeh Jahromi, Yasamin Dehghan,
Volume 16, Issue 2 (7-2025)
Abstract
Background and aim: Cutaneous melanoma is one of the most aggressive skin cancers with high metastatic potential and considerable mortality. Prognostic factors such as tumor thickness, surgical margin status, and lymph node involvement play a decisive role in prognosis and treatment selection. Reports from Iran also indicate an increasing incidence of this disease, and providing epidemiological and clinical data at the regional level can help guide therapeutic policies.
Methods: In this retrospective cross-sectional study, all patients with cutaneous melanoma who underwent surgery at Shahid Faghihi Hospital, Shiraz, between 2019 and 2023 were evaluated. Demographic information, lesion site, tumor size and thickness, histopathological type, surgical method, margin status, and the need for reoperation were extracted from medical records and analyzed using descriptive and analytical statistical tests.
Results: A total of 84 patients were included (51.2% male and 48.8% female). The most common histopathological type was malignant melanoma (31%). Lesions were most frequently located on the hands (28.6%) and feet (21.4%). The majority of lesions measured between 2–5 cm (36.9%). Only 2.4% of patients had tumors thinner than 1 mm, while 11.9% had tumors thicker than 5 mm. Excision was the most common surgical method (54.8%). Surgical margins were free of tumor in 53.6% of cases, and 61.9% of patients required reoperation.
Conclusion: The findings indicate that cutaneous melanoma in southern Iran predominantly occurs in the extremities, and the high rate of reoperation underscores the need for more precise surgical planning and earlier diagnosis.
Mehri Seyedmousavi, Alireza Homayouni, Seyedehtahereh Faezi, Ali Khanekeshi, Jamal Sadeghi,
Volume 16, Issue 2 (7-2025)
Abstract
Background and aim: The aim of the present study was to determine the effectiveness of cognitive-behavioral therapy on Alexithymia and pain coping strategies in women with lupus.
Methods: The research method was semi experimental with a pretest–posttest and two–month follow–up design with a control group. The statistical population of this research included all female patients with lupus who had referred to the Lupus Association in 2024 for lupus counseling and treatment. Among the statistical population, 30 qualified volunteers were available entered into the study and randomly assigned to two experimental and control groups (each group includes 15 people). The cognitive-behavioral therapy was implemented in the experimental group as 8 sessions one a week. Data analysis of the research was conducted using repeated measures analysis of variance and Bonferroni post-hoc test at a significance level of 0.05, with SPSS software version 27.
Results: The results indicated that the effect of time, the effect of group, and the interaction effect of time and group on emotional distress scores and pain coping strategies were significant (p<0.001). In the intervention group, there was a significant difference in Alexithymia scores and pain coping strategies between the pre-test and post-test stages, as well as between the pre-test and follow-up (p<0.001). However, no significant difference observed between the post-test and follow-up for these variables.
Conclusion: This research showed that teaching the cognitive-behavioral therapy to women with lupus is suitable for improving alexithymia and pain coping strategies.
Forouhe Zahirjouzdani, Farid Mohamadi,
Volume 16, Issue 2 (7-2025)
Abstract
The health of the skin and hair serves not only as an indicator of overall physiological well-being but also plays a significant role in personal appearance and self-confidence. A range of intrinsic and extrinsic factors-including genetics, hormonal balance, environmental exposures, and, most notably, nutrition-affect the maintenance and integrity of skin and hair. Micronutrients, comprising essential vitamins (such as B-complex, C, and E), minerals (including zinc), and bioactive phytochemicals with antioxidant and anti-inflammatory properties (such as astaxanthin), play a critical role in supporting the structural and functional health of these tissues. These compounds contribute to the regulation of cellular metabolism, mitigation of oxidative and inflammatory damage, and enhancement of immune function, thereby aiding in the prevention of common dermatological and hair-related conditions such as dryness, hair loss, and premature aging, and promoting overall skin and hair health.
Azin Ayatollahi,
Volume 16, Issue 2 (7-2025)
Abstract
Human lip aging is one of the natural signs of the body’s aging process, occurring over time due to factors such as a decrease in collagen and elastin, exposure to sunlight, environmental stress, and genetic changes. As time passes, the lips may lose their appearance, and fine lines or deep wrinkles may form around the lips and the upper lip area. These changes can lead to a reduction in lip volume and the loss of their natural shape. Additionally, dryness and chapping of the lips are other issues commonly observed with lip aging. Skin care, the use of moisturizers, and avoiding prolonged sun exposure can help slow down this process.
Fatemeh Yazdani Hamid,
Volume 16, Issue 2 (7-2025)
Abstract
This article reviews the impact of isotretinoin on thyroid function, based on various clinical studies. Isotretinoin, a commonly prescribed treatment for severe acne, has been linked to significant changes in thyroid hormone levels, including elevated TSH and decreased FT3 and FT4. Several studies suggest that long-term isotretinoin use can induce thyroid dysfunction, with potential effects on thyroid volume, hormone levels, and the immune system. Autoimmune thyroid conditions, particularly autoimmune hypothyroidism, have also been observed in patients receiving isotretinoin. These findings highlight the need for regular thyroid monitoring during isotretinoin therapy, especially for patients with autoimmune predispositions. Additionally, the article emphasizes the importance of collaboration between endocrinologists and dermatologists to ensure optimal patient care. Further studies are needed to elucidate the mechanisms behind these changes and their clinical significance.
Farid Mohamadi, Khatere Zahedi,
Volume 16, Issue 2 (7-2025)
Abstract
Erosive lichen planus of the genitalia is a chronic inflammatory autoimmune disease primarily affecting the genital mucosa, causing pain, discomfort, and impairing urinary, reproductive, and sexual functions. This condition is more common in postmenopausal women and is often associated with other autoimmune diseases such as vitiligo and thyroid disorders. Standard treatments include topical and systemic corticosteroids, but several challenges persist, especially in cases resistant to conventional therapies. This review discusses novel and alternative treatment options, including immunomodulators and systemic therapies like tacrolimus, secukinumab, and anti-malarial drugs. It also emphasizes the importance of personalized treatment strategies for patients resistant to standard treatments. Additionally, the psychological impacts of the disease on patients’ quality of life and the need for a multidimensional approach in managing these patients are highlighted.
Pegah Tamimi, Aliasghar Ghaderi, Parham Tamimi,
Volume 16, Issue 2 (7-2025)
Abstract
This article reviews the impact of Menopausal Hormone Therapy (MHT) and oral contraceptives on melanoma risk. While some studies suggest an association between MHT and melanoma, conflicting evidence exists, including differences in drug formulations across countries, age at the start of treatment, and duration of use. Most studies have found no connection between oral contraceptive use and an increased melanoma risk, though environmental factors like sun exposure may play a role in this relationship. Overall, it appears that women should continue hormone therapy based on their healthcare provider’s advice, without specific concerns about melanoma risk.
Mansour Nassiri Kashani,
Volume 16, Issue 3 (11-2025)
Abstract
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Aniseh Samadi, Mansour Nassiri Kashani, Azin Ayatollahi, Hamed Zartab, Maryam Ahmadi, Alireza Firooz,
Volume 16, Issue 3 (11-2025)
Abstract
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.
Sepehr Bazrafkan, Afshan Shirkavand, Elaheh Nahvifard,
Volume 16, Issue 3 (11-2025)
Abstract
Cutaneous warts are among the most common benign skin lesions and, due to their high prevalence, risk of infection, and cosmetic concerns, they remain a frequent focus of clinical attention. Among the available treatment modalities, cryotherapy is widely used as a first-line option owing to its simplicity, low cost, and high success rate. However, the optimal choice of probe temperature and freeze duration still largely relies on clinical experience, and uncertainties in tissue thermal parameters may result in incomplete treatment or unintended damage to surrounding healthy tissue.
In this study, a numerical model was developed to investigate the temperature distribution within human skin during the cryotherapy of warts. The model is based on the radial heat-conduction equation and incorporates temperature-dependent thermophysical properties of human skin as reported by Agafonkina et al. (2021). Simulations were performed for a range of probe surface temperatures between -30 °C and -70 °C, and the temporal evolution of the wart center temperature was examined until it reached the cellular destruction threshold. The results indicate that lowering the probe temperature accelerates the freezing process; however, below approximately -55 °C, this enhancement becomes saturated and the risk of collateral tissue damage increases. Based on the obtained optimization map, the optimal probe temperature was found to lie within the interval -45 to -55 °C, for which the wart core reaches the critical temperature (-20°C) within 5 to 8 seconds. Comparison with clinical data demonstrates that the developed numerical model can serve as an effective tool for predicting and optimizing cryotherapy parameters, thereby improving treatment precision and reducing the likelihood of clinical error.
Maryam Kazemi, Fedora Khatibi, Shaghayegh Nasr, Afshan Shirkavand, Leila Ataie Fashtami,
Volume 16, Issue 3 (11-2025)
Abstract
Antimicrobial photodynamic inactivation is emerging as a non‑antibiotic strategy for treating infected wounds, particularly those harboring multidrug‑resistant bacteria. aPDI relies on a photosensitizer that, when illuminated with an appropriate wavelength, generates reactive oxygen species (ROS) that cause rapid, non‑specific damage to microbial membranes, proteins and nucleic acids. Effective photosensitizers combine high quantum yield to penetrate both Gram‑positive and Gram‑negative organisms, while light sources such as LEDs or lasers provide precise control of irradiance and tissue penetration. Clinical investigations have demonstrated that aPDI, alone or in combination with low‑dose antibiotics or growth factors, can reduce bacterial load in chronic wounds by up to 84 % and accelerate healing. Current challenges include limited light penetration, optimal dosing, and potential phototoxicity, emerging solutions involve nanocarrier‑delivered photosensitizers, oxygen‑releasing dressings, and ultrasound‑mediated activation to enhance efficacy and safety.
Hanie Bakhtiyari, Mohamadsaeid Emaminia, Amin Bakhtiyari,
Volume 16, Issue 3 (11-2025)
Abstract
Skin aging is a complex process characterized by structural alterations, reduced elasticity, and wrinkle formation, adversely affecting self-confidence and quality of life. Emerging evidence indicates that epigenetic mechanisms—including DNA methylation, histone modifications, and microRNA regulation-play pivotal roles in initiating and progressing these changes. These modifications, which occur without altering the DNA sequence, are reversible and thus represent promising targets for rejuvenation interventions. This review provides a comprehensive analysis of the role of these pathways in skin aging, as well as the impact of environmental factors such as ultraviolet (UV) radiation, air pollution, and nutrition. Furthermore, it discusses innovative therapeutic strategies, including Sirtuin activators, histone modification inhibitors, platelet-rich plasma (PRP), cell-based therapies, and epigenetic editing technologies. Although preliminary results are encouraging, limitations such as the paucity of longitudinal studies, methodological heterogeneity, and safety and ethical concerns remain. Overall, a deeper understanding of epigenetics may open new avenues for personalized and non-invasive skin rejuvenation therapies.
Zeinab Vafaeipour, Behrouz Akbari Adergani,
Volume 16, Issue 3 (11-2025)
Abstract
Cosmetic products used around the eyes, such as kohl, eyeliner, eye pencil, mascara, and eyeshadow are of particular importance due to the sensitivity of the eyes and the potential for contamination. Among these, kohl is a traditional product widely used in Middle Eastern countries, especially among infants, based on the belief in its therapeutic and protective properties. However, kohl has been reported to contain the highest concentration of lead among these products. This study aimed to assess the lead content in different types of kohl, which is an important step toward raising awareness among consumers of this cosmetic-hygienic product. The objective of this systematic review was to evaluate studies published in recent years that investigated the lead content of kohls available on the Iranian market. To achieve this, a comprehensive search was conducted in national and international databases including Pubmed, Scopus, Science Direct, Google Scholar using relevant keywords. Findings indicate that in some cases, the concentration of lead in tradithinal or handmade kohls greatly exceeded the permissible limits. Repeated or prolonged use particularly in children can lead to elevated blood lead levels and symptoms of lead poisoning. Considering the health risks associated with this product, stricter monitoring of its production and distribution, as well as public education regarding the safe use of kohl, appears to be essential.
Alireza Sadeghi Moghaddam Bijari, Hoda Keshmiri Neghab, Mohammadhasan Soheilifar,
Volume 16, Issue 3 (11-2025)
Abstract
The treatment of wounds has historically been a significant challenge in medicine, incurring substantial financial and emotional costs for both governments and patients. Consequently, researchers have continuously sought novel methods to enhance the wound healing process. In recent years, with the advancements in computer science and the emergence of Artificial Intelligence (AI), many professional fields, including medical sciences, have undergone transformations. There has been a general effort to utilize AI as an assistant or even a human replacement in certain processes. In the field of wound care, the application of AI-based tools is expected to improve the speed and accuracy of the treatment system, leading to faster wound healing and better outcomes for patients.
AI has been presented in various models, each operating on different datasets and employed in diverse research studies. Both software and hardware tools based on AI have been designed and introduced in several investigations. Their performance has been evaluated at various levels, from laboratory to clinical settings, and their efficacy has been demonstrated.
Based on the findings, it can be stated that AI can provide effective assistance to clinical and research staff in the diagnostic, therapeutic, and educational processes of wound treatment. In some cases, it may even reduce the need for direct clinical staff involvement for patients.
Mahsa Fattahi,
Volume 16, Issue 3 (11-2025)
Abstract
Background: Chronic granulomatous disease (CGD) is a rare primary immunodeficiency caused by defects in the NADPH oxidase complex, predisposing patients to severe bacterial and fungal infections. Dermatophytosis with severe inflammatory presentations such as tinea capitis is uncommon but challenging to manage in these patients.
Case presentation: We report a 9-year-old Iranian girl with autosomal recessive CGD who presented with refractory inflammatory scalp lesions. Mycological examination confirmed tinea capitis caused by Microsporum canis. Antifungal susceptibility testing showed reduced susceptibility to itraconazole, while susceptibility to terbinafine and fluconazole was preserved. Due to limited access to terbinafine, the patient received alternative management including antibacterial and anti-tuberculosis therapy, leading to clinical improvement.
Conclusion: This case highlights the diagnostic and therapeutic challenges of dermatophytosis in CGD patients and emphasizes the importance of accurate mycological diagnosis, antifungal susceptibility testing, and individualized multidisciplinary management, particularly in resource-limited settings.
