Majid Banimohammad, Mahdi Forghani Ramandi, Hamidreza Pazoki Toroudi,
Volume 12, Issue 2 (8-2021)
Abstract
Alopecia areata (AA) is a sudden non-scarring hair loss that can be seen in any hairy area in the form of round or oval patches. It is an autoimmune disorder with an immunological response against hair follicles that is caused by genetic and environmental factors. The prevalence of AA is about 0.1% to 0.2% worldwide. Depending on the severity of the disease and sites of involvement, it can be divided into: Alopecia with Patchy pattern, alopecia reticularis, alopecia totalis, alopecia universalis, alopecia ophiasis, alopecia sisiapho, diffuse type and perinevoid alopecia areata. There are various treatment options for AA, but once terminated, they have a high recurrence rate. AA is known for the infiltration of T lymphocytes around the hair follicle bulb, and corticosteroids are its main treatment. Another treatment is topical immunotherapy, the most important of which is Diphenylcyclopropenone (DPCP). It is used in cases that have more than 50% hair loss or are resistant to treatment. The exact DPCP mechanism of action is not well understood, but it may have some kind of antigenic competition and reduce the production of anti-hair follicle antibodies. It can alter the immune response in the skin and alter the ratio of CD4 to CD8 cells around the hair follicle in a way that enhances healing of the disease. It is stated that the rate of hair regrowth in DPCP treatment is about 50% on average. In this article, we review the latest findings of about AA and discuss its therapeutic aspects, especially with DPCP.
Ghasemali Khorasani, Javad Rahmati, Hojjat Molaie, Afshin Fathi, Gholamhosein Hayatollah,
Volume 12, Issue 3 (11-2021)
Abstract
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.
Shokouh Taghipour Zahir, Ali Rastrouw, Koorosh Rahmani, Nosrat Poursina,
Volume 12, Issue 3 (11-2021)
Abstract
Background and Aim: Warts are one of the most common lesions sent to the pathology department. Genital warts are at risk for malignancy transformation, especially in the cervix. By recognizing these lesions as soon as possible, especially in the genital areas, malignancies can be prevented with prompt treatment.
Methods: In this retrospective and descriptive study, demographic information (age and sex) and anatomical location of the lesion were extracted from patients' pathology records according to a pre-arranged checklist. Data were entered into SPSS version 22 and then statistical analysis was performed using descriptive tests or mean±standard deviation, or analytical statistical tests (with 95% confidence, interval). P<0.05 was considered statistically significant.
Results: A total of 267 patients were included in the study. 143 patients (53.6%) were women. The age range of patients was 2 to 80 years (31.3+15.5). The locatin of warts were on limbs in 150 (56.2%), genital area in 82 (30.7%), head and neck in 25 (9.4%) and trunk in 10 (3.7%) patients. The distribution frequency of lesions on the limbs was higher in males (P=0.01). Warts in the genital area, trunk and neck were more common in females (P=0.02).
Conclusion: Genital warts were more common in female patients and on the other hand, warts on limbs were more common in males. Therefore, any lesion with wart characteristics in women should be taken seriously.
Ehsan Zarei, Atefeh Gholamhosseini, Narges Ghandi,
Volume 12, Issue 3 (11-2021)
Abstract
Background and Aim: Psoriasis is a systemic and non-transmissible chronic inflammatory autoimmune skin disease that about 2-3% of Iranians suffer from it. Cost of management and budgeting and planning for the treatment of patients with psoriasis requires accurate information. The present study estimates the direct and indirect costs for one-year treatment of patients admitted in Razi Dermatology Hospital.
Methods: In this descriptive-analytical study, treatment costs of 170 patients with psoriasis, including direct (medical and non-medical) and indirect costs were evaluated by census method and using a researcher-made checklist, from October 2017 to October 2018. The fee was collected through reviewing patients' bills in the hospital information system and through telephone interviews with patients.
Results: The average cost of one year was 9037480 Tomans ($ 758), of which direct cost of treatment was 90.22% (8178681 Tomans) and indirect cost of treatment was 9.78% (858799 Tomans). The highest cost of treatment was related to pharmaceutical services with 5825233 Tomans. Also, the total direct medical cost was equal to 7069890 Tomans, of which 62% was the insurance share and 38% was the patient share. The findings showed that injecting biological drugs and accommodation had a significant effect on the direct cost of treatment. Supplementary insurance and accommodation variables also affect out-of-pocket costs.
Conclusion: Drugs made up most of the costs. The high price of biologics and the low coverage of these drugs by insurance companies have caused many economic problems for these patients. According to the findings of this study, it seems necessary to review the more complete insurance coverage of these drugs as well as the use of charitable assistance to cover part of the cost for treatment.
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Volume 12, Issue 3 (11-2021)
Abstract
Background and Aim: Microneedle technology has led to huge changes in the field of drug delivery medicine. Using microneedles, the drug can be injected locally, painlessly, and in very low and controlled doses with high precision. Local drug delivery through the skin with microneedles has many advantages over other methods of drug delivery. In this method, the drug does not enter the gastrointestinal tract and blood circulation, and therefore non-target organs are protected from the side effects of the drug. The present study is designed to construct an array of micron needles using the lithography method.
Methods: In this study, a silicon microneedle array is fabricated using the photolithography method with proper adjusting of the effective parameters. The constructed microneedle array has 256 needles with a height of 500 microns, a base diameter of 250 microns, and a center-to-center distance of 600 microns.
Results: Microscopic images show that the microneedles are tapered with a relatively sharp tip. Their surface is smooth and without cracks, and they also have an acceptable resemblance to the original design.
Conclusion: The produced microneedle array can be used directly to pierce the skin and increase its permeability by creating micron holes. In addition, this array can be used as a mold for the production of microneedles with malleable materials in the casting method.
Ali Yousefi, Athar Moin, Ali Davati,
Volume 12, Issue 3 (11-2021)
Abstract
Background and Aim: Androgenetic alopecia is a type of androgen and genetic dependent hair loss and although it is more of a beauty issue, but in recent years studies have shown that this type of alopecia is associated with underlying disorders such as coronary artery disease. The aim of this study was to evaluate the frequency of androgenetic alopecia in hospitalized patients and its relationship with the history of coronary heart disease and its risk factors.
Methods: In this cross-sectional descriptive-analytic study, 250 patients (125 women and 125 men) admitted to Shahid Mostafa Khomeini Hospital in Tehran from October to December 2020 were examined and after examination and data collection, the data were analyzed using SPSS statistical software SPSS Statistics 25 version.
Results: The prevalence of alopecia was generally 46.8% in hospitalized patients, 61.6% in men and 32% in women. The prevalence of coronary heart disease in hospitalized patients was 25.6%, 34.4% in men and 16.8% in women. In patients with alopecia, the frequency of history of coronary heart disease was 39.31%, the history of hypertension was 20.8%, history of hyperlipidemia was 17.2%, history of diabetes was 14.4% and the smoking history was 15.6%. All of these factors were significantly associated with alopecia, except for smoking.
Conclusion: According to the results of this study, the frequency of androgenetic alopecia in patients admitted to the hospital is common and its prevalence in men is more than twice that of women. History of coronary heart disease and its risk factors in patients with alopecia are high, and have a significant relationship with it. This can be important and help in screening and early diagnosis of coronary heart disease and its subsequent prevention.
Afsarolmoluk Hadadian, Azin Ayatollahi, Akram Miraminmohammadi, Mahshid Shahrzadkavkani, Alireza Firooz, Ensieh Lotfali, Mahsa Fattahi,
Volume 12, Issue 3 (11-2021)
Abstract
Introduction: Dermatophytosis are micro-organisms which can lead to skin diseases. In rare occasions they can have atypical skin manifestations, which could result in delay in diagnosis.
Case Report: A 20-year-old Iranian boy was referred to our center with a 5-month history of circular, symmetrical, itchy crusted skin lesions on his groin. Direct microscopy, culture test and PCR-sequencing of ITS regions of the rDNA gene were conducted and showed T. indotinea as the causative agent. Based on antifungal susceptibility test oral pulse therapy with itraconazole 100 mg twice daily for 1 week combined with topical clotrimazole cream for 1 month was initiated, which cleared the lesions.
Conclusion: This case report is of significance since T. indotinea produces atypical skin lesions, as well as, multidrug resistance to antifungal agents.
Mansour Nassiri Kashani,
Volume 12, Issue 4 (2-2022)
Abstract
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Aniseh Samadi, Hasti Ahmadianyazdi, Maryam Ahmadi, Atefeh Naeimifar, Saman Ahmadnasrollahi, Alireza Firooz,
Volume 12, Issue 4 (2-2022)
Abstract
Background and Aim: Although several commercial moisturizers are available in the market, continued role of pharmaceutical compounding have been still felt in dry skin management. This study aimed to evaluate the effect of a two urea- based compounded moisturizers on barrier function, compared to similar commercial product. 15 volunteers (14 females and one male) age 36.15 ±9.55 years old (range 21-56 years old) with non-pathologic dry skin, recruited to the study applied 5% urea containing hydrophilic petrolatum and 10% urea containing hydrophilic petrolatum during two following phases.
Methods: Upper parts of right and left forearms randomly were assigned for twice a day application of commercial or compounded products. Biophysical assessments including trans epidermal water loss (TEWL), skin hydration, friction co efficient, pH and surface lipids, performed before intervention, 1, 4 after single application and at 24 hours and one week twice daily application.
Results: In both phases, commercial and compounded moisturizers showed appropriate and comparable effect on skin barrier function compared to the baseline. However commercial products, led to better improvement in TEWL, 4 hours after single application in both phases (P=0.04). The rate of increase in skin hydration was also significantly higher for commercial emollient, compared to compounding product (57.48±11.23 vs. 50.59±11.42, P=0.01).
Conclusion: Commercial formulation led to higher acceptability and better improvement on skin barrier function after single application, probably due to influence of excipients. Present study did not find sufficient added value for pharmacy product relative to commercial one and suggest to be replaced in similar condition.
Javad Rahmati, Zia Dadgar, Shahriar Haddady Abianeh, Sina Dadgar, Hojjat Molaei,
Volume 12, Issue 4 (2-2022)
Abstract
Background and Aim: This study is executed to compare two common reconstructive surgeries in suppurative hidradenitis.
Methods: Patients with severe supporutive hidradenitis who had operations to excise their axillary lesions and then treated with two standard surgical repair techniques (lateral thoracic flap vs parascapular pedicle flap) were evaluated in a retrospective cohort study. Assessments included range of motion of shoulder, scar objective measurments, and Dermatology Quality of Life Index questionnaire.
Results: Mean range of motion in flexion of parascapular flap and lateral thoracic flap were 176 and 175 degrees, respectively. Range of motion in abduction of parascapular flap and lateral thoracic flap were 166 and 147 degrees, respectively which is interesting according to future disabilities. Pigmentation, thickness, pliability and vascularization were objective scar measurements which there were not significant differences between groups. Patients` responses to questionnaire on their satisfaction of surgery did not differ significantly between two groups in any items of questionnaire. But summation of items took lower points in parascapular flap group versus lateral thoracic flap group.
Conclusion: Despite various reconstructive options in axillary skin defects following suppurative hidradenitis surgery, there is not a generalized agreement on best choice, and each technique has its advantages and disadvantages.
Zahrabeigom Moosavi, Alireza Firooz, Mahsa Fattahi,
Volume 12, Issue 4 (2-2022)
Abstract
Introduction: Tinea incognito is a localized skin infection caused by a fungus. Due to the use of corticosteroids, the shape and severity of the lesion are different from the usual skin manifestations by dermatophytes.
Background and Aim: A 39-year-old female with history of erythematous, scaly skin lesions on her hands, buttock, inguinal and both legs for 7 months referred to clinician, who prescribed Calamine-D and hydrocortisone without any treatment and clobetazole was recomended. She self-continued clobetazole. This case highlight the importance of mycological test in case of atypical skin lesions to choose an appropriate treatment and avoiding to spread of drug resistance species.
Methods: Regarding to history of patient, the mycological test (Direct Microscopy and culture) was made. In direct microscopy and culture mycelia of dermatophyte species was seen.
Results: In our case steroid discontinued and she was treated with oral terbinafine 250 mg once a day for 4 weeks in combination with topical clotrimazole cream.
Conclusion: the prescription of topical/oral corticosteroids should still be limited and take a caution until confirmation of diagnosis, particularly since the use of steroids during COVID 19.
Zahrabeigom Moosavi, Alireza Firooz,
Volume 12, Issue 4 (2-2022)
Abstract
The COVID-19 pandemic is still present and we are directly or indirectly affected by it. The skin is one of the organs that has some manifestations not only during the course of the disease, but also long after recovery and also after vaccination. Hair is one of the parts that, like the skin, may show disorders during and after recovery of the infection and also after vaccination. In this issue, we aimed to provide an overview of the effects of COVID-19 and vaccination on hair. We also express the instrumental role of hair in the study of other diseases, including psychological problems.
Kiana Shomali, Atefeh Naeimifar, Saman Ahmadnasrollahi,
Volume 12, Issue 4 (2-2022)
Abstract
Alterations in barrier function are associated with a number of skin diseases, including xerosis, atopic dermatitis, and psoriasis. Urea, a component of the natural moisturizing factor of the skin, plays an important role in the preservation of skin hydration and integrity. Several studies have investigated the effects of urea in the clinical setting. Here, we summarize the available clinical evidence regarding the effects of urea in the maintenance of healthy skin and management of skin disorders. At lower doses (≤10%),
urea-containing topical formulations act as a skin moisturizer, while at higher concentrations (>10% urea), urea-based preparations exert a keratolytic action. Urea is also useful in combination therapies with anti-inflammatory and anti-fungal drugs, due to its activity as a penetration enhancer.
Seyedalireza Golshani, Zahra Hosseinhashemi, Mohammadmahdi Zarshenas,
Volume 12, Issue 4 (2-2022)
Abstract
Khadab is one of the most important solutions used to beautify and strengthen hair, and Khadab has been used for a long time throughout history. Moreover, putting Khadab has been a long- lasting tradition in the course of history. Also, Iranian medical sources pointed out to the herbs used in Khadab and its role in human health. In this regard, the present study examines Khadab and its place in the history of Islamic civilization.
This is a desk study which is conducted through reviewing the main sources, Hadiths, and written sources of Iranian medicine. Also, various databases such as Magiran, SID, Google Scholar were searched to reach new findings. What is important in this study is putting Khadab during the course of history for adornment and human health. Moreover, diseases were cured through putting Khadab.
Putting Khadab and promoting this act can be effective in improving mental and physical health. Therefore, putting Khadab and its effect on the health of the human body and the herbs used in it need further investigation, as this research can be used to enhance the knowledge of the experts of traditional medicine.
Bahareh Nowruzi,
Volume 12, Issue 4 (2-2022)
Abstract
Today, the valuable metabolites of microalgae are widely used in the production of many cosmetic products, as the biomass of algae contains pigments, proteins, essential fatty acids, polysaccharides, vitamins and minerals, all of which are present in both natural foods and cosmetics are used. In fact, these secondary metabolites with anti-blemish and anti-microbial, anti-aging, sunscreen and skin whitening effects can repair and heal the skin and protect the skin from UV damage and prevent inflammation. Existing cosmetics can in many cases be replaced with microalgae-derived cosmetics that are environmentally friendly as well as safe. The effects of microalgae and their derivatives have been tested in various nutritional studies around the world. However, there are very few studies on their cosmetic applications, so in this review article we tried to study several species of microalgae, cultivation methods, use of biomass and bioactive molecules derived from microalgae in the production of anti-aging products, sunscreen and skin whitening in the formulation of cosmetic compounds.
Akram Miraminmohammadi, Minoo Tasbihi, Seyedebrahim Eskandari, Maryam Ahmadi,
Volume 12, Issue 4 (2-2022)
Abstract
Leishmaniasis is a neglected disease caused by different Leishmania species and transmitted by various sand flies. Iran is endemic to both visceral and cutaneous form of the diseases. The aim of this study was to investigate the epidemiological factors of leishmaniasis in patients referred to the Center for Research and Training Skin Disease and Leprosy from 1399-1400. The present study is a cross-sectional study in which every patient with suspected cutaneous leishmaniasis lesion(s) referred to the center during 1399-1400 were included. The results showed a higher number of patients with leishmaniasis are in the age group of 10 to 19 years. Among the mentioned jobs, a higher percentage was assigned to housewives in the affected women and workers in the affected men. According to the results, autumn is the most common season for cutaneous leishmaniasis. The average time from beginning to the diagnosis of leishmaniasis was 1.5-3 months and most patients showed a history of traveling to rural areas. The number of wet type lesions were higher than dry type and most of the lesions were in the hands. Most cases were reported from Isfahan province.
Azin Ayatollahi, Taraneh Yazdanparast, Saman Ahmadnasrollahi, Mahsa Fattahi, Mahdieh Emambakhsh, Alireza Firooz,
Volume 13, Issue 1 (5-2022)
Abstract
Background and Aim: Hair loss is one of the most common problems among the skin and hair related diseases. Hair loss can lead to anxiety, depression, low self-esteem and dissatisfaction with appearance.
Methods: Patients with androgenetic alopecia who met the eligibility criteria entered the study. Participants were asked to randomly apply a solution of valproic acid 8.3% or a solution of minoxidil 5% on the affected areas according to the treatment protocol (twice a day). Before and 2 months after treatment, the participants were evaluated. The studied indices included the number of hair follicles in the specified area, the number of velus hairs, the number of terminal hairs, the average hair thickness, and the percentage of hairs in the anagen and telogen phases, as well as the skin reactions in the area. Hairs were examined at the beginning of the study and at 2 months after treatment using Foto Finder-trichoscale device.
Results: Two months after treatment compared to baseline in the valproic group, anagen hair count index (P=0.02), general hair count index (P=0.03), and terminl hair count index (P=0.012) showed significant changes. While telogen hair count (P=0.059) and vellus hair count (P=0.097) did not show significant changes. These changes were more significated in minoxidil group.
Conclusion: 8.3% valproic acid solution showed positive effects in increasing the number of hairs and decreasing the percentage of telogen hairs. Due to the delayed mechanism of valproic acid, the duration of treatment with this compound should be considered longer than minoxidil as a positive control.
Seyedesaba Sharifzadeh, Ensieh Lotfali, Nargol Novin, Shayan Norouzi, Farinaz Azizi,
Volume 13, Issue 1 (5-2022)
Abstract
Background and Aim: Oral lichen planus is a chronic
muco-cutaneous immunopathological disorder that commonly affects the oral mucosa. Candida albicans is the most common pathogen associated with oral candidiasis. The aim of this study was to determine the effect of 810 nm low power laser wavelength as an adjuvant in the treatment of
nystatin-resistant C.albicans in patients with oral lichen planus.
Methods: In this experimental study, 5 nystatin-resistant C.albicans were isolated from the oral cavity of patients with ulcerative lichen planus. Drug susceptibility testing was performed based on CLSI-M27-A3 and showed that these isolates were resistant to nystatin. The fungal suspension with a dilution of 0.5 McFarland was exposed to a diode laser with a wavelength of 810 nm and a density energy of 20.38 j / cm with a time of 20 seconds. Then the results of minimum inhibitory concentration (MIC) were recorded for each group.
Results: 810 nm laser caused a significant reduction in nystatin-resistant C.albicans colonies (P<0.001). The MIC did not decrease significantly after the exposure.
Conclusion: Laser irradiation reduces the number of nystatin-resistant C.albicans colonies. But this effect does not necessarily change the MIC. Dentists should be aware that in cases of resistant Candida strains, a low-power diode laser with a wavelength of 810 nm can play a role in reducing colonies and responding better to standard treatment.
Pedram Noormohammadpour, Amirhooshang Ehsani, Ifa Etesami, Amin Rahmani,
Volume 13, Issue 1 (5-2022)
Abstract
Background and Aim: Skin injuries with various causes may lead to legal action. Complaints are referred to specialized authorities such as Razi Hospital, before specialized forensic medicine commission comment. The present study surveyed demography of patients' complaints and initial diagnosis at the time of referral over a period of 6 months.
Methods: In this retrospective study, patients referred for initial visit, from Forensic Medicine Office in the September 2018-March 2019, were examined. The patients' complaints at the time of referral and the clinical diagnosis made at the initial examination were recorded.
Results: A total of 220 patients including 176 women (80%) and 44 men (20%) with a mean age of 34.8 years were included. 42 different complaints were documented, including traumatic hair loss with 91 cases (41.4%) - the most common - followed by complications of laser hair removal with 32 cases (14.6%) and filler injections with 16 cases (7.3%). Scarring from trauma, reaction to chemicals during work or accidental contact, rare injuries from various treatments, and even cases of pediculosis (contamination of the accommodation) or zoster (complaint about care in the treatment center), etc. were observed.
Conclusion: Traumatic hair loss (mainly due to fight) was the most common complaint. Knowing other cases may expand physicians' awareness regarding the wide range of complaints that can be raised and improve the process of some treatment measures.
Houshang Nemati, Mozafar Khazaei, Mehri Nazeri, Maryam Bozorgi,
Volume 13, Issue 1 (5-2022)
Abstract
Background and Aim: Psoriasis is a chronic inflammatory skin disease, influenced by genetic and immune-based factors that is associated with skin inflammation. Aloe vera gel is traditionally used to treat skin diseases including psoriasis.
Methods: In this study, ethanolic extract of aloe vera gel was evaluated for its anti-inflammatory and antioxidant activity in skin-derived A431 cells. First, after preparing the extract and then the green synthesis of gold nanoparticles using the extract, their effect on the expression of inflammatory genes as well as their antioxidant properties were investigated.
Results: The use of different concentrations of aloe vera extract caused a relative increase in EGFR and Nrf2 expression levels and decreased expression of NF-κB, TNF-α and IL-6 inflammatory genes in A431 skin cells. But the effect of synthesized nanoparticles was greater than aloe vera extract in altering the expression of signaling and inflammatory genes.
Conclusion: The synthesized extracts and nanoparticles had antioxidant properties and also reduced the expression of inflammatory genes in cells. However, the effect of nanoparticles was much greater than that of extracts in reducing inflammatory genes.
