Journal of

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Background and Aim: Eczema is a common chronic inflammatory skin disease that reduces quality of life of the patient. The present clinical trial with control group aimed to determine therapeutic effects of natural honey plus cold cream compared to cold cream alone on hand eczema. Methods: Through a blind clinical trial, 72 patients with hand eczema were categorized in two equal groups. The first group used a mixture of honey plus cold cream and the other group applied cold cream alone. Patients used either Treatment 2 times a day for 21 days on their lesions. The effects including relief of symptoms such as dryness, redness, itching and scaling were evaluated by a dermatologist as well as the patients themselves. The results were analyzed using SPSS software and P values less than 0.05 were considered statistically significant. Results: According to the physician’s evaluation, 26 (36.1 %) patients in group combined honey and coldcream, were cured and 9 (59.12%) patients do not recover while in cold cream alone group, 6 (3.8%) patients were recovered and 30 (7.41%) patients did not. This difference was statistically significant (P<0.001). According to the patients evaluation in group combined honey and coldcream, 26 (36.1%) felt better and 9 cases (59.12%) did not, while the corresponding rates in group cold cream alone were 6 (2.8%) and 30 patients (7.1%) respectively. This finding was statistically significant (P<0.001). Conclusions: With respect to the therapeutic effects of honey on hand eczema, it is recommended to use honey with other therapies to treat eczema.

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Background and Aim: Melasma is a common acquired disorder characterized by symmetric, hyperpigmented patches with an irregular outline, occurring most commonly on the face. The goal of this study was to evaluate the efficacy of a cream containing 4% licorice extract with a novel formulation based on solid lipid nanoparticles technology in the treatment of melasma. To the best of our knowledge, it is the first study designed to investigate the efficacy of this novel formulation in the treatment of melasma all over the world.

Methods: In this randomized, double-blind, placebo-controlled clinical trial, 44 women with clinical diagnosis of melasma referred to the Afzalipour hospital dermatology clinic were randomly allocated into two treatment groups of equal size. All the patients were interviewed and examined every four weeks during the trial and their Modified Melasma Area and Severity Index (MMASI) score were evaluated at 4, 8 and 12 weeks. The efficacy of the interventions were classified in four levels: complete response, significant response, partial response and no response.

Results: Forty patients were enrolled in the study. At the end of the study (12 weeks), mean± standard deviation of MMASI score changed from 11.03±2.7 to 1.41±0.6 in the intervention group and from 11.25±2.9 to 2.37±1.2 in the placebo group, respectively (P<0.001).

Conclusion: Licorice extract can be used as a skin-lightening agent with minimal side effect in the treatment of melasma. Nano/micro solid lipid particles are used as carriers with unique properties like size, surface electrical bar. Moreover, a large amount of the drug might be loaded to increase the efficacy and decrease the adverse events.

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This is a letter to editor criticizing the paper entitled “Efficacy of licorice extract in the treatment of melasma: A randomized, double-blind, placebo-controlled clinical trial”. We discuss some methodological points on external and internal validity of results. The paper suffers from lack of detailed information on sample size and power calculation to make sure generalisability of results to study population. The paper also did not report blinding procedure and placebo details. The results of the paper also suffer from multiplicity (multiple comparisons) and suitability of data analysis approach. It is recommended to apply either repeated measure ANOVA or a mixed model to consider correlation between repeated measure of outcomes and multiplicity problem.