Journal of

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Pseudo-Kaposi sarcoma (PKS) or acroangiodermatitis is a benign angioproliferative disease which shares many clinical and histopathological features with Kaposi sarcoma. Clinical presentations include violaceous macules, papules or plaques in the lower extrimities, which is usually associated with chronic venous insufficiency or congenital or acquired arterio-venous malformations. Its pathogenesis is not well recognized yet but the ischemia due to venous insufficiency or arterio-venous malformation is considered to play a role. The diagnosis is made through the histopathologic examination of biopsy specimens. Different treatment modalities have been suggested including conservative treatment or correction of vascular abnormalities.This paper introduces a 28-year old man with a brown linear plaque in a scar of 3-month duration due to trauma on the anterior of left thigh. A biopsy was performed and the histopathologic examination confirmed the clinical diagnosis of Pseudo-kaposi sarcoma.

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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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Introductio: Sarcoidosis is a chronic multi-organ disease. Scar sarcoidosis is a rare but specific cutaneous presentation. Most patients with scar sarcoidosis suffer from systemic involvement especially lung disease.

Case Report: We present here a 77 year-old-woman with sarcoidal infiltration in burn scars that she had acquired 30 years ago. She was treated with systemic steroids which led to regression of cutaneous lesions.

Conclusion: Scar sarcoidosis should be suspected in occurrence of new lesions in burn scars

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Hypertrophic scars and keloids are fibrosis abnormalities associated with the accumulation of collagen and extra cellular matrix components. These scars are caused by abnormal wound healing, which may occur after skin injuries caused by surgery, trauma, burns, etc. and may have a large impact on the patients’ quality of life. Hypertrophic scars and colloids in addition to aesthetic problems can cause functional disruption due to tissue contraction and itching. Large numbers of research are currently being performed in the area of scar prevention or treatment, but since the physiopathological mechanisms of scar formation have not been fully elucidated, the current strategies are still unsatisfactory. In this review, we discuss the recent biological advances in scar formation and current and future strategies for the prevention and treatment of hypertrophic and keloid scars.

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Background and Aim: Cicatricial (scarring) alopecia is a group of disorders in which permanent hair loss results from replacement of hair follicles by fibrosis or hyalinized collagen, which includes two types: primary such as discoid lupus erythematosus (DLE), lichen plano pilaris (LPP), frontal fibrosing alopecia (FFA), Folliculitis decalvans, and secondary like kerion and burn. The aim of this study was to evaluate the frequency of different types of scarring alopecia in patients referred to Imam Reza Dermatology Clinic in Ardebil in 1397.

Methods: In this descriptive cross-sectional study, 96 patients referred to the dermatology clinic of Imam Reza Hospital, Ardebil, Iran, were evaluated. Epidemiologic and pathologic causes of primary and secondary cicatricial alopecia were analyzed using descriptive statistics in SPSS version 16 software.

Results: The most common causes among patients with primary cicatricial alopecia were DLE (51.16%), LPP (6.25%), acne keloidalis (4.16%), folliculitis decalvans (2.08%), FFA (2.08%) and pseudopelade of Brocq 1.04%). In patients with secondary cicatricial alopecia the most common causes were kerion (55.2%), followed by morphea cutaneous lymphoma and burn (1.04%).

Conclusion: Considering that the majority of patients in rural area had kerion (92.45%), we can prevent the spread of the disease by improving hygiene standards as an important factor in controlling this disease in order to early diagnosis and treatment.

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Background and Aim: Atrophic scars constitute a common complication of acne and various methods have been proposed for their treatment. This study aims at comparing the efficacy of fractional CO₂ laser with microneedling in the management of atrophic acne scars.

Methods: Patients with atrophic acne scars presenting to dermatology clinic of Hamadan’s Sina hospital between March 2016 and March 2018 were included in the study. Every 3 weeks, each patient received fractional CO₂ laser on one side of the face and microneedling on the other side, for a total of 4 sessions. Patient’s satisfaction and the severity of scars (based on Goodman and Baron’s scar scale) were assessed 1, 2 and 6 months thereafter.

Results: Overall, 24 participants were included. Prior to intervention, no significant difference was observed between groups in terms of mean scar score (P=0.726). At 1, 2 and 6month follow-up visits, the scar score of the side treated with laser was significantly lower than the microneedling side (P for 1, 2 and 6month follow-up visits: 0.033, 0.008 and 0.014). No significant difference was observed between groups in terms of patient’s satisfaction (P for 1, 2 and 6 month follow-up visits: 0.589, 0.469 and 0.840). The most prevalent side effect was erythema in 3 patients treated with laser. Due to low prevalence, statistical analysis of side effects between groups was impossible.

Conclusion: Compared to microneedling, fractional CO₂ laser was more effective in reducing the scar score of patients. The prevalence of side effects in both treatments were low.

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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.