Journal of

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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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Topical corticosteroids (TCs) are very useful in the treatment of some skin disorders such as eczema and psoriasis. TCs exhibit potent anti-inflammatory and anti-proliferative effects responsible for their efficacy in the treatment of skin disorders. TCs can be classified into different groups according to their potency that depends on the intrinsic activity of the corticosteroid molecule, the characteristics of the vehicle (cream, ointment, lotion) that directly influence patient’s compliance and may modify penetration through the skin. British National Formulary classified them into four potency groups with Class I grouping the most potent molecules (e.g. clobetasol propionate) and Class IV the least potent (e.g. hydrocortisone). In contrast, the American classification considers seven potency groups, with super potent, potent, upper mid-strength, mid-strength, lower mid-strength, mild and least potent.

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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.

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Background and aim: Pityriasis lichenoides (PL) is a rare papulosquamous disorder with an unknown etiology. Due to limited recent studies on this subject, the present research was conducted to describe the clinical manifestations and treatment course of these patients.
Methods: This retrospective cross-sectional study (2019-2023) was conducted on patients diagnosed with PL at Razi Dermatology Hospital, Tehran University of Medical Sciences, Iran confirmed by biopsy of skin lesions. Basic information was obtained from hospital records, and treatment follow-up was gathered from medical files and phone interviews with patients. Data were analyzed using R software, with a P<0.05 considered statistically significant.
Results: A total of 147 patients were evaluated. No significant difference was found between genders (P=0.358). The predominant subtype was PLC (91.8%), with a mean age of onset of 29.79 ± 18.73 years. The most common type of skin lesion was papules (48.4%), and generalized body involvement was the most frequent manifestation, observed in 58 patients (32.4%). The most commonly used treatment was topical corticosteroids, administered to 86 patients (52.4%). The average duration from onset to full recovery was 160.80±221.40 days. A total of 45 patients (30.6%) reported recurrent episodes of the disease. No significant association was found between treatment efficacy and gender (P=0.620), underlying conditions (P=0.293), or age (P=0.876).
Conclusion: Given the limited clinical data on patients with pityriasis lichenoides, establishing an electronic database and a national registry system for this condition is recommended.

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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.