Ali Asilian; Fariba Iraji; Saba Khalilian; Zabihollah Shahmoradi; Mina Saber
Abstract
Background: Psoriasis is an immune-mediated inflammatory disease with unclear pathophysiology. Although diverse medications have been applied, a paucity of knowledge is accessible regarding the use of corticosteroids for psoriasis management. We evaluated the efficacy of corticosteroid pulse therapy ...
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Background: Psoriasis is an immune-mediated inflammatory disease with unclear pathophysiology. Although diverse medications have been applied, a paucity of knowledge is accessible regarding the use of corticosteroids for psoriasis management. We evaluated the efficacy of corticosteroid pulse therapy in combination with methotrexate versus methotrexate alone for psoriasis treatment.Methods: This cohort study was conducted on 51 hospitalized patients with erythrodermic or pustular psoriasis who were assigned to one of the therapeutic interventions of subcutaneous methotrexate alone (n = 33) or in combination with betamethasone pulse therapy (n = 18). The first group was treated with weekly 15 mg subcutaneous methotrexate for six weeks, and the second group received a similar dose of methotrexate plus 3 mg oral betamethasone weekly. The patients were followed for six months and assessed regarding the disease remission, relapses, the interval between the medication and relapse incidence, and patient satisfaction with the regimens.Results: The studied groups were similar regarding gender (P = 0.296), age(P = 0.561), and the type of cutaneous lesions (P = 0.807). Six months follow-up of the two therapeutic interventions revealed insignificant differences in terms of early response to the treatment (P = 0.993), the incidence (P = 0.142) and frequency of relapses (P = 0.928), and the interval period between the treatment and relapse (P = 0.213). Besides, the patients’ treatment satisfaction did not differ between the groups (P = 0.453).Conclusion: Based on this study, combining methotrexate and lowdose corticosteroid pulse therapy does not lead to better outcomes than methotrexate alone for managing pustular and erythrodermic psoriasis. Further studies are strongly recommended.
Ali Asilian; Zabihollah Shahmoradi; Shahryar Rahmani; Hossein Hafezi; Samaneh Mozafarpoor
Abstract
Background: Bleomycin is used for the treatment of warts. However, only its injected form can be used due to systemic use side effects, and plantar warts have a high recurrence rate following administration of bleomycin tattooing alone. To find an effective alternative with fewer side effects, we decided ...
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Background: Bleomycin is used for the treatment of warts. However, only its injected form can be used due to systemic use side effects, and plantar warts have a high recurrence rate following administration of bleomycin tattooing alone. To find an effective alternative with fewer side effects, we decided to investigate the effectiveness of bleomycin tattooing combined with trichloroacetic acid (TCA) and shaving in the management of treatment-resistant plantar warts.
Methods: The patients with treatment-resistant plantar warts entered the present quasi-experimental study. the wart site was shaved ahead of bleomycin tattooing and TCA peeling. This treatment was provided at one-month intervals and was repeated a maximum of four times. Patients were followed for six months after completion of the therapy. Finally, the patients’ data were completed according to photographs (monthly photos taken of lesions) and careful examinations.
Results: The present study involved 56 patients with a mean age of 25.75 ± 12.22 years. Twelve patients (21.4%) recovered after the first treatment; 14 (25%) needed the second treatment, 12 (21.4%) needed the third, 10 (17.9%) the fourth, and eight (14.3%) did not recover after the fourth treatment. The recovery rate was 21.4% with one, 45.4% with two, 66.8% with three, and 85.7% with four treatment sessions.
Conclusion: The combination treatment of bleomycin plus TCA and shaving led to a remarkable recovery from treatment-resistant plantar warts (21.4% recovery with the first treatment session and up to 85.7% recovery after four sessions). The treatment included tattooing and local injections, leaving few side effects.
Ali Asilian; Hossein Hafezi; Zabihollah Shahmoradi; Gita Faghihi; Amir Hossein Siadat; Samaneh Mozafarpoor; Fatemeh Mohaghegh; Mojtaba Nasimi; Mahboobeh Talakoub
Abstract
Background: Becker’s nevus syndrome (BNS) is a benign hamartoma that is aesthetically bothersome and usually appears during puberty. Various modalities of laser therapy alone or in combination with other medications can be used for the treatment of BNS, but no unified approach with an acceptable ...
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Background: Becker’s nevus syndrome (BNS) is a benign hamartoma that is aesthetically bothersome and usually appears during puberty. Various modalities of laser therapy alone or in combination with other medications can be used for the treatment of BNS, but no unified approach with an acceptable response is yet available. The current study aimed to compare the outcomes of Q-switched ruby 694 nm laser (QSRL) alone and in combination with 4% topical flutamide for the management of BNS. Methods: The current randomized clinical trial was conducted on twenty-two BNS patients between 2016-2018. The patients were randomly allocated to treatment with QSRL 694 nm alone (group A) versus in combination with 4% topical flutamide (group B). The QSRL was administered twice with four-week intervals for both groups, while group B was also administered topical flutamide 4% twice a day for eight weeks. The treatment outcomes were assessed and compared at baseline and then within 4 and 8 weeks of commencing the interventions. Results: The evaluation of the two groups in terms of lesion size alterations, response to treatment, and patients' satisfaction showed insignificant differences between the two groups (P>0.05). In addition, neither approach A (P=0.33) nor approach B (P=0.46) led to remarkable changes in lesion color. Conclusion: Based on the findings of the current study, the use of QSRL alone or even in combination with topical 4% flutamide was not suitable for the management of BNS lesions.