Samer A Dhaher; Ali M Yosif
Abstract
Background: Acne vulgaris is a common chronic inflammation ofpilosebaceous units with a multifactorial pathogenesis. Traditionaltreatment may have limited success with potential side effects.The long-pulsed neodymium-doped yttrium garnet (Nd:YAG)laser may be a desirable alternative.Methods: A prospective ...
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Background: Acne vulgaris is a common chronic inflammation ofpilosebaceous units with a multifactorial pathogenesis. Traditionaltreatment may have limited success with potential side effects.The long-pulsed neodymium-doped yttrium garnet (Nd:YAG)laser may be a desirable alternative.Methods: A prospective clinical trial was conducted on 61 acnepatients at the Department of Dermatology, Basrah TeachingHospital, from April 2019 to April 2020. Three treatments withlong-pulsed Nd:YAG were performed across two-weeks intervals(fluence 50 J/cm2, spot size 5 mm, pulse duration 15 ms, andfrequency 1.5 Hz). Patients were assessed at baseline and 2, 4,6, and 12 weeks later by counting the acne lesions and scoringthe response according to the percentage of lesions’ reduction.Results: Sixty-one patients completed the study (49 femalesand 12 males); the mean age was 18.7 ± 1.67 years. A significantreduction of acne lesions at the end of therapy was observedcompared to the baseline. The mean number of total lesions wasreduced from 84.2 ± 25.8 to 16 ± 23.3 (P < 0.05). Overall, 49 (80.3%)patients achieved an excellent response, 3 (4.9%) good, 1 (1.6%)moderate, and 8 patients (13.1%) showed a poor response. Thetreatment was well tolerated with insignificant adverse effects.Conclusion: Long-pulsed Nd:YAG laser is an effective and safemodality for treating acne vulgaris and may be considered analternative option for cases of recurrence after conventionaltreatment. However, more sessions are needed for severe cases.
Ramin Radmanesh; Mohammad Radmanesh
Abstract
Background: There is no cure for xeroderma pigmentosum (XP) patients who suffer from persistent freckling and recurrent lifethreatening malignancies. We aimed to remove facial lentiginous pigmentations using CO2 laser resurfacing.Methods: 5 patients with clinically proven XP living in their third decade ...
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Background: There is no cure for xeroderma pigmentosum (XP) patients who suffer from persistent freckling and recurrent lifethreatening malignancies. We aimed to remove facial lentiginous pigmentations using CO2 laser resurfacing.Methods: 5 patients with clinically proven XP living in their third decade were scheduled to be treated with CO2 laser resurfacing. After tumescent anesthesia, the whole facial skin was treated with 3 UltraPulse® conventional CO2 ablation passes. The parameters used were 6 mJ, 5 mJ, and 4 mJ for the first to third passes. The mandibular areas were treated with two passes of 4 and 3.2 mJ, while the eye contours were treated with two passes of 3.6 mJ and 3.2 mJ.Results: The face was edematous and almost free of freckling immediately after resurfacing. The edema persisted for a week. The facial skin oozed within the first three days, followed by crust formation. After a week and after complete shedding of the crusts, smooth and erythematous skin appeared. The erythema persisted for more than two months. The patients were free of malignancy and freckling for up to 16 months follow-up.Conclusion: CO2 laser can remove lentiginous pigmentation and prevent or postpone malignancies for a considerable length of time.
Samaneh Mozafarpoor; Ali Asilian; Mohammad Amin Jafari; Azadeh Goodarzi
Abstract
Recessive dystrophic epidermolysis bullosa (RDEB) is an autosomal recessive disorder that affects type VII collagen, one of the main components of the basement membrane. Patients present with non-healing chronic wounds in the body, extremities, and mucosal areas. There are many suggestive medical and ...
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Recessive dystrophic epidermolysis bullosa (RDEB) is an autosomal recessive disorder that affects type VII collagen, one of the main components of the basement membrane. Patients present with non-healing chronic wounds in the body, extremities, and mucosal areas. There are many suggestive medical and surgical treatments, but most are ineffective. In this case, we discuss a new laserassisted surgical protocol for these types of patients. A 54-year-old male patient was suffering from RDEB with large, excruciating, non-healing wounds on his extremities dating ten months, with no reasonable improvement, despite receiving intensive wound care. After ruling out other diagnoses (particularly malignancies), treatment was performed with a fractional Er:YAG laser for a single session. After four weeks of follow-up, the patient showed significant improvement, with no considerable complications reported. Fractional ablative Er:YAG laser could be an effective treatment option in RDEB patients. Clinical trials are required with long-term follow-ups for this novel treatment approach.
Samaneh Mozafarpoor; Ali Asilian; Azadeh Goodarzi; Zahra Ebrahimi; Fatemeh Mokhtari; Zeynab Rastgar Moqaddam
Abstract
Lymphangioma is an unusual congenital malformation of the lymphatic system that affects the skin and subcutaneous tissue. A surgical procedure is among the options for lymphangioma treatment, although it can lead to significant complications. The Nd:YAG Laser appears to be one of the safest therapeutic ...
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Lymphangioma is an unusual congenital malformation of the lymphatic system that affects the skin and subcutaneous tissue. A surgical procedure is among the options for lymphangioma treatment, although it can lead to significant complications. The Nd:YAG Laser appears to be one of the safest therapeutic options rarely proposed to treat oral cavity lesions. This paper comprehensively reviewed the studies published from 2010 to date on the treatment of cutaneous and mucosal lymphangioma with different types of lasers. In the current report, an 18-yearold female presented with a lymphangiomatous lesion on the tongue diagnosed through a pathologic study. The patient initiallyunderwent three sessions of pulsed-dye laser (PDL) therapy that evoked an insignificant response. Therefore, the approach was changed to long-pulsed Nd:YAG laser therapy, and a dramatic response was observed within three sessions of the treatment.
Vahid Mashayekhi Goyonlo; Hossein Hassan Abadi; Hanieh Zandi; Jamshid Jamali; Yalda Nahidi; Ahmad Reza Taheri; Bita Kiafar
Abstract
Background: The treatment of cutaneous leishmaniasis has long been a challenge. The application of heat to the lesions has been described in some studies, with no consensus regarding the types of thermotherapy and their practical implications.We sought to evaluate the efficacy of infrared thermotherapy ...
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Background: The treatment of cutaneous leishmaniasis has long been a challenge. The application of heat to the lesions has been described in some studies, with no consensus regarding the types of thermotherapy and their practical implications.We sought to evaluate the efficacy of infrared thermotherapy in the treatment of cutaneous leishmaniasis. Methods: We evaluated the results of infrared thermotherapy in 35 cutaneous leishmaniasis patients (53 lesions) who attended the leishmaniasis clinic of Imam Reza Hospital, Mashhad, Iran. Three times a week, the lesions were warmed to 45 degrees centigrade for two cycles of 10 minutes. Treatment outcomes were classified as complete (90-100%), good (50-89%), and poor responses (less than 50% size reduction). Results: Thirteen (24.5%) lesions were cured after three months; 31 (58.5%) and 9 (17%) lesions showed good and poor responses, respectively. Treatment outcomes were significantly related to the number of treatment sessions (P ≤ 0.05). No significant side effects were seen. Conclusion: Infrared thermotherapy is a relatively effective and well-tolerated treatment for cutaneous leishmaniasis.
Rezvan Talaee; Mahdiyeh Mohammadzadeh; Habibollah Rahimi
Abstract
Background: Cracked nipples represent the most common complication of breastfeeding. This study aimed to compare the therapeutic effect of the Cicalfate® commercial cream (containing copper, zinc, and sucralfate) with white soft paraffin in treating cracked nipples. Methods: This study was a double-blind ...
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Background: Cracked nipples represent the most common complication of breastfeeding. This study aimed to compare the therapeutic effect of the Cicalfate® commercial cream (containing copper, zinc, and sucralfate) with white soft paraffin in treating cracked nipples. Methods: This study was a double-blind clinical trial conducted on 115 patients with cracked nipples. Patients were randomly divided into two case and control groups. The case group received the Cicalfate® cream and the control group received white soft paraffin. After a period of one to two weeks of treatment, all patients were re-examined and the severity and rate of their recovery were recorded. Data were analyzed using SPSS version 15. Results: In this study, 68 patients were in the case group and 47 were in the control group. The comparison of the two groups in terms of improvement of the right nipple with the removal of other variables showed that the degree of cracking reduction in the case group was 3.3 times that of the control group (OR=3.3; CI=1.3-8.3). Also, the comparison of the two groups in terms of improvement of the left nipple with removing the effect of other variables showed that the degree of cracking reduction in the case group was 5.3 times that of the control group (OR=5.3; CI=2.0-14.1). Conclusion: The results of this study showed that the therapeutic effect of Cicalfate® is more than that of white soft paraffin.
Kuntal Das
Abstract
The daily work plan of the human has changed dramatically due to the spread of the coronavirus disease 2019 (COVID-19) pandemic. The viral infection was first detected in Wuhan, China, and was first transmitted via the bat as a zoonotic disease that was confirmed in December 2019. On 30th January 2020, ...
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The daily work plan of the human has changed dramatically due to the spread of the coronavirus disease 2019 (COVID-19) pandemic. The viral infection was first detected in Wuhan, China, and was first transmitted via the bat as a zoonotic disease that was confirmed in December 2019. On 30th January 2020, this viral outbreak was declared a public health emergency or epidemic. Subsequently, on 11th February 2020, the World Health Organization (WHO) declared it a pandemic. The potentially lethal virus has become a threat to the global population. The WHO provides special precautions and instructions to people all around the world, among which the importance of wearing a face mask, gloves, and a head protector are discussed. Many healthcare workers (especially doctors and nurses) and common people suffer from skin infections with the use of a continuous face mask, gloves, or other protective items. In order to alleviate skin dermatitis, it is important to use well-known natural herbals in the search for new drug sources. It is advisable to use useful herbal extracts in sole or in combination as cosmetic products for the treatment of skin diseases. India is a focal point of medicinal plants. Many Indian herbal plants are essentially used as cosmetics to cure skin infections. Natural herbs are safe, non-toxic, and cost-efficient for treating skin dermatitis during the COVID-19 situation.
Ramin Radmanesh; Mohammad Radmanesh
Abstract
Lichen planus pigmentosus (LPP) develops as an asymptomatic and dusky pigmentation of the facial skin with no effective treatment. Herein we report a 54-year-old lady with clinical and histopathologic confirmation of LPP who was scheduled to be treated with CO2 laser resurfacing. ...
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Lichen planus pigmentosus (LPP) develops as an asymptomatic and dusky pigmentation of the facial skin with no effective treatment. Herein we report a 54-year-old lady with clinical and histopathologic confirmation of LPP who was scheduled to be treated with CO2 laser resurfacing. After tumescent anesthesia, the whole facial skin was treated with three passes of Ultrapulse conventional CO2 ablation. The energy used in the first, second, and third passes were 6.6, 5.4, and 4.8 mJ, respectively. The mandibular area was treated with two passes (4.2 and 3.6 mJ). The eye contours were treated with two passes (3.9 and 3.3 mJ). The patient’s face remained edematous for a week, with the facial skin oozing within the first three days before it became crusted. The crust shed out from day three to six. After a week, smooth and erythematous skin appeared. The erythema persisted for up to four months, after which uniform skin with considerable bleaching and rejuvenation developed. No recurrence occurred within 18 months of follow-up. We conclude that LPP can be treated with CO2 laser resurfacing without any complications.
Firooz Alireza; Handjani Farhad; Lajevardi Vahideh; Mansouri Parvin; Nassiri-Kashani Mansour; Norouzi Yasaman
Abstract
Urticaria is a common and challenging skin disorder. Diagnosis and treatment of urticaria is not limited to the field of dermatology. General physicians, allergologists and clinical immunologists are also commonly involved in the management of patients with urticaria. Iranian Society of Dermatology developed ...
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Urticaria is a common and challenging skin disorder. Diagnosis and treatment of urticaria is not limited to the field of dermatology. General physicians, allergologists and clinical immunologists are also commonly involved in the management of patients with urticaria. Iranian Society of Dermatology developed a clinical practice guideline concerning diagnosis and treatment of urticaria that was published in 2015. The current guideline is an update to the previous one and includes findings related to this subject which has been published in the medical literature from 2015 to August 2018.
Dhaher Samer A; Alhamdi Dhoha Kh
Abstract
Background: Rosacea is a chronic inflammatory disease of unknown etiology. Few studies have been published on the use of oral ivermectin in the treatment of the inflammatory subset of rosacea. The aim of the present research was to evaluate the efficacy and safety of oral ivermectin prescribed for a ...
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Background: Rosacea is a chronic inflammatory disease of unknown etiology. Few studies have been published on the use of oral ivermectin in the treatment of the inflammatory subset of rosacea. The aim of the present research was to evaluate the efficacy and safety of oral ivermectin prescribed for a series of patients with inflammatory rosacea.
Methods: On a weekly basis, 29 patients with papulopustular rosacea were orally given ivermectin at a dose of 200 µg/kg before meal for three consecutive weeks. Subjects were evaluated weekly and during the follow-up period for two successive treatment-free months.
Results: After 3 doses of ivermectin, there was a significant reduction in the total count of inflammatory lesions compared to the base line (the mean was reduced from 51.6±27.4 to 21±14.7) (P<0.05). At the end of the two-month follow-up period, more reduction was observed in inflammatory lesions (mean was reduced to 9.3±7), and 62% of the patients showed excellent responses to the treatment (≥ 80% reduction in the lesions). Nausea was reported in 10%.
Conclusion: A three-week use of oral ivermectin is an effective, safe, and well-tolerated approach to treating inflammatory rosacea .
Radmanesh Ramin; Radmanesh Mohammad
Abstract
Angioma serpiginosum (AS) is a nevoid capillary malformation developed congenitally or thereafter. The AS stops growing after puberty and may remain persistent throughout life. The pulsed dye laser (PDL) and KTP are used to treat the AS usually after several sessions. We treated a patient with AS with ...
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Angioma serpiginosum (AS) is a nevoid capillary malformation developed congenitally or thereafter. The AS stops growing after puberty and may remain persistent throughout life. The pulsed dye laser (PDL) and KTP are used to treat the AS usually after several sessions. We treated a patient with AS with only one session of intense pulsed light (IPL) therapy. A 40-year-old lady with Fitzpatrick skin type 3 and AS on the left maxillary and infraorbital area was scheduled to be treated with IPL. The lesion was treated by a single pass of IPL therapy with 8 joules/ cm2, in the telangiectatic mode. No anesthesia more than cooling was used, and a mild erythema was developed immediately after IPL therapy, which subsided soon after the procedure. Two months later, telangiectatic lagoons were completely removed, and only very faint erythema remained. IPL is an effective and more tolerable device for the treatment of AS, with no purpura and discoloration, as frequently observed following PDL therapy.
Jawade Sugat A.; Saigaonkar Vaidehi A.; Kondalkar Ambika R.
Volume 19, Issue 4 , 2016, , Pages 105-112
Abstract
Background: Topical retinoid based combinations are recommended to enhance the outcome of acne treatment. Adapalene-benzoyl peroxide (BPO) combination gel was approved in 2009 for acne treatment. The aim of this study was to evaluate the efficacy and tolerability of adapalene 0.1%-benzoyl peroxide 2.5% ...
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Background: Topical retinoid based combinations are recommended to enhance the outcome of acne treatment. Adapalene-benzoyl peroxide (BPO) combination gel was approved in 2009 for acne treatment. The aim of this study was to evaluate the efficacy and tolerability of adapalene 0.1%-benzoyl peroxide 2.5% combination gel compared to adapalene 0.1% gel monotherapy and benzoyl peroxide 2.5% gel monotherapy in treatment of acne vulgaris in Indian patients.Methods: A randomized, parallel group, investigator-blind clinical trial was conducted from September 2014 to September 2015 in the Dermatology outpatient department. The patients were randomized into three groups of adapalene 0.1% gel, benzoyl peroxide 2.5% gel, and adapalene 0.1%-benzoyl peroxide 2.5% combination gel. The patients were asked to apply the allocated gel to the face in the evening for 12 weeks. Efficacy was evaluated using percent of reduction in total, inflammatory, and non-inflammatory lesions and success rate while tolerability was assessed by evaluating skin dryness, erythema, stinging or burning sensation and scaling at baseline and 1, 2, 4, 8, and 12 weeks.Results: At the end of 12 weeks, the success rate reached 37.2% with adapalene-BPO combination gel compared to 23.3% and 19.4% for adapalene and benzoyl peroxide gel monotherapy respectively. Adapalene-BPO combination gel was significantly effective in the reduction of total, non-inflammatory and inflammatory lesions by 75.9%, 75.4%, and 74.7% respectively compared to the corresponding monotherapies. Side effects with adapalene–BPO combination gel were mild and transient.Conclusion: Adapalene–BPO combination gel was more efficacious and better tolerated than adapalene and benzoyl peroxide gel monotherapy.
Shahidi-Dadras Mohammad; Abdollahimajd Fahimeh; Younespour Shima; Nikvar Mohammad
Volume 19, Issue 4 , 2016, , Pages 119-124
Abstract
Background: Psoriasis is a chronic disease with multiple biochemical and vascular abnormalities. Several studies have evaluated circulating levels of vascular endothelial growth factor (VEGF) in psoriasis, but none of them evaluated it after reaching a PASI-75 response, as a practical treatment goal. ...
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Background: Psoriasis is a chronic disease with multiple biochemical and vascular abnormalities. Several studies have evaluated circulating levels of vascular endothelial growth factor (VEGF) in psoriasis, but none of them evaluated it after reaching a PASI-75 response, as a practical treatment goal. The aim of this study was to evaluate serum levels of VEGF in moderate to severe psoriatic patients before and after treatment compared with healthy controls.Methods: This study was approved by the Ethics Committee of Shahid Beheshti University of Medical Sciences. Fifty-eight patients with moderate- severe psoriasis and 60 age-and gender-matched healthy controls were recruited to this study. Serum VEGF levels (pg/ml) of both groups were measured. We used Psoriasis Area and Severity Index (PASI) scoring to assess disease activity in patients. According to the disease severity, the patients received proper treatment. When they reached a PASI-75 response, serum VEGF levels were measured once more.Results: In our study, the median serum VEGF level was significantly higher in psoriatic patients (before and after treatment) as compared to healthy controls. Moreover, patients showed a significant reduction in their serum VEGF levels after reaching PASI-75. The median time of therapeutic effect (reaching a PASI- 75 response) was four months. Furthermore, our study showed a significant correlation between the serum VEGF level and age, BMI, PASI, and disease duration (P
Farhad Handjani; Nasrin Saki; Sona Zandi; Mohammad Sadegh Sayyafan; Bahareh Kardeh; Yasaman Emami; Alireza Heiran
Volume 19, Issue 1 , 2016, , Pages 14-5
Abstract
Background: Wart is a common skin disease that can occur at any age. While they are usually benign and self-limited, they can become irritating and cosmetically disabling to patients. The objective of this study is to compare the effectiveness of a topical 85% formic acid preparation with a combination ...
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Background: Wart is a common skin disease that can occur at any age. While they are usually benign and self-limited, they can become irritating and cosmetically disabling to patients. The objective of this study is to compare the effectiveness of a topical 85% formic acid preparation with a combination of topical salicylic acid and lactic acid.Methods: We enrolled 66 patients, 7-60 years of age, in this triple-blind study. Patients were randomly divided into 2 groups: group 1 received a topical 85% formic acid solution and group 2 received DuoFilm (topical 16.7% salicylic acid + 16.7% lactic acid). The duration of treatment was a maximum of 4 weeks and we followed the patients every two weeks.Results: In group 1, 74.1% of the warts completely healed and 3.5% partially healed. In group 2 complete healing occurred in 40.8% and partial healing in 26.8% of the warts (P<0.001). Statistical analysis showed a significant difference in the favor of formic acid on the hands (P<0.001) but we did not observe a better effect for the feet. The time to complete healing was less for the majority of patients in the formic acid group (1 week versus 4 weeks). There were minimal adverse effects in each group, none that necessitated cessation of treatment.Conclusion: Topical formic acid had a higher cure rate for warts compared with a conventional preparation that consisted of both topical salicylic acid and lactic acid. This effect was particularly noted on the hands. This topical remedy could be regarded as an alternative to conventional treatments in the management of warts.
Sepaskhah Mozhdeh; Maghami Zohreh
Volume 18, Issue 4 , 2015, , Pages 179-181
Abstract
Pityriasis lichenoides is an uncommon, acquired, papulosquamous disorder that exhibits various clinical presentations, including acute, chronic, and febrile ulceronecrotic Mucha- abermann forms. Pityriasis lichenoides chronica (PLC) is the chronic form of this continuum. Its treatment is challenging ...
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Pityriasis lichenoides is an uncommon, acquired, papulosquamous disorder that exhibits various clinical presentations, including acute, chronic, and febrile ulceronecrotic Mucha- abermann forms. Pityriasis lichenoides chronica (PLC) is the chronic form of this continuum. Its treatment is challenging for patients and clinicians and some cases are multidrug resistant. Today, this disorder has many treatment choices, including topical corticosteroids, topical calcineurin inhibitors, phototherapy (ultraviolet (UV) A and narrow band UVB), methotrexate, dapsone, cyclosporine and recently etanercept. In our experience, mycophenolate mofetil was effective as a new treatment for pityriasis lichenoides.
Firooz Alireza; Hallaji Zahra; Khatami Alireza; Lajevardi Vahideh; Mansouri Parvin; Pedram Mehryan; Zohreh Mozafari; Mansour Nassiri-Kashani; Reza Robati; Hassan Seirafi
Volume 18, Issue 3 , 2015, , Pages 81-96
Abstract
Urticaria is a common and challenging skin disorder. Diagnosis and treatment of urticaria is not limited to the field of dermatology. General physicians, allergologists and clinical immunologists are also commonly involved in the management of patients with urticaria.One of the missions of the Iranian ...
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Urticaria is a common and challenging skin disorder. Diagnosis and treatment of urticaria is not limited to the field of dermatology. General physicians, allergologists and clinical immunologists are also commonly involved in the management of patients with urticaria.One of the missions of the Iranian Society of Dermatology is to develop strategies in order to provide the best possible management for patients suffering from dermatological conditions. To accomplish this mission, the Society assigned a committee to search and critically appraise the recent research evidence and available guidelines to develop a clinical practice guideline concerning diagnosis and treatment of urticaria.
Amanjot Kaur Arora; Alka Dogra; Sunil Kumar Gupta
Volume 17, Issue 3 , 2014, , Pages 85-90
Abstract
Background: Plantar warts may be refractory to any form of treatment and are associated with pain and a decreased quality of life. There are very few randomized controlled studies that focuson the treatment of plantar warts. Cryotherapy and radiofrequency ablation (RFA) have been used ...
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Background: Plantar warts may be refractory to any form of treatment and are associated with pain and a decreased quality of life. There are very few randomized controlled studies that focuson the treatment of plantar warts. Cryotherapy and radiofrequency ablation (RFA) have been used in the treatment of this recalcitrant condition. However, no data exists comparing the efficacy ofthese treatment options in the treatment of plantar warts. The aim of the study was to compare the efficacy of cryotherapy and RFA in the treatment of plantar warts.Method: Fifty patients with a clinical diagnosis of plantar warts were included in the study. They were randomly divided into two groups of 25 patients. After paring the warts, Group A wastreated with cryotherapy with nitrous oxide and Group B was treated by RFA of warts every 2 weeks for a maximum period of 12 weeks. The results of the two groups were compared atthe end of 12 weeks.Result: Fifty patients had a total of 212 warts. Eighty four percent (21/25) of the patients receiving RFA experienced subjective benefits within 2 sessions whereas in the cryotherapy group, 72% (19/25) of the patients required three to four sessions to experience subjective benefits (p = 0.00189). Eighty four percent (21/25) of the patients and 91.6% (121/132) of the warts in theRFA group achieved complete clearance by the end of 12 weeks whereas only 32% (8/25) of the patients and 31.25 % (25/80) of the warts receiving cryotherapy achieved complete clearance bythe end of 12 weeks (p = 0.00681).Conclusion: Radiofrequency ablation is more effective than cryotherapy in the treatment of plantar warts and gives quicker subjective and objective results.
Iffat Hassan; Peerzada Sajad; Syed Mubashir
Volume 17, Issue 3 , 2014, , Pages 101-103
Abstract
Background: Bowen’s disease is a form of intraepidermal squamous cell carcinoma (SCC) characterised by a persistent, non-elevated, red, scaly or crusted plaque with a small potentialfor invasive malignancy. Most cases of typical Bowen’s disease in the white population are found ...
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Background: Bowen’s disease is a form of intraepidermal squamous cell carcinoma (SCC) characterised by a persistent, non-elevated, red, scaly or crusted plaque with a small potentialfor invasive malignancy. Most cases of typical Bowen’s disease in the white population are found on the lower legs of the elderly women. However, in this part of the world, i.e. Kashmir, the mostcommon site is thighs followed by the lower abdomen. A range of treatment options are available for it including cryotherapy, curettage and cautery, photodynamic therapy, laser destruction,surgical excision, 5-fluorouracil cream, imiquimod cream, and radiotherapy. The aim of this study was to evaluate the efficacy of surgical excision in Bowen’s disease.Method: All the patients with biopsy proven Bowen’s disease were included for the study. A detailedhistory was taken for each patient including the history of medical treatment for Bowen’s disease. Wide surgical excision (including either fusiform excision, W-plasty, or Z-plasty) was performed in each patient and the patients were then followed up for any recurrence. No sign of renewed disease activity at 6 months follow-up was taken as cure. All patients are intended to be followed up for 5 years.Result: Ten out of 12 patients reported the use of topical imiquimod cream but complained of the progression of lesions. Surgical excision was performed in 12 patients. All the patients are currently under regular follow-up. Except for secondary infection and wound dehiscence in one patient, all the patients are in good condition with no signs of recurrence.Conclusion: Although it was a preliminary study, we recommend surgical excision in treatment of Bowen’s disease due to low recurrence rate.
Radmanesh Mohammad; Azar-Beig Mohsen
Volume 16, Issue 2 , 2013, , Pages 49-52
Abstract
Background: The cold-induced inflammation of cryotherapy mayalter the immunologic processes and structural components ofthe hair follicles responsible for AA. The aim of this study was tostudy the efficacy of cryotherapy in alopecia areata, and totalis.Method: Forty-four patients with recalcitrant scalp ...
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Background: The cold-induced inflammation of cryotherapy mayalter the immunologic processes and structural components ofthe hair follicles responsible for AA. The aim of this study was tostudy the efficacy of cryotherapy in alopecia areata, and totalis.Method: Forty-four patients with recalcitrant scalp alopeciaareata or totalis were treated with cryotherapy. The cryo-systemchosen was a closed contact CO2 system with metallic probes.The patients were evaluated for 4-8 weeks for hair growth.Satisfactory hair growth after 8 weeks was an indication forperforming cryotherapy for the remaining untreated areas.Result: Varying degrees of hair growth were detected in 52.50%of the patients four weeks and in 65.90 % eight weeks aftertreatment. About 38.64% of the patients showed more than 50%hair regrowth 8 weeks after therapy.Conclusion: Cryotherapy is effective for about two-thirds of thepatients with alopecia areata, many of whom are unresponsiveto conventional therapies.
Pedram Noormohammadpour; Somayeh Khezri; Zahra Safaee Naraghi; Alireza Ghanadan; Farzaneh Khezri
Volume 15, Issue 4 , 2012, , Pages 134-136
Abstract
Confluent and Reticulate Papillomatosis (CRP) is a rare disease withpoorly recognized etiology. Various agents such as antibacterial,topical/systemic antifungal and topical/oral retinoids have beenused as treatment. Here, we report a 15-year-old female withCRP in whom yeasts of Malassezia were found ...
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Confluent and Reticulate Papillomatosis (CRP) is a rare disease withpoorly recognized etiology. Various agents such as antibacterial,topical/systemic antifungal and topical/oral retinoids have beenused as treatment. Here, we report a 15-year-old female withCRP in whom yeasts of Malassezia were found in the PAS stainof the skin lesions. Topical terbinafine hydrochloride 1% sprayand oral fluconazole disappeared the lesions, supporting thehypothesis that CRP maybe a reactive dermatosis to Malassezia..
Esmaili Nafiseh; Chams-Davatchi Cheyda; Daneshpazhooh Maryam; Ghiasi Maryam; Abedini Robabe; Mortazavi Hossein; Roghani Iman
Volume 15, Issue 2 , 2012, , Pages 33-37
Abstract
Background: Pemphigus vulgaris (PV) is an autoimmune bullous disorder that is fatal if left untreated. High dose systemic corticosteroids are the basis of therapy. The addition of immunosuppressive agents has improved the disease outcome and reduced the required corticosteroid dose and related toxicity. ...
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Background: Pemphigus vulgaris (PV) is an autoimmune bullous disorder that is fatal if left untreated. High dose systemic corticosteroids are the basis of therapy. The addition of immunosuppressive agents has improved the disease outcome and reduced the required corticosteroid dose and related toxicity. Mycophenolate mofetil is increasingly used as a steroid-sparing agent in immunotherapy of PV. Herein, we tried to appraise the efficacy of mycophenolate mofetil and topical clobetasol in the control of the major relapses of pemphigus vulgaris. Method: Seventeen patients with severe relapse of pemphigus vulgaris were included in this study. All patients had complete remission on/off therapy before this period of recurrence. The patients were treated with 2g/day mycophenolate mofetil and 25-35g/day topical clobetasol propionate ointment. All patients were monitored for the side effects of therapy. Result: The patients were followed for a mean period of 12.7 months. The average length of time from initiating mycophenolate to 50% control (partial remission), which occurred in all patients, was 6±1.17 weeks. Fifteen patients achieved complete remission averagely at week 20.8±7.70. The average duration of followup after complete disease control was 8 months (ranging from 2-13.5 months). Three patients were free of lesions for more than 12 months and 10 for more than 6 months. No important mycophenolate mofetil related complication was observed during treatment. Conclusion: The combination of mycophenolate mofetil and topical corticosteroid can be used to control PV relapses and taper-off corticosteroid.
Nazemi-Tabrizi Mohammad-Javad; Hatami Parvaneh; Ghiasi Maryam; Daneshpazhooh Maryam; Chams-Davatchi Cheyda
Volume 15, Issue 2 , 2012, , Pages 42-46
Abstract
Background: Pemphigus vulgaris is a rare autoimmune disorder characterized by cutaneous and mucosal blistering. Surprisingly, the management of oral lesions has been detailed only infrequently. As current topical therapies for oral lesions are of limited efficacy, application of calcineurin inhibitors ...
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Background: Pemphigus vulgaris is a rare autoimmune disorder characterized by cutaneous and mucosal blistering. Surprisingly, the management of oral lesions has been detailed only infrequently. As current topical therapies for oral lesions are of limited efficacy, application of calcineurin inhibitors is considered to be a potential option. The aim of this essay was to investigate the efficacy of tacrolimus 0.1% ointment (Protopic®) versus triamcinolone acetonide 0.1% paste (Volon-A®) in the treatment of oral pemphigus vulgaris. Method: Fifteen patients were involved in a prospective randomized trial with a split- mouth design. After two weeks of administering study drugs, oral lesions were monitored and quantified pain and mucosal surface involvement scores were obtained. Result: Within 14 days, the degree of involvement and pain scores significantly reduced in both tacrolimus-treated and triamcinolone-treated sites, but there was no significant difference between them. No severe adverse events were observed. Conclusion: This study showed that tacrolimus could be as effective as triamcinolone acetonide in the topical treatment of oral pemphigus vulgaris.
Sepideh Tehrani; Setareh Tehrani; Mitra Esmaili-Azad; Mahnaz Vaezi; Nazi Saljoughi
Volume 15, Issue 1 , 2012, , Pages 11-14
Abstract
Background: Melasma is a brown or grayish brown symmetrical facial hyperpigmentation.A number of medicamens can be used for the treatment of this condition. For better results in treating melasma, combination therapy is preferred. The aim of this study was to determine the clinical efficacy and adverse ...
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Background: Melasma is a brown or grayish brown symmetrical facial hyperpigmentation.A number of medicamens can be used for the treatment of this condition. For better results in treating melasma, combination therapy is preferred. The aim of this study was to determine the clinical efficacy and adverse effects of azelaic acid 20% plus hydroquinone 5% versus hydroquinone 5% alone in the management of melasma. Method: This study was performed as a double blind randomized clinical trial. We randomly prescribed two regimes including azelaic acid 20% cream plus hydroquinone 5% or hydroquinone 5% alone once daily for 4 months in 64 patients. Clinical efficacy (with MASI score) and side effects were assessed after one, two and four months of treatment. Result: MASI score reduction was from 9.35 to 2.9 in patients using azelaic acid 20% plus hydroquinone and from 9.58 to 4.02 in patients using hydroquinone 5%. Drug adverse effects, including burning (most frequent), itching, stinging, dryness and erythema, were present in 50% of the participants in the azelaic acid 20% plus hydroquinone group and 35% of the individuals in the hydroquinone 5% group (P= 0.034), but were tolerated by most patients. Conclusion: Both therapeutic regimens showed a remarkable efficacy in the treatment of melasma but azelaic acid 20% plus hydroquinone was more effective with a more rapid onset of therapeutic response. Azelaic acid 20% plus hydroquinone had more side effects although they were slight in most cases.
Nasrin Hamidizadeh; Behrooz Barikbin; Maryam Yousefi; Abbas Sahraei; Ali Khamesipour; Shima Younespour; Hanif Sadeghitehrani
Volume 14, Issue 2 , 2011, , Pages 48-51
Abstract
Introduction: Cutaneous Leishmaniasis (CL) is a parasitic disease caused by Leishmania species. Currently accessible treatments remain insufficient, and there is pressure to develop suitable and effectual options. In this study, we used different concentrations of podophyllin in vitro on leishmania parasites ...
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Introduction: Cutaneous Leishmaniasis (CL) is a parasitic disease caused by Leishmania species. Currently accessible treatments remain insufficient, and there is pressure to develop suitable and effectual options. In this study, we used different concentrations of podophyllin in vitro on leishmania parasites and then on leishmaniasis lesions in mice and compared their efficacy. Method: We used podophyllin (14.3 µg/ml) in vitro against leishmania major parasites, then in experimental animals in different concentrations. Results: Podophyllin (14.3 µg/ml) that used in vitro eradicated leishmania major parasites, but, in mice after four weeks was not effective and the diameter of the lesions increase with use of topical podophyllin. Conclusion: Despite the lethal effect on leishmania in vitro, treatment with different doses of podophyllin could not accelerate the healing process of the leishmaniasis lesions of the experimental rats.
Arun Achar; Pratim Chakraborty Partha; Tarapada Ghosh; Biswanath Naskar; Tapobrata Guharay; Samiran Bisai
Volume 14, Issue 2 , 2011, , Pages 52-57
Abstract
Background: Acyclovir, a specific and selective inhibitor of replication of herpesviridae family, has well documented efficacy for speedy rash healing and decreasing pain of herpes zoster. Limited oral bioavailability of acyclovir requires frequent dosing. Valacyclovir is rapidly and almost completely ...
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Background: Acyclovir, a specific and selective inhibitor of replication of herpesviridae family, has well documented efficacy for speedy rash healing and decreasing pain of herpes zoster. Limited oral bioavailability of acyclovir requires frequent dosing. Valacyclovir is rapidly and almost completely converted to acyclovir in vivo and gives three to fivefold increase in acyclovir bioavailability. The aim of this study was to assess the clinical efficacy, safety and tolerability of oral valacyclovir versus standard oral acyclovir in the treatment of herpes zoster. Methods: A blind randomized prospective study was performed during May 2007 to August 2007 in Midnapore Medical College. Immunocompetent patients, aged ≥40yrs presenting with herpes zoster within 72 hours after onset of rash were enrolled and randomized to receive one of the following treatments: 1000 mg of valacyclovir thrice daily for 7 days or acyclovir 800 mg 5 times daily for 7 days. A total of 60 patients were included and randomized to receive either valacyclovir (n=30) or acyclovir (n=30) and they were evaluated at 8 days, 15 days and 29 days, respectively. Results: A statistically significant reduction of skin lesion and zoster associated pain were noticed in valacyclovir compared to acyclovir group. However, presence of post herpetic neuralgia on the 29th day was less in acyclovir compared to valacyclovir group (70.0% vs. 83.3%, P>0.05). Only one patient on valacyclovir and two patients on acyclovir complained of nausea and mild abdominal pain. Conclusion: We conclude that for the management of herpes zoster, valacyclovir might be superior to acyclovir in respect to reduction of skin lesions and pain.