Iranian Journal of Dermatology

Abstract Background: Microneedling has been shown to be a clinically effective and safe treatment for comedonal acne vulgaris. The aim of the present study was to compare the clinical effect
of microneedling and the most commonly used topical drug, tretinoin, in the treatment of comedonal acne.
Methods: Patients with comedonal acne (n = 82) were randomized to receive topical tretinoin (n = 41) or 6 sessions of microneedling (n = 41) over a period of 3 months. Objective assessments such
as changes in acne severity score by global acne grading system (GAGS) and patients’ subjective satisfaction were investigated at the baseline, at the end of the treatment period, and at the
3-month follow up.
Results: GAGS was significantly reduced in both microneedling (7.8±3.8 to 3.5±2.6) and tretinoin (8±3.8 to 6.6±3.2) groups at the end of the treatment course compared with the baseline. The
overall acne severity index reduction in microneedling group was significantly higher than that of the tretinoin group (P<0.001). Improvement in acne severity was also more permanent by
microneedling. The severity of acne in tretinoin recipients was increased to 8.2±3.2 at the follow-up visit, while it remained nearly unchanged in the microneedling group. (3.3±2.4). Patients’
subjective assessment concerning acne improvement was significantly more satisfactory in microneedling group (P<0.001). Conclusion: Compared with tretinoin, microneedling seems to be a more effective, permanent and satisfactory treatment in the treatment of comedonal acne.

Abstract Background: The role of smoking and alcohol consumption in the pathogenesis of psoriasis is well-known; however, certain published studies have focused on the relationship between substance abuse and psoriasis. The present study was conducted to evaluate the prevalence of tobacco smoking, and substance and alcohol use in patients with psoriasis.
Methods: Patients with a definite diagnosis of psoriasis at ages of 15 or more were recruited and general information of patients and their smoking behavior, alcohol consumption and substance
abuse were further collected.
Results: 203 patients (103 men and 100 women) with psoriasis were included in this cross-sectional study. There were 76 smokers (37.45%) and 49 patients (24.1%) who consumed alcohol. Smoking, opium and alcohol consumption were significantly higher in men with psoriasis compared with women (P-values = 0.0001, 0.003, 0.002, respectively). Tranquilizer use was higher in married patients (P = 0.002), and those with joint involvements (P = 0.009). Hookah use was considerably high in female psoriatic patients, although not statistically significant (P = 0.37). Moreover, patients older than 40 years, and with nail disease (odds Ratio = 3.8) were
more prone to hookah use.  Conclusion: Our study revealed that the prevalence of smoking, opium and alcohol consumption is higher in men with psoriasis. Moreover, tranquilizer use is higher in married patients, and those with joint involvements. These findings should prompt public health workers to consider the modifiable habitual risk factors in patients with psoriasis.

Abstract There are many patients with inflammatory acne vulgaris who are not compliant or eligible to consume acne medications, such as oral antibiotics or isotretinoin. PubMed and Medline databases were searched for all related articles. All finding were summarized and chronologically presented in the tables. Nonmedical device-based therapies largely improve the treatment of active inflammatory acne vulgaris, especially in patients who are not compliant or eligible to consume acne medications, do not respond to these drugs over a specified period of time, or do not sustain in the remission phase.

Abstract Tinea corporis is a superficial dermatophyte infection. This is a case report of a 45-year-old female presenting with a history of erythematous raised lesions with itching all over the body since one year ago. Based on clinical findings, the lesions were diagnosed as tinea corporis. A KOH smear was carried out and results were negative probably due to application of steroids, and a histopathological examination was done. On histopathological examination, the patient was proved to have dermatophytosis caused by Trichophyton mentagrophytes. The patient was successfully treated with oral itraconazole 200mg once a day and griseofulvin 250 mg once a day along with 2 % ketoconazole for topical application.

Abstract Progeroid syndromes, one of which is metageria, are characterized by signs of premature aging with multiple systemic and skin symptoms. Here we describe an 8-year-old girl with no history
of specific underlying disease in her family, no hair growth at the scalp since she was born, and taller and thinner than her peers. We noticed diffuse subcutaneous fat atrophy. The patient
was referred to Sina Hospital, Tabriz because of the appearance of pseudomilia lesions throughout the body following pulse corticosteroid therapy. Proper and timely diagnosis of progeroid syndromes is important in preventing undesirable side effects. Introducing this case is important as it prevents other patients from undergoing corticosteroid therapy due to misdiagnoses, such as alopecia areata.

Abstract Granuloma annulare (GA) is an idiopathic benign skin disease, characterized by annular dermal plaques or papules. Much is still unknown concerning its aetiology, association, and pathogenesis.
We report two patients with generalized GA (GGA), with different age of presentation, co-morbidities, and disease morphology. Herein, we report two patients with GGA with different clinical features, disease morphologies, and histology patterns. We also illustrate the treatment used in our patients and the outcome. GA is a self-limiting disease and can regress spontaneously. GGA tends to be more persistent and usually requires treatment for symptomatic or cosmetic reasons. Expert consensus on treatments recommends topical corticosteroid, psoralen and ultraviolet A (PUVA), and antimalarial drugs.

Abstract