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.
Abbas Darjani; Ehsan Aboutaleb; Narges Alizadeh; Rana Rafiei; Kaveh Gharaee Nejad; Sahar Nabatchii; Elahe Rafiei; Zahra Atrkar Roushan; Hojat Eftekhari
Abstract
Background: Acne vulgaris is a common skin disease. Choosing an appropriate treatment modality is important. We compared benzoyl peroxide 5% gel vs. new topical dapsone 5% gel in combination with doxycycline to improve acne.Methods: In a clinical trial, 60 cases with acne vulgaris aged 18-25 years were ...
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Background: Acne vulgaris is a common skin disease. Choosing an appropriate treatment modality is important. We compared benzoyl peroxide 5% gel vs. new topical dapsone 5% gel in combination with doxycycline to improve acne.Methods: In a clinical trial, 60 cases with acne vulgaris aged 18-25 years were divided randomly into two groups, DD (dapsone 5% gel plus oral 100 mg doxycycline) and BD (benzoyl peroxide 5% gel plus oral 100 mg doxycycline). Topical dapsone 5% gel was made for the first time at Guilan University of Medical Sciences. The lesion counts, side effects, and acne severity (GAAS) were examined at baseline, 2, 4, 8, and 12 weeks. Satisfaction and improvement were assessed after 12 weeks. The Mann-Whitney, chi-squared, Wilcoxon, and Friedman tests were used for statistical analysis in SPSS v. 21.Results: Inflammatory and non-inflammatory lesions were similar between the groups. Lesions were reduced within groups (P > 0.05). GAAS scores were similar between groups but decreased in both groups after 12 weeks (P = 0.003). Side effects (especially skin dryness) were less in the BD group after 12 weeks (P = 0.017), though erythema and skin irritation were less in the DD group (P > 0.05). Both groups reported a similar improvement rate (85%). However, satisfaction was more in the DD group (78%).Conclusion: The new dapsone 5% gel seems to be as effective as benzoyl peroxide 5% in combination with doxycycline. Considering its good tolerability, safety, and acceptability, it is suggested as an appropriate treatment for moderate acne vulgaris. (Clinical trial number: IRCT2017072035195N1)
Golnaz Mehran; Saba Sepasgozar; Masoomeh Rohaninasab; Azadeh Goodarzi; Mohammadreza Ghassemi; Mahrokh Fotooei; Elham Behrangi
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 effectof microneedling and the most commonly used topical drug, tretinoin, in the treatment of comedonal acne.Methods: ...
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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 effectof 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 suchas 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 the3-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. Theoverall 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 bymicroneedling. 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.
Vahideh Lajevardi; Seyede Zahra Ghodsi; Maryam Daneshpazhooh; Homa Kazemi; Zeinab Aryanian; Azadeh Goodarzi
Volume 17, Issue 1 , 2014, , Pages 13-17
Abstract
Background: Acne vulgaris is a common skin disorder that affects 79% to 95% of the young population. Some studies have focused on the role of overweight and obesity in initiation and exacerbation of acne. This study investigated the relationship between BMI and the severity of acne. Method: This cross-sectional ...
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Background: Acne vulgaris is a common skin disorder that affects 79% to 95% of the young population. Some studies have focused on the role of overweight and obesity in initiation and exacerbation of acne. This study investigated the relationship between BMI and the severity of acne. Method: This cross-sectional study was conducted on 107 acne patients. One form was completed for each patient with regard to demographic characteristics including age, sex, weight, height, BMI, and also the severity of acne based on the Global Acne Severity Scale (GEA Scale), duration of the disease, type of medication, smoking history, duration of exposure to sunlight and intake of dairy products and chocolate. Result: In this study, 93 patients (86.9%) were female and 14 patients (13.1%) were male, with a mean age of 22.5 years. The mean BMI of the participants was 23.36 kg/m2 . With regard to acne severity groups, the moderate acne group had the highest frequency in total (37.4%). The highest mean BMI was seen in the very severe acne group (24.4 kg/m2 ), and the lowest mean BMI was observed in the severe acne group (21.86 kg/m2 ). There was no significant correlation between the acne severity and BMI (p=0.806).The mean disease duration was 4.13 years, which was not significantly associated with BMI. There was no significant association between the type of medical therapy and BMI. Conclusion: The prevalence of acne with severity more than moderate was much lower in patients who were underweight (BMI less than 18.5). However, this study showed no statistically significant difference in BMI among people with different severities of acne. Population-based studies, as well as age restriction of the participants, can lead to more accurate and reliable results in this regard.
Ghiasi Maryam; Lajevardi Vahide; Mortazavi Hossein; Damavandi Maedeh Raiyati
Volume 16, Issue 4 , 2013, , Pages 137-140
Abstract
Background: Systemic isotretinoin is a very effective medication for the treatment of acne, but it has some side effects. One of its side effects is musculoskeletal problems such as increased levels of creatine phosphokinase (CPK), myalgia, and serious muscle damage such as rhabdomyolysis. The aim of ...
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Background: Systemic isotretinoin is a very effective medication for the treatment of acne, but it has some side effects. One of its side effects is musculoskeletal problems such as increased levels of creatine phosphokinase (CPK), myalgia, and serious muscle damage such as rhabdomyolysis. The aim of this study was to evaluate the incidence of myalgia and its relationship with the elevation of serum CPK levels in patients treated with isotretinoin.Method: This study was done on forty acne patients in Razi Hospital. Isotretinoin was administered at a dose of 0.25 mg/kg in all patients. Serum CPK levels were measured before the treatment and every 2 months during treatment. On each visit, the patients were asked about muscular symptoms such as myalgia.Result: Twenty-eight (70%) patients were female. The mean age of the patients was 22.6±5.4 years. The mean serum CPK level did not increase during treatment with isotretinoin. However, 2.5%, 36.8% and 31.5% of the patients had myalgia 2, 4, and 6 months after the initiation of isotretinoin, respectively. There was no significant difference in the mean CPK level of those who had myalgia after treatment with isotretinoin and those who were asymptomatic.Conclusion: It seems that low dose isotretinoin does not induce the elevation of CPK, but can cause myalgia in some patients irrespective of the CPK level. Myalgia in patients under treatment with low dose isotretinoin is a benign phenomenon and is not an alarm for serious muscle damage. Therefore, routine measurement of the CPK level in patients receiving low dose isotretinoin is not recommended.
Nahidi Yalda; Javidi Zari; Shakeri Mohammad Taghi; Farrokhnezhad Somayyeh
Volume 15, Issue 3 , 2012, , Pages 80-84
Abstract
Introduction: Acne is a common problem in adolescent and youngage groups, for which several risk factors have been suggested.One of the risk factors is smoking. In studies on the relationshipbetween smoking and acne, conflicting results have been obtained.Method: This study was conducted on 133 male ...
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Introduction: Acne is a common problem in adolescent and youngage groups, for which several risk factors have been suggested.One of the risk factors is smoking. In studies on the relationshipbetween smoking and acne, conflicting results have been obtained.Method: This study was conducted on 133 male patients whowere visited at the dermatology clinic of Imam Reza hospital dueto acne as the case group, and 133 healthy individuals withoutany skin diseases including acne among those accompanying thepatients as the control group. The case and the control groups wereage matched. For each patient who had the criteria for inclusionin the study, a questionnaire was completed and the necessaryinformation was collected and then analyzed statistically.Result: The questionnaires were filled for 133 patients with acneand 133 healthy controls. Twenty-nine patients with acne (21.8%)and 12 patients in the control group (9.1%) were smokers, and thedifference between them was significant (P = 0.004). The numberof cigarettes smoked per day was significantly different in thetwo groups (4.75 in the case group versus 1.88 in the controlgroup). No correlation was found between smoking and acnelocalization, severity of acne, the type of lesion, symptomaticor asymptomatic nature of acne and acne complications. In thecase group, the smokers developed acne at an older age thanthe non-smokers.Conclusion: Patients with acne were more likely to smoke thanpatients without acne; thus, smoking might be a factor affectingthe incidence of acne.
Pouran Layegh; Hamid Reza Arshadi; Sara Shahriari; Fakhrolzaman Pezeshkpour; Yalda Nahidi
Volume 13, Issue 4 , 2010, , Pages 106-111
Abstract
Background: Due to their chronic nature, influences on the body image, hopelessness toward complete recovery and frequent recurrences, dermatological diseases seem to be one of the important predisposing factors in depression and suicidal ideation. Thus, the present study aimed at evaluating the degree ...
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Background: Due to their chronic nature, influences on the body image, hopelessness toward complete recovery and frequent recurrences, dermatological diseases seem to be one of the important predisposing factors in depression and suicidal ideation. Thus, the present study aimed at evaluating the degree of depression and suicidal ideation in patients with psoriasis, acne, alopecia areata and vitiligo.Methods: The study was carried out on 300 patients with psoriasis, acne, alopecia and vitiligo who were referred to the dermatology clinic of Ghaem Hospital in Mashad. Beck depression questionnaire was used to collect the data which was then statistically analyzed with ANOVA and T-test, using SPSS software.Results: In this study, 35.7% (107) of the subjects were female and 64.3% (193) were male with a mean age of 26.55±10.81 years. The prevalence rate of clinical depression was found to be 47.4% in patients with acne; 69.4% in those with psoriasis; 70.1% in those suffering from vitiligo; 50% in diffuse alopecia areata; 60% in universalis alopecia areata; 100% in ophiasis alopecia areata and 68.3% in patients with localized alopecia areata. As for suicidal ideation, there was no sign in 88.3% (265); however, 6.3% (19) of the patients reported to have thought of suicide but they had no desire for the attempt while 4% (12) of them had some desire for suicide and 1.3% (4) were seriously determined to commit suicide if only they would find themselves in an appropriate situation.Conclusion: As shown by the findings of the study, there was a close relationship between dermatological diseases and psychological factors; thus, it is important to immediately diagnose concurrent psychological effects, especially those of depression and suicidal ideation. We found that there was a significant relationship between the prevalence rate of dermatological conditions and psychological effects; i.e. depression (P=0.008) and suicidal ideation (P=0.001). We also found out that the rate of suicide attempt was highest among the patients with universalis alopecia, diffuse alopecia areata and vitiligo, respectively.
Supreeti Biswas; Kanchan Kumar Mondal; Indranil Saha; Rathindra Nath Dutta; Saibendu Kumar Lahiri
Volume 13, Issue 2 , 2010, , Pages 37-41
Abstract
Introduction: Acne vulgaris is a frequently encountered skin disease in daily practice. Its clinico-epidemiological status was evaluated in this study.Methods: Four hundred patients were studied by record-based observation for 2 years in the Acne Clinic of a tertiary care hospital.Results: This study ...
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Introduction: Acne vulgaris is a frequently encountered skin disease in daily practice. Its clinico-epidemiological status was evaluated in this study.Methods: Four hundred patients were studied by record-based observation for 2 years in the Acne Clinic of a tertiary care hospital.Results: This study revealed a male preponderance (53%) with a higher prevalence in adolescents (75%). Women with a regular menstrual cycle had a lower acne grading (ρ = – 0.31). Increased physical activity led to a decrease in acne grading (ρ = – 0.20). An association was found between acne and family history (42%) and nonvegetarian, oily, spicy fast food (99%). Our prescribed allopathic treatment in the Acne Clinic showed improvement. No drug induced ocular toxicity was observed. Hot, humid, dusty environment influenced the majority (87%) of the respondents. Urbanization (69%) increased the occurrence of acne.Conclusion: Community based studies are required to find out the actual burden of acne vulgaris.
Yazdi Simin Sar; Farajzadeh Saeedeh; Abadi Ali Zeinali Hossein
Volume 13, Issue 2 , 2010, , Pages 54-56
Abstract
Introduction: Various factors are involved in the pathogenesis of acne vulgaris. Recently, G6PD deficiency has been proposed in the pathogenesis of acne. G6PD has an important role in the oxidant/antioxidant balance. According to this theory, antioxidants are used in the treatment of acne recently. The ...
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Introduction: Various factors are involved in the pathogenesis of acne vulgaris. Recently, G6PD deficiency has been proposed in the pathogenesis of acne. G6PD has an important role in the oxidant/antioxidant balance. According to this theory, antioxidants are used in the treatment of acne recently. The aim of this study was to evaluate G6PD deficiency in patient with acne vulgaris. Methods: The activity of G6PD enzyme was measured in the venous blood of 82 patients with acne vulgaris of different severity. The fluorescent lamp method was used in order to determine the activity of G6PD enzyme. Results: The mean age of the patients was 25± 3. From 82 patients, the level of the G6PD enzyme was normal in 77 (93.9%) patients. Also, 4 (4.9%) patients had relative G6PD deficiency and 1 (1.2%) patient had severe G6PD deficiency. As the incidence of G6PD deficiency is 5.7% in the normal population, there was no statistically significant difference in G6PD deficiency between patients and the normal population. No significant relationship was found between acne severity and G6PD deficiency. Conclusion: In order to detect the association between acne and G6PD deficiency, other case-control studies with lager sample sizes are recommended.
Tabari Soudabeh Tirgar; Moghadam Nia Ali Akbar; Hajian Karimollah; Moeinzadeh Amirmajid
Volume 12, Issue 4 , 2009, , Pages 106-110
Abstract
Introduction: Topical antimicrobials, such as clindamycin, are effective in the treatment of acne and azelaic acid, due to the lack of bacterial resistance, could be a useful alternative in topical treatment of acne. The aim of this study was to compare the effect of topical azelaic acid 20% with clindamycin ...
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Introduction: Topical antimicrobials, such as clindamycin, are effective in the treatment of acne and azelaic acid, due to the lack of bacterial resistance, could be a useful alternative in topical treatment of acne. The aim of this study was to compare the effect of topical azelaic acid 20% with clindamycin 1% lotion for the treatment of acne. Method: This randomized clinical trial study was performed on 108 patients with mild and moderate acne. Patient were randomly assigned to one of the two groups of treatment with azelaic acid 20% cream (50 patients) or clindamycin 1% lotion (58 patients). The patients were evaluated by grading and lesion counting methods before treatment and one month and two months after the treatment. Results: The mean age of the patients in clindamycin group and azalic acid was 19. 6±3. 9 and 20. 3±4. 5 years, respectively (P=0. 41). The mean score of acne severity decreased after treatment according to grading and lesion counting methods (P0. 05) Conclusion: Result showed that the azelaic acid 20% topical cream was as effective as clindamycin 1% lotion for treating mild to moderate acne.
Balighi Kamran; Moslehi Homayun; Robati Reza Mahmoud; Robati Amin Mahmoud
Volume 10, Issue 4 , 2007, , Pages 271-277
Abstract
Background and aim: Subcision is a procedure that has been reported to be beneficial in treatment of acne scars. The objective of this trial was to assess the efficacy of subcision in the treatment of rolling acne scars and evaluate a novel subdermal filler" absorbable plain catgut suture" with subcision. ...
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Background and aim: Subcision is a procedure that has been reported to be beneficial in treatment of acne scars. The objective of this trial was to assess the efficacy of subcision in the treatment of rolling acne scars and evaluate a novel subdermal filler" absorbable plain catgut suture" with subcision. Materials and methods: 22 patients with rolling acne scars underwent subcision, 20 of whom completed treatment and follow-up period. One side of the face underwent subcision and another side subcision with subdermal implant. The patients and investigators' assessments of improvement were both recorded. Results: Subcision showed mild improvement in about 60% of patients and moderate improvement in about 40% of them. The rate of response showed no significant difference with the use of subdermal implant. The side effects of local edema, bruising, and infection were all transient. Conclusion: Subcision appears to be a safe method to correct the rolling acne scars with long term improvement. However, the subdermal implant led to no significant superior results.
Javidi Zari; Maleki Massoud; Mashayekhi Vahid; Jafari Ghazalleh
Volume 10, Issue 4 , 2007, , Pages 316-319
Abstract
Background and aim: Deficiency of zinc -as a necessary trace element-causes exacerbation of acne and development of acne lesions. Also zinc has been used in acne treatment. In this study serum zinc level was evaluated in severe acne cases. Materials and methods: Severe acne cases as well as sex and age ...
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Background and aim: Deficiency of zinc -as a necessary trace element-causes exacerbation of acne and development of acne lesions. Also zinc has been used in acne treatment. In this study serum zinc level was evaluated in severe acne cases. Materials and methods: Severe acne cases as well as sex and age matched controls were selected from dermatology clinics of Imam Reza and Qaem Hospitals during 2003 to 2005. Five ml of blood was sampled from each individual and serum zinc level was measured by atomic absorption spectrophotometric method. The mean of zinc serum level between the two selected groups was compared by t and Mann-Whitney tests. Results: Thirty patients (16 females and 14 males) with mean age of 19.8±2.05 years and 28 cases in control group (13 females and 15 males) with mean age of 20.78±2.46 years were included in this study. The mean serum zinc level in patients and control groups were 99.85±18.07 and 101.57±10.52µg/dl, respectively. There was no significant difference between the serum zinc level of the two groups.Conclusion: In this study, there was no relation between the serum zinc level and severe acne disease. Considering the high prevalence of acne and the rarity of zinc deficiency in the general population, the etiologic role of zinc deficiency in acne needs a study in a very large sample, or evaluation of acne prevalence in zinc deficient patients.
M Akhyani; M Danesh Pazhooh; M Barzegari; N Ghandi; M Ghiasi; Z Chenari; S Soudavari
Volume 9, Issue 3 , 2006, , Pages 242-249
Abstract
Background and aim: Hirsutism is a common clinical problem among women; however estimates regarding its prevalence in our population are limited. The objective of this study was to estimate the frequency and features of hirsutism in yound women in Iran.Materials and Methods: This descriptive-cross sectional ...
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Background and aim: Hirsutism is a common clinical problem among women; however estimates regarding its prevalence in our population are limited. The objective of this study was to estimate the frequency and features of hirsutism in yound women in Iran.Materials and Methods: This descriptive-cross sectional study was performed on 800 female (18-25 years) medical students of Tehran medical universities in 1999. Evaluation included a history and a modified Ferriman-Gallwey hirsutism score in four different androgen-sensitive skin areas. The volunteers recorded their weight and height, the presence of menstural dysfuncion, acne, positive family history for hirsutism, as well as ingestion of oral contraceptive pills, corticosteroids or anabolic steroids using a questionnaire. Data were analyzed using chi-square test and P<0.05 was considered significant.Results: The frequency of hirsutism in our population was 22.8% (183 of 800). 17.3%, 5.1% and 0.3% of the population studied had mild, moderate and severe hirsutism, respectively. The prevalence of obesity (body mass index > 25), acne, positive family history for hirsutism, menstrual dysfunction, and consumption of corticosteroid and OCP was significantly higher in hirsutes.Conclusion: Hirsutism is a very common abnormality in this group of woman in Iran. Higher hirsutism frequency in this survey comparing to previous records in other population shows that the hirsutism definition and scoring system should be modified due to racial/ethnic variations in terminal hair quantity and distributions and different concept of this abnormality in each population.
P Toosi; A Sadiqha; H Monshi Zadeh; R Toosi
Volume 8, Issue 4 , 2005, , Pages 256-259
Abstract
Background and objective: Oral isotretinoin is the only treatment that has an effect on all the major etiological factors involved in acne (Increased sebum production, alterations in microbial flora, hyperkeratinization of pilosebaceous duct, and inflammation). Considering complications and relative ...
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Background and objective: Oral isotretinoin is the only treatment that has an effect on all the major etiological factors involved in acne (Increased sebum production, alterations in microbial flora, hyperkeratinization of pilosebaceous duct, and inflammation). Considering complications and relative expense, several treatment regimens have been suggested. The objective of this study was to evaluate the efficacy of intermittent doses of isotretinoin in acne patients. Materials ad Methods: We made a quasi-experimental clinical trial in the acne patients without nodular and cystic lesions that were recalcitrant to conventional therapy. Therapeutic regimen included 0.5 mg/kg isotretinoin per day for a week every month; So we use 21 mg/kg as total dosage. Results: Acne severity decreased in entire patients at the end of treatment course. After six months follow up, recurrence rate was 19.3% and partially recurrence rate was 44%. Conclusion: It seems that intermittent isotretinoin treatment with a total dose of 21 mg/kg has led to good therapeutic results in patients without nodulocystic lesions.
