Publications by authors named "Amir Hossein Siadat"

48 Publications

Heat therapy for cutaneous leishmaniasis: A literature Review.

J Res Med Sci 2021 27;26:15. Epub 2021 Feb 27.

Department of Dermatology, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.

Cutaneous leishmaniasis (CL) is endemic in many parts of the world with a high economic and health impact. Despite many treatments that have been suggested for this zoonotic infection, there is still no definite therapy for CL. Meglumine antimony compounds are considered as a standard treatment for leishmaniasis, however, these medications have a relatively high side effect profile and not always effective. Physical modalities including cryotherapy, laser, and heat therapy have also been used for this purpose. As a source of heat therapy, different methods have been used including radiofrequency, ultrasound, infrared, exothermic crystallization thermotherapy, and microwave. We reviewed all of the articles in PubMed regarding the use of heat therapy for the treatment of CL up to January 2020. According to our literature review, heat therapy using different sources showed promising results for the treatment of CL that were comparable to meglumine antimony. In addition, heat therapy has very low side effect profiles that are localized to the treatment area suggesting this method as a safe procedure for CL therapy. This study is a brief review of the literature about the effect of heat therapy on the treatment of CL. Performing randomized clinical trials to compare different methods of heat therapy and to compare it with meglumine antimony compounds is recommended.
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http://dx.doi.org/10.4103/jrms.JRMS_934_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8106408PMC
February 2021

Cutaneous leukocytoclastic vasculitis secondary to COVID-19 infection: A case report.

Clin Case Rep 2021 Feb 18;9(2):830-834. Epub 2020 Dec 18.

Faculty of Pharmaceutical Sciences Isfahan University of Medical Sciences Isfahan Iran.

COVID-19 is a novel disease that mostly affects the respiratory system but as the number of cases is rising significantly around the world, more extra-respiratory manifestations are being reported among which are various dermatologic manifestations.
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http://dx.doi.org/10.1002/ccr3.3596DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7869328PMC
February 2021

Comparative evaluation of Gracilaria algae 3% cream vs Clobetasol 0.05% cream in treatment of plaque type psoriasis: A randomized, split-body, triple-blinded clinical trial.

Dermatol Ther 2020 11 8;33(6):e14317. Epub 2020 Oct 8.

Alzahra Hospital Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Gracilaria algae is red macro algae which has demonstrated considerable anti-inflammatory effects. Our objective was to compare the efficacy of Gracilaria algae topical cream 3% vs Clobetasol cream 0.05% in treatment of plaque-type psoriasis. Thirty adult patients with baseline modified Psoriasis Area and Severity Index (PASI) score ≤12 were randomized to receive either Clobetasol or Gracilaria algae cream on right or left-sided symmetric plaques once daily for 8 weeks and follow-up of 4 weeks. Modified PASI score, patient's satisfaction using VAS and global physician assessment score were assessed to evaluate clinical response. Thirty patients with 94 symmetrical psoriasis plaques were enrolled in this trial. The mean baseline modified PASI score of both sides was similar; however, at the end of trial, modified PASI score was reduced more on the sides treated with Gracilaria algae cream (0.80 ± 0.19% vs 0.63 ± 0.25%, P < .05). No significant difference was found regarding mean physician global assessment score between the two groups (P > .05). Patients' satisfaction was significantly higher in favor of algae cream only at week 8 of the intervention (P < .05). Gracilaria algae cream can be an effective and safe alternative of Clobetasol in the treatment of plaque type psoriasis.
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http://dx.doi.org/10.1111/dth.14317DOI Listing
November 2020

Application of laser for treatment of cutaneous leishmaniasis: a review of literature.

Lasers Med Sci 2020 Sep 24;35(7):1451-1457. Epub 2020 Apr 24.

Isfahan University of Medical Sciences, Isfahan, Iran.

Cutaneous leishmaniasis (CL) is a major health problem in developing countries with high economic and health impact. Despite suggested treatment for CL, there is still no definite therapy for this infection, and many of these treatments are associated with serious local and systemic side effects. In the current paper, use of different laser types including continuous and fractional CO2, argon, PDL, erbium glass, and Nd:YAG have been reviewed. Based on our review, given the high reported efficacy and low side-effect profile, use of laser can be considered as a good alternative to standard treatment of cutaneous leishmaniasis (CL). Performing more studies using different types of lasers is recommended to evaluate the efficacy of this method for treatment of CL.
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http://dx.doi.org/10.1007/s10103-020-03006-1DOI Listing
September 2020

Evaluation of combination therapy with peeling added to minimal invasive blepharoplasty in lower eyelid rejuvenation.

J Cosmet Dermatol 2020 Nov 3;19(11):2922-2928. Epub 2020 Apr 3.

Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran.

Introduction: Aging is an inevitable process in life that can pose unsatisfactory changes in appearance. Recently, rejuvenation surgeries have opened an exciting new window toward people who are vulnerable according to their facial appearance. Periocular plastic microsurgeries are among the most common aesthetic surgeries with various outcomes. The current study was aimed to compare outcomes of blepharoplasty with and without peeling regarding lower eyelid rejuvenation.

Methods: This is a randomized clinical trial study conducted on 30-patients referred for inferior lid rejuvenation in 2017-18. Patients were randomly divided into two 15-member subgroups of microinvasive blepharoplasty with and without peeling. Peeling for the group underwent blepharopeeling was performed all over the inferior periocular region using Phenol 89%. Then, skin and underlying muscle were incised superficially, and underlying fat tissue was excised. The other group underwent blepharoplasty without peeling. Patients were followed daily for 2 months to assess complications, patients' and physicians' satisfaction.

Results: Two assessed groups were not statistically different regarding age and gender distribution (P-value = .417 and .666, respectively). Considering patients' opinion, symmetry, scar formation, skin laxity, swelling, and total satisfaction score were not different between two groups (P-value > .05) while physicians presented similar outcomes except for better scar formation status of peeling add-on therapy (P-value = .042). Rate of adverse effects was significantly higher among those under blepharoplasty plus peeling treatment (P-value < .05).

Conclusion: Outcomes of blepharoplasty alone versus blepharoplasty plus peeling were not significantly different regarding both patients' and physicians' assessments in general while fewer complications due to blepharoplasty without peeling were presented.
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http://dx.doi.org/10.1111/jocd.13394DOI Listing
November 2020

The effectiveness of adapalene 0.1% with intense pulsed light versus benzoyl peroxide 5% with intense pulsed light in the treatment of acne vulgaris: A comparative study.

J Res Med Sci 2019 27;24:101. Epub 2019 Nov 27.

Skin Disease and Leishmaniosis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Acne vulgaris (AV) is one of the most common skin diseases with major psychological impacts. Hence, selecting the best treatment modality is so important; there are different ways to treat AV such as topical and systemic agents, laser, and also photodynamic therapy. In this study, we tried to assess the difference between the efficacy of combination therapy with intense pulsed light (IPL) and benzoyl peroxide (BPO) in comparison with IPL and adapalene (AD) in the treatment of the mild to moderate AV.

Materials And Methods: Thirty Iranian females in reproductive age with mild to moderate acne were enrolled in this study. The left and right side of the patients were randomized to receive either AD 0.1% or BPO 5% every other day plus three sessions of monthly apart IPL in the treatment of AV. Different parameters of AV such as acne severity index (ASI), total acne lesions counting (TLC), and Acne Global Severity Scale (AGSS) were measured before, during, and after the treatments.

Results: There was a significant difference regarding AGSS, TLC, and ASI before and after treatment with AD plus IPL ( < 0.001). Furthermore, there was a significant difference regarding AGSS, TLC, and ASI before and after treatment with BP plus IPL ( < 0.001). However, no significant difference regarding AGSS, TLC, and ASI were observed between the 2 groups after treatment ( > 0.05). No significant side effects were observed in both groups.

Conclusion: Our study shows that there was not any significant difference between combining IPL with either AD or BPO so we can use either one of these combinations to achieve similar efficacy.
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http://dx.doi.org/10.4103/jrms.JRMS_398_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6906921PMC
November 2019

Evaluation of Different Concentrations of Imatinib on the Viability of : An Study.

Adv Biomed Res 2019 31;8:61. Epub 2019 Oct 31.

Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Leishmaniasis is an infectious disease caused by an intracellular parasite of and is transmitted through the female sandflies bite and may lead to severe skin lesions. Although drugs such as antimony compounds are available, their side effects such as toxicity, low efficacy, and emergence of resistance have raised the importance of effective replacement. Imatinib, as an inhibitor of tyrosine kinase (TK) of , stops abnormal function of TK such as Bcr-Abl through assembling into transmembrane pores in a sterol-dependent manner. Hence, the evaluation of killing effects of different concentrations of imatinib against amastigotes and were the objectives of the present study.

Materials And Methods: The killing effects of different concentrations of imatinib (25, 50, and 100 μg) and 25 μg amphotericin B (as positive control) were evaluated against RPMI 1640-cultured promastigotes and the amastigote/macrophage model by MTS cell proliferation assay kit (ab197010) and Giemsa staining method during 24, 48, and 72 h.

Results: The results showed anti- effect of imatinib in concentration and time-dependent manner. The lowest number of live promastigotes and amastigotes were obtained due to treat with 100 μg/ml imatinib at 72 h. Furthermore, 100 μg concentration of imatinib had the same effect as 25 μg amphotericin B on both promastigotes and amastigotes ( < 0.001).

Conclusion: The anti- effect of imatinib was confirmed by MTS and direct microscopy. Further study is recommended for evaluating possible therapeutic effects of imatinib on leishmaniasis .
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http://dx.doi.org/10.4103/abr.abr_58_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6839269PMC
October 2019

Prolotherapy: Potential for the Treatment of Chronic Wounds?

Adv Wound Care (New Rochelle) 2019 Apr 3;8(4):160-167. Epub 2019 Apr 3.

Department of Dermatology, University of California, Davis, Sacramento, California.

Chronic skin ulcers, including venous, diabetic, and pressure ulcers, constitute a major health care burden, affecting 2-6 million people in the United States alone, with projected increases in incidence owing to the aging population and rising epidemic of diabetes. The ulcers are often accompanied by pain. Standard of care fails to heal ∼50% of diabetic foot ulcers and 25% of venous leg ulcers. Even advanced therapies do not heal >60%. Thus there is an unmet need for novel therapies that promote healing and also address the concomitant pain issue. Prolotherapy involves injection of small amounts of an irritant material to the site of degenerated or painful joints, ligaments, and tendons. Multiple irritants are reported to be efficacious, but the focus here is on dextrose prolotherapy. and studies support translation to clinical use. Concentrations as low as 5% dextrose have resulted in production of growth factors that have critical roles in repair. Numerous clinical trials report pro-reparative effects of dextrose prolotherapy in joint diseases, tendon, and ligament damage, and for painful musculoskeletal issues. However, most of the studies have limitations that result in low-quality evidence. The preclinical data support a role for dextrose prolotherapy in promoting tissue repair that is required for healing chronic wounds and ameliorating the associated pain. Critical issues include provision of evidence of efficacy in human chronic wounds. Another potential obstacle is limitation of reimbursement by third-party payers for a therapy with as yet limited evidence. Preclinical studies in models of chronic wounds would support clinical translation. As dextrose prolotherapy has some mechanistic similarities to already approved honey therapies, it may have a shortened pathway for clinical translation. The gold standard for widespread adoption would be a well-designed clinical trial.
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http://dx.doi.org/10.1089/wound.2018.0866DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6804793PMC
April 2019

Combination of continuous wave CO laser and topical application of trichloroacetic acid 50% vs CO laser alone the treatment of cutaneous leishmaniasis (A case series of 6 patients).

J Cosmet Dermatol 2020 Jun 22;19(6):1367-1370. Epub 2019 Oct 22.

Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Cutaneous leishmaniasis (CL) is an endemic disease of Iran and despite self-healing nature of this disease and many suggested treatments, scar is usually inevitable results of the affection with this cutaneous infection. CO laser in CL has a specific thermolysis effect on infected tissues and application of trichloroacetic acid (TCA) 50% solution for treatment of leishmaniasis scars showed promising results.

Aim: To evaluate CO laser plus TCA 50% versus CO laser alone for treatment of CL.

Patients/methods: In the current report, we present 6 cases of noduloulcerative CL that were treated successfully by the combination of the continuous wave CO laser plus topical application of TCA 50%.

Results: Five patients improved after 3 weeks of starting treatment, and 1 patient needed to repeat treatment. The scars were flat and good.

Conclusions: The CO laser plus topical TCA 50% may be more effective in treatment of the cutaneous leishmaniasis and results in shorter healing time.
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http://dx.doi.org/10.1111/jocd.13181DOI Listing
June 2020

Efficacy of Intense-pulsed Light Therapy with Topical Benzoyl Peroxide 5% versus Benzoyl Peroxide 5% Alone in Mild-to-moderate Acne Vulgaris: A Randomized Controlled Trial.

J Res Pharm Pract 2017 Oct-Dec;6(4):199-205

Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Objective: Acne vulgaris is a disease of pilosebaceous unit with multifactorial pathogenesis and threats patients' social functioning. There is a growing research to find faster, more effective, and easy to use treatments. The aim of this study is to evaluate the efficacy of benzoyl peroxide 5% (BP) with and without concomitant intense-pulsed light (IPL) therapy in mild-to-moderate acne vulgaris.

Methods: In this controlled trial, 58 eligible patients with mild-to-moderate acne and Fitzpatrick skin phototype III and IV were randomly allocated to two groups. All patients were asked to use a thin layer of BP every night. The IPL therapy was administered at the end of first, 2, and 3 months. Acne Global Severity Scale (AGSS), Acne Severity Index (ASI), and total lesion counting (TLC) along with patient satisfaction were recorded. Patients were also examined 1 month after the final therapeutic visit.

Findings: The IPL group showed greater reduction in AGSS ( < 0.001) and TLC ( = 0.005) than the control group. However, the difference in ASI was not significant ( = 0.12). Patients in IPL groups were more satisfied than control group ( < 0.001).

Conclusion: Adding IPL to BP can result better response to BP alone. In acne treatment, combination therapy such as IPL and other topical agents should be kept in mind.
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http://dx.doi.org/10.4103/jrpp.JRPP_17_29DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5787904PMC
February 2018

Successful Treatment of Facial Acne Fulminans: Antimicrobial Agents and Oral Prednisolone as Promising Regimes.

Case Rep Dermatol Med 2017 27;2017:7092910. Epub 2017 Mar 27.

Skin Diseases and Leishmaniasis Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Acne fulminans (AF), also known as acne maligna, is a rare painful ulcerative form of acne with an abrupt onset and systemic symptoms. Its incidence appears to be decreasing, possibly because of earlier and better treatment of acne. This report highlights a case on a necrotizing facial wound due to AF that was successfully treated with oral prednisolone and antimicrobial medication.
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http://dx.doi.org/10.1155/2017/7092910DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5385906PMC
March 2017

The Effectiveness of a 5% Retinoic Acid Peel Combined with Microdermabrasion for Facial Photoaging: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

Dermatol Res Pract 2017 15;2017:8516527. Epub 2017 Feb 15.

Department of Internal Medicine, Kermanshah University of Medical Science, Imam Reza Hospital, Kermanshah, Iran.

. Tretinoin has been shown to improve photoaged skin. This study was designed to evaluate the efficacy and tolerability of a 5% retinoic acid peel combined with microdermabrasion for facial photoaging. . Forty-five patients, aged 35-70, affected by moderate-to-severe photodamage were enrolled in this trial. All patients received 3 sessions of full facial microdermabrasion and 3 sessions of either 5% retinoic acid peel or placebo after the microdermabrasion. Efficacy was measured using the Glogau scale. Patients were assessed at 2 weeks and 1, 2, and 6 months after treatment initiation. . The mean ± SD age of participants was 49.55 ± 11.61 years, and the majorities (73.3%) were female. Between 1 month and 2 months, participants reported slight but statistically significant improvements for all parameters ( < 0.001). In terms of adverse effects, there were statistically significant differences reported between the 5% retinoic acid peel groups and the control group ( < 0.001). The majority of adverse effects reported in the study were described as mild and transient. . This study demonstrated that 5% retinoic acid peel cream combined with microdermabrasion was safe and effective in the treatment of photoaging in the Iranian population. This trial is registered with IRCT2015121112782N8.
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http://dx.doi.org/10.1155/2017/8516527DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5331278PMC
February 2017

Do serum prolactin levels correlate with antibodies against desmoglein in pemphigus vulgaris?

Adv Biomed Res 2016 27;5:206. Epub 2016 Dec 27.

Skin Diseases and Leishmaniasis Research Center, Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Pemphigus vulgaris is a chronic inflammatory disease of skin, the etiology of which is not completely known. Despite the latter, anti-desmoglein antibodies play a proven role in the pathogenesis. Recent studies showed an etiologic effect for prolactin in the pemphigus vulgaris. This study aimed to quantify the correlation between serum prolactin levels and anti-desmoglein antibodies in patients with pemphigus vulgaris.

Materials And Methods: Prolactin and antibodies against desmoglein 1 and 3 measured with ELISA in 14 new subjects of pemphigus vulgaris.

Results: There was no statistically significant relation between both serum prolactin and anti-desmoglein1 levels (r = 0.02, = 0.47) and serum prolactin and anti-desmoglein 3 levels (r= -0.09, = 0.38).

Conclusion: This study indicates that no correlation was found between serum prolactin levels and anti-desmoglein 1 levels and serum prolactin and anti-desmoglein 3 levels. However, other studies should be initiated regarding exact molecular and cellular effects of prolactin in the pathogenesis of pemphigus vulgaris.
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http://dx.doi.org/10.4103/2277-9175.191002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5220690PMC
December 2016

The comparison between modified kligman formulation versus kligman formulation and intense pulsed light in the treatment of the post-burn hyperpigmentation.

Adv Biomed Res 2016 29;5:125. Epub 2016 Jul 29.

Department of Pathology, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Post inflammatory hyperpigmentation (PIH) is a common problem occurs following many dermatologic diseases and medical interventions. Different modalities including topical agents, lasers and intense pulsed light (IPL) are suggested for treatment of the post-burn PIH. In the current study, we evaluated the efficacy of IPL plus modified Kligman cream (MODIFIED KLIGMAN CREAM) versus MODIFIED KLIGMAN CREAM alone in the treatment of the post-burn PIH.

Materials And Methods: This was a randomized, non-blinded clinical trial. A total of 53 patches of post-burn PIP in 14 patients were randomized to receive either two sessions of IPL plus modified Kligman formula or kligman formula for 2 months. The patients were recommended to apply MODIFIED KLIGMAN CREAM cream for 12 h at night.

Results: According to our results, the patients in the MODIFIED KLIGMAN CREAM + IPL group had higher satisfaction as compared with MODIFIED KLIGMAN CREAM alone (P = 0.000) (Mann-Whitney test). In addition, according to physician evaluation, the patients in the MODIFIED KLIGMAN CREAM + IPL group had higher satisfaction as compared with MODIFIED KLIGMAN CREAM alone (P = 0.000) (Mann-Whitney test). No side effects except a little irritation, erythema and exfoliation due to MODIFIED KLIGMAN CREAM cream were seen in the patients.

Conclusions: The results of our study showed the better efficacy and faster response of the IPL plus modified Kligman formula versus modified Kligman formula in the treatment of the post-burn PIH. To better determine the efficacy of IPL in treatment of the post-burn PIP, more extensive studies as randomized, double-blinded clinical trial are recommended.
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http://dx.doi.org/10.4103/2277-9175.186997DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4976535PMC
August 2016

Multiple Giant Pilar Cyst Distributed Over the Body Since Childhood.

Indian J Dermatol 2016 Jan-Feb;61(1):121

Department of Pathology, Isfahan University of Medical Science Isfahan, Isfahan, Iran.

Trichilemmal cyst or pilar cyst is defined as a cyst containing keratin and its breakdown products. It is usually situated on the scalp with a wall resembling external hair root sheath. In this case report we present a 55-year-old man with multiple giant pilar cysts that were distributed over the whole body since childhood. One of the cyst on the chest was transformed to squamous cell carcinoma (SCC).
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http://dx.doi.org/10.4103/0019-5154.174097DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4763645PMC
March 2016

Autologous fibroblast suspension for the treatment of refractory diabetic foot ulcer.

Indian J Dermatol Venereol Leprol 2016 Jan-Feb;82(1):105-6

Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran.

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http://dx.doi.org/10.4103/0378-6323.172905DOI Listing
October 2016

Repigmentation of Hypopigmented Scars Using Combination of Fractionated Carbon Dioxide Laser with Topical Latanoprost Vs. Fractionated Carbon Dioxide Laser Alone.

Indian J Dermatol 2015 Jul-Aug;60(4):364-8

Department of Epidemiology and Biostatistics, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Fractionated carbon dioxide (CO2) can treat hypopigmented scars. Latanoprost is a prostaglandin analog used to treat glaucoma. It can cause adverse effects, such as periocular hyperpigmentation. The aim of this study was to assess the efficacy and safety of latanoprost plus CO2 laser on the repigmentation of hypopigmented scars.

Patients And Methods: 28 patients with hypopigmented scars were divided randomly into two groups. The patients in group A were treated in six sessions (1-month intervals) with 10600-nm fractional CO2 laser plus latanoprost 0.005% and those of group B fractionated CO2 laser plus placebo (distilled water). Digital photographs were taken at baseline and 3 months after the last treatment session. The blinded dermatologist compared the photographs and evaluated the efficacy of treatment in the hypopigmented scars using a 4-scale point (grade 1-4). Patient satisfaction was scored from 0 to 10 on a visual analog scale.

Results: Follow-up results 12 weeks after the last treatment session demonstrated that 11 of the 14 patients in group A had more than 50% improvement in hypopigmentation The difference in improvement of the two groups was statistically significant (P = 0.027). The mean of the VAS scores of patients in group A was 6.50 ± 1.45 and in group B 4.57 ± 1.6. The difference in mean satisfaction of the two groups was statistically significant (P = 0.003). Side effects were mild and resolved within 1 to 5 days.

Conclusion: The fractional CO2 laser resurfacing plus topical latanoprost can be used as a safe and efficacious method to treat hypopigmented scars.
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http://dx.doi.org/10.4103/0019-5154.160481DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4533534PMC
August 2015

Comparison the efficacy of ablative CO2 laser and fractional CO2 laser on the healing of cutaneous leishmaniasis scars.

Adv Biomed Res 2014 31;3:259. Epub 2014 Dec 31.

Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: The aim of this study is to compare ablative CO2 laser with fractional CO2 laser on healing of the wound and the size of cutaneous leishmaniasis scars.

Materials And Methods: This prospective randomized clinical trial study was done on 120 patients in two groups evaluated in Sedigheh Tahereh Hospital in Isfahan. The patients in case group underwent one session ablative CO2 laser for treatment of leishmaniasis scars and the patients in control group underwent six 3-weeks interval sessions fractional CO2 laser for treatment of leishmaniasis scars. All cases were evaluated from size and other aspects of scar by a questionnaire, and before and 6 months after photos were evaluated by blinded dermatologist. The data collected in the check list was then analyzed by t-test and Chi-square with SPSS 20.

Results: There were 60 people in case group and 60 in control group. The mean age was 27.21 ± 11.2. Our results show that fractional CO2 laser is better than ablative CO2 laser in various aspect of treatment of leishmaniasis scars (P < 0.05).

Conclusions: Fractional CO2 laser is better than ablative CO2 laser in variants aspect of treatment of leishmaniasis scars.
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http://dx.doi.org/10.4103/2277-9175.148231DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4298882PMC
January 2015

Domestic and peridomestic risk factors associated with transmission of cutaneous leishmaniasis in three hypo endemic, endemic, and hyper endemic areas: A randomized epidemiological study.

J Res Med Sci 2014 Oct;19(10):928-32

Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Leishmaniasis is an infection caused by leishmania protozoa. Knowledge about health effects associated with environment situation and human behavior in national and local levels seems to be very necessary.

Materials And Methods: This cross-sectional case-control study was carried out in three adjacent counties of Isfahan province in Iran. Data were collected by face-to-face interviewing and recorded structured questionnaire. Statistical analysis was performed using Chi-square test and logistic. P < 0.05 was considered as significant.

Results: The economic level had significant association with cutaneous leishmaniasis (CL) transmission (P < 0.05). However, there was no significant association between existence of food storage and transmission of CL. We, however, found significant reduction of CL transmission following use of insect control measures (P < 0.05). The odds ratio for peridomestic transmission was 0.420 for houses that weren't round with any old or ruined houses.

Conclusion: We conclude that among aforementioned risk factors, the impact of peridomestic factors is stronger in CL transmission when compared with domestic and behavioral factors.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274567PMC
October 2014

Narrow-Band Ultraviolet B versus Oral Minocycline in Treatment of Unstable Vitiligo: A Prospective Comparative Trial.

Dermatol Res Pract 2014 21;2014:240856. Epub 2014 Aug 21.

Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Background. We have compared NB-UVB and oral minocycline in stabilizing vitiligo for the first time. Subjects and Methods. 42 patients were divided equally into two groups: the NB-UVB and minocycline groups. Phototherapy was administered twice a week on nonconsecutive days. In the minocycline group, patients were advised to take minocycline 100 mg once daily. The treatment period was 3 months. Vitiligo disease activity (VIDA) score was noted every 4 weeks for 12 months. Digital photographs were taken at baseline and monthly intervals. Results. Before the therapy, disease activity was present in 100% of the patients, which was reduced to 23.8% and 66.1% by the end of therapy in the NB-UVB and minocycline groups retrospectively (P < 0.05). 16 of the 21 (76/1%) patients with unstable disease in the NB-UVB group achieved stability, whereas this was the case for only 7 of the 21 (33.3%) in the minocycline group (P < 0.001). The diameter changes were statistically significant at the end of treatment in the NB-UVB group compared to the minocycline group (P = 0.031). Side effects in both groups were mild. Conclusion. NB-UVB was statistically more advantageous than oral minocycline in unstable vitiligo in terms of efficacy and the resulting stability.
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http://dx.doi.org/10.1155/2014/240856DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4158186PMC
September 2014

Comparison of fat maintenance in the face with centrifuge versus filtered and washed fat.

J Res Med Sci 2014 Jun;19(6):556-61

Skin Disease and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Autogenous fat injection of the face is a viable and lasting remedy for soft tissue loss and has become a mainstay in facial rejuvenation. Fat transfer as either a stand-alone technique or as an adjunct to other filler technique and lifting depending on patient needs. Although soft tissue augmentation with autologous fat transfer has been increasingly used by esthetic surgeon, but there is no agreement concerning the best way of processing the harvested fat before injection. This study compared the clinical results obtained using simple filtered and washed fat via metal sieve with those achieved by means of pure centrifuged fat.

Materials And Methods: A prospective single-blind analysis on 32 healthy patients undergoing nasolabial fold fat transplantation from 2009 to 2011 (simple sampling). Patients assigned in two groups randomly. The face of half (16 subjects) was injected with centrifuged, another half with simple filtered and washed fat to evaluate the effect of preparation methods on fat graft viability. Objective method was used to evaluate the results, involving the evaluation of postoperative photographs (in month 1, 6 and 12) by an esthetic surgeon (according to the nasolabial scale). Subjective method was a self-assessment obtained from patients about general level of satisfaction and improvement of skin texture, statistical analysis were performed by means of the Wilcoxon and Mann-Whitney test. Acquired data were analyzed using SPSS version 15 and a value of P > 0.05 was considered as significant.

Results: There was no significant difference in the survival of grafted fat between the Group 1 (fat-processing with centrifuge at 3400 rpm for 1-min) and Group 2 (washing the fat in the sieve).

Conclusion: Our data suggest that the centrifuge of the fat does not enhance survival of grafted fat (P > 0.05).
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4155712PMC
June 2014

Efficacy of adding topical simvastatin to topical calcipotriol on improvement of cutaneous plaque psoriasis.

Adv Biomed Res 2014 9;3:11. Epub 2014 Jan 9.

Department of Dermatology, Skin Diseases and Leishmaniasis Research Centre, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Psoriasis is a common dermatologic disorder, with fluctuating response to treatment. Considering the proven immunomodulatory effects of oral simvastatin in psoriasis, this trial study was enrolled to determine whether the topical form has also antipsoriatic effects. Vitamin D analogs known to be effective and are considered the first line of therapy in mild to moderate cases. In this study, the efficacy of topical calcipotriol 0.005% ointment (as a standard method of treatment for psoriasis) versus combination of calcipotriol plus topical simvastatin is compared in the treatment of psoriasis.

Materials And Methods: A total of 80 subjects with symmetric psoriasis who had body surface involvement up to 20% were divided randomly into 2 groups. Group A were treated with calcipotriol 0.005% ointment twice daily and Group B with calcipotriol 0.005% ointment twice daily and simvastatin 3% ointment twice daily for 12 weeks. The results were evaluated by a Blind Dermatologist using psoriasis area severity index (PASI) score at baseline, 4(th), 8(th) and 12(th) week of treatment. In a similar way, a subjective assessment performed by patients based on photo-evaluation at the end of the study.

Results: Despite a continuous reduction in PASI score in both groups, according to both physician (P = 0.603) and patient (P = 0.243) assessment topical simvastatin was not statistically more effective than conventional treatment of psoriasis at the end of the study.

Conclusion: This study indicates that topical simvastatin is not associated with significant impacts in the treatment of psoriasis as compared to oral form. This study indicates that psoriasis is a systemic disorder with variable skin manifestations.
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http://dx.doi.org/10.4103/2277-9175.124639DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3928851PMC
March 2014

The efficacy of acyclovir in treatment of the pemphigus vulgaris.

J Res Med Sci 2013 Nov;18(11):976-8

Department of Dermatology, Skin diseases and leishmaniasis research center, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Pemphigus is a group of autoimmune blistering diseases of the skin and mucous membranes caused by the presence of antibodies against adhesion molecules on the cell surface of keratinocytes. The possible role of herpes simplex virus infection in the pathogenesis of pemphigus vulgaris (PV) has been suggested. In this study, we evaluated the impact of a course of acyclovir in improvement of the pemphigus patients and reduction of the hospitalization duration.

Materials And Methods: A total of 30 patients with definitive diagnosis of PV were recruited in study. They were randomized in two groups. One group received routine treatment and another received the routine plus 2 week course of oral acyclovir (1200 mg/day). The improvement was defined as a more than 50% change in baseline severity score of the disease. All data was registered at the checklists and after follow-up period, the statistical analyses were performed by aid of t-test and Fisher's exact test.

Results: There was no statistically significant difference in mean severity score and improvement rates between two groups at the end of study (P > 0.05). Meanwhile, there was no statistical difference in duration of hospitalization in two groups (P > 0.05) though the severity score and hospitalization duration were apparently less in acyclovir-group than control group. Neither of the patients (in acyclovir group) showed any side effect.

Conclusion: We did not observe any difference between response to treatment and hospitalization period in the group that was treated with acyclovir as compared with control group. However, the partial and complete remissions were higher in patients on acyclovir therapy compared to controls. In those pemphigus patients who do not respond to sufficient immunosuppressive regimen or show a sudden relapse after reaching partial or complete clinical remission, a trial of oral acyclovir therapy may have promising result.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3906789PMC
November 2013

Topical nicotinamide in combination with calcipotriol for the treatment of mild to moderate psoriasis: A double-blind, randomized, comparative study.

Adv Biomed Res 2013 30;2:90. Epub 2013 Nov 30.

Department of Dermatology and Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Science, Isfahan, Iran.

Background: Current treatment strategies of psoriasis are not completely satisfactorily. By inhibiting inflammatory cytokines, nicotinamide may enhance the effects of current topical treatments. We investigated whether the combination of topical calcipotriol and nicotinamide is more effective than calcipotriol alone in treatment of psoriasis.

Materials And Methods: Adult patients with mild to moderate psoriasis were randomized to receive topical calcipotriol 0.005% and nicotinamide 4% in combination or calcipotriol 0.005% alone, twice daily for 12 weeks. Patients were visited by a dermatologist at baseline and then after the first and third month of therapy, and psoriasis severity was evaluated using the modified psoriasis area and severity index (PASI). Also, patient's satisfaction was evaluated at the end of the trial using a 10-point rating scale.

Results: Sixty-five patients (35 males, mean age = 36.5 ± 8.5 years) completed the trial. Lesions on both sides were similar regarding baseline PASI score. At the end of the trial, PASI score was more reduced with calcipotriol+nicotinamide compared to calcipotriol alone (83.6 ± 7.9% vs. 77.8 ± 9.7%, P < 0.001). Patients were also more satisfied with the improvement of lesions with calcipotriol+nicotinamide compared with calcipotriol alone (P < 0.001). Side effects included mild erythema and pruritus (4.6%) and moderate burning and sensitivity to light (3.0%).

Conclusions: Nicotinamide can enhance the efficacy of calcipotriol when used in combination for topical psoriasis treatment, and it may be a good adjuvant to the current treatment regimens of psoriasis.
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http://dx.doi.org/10.4103/2277-9175.122520DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3908496PMC
February 2014

Comparison of therapeutic effect of low-dose low-molecular-weight heparin (enoxaparin) vs. oral prednisone in treatment of patients with lichen planus; A clinical trial.

Adv Biomed Res 2013 30;2:76. Epub 2013 Jul 30.

Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Science, Isfahan, Iran.

Background: The aim of this study was to evaluate and compare the therapeutic efficacy of subcutaneous enoxaparin versus oral prednisone (as a standard treatment) in patients with disseminated lichen planus.

Materials And Methods: In this parallel randomized clinical trial study, overall 48 patients completed the study. 25 patients were treated with subcutaneous enoxaparin 5 mg weekly and 23 patients with 0.5 mg/kg prednisone orally daily until complete remission or a maximum of 8 weeks. The results of itching severity, extent of active lesions and drug side effects were compared. In remission, patients were followed for 6 months for recurrent lesions.

Results: In enoxaparin group, 8 patients (32%) had complete remission and 10 patients (40%) had partial improvement. In the oral prednisone group, 16 patients (69.6%) had complete remission and 6 patients (26.1%) had partial improvement (P = 0.005). Average size of active lesions in both groups decreased significantly after treatment, but analysis of covariance showed that the mean lesion size after treatment in the oral prednisone group was significantly lower than the enoxaparin group (P = 0.005). The relapse rate from improved patients in the enoxaparin group was 6 (33%) and in oral prednisone group was 9 (40.9%, P = 0.083). In the enoxaparin group no serious complications was seen. But 22% in the oral prednisone group show side effect, the most common complications were dyspepsia.

Conclusion: Low dose enoxaparin on lichen Planus have therapeutic effect and is important for the least side effects but not as much as oral prednisone. But it could be accepted as an alternative treatment.
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http://dx.doi.org/10.4103/2277-9175.115798DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3814546PMC
November 2013

Colloid milium.

Adv Biomed Res 2013 6;2:28. Epub 2013 Mar 6.

Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran.

Colloid milium is a rare cutaneous condition with at least three distinct subtypes, characterized clinically by the development of yellowish translucent papules or plaques on sun-exposed skin, and histologically by the presence of colloid in the dermal papillae. In this case report, we present a man with multiple small papules on dorsum of his hands that in pathology confirmed to be colloid milium. Colloid milium is more commonly observed in fair-skin patients and remain unchanged; however our patient had dark skin type (Fitzpatrick skin type III) and lesions were increasing in summer and decreasing in winter.
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http://dx.doi.org/10.4103/2277-9175.107996DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3748639PMC
August 2013

Comparison of topical 5% nicotinamid gel versus 2% clindamycin gel in the treatment of the mild-moderate acne vulgaris: A double-blinded randomized clinical trial.

J Res Med Sci 2013 Feb;18(2):115-7

Skin Disease and Leishmaniasis Research Center, Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Acne vulgaris is considered one of the most common disorders for which patients seek dermatologic care. In the current study, we evaluated efficacy of the 5% nicotinamide gel versus 2% clindamycin gel in the treatment of the mild-moderate acne vulgaris.

Materials And Methods: This was a randomized, controlled clinical trial that was performed in 2009-2010. Sixty female patients with mild or moderate acne vulgaris were recurited to be treated either with 5% nicotinamide or 2% clindamycin gel for 8 weeks. Acne severity index (ASI) was used to evaluate response to treatment and SPSS software was used to analyze the data.

Results: The mean of ASI at the baseline was 16.85 ± 8.5 and 18.2 ± 12.27 in nicotinamide gel and clindamycin gel, respectively (P > 0.05). The mean of ASI was significantly decreased compared with baseline ASI during the time in both groups (P < 0.0001). However, there was not a significant difference regarding reduction of ASI between the nicotinamide and clindamycin gel (P = 0.583).

Conclusion: Five percent nicotinamide gel is as effective as 2% clindamycin gel for treatment of mild to moderate acne vulgaris. No side effect was observed during the treatment.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3724370PMC
February 2013

Topical effectiveness of different concentrations of nanosilver solution on Leishmania major lesions in Balb/c mice.

J Vector Borne Dis 2012 Dec;49(4):249-53

Skin & Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Background & Objectives: Cutaneous leishmaniasis is an infection caused by protozoan genus Leishmania. Although glucantime is commonly used for the treatment of leishmaniasis, it has some side effects including increased liver enzymes and electrocardiogram changes. In addition, the drug is expensive, the injection is painful, and research shows that resistance of parasite to glucantime is growing in different parts of the world. Therefore, scientists are paying more attention to develop new drugs such as nanosilver solution. The present study is an attempt to evaluate the in vivo topical effects of different concentrations of nanosilver solution in the treatment of leishmaniasis lesions.

Methods: In all, 90 female Balb/c mice aged 6-8 wk were infected with 2×10 power 6 viable stationary-phase promastigotes in the base of tail. Different concentrations (60, 80, 120, 130 and 2000 ppm) nanosilver solution were used in the present study to test the efficacy in the treatment of lesions. Clinical control of the infection trends was conducted weekly for 5 wk by measuring lesion diameter with standard Kulis-Vernieh. Data were analyzed by paired t-test, analysis of variance (ANOVA), and Tukey test.

Results: Mean lesion diameter pre- and post-treatment did not significantly differ between different treatment groups (p >0.05). Likewise, a significant difference in splenic parasite load was also not observed between different treatment groups.

Interpretation & Conclusion: Based on our results, different concentrations of nanosilver are ineffective in reducing mean sizes of lesions.
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December 2012

Bowenoid transformation in seborrheic keratosis: A retrospective analysis of 429 patients.

J Res Med Sci 2012 Mar;17(3):217-21

Professor, Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Seborrheic keratosis is a common, benign skin tumor. Numerous reports have shown its possibility of malignant transformation. This study was designed to demonstrate the occurrence of concomitant seborrheic keratosis and skin cancers.

Materials And Methods: Data was retrospectively reviewed from all patients with a diagnosis of seborrheic keratosis in pathology department of Alzahra Hospital and a private pathology laboratory in Isfahan, Iran over a 4-year period. We classified all demographic data and associated dysplasia or Bowen's disease and analyzed them by student-t or chi-square tests.

Results: From all 429 specimens, 5 (1.2%) were found to be associated with Bowen's disease and one (0.2%) with mild dysplasia in squamous epithelium. All cases arose within the clinically, atypical seborrheic keratosis. More men were affected with lesions alone and with malignancy (230/423 (54.4%) and 5/6 (83.3%), respectively) compared to women. The average age of patients suffering from lesions with and without associated malignancy was 57 and 54 years, respectively. The common site of lesion alone was head and neck but lesions with malignancy involved lower extremities. The two lesions were significantly different in site of occurrence (p < 0.001).

Conclusion: Generally, although the association between seborrheic keratosis and skin malignancy appears to be accidental, it must always be in mind. Therefore, histopathologic examination of all seborrheic keratosis should be considered, especially when seborrheic keratosis has atypical clinical manifestations.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3527037PMC
March 2012

Comparison of the narrow band UVB versus systemic corticosteroids in the treatment of lichen planus: A randomized clinical trial.

J Res Med Sci 2011 Dec;16(12):1578-82

Professor, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Lichen planus is recognized as an inflammatory disease of the skin with different morphologic patterns. Different treatment modalities, including topical and systemic corticosteroids, methotrexate, cyclosporine, azathioprine, topical calcineurin inhibitors, and psoralen plus UVA (PUVA), have been suggested for lichen planus. Although the efficacy of narrowband UVB (NBUVB) for treatment of lichen planus has been shown, no randomized clinical trial has compared NBUVB versus systemic corticosteroids for treatment of the disease. In the current study, we evaluated the efficacy of NBUVB versus systemic corticosteroids in the treatment of the lichen planus.

Methods: Forty-six patients with confirmed diagnosis of lichen planus were randomly selected. The subjects were randomized into two groups of 23 to be treated with either systemic corticosteroids or NBUVB. All of the selected cases had generalized lichen planus that involved at least 20% of the body area and their pruritus was resistant to antihistamine drugs. Patients in the systemic corticosteroids group were treated with prednisolon 0.3 mg/kg for 6 weeks. NBUVB was performed three times a week for 6 weeks. The maximum dose of NBUVB was 9 J/cm(2). Data regarding demographic characteristics of the patients was also collected. All collected data was analyzed using SPSS(15) and statistical tests including analysis of variance (ANOVA), chi-square, and t-test.

Results: 46 patients (23 patients in systemic steroid group and 23 patients in NBUVB group) were evaluated. There was a significant difference between the 2 groups regarding the efficacy of the treatment. According to chi-square test, NBUVB was significantly more effective than systemic steroid in treatment of generalized lichen planus (p = 0.008). According to the results, patient satisfaction was also significantly higher in the group treated with NBUVB as compared with the systemic corticosteroids (p = 0.012).

Conclusions: Overall, the results of our study and other previous studies showed that NBUVB may be regarded as an effective treatment for generalized cutaneous lichen planus. This treatment may be especially utilized when there is contraindication for systemic corticosteroids or other immunosuppressive drugs.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3434899PMC
December 2011
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