Publications by authors named "Fariba Iraji"

55 Publications

Fractional Erbium:YAG Laser (2940 nm) plus Topical Hydroquinone Compared to Intradermal Tranexamic Acid plus Topical Hydroquinone for the Treatment of Refractory Melasma: A Randomized Controlled Trial.

J Dermatolog Treat 2021 Aug 13:1-21. Epub 2021 Aug 13.

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

Objectives: Melasma is a chronic acquired condition characterized by grayish-brown macules and patches with a distinct border on the face. Although various treatments methods have been suggested for treating melasma, none has been completely successful. The aim of the study was to compare the efficiency of erbium: yttrium-aluminum-garnet (Er:YAG) laser and 4% hydroquinone (HQ) with the effects of intradermal tranexamic acid (TA) and 4% HQ for the treatment of refractory melasma.

Methods: The study included 31 female patients with refractory melasma. The left or right side of the patient's face was chosen randomly to receive laser therapy with topical HQ on the one side (i.e., the laser side) and intradermal injection of TA plus topical HQ on the other side (i.e., the mesotherapy side). Digital photography was performed at baseline, at the end of the treatment, and three months after the treatment as follow-up. Two independent dermatologists evaluated the modified Melasma Area and Severity Index (mMASI) score according to the pictures. Overall, 27 patients completed the study and went through the clinical evaluation.

Results: Treatment using HQ in combination with either Er:YAG laser therapy or intradermal injection of TA significantly improved the hemi-mMASI and resulted in higher patient satisfaction. While the improvement was not significantly different between the two regiments after the treatment and upon follow up and both were equally efficient in the treatment of refractory melasma (p = 1.308), recurrence rate was higher after treatment with Er:YAG laser than TA (12% vs 34%).

Conclusion: This study confirmed the comparable efficacy of TA plus topical HQ versus Er:YAG laser plus topical HQ for the treatment of refractory melasma. Both groups improved significantly and no subject left the treatment because of adverse effects.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/09546634.2021.1968996DOI Listing
August 2021

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.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/jrms.JRMS_934_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8106408PMC
February 2021

Platelet-rich plasma versus carboxytherapy for the treatment of periocular hyperpigmentation; which approach is superior?

Dermatol Ther 2021 07 8;34(4):e14980. Epub 2021 Jun 8.

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

Periorbital hyperpigmentation (POH) is a common aesthetic condition causing people referring to dermatology clinics. Although the therapeutic approach is steeply dependent to the etiology of POH, the gold standard approach of treatment is still a question. The current study is designed to compare the use of carboxytherapy versus platelet-rich plasma (PRP) for the treatment of POH. In the current clinical trial, number of 21 patients with POH underwent carboxytherapy in one side of the face and PRP therapy on the other side. SPSS software version 22 was used with independent T-test, Chi-square, and ANOVA for analytics. Carboxytherapy was performed by intradermal injection of 5 cc carbon-dioxide gas once weekly for 6 weeks. The PRP treatment was performed by intradermal injection of PRP in periorbital space using an insulin syringe every 2 weeks for three times. The periorbital darkness was assessed using visual analogue scale preoperatively and within 8 weeks postoperatively by the patients and the dermatologists. Automatic assessments of skin vascularity and pigmentation were assessed using a digital camera. The patients represented significant darkness improvement postoperatively for both of the approaches (p value: 0.84, p value: 0.87), while the comparison of the two groups revealed insignificant postoperative changes by dermatologists assessments (p value = 0.59, p value: 0.61), the patients' assessments (p value = 0.85), the digital camera skin vascularity and pigmentation assessments (p value > 0.05). Conclusion: Although insignificant changes following both of the approaches were found, it may have occurred due to the technique, quality of material, or inadequate treatment sessions due to the type of Iranian skin; therefore, more evaluations considering particular entities such as vascularity for longer duration of follow-up and new design are strongly recommended.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/dth.14980DOI Listing
July 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.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/ccr3.3596DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7869328PMC
February 2021

Multiple disseminated pyogenic granuloma post-oil burning-Review literature.

Clin Case Rep 2021 Jan 6;9(1):169-172. Epub 2020 Nov 6.

Department of Pathology Medical School Isfahan University of Medical Sciences AL-Zahra Hospital Isfahan Iran.

Disseminated pyogenic granuloma is a rare entity. Patients need reassurance for this benign condition and are advised about the risk of recurrence and the risk of scarring with a total surgical excision. Red-flag diagnoses should be ruled out.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/ccr3.3491DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7813101PMC
January 2021

Effectiveness of dermabrasion plus 5-fluorouracil vs suction blister in treating vitiligo: A comparative study.

Dermatol Ther 2021 03 17;34(2):e14750. Epub 2021 Jan 17.

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

Vitiligo is a prevalent destructive melanocyte skin disease that negatively affects the patients' life in terms of self-esteem. Suction blister and dermabrasion plus 5-fluorouracil are effective treatments for vitiligo. The present study was conducted to compare the outcomes of these two techniques. The present clinical trial was conducted on 36 patients with persistent refractory vitiligo which defined as the lack of any new or progressed lesion during the previous year as well as no responding to conventional therapies of vitiligo including topical treatments and phototherapy. Individuals with two vitiligo patches, with similar baseline Vitiligo Area Severity Index (VASI) scores were randomly allocated to dermabrasion plus 5-fluorouracil or suction blister treatments. VASI and repigmentation scores were measured and compared at the baseline, four, and 12 weeks after performing the procedures. Both of the approaches accompanied with significant improvement in both entities of VASI and repigmentation scores (P value < .05) at the end of the study, besides the trend of VASI and repigmentation scores between the two groups revealed insignificant difference (P > .05). The short-term follow-up of the patients was the limitation of this study. The present findings suggested that both surgical techniques of dermabrasion plus 5-fluorouracil and suction blister posed acceptable outcomes within 12-week follow-up.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/dth.14750DOI Listing
March 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.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/dth.14317DOI Listing
November 2020

Microneedling in androgenetic alopecia; comparing two different depths of microneedles.

J Cosmet Dermatol 2021 Apr 29;20(4):1241-1247. Epub 2020 Sep 29.

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

Background: Microneedling has shown to have positive therapeutic effects in treatment of androgenetic alopecia (AGA); however, the best microneedling protocol is still controversial.

Aims: Investigating effect of microneedling with 2 different depths of penetration on promoting hair growth in patients with AGA.

Methods: Sixty patients, in the age of 18-45 years old with moderate and severe AGA, were allocated into 3 groups of control: treatment with minoxidil 5% lotion; group A: treatment with minoxidil 5% lotion and biweekly microneedling with a depth of 1.2 mm and group B: treatment with minoxidil 5% lotion and biweekly microneedling with a depth of 0.6 mm during 12 weeks. Efficacy parameters including change of hair count and hair thickness from baseline and assessment of hair growth by patient and investigator were evaluated.

Results: Compared with the baseline, a significant increase in hair count and hair thickness was observed in all three groups after completion of the treatment course (P < .05). The mean rise in hair count (P = .017) and hair thickness (P = .007) was significantly greater in group B compared with control group. Investigator's evaluation of hair regrowth was significantly greater in group A (P = .04) and group B (P = .007) compared with control group.

Conclusion: Microneedling with a depth of 0.6 mm in combination with minoxidil is more effective than minoxidil monotherapy in patients with AGA in terms of hair count and hair thickness. This depth of penetration tended to be more beneficial than depth of 1.2 mm.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jocd.13714DOI Listing
April 2021

Study of therapeutic effect of different concentrations of imatinib on Balb/c model of cutaneous leishmaniasis.

AIMS Microbiol 2020 2;6(2):152-161. Epub 2020 Jun 2.

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

Leishmaniasis, as a tropical and subtropical disease, is endemic in more than 90 countries around the world. Today, cutaneous leishmaniasis (CL) that affects more than 1.5 million people per year lacks a definitive treatment approach. Imatinib is an anticancer drug that inhibits the abnormal function of Bcr-Abl due to its tyrosine kinase inhibitor, and that was the reason why the drug was tested for CL treatment because protein kinases are essential enzymes in the genus. In this study, the CL model of Balb/c mice was produced by injection of the cultured metacyclic form of parasite at the base of the tail. The possible recovery of CL ulcers and determination of the optimum dose of imatinib against amastigotes were evaluated. A significant decrease was observed in mice treated with amphotericin B (positive control group) as well as imatinib 50 mg/kg compared to the unreceived drug, negative control group (P<0.05). This study could be promising in gaining insight into the potential of imatinib as an effective treatment approach against CL.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3934/microbiol.2020010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7326727PMC
June 2020

Cutaneous horn: A rare subtype of juvenile xanthogranuloma.

Clin Case Rep 2020 Jan 19;8(1):65-67. Epub 2019 Dec 19.

Dermatology, Skin Diseases and leishmaniasis Research Center Department of Dermatology Isfahan medical school Isfahan University of Medical science Isfahan Iran.

Because of variability in the JXG shape and the extensive range of a cutaneous horn differential diagnosis, dermatologists should keep this diagnosis in their mind in the time of encountering with infants or children cases of cutaneous horn.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/ccr3.2549DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6982491PMC
January 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.
View Article and Find Full Text PDF

Download full-text PDF

Source
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 .
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/abr.abr_58_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6839269PMC
October 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.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jocd.13181DOI Listing
June 2020

Comparison between the efficacy of intralesional rituximab versus intralesional triamcinolone in the treatment refractory Pemphigus Vulgaris lesions: A randomized clinical trial.

Int Immunopharmacol 2019 Aug 10;73:94-97. Epub 2019 May 10.

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

Background: Pemphigus Vulgaris (PV) is a vesiculobullous autoimmune disorder characterized by production of autoantibody against cellular adhesion molecules. The treatment of PV is based on the use of systemic corticosteroid along with immunosuppressive therapy, but sometimes there are limited resistant lesions not responding to conventional systemic therapy. This double-blind, randomized clinical trial was designed to evaluate the efficacy of intralesional rituximab versus triamcinolone in treatment of the refractory scalp and mucosal pemphigus lesions.

Methods: 2 refractory lesions of PV were selected in 21 patients, and they were randomly assigned to two groups to be treated with either intralesional triamcinolone or rituximab for 2 times at one-month interval. All of the patients were under treatment with prednisolone and azathioprine. Patients were visited at the baseline, 1 and 6 months after treatment, and all information including demographic characteristics of the patients, Pemphigus Vulgaris Lesion Severity Score (PVLSS), Epithelialization Index (EI) and patient's satisfaction (using Visual Analogue Scale (VAS)) were obtained. The collected data were analyzed using SPSS software (ver18).

Results: The results showed that, both rituximab and triamcinolone were effective in treatment of the refractory PV lesions (p < 0.05). However, there was no significant difference between the effect of intralesional rituximab and triamcinolone (p > 0.05). In addition, no side effect was observed in both groups.

Conclusion: Regarding the results of the present study, the use of intralesional rituximab can be suggested for treatment of the resistant PV lesions as an alternative to intralesional triamcinolone or using more aggressive systemic therapy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.intimp.2019.04.031DOI Listing
August 2019

Efficacy of mesotherapy with tranexamic acid and ascorbic acid with and without glutathione in treatment of melasma: A split face comparative trial.

J Cosmet Dermatol 2019 Feb 8. Epub 2019 Feb 8.

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

Introduction: Melasma is a prevalent annoying skin hyperpigmentation disorder that commonly involves reproductive-aged females. Variety of treatments with controversial results has been recommended. The aim of the current study was to evaluate combination therapy of tranexamic acid (TA) and vitamin C with and without glutathione with mesotherapy technique for treatment of melasma.

Methods And Materials: This is a randomized clinical trial study conducted on 30 patients referred to Dermatology Clinics. Patients were examined under wood lamp in order of melasma type (epidermal, dermal, or mixed) determination. Then, patients underwent melasma therapy using Cocktail A (TA 4 mg/mL; vitamin C 3% and glutathione 2%) on their right half of the face and Cocktail B (TA 4 mg/mL and vitamin C 3%) on their left half of the face, with mesotherapy technique. This procedure was done for six times with 2-week intervals. Patients' modified Melasma Area and Severity Scoring (mMASI) was assessed at initiation and end of the study.

Results: According to mMASI score changes 12 weeks after intervention, both cocktails had significant efficacy in reduction of mMASI score in each side. Mean of mMASI in left side had decrease of 1.82 ± 0.88 (P-value < 0.001) and in right side had decrease of 3.046 ± 1.25 (P-value < 0.001) from base line. Comparison between two groups 12 weeks after treatment showed significantly more reduction (1.28 ± 0.64) of mMASI score with cocktail A than B (P-value < 0.001). Erythema, edema, and ecchymosis was not significantly different among two cocktails (P-value > 0.05).

Conclusion: Use of combination mesotherapy in treatment of melasma was accompanied with appropriate outcomes regardless of type of agents but treatment with glutathione containing cocktail A presented superior results compared with cocktail of TA and vitamin C but not glutathione.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jocd.12874DOI Listing
February 2019

A Rare Case of Branchio-oculo-facial Syndrome: Clinical and Histopathological Features.

Adv Biomed Res 2018 27;7:145. Epub 2018 Nov 27.

Department of Pathology, Skin Diseases and Leishmaniasis Research Center, Isfahan, Iran.

Branchio-oculo-facial syndrome (BOFS), a rare, multiple-malformation congenital disorder, is characterized by facial anomalies, including associated cutaneous and ocular abnormalities. We report a new case of BOFS in an 11-year-old male child with bilateral cervical erythematous scaly linear plaque associated with scar formation and erosion. Although BOFS is very rare, physicians, especially dermatologists, should be aware of the cutaneous and histopathological features of BOFS due to impacts of the associated anomalies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/abr.abr_31_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6282485PMC
November 2018

Real life management of chronic urticaria: Multicenter and cross sectional study on patients and dermatologists in Iran.

Dermatol Ther 2019 03 13;32(2):e12796. Epub 2018 Dec 13.

Department of Dermatology, Imam Khomeini Hospital Complex, Tehran University of Medical Science, Tehran, Iran.

Recently, advances in understanding the etiology of urticaria and updates of diagnostic and therapeutic management guidelines have drawn attention to chronic urticaria (CU) morbidity. The present study aimed to evaluate Iranian dermatologists' practice and real life management of CU patients. A total of 35 dermatologists and 443 patients were included in the study. Number of female patients was 321 (72.5%). Mean (standard deviation) age of the study patients was 38 (13) years and the median (inter quartile range) of disease duration was 12 (6-48) months. Severity of patients' symptoms was mild for 32.1%, moderate for 38.7%, severe for 18.8%, and 10.4% of them had no evident signs or symptoms. The most common diagnostic methods were physical examination (96.6%), differential blood count (83.5%), erythrocyte sedimentation rate (77.4%), and C-reactive protein (62.8%). The number of dermatologists prescribed nonsedating antihistamines (nsAH) in regular dose and high dose mono therapy were 26 (74%) and 6 (17%), respectively. About 66% of dermatologists were familiar with British Association of Dermatologists (BAD) guideline. The most common first-line treatment for CU by Iranian dermatologists was nonsedating antihistamines in regular or high doses. The real-life management of patients with CU in Iran was in accordance with the available practice guidelines.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/dth.12796DOI Listing
March 2019

Langerhans Cell Histiocytosis: A Case Report with Unusual Cutaneous Manifestation.

Adv Biomed Res 2018 25;7:102. Epub 2018 Jun 25.

Alzahra Research Institute, Isfahan, Iran.

Langerhans cell histiocytosis (LCH) is characterized by idiopathic monoclonal infiltration of Langerhans cells in different organs such as the skeleton, skin, pituitary gland, liver, spleen, lungs, and the hematopoietic system. Skin lesions are common in LCH and affect about 40% of cases. It is reported that skin lesions are usually the first manifestation of LCH in 80% of patients. Usually, cutaneous presentations of LCH in adults are generalized or seborrhea-like lesions and it is often the first manifestation of disease. Here, we describe a 45-year old female who was known case of hypothyroidism, systemic lupus erythematosus, and diabetes insipidus. In our patient, cutaneous involvement was unusual. It was single and presented in unusual site (ankle) and before developing such lesion, she had diabetes insipidus for several years due to the involvement of pituitary gland.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/abr.abr_119_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6036769PMC
June 2018

Corrigendum to "Topical Colchicine Gel versus Diclofenac Sodium Gel for the Treatment of Actinic Keratoses: A Randomized, Double-Blind Study".

Adv Med 2017;2017:7192180. Epub 2017 Dec 28.

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

[This corrects the article DOI: 10.1155/2016/5918393.].
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2017/7192180DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5763074PMC
December 2017

Potential emerging treatment in vitiligo using Er:YAG in combination with 5FU and clobetasol.

J Cosmet Dermatol 2018 Apr 19;17(2):165-170. Epub 2017 Jul 19.

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

Background: Vitiligo is a pigmentary disorder of skin affecting at least 1% of the world population of all races in both sexes. Its importance is mainly due to subsequent social and psychological problems rather than clinical complications. Various treatment choices are available for vitiligo; however, laser-based courses have shown to give more acceptable results.

Objective: The aim of this trial was to evaluate the efficacy of Er:YAG laser as a supplementary medicine to topical 5FU and clobetasol in vitiligo patients.

Methods: Two comparable vitiligo patches from 38 eligible patients were randomized to receive topical 5FU and clobetasol in control group and additional Er:YAG laser in intervention group. Major outcomes of interest were the size of patch and pigmentation score at randomization and 2 and 4 months after therapy.

Results: Final sample included 18 (47%) male patients and age of 35.66±8.04. The performance Er:YAG group was superior in all sites. Reduction in the size of patches was greater in Er:YAG group (p-value=.004). Also, this group showed a higher pigmentation scores in the trial period than control group (p-value<.001).

Conclusions: Greater reduction in the size and increase in pigmentation score was seen in Er:YAG group especially for short periods after therapy and repeating laser sessions may help improving final outcomes. Er:AYG could help in reducing complications of long-term topical treatments, achieving faster response, and improving patient adherence.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jocd.12373DOI Listing
April 2018

A Comparison of Betamethasone Valerate 0.1% Cream Twice Daily Plus Oral Simvastatin Versus Betamethasone Valerate 0.1% Cream Alone in the Treatment of Vitiligo Patients.

Adv Biomed Res 2017 28;6:34. Epub 2017 Mar 28.

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

Background: Vitiligo, a common disorder of depigmentation, is often difficult to treat. Corticosteroids are known to be effective, but with modest results. Although simvastatin has been reported to be effective for immunorelated dermatologic disorders including vitiligo, controlled trials are lacking. This study was conducted to compare the efficacy of topical betamethasone valerate 0.1% cream (as a standard method of treatment for vitiligo) versus a combination of betamethasone valerate plus oral simvastatin in the treatment of vitiligo.

Materials And Methods: Eighty-eight subjects with symmetric vitiligo who had body surface involvement up to 20% were divided randomly into two groups. Group A were treated with betamethasone valerate 01% cream twice daily and Group B with betamethasone valerate 01% cream twice daily and oral simvastatin 80 mg daily for 12 weeks. Finally, 46 patients completed treatment after 12 weeks in both groups. The results were evaluated by a blind dermatologist using Vitiligo Area Scoring Index (VASI) score at baseline, 4, 8, and 12 week of treatment. In a similar way, subjective assessment performed by patients based on photo evaluation at the end of the study.

Results: Despite a continuous reduction in VASI score in both groups, according to both physician ( = 0.13) and patient ( = 0.374) assessment oral simvastatin was not statistically more effective than conventional treatment of vitiligo.

Conclusion: This study indicates that oral simvastatin is not associated with significant impacts in the treatment of vitiligo as compared to other inflammatory dermatologic conditions such as psoriasis. Indeed, other studies should be initiated regarding exact molecular and cellular effects of statins in the treatment of vitiligo.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/2277-9175.203159DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5385703PMC
March 2017

Efficacy of fractionated microneedle radiofrequency with and without adding subcision for the treatment of atrophic facial acne scars: A randomized split-face clinical study.

J Cosmet Dermatol 2017 Jun 22;16(2):223-229. Epub 2017 Apr 22.

Department of Dermatology, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Background: There is no gold standard treatment for facial acne scars, and overall, little literature exists about the combination therapy for treatment of acne scar.

Aims: The aim of this study was to evaluate the efficacy of fractionated microneedle radiofrequency (FMR) vs FMR combined with subcision for the treatment of atrophic acne scars.

Patients/methods: This was a randomized, split-face clinical study of 25 patients with II-IV Fitzpatrick skin types with moderate to severe facial atrophic acne scars. Initially, standard subcision by Nokor needle was performed on one side. Two weeks after subcision, FMR treatment was performed on both cheeks of each participant. Second and third FMR treatment sessions were performed within 4-week intervals. Two-blinded dermatologists performed clinical assessments using a quartile grading scale, and patients were also asked to judge their satisfaction using a visual analog scale (VAS) scoring system.

Results: The age of the patients varied from 24 to 40 years (mean: 30.08±4.94 years). Only nine patients (36%) were males. Clinical assessment by two-blinded dermatologists showed statistically significant improvement in the combination (FMR+subcision) group (P=.009). Patient satisfaction was statistically significantly better in the combination group (P=.001). A darkening of skin phototype was associated with a decrease in patient's satisfaction VAS score (P=.07).

Conclusion: The combination of subcision and FMR is a safe and effective modality for mixed type acne scars. Additional randomized clinical study with long-term follow-up is necessary for further evaluation of FMR in combination with other procedures. The full trial protocol can be accessed in: http://www.irct.ir/searchresult.php?keyword=%20%20IRCT2016103130597N1&id=30597&number=1&field=a&prt=1&total=1&m=1. The clinical trial registration number is IRCT2016103130597N1.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jocd.12346DOI Listing
June 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.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/2277-9175.191002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5220690PMC
December 2016

Topical Colchicine Gel versus Diclofenac Sodium Gel for the Treatment of Actinic Keratoses: A Randomized, Double-Blind Study.

Adv Med 2016 5;2016:5918393. Epub 2016 Sep 5.

Cancer Research Center, Semnan University of Medical Sciences, Semnan, Iran.

Introduction. Actinic keratoses (AKs), a premalignant skin lesion, are a common lesion in fair skin. Although destructive treatment remains the gold standard for AKs, medical therapies may be preferable due to the comfort and reliability .This study aims to compare the effects of topical 1% colchicine gel and 3% diclofenac sodium gel in AKs. Materials and Methods. In this randomized double-blind study, 70 lesions were selected. Patients were randomized before receiving either 1% colchicine gel or 3% diclofenac sodium cream twice a day for 6 weeks. Patients were evaluated in terms of their lesion size, treatment complications, and recurrence at 7, 30, 60, and 120 days after treatment. Results. The mean of changes in the size was significant in both groups both before and after treatment (<0.001). The mean lesion size before treatment and at 30, 60, and 120 days was not different between the two groups (p > 0.05). No case of erythema was seen in the colchicine group, while erythema was seen in 22.9% (eight cases) of patients in the diclofenac sodium group (p = 0.005). Conclusions. 1% colchicine gel was a safe and effective medication with fewer side effects and lack of recurrence of the lesion.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5027305PMC
http://dx.doi.org/10.1155/2016/5918393DOI Listing
September 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.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/2277-9175.186997DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4976535PMC
August 2016

Efficacy of topical azathioprine and betamethasone versus betamethasone-only emollient cream in 2-18 years old patients with moderate-to-severe atopic dermatitis: A randomized controlled trial.

Adv Biomed Res 2015 7;4:228. Epub 2015 Oct 7.

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

Background: Atopic dermatitis is a chronic skin disease with increasing prevalence worldwide and a considerable burden especially among children. To circumvent the problems related to oral azathioprine (AZT) we aimed to evaluate its topical variant and assess its efficacy in patients aged 2-18.

Materials And Methods: In a single-blind trial, we randomized the patients into two groups, one treated with topical emollient containing AZT and betamethasone (BM), and the other treated solely with topical emollient of BM. The treatments were administered twice a day for 8 weeks in both groups. The efficacy, recurrence, and the presence of side effects were evaluated using SPSS 20.

Results: The amount of reduction in severity scoring for atopic dermatitis (SCORAD) score was significantly greater in the group treated with the topical AZT (P = 0.024). Incidentally, there were no difference between two treatments in difference in proportions of recurrence and adverse effects as well as SCORAD reduction in subgroups of sex and age (all P > 0.05).

Conclusions: Our results showed the superiority of topical AZT over BM with a low recurrence and adverse effects. No expectation of severe side effects, like those of oral AZT, is the major advantage of topical AZT. The sample size was an issue in uncovering the value of AZT in the subgroups. Conducting prolonged studies of quality-of-life and comparing the topical AZT potency relative to the common alternatives are recommended areas of future work.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/2277-9175.166651DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4638058PMC
December 2015

Bacillary Angiomatosis in Immunocompetent Patient with Atypical Manifestations.

Indian J Dermatol 2015 Sep-Oct;60(5):523

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

Bacillary angiomatosis is an infectious disease caused by two Gram-negative bacilli; this disease usually affects immunosuppressed hosts with a history of cat scratch. We report a rare case of bacillary angiomatosis in an immunocompetent 26-year-old woman with no history of exposure to cats, and with atypical clinical features (very pruritic vascular papules and nodules with ulceration and hemorrhage on the right arm and fingers). She was successfully treated with clarithromycin for 3 months. Bacillary angiomatosis must be kept in mind in the differential diagnosis of any papules and nodules in cases of unknown etiology and also in immunocompetent patients and HIV-negative individual.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/0019-5154.164444DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4601457PMC
November 2015

Complementary Therapies for Idiopathic Hirsutism: Topical Licorice as Promising Option.

Evid Based Complement Alternat Med 2015 27;2015:659041. Epub 2015 Jul 27.

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

Hirsutism is one of the most prevalent health problems in women. The aim of the study was to compare the effect of 755 nm alexandrite hair removal laser with that of alexandrite laser plus topical licorice on the improvement of idiopathic hirsutism. A double-blind, randomized placebo-controlled study was performed on 90 female subjects. The patients were divided into two groups: alexandrite laser plus 15% licorice gel (group A) and placebo (group B). Each subject received one of both products over one side of the face, twice daily for 24 weeks on the hirsute locations. Each group underwent five sessions of alexandrite laser at 6-week intervals. To minimize the effects of confounding variables, the test was performed on two separate zones of patients' skin. The mean ± SD numbers of terminal hairs in group A were 7.05 ± 4.55 for zone 1 and 6.06 ± 3.70 for zone 2. In group B, they were 3.18 ± 1.75 for zone 1 and 2.49 ± 1.63 for zone 2. The difference in the mean number of terminal hairs was statistically significant between the two groups (p < 0.001), and there were no serious adverse reactions. The treatment of idiopathic hirsutism with 755 nm alexandrite laser plus topical licorice is more effective than alexandrite laser only.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2015/659041DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4530245PMC
August 2015

Dyskeratosis Congenita Without Oral Involvement: A Rare Hereditary Disease.

Oman Med J 2015 May;30(3):212-5

Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran ; Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran.

Dyskeratosis congenita (DC) is a rare, progressive, multi-system, inherited disorder of telomere biology, first described in 1906 as the Zinsser-Engman-Cole syndrome. The condition presents with the classic triad of nail dystrophy, reticulate skin pigmentation, and oral leukoplakia. Variable somatic abnormalities may be present; these include pulmonary, gastrointestinal, genitourinary, cerebral, and dental complications. Pancytopenia eventually develops, progressing to bone marrow failure. In our patient, the progression of DC did not follow the "classic triad" typically seen in the condition. Here we report the case of a 27-year-old male who had features consistent with this syndrome but who had a normal oral cavity associated with aplastic anemia for which longstanding nail dystrophy and reticular pigmentation were the dominant clinical features. The patient was advised to avoid smoking and severe exposure to the sun, and to return regularly for follow-up. Because all symptoms of this disorder are not necessarily seen collectively in any one patient, physicians should consider it as a probability in all patients showing signs of reticular hyperpigmentation, especially accompanied by aplastic anemia. Our report emphasizes the fact that not all components of the syndrome need to be present and in all cases of genodermatosis, pleomorphism may be expected with variable clinical manifestations. Even though many variants have been described in literature, sparing of the oral cavity as in our patient is extremely uncommon. Therefore, physicians should be aware of the mucocutaneous manifestation of DC and its diagnosis and refer the patient for better evaluation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5001/omj.2015.44DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4459155PMC
May 2015

Pustular Bacterid: Look at the Throat for Prevention over Treatment.

Int J Prev Med 2015 4;6:51. Epub 2015 Jun 4.

Students' Research Committee, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/2008-7802.158180DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4462810PMC
June 2015
-->