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Background: A permanent, unpleasant atrophic leishmaniasis scar is a potentially disfiguring condition that causes social stigma with limited treatment choices. Fractionated carbon dioxide (CO2) laser resurfacing is expected to be a safe and effective treatment for leishmaniasis scars. Objective: To assess the safety and efficacy of ablative fractional resurfacing (AFR) with a CO2 laser for facial leishmaniasis atrophic scars. Methods: Eleven patients (five males, age 18–47 years) underwent the fractional CO2 laser procedure. The mean duration for scars was 18.3 years. Three to five treatment sessions with the fractional laser eCO2 (10,600 nm, Lutronic Corporation, Gyeonggi-do, Korea) were performed for each patient, at 2-month intervals, under topical anesthesia. Two passes (with tip type 120, density 150 spots/cm2 in static mode, and peak power of 30 watts) were performed on each leishmaniasis scar. Pulse energies ranged between 100 and 140 mJ. Posttreatment improvements in texture, atrophy, and overall satisfaction with appearance were graded on a quartile scale 1 month after the second session and 3 months after the final session. Scar improvement was graded using a 4-point score with a maximum score of 20. Results: At the 3-month posttreatment follow-up, all subjects were rated as having at least 50% improvement in texture, atrophy, borders, and overall appearance of scars. The median score of improvement was 18 of 20 (range 11–19). Mild postinflammatory hyperpigmentation was the only adverse effect, observed in 18% (2 of 11) of subjects. After the procedure, moderate to severe erythema and edema typically resolved within 24 to 48 hours. No additional adverse effects were observed. Conclusion: Fractional CO2 resurfacing represents a safe, effective, and well-tolerated potential treatment for atrophic facial leishmaniasis scars in ethnic skin.

Background: Previous studies have discussed attitudes of vitiligo patients toward their disease. However, no studies have addressed this issue from the public's point of view. Objective: To explore the perceptions, attitudes, and misconceptions of the public toward vitiligo. Methods: A self-administered questionnaire was distributed to attendees of primary health care centers in Riyadh, Saudi Arabia, between January and August 2010. Results: Overall, 924 of the 1,000 distributed questionnaires were returned, and 429 were males (46.8%). Moreover, 33.1% (303 of 916) believed that vitiligo is contagious or did not know that it is not. The cause of vitiligo was thought to be infectious by 20.4% of respondents (182 of 894), inherited by 40.5% (365 of 902), autoimmune by 41.2% (370 of 899), and due to a lack of hygiene by 22.5% (199 of 883). Unmarried individuals and those with less education were more likely to state that vitiligo is caused by an infection ( p = .02, p = .03, respectively). Younger individuals and those with less education were more likely to think that vitiligo is caused by a lack of hygiene ( p = .01, p = .001, respectively). More than half of the participants (56.1%, 504 of 898) would be unwilling to marry a vitiligo patient. Younger individuals and males were less likely to marry a vitiligo patient ( p = .01, p = .05, respectively), whereas those of lower income were more likely to accept it ( p = .002). Conclusions: Various misconceptions and negative attitudes about vitiligo among the public are prevalent. Educating the public about vitiligo could ultimately lead to better psychosocial well-being of vitiligo patients. Contexte: Des études ont déjà porté sur la perception des personnes atteintes de vitiligo à l'égard de leur propre maladie, mais aucune étude n'a porté sur la perception du public à l'égard de cette maladie. Objectif: L'étude visait à analyser les perceptions, les attitudes, et les idées fausses du public à l'égard du vitiligo. Méthodes: Un questionnaire autoadministré a été remis à des personnes présentes dans des centres de soins primaires à Riyad, en Arabie saoudite, entre janvier et août 2010. Résultats: En tout, 924 questionnaires sur 1,000 ont été remis. Sur ce nombre, 429 avaient été remplis par des hommes (46.8%). De plus, 33.1% (303 sur 916) des répondants croyaient que le vitiligo était contagieux ou ne savaient pas qu'il ne l'était pas. Quant à la cause du vitiligo, 20.4% des participants (182 sur 894) croyaient que c'était une maladie contagieuse; 40.5% (365 sur 902), que c'était une maladie héréditaire; 41.2% (370 sur 899), que c'était une maladie auto-immune; et 22.5% (199 sur 883), que c'était une maladie due à un manque d'hygiène. Les personnes célibataires et celles moins instruites étaient plus portées à croire que le vitiligo était causé par une infection ( p = .02 et p = .03, respectivement). Les jeunes et les personnes moins instruites étaient plus susceptibles de croire que le vitiligo était causé par un manque d'hygiène ( p = .01 et p = .001, respectivement). Plus de la moitié des participants (56.1%, 504 sur 898) ne voulaient pas se marier avec une personne atteinte de vitiligo. Les jeunes et les hommes étaient moins disposés à se marier avec une personne atteinte de vitiligo ( p = .01 et p = .05, respectivement), tandis que ceux à faible revenu étaient plus susceptibles d'accepter le fait ( p = .002). Conclusions: Il existe plusieurs idées fausses sur le vitiligo au sein de la population, et la maladie suscite des réactions négatives. L'éducation du public sur le vitiligo pourrait peut-être améliorer le bien-être psychosocial des personnes atteintes de vitiligo.

Background: Plantar warts are common and often painful. Treatment of plantar warts is difficult and requires multiple treatments. Several clinical trials have proven the efficacy of bleomycin, but relatively high concentrations have been required and considerable side effects have been experienced. Objective: To evaluate the efficacy and safety of low-concentration (0.1 U/mL) bleomycin using a translesional injection technique for the treatment of plantar warts. Methods: The study included 23 patients with single or multiple plantar warts. Very low-concentration bleomycin was injected into a single wart or the largest plantar wart in the case of multiple lesions. Injections were performed at 4-week intervals until resolution of the warts or development of side effects. The translesional multipuncture technique was used. Results: Thirteen patients were male (56.5%), and the mean age was 27.7 years. The results revealed complete clearance of warts in 17 of 23 (74%) patients, partial response in 1 (4.3%) patient, and no response in 3 (13%) patients. Recurrence was observed in 2 patients at 3 months of follow-up. Among those two, one patient showed complete clearance after the second injection at 6 months of follow-up. All patients were followed for 6 months after the initial treatment. No significant long-term adverse effects were noted. Only three patients (13%) had localized moderate pain for 2 to 3 days after the injection. Conclusion: Translesional injection by very low-concentration (0.1 U/mL) bleomycin appears to be a simple, effective, and safe treatment modality for plantar warts.