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Background: Psoriasis is a common, chronic disease of the skin, in which both genetic and environmental factors play a critical role. The most characteristic lesions consist of red, scaly plaques present particularly over extensor surfaces and scalp. Studies have reported association between psoriasis and many other diseases in both cutaneous and systemic forms of the disease. Several studies with different and sometimes controversial results have been done about the relationship of hyperuricemia and psoriasis. The aim of our study was to assess serum uric acid levels in patients with psoriasis. Methods: We studied 126 patients with psoriasis in a case-series study in Razi Hospital during one year. After recording the age, sex, duration, type and severity of the disease and presence or absence of psoriatic arthritis in the patients, they were referred to the laboratory for the determination of serum uric acid concentrations. Results: The mean (±SD) serum uric acid level was 5.4±1.5 mg/dL (ranging from 1.9- 9.5 mg/dL). Although the mean serum uric acid levels were in the normal range but the values were significantly higher in patients with more severe forms of psoriasis (P

"n 800x600 Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";} Background: Psoriasis is a chronic, inflammatory disease of the skin. Recently, nicotinic cholinergic receptors have been demonstrated on keratinocytes, stimulating calcium influx and accelerating cell differentiation. Therefore, smoking and nicotine seem to influence inflammatory processes in psoriatic skin. The aim of this study was to determine the frequency of cigarette smoking as an independent risk factor in patients with psoriasis who attended the department of dermatology at Razi Hospital in Rasht during the years 2008 and 2009. "n"nMethods : In this descriptive-inferential study, we recruited 96 patients with psoriasis vulgaris and 96 individuals as the controls. The participants were adjusted for sex, age and body mass index. The collected data related to smoking status, duration of smoking habit, smoking intensity, pack-year smoking history, and passively exposure to smoking were documented in a researcher-devised questionnaire. Subsequently, the data were analyzed by descriptive and inferential statistics such as χ2, t-test and Mann-Whitney U test by SPSS software."n"nResults : The smoking rate was 33.3% in the patients and 19.4% in the controls. Pack-year history, regarded as the intensity and duration (years) of smoking, significantly increased the risk of psoriasis vulgaris (P

"n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 st1":*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP) is a specific dermatosis of the third trimester of pregnancy, commonly seen in primigravid women."n"nCase presentation: A 24-year-old primigravida woman who had developed a rash immediately after delivery was admitted to Razi Hospital in Tehran, Iran. She had an erythematous eruption, particularly concentrated on the abdominal striae with umbilical sparing and involvement of limbs and extremities. Skin biopsy of the lesions on the lower abdomen, showed superficial perivascular infiltrates with occasional neutrophils and eosinophils. Both direct and indirect immunofloresence assays were negative. The patient was ultimately treated with topical clobetasol butyrate and oral chlorpheniramine for pruritus. Within a week, the lesions and the itchings had disappeared completely."n"nConclusion: Pruritic urticarial papules and plaques of pregnancy are often, but not always, seen during the third trimester of pregnancy, but sometimes they present in postpartum period without any prior manifestations during pregnancy.

"n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 st1":*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Alopecia areata, a non-cicatricial form of hair loss, is believed to be an immunologic response that targets hair follicles. Genetic background is important in the pathogenesis of this disorder, although some evidence point to the role of melanocytic antigens. There are some reports on the relationship between alopecia areata and celiac disease. The aim of the present study was to identify antigliadin antibodies in patients with alopecia areata. "n"nMethods: Fifty patients, aged 2.5-50 years, with alopecia areata presenting to the dermatology clinic of Razi Educational Hospital in Tehran, Iran, and fifty healthy individuals, aged 5-48 were matched and enrolled in the study. After signing an informed consent form, blood samples (10 ml clotted blood) were obtained from the participants and sent to referral laboratory for the presence of antigliadin IgA and IgG antibodies. Concentrations of antibodies were measured by ELISA through a full automatic ELISA reader. The data were analyzed statistically."n"nResults: The study included 29(58%) male and 21(42%) female patients with a mean age of 24.6 years. The control group included 29(58%) male and 21(42%) female individuals with a mean age of 24 years. In the case group, 9(18%) patients were positive for antigliadin antibody, while only one (2%) individual was positive for the antibody in the control group (p

Background: Vitiligo is an acquired pigmentary disorder that affects 1% of population. It presents as depigmented patches. One of the most probable theories regarding the pathogenesis of vitiligo is autoimmunity. Systemic corticosteroids may arrest the progression of vitiligo and lead to repigmentation by suppressing immune system. The objective of this study is to assess the clinical efficacy of low-dose oral corticosteroids in actively progressing vitiligo. Materials and Methods: Seventy four patients with vitiligo were evaluated. The patients took daily doses of oral prednisolone (0.3 mg/kg) initially for 2 months. Then the dosage was halved monthly, for the five subsequent months of treatment. The effects of treatment were evaluated using photography's before and after the study. Side effects were assessed at the first, second, third and fourth month of the treatment. Results: Arrested progression of vitiligo and repigmentation were noted in 74.3% and 62.1% of patients respectively. The mean pigmentation was 26.8%. The localized form, lower age of disease onset, no hair whiteness on the lesions and less affliction percent showed increased repigmentation with statistical significance. There was no significant difference between sexes and positive family history of vitiligo in patients. The best therapeutic results were obtained for facial lesions and the worst for mucosal lesions. The side effects of treatment were minimal and did not affect the course of the treatment. Conclusion: Low-dose oral corticosteroids are effective and have few serious side effects in preventing the progression of actively progressing vitiligo but regimentation is not significant and this regimen is effective in patients who are refractory to topical corticosteroids or phototherapy.

Development of inhibitor to factor VIII is the most serious complication of hemophilia therapy. To determine the prevalence of inhibitors in Iran hemophilia A patients exposed to blood products, 1280 hemophilia A patients (age range 9 months-84 years) were evaluated. All patients received several blood products such as fresh frozen plasma (FFP), cryoprecipitate, and factor VIII. 635 of 1280 patients (49.6%), 277 patients (21.6%) and 368 patients (28.8%) had severe, moderate and mild disease, respectively. 184 of 1280 patients (14.4%) developed inhibitor. The prevalence of inhibitor for severe, moderate and mild in hemophilia A patients was 22.8%, 9.4%, and 3.5% respectively. 41 patients (22.2%) and 143 patients (77.8%) were high responder and low responder respectively. Among 184 patients with inhibitor, 67 patients (36.4%) had blood group O and for B, A, AB blood groups, number of patients with inhibitor was 55 (29.9%), 50 (27.2%), 12(6.5%) respectively and 153 patients (83.1%) had Rh blood group.

Soil moisture (SM) is a critical variable influencing various environmental processes, but traditional microwave sensors often lack the spatial resolution needed for local-scale studies. This study develops a novel stacking ensemble learning framework to enhance the spatial resolution of satellite-derived SM data to 1 km in the Urmia basin, a region facing significant water scarcity. We integrated in-situ SM measurements (obtained using time-domain reflectometry [TDR]), Soil Moisture Active Passive (SMAP) and Advanced Microwave Scanning Radiometer 2 (AMSR2) SM products, Moderate Resolution Imaging Spectroradiometer (MODIS) land surface temperature and vegetation indices, precipitation records, and topography data. Ten base machine-learning models were evaluated using the Complex Proportional Assessment (COPRAS) method, and the top-performing models were selected as base learners for the stacking ensemble. The ensemble model, incorporating Random Forest, Gradient Boosting, and XGBoost, significantly improved SM estimation accuracy and resolution compared to individual models. The XGBoost and Gradient Boosting meta-models achieved the highest accuracy, with an unbiased root mean square error (ubRMSE) of 1.23% m 3 /m 3 and a coefficient of determination (R 2 ) of 0.97 during testing, demonstrating the exceptional predictive capabilities of our approach. SHapley Additive exPlanations (SHAP) analysis revealed the influence of each base model on the ensemble's predictions, highlighting the synergistic benefits of combining diverse models. This study establishes new benchmarks for soil moisture monitoring by showcasing the potential of ensemble learning to improve the spatial resolution and accuracy of satellite-derived SM data, providing crucial insights for environmental science and agricultural planning, particularly in water-stressed regions., (© 2024. The Author(s).)

Even though many studies have been thus far devoted to landscape services (LS) or vulnerability assessment (VA) alone, the relationship between these two concepts has been less investigated. The current study attempts to model the spatial relationship between LS and VA in the Tarhan area (west of Iran). For this purpose, a combination of the analytic hierarchy process (AHP), remote sensing (RS), and geographic information system (GIS) techniques are applied to assess vulnerability. Variogram models and geostatistical simulations are used for mapping and evaluating landscape services. Moreover, the geographically weighted regression (GWR) is operated to predict the relationship between LS and VA. The results indicate that landform and socioeconomic variables are also two main factors shaping variations in VA. As well, the levels of services provided in the possible landscape are affected by the vulnerability. The assessment accordingly establishes that natural and cultural values have significant effects on services, in terms of their spatial distribution and nature. Exploring the relationship between LS and VA correspondingly depicts that VA has a direct influence on the capacity and entity of LS provision (adjusted R 2  = 0.67). The outcomes of the study provide a foundation for nature management and conservation, although it is less able to analyze the trade-off between ecosystem degradation and future development trends. The nexus of LS and future ecological processes in an integrated system can be thus the subject of further research., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Structure and function are the inherent characteristics of each ecosystem providing various services such as clean air, extreme weather mitigation, and mental and physical well-being. The objective of this study is to develop a unified model combining Integrated Valuation of Ecosystem Services, ecological network (EN), and correlation analysis to investigate changes in ecosystem structure, function, and process. In this context, carbon sequestration, soil reduction, and flood risk mitigation were quantified from 2000 to 2020 and predicted for 2040 using the cellular automata and Markov chain (CA-Markov) model. Finally, correlation analysis was used to analyze the relationship over time between the land use (LU) classes and the components of the forest EN that provide and exchange desired ecosystem services (ESs). Thus, the changes in LU in the region in recent years led to significant reduction of ESs in the region as well as changes in the interaction between services. These changes, on the one hand, reduced the area of cores and increased isolated forest patches and, on the other hand, led to the horizontal expansion of cities and agricultural lands. If this trend continues, the decline in services provided by the ecosystem will persist into the future. Consequently, it can be said that structural changes in the ecosystem can lead to changes in the ESs. Integr Environ Assess Manag 2024;20:1099-1111. © 2023 SETAC., (© 2023 SETAC.)

Background: Acne scar is an inflammatory condition, which commonly occurs in patients with acne vulgaris, especially in adults. Mesogels have been reported effective in improving atrophic acne scars., Aims: We investigated the efficacy of adding Profhilo (a hyaluronic acid-based filler) to subcision as a new treatment method., Methods: Twelve patients aged 18-45 years with atrophic acne scars on both sides of the face participated in this single-blinded, split-face, randomized controlled trial. Each side of the face was randomly assigned to one of the treatment methods, including subcision alone and subcision + Profhilo. Patients in the Profhilo arm received mesogel (1 cc) in addition to the subcision procedure. Both methods were carried out two times at 1-month intervals. Assessments were done based on the sonographic depth of scars, and two blinded observers examined photographs at baseline and 3 months after the final session and the results were reported based on an exclusively made formula as the total score. The Global Improvement Scale and Visual Analogue Scale (VAS) (for patient satisfaction) were also used., Results: The VAS score of patient satisfaction was statistically significant in the Profhilo arm, with a mean improvement of 528.08 and 219.06 in the subcision arm (p = 0.02). No significant difference was seen in total acne scar reduction comparing the two methods (29.74 in the Profhilo arm and 22.27 in the subcision arm, p = 0.56). Sonographic depth reduction was also non-significant, with a mean of 29.21 in the Profhilo arm and 28.53 in the subcision arm (p = 0.4). The mean global improvement was reported as four in both arms, and no statistical significance was observed (p = 0.89). The best response to treatment belonged to the rolling subtype in both methods (p = 0.029 for the Profhilo arm and p = 0.001 for the subcision arm)., Conclusion: Despite no significant difference between the methods, Profhilo is more effective due to a higher satisfaction rate and better physiologic effects., (© 2024 The Authors. Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.)

Background: Botulinum toxin type A is a widely used treatment of facial wrinkles. The objective of this study was to compare the efficacy and safety of a new botulinum toxin type A (Masport [abobotulinum toxin A], MasoonDarou Co) with DYSPORT ® for the treatment of glabellar lines., Methods: 262 subjects with moderate-to-severe glabellar lines received either a fixed dose of 50 units of MASPORT ® or DYSPORT ® (Ipsen Company, England). Subjects were followed up at 14, 30, 60, 90 and 120 days after injection. Efficacy was assessed by investigator at maximum frown and rest and also by Subject Global Assessment of Change (SGA). The responders were defined as persons with +2 grade improvement from baseline for both investigator and patient assessment. The occurrence and duration of adverse effects were recorded up throughout the study., Results: According to the investigator evaluations, the responder rate at maximum frown were 94.5% for MASPORT and 95.6% for DYSPORT group on day 30 and at rest were 85.45% and 85.68% for MASPORT and DYSPORT group, respectively. According to the subject self-assessment, the proportion of responders in MASPORT group at day 30 was 95.28% versus 97.04% for DYSPORT group. No serious drug related adverse effect was recorded in either study groups, and the rates of adverse effects were similar for both groups., Conclusion: Abobotulinum toxin A [MASPORT] is equally safe and effective as commercial product [DYSPORT] for the treatment of glabellar lines with the dose of 50 units, up to 120 days., Level of Evidence I: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 ., (© 2024. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery.)

Background: The advanced glycation end product (AGE) is produced from the nonenzymatic reaction between glucose and macromolecules by aging. Accumulation of AGE causes functional and structural changes in body proteins that lead to impairment of tissue protein functions. We aimed to validate AGE measurement by skin autofluorescence (SAF) in diabetes mellitus (DM) compared to the nondiabetes population., Materials and Methods: We searched the PubMed, Cochrane, and Scopus databases from their inception till September 18, 2022, for casecontrol studies measuring AGE by SAF. Nonhuman studies, as well as review articles, study proposals, editorials, case reports, or congress posters, were excluded. We used a random effects model to assess the standard mean difference (MD) of age, body mass index (BMI), HbA1c, and SAF between diabetes and nondiabetes individuals., Results: Higher SAF in DM patients indicated more accumulation of AGE compared with the nondiabetic population. Furthermore, HbA1c was considerably higher in DM patients. The MD of age, male gender, and BMI were significantly different between the DM individuals, compared with nondiabetic subjects, which can lead to altered SAF level and AGE production. There was a remarkable heterogeneity between diabetes and nondiabetes when measuring age, gender, and BMI, as well as HbA1c and SAF level., Conclusion: This study could not confirm the validity of SAF as a surrogate marker in diabetes patients. Interestingly, metabolic load and high BMI can increase SAF, considerably. Altogether, SAF could be helpful in the future as a marker for metabolic syndrome or diabetes., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Research in Medical Sciences.)

Background: Knowledge of normal facial vascular variations could prevent catastrophic complications of cosmetic procedures as well as providing a guide for surgical planning. Color Doppler ultrasound is a safe and noninvasive method for real time vascular evaluation., Objective: The aim of this study was to evaluate the normal variations of the facial, angular, transverse facial, supratrochlear and supraorbital arteries in a sample of normal individuals., Methods: Normal individuals referred for dermal filler injection to the tertiary dermatologic center, were selected. Patients who were smoker or had a history of facial filler injection, facial surgery, or trauma were excluded from the study. Facial artery at three levels as well as angular, supratrochlear, supraorbital, and transverse facial arteries were evaluated by an 18 MHz ultrasound linear probe regarding their distance from facial reference lines and landmarks, and also their depths in various regions of face., Results: A total number of 43 individuals were evaluated in this study. Thirty-one (72.1%) were women. The number of absent facial artery was zero in level one, three (3.48%) in level two, and nine (10.46%) in level three. The angular artery was absent in 10 (11.62%) participants. The transverse facial artery was absent in 27 (31.39%) assessed individuals. Distance from reference lines at level 2 and 3 of facial artery and its depth at level 2 were significantly different between left and right side (p-values: <0.001, 0.01, and 0.03, respectively). No significant difference was seen between depth and distance of two sides for angular and transverse facial arteries. The comparison of the depths and distances from the reference lines of the assessed arteries between two sexes revealed only a significantly greater value of facial artery distance in level 1 in males (p-value: 0.001). BMI was also significantly correlated with the depth of facial artery in level 2 (Pearson correlation coefficient = 0.471, p-value = 0.002) and level 3 (Pearson correlation coefficient = 0.357, p-value = 0.03) and the distance of the facial artery in level 1 (Pearson correlation coefficient = 0.333, p-value = 0.029)., Conclusions: Color Doppler ultrasound could be used to map the arteries of face to prevent vascular complications and safely guide cosmetic procedures., (© 2023 The Authors. Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.)

Background: Striae gravidarum (SG) is a common pregnancy-related dermatologic problem, for which finding an effective treatment remains a challenge., Aim: To evaluate the safety and efficacy of 1540 nm non-ablative fractional laser (Star lux 500) in the treatment of SG in Iranian women and peruse the relationship between clinical improvement rate and patient characteristics as well as clinical features of striae., Method: A prospective before-after study was conducted on 50 patients with SG who received three monthly sessions of 1540 nm non-ablative fractional laser and were followed for 2 months after the last treatment session. Clinical changes were measured using both provider-rated outcome through before/after pictures represented by final clinical score (from 0 to 5) and patient-reported outcome (patient global assessment or PGA)., Results: Over the course of the study both final clinical score and PGA increased significantly from week 4 to week 20 ( P value: <0.001 and 0.048, respectively). Only modest adverse effects including erythema, edema and hyperpigmentation were noted., Conclusion: In conclusion, patients with SG of different type (rubra/alba) or maturity may somehow benefit from treatment with NAFL experiencing minimal transient side effects.Therefore, NAFL may be considered a safe and partially effective treatment option for stretch mark of patients with SG.

One of the greatest environmental risks in the cement industry is particulate matter emission (i.e., PM 2.5 and PM 10 ). This paper aims to develop descriptive-analytical solutions for increasing the accuracy of predicting particulate matter emissions using resample data of Kerman cement plant. Photometer instruments DUST TRAK and BS-EN-12341 method were used to determine concentration of PM 2.5 and PM 10 . Sampling was performed on 4 environmental stations of Kerman cement plant in the four seasons. In order to accurate assessment of particulate matter concentration, a new model was proposed to resample cement plant time series data using Pandas in Python. The effect of meteorological parameters including wind speed, relative humidity, air temperature and rainfall on the particulate matter concentration was investigated through statistical analysis. The results indicated that the maximum annual average of 24-h of PM 2.5 belonged to the east side (opposite the clinker depot) in 2019 (31.50 μg m -3 ) and west side (in front of the mine) in 2020 (31.00 μg m -3 ). Also, maximum annual average of 24-h of PM 10 belonged to the west side (in front of the mine) in 2020 (121.00 μg m -3 ) and east side (opposite the clinker depot) in 2020 (120.75 μg m -3 ). The PM 2.5 and PM 10 concentrations are more than the allowable limit. The results demonstrate that particulate matter concentration increases with increasing relative humidity and rainfall. Finally, the SARIMA model was used to predict the particulate matter concentration., Supplementary Information: The online version contains supplementary material available at 10.1007/s13762-022-04645-3., Competing Interests: Conflict of interestThe authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© The Author(s) under exclusive licence to Iranian Society of Environmentalists (IRSEN) and Science and Research Branch, Islamic Azad University 2022, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

In this study, the distribution and alterations of ozone concentrations in Tehran, Iran, in 2021 were investigated. The impacts of precursors (i.e., CO, NO 2 , and NO) on ozone were examined using the data collected over 12 months (i.e., January 2021 to December 2021) from 21 stations of the Air Quality Control Company (AQCC). The results of monthly heat mapping of tropospheric ozone concentrations indicated the lowest value in December and the highest value in July. The lowest and highest seasonal concentrations were in winter and summer, respectively. Moreover, there was a negative correlation between ozone and its precursors. The Inverse Distance Weighting (IDW) method was then implemented to obtain air pollution zoning maps. Then, ozone concentration modeled by the IDW method was compared with the average monthly change of total column density of ozone derived from Sentinel-5 satellite data in the Google Earth Engine (GEE) cloud platform. A good agreement was discovered despite the harsh circumstances that both ground-based and satellite measurements were subjected to. The results obtained from both datasets showed that the west of the city of Tehran had the highest averaged O 3 concentration. In this study, the status of the concentration of ozone precursors and tropospheric ozone in 2022 was also predicted. For this purpose, the Box-Jenkins Seasonal Autoregressive Integrated Moving Average (SARIMA) approach was implemented to predict the monthly air quality parameters. Overall, it was observed that the SARIMA approach was an efficient tool for forecasting air quality. Finally, the results showed that the trends of ozone obtained from terrestrial and satellite observations throughout 2021 were slightly different due to the contribution of the tropospheric ozone precursor concentration and meteorology conditions., Competing Interests: Competing InterestsThe authors declare no competing interests., (© The Author(s), under exclusive licence to Springer Nature Switzerland AG 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Introduction: Hirsutism, mainly due to polycystic ovary syndrome (PCOS), causes stress, anxiety, and depression in females. Laser-assisted hair removal (LAHR) is currently accepted as a good treatment option for hirsutism. The goal of the current study was to ascertain how LAHR affected the degree of hirsutism, quality of life, and depression in hirsute females. Methods: A single-arm before/after clinical trial was designed and performed in the Razi hospital Laser Clinic over a 15-month period. All hirsute females visiting the Razi hospital laser clinic were enrolled and received three sessions of LAHR every 4-6 weeks if they were interested and signed an informed consent form. Before the commencement of LAHR and six to eight weeks after the last session, the Ferriman-Gallwey score (hirsutism severity), Beck score (depression index) and DLQI score (quality of life index) were calculated and stored. Results: There were 80 subjects in all. The mean ± SD of the Ferriman-Gallwey score was reduced from 7.05 ± 2.27 to 4.91 ± 2.41, P  < 0.001. The mean ± SD of the Beck depression score was reduced from 13.3 ± 8.7 to 10.2 ± 8.4, P  < 0.001, and the mean ± SD of the DLQI score decreased from 5.6 ± 5.2 to 3.5 ± 2.3, P  < 0.001. No significant complications were reported. Conclusion: LAHR can improve hirsutism-related depression and degradation of quality of life, as well as hirsutism physical signs., Competing Interests: The authors declare that they have no conflict of interest., (Copyright © 2022 J Lasers Med Sci.)

Air pollution and its effects on human health and the environment are one of the main concerns in urban areas. This study focuses on the distribution and changes in the concentrations of ozone and its precursors (i.e., NO, NO 2 and CO) in Tehran for the 20-year period from 2001 to 2020. The effects of precursors and meteorological conditions (temperature, wind speed, dew point, humidity and rainfall) on ozone were investigated using data from 22 stations of the Air Quality Control Company (AQCC) and meteorological stations. Regression models were applied to evaluate the dependence of ozone concentration on its precursors and meteorological parameters based on monthly average values. Finally, the monthly and annual levels of surface ozone and total column ozone were compared during the study period. The results show that the average ozone concentration in Tehran varied substantially between 2001 and 2008, and decreased after 2008 when stringent air quality control measures were implemented. The highest average concentration of ozone occurred in the southwest of Tehran. Although mobile and resident sources play an important role in the release of precursors, the results also indicate a significant effect of meteorological conditions on the changes in ozone concentration. This study is an effective step toward a better understanding of ozone changes in Tehran under the changing influence of precursors and meteorological conditions., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V.)

Background and Objective: Sunlight exposure, the main source of endogenous vitamin D synthesis, may increase the risk of non-melanoma skin cancers (NMSC) development. Vitamin D receptor (VDR) polymorphisms are associated with various malignancies. This study aimed to examine the associations between vitamin D status and VDR FokI polymorphisms in Iranian subjects with NMSC., Materials and Methods: This case-control study included 73 diagnosed cases of NMSC and 72 healthy controls from dermatology clinics at Razi Hospital, Tehran, Iran. A questionnaire was used to assess sunlight exposure. The extracted DNA from whole blood samples was genotyped and serum concentrations of 25-hydroxycalciferol (25(OH)D)) and intact parathyroid hormone (iPTH) were measured., Results: We found a significant higher duration of cumulative sunlight exposure in cases compared with controls (p<0.001). However, 25(OH)D and iPTH concentrations were not significantly different between cases and controls (30±15 vs. 29±15 ng/mL, p=0.78 and 46.0±20 vs. 40.5±23 pg/mL, p=0.14, respectively). We did not observe any significant increased risk of NMSC due to f allele, as compared with FF (OR =2.33, 95% CI 0.81-6.75, p=0.12)., Conclusion: Though sunlight exposure was associated with increased NMSC risk, there were no significant associations between vitamin D status or VDR FokI polymorphisms with NMSC development in our subjects.

Background: Psoriasis is a common chronic dermatosis that can negatively affect patients' lives., Aim: To obtain more insight about how having psoriasis and how the various clinical and physical characteristics of the disease impact the health-related quality of life (HRQoL) of pediatric patients., Methods: A retrospective cross-sectional study was designed with 40 pediatric patients with psoriasis. HRQoL was evaluated using the Children Dermatology Life Quality Index (CDLQI)., Results: A total of 40 patients enrolled in this study. The mean age of participants was 12.42 ± 7.1 years (age range: 4-16 years), 21 males (52.5%), and 19 females (47.5%). The mean Psoriasis Area Severity Index (PASI) score was 8.03 ± 9.31 with a range of 0.4-25. Mean CDLQI score was 18.87 ± 8.15, indicating a considerable burden on health-related QoL. There was a strong positive correlation between CDLQI and PASI scores (p < .001, r: .653)., Conclusion: The negative effect of psoriasis on HRQoL in pediatrics was confirmed, and a strong correlation between disease severity scores and HRQoL in children with psoriasis was found in this study. Taking HRQoL indices into account while managing adolescent patients will improve our insight into the patient's experience and may provide better patient adherence to treatment., (© 2022 Wiley Periodicals LLC.)

Rituximab is widely used as the first-line treatment for pemphigus patients. Since it depletes the B cells, it increases the risk of infections. Here, we evaluated the prophylactic efficacy of cotrimoxazole in decreasing the risk of pneumocystis pneumonia (PCP) infection in the pemphigus patients treated with rituximab. The medical records of confirmed pemphigus patients receiving rituximab were evaluated in two groups; those who received cotrimoxazole as a prophylactic after rituximab and patients who only received rituximab without any prophylaxis. The occurrence of PCP infection was determined in each group and compared. Medical records of 494 patients, including 301 women and 193 men, with the mean age of 46.74 years were analyzed. The phenotypes of the disease were mucocutaneous (n = 364), mucosal (n = 88), and cutaneous (n = 42). Among them, 235 cases had received cotrimoxazole as a prophylaxis and 259 patients did not. The incidence of PCP in total patients was 2 (0.4%), one in each group. Accordingly, no significant difference was observed in the incidence of PCP between two groups (p = 0.84). Also, no cotrimoxazole-related side effect was observed in the treated group. It seems that due to the low incidence of PCP in pemphigus patients treated with rituximab, prophylactic cotrimoxazole therapy is not necessary and it only increases the overall therapy cost and might cause cotrimoxazole-related adverse effects in some patients. However, regarding its probable beneficial effect in patients with long-term history of immunosuppressive therapy, more studies are required., (© 2021 Wiley Periodicals LLC.)

The associations between components of metabolic syndrome (MetS), insulin resistance (IR), and several malignancies have been reported. However, the possible link between IR and dermal malignancies, including non-melanoma skin cancers (NMSCs), has not been investigated to date. In this study, we aimed to examine the possible association between components of MetS, IR, adhesion molecules, and NMSC for the first time. This was a case-control study comprising 73 confirmed cases of NMSC and 72 unrelated healthy controls. Anthropometric and biochemical assessments including fasting blood lipid profile, glucose and insulin assays were performed. To evaluate IR, HOMA-IR formula was used. Though fasting serum glucose showed no significant between-group difference, serum concentrations of insulin ( p  = 0.048) as well as HOMA-IR ( p  = 0.037) were both significantly higher in NMSC group than in controls. Logistic regression analysis revealed significant associations between waist circumference (OR: 1.04, 95% CI: 1.007-1.080, p  = 0.018), percent of visceral fat (OR: 1.10, 95% CI: 1.024-1.190, p  = 0.01), HOMA-IR (OR: 1.169, 95% CI: 1.004-1.360, p  = 0.044), circulating VCAM-1 concentrations (OR: 1.005, 95% CI: 1.003-1.007, p  < 0.001) and NMSC risk. Interestingly, the occurrence of MetS was significantly higher in subjects with NMSC than in healthy controls ( p  = 0.038). MetS and its components were associated with increased NMSC risk.

This paper presents a time-series analysis of SO 2 air concentration and the effects of particulates (either PM 2.5 and PM 10 ) concentrations and meteorological conditions (relative humidity and wind speed) on SO 2 trend in Tehran for the period from 2011 to 2020. The source data were obtained from 21 monitoring stations of Air Quality Control Company and meteorological stations in Tehran. To predict the status of future concentration of SO 2 , PM 2.5 and PM 10 , a Box-Jenkins ARIMA approach was used to model the monthly time series. Considering the whole period of ten years, a somewhat downward trend was noted for SO 2 air concentration, even though a slight rising trend was observed in 2020 year. Monthly sulfur dioxide concentrations showed the lowest value in June and the highest value in January. Seasonal concentrations were lowest in spring and highest in winter. Then, in the ArcGIS software, the IDW method was used to obtain air pollution zoning maps. As a result, the highest average concentration of SO 2 occurred in the north and southwest of Tehran. In the last step, Relations between the SO 2 concentration and particulate matters and relative humidity and wind speed were calculated statistically using the daily average data. We finally concluded that the combined effect of particulate matters and relative humidity with the increasing role of Sulfur dioxide overcomes the decreasing role of wind speed. This study can contribute to a better understanding of the SO 2 air pollution in Tehran affected by meteorological conditions and the rapid urbanization and industrialization, followed by the possible combustion of fuel oil in power plants and health problems., Competing Interests: Conflict of interestThe authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2022.)

Background: Advanced glycation end products (AGE), one of the main factors causing diabetic end-organ damage, accumulate in long half-life proteins, such as skin and cartilage collagen. AGE measurement may offer additional evidence to predict diabetic vascular complications. Skin autofluorescence (SAF) is suggested as a non-invasive, quick, and reliable method to measure tissue AGE level. The aim of this study was to review and evaluate evidence on the clinical validation of SAF measurement in diabetes mellitus (DM) patients., Methods: In this systematic review and meta-analysis, we searched "PubMed" (MEDLINE) and "Cochrane" databases from their inception to 10 August 2021 for observational studies concerning SAF measurement in diabetic patients. The following key terms were used in advanced searching: "Diabetes", "Diabetes Mellitus"," DM", "Glycation ", "Advanced Glycation End product", "AGE", "skin autofluorescence", "SAF". Published studies that included DM patients and estimated their AGE using SAF were considered eligible for meta-analysis. Articles that were editorials, study proposals, congress posters, or case reports and were not on human subjects were excluded. We used a random-effect models for meta-analyzing the clinical validation of SAF in DM with particular emphasis on chronic diabetes complications., Findings: We identified 881 records and twenty-nine records fulfilled our eligibility criteria and were included in the systematic review and meta-analysis. A statistically significant correlation was found between SAF and diabetes last HbA1c 0.21(0.13,0.28) in studies with substantial heterogeneity (I 2 =77.99%, p<0.05). Nevertheless, a significant positive association between SAF level and diabetic retinopathy (DR) [(OR= 1.05, 95% CI=1.03,1.08), (I 2 =63.78%, p<0.05)], diabetic peripheral neuropathy (DPN) [(OR= 1.11, 95%CI= 1.06,1.16), (I 2 =79.17%, p<0.05)], diabetic nephropathy (DNP) [(OR= 1.08, 95%CI: 1.05,1.11), (I 2 =65.36%, p<0.05)] and diabetic macrovascular events (D-MVE) [(OR=1.08, 95%CI=1.05,1.11) (I 2 =67.32, p<0.05)] were found., Interpretation: Our study confirmed the significance of SAF measurement as a non-invasive surrogate marker of DM micro and macrovascular complications. Skin AGE estimation may be a useful factor for the prediction and early detection of irreversible DM complications. More studies with larger populations and longer follow-up periods are required., Competing Interests: None., (© 2021 The Authors.)

Introduction: Laser-assisted hair removal is widely used by a large number of patients complaining of unwanted hair. However, little is known about the effect of varying the pulse duration on clinical results and side effects. This study aimed to investigate the effectiveness of hair removal using an alexandrite laser with different pulse durations. Methods: Fifty female patients with facial hirsutism were subjected to a hair removal procedure with an alexandrite laser, using 3 and 10 milliseconds pulse durations on each side of the face every 5 weeks for three sessions. Photographs were taken and hair counts were checked before the treatment and one month postoperatively. Results: one month after the laser treatment, the clearance rate was 56% with both 3 and 10 milliseconds pulse durations. There was not any significant difference in clinical efficacy or the side effect profile. Conclusion: Using a 755 nm alexandrite laser for hair removal is an effective and safe method for delaying hair regrowth and this delay is not markedly different by increasing the pulse duration from 3 to 10 milliseconds., (Copyright © 2021 J Lasers Med Sci.)

This study investigates the changes of short-lived climate pollutants and other air pollutants during the COVID-19 pandemic in Tehran, Iran. Concentrations of air pollutants were obtained from 21 monitoring stations for the period from 5 January 2019 to 5 August 2019, representing normal conditions unaffected by COVID-19, and the period 5 January 2020 to 5 August 2020, i.e., during the COVID-19 crisis. We concentrated our analysis on three time windows (23 February 2020 to 15 March 2020, 18 March 2020 to 3 April 2020, and 5 April 2020 to 17 April 2020) during the lockdown when different sets of measures were taken to limit the spread of COVID-19. In comparison to the period not affected by COVID-19 measures, mean concentrations of pollutants were increased during the first lockdown period; when the number of COVID-19 patients increased sharply compared to the other periods, the mean surface concentrations of NO 2 , SO 2 , and CO were decreased and concentrations of other pollutants (i.e., O 3 , PM 10 , and PM 2.5 ) were increased during the second lockdown period compared to the corresponding period in 2019. In the third period, the mean concentrations were decreased compared to the corresponding period in 2019. For the full period, decreases in mean concentrations of O 3 , NO 2 , SO 2 , CO, and PM 10 and increases in PM 2.5 were observed during the COVID-19 crisis, compared to 2019. Overall, the strongest reductions, 12% and 6%, respectively, were observed for CO and NO 2 , pointing to reduced emissions from traffic as a result of lockdown measures. The concentrations of other pollutants changed little, suggesting that the lockdown measures did not result in strong changes in the emissions from stationary sources.

Background: Although pulsed-dye laser (PDL) 595 nm is known as the gold standard for treatment of port-wine stains (PWS), complete clearance of lesions occurs in a minority of cases., Objective: To compare the efficacy and safety of double-pass pulsed-dye laser (DPL), long pulse duration (20 m/s) followed by short pulse duration (1.5 m/s) within 20 minutes interval, with single-pass pulsed-dye laser (SPL) for (1.5 m/s) in the treatment of PWS., Methods: Twenty-four patients with PWS underwent 3 sessions of PDL. Each lesion was randomly divided into 2 portions to receive DPL or SPL. Colorimetric and dermoscopic evaluations were used to determine the response objectively. In addition, improvement was scored subjectively using the visual analog scale (VAS)., Results: According to colorimetric analysis, the mean blanching rates for DPL and SPL treated sites were 48% (SD = 0.215) and 37% (SD = 0.213), respectively (p = .001). With VAS, 3.79 (SD = 0.93) and 3.33 (SD = 0.91) improvement scores were reported in the DPL and SPL treated areas, respectively (p = .008). Dermoscopic images showed that larger deep vessels were the most common remnant vessels in both treatment areas., Conclusion: Compared with SPL, DPL with 20 minutes interval seems to be a more effective and safe method for the treatment of PWS., (Copyright © 2020 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Rapid diagnosis of pemphigus vulgaris (PV) is an important task in patient's prognosis and treatment. Although PV is routinely diagnosed through investigation of pathology specimens and direct immunofluorescence assays, Tzanck smear can be used as rapid, inexpensive, and easily used test to confirm its clinical diagnosis. This study aimed to determine the diagnostic value of Tzanck smear in erosive oral lesions of PV and also determine its sensitivity and specificity for diagnostic purposes. A total of 68 patients with erosive/ulcerated oral lesions were included in this study and divided into PV (case group) vs other causes of erosive oral lesions (control group). From all participants, two Tzanck smears were prepared for both Giemsa and hematoxylin-eosin (H&E) staining. For definite diagnosis, histopathology and direct immunofluorescence evaluations were performed based on clinical findings. The sensitivity of acantholytic cells in Tzanck smear of erosive oral lesions of PV cases was 80.5% (for both Giemsa and H&E staining), whereas specificity values of Giemsa and H&E staining were 84.6% and 96.3%, respectively. Based on our findings, the Tzanck smear of erosive oral lesions is a simple, quick, and inexpensive test for screening and primary diagnosis of PV., (© 2020 Wiley Periodicals LLC.)

Objective: To evaluate the safety and efficacy of a new topical skin ointment with natural ingredients (aloe vera, honey, and peppermint) for dressing skin graft donor sites., Design: A double-blind, placebo-controlled, randomized clinical trial., Patients and Intervention: Researchers enrolled patients who were referred for split-thickness skin graft after burns or surgical wounds on the scalp or face area. For each patient, a thin layer of skin (depth, 0.04 mm; approximate size, less than 15 × 7 cm) was harvested from the thigh by a plastic surgeon with an electric or manual dermatome. The donor sites were divided and randomized to receive either natural ointment or petroleum jelly as a topical agent to dressing. Topical agents were applied on donor site wounds on days 0, 4, 7, and 14., Main Outcome Measures: Wound size, pain, erythema, pruritus, patient discomfort, complications, and physician satisfaction were evaluated at each visit., Main Results: Among 28 patients, there was no significant difference between the two treatment agents regarding the rate of wound healing (P = .415), pain (P = .081), pruritus (P = .527), and patient discomfort (P = .616). The ointment was superior to petroleum jelly in reducing wound erythema (P = .001) and was associated with significantly better treatment satisfaction (P < .001)., Conclusions: The natural topical ointment investigated in this study may be an acceptable alternative to petroleum jelly in caring for split-thickness donor skin graft donor site wounds to effectively promote wound healing, prevent infection and scarring, reduce pain, and comfort the patient.

Scleromyxedema is an uncommon disease, affecting the skin mainly and other internal organs sometimes, characterized by fibroblasts proliferation, fibrosis, and mucous deposition in the absence of thyroid disorder. It is associated with monoclonal gammopathy in most cases. We are reporting a case with a rare presentation of tumoral scleromyxedema in the neck, with a mass mimicking other tumoral lesions, highlighting the importance of diagnosis and histopathologic correlation., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Indian Journal of Dermatology.)

Competing Interests: Competing interests: The authors have no conflicts of interest to disclose.

Background: Efinaconazole is non-lacquer-based with a low surface tension that efficiently targets delivery of active ingredient into the nail and nail bed., Objectives: To develop an optimal, stable formulation of efinaconazole topical solution 10% (ETS10)., Methods: We evaluated the safety and efficacy of ETS10 on 10 Iranian participants in a pilot, single-group and before-after clinical study, for up to 8 weeks in onychomycosis., Results: The study showed reasonable results concerning the short period of treatment. During the period of storage, the formulation showed no variation in colour, odour and pH. The average pH at initial, 1st, 6th and 12th months was 4.65, 4.64, 4.65 and 4.64, respectively. The assay of an active pharmaceutical ingredient in the formulation was desired over the whole period. This indicates that antimicrobial activity has been adequate and efficient. A significant decrease in Investigator Global Assessment (IGA) of the target toenails was also defined as the efficacy endpoint. The median score for IGA at baseline visit was 3 out of 5 which decreased to 2 out of 5 and the decrease was statistically significant., Conclusion: The study clarifies the new efficacy of ETS10 in subjects with onychomycosis and passed the safety study successfully. These properties may develop the potentiality of ETS10 as a good treatment option for patients with onychomycosis., (© 2020 Blackwell Verlag GmbH.)

Background: Bullous pemphigoid (BP) is an autoimmune subepidermal blistering disease associated with immune response against BP-180 and BP-230. Peripheral blood eosinophilia and dermal infiltration of eosinophils are common findings in BP., Objective: The aim of our study was to demonstrate a statistical correlation between dermal and peripheral blood eosinophilia, anti BP-180, and anti BP-230 IgG and clinical severity of BP., Methods: A total of 27 patients with newly diagnosed BP were included. Severity of disease was assessed according to the bullous pemphigoid disease activity index (BPDAI). Anti-BP-180 and anti-BP-230 titers, peripheral blood eosinophilia, and dermal eosinophil infiltration and tissue inflammation severity were assessed for each patient., Results: A significant correlation was found between the serum levels of anti-BP-180 and anti-BP-230, and dermal eosinophilia and tissue inflammation severity with objective and subjective BPDAI scores. In addition, there was a significant correlation between the percentage of peripheral blood eosinophils and subjective BPDAI scores and urticarial/eczematous lesions. Moreover, the mucosal component did not show any correlation with autoantibody levels and inflammation severities., Conclusion: Anti-BP-180 and anti-BP-230 levels, tissue inflammation severity, and dermal eosinophilia had a strong and significant correlation with BP severity. In addition, percentage of peripheral blood eosinophilia showed a correlation with subjective BPDAI scores., (© 2020 Published by Elsevier Inc. on behalf of Women's Dermatologic Society.)

Mycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma (CTCL). It may arise rapidly in a scar or keloid, presumably due to a long-standing proliferative state or autoimmune theory. There should be a low threshold for performing a skin biopsy if unusual lesions develop at those sites., Competing Interests: None declared., (© 2020 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.)

Nowadays lip augmentation with FDA-approved fillers is becoming popular. However, because of financial concerns many patients seek for unregistered materials. Here, we report two cases who use vitamin E for lip augmentation. They experience severe infiltration and discharge less than one month after injection. Biopsy revealed lipogranuloma formation. They were treated with incision and drainage, antibiotic, and corticosteroids. Although these complications are usually difficult to treat, the patients had good clinical response and no recurrence in 5-month follow-up., (© 2019 Wiley Periodicals, Inc.)

Background: The relationship between vitamin D and skin squamous cell carcinoma (SCC) is not well defined., Objective: To investigate the relationship between vitamin D levels and the incidence of skin SCC for the first time in Iran., Methods and Study Design: In this case-control study, 126 subjects were enrolled (63 in each group) out of referents to Razi Skin Hospital in Tehran in 2014. The risk factors for cancer gathered by self-reported questionnaires and blood samples were obtained to measure the level of 25-hydroxyvitamin D. Multivariate logistic regression was used to neutralize the effect of confounding factors., Results: Cases of SCC were more likely to be in men, older than 49 years and working in an outdoor environment, and with longtime exposure to sunlight and a personal history of skin cancers. Family history of skin cancer and of cigarette smoking were not significantly related to SCC. In the SCC and control groups, 69.8% and 31.7%, respectively, had sufficient levels of vitamin D (P < 0.001). Mean level of 25-hydroxyvitamin D was 40.99 ng/mL in the SCC group and 26.34 ng/mL in the control group (P < 0.05). In the unadjusted model, the level of vitamin D as a continuous variable was positively related to SCC risk. In the adjusted model, vitamin D did not independently predict the likelihood of SCC., Conclusion: Vitamin D level and SCC risk are directly related, although not in an independent fashion. Indeed, this relation is severely confounded by exposure to sunlight, which was evidenced by an increased vitamin D level in the people working outside and the higher prevalence of SCC in the same population., Competing Interests: Competing interests: The authors have no conflicts of interest to disclose., (Copyright: ©2019 Hosseini et al.)