Search

Background: Periorbital hyperpigmentation (POH) is a common cosmetic problem with a negative impact on the patient's self‐confidence, leading to a decrease in the quality of life. Current treatments include topical agents and mesotherapy, but research remains limited. Aims: Due to the undesirable effect of the available treatments, the present study was designed to compare the effectiveness of platelet‐rich plasma (PRP) injection and intradermal injection of tranexamic acid plus vitamin C mesotherapy as a therapeutic method to treat POH. Methods: Patients received an intradermal injection of PRP randomly on one side and an intradermal injection of tranexamic acid + vitamin C on the other side of their face, for three sessions with an interval of 3 weeks. Digital photography was taken, and data were assessed based on physician global assessment (PGA) and patient satisfaction. Results: Eighteen patients were studied. Among all, 12 patients had a positive family history, 2 had asthma, and 4 had a history of atopic dermatitis. Even though patient satisfaction was higher in the PRP group than in mesotherapy, it was not statistically significant. Both groups showed similar rates of improvement. However, improvement rates did not significantly differ based on various factors including gender, skin type, family history, or medical history. Age and the age of disease onset also did not significantly affect the improvement rates. Conclusion: Both methods revealed successful results in the reduction of POH. Comparing the efficacy of these two methods showed that both treatments had similar improvements. [ABSTRACT FROM AUTHOR]

Eccrine poroma (EP) is an uncommon benign tumor of intra-epidermal portion of sweat ducts, usually affecting palmoplantar area in middle-aged patients. In this report, we describe the case of a 66-year-old man with an asymptomatic, rapidly growing, pedunculated nodule on his neck. The lesion was removed by simple excision. Histopathologic studies confirmed eccrine poroma as final diagnosis. No sign of recurrence was seen during 6 months of follow-up. Pedunculated presentation, rapid growth and the site of the lesion in our case is rare. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the in vitro and in silico antileishmanial activity of azacitidine (AZA) on Leishmania major promastigotes and amastigotes. The in silico method was used to evaluate the possibility of the interaction of AZA into the binding pocket of inducible nitric oxide synthase (iNOS), a leading defensive oxidative metabolite. Following that, in vitro anti-promastigote, and anti-amastigote activity of AZA was determined using an MTT assay and a macrophage model, respectively. Cytotoxic effects of AZA and meglumine antimoniate (MA) were also assessed by MTT assay on murine macrophages. All experiments were performed in triplicate. The results showed that AZA interacted with Ser133, Gln134, and Lys13 amino acids of iNOS, and the molecular docking score was obtained at -241.053 kcal/mol. AZA in combination with MA significantly (P<0.001) inhibited the growth rate of nonclinical promastigote (IC50 247.6±7.3 μM) and 8.5-fold higher of clinical intramacrophage amastigote stage (29.8±5.3 μM), compared to the untreated group. A significant upsurge of Th1 subsets and transcription genes and a meaningful decline in Th2 cytokines subclasses at the equivalent concentrations of AZA and MA was observed (P<0.001). The apoptosis effect of AZA along with MA was significantly induced on L. major in a dose-dependent manner (P<0.001). The present study demonstrated that AZA possesses antileishmanial activity in in vitro and in silico models. However, AZA combined with MA was more effective than AZA alone in inhibiting the growth rate of promastigotes and amastigotes of L. major. This study indicates that AZA in combination with MA demonstrated a potent antileishmanial mechanism, promoting immune response and enhancing an immunomodulatory role toward the Th1 pathway. This experimental study is a basic study for applying more knowledge about the mechanisms of AZA along with MA in animal models in the future. [ABSTRACT FROM AUTHOR]

Background Autoimmune bullous diseases (AIBDs) are a group of chronic blistering diseases that affect mucocutaneous membranes. These diseases are common worldwide and affect males and females of all races. Treatment options include corticosteroids, rituximab, and topical agents. We evaluated the epidemiology of AIBD in Kerman, Iran, over a five-year period. Methods This retrospective study was conducted on 100 patients diagnosed with an AIBD between 2015-2020. All patients were included in this study by census method. Factors like age, sex, disease type, and age at diagnosis were evaluated. Data analyses were performed using SPSS version 26. Results One hundred patients participated in this study, and the male-to-female ratio was 1:1.08. The mean age of participants was 51.99±19.52 years, and the mean age at diagnosis was 49.19±8.31. Out of 100 patients, 82 suffered from pemphigus disease (70 pemphigus vulgaris; 12 pemphigus foliaceus), 17 had bullous pemphigoid, and one patient had pemphigus gestationis. Conclusion In many countries, pemphigus is the most common AIBD. Although AIBDs are uncommon, the diagnosed cases increase with age. [ABSTRACT FROM AUTHOR]

Acne scars have negative profound impact on the quality of life of patients. Treatment of acne scars should be customized based upon characteristics of the scar, skin type, patient's preferences, and physician's experience. In this article, we comprehensively review the existing evidence for employing soft tissue augmentation in acne scars treatment. We searched PubMed, Medline, Scopus, Embase, Google scholar and Science Direct for articles that evaluated the efficacy of soft tissue augmentation via injection method for the treatment of atrophic acne scars from January 2000 until June 2021. Thirty articles were selected for final evaluation. The materials that were used for soft tissue augmentation in treatment of acne scars included hyaluronic acid-based fillers, autologous fat, polymethylmethacrylate microspheres plus bovine collagen, calcium hydroxylapatite, plasma gel, poly-L-lactic acid, collagen and silicone. Adjuvant treatments included microneedling, high-frequency ultrasound, microfocused ultrasound with visualization, radiofrequency, fractional carbon dioxide laser, erbium-doped yttrium aluminum garnet, fractional Er: glass, subcision and platelet rich plasma. Currently, soft tissue augmentation has gained popularity in treatment of acne scars. Soft tissue augmentation is a minimally invasive procedure that can provide both immediate and gradual improvement and is effective in the treatment of rolling and boxcar scars, while its efficacy is limited in icepick scars. Ideal filler in treatment of atrophic acne scars should have long-lasting effects with minimal side effects or serious complications such as nodule formation and immune system activation. [ABSTRACT FROM AUTHOR]

Background Recognition of parameters to predict severity of drug eruptions can be helpful in early intervention in severe cases. In this study, we evaluate the role of hematological factors including neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte (PLR) ratio in prediction of severity in cutaneous drug reactions. Methods This is a retrospective cross-sectional study on 46 hospitalized patients with drug eruptions and 46 healthy individuals as control group. NLR/PLR was compared between patients with drug eruptions and healthy control group by independent t test. Moreover, the values of these hematological markers were compared between serious and non-serious types of drug eruptions by independent t test. Results Serious drug eruptions constitute nearly one-fourth of total drug eruptions. The mean values of NLR in case and control groups were 3.91±2.87 and 2.30±1.62, respectively (P=0.001). The mean values of PLR in case and control groups were 155.35±90.60 and 125±45.64, respectively (P=0.045). Females with drug eruptions had significantly higher PLR compared to males (P=0.02). Furthermore, there was no significant correlation between NLR/PLR in serious and non-serious types of drug reactions. Conclusion NLR/PLR was significantly higher in patients with drug eruptions compared to control group. There was no significant correlation between NLR/PLR with either demographic features of patients or severity of drug eruption; except significantly higher PLR in female with drug eruptions compared to males. [ABSTRACT FROM AUTHOR]

Background Nowadays, role of hematologic markers including neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), as cost-effective and reliable tests, in recognition of chronic inflammatory and autoimmune diseases, as well as prediction of their prognosis has been elucidated. In this study we investigate role of these factors in prediction of severity of psoriasis and associated arthritis. Methods This is a retrospective cross-sectional study on thirty moderate-to-severe psoriasis patients, hospitalized in dermatology ward, and thirty aged- and sexed-matched healthy adults. NLR/PLR in psoriasis patients was compared to healthy controls. Furthermore, NLR/PLR of classic type of psoriasis was compared to other types of psoriasis (including psoriatic arthritis and erythrodermic psoriasis) by variance analysis. Correlation of demographic features with NLR/PLR was assessed via chi-square test and independent t test. Results Mean age of patients in psoriasis and control groups was 35.66±16.62 and 39.8±11.18, respectively. Psoriasis patients had significantly higher NLR/PLR compared to control groups (3.47±3.83 vs. 1.37±0.55 and 133.26±83.99 vs. 96.25±40.72, respectively). The highest and lowest NRL/PLR belonged to erythrodermic and vulgaris types, respectively. Moreover, there was no significant correlation between NLR/PLR and psoriasis patients, with or without underlying disease. Conclusion NLR/PLR can be a useful indicator for psoriasis severity and associated arthritis. It might be helpful in selection of type of treatment in psoriasis patients and employed as a prognostic factor in prediction of disease course and possible accompanied morbidities. [ABSTRACT FROM AUTHOR]

The systemic and respiratory clinical manifestations of coronavirus disease 2019 (COVID‐19) include fever, coughing, sneezing, sore throat, rhinitis, dyspnea, chest pain, malaise, fatigue, anorexia and headache. Moreover, cutaneous manifestations have been reported in 0.2% to 20.4% of cases. Early diagnosis of COVID‐19 leads to a better prognosis; knowledge of its cutaneous manifestations is one way that may help fulfil this goal. In this review, PubMed and Medline were searched with the terms "dermatology", "skin" and "cutaneous", each in combination with "SARS‐CoV‐2" or "COVID‐19". All articles, including original articles, case reports, case series and review articles published from the emergence of the disease to the time of submission, were included. In this comprehensive narrative review, we tried to provide an analysis of the cutaneous manifestations associated with COVID‐19, including maculopapular rash, urticaria, Chilblain‐like, vesicular lesions, livedo reticularis and petechiae in asymptomatic/symptomatic COVID‐19 patients that might be the first complication of infection after respiratory symptoms. Immune dysregulation, cytokine storms, side effects of antiviral drugs, environmental conditions and high‐dose intravenous immunoglobulin (IVIG) therapy might be involved in the pathogenesis of the cutaneous manifestations in COVID‐19 patients. Therefore, knowledge of cutaneous COVID‐19 manifestations might be vital in achieving a quick diagnosis in some COVID‐19 patients, which would help control the pandemic. Further research is very much warranted to clarify this issue. [ABSTRACT FROM AUTHOR]

Backgrounds: Nowadays, lasers are used for treatment of vitiligo in difficult‐to‐treat areas and refractory lesions. Combination of lasers with other medical modalities can provide higher efficacy, faster response rate, and higher compliance of patients to treatment. Aim: In this article, we reviewed articles regarding safety, efficacy, and treatment protocols of combined laser with other medical modalities. Methods: We searched articles with relevant key words in Google scholar and PubMed. Inclusion criteria were articles in English language since January 2000 until March 2021that evaluate combination of laser with other topical or systemic medical treatments. Results: A total of 42 articles evaluated efficacy of lasers [excimer, carbon dioxide (CO2), erbium‐doped yttrium‐aluminum‐garnet (Er:YAG), and non‐ablative resurfacing laser] combined with topical or systemic medical treatment modalities. Effective response rate (more than 50% improvement) varied between 7.7% and 92%. Initial repigmentation observed between 4 and 13 weeks after beginning of treatment. Conclusion: Combination of laser with medical modalities leads to more rapid repigmentation, superior efficacy, and better compliance of patients with localized non‐segmental type of vitiligo compared to monotherapy. Combination of excimer laser with topical therapy might be suggested for recalcitrant vitiligo lesions in face and neck. Combination of fractional ablative resurfacing lasers with topical therapy, especially 5‐flurouracil, can be recommended particularly in recalcitrant acral and bony prominent areas. Further studies are required to achieve conclusive evidence in order to define the best stage of vitiligo for laser therapy and most effective combined treatment regimen. [ABSTRACT FROM AUTHOR]

Carboxytherapy has been used in the treatment of autoimmune skin diseases such as psoriasis and morphea. Carboxytherapy has antioxidant effects, and leads to better tissue oxygenation, and release of growth factors. In this article, we decided to evaluate efficacy of combined carboxytherapy and narrowband‐ultraviolet B (NB‐UVB) compared to NB‐UVB alone in the treatment of vitiligo. This is a prospective, split‐body double‐blind comparative study performed in patients with generalized stable vitiligo in acral areas and extremities referred to dermatology clinic of Afzalipour hospital in Kerman University of Medical Sciences. NB‐UVB was performed three times a week in non‐consecutive days for 4 months. In each patient, one lesion was randomly treated with carboxytherapy (weekly sessions for total of 16 sessions). Efficacy of treatment was evaluated by percentage of repigmentation of the lesions. Chi‐square test and analysis of variance test (ANOVA) were used to compare efficacy of treatment based on demographic features of the patients and clinical features of the lesions, respectively. Twenty‐eight patients with mean age of 32.35 ± 7.37 years old completed the study. At the end of the treatment, 37% of the patients in combination therapy group demonstrated more than 75% improvement compared to 0% in the monotherapy group (p = 0.001). There was no significant difference between either demographic features of the patients (age, sex, and skin phototypes) or duration of disease with efficacy of the treatment in both groups. Combination of carboxytherapy with NB‐UVB leads to higher percentage of repigmentation and patients' satisfaction compared to monotherapy with NB‐UVB. [ABSTRACT FROM AUTHOR]

Background: Mesotherapy is a popular novel therapeutic modality that is defined as intradermal or subcutaneous microinjection of pharmaceutical compounds. Although this novel treatment method is used commonly in aesthetic dermatology, there is little information about details of injections, efficacy, and side effects of mesotherapy in melasma. Aim: In this review, we evaluated efficacy and safety of various types of mesotherapy in the treatment of melasma. Method: We searched Google Scholar, Medline, and PubMed for related articles with keywords "melasma" OR "chloasma" AND "mesotherapy" OR "injection." Inclusion criteria were articles that evaluated intradermal injection of lightening drugs and published dates between January 2000 and September 2021. Exclusion criteria were articles in languages other than English or non‐human studies. Results: Thirty‐three articles evaluated efficacy of mesotherapy in melasma, including 28 articles about tranexamic acid, 4 articles about vitamin C, 2 articles about glutathione, and 2 articles about triamcinolone. Conclusion: Mesotherapy is a good alternative or adjunctive choice in patients who are refractory to first‐line therapy, patients with low compliance with everyday use of topical therapy, patients with contraindication to oral tranexamic acid therapy, or who wish short downtime and fast recovery period. Further studies with large sample sizes are required to determine ideal concentrations of mesotherapy substances and intervals between sessions and to evaluate the efficacy of different substances for mesotherapy as monotherapy compared to combination therapy and other treatment modalities for melasma. [ABSTRACT FROM AUTHOR]

Traditional treatment modalities for wart require long‐term treatment course and usually have high recurrence rates and unwanted side effects. In this review article, we evaluated different types of laser therapy in the treatment of warts. Published articles since 2000 up to July 2020 about laser therapy in genital and non‐genital warts were searched and assessed. Fifty articles were selected for the final review, including 22 pulsed dye laser (PDL), 10 neodymium‐yttrium‐aluminum‐garnet (Nd: YAG), 3 erbium‐doped yttrium‐aluminum‐garnet (Er: YAG), 14 carbon dioxide (CO2) laser and one systematic review. Complete response rates were different in terms of laser type used (0%‐100%, 9.1%‐100%, 83.3%‐100%, and 59.15%‐100% for PDL, Nd: YAG, Er: YAG, and CO2 laser, respectively). There was no significant difference between conventional treatment modalities and laser therapy regarding efficacy and recurrence rate. Combination of lasers with keratolytic agents, immunomodulators and photodynamic therapy can be helpful especially in immunosuppressed patients, refractory, and recurrent lesions. PDL has the lowest occurrence of adverse effects relative to other types of lasers. [ABSTRACT FROM AUTHOR]

Dysgeusia is the first recognized oral symptom of novel coronavirus disease (COVID‐19). In this review article, we described oral lesions of COVID‐19 patients. We searched PubMed library and Google Scholar for published literature since December 2019 until September 2020. Finally, we selected 35 articles including case reports, case series and letters to editor. Oral manifestations included ulcer, erosion, bulla, vesicle, pustule, fissured or depapillated tongue, macule, papule, plaque, pigmentation, halitosis, whitish areas, hemorrhagic crust, necrosis, petechiae, swelling, erythema, and spontaneous bleeding. The most common sites of involvement in descending order were tongue (38%), labial mucosa (26%), and palate (22%). Suggested diagnoses of the lesions were aphthous stomatitis, herpetiform lesions, candidiasis, vasculitis, Kawasaki‐like, EM‐like, mucositis, drug eruption, necrotizing periodontal disease, angina bullosa‐like, angular cheilitis, atypical Sweet syndrome, and Melkerson‐Rosenthal syndrome. Oral lesions were symptomatic in 68% of the cases. Oral lesions were nearly equal in both genders (49% female and 51% male). Patients with older age and higher severity of COVID‐19 disease had more widespread and sever oral lesions. Lack of oral hygiene, opportunistic infections, stress, immunosuppression, vasculitis, and hyper‐inflammatory response secondary to COVID‐19 are the most important predisposing factors for onset of oral lesions in COVID‐19 patients. [ABSTRACT FROM AUTHOR]

Prevalence of dermatological manifestations of coronavirus disease 2019 (COVID‐19) is estimated between 0.25% and 3% in children and adolescents. In this review article, we decided to describe the cutaneous and histopathological manifestations of COVID‐19 infection in pediatrics. We searched published articles in PubMed database for key words of "children" or "pediatric" and "cutaneous" or "dermatology" or "skin" and "COVID‐19" or "SARS‐CoV‐2" or "Coronavirus disease 2019" in abstract or title from December of 2019 until September 2020. Finally, 38 articles were selected. The majority of patients were between 11 and 17 years old with predominantly male gender. Most of the patients were either asymptomatic or had a few general symptoms. The latency time from appearance of general symptoms to cutaneous ones was between 1 day and weeks. Skin lesions faded between 3 and 88 days without any sequelae, spontaneously or with either topical or systemic corticosteroids. Skin manifestations were chilblain‐like (pseudochilblain), erythema multiforme‐like, dactylitis, acral erythema, acute urticaria, livedo reticularis, mottling, acro‐ischemia, generalized maculopapular lesions, eyelid dermatitis, miliaria‐like, varicelliform lesions, and petechiae and/or purpura. Kawa‐COVID‐19 patients were presented more frequently with cardiogenic shock, neurological symptoms, lymphocytopenia, and thrombocytopenia as compared to classic Kawasaki's disease. Furthermore, more number of cases were resistant to the first‐line treatments. [ABSTRACT FROM AUTHOR]

Summary: Background and aim: A comprehensive study comparing two different modalities, Nokor needle subcision (NNS) and blunt cannula subcision (BCS), for treatment of acne scars, has not been reported previously. The aim was to compare the effectiveness of these two methods based on patient's and doctor's satisfaction measures, in addition to the late complications 3 months postsubcision. Method of intervention: Patients had 18‐65 years old, with acne scars on both malar sides. They were treated at one malar side with NNS and with BCS at another side. They were monitored during the first week, at one and 3 months postintervention. Patient's and two dermatologist's satisfactions were compared during 3 months, for each modality and between modalities. Results: From 34 patients, 29.4%, 55.9%, and 14.7% had mild, moderate, and severe acne scars, respectively. Ecchymosis, nodule formation post‐NNS, and edema after BCS were the complications. Patients were satisfied with BCS during 3‐month monitoring (P = .021), but not with NNS (P = .353). Physician‐1 was satisfied from the outcome of both BCS and NNS procedures (P = .044 and.006, respectively). However, physician‐2 was only satisfied with NNS at the month 3 than the month 1 (P = .002). All patients and physicians were significantly more satisfied with BCS than NNS (P = .000). Anyway, at the month 3, physician‐2 had no significant different points of view about applied methods (P = .25). Discussion: Considering the complications and satisfaction rates, BCS was more efficient than NNS for acne scar treatment. Then, we suggest BCS as a good replacement for NNS. [ABSTRACT FROM AUTHOR]