Journal of Skin and Stem Cell
Volume:1 Issue: 1, Jun 2014

Cutaneous leishmaniasis is an endemic disease in Iran. Although there are several treatment modalities for this disease, pentavalent antimonials are still considered as first line agents. There have been several reports concerning the effectiveness of Cassia fistula plant for leishmaniasis treatment.

This study was designed to assess the effectiveness of concentrated boiled and hydroalcoholic extracts of C. fistula on leishmaniasis lesions in comparison with intralesional injection of meglumine antimoniate (MA).
Patients and

In this randomized parallel clinical trial, 165 patients, 6-60 years old, with positive results of leishmaniasis smear tests were selected amongst the patients referred to the Skin Diseases and Leishmaniasis Research Center (SDLRC), Isfahan, Iran. They were randomly allocated to three groups for treatment with concentrated boiled extract of C. fistula, hydroalcoholic extract of C. fistula, and intralesional injection of MA. Patients were assessed at weeks one, two, three, four, and 16. Results of the treatment were reported as complete, partial, and no improvement.

complete resolution of the lesions at week 16 was observed in 22 (40%), 20 (36.4%), and 36 (65.5%) patients, in those treated with concentrated boiled extract of C. fistula, hydroalcoholic extract of C. fistula, and intralesional injection of MA, respectively. The efficacy of intralesional injection of MA was significantly more than concentrated boiled extract of the C. fistula application (P = 0.02). In addition, the efficacy of intralesional injection of MA was significantly more than hydroalcoholic extract of the C. fistula application (P = 0.005). There was no significant difference between the efficacy of concentrated boiled extract and the hydroalcoholic extract of the C. fistula (P = 0.61).

Our study showed that almost 40% of the patients treated with C. fistula achieved complete resolution of the lesions. We recommend further evaluation of the effect of combined intralesional injection of MA and topical therapy with this plant, to assess the accelerating resolution of leishmaniasis lesions, and possibly decrease the applied dose of MA.

Cutaneous leishmaniasis (CL) is an endemic disease in Iran. Pentavalent antimonials including meglumine antimoniate (MA) are still the gold standard treatment. Trichloroacetic acid (TCA) is used in treatment of acne scar, photodamaged skin, and some other dermatologic diseases. Considering the TCA potential to induce collagen synthesis and its efficacy in the treatment of papular CL lesions, this study was conducted to assess the efficacy of combined intralesional MA and TCA in comparison to MA alone in treatment of CL.

This study was designed to compare the efficacy of the combination therapy of intralesional MA and TCA with intralesional MA alone in the treatment of CL.
Patients and

A total of 200 patients with confirmed CL were selected and randomized into two treatment groups. Both groups were treated with intralesional injection of MA twice a week until complete resolution of the lesions or end of the eighth week. In combination therapy group, TCA was applied to the lesions fortnightly for eight weeks. Data were analyzed statistically using chi-square, student t, and Kaplan-Meier tests.

Complete resolution of the lesions was achieved in 79.2% of patients treated with MA and 85.7% of patients receiving combination therapy (P > 0.05). There was a significant difference in time to achieve the complete resolution between the groups with an accelerated resolution rate in the combination therapy group (P < 0.05).

According to the results of this study, combination therapy with intralesional MA and TCA 50% could accelerated the resolution of CL lesions with no significant difference in complete resolution rate in comparison to the patients treated with intralesional MA alone. Topical application of TCA 50% as an adjuvant therapy might have some advantages in decreasinge the resolution time of the lesions in patients with CL

Liposuction nowadays is the most popular way of weight loss and body contouring. It is a mechanical procedure to reduce fat through the back-and-forth movement of a heavy metal called cannula. The thick cannula, essential for efficient fat removal and subsequent suctioning, causes some undesirable effects such as bruise, scars, heavy blood loss, skin laxity and long-run recovery. While, the new method of liposuction using a 100-300 µm fiber laser inserted into a thin cannula of 1 mm diameter causes less distress and bleeding. Simultaneous interaction between laser radiation and tissue causes faster skin tightening and coagulation of small blood vessels.

The study aimed at evaluating the effects of these highly important parameters of lipolysis operations.

In this study, penetration depth and tissue heating following laser irradiation with a 980 nm diode laser were investigated. This laser is different from 1064 nm Nd:YAG in terms of absorption and scattering coefficient. Hence, dissimilar results for beam penetration and tissue heating were expected. Monte Carlo method was used to simulate radiation (photons) propagation in tissues. Using such simulation can be useful in evaluating penetration depth, absorption, scattering and reflection of the photon within the tissue and across the tissue borders. Temperature rise was simulated using Comsol Multiphysics software.

The simulation results showed that the penetration depth and temperature rise of 980 nm wavelengths were different from those of 1064 nm wavelength. It appeared that 1064 nm wavelength penetrated to deeper layers of tissue compared with 980 nm. Moreover, temperature rise during 1064 nm irradiation led to temperature increase in allowable ranges. The findings proved the reason why 1064 nm wavelength are commonly used in laser lipolysis in comparison with 980 nm wavelength.

The simulation indicated that temperature rise in 980 nm wavelength was 70.802 ℃, which was higher than that of 1064 nm wavelength. Therefore, 980 nm laser can leave unwanted negative effects on tissues including hyperthermia.

Warts are benign tumors of the skin and mucosa and are caused by human papilloma virus (HPV). They are one of the most common skin diseases found mainly in children and adolescents. Although most of the warts disappear spontaneously or respond to the usual therapeutic measures, resistant forms of the warts impose a problem in dermatology. Intralesional injection of bleomycin has been tried in the treatment of resistant warts with variable results in different studies.

This study aimed to assess the efficacy of intralesional injection of bleomycin in resistant warts.
Patients and

In this cross-sectional study, a total of 130 warts in 30 patients were treated with 1 mg/mL intralesional injection of bleomycin. Patients received one to three doses of bleomycin every four weeks, and were followed for six months. Response to the treatment was categorized as complete resolution, partial resolution, and nonresponsive. We employed SPSS version 13 to perform t test and analysis of variance (Anova) as statistical methods for analyzing the data.

Out of 130 warts, 126 (97%) cases showed resolution after bleomycin injections. Ninety-five warts (73%) showed complete resolution and 31 (24%) cases showed incomplete resolution. The cure rate (80%) was better in warts with the size smaller than 20 mm in diameter in comparison with larger lesions (46%). After six months follow-up, 7 patients showed recurrence. Recurrence was seen more among those with greater number of warts.

This form of treatment for resistant warts would be reliable, safe, and acceptable to the patients if it is performed under care and with proper dose and concentration

The patients’ concerns about injection pain can cause some unwanted adverse reactions such as hypotension, vasovagal shock, syncope, and unconsciousness. Therefore, using a skin anesthetic can facilitate performing many medical procedures.

This double-blind randomized clinical trial was designed to compare the anesthetic effect of topical EMLA 5% cream with Iranian lidocaine 5% and benzocaine 5% creams.
Patients and

Sixty-four healthy volunteers were randomly allocated into two groups. In each individual, EMLA cream and one of Iranian topical anesthetic products, namely lidocaine 5% and benzocaine 5%, were tested. One hour before blood sampling, a predetermined amount of A or B cream was used on the right cubital fossa and the same amount of C or D cream on the left cubital fossa. Blood sampling was done via cubital fossa veins with a 2 cc syringe. The pain of blood sampling was recorded using visual analogue scale (VAS). Data were analyzed by student t-test and ANOVA using SPSS version 11.

At the end of study, the EMLA products (A and B) caused a significant decrease in pain (P < 0.05) in comparison with the products C (lidocaine) and D (benzocaine) while there was no differences between benzocaine and lidocaine. In this study, no significant side effect was observed.

Although the results of this study showed superiority of application of EMLA cream as a topical anesthetic for pain relief of blood sampling, both lidocaine 5% and benzocaine 5% offer considerable efficacy in pain relief of venipuncture

Vitiligo involves 1% of the population and is equally seen in all races and in both genders. It is a multifactorial polygenic disorder, although various hypotheses have been proposed including autoimmunity, viral infection, biochemical, neural and oxidant/antioxidant theories (oxygen radical species), yet the exact mechanism of the disease has not been yet established.

To evaluate the prevalence of ocular findings in patients with vitiligo and reveal risk factors or possible associations that might increase the risk of ocular manifestations.
Patients and

In this cross-sectional study, 92 patients previously diagnosed as cutaneous vitiligo referred to the dermatology clinic of Rassoul Akram Hospital from April 2007 to September 2008, were examined for ocular abnormalities. The data of the patients including age, gender, duration of vitiligo, positive family history, association with autoimmune diseases, and anatomic distribution of depigmented macules were recorded. Next, an ophthalmologist at the hospital’s ophthalmology clinic examined the patients to detect depigmentation of eyelids, poliosis and signs of uveitis as well as signs of retinal atrophy or hypopigmentation by a direct ophthalmoscope. Corneal sensation and intraocular pressure (IOP) were evaluated to rule out infection and glaucoma in patients with uveitis. All recorded data were analyzed by the Social Sciences Statistical Software (SPSS version 15) using Chi-square tests and t-test.

This cross-sectional study included 92 patients (47 male and 45 female) with mean age of 32.1 ± 13.16 years (ranging from nine to 61 years of age). Mean duration of vitiligo was 10.84 ± 10.17 years. The most common distribution of the lesions was on the upper limbs (60.8%) and the least was on the genital region (10.8%). Positive family history was found in 26 (28.3%) patients. Diabetes and Hypothyroidism were found in 10 (10.86%) and 9 (9.87%) patients, respectively. Ocular problems were discovered in 19 (20.7%) patients with mean age of 41.26 ± 10.7 years, including uveitis in 10 (10.9%), optic atrophy in 4 (4.3%) and retinal hypopigmentation in 5 (5.4%) patients. Mean age of cases with positive ocular findings was significantly higher than those without ocular findings (29.6 ± 12.7 years, P < 0.0001). Mean duration of vitiligo was significantly longer in patients with positive ocular findings than in those without ocular problems (8.84 ± 9.08 years, P < 0.0001). No statistical correlation was found between sex and ocular findings (P > 0.05). Ocular findings were statistically more in patients with positive family history of vitiligo (P = 0.001) and with associated autoimmune diseases (P = 0.01). No significant association was found between anatomical distribution of depigmented macules and ocular findings (P > 0.05).

Ocular findings are important and assessable in patients with vitiligo. Older age and duration of vitiligo can increase the risk of ocular abnormalities and patients with positive family history and autoimmune disorders should be prioritized for screening.