alireza firooz

Leishmaniasis is difficult to control and is not cost-effective in endemic areas. Antimony toxic compounds is the drug of choice, which drug resistance is increasing. Animal studies showed that interferon-gamma deficiency impairs the recovery of leishmaniasis. In this study, the therapeutic effects of subcutaneous injection of recombinant gamma interferon on leishmaniasis lesions in Balb/ C mice were evaluated.

40 Balb/ C mice were infected with Leishmania major. After developing lesions, the therapeutic effects of interferon gamma alone or in combination with glucantime were investigated. Also, the standard treatment of glucantime and the control group without treatment were evaluated for comparison.

The treatment groups (glucantime, gamma interferon, and gamma interferon-glucantime) had a significant difference (P<0.01) in terms of reduction in the footpad thickness compared to the control group. There was no significant difference in the mortality rate in the groups receiving gamma interferon and the group receiving standard glucantime treatment.

It seems that gamma interferon was effective in treating cutaneous leishmaniasis lesions in Balb/c mice alone and in combination with standard treatment and can be considered as an alternative treatment.

This review study examines the effects of oral collagen supplementation on various biophysical properties of the skin, including hydration, elasticity, and wrinkle reduction. Collagen, as the most abundant structural protein in the skin, plays a vital role in maintaining its firmness, elasticity, and moisture. With aging, collagen production declines, leading to visible signs of aging such as wrinkles, sagging, and dryness of the skin. Additionally, factors like UV radiation and environmental pollutants accelerate collagen degradation, contributing to premature skin aging. In recent years, oral supplements containing hydrolyzed collagen, particularly collagen peptides, have gained significant popularity due to their potential ability to stimulate collagen production and improve skin quality. Various studies indicate that regular consumption of these supplements can significantly increase skin hydration, enhance elasticity, and reduce the depth and number of wrinkles. However, there are notable limitations in the existing studies, including variations in dosage, intervention duration, and collagen sources. Moreover, many of these studies have small sample sizes and short intervention periods, which limit the validity of the results. Additionally, the presence of other ingredients, such as vitamin C and hyaluronic acid in some supplements, makes it challenging to isolate the direct effects of collagen. Despite these challenges, the existing evidence suggests that oral collagen supplementation holds high potential as an effective approach for addressing skin aging. However, further long-term studies with larger sample sizes and more diverse populations are necessary to determine the precise mechanisms and optimal dosage, thereby providing more definitive scientific recommendations.

The recent coronavirus (COVID-19) is a rapidly spreading multisystemic disease with a broad spectrum of cutaneous manifestations. Recently, DNA-based/RNA-based vaccines, inactivated vaccines, and non-replicating viral vector vaccines have been manufactured to reduce viral transmission and attenuate the morbidity and mortality of COVID-19. The neurotropic virus of varicella-zoster can reactivate spontaneously or in response to a trigger such as trauma, fever, or immunosuppression. Recently, COVID-19 infection was assumed as a potential trigger as well. Up to now, 91 cases of herpes zoster have been reported after COVID-19 vaccinations. The present study reported a case of a 69-year-old woman from Iran. She had received an Astra Zeneca COVID-19 vaccine 5 days before the skin eruption. A clinical diagnosis of herpes zoster infection was confirmed by a polymerase chain reaction (PCR) test for varicella zoster DNA. Oral acyclovir 800 mg five times a day together with gabapentin 300 mg every night resulted in the resolution of the lesions in 2 weeks with no sequelae. The present study then discussed the potential contribution of vaccination against COVID-19 and the reactivation of the varicella-zoster virus.

The rising demand for body contouring and concerns about side effects of invasive surgical procedures have led to advances in providing new non-invasive alternative methods for weight reduction. The current retrospective study investigated the safety and efficacy of photobiomodulation technology in reducing local obesity in Middle Eastern participants.

Providing data about body circumferences of 30 participants, with body mass index (BMI) >28 and localized obesity in the abdomen, thighs, buttocks, or arms were included in the final data synthesis. All the records were received at least 4 treatment sessions with the photobiomodulation technology (Volcano device) in Center for Research and training in Skin Diseases and Leprosy (CRTSDL) during June 2022-September 2022 Reductions in body standing circumferences as well as reported adverse effects and participants’ satisfaction were retrospectively evaluated and reported.

The extricated data included 30 females’ participants aged 42.06 ± 11.6 years and localized obesity in the abdomen (15 cases), thighs (7 cases), hip (one case) and arms (7 cases). While BMIs were not significantly different from the baseline, abdominal, arm and tight circumferences showed a significant decline after receiving 4 and 6 treatment sessions (P<0.01). There was no report of adverse effect and overall satisfaction was an "excellent" grade.

This study demonstrated the effectiveness and safety of photobiomodulation in reduction of circumferential size in abdomen, buttock, thigh, and arm areas in Middle Eastern participants with high patient satisfaction and acceptable safety profile.

The relative darkening of the lower eyelid skin, often linked with dark circles, may make one seem tired and older than the actual age. Considering the recommendations in the sources of Persian medicine regarding Artemisia absinthium L., this clinical trial aimed to investigate the effectiveness of cream prepared from the aqueous extraction of A.absinthium for infra-orbital dark circles removal.

In this double-blind controlled clinical trial, an eye cream is made with 20% of the aqueous extract of A.absinthium in the base of the cream. For standardization based on Artemisinin, the high-performance liquid chromatography (HPLC) method was used. In two drug and placebo groups, 60 patients were equally enrolled in the trial. Erythema and pigmentation were evaluated via Mexameter®.

The cream was standardized, including 1.29±0.02 µg/mg Artemisinin in the product. Finally, 21 and 24 patients in the drug and placebo groups completed the study, respectively. In these groups, the difference in the mean ± standard deviation (SD) delta erythema (DE), delta luminance (DL), erythema, and melanin factors before and after the research were significant (P<0.05). However, the rate of reduction of DE, Erythema, and Melanin and the rise of DL are more significant in the treatment group than in the placebo group. Furthermore, the mean values of DE and DL factors before the research were significantly different in the two groups (P<0.001), but after the investigation did not show a significant difference. The mean value of the Erythema factor in the two groups before (P=0.25) and after (P=0.5) did not show a significant difference. The mean value of Melanin after the research between the two groups showed a significant difference (P=0.01).

The results show that the cream prepared from the herbal composition of Persian medicine improves the infra orbital dark circle around the eyes. 

Recently, many Iranian companies have started manufacturing hyaluronic acid based dermal fillers. Current review aimed to assess and compare the clinical safety and efficacy of 5 Iranian hyaluronic acid based dermal fillers.

The first part of the study reported, the overall safety and efficacy of 5 Iranian hyaluronic acid based dermal fillers for improvement of nasolabial folds in 150 participants (age 44.30±9.97 years) using clinical and objectives assessment methods. In the second part, we performed a comparative study among 5 tested dermal fillers.

Generally, at weeks 2, 12, and 24, 80.6%, 63.3%, and 60.66% of the participants, showed one grade or more improvement in the severity of nasolabial folds respectively. In all visits, the nasolabial folds biophysical parameters as well as the echo density dermis improved significantly compared to baseline. In comparative study, two fillers with the hyaluronic acid concentration of 24 mg/ml, showed the best objective efficacy, while in clinical evaluations, the filler containing mannitol has the best performance in reducing the severity of nasolabial folds showed.

Iranian hyaluronic acid based dermal fillers showed different levels of safety and efficacy for improvement of moderate to severe nasolabial folds, with efficacy.

Tinea incognita (TI), or the other equivalent tinea atypica, is a term used to declare the atypical presentation of dermatophyte infections caused by the administration of steroids or other immunosuppressive medications which modulate the local and systemic immune response. It can mimic other dermatoses; hence making diagnostic challenges for dermatologists. Tina incognita may be misdiagnosed as many dermatoses. Based on previous studies, corticosteroids may cause different clinical manifestations of dermatophytes that might be very different from those that are commonly described.

This narrative review was conducted using PubMed and Scopus databases. Search terms included “Tinea incognita” and “Atypical dermatophytosis”. The search strategy included meta-analyses, randomized controlled trials, clinical trials,observational studies, reviews, and case reports. The search was restricted to articles written in the English language from 2006 to Feb 01, 2023. Moreover, duplicate articles and non available full-text articles were excluded. The extracted data of the search results were retrieved in this study. The morphological patterns, prevalence, sight of infection, and causative agents were also described.

Prevalence of different patterns of TI were recorded as 50% (431 out of 862 cases) for eczema-like lesions followed by psoriasis-like and 6.61% (57 out of 862) for parapsoriasis-like pattern. Moreover, each of the rosacea-like and pyoderma-like lesions equally accounted for 4.98 % of cases (43 out of 862). In addition, the prevalence of causative agents was reported as follows: Trichophyton rubrum accounted for 247 isolates (40%) as the most prevalent, followed by Trichophyton mentagrophytes (n=152, 24%) and Microsporum canis (n=119, 19%).

Tinea incognita is a great mimicker; hence, dermatologists should obtain a full medical history of the patients to make correct diagnoses. It is vital to encourage an exact identification of the etiological agent according to the internal transcribed spacer sequencing in some uncertain cases. This review highlights the importance of mycological tests and fast diagnosis of TI, especially in cases of atypical skin lesions, to choose appropriate treatment and avoid the spread of drug resistant species.

Urticaria is a frequent and difficult-to-treat skin condition, described as temporary erythematous, raised, and itchy skin lesions (wheals) brought on by dilated blood vessels, elevated local blood flow, and increased vascular permeability. It can occur alone or in conjunction with angioedema. Urticaria can be diagnosed and treated in fields other than dermatology; patients often visit general physicians, internal medicine specialists, allergologists, and clinical immunologists. In 2018, the Iranian Society of Dermatology produced a clinical practice guideline on diagnosing and managing urticaria. To update the guideline, the Guideline Development Committee conducted an exhaustive search of scientific papers published on the topic from April 2018 to the end of August 2022, and the new guideline was developed. Finally, the updated guideline was critiqued by members of the Dermatology Board Certificate Examination Panel and chairs of dermatology departments in Iran, and it was improved using their feedback.

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.

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.

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.

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.

Cellulite is a cosmetic problem, especially in women. We compared the safety and efficacy of a herbal anti-cellulite lotion with a placebo in a randomized, double-blind, right-left comparison clinical trial. Ten healthy women (22-58 years) with cellulite (grades 2-4) participated in this study. The anti-cellulite lotion and placebo were applied twice daily on the thighs and buttocks for two months. Treated areas were photographed, and the thigh circumference, subcutaneous fat thickness, and dermal echo density were assessed and compared before and after the treatment. The satisfaction of the participants was also assessed. A comparable improvement in cellulite grade was detected by a blinded dermatologist on both treatment sides. Cellulite improved much in one participant, improved in six, and did not change in three participants. The dermis thickness increased compared with placebo after two months (P = 0.046). A significant reduction was observed in subcutaneous fat thickness on the treated side (P = 0.03). However, the decrease was not significant on the placebo site. There was an increase in the echo density of the dermis in the treatment site, though it was not statistically significant. Both products were well tolerated, and none of the participants experienced skin burning or itching. The studied anti-cellulite lotion reduced the thickness of subcutaneous fat and increased the dermis thickness without serious adverse effects.

Otomycosis is one of the overwhelming diseases both for patients and specialists with a high recurrence rate despite adequate and proper treatment. This study aims to investigate further the various types of fungi involved in otomycosis and test their susceptibility against common antifungals. In total, among candidiasis-suspected patients, 60 samples were incorporated into the study. PCR method was used for Candida species detection. Broth microdilution method of Clinical and Laboratory Standards Institute document M60 was applied to assess MIC values of rampant antifungals. We used SPSS software (version 16.0) for statistical analysis. In this survey, 20, 3, and 1 type of Candida albicans, Candida parapsilosis, and Candida glabrata were identified, respectively. All 20 C. albicans isolates were sensitive to amphotericin B (range 0.03-1 μg/ml), voriconazole, (0.03-1 μg/ml), and itraconazole (0.03-0.5 μg/ml.); moreover, one isolate was resistant to fluconazole. Two isolates out of three isolates of C. parapsilosis, were susceptible to all agents while the other one isolate was resistant to fluconazole. C. glabrata isolate was susceptible to all agents. In summary, the results conveyed the importance of clinicians remaining vigilant in diagnosing otomycosis due to its non-specific manifestations. To manage effectively otomycosis and avoid complications or recurrence, it is imperative to diagnose the condition at the earliest time, confirm its virulence through various tests, and identify antifungal susceptibility patterns. Despite this, relapse is often seen and achieving complete remission can prove to be a major hurdle in individuals who have had mastoidectomy and those with weakened immune systems.

Cutaneous leishmaniasis is one of the most important health problems in Iran. There is still no effective vaccine available against human leishmaniasis and current treatment is based on chemotherapy. Conventional drugs are toxic and expensive, and drug resistance has caused the search for new treatments. Tofacitinib is a Janus kinase inhibitor that disturbs the signaling pathway of several cytokines in the immune system. The aim of this study was to evalute the effect of topical tofacitinib 2% ointment in healing cutaneous leishmaniasis in Balb/C mice.

This experimental study was performed using tofacitinib and glucantim drugs in 40 female Balb/C mice. The metacyclic form of promastigote of Leishmania major standard strain (MRHO/IR/75/ER) was injected into the footpad of the mice, the mice were divided into 4 treatment groups: tofacitinib, glucantim, tofacitinib-glucantim and control without treatment. The treatment period was 28 days. The footpad thickness of all groups was measured at the end of each week.

After the end of the treatment in the groups treated with tofacitinib, a significant decrease in the size of lesion and the footpad thickness was observed compared to the control group without treatment (P<0.01).

It seems that tofacitinib ointment accelerates lesion healing in Balb/C mice and has worked similarly to standard glucantim treatment. Ointment can be a better option for leishmaniasis treatment and due to its ease of use and no need for painful injections it can be considered as an option for the treatment of patients with cutaneous leishmaniasis.

Allergic contact dermatitis is the most frequent cause of eyelid dermatitis; but it is often misdiagnosed. This study aims to evaluate the characteristics of patients with eyelid dermatitis who referred for patch test.

This was a retrospective study. Three major subgroups were made: patients with only eyelid involvement, involvement of eyelids and other areas, and without eyelid involvement. Collected data included past history, diagnoses, personal care product & make-up use, occupational dermatitis, and positive allergens. Chi-squared, independent t-test, and one-way ANOVA were used for analysis. 

139 patients with eyelid dermatitis who referred for patch test were included in the study. Allergic contact dermatitis was the most common diagnosis in all three groups referred for patch test. Use of shaving cream and hair conditioner was significantly higher in patients with only eyelid involvement and nickel sulphate was the most common allergen among them.

Patch testing is an important tool in the evaluation of the common dermatologic disease of eyelid contact dermatitis, as the gold standard. It is a necessity in the treatment of eyelid dermatitis, because of accurate identification of responsible allergens.

In order to overcome the local side effects of the conventional treatments for atopic dermatitis, a new attitude regarding alternative treatments would be needed, which herbal medicines are promising approachs in this case.

It was a 4-week, before-after clinical study, conducted on 20 participants (16 women and 4 men) aged 39.95±11.04 years. The severity scoring of atopic dermatitis was determined based on total & local SCORAD. skin biophisical parameters including TEWL ,skin hydration, pH, temperature, sebum and skin erythema were also measured after 2 and 4 weeks application of the study product. Participants’ satisfaction as well as tolerability of the product were assessed by monitoring the adverse effects.

A significant improvement was detected in LOCAL and TOTAL SCORAD at weeks 2 and 4 (P<0.01). The intensity of burning and pruritus also showed a significant decrease at weeks 2 and 4 (P<0.01). A significant increase in the skin hydration was shown at weeks 2 and 4 after treatment (P<0.01). 84.1% and 78.9% of participants described their skin lesions as "improved" or "much improved", 2 and 4 weeks after treatment respectively.

The test cream containing oats and chamomile extract is considered a safe and effective product for improving mild to moderate lesions of atopic dermatitis.

Urticaria is a common and challenging skin disorder. Diagnosis and treatment of urticaria is not limited to the field of dermatology. General physicians, internal medicine specialists, allergologists and clinical immunologists are also commonly involved in the management of patients with urticaria.Iranian Society of Dermatology developed a clinical practice guideline concerning diagnosis and treatment of urticaria that was published in 2018. The current guideline is the result of scientific papers that got published from April 2018 to August 2022.

Oral hydrolyzed collagen is one of the newest and most popular systemic supplementations for skin rejuvenation. However, there are limited information in case of Middle Eastern consumers. The purpose of this study was to evaluate the tolerability and efficacy of an oral collagen supplement for improvement of skin elasticity, hydration and roughness.

It was a 12-week, before-after clinical study, conducted on 20 participants (18 women and two men) aged 44.15±5.36 years with skin type III-IV. Skin elasticity parameters (R0, R2, R5 and R7), skin hydration and friction, as well as the thickness and echo density of the dermis, were measured after six and 12 weeks daily intake of the study product, as well as four weeks after stopping its use (week 16). Participants’ satisfaction was assessed on the basis of their answers to the standard questionnaire, and tolerability of the product was assessed by monitoring the adverse effects.

A significant improvement was detected in R2, R5 and skin friction at week 12 (P<0.041, P<0.012 and P<0.01, respectively). At week 16, the values remained at an increased level, which indicates the stability of the results. The increase of dermis density in week 16 was also significant (P=0.03). Moderate overall satisfaction was reported with the treatment, and a few gastrointestinal complications were reported.

The study demonstrated that oral collagen peptides could significantly improve the skin elasticity, roughness, and dermis echo density, and they also proved to be safe and well-tolerated.

Brimonidine tartrate is an alpha-2 adrenergic receptor agonist approved for treating rosacea. This study aimed to assess the efficacy and safety of a brimonidine gel in rosacea patients with skin types III and IV.
This study was a phase II before-after clinical study in 20 patients with moderate to severe rosacea treated with brimonidine 0.33% gel. Clinician’s Erythema Assessment (CEA), Patients’ Self-Assessment (PSA), skin erythema (ΔE), lightness (ΔL), and biophysical parameters were measured before treatment and 4 and 8 weeks later. Ultrasound parameters were also measured at the same time points.
Eighteen patients completed the study. CEA and PSA decreased significantly from 3.05 to 2.10 and 2.15 after 4 weeks and 2.20 and 2.15 after 8 weeks, respectively (P<0.01 for both). Furthermore, ΔE and ΔL, as well as the skin erythema index, improved after 4 weeks of treatment. The skin echo density of both the epidermis and dermis also increased after 8 weeks (P<0.05). During the study, no serious adverse events occurred other than some reports of temporary moderate redness.
Daily application of brimonidine 0.33% gel is safe and effective for the treatment of rosacea in darker skin types.

The JAK-STAT pathway has been revealed to play a crucial role in the dysregulation of immune responses in autoimmune skin disorders. Ruxolitinib, a selective inhibitor of JAK1 and JAK2, potently suppresses cytokine signaling.

A topical emulgel containing ruxolitinib nanoliposome (RuxoLip) was prepared by thin film hydration method. Then, its physicochemical characteristics were evaluated at 25±2 ̊C/60±5% RH for 12 months. RuxoLip was assessed based on particle characteristics, Scanning Electron Microscopy (SEM), entrapment efficiency (EE), drug loading (DL), and Differential Scanning Calorimetry (DSC). The pH, density, viscosity, microbial assessment, in vitro drug release, and in vivo tape stripping test were evaluated on the emulgel of RuxoLip. Validating the analysis method was performed by UV spectroscopy.

Nanoliposomal preparation was successfully formulated with a good particle size (218±2 nm), an EE of 67% and a DL of 8%. The formulation was stable in a long-term condition. SEM showed that liposomes had a regular spherical surface. Moreover, in vitro drug release and the in vivo tape stripping test revealed good absorption and permeation, respectively.

The liposome dosage form is anticipated to be a perfect carrier for the topical drug delivery system of ruxolitinib in autoimmune skin disorders.

Tinea capitis is the term used for scalp infections caused by dermatophyte fungi. Tinea capitis is common in children and is less common in adults.

The case was a 9-year-old girl with itchy patches of alopecia on the. The patient had a cat as a pet. On examination, the patch of hair loss was itchy and the hair shaft was broken and scales were mild. In the examination with Wood's lamp and direct microscopic examination, the ectothrix infection was deagnised. According to the dermatologist's opinion, a terbinafine 50 mg was prescribed daily. However, no significant improvement was observed despite 4 weeks of terbinafine. As a result, the dose of terbinafine treatment was changed from 50 mg to 250 mg per day. After 6 weeks of treatment, the clinical manifestations of the patient improved significantly.

After ringworm is confirmed microscopically, choosing the most appropriate antifungal treatment depends on determining the fungal species by culture. Therefore, when choosing empiric antifungal agent therapy, a dose of 250 mg terbinafine may be a good choice for children.

Leishmaniasis is a parasitic disease transmitted by sandflies and is one of the endemic diseases of Iran. With the spread of the Covid-19 epidemic worldwide, the virus will interface with endemic infectious diseases in different regions. In this study, coronavirus disease was evaluated in patients with a history of leishmaniasis referred to the Center of Research and Training in Skin Diseases and Leprosy.

A total of 91 patients with a history of leishmaniasis were studied for possible SARS-CoV-2 infection. The number of patients referred to the Center of Research and Training in Skin Diseases and Leprosy during the coronavirus epidemic was also compared with the same period before the epidemic 

A total of 60% of patients with leishmaniasis
did not report coronavirus disease. Twenty-one percent of cases had a mild corona disease, 13% had a moderate and 3% had severe corona disease. Only a single death was reported in corona patients with a history of cutaneous leishmaniasis. The number of referrals before the beginning of the corona epidemic was twice as high as during the epidemic.

In these participants, mortality and side effects of COVID-19 were significantly less reported. However, further studies are needed to evaluate the immune system and cutaneous leishmaniasis protection against COVID-19. Various factors can be effective in reducing patients during the epidemic, including not going to medical centers, reducing the number of trips, and observance of health issues.

Hair loss is one of the most common problems among the skin and hair related diseases. Hair loss can lead to anxiety, depression, low self-esteem and dissatisfaction with appearance. 

Patients with androgenetic alopecia who met the eligibility criteria entered the study. Participants were asked to randomly apply a solution of valproic acid 8.3% or a solution of minoxidil 5% on the affected areas according to the treatment protocol (twice a day). Before and 2 months after treatment, the participants were evaluated. The studied indices included the number of hair follicles in the specified area, the number of velus hairs, the number of terminal hairs, the average hair thickness, and the percentage of hairs in the anagen and telogen phases, as well as the skin reactions in the area. Hairs were examined at the beginning of the study and at 2 months after treatment using Foto Finder-trichoscale device. 

Two months after treatment compared to baseline in the valproic group, anagen hair count index (P=0.02), general hair count index (P=0.03), and terminl hair count index (P=0.012) showed significant changes. While telogen hair count (P=0.059) and vellus hair count (P=0.097) did not show significant changes. These changes were more significated in minoxidil group.

8.3% valproic acid solution showed positive effects in increasing the number of hairs and decreasing the percentage of telogen hairs. Due to the delayed mechanism of valproic acid, the duration of treatment with this compound should be considered longer than minoxidil as a positive control.

Although several commercial moisturizers are available in the market, continued role of pharmaceutical compounding have been still felt in dry skin management. This study aimed to evaluate the effect of a two urea- based compounded moisturizers on barrier function, compared to similar commercial product. 15 volunteers (14 females and one male) age 36.15 ±9.55 years old (range 21-56 years old) with non-pathologic dry skin, recruited to the study applied 5% urea containing hydrophilic petrolatum and 10% urea containing hydrophilic petrolatum during two following phases.

Upper parts of right and left forearms randomly were assigned for twice a day application of commercial or compounded products. Biophysical assessments including trans epidermal water loss (TEWL), skin hydration, friction co efficient, pH and surface lipids, performed before intervention, 1, 4 after single application and at 24 hours and one week twice daily application. 

In both phases, commercial and compounded moisturizers showed appropriate and comparable effect on skin barrier function compared to the baseline. However commercial products, led to better improvement in TEWL, 4 hours after single application in both phases (P=0.04). The rate of increase in skin hydration was also significantly higher for commercial emollient, compared to compounding product (57.48±11.23 vs. 50.59±11.42, P=0.01).

Commercial formulation led to higher acceptability and better improvement on skin barrier function after single application, probably due to influence of excipients. Present study did not find sufficient added value for pharmacy product relative to commercial one and suggest to be replaced in similar condition.

 Tinea incognito is a localized skin infection caused by a fungus. Due to the use of corticosteroids, the shape and severity of the lesion are different from the usual skin manifestations by dermatophytes.

A 39-year-old female with history of erythematous, scaly skin lesions on her hands, buttock, inguinal and both legs for 7 months referred to clinician, who prescribed Calamine-D and hydrocortisone without any treatment and clobetazole was recomended. She self-continued clobetazole. This case highlight the importance of mycological test in case of atypical skin lesions to choose an appropriate treatment and avoiding to spread of drug resistance species.

Regarding to history of patient, the mycological test (Direct Microscopy and culture) was made. In direct microscopy and culture mycelia of dermatophyte species was seen.

In our case steroid discontinued and she was treated with oral terbinafine 250 mg once a day for 4 weeks in combination with topical clotrimazole cream.

the prescription of topical/oral corticosteroids should still be limited and take a caution until confirmation of diagnosis, particularly since the use of steroids during COVID 19.

The COVID-19 pandemic is still present and we are directly or indirectly affected by it. The skin is one of the organs that has some manifestations not only during the course of the disease, but also long after recovery and also after vaccination. Hair is one of the parts that, like the skin, may show disorders during and after recovery of the infection and also after vaccination. In this issue, we aimed to provide an overview of the effects of COVID-19 and vaccination on hair. We also express the instrumental role of hair in the study of other diseases, including psychological problems.

Hand hygiene plays a vital role in controlling pathogenic microorganisms’ transmission and maintaining the interaction between skin microbiota and biometric parameters. This study evaluated the effects of hand cleansers including alcoholic gel, alcoholic pad, antibacterial, and simple wipes on skin biometric parameters and microbiota. Samples were collected from the hands of 15 healthy office workers with a mean age of 37.70 ± 9.6 years. Then, the subjects were instructed to use cleansers in four following rounds, with a one-week washout period between the rounds. Sample collection was performed before, right after, and one hour after using the cleansers. Microbial isolates were investigated via standard microbiological techniques, and biometric measurements were made using the Cutometer® MPA 580. The obtained data were analyzed using the paired t-test and repeated measures ANOVA. Overall, there were no significant differences between cleansers in reducing the total aerobic microbial count (TAMC). Also, there was an approximate return to the initial count of resident microbiota one hour after using the alcoholic pad. A significant difference was observed in decreasing the Staphylococcus aureus count using antibacterial wipes rather than simple wipes. Simple wipes had the most increasing effect on transepidermalwater loss (TEWL), showing a significant difference with the alcoholic gel. Furthermore, alcoholic gel caused a greater pH decrease in comparison to other products. Alcoholic cleaners are more effective than antibacterial and simple wipes due to maintaining the skin’s biometric parameters. An additional advantage is that alcoholic pads can preserve the resident microbiota.