fariba iraji

Atopic dermatitis, also known as atopic eczema, is one of the most common recurring chronic inflammatory skin diseases. The primary approach to initial treatment for this condition involves corticosteroids and anti-allergic drugs, albeit with potential side effects, particularly with prolonged usage.

This study aimed to investigate the effectiveness of a combination herbal cream formulation incorporating Calendula officinalis , Glycyrrhiza glabra , Curcuma longa , and Fumaria parviflora and compare it with topical mometasone 0.01% in the treatment of atopic dermatitis.

This clinical trial study was conducted from 2020 to 2021 at skin clinics in Isfahan, Iran. Patients were divided into two groups: One treated with mometasone (25 participants) and the other with a herbal combination (31 participants) for one month. The effectiveness of the treatment was evaluated based on the SCORAD Index and patient satisfaction measured through the Visual Analogue Scale (VAS) Index at the 8th and 16th weeks after initiating the treatment.

The study outcomes indicate that, at the end of the 8th and 16th weeks of treatment, the average scores in the SCORAD Questionnaire were significantly higher in the herbal group compared to the mometasone group (P = 0.003 and P = 0.005, respectively). Additionally, both mometasone and herbal combination treatments demonstrated effectiveness in managing patients, with a significant overall P < 0.001.

In conclusion, our study affirms the acceptable effectiveness of both mometasone and the herbal combination in treating atopic dermatitis. Nevertheless, it is noteworthy that the herbal combination demonstrated a significantly lower efficacy compared to mometasone. However, due to the lesser rate of complications, this herbal combination could be promising.

Eczema, a common inflammatory skin condition characterized by itching and dermatitis, can significantly impact the quality of life. While conventional treatments exist, there is interest in exploring natural alternatives. This study investigates the efficacy of a rosehip extract-based cream in mitigating eczema symptoms in a mouse model.

Thirty-five mice were divided into five groups: control, dinitrochlorobenzene (DNCB)-induced eczema (model group), and treatment groups receiving placebo, betamethasone cream (positive control), or rosehip extract cream. Following topical treatment for four weeks, the animals were euthanized, and their skin was evaluated for inflammation, moisture, and thickness. Histopathological analysis was performed using hematoxylin and eosin (H&E) staining.

Compared to the control group, DNCB treatment significantly increased inflammation, erythema (redness), dryness, and epidermal thickness. Notably, topical application of the rosehip extract cream significantly reduced these eczema-associated parameters, demonstrating efficacy comparable to the positive control (betamethasone cream).

This study suggests that a topical cream formulated with rosehip extract may be a promising therapeutic strategy for alleviating eczema symptoms. The anti-inflammatory and potentially regenerative properties of rose extract warrant further investigation for the development of natural eczema treatments.

Atopic dermatitis is a common disease in infants and children which is chatacterized with pruritus and skin lesions and is known to be chronic and recurrent. Since the side effects caused by common treatments (topical corticosteroids) may cause a limitation to their long-term use, the need for alternative treatments is mandatory. Considering the anti-inflammatory effects, immune system, and sleep-regulating properties of melatonin, this study compared the effects of topical betamethasone alone with topical betamethasone combined with oral melatonin in the atopic treatment dermatitis.

This clinical trial was carried out on 50 patients with atopic dermatitis. Participants were randomly assigned to two treatment groups. The control group received betamethasone, and the intervention group, in addition to betamethasone, received 3 mg melatonin tablets for 12 weeks. The disease status of participants was also assessed using the Scoring Atopic Dermatitis (SCORAD) scale.

Both treatment groups showed significant changes in SCORAD score, affected area, disease intensity, and reported symptoms like insomnia and itching. So, the SCORAD index in the intervention and control groups decreased on average by 29.44 ± 14.09 and 33.56 ± 16.08, respectively, at the end of the treatment. But, no significant difference was observed between the two groups in these changes. Additionally, no specific treatment-related side effects also were reported during this study.

Although both treatment regimens resulted in significant improvement in the condition of atopic dermatitis, this study found no significant difference in the effectiveness of the two treatment regimens, suggesting the need for further investigation into alternative topical corticosteroid therapies to provide similar efficacy with reduced side effects.

Isotretinoin is the primary treatment for moderate to severe acne vulgaris. Recently, combining an antihistamine with this medication has received attention. Researchers investigated the presence of H1 receptors and evaluated the impact of antihistamines on cellular squalene levels. They investigated how antihistamines affected cultured sebocytes and discovered that these medications were efficient anti-inflammatory agents that reduced lipogenesis in sebocytes. This study aimed to compare the effectiveness and safety of combination therapy with isotretinoin and desloratadine to isotretinoin alone for treating acne. In this randomized clinical trial, 60 patients with moderate to severe acne vulgaris were randomly assigned to receive either 20 mg of isotretinoin alone every other day (group 1) or combination therapy including isotretinoin (20 mg/ every other day) and desloratadine (5 mg/ every day) (group 2) for 6 months. A t-test was used to examine and compare the improvement in acne severity (GAGS Score), which was assessed by a blinded dermatologist, and side effects before and 24 weeks after treatment. The study included 56 patients. The mean GAGS Score (Acne Severity) for groups 1 and 2 was 24.93 ± 6.19 and 25.04 ± 5.39, respectively (P = 0.945). After 6 months of treatment, it decreased to 7.00 ± 2.76 in group 1 versus 4.85 ± 3.15 in group 2 (P = 0.019). The trend of changes in GAGS score was significantly different between the two treatment regimens (P = 0.006). Dermatologists observed no significant difference in improvement rates between the two groups after 6 months of therapy (88.36% versus 90.31%; P = 0.609). Regarding side effects, there was a significant difference between the two groups after 6 months (P = 0.05). Adding desloratadine to isotretinoin was a more effective and safer therapeutic approach in treating acne vulgaris than isotretinoin alone, resulting in a more significant reduction in acne severity.

Skin aging is a natural process, and microneedling is a method used for skin rejuvenation. This study aimed to evaluate the impact of microneedling on reducing perioral wrinkles.

A clinical trial was conducted on 30 women referred to a skin clinic in Isfahan, Iran, from December 22, 2021, to June 20, 2022. The patients underwent three microneedling sessions at 2-week intervals. Perioral wrinkles were photographed using a digital camera under consistent conditions and at a distance of 30 cm before the intervention, 6 weeks post-intervention, and 3 months after the final treatment session. Two dermatologists, blinded to the treatment, assessed the photographs. Moreover, patients self-reported improvement using the Visual Analog Scale (VAS) at the beginning, 6 weeks, and 3 months after the intervention.

Following the microneedling sessions, the first dermatologist reported poor improvement in 7 (23.3%), moderate improvement in 14 (46.7%), good improvement in 7 (23.3%), and excellent improvement in 2 (6.7%) cases. The second dermatologist observed good improvement in 13 (43.3%), moderate in 11 (36.7%), and poor improvement in 6 (20%) patients. According to patient reports, perioral wrinkles showed significant improvement at 6 weeks and 3 months post-intervention compared to baseline (P<0.001). Additionally, there was a significant improvement in perioral wrinkles at 3 months compared to 6 weeks post-intervention (P<0.001).

The results suggest that three microneedling sessions at 2-week intervals led to a significant improvement in perioral wrinkles based on assessments by dermatologists and patient reports.

Vitiligo is an autoimmune disease of the skin that affects both sexes and people of any age. The genetic and environmental factors are involved in the vitiligo etiology. Helicobacter pylori (H. pylori) has an important role in vitiligo progression. Therefore, the present study evaluated H. pylori seropositivity in vitiligo patients compared to healthy individuals. H. pylori infection was investigated in 210 vitiligo patients and 127 sex- and age-matched healthy controls using Enzyme- Linked Immunosorbent Assay (ELISA) test. The data was analyzed using SPSS software version 20.0, and the groups were compared using T-test and ANOVA tests. P < 0.05 was considered statistically significant. Vitiligo patients had higher median levels of IgG (29.68 ± 28.28 RU/mL) than (19.08 ± 20.12 RU/mL) in healthy controls (P < 0.000). Moreover, there was no significant difference between groups based on the level of IgM (P < 0.207). In the vitiligo group, IgG or IgM means were different compared to age (P < 0.33)/ (P < 0.017) and early symptoms (P < 0.00) (P < 0.02), respectively. Unlike IgG, there was a significant difference between the mean level of IgM, the onset age of vitiligo (P < 0.022), and the duration of the disease (P < 0.05). Moreover, males and females with vitiligo had a higher seropositivity to H. pylori antibodies than the control group. Vitiligo was found to be significantly associated with H. pylori in Iranian patients. Therefore, it seemed probable that H. pylori had an important role in the initiation or progression of disease activity in vitiligo.

Hair loss, which is known as telogen effluvium (TE), was reported in COVID-19 patients both during and after their recovery.

Psoriasis is an immune-mediated inflammatory disease with unclear pathophysiology. Although diverse medications have been applied, a paucity of knowledge is accessible regarding the use of corticosteroids for psoriasis management. We evaluated the efficacy of corticosteroid pulse therapy in combination with methotrexate versus methotrexate alone for psoriasis treatment. This cohort study was conducted on 51 hospitalized patients with erythrodermic or pustular psoriasis who were assigned to one of the therapeutic interventions of subcutaneous methotrexate alone (n = 33) or in combination with betamethasone pulse therapy (n = 18). The first group was treated with weekly 15 mg subcutaneous methotrexate for six weeks, and the second group received a similar dose of methotrexate plus 3 mg oral betamethasone weekly. The patients were followed for six months and assessed regarding the disease remission, relapses, the interval between the medication and relapse incidence, and patient satisfaction with the regimens. The studied groups were similar regarding gender (P = 0.296), age(P = 0.561), and the type of cutaneous lesions (P = 0.807). Six months follow-up of the two therapeutic interventions revealed insignificant differences in terms of early response to the treatment (P = 0.993), the incidence (P = 0.142) and frequency of relapses (P = 0.928), and the interval period between the treatment and relapse (P = 0.213). Besides, the patients’ treatment satisfaction did not differ between the groups (P = 0.453). Based on this study, combining methotrexate and lowdose corticosteroid pulse therapy does not lead to better outcomes than methotrexate alone for managing pustular and erythrodermic psoriasis. Further studies are strongly recommended.

Psoriasis (PSO) is a common chronic autoimmune skin disease with a significant psycho‑socio‑economic burden. Some antidepressants(ADs) such as fluoxetine and bupropion can induce or exacerbate PSO. This study aimed to investigate the correlation between ADs history before PSO onset, and the risk of PSO induction, in Isfahan province, Iran.

In this case–control study, 80 patients with PSO were selected by non‑probability sampling method, and 80 healthy individuals were selected using simple random sampling. They were interviewed and medical information was recorded. Chi‑square, Mann–Whitney, and Kruskal–Wallis tests for dichotomous or categorical data, and independent‑sample t test for continuous data were used. Statistical significance was taken as P ≤ 0.05.

In this case–control study, a total of 160 individuals, 80 participants in each group, were included. The mean age of the total samples was 44.8 ± 16 years. Forty‑three percent of the individuals were women. PSO familial history in the cases was significantly higher than the control group (OR = 11.94, P = 0.001). It was revealed that use of ADs by patients before PSO induction, was greater than the controls (OR = 2.78, P = 0.058).

Past history of ADs in the cases before PSO onset, was higher than the controls, indicating a possible association between ADs and the risk of PSO induction. This study can be effective to pay more attention to the possible complications of ADs and PSO risk factors. Accurate knowledge of PSO risk factors will be useful for better management and morbidity reduction.

Mycosis fungoides (MF) is the most common skin subtype of T-cell lymphoma. Its underlying cause is not yet clearly understood, and diagnosis might be difficult since MF presents itself with symptoms similar to some other dermatologic disorders. In the current case presentation, we report a 12-year-old female with concurrenthypopigmented and pigmented purpuric dermatosis-like lesions that underwent skin biopsies and immunohistochemistry study. Microscopic findings of hyperkeratosis and mild acanthosis in addition to epidermotropism of lymphocytes with perivascular and interstitial infiltration led us to the probable diagnosis of MF.Intraepidermal lymphocyte immunohistochemistry assessments were positive for CD3 and CD4 while negative for CD8 and CD7. The peripheral blood smear revealed a normal CD4 to CD8 ratio, and the number of Sézary cells detected was insufficient to diagnose Sézary syndrome. Therefore, the final diagnosis of MF was made for this young patient.

 Acne is the most common chronic skin disease affecting young adults and adolescents worldwide. A characteristic of this disease is the chronic inflammation of sebaceous glands leading to comedones, papules, pustules, nodules, and cysts. Topical and systemic uses of medicines are common approaches to treat acne. However, these medicines are associated with some adverse effects and increased microbial resistance.

 We aimed to prepare and apply an herbal formulation containing several herbs with different effects on mechanisms associated with acne formation.

 In this study, 66 patients with mild-to-moderate acne randomly received a packet containing herbal medicine or clindamycin gel. The treatment period was two months, and the total acne lesions and acne severity index were measured every four weeks. After eight weeks of treatment and follow-up, the physician examined clinical outcomes and possible complications.

 Decreases in total acne lesions and acne severity index were significantly different in both treatment groups (P < 0.05 in both groups). Although the herbal cream provided better improvement than clindamycin, there was no significant difference between the two groups (P > 0.05).

 The use of the herbal cream could be recommended for treating acne lesions due to few complications, greater patient satisfaction, and avoiding microbial resistance to chemical antimicrobials.

Atopic dermatitis (AD) is a common skin disorder with symptoms including severe pruritus and eczematous lesions. AD affects between 5 and 20% of people in their life. Silymarin (SM) is a polyphenolic flavonoid from Silybum marianum L.  and has several therapeutic characteristics including antiallergic, anticancer, and anti-inflammatory properties. Fumaria officinalis is a small plant that has a high antioxidant power and modulating effects on the immune system. Therefore, the current study intended to examine the influence of these two herbs extract on severity and symptoms of AD in patients. 40 patients with mild to moderate eczema randomly received mometasone 0.1% or the herbal cream. Treatment course was 2 weeks and patients were examined before and after 2 weeks of treatment using the SCORAD system. The reduction of SCORAD score was significant in both groups (p=0.04 in the herbal group and p=0.03 in the mometasone group) but no significant difference was observed between the groups. Mean SCORAD score was 27.66±5.9 before therapy and 4.77±1.6 after therapy in the mometasone group and mean SCORAD score was 26.05±7.1 before therapy and 6.944±2.6 after therapy in the herbal group. The current study indicated the impact of these two herbs extract on severity and symptoms of AD in patients; these plants may be a new treatment in reducing eczema symptoms and its problems.

Leishmaniasis is caused by protozoan Leishmania parasites. The disease is predominantly endemic to the tropics and has been reported in more than 98 countries with an estimated increase of approximately 1.5 million per year and more than 12 million infected cases. Key management of control and treatment relies mainly on the detection of infected cases that have been disrupted due to the toxicity of drugs, side effects, and the emergence of drug resistance in parasites. Control of reservoirs and vectors is complex in most involved countries due to operational problems and lack of financial resources. Therefore, it is highly desirable to establish an effective and reasonable immunized agent against leishmaniasis. There have been advances to understand underlying immune mechanisms using a variety of candidate antigens, including attenuated live parasites, crude antigens, pure or recombinant Leishmania proteins, Leishmania genes encoding protective proteins, also, immune system activators from the saliva of flies. However, there is still no protective vaccine against different types of human leishmaniasis. In recent years, more focus on leishmaniasis vaccine studies has been forced on cutaneous leishmaniasis. In this review, we will take a look at the works done or being done concerning this issue. Previous studies have shown that different ways the vaccine enters the body play an important role in making protective immunity. The process of identifying articles was developed using the following electronic databases in which the immune response and vaccines of leishmaniasis were assayed: PubMed, SciELO, ScienceDirect, Scopus, Google Scholar, and Web of Science databases.

Bullous pemphigoid (BP) is a widely recognized autoimmune blistering disease (AIBD) linked with a high incidence of morbidity and mortality. The aim of this study was to evaluate the available findings of randomized clinical trial studies to update interventions for Bullous pemphigoid.

This article provides an updated overview of interventions for BP. A literature search was performed using Cochrane Central Register of Clinical Trials, MEDLINE, Scopus, and Web of Science from August 2010 to December 2020. All randomized clinical trials (RCTs) were done on adults and investigated the effectiveness of administered topical or systemic medications versus placebos or controls included in the current systematic review. Three RCTs comprising 363 patients were included in the systematic review. One of the eligible studies was placebo-controlled. All of the included studies used various interventions including, methylprednisolone plus azathioprine versus methylprednisolone plus dapsone, doxycycline versus prednisolone, and intravenous immunoglobulin (IVIG).

Following their potentials in disease control, no difference was observed between dapsone and azathioprine; although, dapsone had a higher corticosteroid-sparing potential. The evaluation of the effect of doxycycline in short-term blister control in comparison to corticosteroids showed that the medication was not inferior to prednisolone, although it had a higher long-term safety.

Therapeutic outcome of IVIG for steroid-resistant patients was satisfactory. Moreover, the effectiveness and reliability of various immunosuppressive drugs and tetracyclines are investigated by blinded RCTs for the treatment of BP.

A special type of alopecia called androgenetic alopecia is one of the most common skin and hair diseases, and topical minoxidil solution is one of the best treatments. Studies have shown that the use of topical 5% minoxidil solution in patients with androgenetic alopecia reduces hair loss, increases patients' satisfaction with recovery and increases hair growth. Also, the therapeutic effects of flutamide in women with hair loss have been shown that flutamide is a very suitable treatment regimen for the treatment of these patients and its low doses are very suitable and have few side effects. Accordingly, the aim of this study was to compare the therapeutic effects of 5% minoxidil solution with the combined solution of minoxidil 5% and flutamide 2% in patients with androgenetic alopecia referring to Isfahan Skin Clinic.

This study was a randomized double-blind clinical trial that was conducted as a preliminary study from the summer of 1397 to the summer of 1398 in Al-Zahra Hospital. After identifying patients with mild to moderate androgenetic alopecia as a simple coincidence available to 40 people, they were randomly divided into two groups of cases and 20 subjects. Patients in the control group received 5% minoxidil solution, 1 cc each 20 drops 2 times a day, and patients in the combined group received 2% flutamide and 5% minoxidil in the same way for 9 months. The required data were collected based on the checklist. After collecting the data in SPSS software, version 22 was examined at a significance level of 0.05.

There was no significant difference between gender, age, hair thickness in the two groups of case and control (P>0.05), but there was a significant difference between hair thickness in the two groups of case and control after intervention (P<0.05). There was no significant difference between hair thickness in the case and control groups before the intervention (P>0.05), but there was a significant difference after the intervention (P<0.05). There was a significant difference between hair thickness in the case group before and after the intervention (P<0.05), but there was no significant difference in the control group before and after the intervention (P>0.05). There was a significant difference between hair size in the case and control group before and after the intervention (P<0.05). However, the difference between the mean of the control group before and after the intervention does not show much difference. There was a significant difference between patient satisfaction and physician satisfaction in both case and control groups (P<0.05). There was no significant difference between the time of admission in the two groups of case and control (P>0.05).

According to the results of this study and since conducting this study was an introduction to better understanding the therapeutic effects of minoxidil and flutamide in the treatment of androgenetic alopecia and comparing its therapeutic effects in men and women with androgenetic alopecia, so the necessary measures can be taken. He used a combination of these two drug solutions.

Patients admitted in especial units such as coronary care unit (CCU) require intensive care for different aspects including skin problems. Here in this report we aimed to perform a survey on different skin lesions in patients admitted in CCU by the time of admission and when discharging.

In this cross-sectional study, we had a survey on 200 patients admitted in CCU in AL-Zahra hospital, Isfahan. A dermatologist observed and examined each patients for any skin lesions by the time of admission and when discharging from CCU.

Here we showed that 15 percent of patients admitted in CCU have at least one skin lesion and also we indicated that seborrhea dermatitis and then rosacea have the most prevalence by the time of admission in CCU. Other skin lesions were acute skin failure. We also showed that prevalence of bed sore and pressure sores increased amazingly during admission.

Rosacea, seborrhea dermatitis and drug allergic reactions after pressure sores are the most frequent skin lesions in CCU and there might be an association between rosacea and cardiovascular diseases.

Cutaneous leishmaniasis (CL) is endemic in many parts of the world with a high economic and health impact. Despite many treatments that have been suggested for this zoonotic infection, there is still no definite therapy for CL. Meglumine antimony compounds are considered as a standard treatment for leishmaniasis, however, these medications have a relatively high side effect profile and not always effective. Physical modalities including cryotherapy, laser, and heat therapy have also been used for this purpose. As a source of heat therapy, different methods have been used including radiofrequency, ultrasound, infrared, exothermic crystallization thermotherapy, and microwave. We reviewed all of the articles in PubMed regarding the use of heat therapy for the treatment of CL up to January 2020. According to our literature review, heat therapy using different sources showed promising results for the treatment of CL that were comparable to meglumine antimony. In addition, heat therapy has very low side effect profiles that are localized to the treatment area suggesting this method as a safe procedure for CL therapy. This study is a brief review of the literature about the effect of heat therapy on the treatment of CL. Performing randomized clinical trials to compare different methods of heat therapy and to compare it with meglumine antimony compounds is recommended.

Psoriasis is a kind of common, chronic, and exacerbating skin diseases. It does not have any certain treatment but it can be controlled. Different treatments have been used to control the disease, from positional steroids in mild cases to methotrexate in severe cases, all of which have multiple side effects. The aim of the present study was to investigate the effects of Florabile, derived from Iranian Traditional Medicine, on reducing the severity of psoriasis rashes.

In a semi-experimental study, 25 patients aged 20 to 50 years with mild to moderate psoriasis and patients whose bodies were involved below than 20 percent were participated for a 30-days experimental period. They diluted Florabile syrup containing three spoons (each spoon with an approximate volume of 15 cc) with a glass of water (250 cc), and consumed one hour before lunch daily. Results were scored using the Psoriasis Area Severity Index (PASI) at the beginning and at the end of the study, and then evaluated by two dermatologists.

Consuming the medicine meaningfully reduced inflammation of the rashes, scaling, plaque, percentage of involvement, and PASI score (P < 0.050).

Findings show significant positive effect of Florabile syrup on reducing the severity of psoriasis rashes.

Keratosis rubra pilaris is a common condition with an estimated percentage of 40% involvement in the population. This condition is inherited as an autosomal dominant trait and more commonly involves patients with dry skin. In the current study, we evaluated the efficacy of intense pulsed light (IPL) plus ammonium lactate versus ammonium lactate alone in the treatment of keratosis pilaris.

A total of 50 patches were selected in 10 patients. If there were two similar patches with the same color and same location, each of them was randomized to receive ammonium lactate (Kerapil cream®) or ammonium lactate (Kerapil cream®) +IPL. Treatment was performed for 3 months, and improvement was rated by physicians and patients one month and two months after the intervention.

The grade of improvement in the IPL + ammonium lactate was not significantly higher than ammonium lactate alone group as rated by blinded physicians at week 4 (P > 0.05). However, the score of improvement was also higher, as rated by the patients, in the IPL + ammonium lactate versus ammonium lactate alone (P < 0.05) at week 8.

Our results demonstrated that addition of IPL to ammonium lactate could improve the clinical response of keratosis pilaris lesions.

Leishmaniasis is an infectious disease caused by an intracellular parasite of Leishmania and is transmitted through the female sandflies bite and may lead to severe skin lesions. Although drugs such as antimony compounds are available, their side effects such as toxicity, low efficacy, and emergence of resistance have raised the importance of effective replacement. Imatinib, as an inhibitor of tyrosine kinase (TK) of Leishmania, stops abnormal function of TK such as Bcr‑Abl through assembling into transmembrane pores in a sterol‑dependent manner. Hence, the evaluation of killing effects of different concentrations of imatinib against Leishmania major amastigotes and promastigotes in vitro were the objectives of the present study.

The killing effects of different concentrations of imatinib (25, 50, and 100 μg) and 25 μg amphotericin B (as positive control) were evaluated against RPMI 1640‑cultured promastigotes and the amastigote/macrophage model by MTS cell proliferation assay kit (ab197010) and Giemsa staining method during 24, 48, and 72 h.

The results showed anti‑Leishmania effect of imatinib in concentration and time‑dependent manner. The lowest number of live promastigotes and amastigotes were obtained due to treat with 100 μg/ml imatinib at 72 h. Furthermore, 100 μg concentration of imatinib had the same effect as 25 μg amphotericin B on both L. major promastigotes and amastigotes (P < 0.001).

The anti‑Leishmania effect of imatinib was confirmed by MTS and direct microscopy. Further study is recommended for evaluating possible therapeutic effects of imatinib on leishmaniasis in vivo.

Acne vulgaris (AV) is one of the most common skin diseases with major psychological impacts. Hence, selecting the best treatment modality is so important; there are different ways to treat AV such as topical and systemic agents, laser, and also photodynamic therapy. In this study, we tried to assess the difference between the efficacy of combination therapy with intense pulsed light (IPL) and benzoyl peroxide (BPO) in comparison with IPL and adapalene (AD) in the treatment of the mild to moderate AV.

Thirty Iranian females in reproductive age with mild to moderate acne were enrolled in this study. The left and right side of the patients were randomized to receive either AD 0.1% or BPO 5% every other day plus three sessions of monthly apart IPL in the treatment of AV. Different parameters of AV such as acne severity index (ASI), total acne lesions counting (TLC), and Acne Global Severity Scale (AGSS) were measured before, during, and after the treatments.

There was a significant difference regarding AGSS, TLC, and ASI before and after treatment with AD plus IPL (P < 0.001). Furthermore, there was a significant difference regarding AGSS, TLC, and ASI before and after treatment with BP plus IPL (P < 0.001). However, no significant difference regarding AGSS, TLC, and ASI were observed between the 2 groups after treatment (P > 0.05). No significant side effects were observed in both groups.

Our study shows that there was not any significant difference between combining IPL with either AD or BPO so we can use either one of these combinations to achieve similar efficacy.

Bullous pemphigoid is one of the most common autoimmune blistering diseases. Incidence of bullous pemphigoid has been estimated 4 new cases per 100000, but new studies show that the incidence rate is increasing. The disease typically happens in the elderly people usually after 70 years. Annual mortality rate for bullous pemphigoid is reported up to 40%. The aim of this study was to evaluate epidemiological features of bullous pemphigoid in center of Iran. This was a cross-sectional study conducted in Alzahra hospital in Isfahan City. 69 patients with bullous pemphigoid hospitalized during the years 2008-2016 were studied. 59.45% of the patients were women. The mean and standard deviation of age was 68 ± 13 and 72 ± 14 years in woman and men, respectively (P = 0.01). Mucosal involvement was seen in 55.4%., and the most common underlying disease was hypertension (23.6%). 15.4% of women and 3.7% of men used furosemide, and the most commonly prescribed drugs were antihistamine (98%), antibiotics (97%), and topical (91%) and systemic (88.4%) corticosteroids, respectively. The mean and standard deviation of the dose of prednisolone was 54 ± 12 mg per day. Rise in serum blood sugar was reported in 30% of patients, and 3.6% of men and 15% of women needed intensive care unit (ICU) admission. 42.9% of men and 44.4% of women had relapse after discharge, and 38.64% of patients died during one-year follow-up. It seems that patients with bullous pemphigoid need careful follow up, especially during treatment, and at least for one year, because of their age (> 60), underlying diseases, type of treatment (corticosteroid use), and high mortality and relapsing rates in the first year after diagnosis.

Branchio‑oculo‑facial syndrome (BOFS), a rare, multiple‑malformation congenital disorder, is characterized by facial anomalies, including associated cutaneous and ocular abnormalities. We report a new case of BOFS in an 11‑year‑old male child with bilateral cervical erythematous scaly linear plaque associated with scar formation and erosion. Although BOFS is very rare, physicians, especially dermatologists, should be aware of the cutaneous and histopathological features of BOFS due to impacts of the associated anomalies.

Langerhans cell histiocytosis (LCH) is characterized by idiopathic monoclonal infiltration of Langerhans cells in different organs such as the skeleton, skin, pituitary gland, liver, spleen, lungs, and the hematopoietic system. Skin lesions are common in LCH and affect about 40% of cases. It is reported that skin lesions are usually the first manifestation of LCH in 80% of patients. Usually, cutaneous presentations of LCH in adults are generalized or seborrhea‑like lesions and it is often the first manifestation of disease. Here, we describe a 45‑year old female who was known case of hypothyroidism, systemic lupus erythematosus, and diabetes insipidus. In our patient, cutaneous involvement was unusual. It was single and presented in unusual site (ankle) and before developing such lesion, she had diabetes insipidus for several years due to the involvement of pituitary gland.

Vitiligo, a common disorder of depigmentation, is often difficult to treat. Corticosteroids are known to be effective, but with modest results. Although simvastatin has been reported to be effective for immunorelated dermatologic disorders including vitiligo, controlled trials are lacking. This study was conducted to compare the efficacy of topical betamethasone valerate 0.1% cream (as a standard method of treatment for vitiligo) versus a combination of betamethasone valerate plus oral simvastatin in the treatment of vitiligo.

Eighty‑eight subjects with symmetric vitiligo who had body surface involvement up to 20% were divided randomly into two groups. Group A were treated with betamethasone valerate 01% cream twice daily and Group B with betamethasone valerate 01% cream twice daily and oral simvastatin 80 mg daily for 12 weeks. Finally, 46 patients completed treatment after 12 weeks in both groups. The results were evaluated by a blind dermatologist using Vitiligo Area Scoring Index (VASI) score at baseline, 4th, 8th, and 12th week of treatment. In a similar way, subjective assessment performed by patients based on photo evaluation at the end of the study.

Despite a continuous reduction in VASI score in both groups, according to both physician (P = 0.13) and patient (P = 0.374) assessment oral simvastatin was not statistically more effective than conventional treatment of vitiligo.

This study indicates that oral simvastatin is not associated with significant impacts in the treatment of vitiligo as compared to other inflammatory dermatologic conditions such as psoriasis. Indeed, other studies should be initiated regarding exact molecular and cellular effects of statins in the treatment of vitiligo.