فصلنامه پوست و زیبایی
سال هفتم شماره 2 (پیاپی 26، تابستان 1395)

Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit. Retinoids are used as the first line therapy in acne. Systemic absorption and skin irritation including redness, pruritus and exfoliation are some of their side effects. In this study we compared the efficacy of isotretinoin 0.05% niosomal gel versus adapalen 0.1% gel in treatment of acne vulgaris.
In this randomized double blind clinical trial, 144 patients with mild to moderate acne vulgaris aged from 15 to 30 years were enrolled. The patients were randomly allocated into two groups of A, whom were treated with isotretinoin 0.05% niosomal gel and B whom were treated with adapalen 0.1% gel. The patients were evaluated for clinical reponse, decrease in the number of inflammatory and non-inflammatory lesions and side effects after 2, 4, 8, and 12 weeks of the initiation of treatment.
At the end of the study the clinical responses of comedones and inflammatory lesions in isotretinoin 0.05% niosomal gel group were 68% and 79%, in comparison with 65% and 76% in the adapalen gel group, respectively. The differences were not statistically significant. At the end of the treatment period more decrease in number of inflammatory and non-inflammatory lesions were seen in group A patients (niosomal isotretinoin) than group B (adapalen 0.1% gel) (P Isotretinoin 0.05% niosomal gel has less side effects and more efficacy in the treatment of mild to moderate acne vulgaris in comparison with adapalen 0.1% gel.

Dermatitis or eczema is an itchy skin disorder which is usually caused by the skin inflammatory reaction in response to combination of genetic and environmental factors. This study was aimed to assess the safety of anti-dermatitis creams and possible side effects on human volunteers through measuring the skin biophysical parameters with non-invasive methods.
Two groups of 15 adults and 15 children as healthy volunteers participated for safety assessment of three anti atopic and contact dermatitis creams. All measurements were done using Cutometer® MPA 580 and the changes in the rate of transepidermal water loss (TEWL), stratum corneum hydration, content of melanin and hemoglobin (erythema) and skin pH were recorded. The obtained data were analyzed using SPSS software version 20 and P In this trial, no statistically significant changes in skin biophysical parameters including TEWL, melanin, erythema and pH was observed. The stratum corneum hydration on the applicatioins areas of Dermalex Repair Eczema, Dermalex Repair Contact Eczema, Dermalex Repair Eczema for Babies & Children compared to the control sides were significantly different (P=0.002, 0.001 and 0.013). This significant difference was due to emollient or humectant compounds in these creams.
Because of no adverse changes in the skin biophysical parameters, the studied anti-dermatitis creams could be conisdered as safe products. In addition, due to self-assessment results of adverse effects by the participants, no significant adverse effect was seen.

Acne vulgaris is a common skin disorder. This study was conducted to evaluate the impact of Ramadan fasting on acne healing in patients admitted to the dermatology clinic, Razi Hospital, Tehran.
In this prospective cohort study, 10 fasting persons (9 women and 1 man) and 10 non-fasting persons (9 women and 1 man) with acne were studied. Their baseline acne severities were recorded and acne improvement was evaluated in both groups after Ramadan month.
Acne improvement was 71% in fasting persons and 49% in non-fasting persons. Improvement in fasting persons i.e. was 1.4 times of non-fasting ones (P=0.158). However, no significant statistical difference was detected. Also, it was determined that improvement was different according to acne grading. Improvement in acne lesions in patients with grade 2 severity was 100%, in those with grade 3 acne was 78%, and in patients with grade 4 acne was 35 % (P=0.025). But in non-fasting patients there was not a statistical difference between acne severity and improvement rate. Furthermore in patients younger than 24, improvement rate of acne was 1.6 fold more than non-fasting persons and in patients older than 24, this ratio was 1.3 (P=0.011).
This study did not show any statistically significant difference in acne improvement between who were fasting and who were not during Ramadan. Studies with larger sample size are recommended.

Hair loss is a common issue among men and women. Studies have shown that 1-25 (OH) vit D affects differentiation in normal follicles and hair growth, through effect on the translation of genes. The aim of this study was to assess vitamin D3 level in patients suffering from hair loss between the age of 18 to 50 years.
This cross sectional study was conducted on 100 patients including 27 men and 73 women suffering from hair loss. Cases were chosen from one of the educational hospitals of Islamic Azad University, Tehran Medical Branch. Blood samples were obtained from the patients and were sent to the laboratory for assessment of vitamin D3 serumic levels.
The average of patients’ age was 29.5±8.5 years. The average serum level of vitamin D in patients was 17.26±14.5 ng/mL. Sixty-six percent of patients suffering from hair loss had vitamin D deficiency as well. The prevalence of vitamin D insufficiency in women was considerably more than men (P Prevalence of vitamin D deficiency among people suffeing from hair loss is noteworthy.

Lichenoid tissue reactions are a group of skin diseases with hydropic degeneration of the basal cell layer and inflammatory infiltrations in papillary dermis. The aim of this study was to investigate the clinicopathological features of skin diseases with lichenoid tissue reaction.
This retrospective cross-sectional study was conducted on 118 cases with lichenoid tissue reactions. Pathological and clinical features such as age, sex, location of the lesions were evaluated.
53.4% of the patients were female. Mean age of the patients was 39.9±17.37 years. Mean duration of the disease was 21.82±14.3 months. The most common site of involvement was upper limb (24%). The most frequent histopathological findings in epidermis and dermis were hydropic degeneration of the basal cell layer and papillary lymphocytic infiltration (89.9%, 85.5%, respectively). Lymphocytes were the most frequent inflammatory cells in dermis. Colloid bodies and melanin incontinency also were seen in 60.2% and 78% of cases, respectively.
Pathological evaluation can be helpful in differentiating skin disease with lichenoid tissue reactions, if there is a doubt in clinical diagnosis.

About 25 years have been passed since the evidence-based medicine (EBM) group declared it as a new approach to teaching and practicing clinical medicine. EBM was based on the combination of three principles: use of current best evidence from research, clinical expertise, and patient's values and preferences. Practically, EBM substitutes pathophysiological reasoning based on basic science research with use of clinical evidence from high quality randomized controlled clinical trials. Like all other approaches to clinical medicine, EBM has been criticized since it was introduced. Herein, we review common problems of EBM according to its critics, introduce what is known as real EBM, and briefly discuss how we could move towards real EBM.

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare disease due to benign proliferation of dermal and subcutaneous capillaries. It is most commonly seen in young to middle-age females. Skin lesions include single or multiple red papules, plaques and nodules. It most commonly involves head and neck. Its etiology has not been determined. ALHE lesions are usually resistant to commonly suggested treatment methods including surgery. Recurrence of treated lesions is also common. Herein, we report a 38-year-old pregnant woman who presented with multiple red papules and nodules on her periauricular and occipital skin. Her lesions were confirmed to be ALHE after histopathological assessment.