فصلنامه پوست و زیبایی
سال هفتم شماره 4 (پیاپی 28، زمستان 1395)

Dandruff and seborrheic dermatitis (SD) are common chronic skin diseases. There are many chemical drugs for treating dandruff and SD. Prolonged use of them may cause side effects and drug resistance. The aim of this study was to compare the efficacy of a herbal extract lotion with clotrimazole 1% lotion in the treatment of SD.
Twenty volunteers (12 men and 8 women) aged 20 to 40 years, with seborrheic dermatitis were enrolled in this trial and were randomly allocated into two groups. One group was treated with a herbal extract lotion and the other group with clotrimazole lotion. The herbal extract contained common sage, thyme vulgaris, tea tree oil, lavender, willow, rosemary, and aloe vera. The patients were instructed to use the lotions three times a week for 4 weeks. We evaluated the patients by clinical assessment and measured the scalp sebum, pH, and dandruff number before two weeks, and four weeks after completed a treatment. At the end of the study, each participant satisfaction form.
At the end of the study, the participants whom received the herbal extract lotion had a significantly greater reduction in scalp scaling, erythema, itching, and number of dandruff compared with those who received clotrimazole (P This study showed that herbal extracts lotion was effective in the treatment of dandruff and seborrheic dermatitiand can be an appropriate alternative to chemical agents.

Acne vulgaris is a common skin disease and oral isotretinoin is the only treatment that is dramatically effective on its severe type The aim of this study was to evaluate the effects of oral Isotretinoin on the level of sex hormones and menstrual cycle in female patients with severe acne.
In this before and after treatment study, 50 patients with severe acne vulgaris whom were referred to the dermatology clinic of Amir-Almomenin Hospital in Tehran in 2015 and 2016, were recruited. The inclusion criteria were female gender, age between 18 to 50 years, and having severe acne. Exclusion criteria were: pregnancy, lactating, and suffering from other diseases which could confound the study results. The prescribed dose of the oral isotretinoin was 0.5 mg/kg/day for three months. Before initiation of treatment and after three months of treatment serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol, and total and free testosterone were measured and compared.
The mean ± standard deviation (SD) age of the patients was 26.0 ± 7.1 years, and 10% of them had polycystic ovary syndrome (PCOs). After taking isotretinoin, 33 (66%) of patients had no change in their menstrual periods, while 3 (6%) had oligomenorrhea, 4 (8%) had amenorrhea, and 10 (20%) had dysmenorrhea. After treatment, mean serum LH levels significantly increased (P=0.001), but FSH, estradiol, and total and free testosterone serum levels did not change statistically (P>0.05).
This study showed that oral isotretinoin can increase the level of serum LH and cause changes in menstrual cycles.

Vitiligo is a common pigmentary disorder that melanocytes are destroyed. Treatment of vitiligo depends on the extent of the disease and its distribution pattern. The aim of this study was to compare the efficacy of PUVA and NBUVB in patients with vitiligo.
A clinical trial has been performed on 60 patients with vitiligo referred to Bouali hospital and Mehrgan laser center in 1392 and treated with UVB and PUVA therapy methods. In first group treated with PUVA, oral tablets containing 8-methoxypsoralen were taken 3 hours before phototherapy twice a week. The second group was treated with NBUVB twice a week.
In patients treated with PUVA, 40% and in patients treated with NBUVB, 43.3% were male. Seventeen (56.7%) of patients treated with PUVA had generalized vitiligo, 30% of them had segmental Vitiligo and 13.3% had focal Vitiligo. Seventeen (56.7%) patients that were treated with NBUVB generalized vitiligo, 30% had segmental and 10% had focal vitiligo. Repigmentation was significantly higher in patients treated with NBUVB than PUVA 3 and 6 months after initiation of treatment (P NBUVB is superior to PUVA in treatment complications and its recovery rate was acceptable.

The present world is a world of short-sectional relationships, most people identify themselves by acknowledging their appearance instead of considering their inherited or acquired different characteristics. In this study, we decided to compare the body image between patients with skin diseases and healthy participants.
In this case-control study, 300 (150 cases and 150 controls) individuals aged from 18 to 64 years were selected in the Isfahan city. Satisfaction with body image and feelings of respondents regarding their apparent looks in different situations and different conditions were investigated using an a researcher-constructed questionnaire. To analyze the collected data, we used the analysis of covariance and compared the means.
Single, younger, and less educated women had body image scores higher and more positive look to their bodies. Healthy people had higher score of body image than the patients with skin diseases. There was no significant relationship between gender and body image scores.
Skin diseases had an important role in body image. So we suggest that the effect of other diseases, that somehow affect the appearance of people on body image, be examined deeply for each disease.

One of the most important characteristics of women and girls is their eagerness for showing their beauty, which is commonly achieved by using cosmetics and doing makeup. The aim of this study was to determine the prevalence of cosmetics use among high school and university students girls in Yazd city and to measure their knowledge, attitude and practices.
This cross-sectional study was conducted on 400 female high school and university students in Yazd city in 2016. Data were gathered using a four-part questionnaire, which was designed to collect demographic data of the participants as well as, items needed for assessment of knowledge, attitudes, and practice of the participants about using cosmetics. The collected data were described and analyzed using IBM SPSS Statistics (IBM Corp., Armonk, NY, USA) version 22. Independent t, one-way analysis of variance (ANOVA), and chi square tests were used for statistical analyses.
The mean scores of knowledge, attitude and practices of the participants showed that the mean knowledge score of them was related to the age, level of education of parents, parent's occupation and household income (P This study demonstrated that the use of cosmetics among female high school and university students in Yazd was high. Proper training in appropriate use of the cosmetics is needed.

I commonly meet colleagues, resident dermatologists, and medical students who have a misunderstanding about an important point of evidence-based medicine (EBM). Their problem is rooted in their misinterpretation of the "highest level of evidence" and "current best evidence". They usually do not differentiate the crucial difference between the two. Indeed, if they cannot find the "highest level of evidence" for a certain disease, they interpret it as "not having the current best evidence".
It is important to remember that when the "highest level of evidence" cannot be found, the next level of evidence will be considered as the "best current evidence". For example, if there is no systematic review of homogenous, high quality randomized controlled trials for the treatment of a certain disease, the next level, i.e. high quality randomized controlled trial(s), will be "the current best level of evidence". So, there is a need for looking for lower levels of evidence when we could not find the higher ones. Rare diseases are common in dermatology, in many cases the "current best evidence" may be limited to a case report or a colleague's experience.

This is an abstract of the review of the second edition (2017) "Tropical Dermatology" published by Elsevier (ISBN-13: 978-0323296342) and edited by three distinguished tropical dermatologists: Professor Stephen K. Tyring, University of Texas Health Science Center, Houston, Texas; Professor Omar Lupi, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; and Professor Ulrich R. Hengge, University of Düsseldorf, Düsseldorf, Germany.
The book intends to address the needs of dermatologists, infectious and tropical diseases specialists, and travel medicine physicians for updated and practical information on tropical dermatology conditions. It is consisted of 36 chapter in 463 pages.
Of interesting points about this book is its first chapter, which provides a "syndromal" approach to tropical skin conditions facilitating approach to the patients and making differential diagnoses. Chapters two and three provide guidance for the travelers and who are going to work in tropics from a pragmatic point of view. The contents of those two chapters are of significant preventive importance. Another point of strength of "Tropical Dermatology" is providing information on emerging infectious diseases as well as Zika, Ebola, and Dengue fever diseases, which got importance over the past couple of years mainly because of changes in their epidemiology. The chapter on poxviruses was very well written too. Another important feature of this book is its wonderful illustrations. With over 650 full-colored illustrations, all clinical photos, photomicrographs, flowcharts, and tables help the reader to achieve a rapid and deeper understanding of the content. Another strength of "Tropical Dermatology" is its well coverage of both common and rare diseases.
I recommend this book to all resident and practicing dermatologists, infectious diseases and tropical diseases specialists, and those who are dealing with travelers or intend to work in tropics.