Journal of Skin and Stem Cell
Volume:4 Issue: 1, Mar 2017

Scars result from prolonged inflammatory phases and abnormal fibroproliferative responses in wounds. Regardless of beauty considerations that have profound psychological and social effects, scars can also have physical effects, such as growth constraints in children. Applying molecular and cellular mechanisms imitating the fetal scarless wound healing, brings about new and effective therapeutic strategies for alleviating scars. This review concentrated on innovative approaches, which simultaneously target multiple effective pathways in reducing scars.

 The most outstanding products for reducing scars, were TGF-β3 and IL-10, which failed in phase III clinical trial on their way to reach the market. In this review, multi-targeting remedies for reducing scars and their effective in vitro and in vivo mechanisms are discussed in details. There is also evidence in translation of these investigations to clinical trials.

MiRNAs are unique molecular components with pleiotropic actions, which target multiple signaling pathways in scars at the same time. Fetal cells, mesenchymal stem cells, and oral mucosal cells secrete a natural relevant concentration of growth factors and cytokines that are effective in scar reduction. Fat grafting is a promising treatment for scars, providing an appropriate extra cellular matrix with homing mesenchymal stem cells.

Increasing the concentration of one growth factor or cytokine overexpressed in fetal scarless wound healing is not sufficient individually in scar reduction. Despite the profound effects of cells in scars, using biomimetic materials, which mimic the fetal cell microenviroment, should also be taken into account

Melasma is an acquired facial hyperpigmentation that is chronic and resistant to treatment. This study aimed at comparing the therapeutic response and safety of 5% methimazole cream versus 2% hydroquinone cream in Iranian females with melasma.

This was a randomized, controlled, double-blind clinical trial. Fifty-eight patients aged 18 to 50, and who had been clinically diagnosed with melasma were enrolled. They were randomly divided to 2 groups: those treated with 5% methimazole cream and those treated with 2% hydroquinone once nightly for 8 weeks. Their responses to treatment were evaluated using the Melasma area and severity index (MASI), the ΔE score obtained using VisioFace digital photography, and the patients’ own satisfaction. Safety was assessed by measuring thyroid-stimulating hormone (TSH) levels. For statistical analysis, the SPSS version 16.0 for Windows (SPSS Inc., Chicago, IL) was used.

The subjective assessments of methimazole and hydroquinone (patient satisfaction) were as follows: excellent and good, 67.7% for methimazole vs. 70.3% for hydroquinone, and moderate and mild, 32.2% for methimazole versus 29.6% for hydroquinone. The assessments showed no statistical differences between the 2 groups (P = 0.942). At the end of treatment, MASI scores were significantly lower in the methimazole group than in the hydroquinone group (P = 0.042). The VisioFaceΔE scores were also significantly lower in the methimazole group than in the hydroquinone group (P = 0.049). Serum thyroid stimulating hormone (TSH) levels showed no statistical differences between the 2 groups (P = 0.613).

Compared with 2% hydroquinone, topical methimazole was more effective for improving melasma and had no effect on serum TSH levels. Therefore, methimazole could be considered as a first-line or combination therapy for melasma.

The use of botulinum toxin-A is increasing for aesthetic treatments and new reassuring data have been reported in recent studies. The purpose of this study was to evaluate the complications of botulinum toxin-A (BoTo-A) (NEURONOX) injection to eliminate wrinkles in the upper one-third of the face.

The present study was conducted on 235 patients referring to the dermatology clinic of Rasoul Akram hospital in Iran (including 82 men and 153 women with a mean age of 50 years) for the treatment of forehead, frown, and lateral orbital rim wrinkles between 2011 and 2015. The injection level was 35 units of botulinum toxin-A (NEURONOX) for women and 45 for men in the glabella area, and 15 units for women and 20 units for men in the crow’s feet area.

The complications of botulinum toxin-A injection among 235 subjects were as follows: 1.3% ptosis (n = 3), 1.7% angioneurotic edema (n = 4), 2.1% vasovagal syncope (n = 5), 3.8% haematoma (n = 9), 1.7% diplopia (n = 4), and 2.1% musculoskeletal pain (n = 5). The satisfaction rate of patients with a complication measured one month after injection indicated that 63.3% (19/30) were satisfied with the injection and 36.7% (11/30) were dissatisfied. The satisfaction rate of patients without a complication showed that 91.7% (188/205) were pleased and 8.3% (17/205) were dissatisfied with the injection.

According to the findings of this study, the injection of BoTo-A (NEURONOX) to attenuate glabellar lines and the lateral orbital rim was safe and effective. The complications in this study were not serious and generally were transient and self-limiting

Photodynamic therapy (PDT) by nanoparticles (NPs) has been proposed as a new emerging therapeutic approach for the treatment of melanoma. In this study, the researchers investigate potential of photodynamic graphene oxide (GO)/TiO2 hybrid (GOT) NPs as new photosensitizers (PSs) in A375 melanoma cancer cell line. The results showed that while different concentrations of GOT NPs (1 - 100 μg/mL) were inert, their irradiation with visible-light induced growth arrest and cell death in A375 cells in a dose-despondent manner. These anti-cancer effects were accompanied by significant morphological changes, suggesting GOT NPs have a potential for further evaluation as new generation of PSs for cancer therapy.

Kaposi sarcomais a low-grade malignant vascular lesion, which has different histological variants. Pyogenic granuloma-like Kaposi sarcoma is an unusual type of this tumor, which presents as anexophytic small nodule surrounded by an epidermal collaret mimicking pyogenic granuloma yet it has immunohistopathologic features of Kaposi sarcoma.

A 57-year old male with 2 exophytic lesions on the left hand and left foot for 3 months was presented to our center. Both lesions were excised and diagnosis of Kaposi sarcoma was confirmed by histopathology and immunohistochemistry. Human herpesvirus 8 DNA was detected by the polymerase chain reaction in the lesions.

Immunostaining methods should be considered in pyogenic granuloma-like lesions with unusual presentation