فصلنامه پوست و زیبایی
سال یازدهم شماره 4 (پیاپی 44، زمستان 1399)

The fourth paper of review article series about COVID-19 includes a selection of interesting and useful information about this disease and dermatology. This paper contains materials published in literature in various basic fields such as epidemiology, pathogenesis, as well as clinical topics such as symptoms and treatments. The skin manifestations of COVID-19, the challenges of treating skin diseases and dermatoses caused by the virus have also been reviewed.

Lesions of the skin can impair its vital function to protect humans against external pathogens. Therefore, producing a suitable wound dressing to repair injuries is always one of the challenges of researchers. The present study aims to Synthesize a hydrogel film for wound dressing applications.

In this research, a hydrogel film of polyvinyl alcohol / hyaluronic acid / nano zinc oxide was fabricated for application as a wound dressing. For this purpose, three films with different percentages were prepared using the solvent casting method. The synthesized samples were characterized using FTIR, SEM, XRD, and tensile tests.

Evaluation of the morphology of the samples showed that the increase of zinc oxide nanoparticles led to porosity and growth of their size in the films. It was also characterized that the percentage of film elongation increased with increasing nanoparticles of zinc oxide and hyaluronic acid. The elongation percentage from the lowest amount of nano zinc oxide to the maximum (5, 10 and 15% of weight was 159%, 166%, and 230%, respectively. The MTT study indicated the cell viability above 80% in all three films.

A film containing 15% zinc oxide can be a suitable option for using in tissue engineering and wound dressing.

Patients' complaints against doctors and medical malpractice is one of the most serious and challenging issues in the medical profession. Due to the importance of this issue and the lack of sufficient information about skin and beauty complaints in the medical system. The purpose of this study is to investigate and identify skin and beauty complaints referred to the Tehran Medical System Organization.

In this descriptive-analytical and retrospective study, all cases of complaints of medical malpractice in the field of dermatology in the medical system of Tehran province from 2014 to 2019 were reviewed and after collecting information, the data were analyzed using SPSS statistical software (SPSS Statistics 25).

Of the total cases, 1.6% were related to skin and beauty. Most of the plaintiffs were female (79.8%) and single (59.6%). The attending physicians were mostly male (79.8%) and general practitioner (48.1%). The most common type was private medical center (95.2%). The most common complaints were treatment complications (36.7%), most of which were related to the side effects of Botox or fat injections (15.4%) and then laser complications (12.5%). The most common type of negligence was carelessness (30%) and 20.7% of cases were declared negligent. The highest percentage of verdicts was written reprimand and inclusion in the file (42.3%).

Physicians should avoid engaging in unrelated disciplines and unscientific practices. Reducing financial relationships and emphasizing the physician's proper interaction with the patient and adhering to a professional commitment are helpful in preventing complaints.

Atrophic scars constitute a common complication of acne and various methods have been proposed for their treatment. This study aims at comparing the efficacy of fractional CO2 laser with microneedling in the management of atrophic acne scars.

Patients with atrophic acne scars presenting to dermatology clinic of Hamadan’s Sina hospital between March 2016 and March 2018 were included in the study. Every 3 weeks, each patient received fractional CO2 laser on one side of the face and microneedling on the other side, for a total of 4 sessions. Patient’s satisfaction and the severity of scars (based on Goodman and Baron’s scar scale) were assessed 1, 2 and 6 months thereafter.

Overall, 24 participants were included. Prior to intervention, no significant difference was observed between groups in terms of mean scar score (P =0.726). At 1, 2 and 6month follow-up visits, the scar score of the side treated with laser was significantly lower than the microneedling side (P for 1, 2 and 6month follow-up visits: 0.033, 0.008 and 0.014). No significant difference was observed between groups in terms of patient’s satisfaction (P for 1, 2 and 6 month follow- up visits: 0.589, 0.469 and 0.840). The most prevalent side effect was erythema in 3 patients treated with laser. Due to low prevalence, statistical analysis of side effects between groups was impossible.

Compared to microneedling, fractional CO2 laser was more effective in reducing the scar score of patients. The prevalence of side effects in both treatments were low.

Full term newborns have a skin that rapidly develops towards adult skin. From the anatomical point of view, the differences are limited, but some changes at birth are responsible for the physiological differences between the skin of infants and adults. Newborns skin exhibits the same barrier function and absorption properties as adults, but external conditions for newborns may be different from those for adults, and these differences may lead to different skin absorption profiles between these two groups. Also, a babychr('39')s temperature regulation (transepidermal water loss (TEWL) and sweating) is not completely developed and the skin becomes easily infected, which is mainly due to changes in pH and immaturity of the skins defense system. This implies why only cosmetics with safe ingredients should be used for newborns. The initial aim is to formulate a simple, pure, gentle and pathogen-free product. Systemic side effects are not expected with washable products but should be taken into account for leave-on products. Great attention should be given to cosmetic products used in the napkin area, especially where there is a possibility of rash. If necessary, more safety precautions should be taken for these products.

Tinea capitis is the most common skin infection on the scalp and an uncommon dermatophytosis in adults. Its clinical appearance varies greatly depending on the causative organism, the type of hair involvement and the extent of the patient inflammatory response. Its common features are fragmented hair loss with varying degrees of scaling and erythema. However, if the clinical symptoms are mild, the diagnosis can be challenging.

We report a case of tinea capitis in a 60-year-old woman who initially had few clinical symptoms and according to the biopsy result and the presence of fibrosis, lichenpilanopilaris (LPP) were diagnosed and she received related treatment with methotrexate and cyclosporine, but after 4 months, no response to treatment and exacerbation of symptoms were observed. Tinea capitis was diagnosed and the patient was given appropriate treatment.

Tinea capitis can imitate clinical features of lichenplanopilaris and mistreatment with corticosteroids can lead to extension of the disease.

Fleas are small, blood-sucking insects that can transmit some pathogens to human and animals.

This paper presents a 21-year-old woman with severe skin reactions in her right forearm. After initial examinations, the symptoms were recognized as skin reaction caused by the bite of some human blood-sucking insects. Finally, after 15 days of flea bites, the symptoms were treated with topical after bite cream and oral antihistamines. In order to prevent and control the infestation of this blood-sucking pest, public awareness should be increased specially in at risk populations.

Increasing awareness among physicians, about the symptoms of this health pest can help to accelerate treatment process.