فصلنامه پوست و زیبایی
سال دوازدهم شماره 1 (پیاپی 45، بهار 1400)

The fifth paper of reviews on COVID-19 addresses COVID-19 vaccines, as vaccination has started in the world and Iran. In this paper, we review different types of available vaccines and also various platforms for production of COVID-19 vaccines as well as the vaccines produced in each platform in the world and Iran. Then the considerations about vaccination in patients with skin diseases, specially those using immunomodulator drugs will be presented. Finally, the cutaneous adverse effects of COVID-19 vaccines will be reviewed.

Warts are benign tumors caused by different types of human papillomavirus. Different methods are used in the treatment of warts. The aim of this study was to compare the effectiveness, side effects and number of treatment sessions of CO2 laser and cryotherapy in the treatment of plantar warts

Seventy patients (140 feet) with plantar warts on both feet who referred to the dermatology clinic of Farshchian (Sina) Hospital in Hamadan during 2019-2020 were selected by convenience sampling method. The warts were randomly treated with either CO2 laser or cryotherapy on each foot. After treatment, patients were evaluated every two weeks for up to five sessions for requirement of treatment repetitions and assessment the extent of healing. In the cases with non-healing lesion, treatment was repeated once every two weeks for up to five sessions. 

The mean age of the patients was 22.11±8.73 years, and 35.7% were male and 64.3% were female. In the CO2 laser and cryotherapy groups, the frequency of recovery rate was 81.4% and 41.4%, (P<0.001), and the mean number of treatment sessions was 1.90±0.84 and 3.55±0.69 (P<0.001) respectively. Frequency and type of side effects in the CO2 laser and cryotrapy group was pain 25.7% and 94.3% (P<0.001), itching zero and 32.9% (P<0.001), blisters 2.9% and 82.9% (P<0.001) and hyperpigmentation with zero and 12.9% (P=0.003), respectively.

CO2 laser is more effective than cryotherapy in less number of sessions and with less side effects for the treatment of plantar warts

Alopecia by reduction of hair follicles at the wound healing site is a complication of cryosurgery that creates an unpleasant appearance in the scar of healed tissue. The aim of this study was to evaluate the effect of low level laser on preventing necrosis of hair follicles and increasing hair follicles in cryosurgery induced wounds.

Fifty male Wistar rats were randomly divided into 2 main experimental and control groups (with and without low power laser) and 5 subgroups. Histopathological examination of the amount of hair follicle count and angiogenesis at intervals of 3, 7, 14, 21 and 28 days was performed in the laboratory. SPSS software was used for statistical analysis. 

There was no significant difference in the  angiogenesis had significantly index between the main groups on days 14 and 21 (P>0.05), but on days 3, 7 and 28, the experimental group had significantly higher angiogenesis than the control group. Throughout the days, both groups showed a significant increase in angiogenesis (P<0.05), except for the third and seventh days in the control group, and in both groups between the 21st and 28th days (P>0.05). In the comparison of hair follicle index, there was an increase on all days, which was significantly higher in the experimental group than the control group (P<0.05). However, no statistical difference was observed between the third and seventh days (P>0.05).

The use of low-power lasers on cryosurgery induced wounds with scars and alopecia can prevent hair follicles necrosis and subsequent increase in their numbers in rats.

Acne vulgaris is one of the most common skin disorders, affecting more than eighty percent of individuals around puberty. Because of the adverse effects on the patient’s appearance, the disease may have detrimental psychological impacts such as low self-esteem and social isolation. The aim of the present study was to evaluate factors affecting self-esteem in patients with acne vulgaris in Hamadan.

Patients with acne vulgaris referred to the  dermatology clinic of Hamadan’s Sina Hospital (as the case group), and their healthy accompanying persons (as the control group) were included in the study. After obtaining written informed consent, demographic data were recorded and participants were asked to fill out a questionnaire. To assess the severity of acne, Global Acne Grading System (GAGS) was used. In addition, Coopersmith Inventory was applied to measure the self-esteem of the participants. In data were analyzed using STATA 14.0 software.

Overall, 184 patients with acne and 177 controls were included in this study. The mean age of patients and controls was 17.89+3.13 and 17.72+2.94, respectively. Independent samples t-test showed that the mean Self-Esteem Index of patients was significantly lower than controls (32.04+8.29 vs. 34.85+7.73, P<0.001). The severity of acne was inversely correlated with self-esteem; one score increase in GAGS would result in 0.1 unit decrease in self-esteem index (P<0.001).

Acne vulgaris is associated with low self-esteem and the severity of acne is inversely correlated with self-esteem level.

Care of patients with skin diseases may lead to high financial costs and burden on health system for societies and family members. In this study, we decided to evaluate the costs of treatments of patients admitted in the dermatology ward of Afzalipour Hospital, Kerman.

This is a retrospective, cross-sectional study performed from 2011 to 2017 on patients admitted in the dermatologic ward of Afzalipour Hospital. Demographic features of patients, duration of admission, cost of treatment, number and type of prescribed drugs as well as the patients’ and insurance organizations’ shares of the cost were recorded.

In this study, 940 patients were evaluated for six years. The mean age of the patients was 38.05±22.35 years and most of them were female. The mean duration of admission was 8.42±2.54 days. The insurance companies’ and patients’ shares of the fees were 93.8% and 6.2%, respectively. The highest costs belonged to prescribed drugs (37.9%) and hoteling (30.3%). The most common prescribed drugs were antihistamines (33.1%), topical steroids (27.7%) and systemic steroids (24.5%). The mean number of prescribed drugs in each admission was 6.30±4.02 (range
0-20). Patients suffering from Erythema and urticaria had the total highest costs of admission (81,360,000 Iran Rials).

In this study, the most frequent skin diseases were infectious and papulosquamous diseases. The highest and lowest cost of admission belonged to prescribed drugs and consultations, respectively. Also, the highest cost of admission belonged to patients with erythema and urticaria.

The presence of variables such as stress, depression and anxiety can overshadow the life of any individual and deviate them from the main path and consequently, from achieving their goals. Therefore, the present study aimed to investigate the efficacy of commitment  and acceptance based therapy (ACT) on reducing stress, depression and anxiety in people with gastrointestinal and skin disorders.

The research method was quasi-experimental with pretest-posttest design, utilizing a control group. The recraited population included all patients with skin and hair disorders, as well as gastrointestinal disorders of psychosomatic origin who visited the clinics of internal medicine physicians and dermatologists and the clinics and hospitals in Bukan in 2019. Among 30 patients who had the highest score in the short form of DASS-21 Depression, Anxiety and Stress Questionnaire were purposefully selected and then randomly divided into experimental (15) and control groups (15). The protocol of ACT sessions based on Hayeschr('39')s (2002) approach was administered to the experimental group for eight 1.5 hour sessions in one month, two sessions per week. The data were analyzed by SPSS software using covariance analysis.

The results showed that there was a significant difference between the means of the experimental and control groups in the variables of stress, depression and anxiety. In fact, ACT reduced the mean stress (7.47±1.959), depression (6.47±1.187), and anxiety (6.67±1.345) in the posttest stage.

Considering the efficacy of this type of treatment, this program is deemed to be a good option for therapists who work in counseling centers and psychological clinics.

Auricular reconstruction of partial ear defects is usually challenging, especially in extended resections or traumas. Helical rim is the most noticeable part of ear with aesthetic significance, which demands detailed procedures. Helical rim advancement is a known procedure to reshape lacerated rim. In the original technique, a chondrocutaneous flap is raised in order to preserve the posterior skin and consequently, the blood supply.

Due to auricle’s rich blood supply, we selected an inferiorly based flap of helical rim, which we incised completely, even the posterior skin, in order to advance the flap more freely to the cephalic side and relaxed cephalically. In five patients with helix tumors, this reconstructive procedure was done without threatening the blood supply and flap ischemia. Moreover, posterior skin traction or subsequent deformity, as one of concerns of reconstructive surgeons, were also eradicated.

It appears that this modification can be noteworthy in auricular reconstruction.