فصلنامه پوست و زیبایی
سال سیزدهم شماره 1 (پیاپی 49، بهار 1401)

Hair loss is one of the most common problems among the skin and hair related diseases. Hair loss can lead to anxiety, depression, low self-esteem and dissatisfaction with appearance. 

Patients with androgenetic alopecia who met the eligibility criteria entered the study. Participants were asked to randomly apply a solution of valproic acid 8.3% or a solution of minoxidil 5% on the affected areas according to the treatment protocol (twice a day). Before and 2 months after treatment, the participants were evaluated. The studied indices included the number of hair follicles in the specified area, the number of velus hairs, the number of terminal hairs, the average hair thickness, and the percentage of hairs in the anagen and telogen phases, as well as the skin reactions in the area. Hairs were examined at the beginning of the study and at 2 months after treatment using Foto Finder-trichoscale device. 

Two months after treatment compared to baseline in the valproic group, anagen hair count index (P=0.02), general hair count index (P=0.03), and terminl hair count index (P=0.012) showed significant changes. While telogen hair count (P=0.059) and vellus hair count (P=0.097) did not show significant changes. These changes were more significated in minoxidil group.

8.3% valproic acid solution showed positive effects in increasing the number of hairs and decreasing the percentage of telogen hairs. Due to the delayed mechanism of valproic acid, the duration of treatment with this compound should be considered longer than minoxidil as a positive control.

Oral lichen planus is a chronic
muco-cutaneous immunopathological disorder that commonly affects the oral mucosa. Candida albicans is the most common pathogen associated with oral candidiasis. The aim of this study was to determine the effect of 810 nm low power laser wavelength as an adjuvant in the treatment of
nystatin-resistant C.albicans in patients with oral lichen planus.

In this experimental study, 5 nystatin-resistant C.albicans were isolated from the oral cavity of patients with ulcerative lichen planus. Drug susceptibility testing was performed based on CLSI-M27-A3 and showed that these isolates were resistant to nystatin. The fungal suspension with a dilution of 0.5 McFarland was exposed to a diode laser with a wavelength of 810 nm and a density energy of 20.38 j / cm2 with a time of 20 seconds. Then the results of minimum inhibitory concentration (MIC) were recorded for each group. 

810 nm laser caused a significant reduction in nystatin-resistant C.albicans colonies (P<0.001). The MIC did not decrease significantly after the exposure. 

Laser irradiation reduces the number of nystatin-resistant C.albicans colonies. But this effect does not necessarily change the MIC. Dentists should be aware that in cases of resistant Candida strains, a low-power diode laser with a wavelength of 810 nm can play a role in reducing colonies and responding better to standard treatment.

Skin injuries with various causes may lead to legal action. Complaints are referred to specialized authorities such as Razi Hospital, before specialized forensic medicine commission comment. The present study surveyed demography of patients' complaints and initial diagnosis at the time of referral over a period of 6 months. 

In this retrospective study, patients referred for initial visit, from Forensic Medicine Office in the September 2018-March 2019, were examined. The patients' complaints at the time of referral and the clinical diagnosis made at the initial examination were recorded. 

A total of 220 patients including 176 women (80%) and 44 men (20%) with a mean age of 34.8 years were included. 42 different complaints were documented, including traumatic hair loss with 91 cases (41.4%) - the most common - followed by complications of laser hair removal with 32 cases (14.6%) and filler injections with 16 cases (7.3%). Scarring from trauma, reaction to chemicals during work or accidental contact, rare injuries from various treatments, and even cases of pediculosis (contamination of the accommodation) or zoster (complaint about care in the treatment center), etc. were observed.

Traumatic hair loss (mainly due to fight) was the most common complaint. Knowing other cases may expand physicians' awareness regarding the wide range of complaints that can be raised and improve the process of some treatment measures.

Psoriasis is a chronic inflammatory skin disease, influenced by genetic and immune-based factors that is associated with skin inflammation. Aloe vera gel is traditionally used to treat skin diseases including psoriasis. 

In this study, ethanolic extract of aloe vera gel was evaluated for its anti-inflammatory and antioxidant activity in skin-derived A431 cells. First, after preparing the extract and then the green synthesis of gold nanoparticles using the extract, their effect on the expression of inflammatory genes as well as their antioxidant properties were investigated.  

The use of different concentrations of aloe vera extract caused a relative increase in EGFR and Nrf2 expression levels and decreased expression of NF-κB, TNF-α and IL-6 inflammatory genes in A431 skin cells. But the effect of synthesized nanoparticles was greater than aloe vera extract in altering the expression of signaling and inflammatory genes.

The synthesized extracts and nanoparticles had antioxidant properties and also reduced the expression of inflammatory genes in cells. However, the effect of nanoparticles was much greater than that of extracts in reducing inflammatory genes.

Direct immunofluorescence (DIF) is represented as a gold standard method in diagnosis of autoimmune blistering dermatoses. Normal saline, liquid nitrogen and michel’ solution are a widely accepted media for preserving biopsy samples of skin or mucosa before DIF examination. Occasionally clinicians put the biopsy specimen taken for DIF in formalin 10%, occasionally clinicians ordered DIF retrogradely and only a paraffin-embedded biopsy specimen exposed to formalin 10% is available. To determine the diagnostic value of DIF when it was performed on biopsy samples of skin or mucosa exposed to formalin 10% in comparison to the same biopsy samples exposed to normal saline. 

In 74 patients (38 immunobullous and 23 chronic dermatitis), which the latter served as the normal controls, 2 perilesional punch biopsy of skin or mucosa were done, one put in formalin 10% and fixed in paraffin and one put in normal saline, and DIF was done on both samples.  

DIF sensitivity and specificity was with IgG 31.5% and 100% in pemphigus and 15.36% and 93.44% in BP, with C3 39.47% and 100% in pemphigus and 7.69% and 91.80% in BP, respectively.

DIF on specimens exposed to formalin 10% in comparison to specimens exposed to normal saline is less sensitive but approximately as specific as it is in the diagnosis of pemphigus and BP patients and especially can be useful in pemphigus patients when only a formalin exposed samples is available.

COVID-19 pandemic has led to many mortalities since the beginning of 2020. As there was no previous experience, no specific therapy was used, except for gloves, masks, special clothes, and antiseptics. So various pharmacologic and non-pharmacological treatments were tried. World Health Organization published therapeutic protocols in the first weeks of the pandemic that has been changed over months. As there are constant and variable signs and symptoms in different patients in different countries, therapeutic modalities and drugs are various too. Some of these drugs have been used for viral and nonviral diseases, including Tamiflu (that has been used in the treatment of influenza), Ribavirin (an effective drug in hepatitis C infection), immunoglobulin (that has been used in the treatment of various disorders like Stevens-Johnson syndrome), hydroxychloroquine (for the treatment of systemic lupus erythematosus and other rheumatologic disorders), azithromycin (that is used for upper respiratory tract infections, acne, etc.). On the other hand, consuming spices such as ginger and turmeric, vitamins like vitamin C and vitamin D, and zinc supplements have been suggested. Over months, treatment complications, including side effects of drugs and protective equipment appeared. Complications included a broad spectrum of pruritus and nonspecific rash to Stevens-Johnson syndrome and angioedema. Aggravation and recurrence of dermatitis due to the use of protective equipment and antiseptics have been observed. Increasing knowledge about treatment complications will result in early diagnosis and management and obviously decreasing mortality rates and costs. This article is a review of common cutaneous side effects of therapeutic modalities and preventive methods in COVID-19.

Portwine stains (PWS) lesions are one of the most common childhood vascular malformations that gradually increase in color and thickness without treatment and have profound devastating psychological effects on the child. For this reason, and also because the lesions become resistant to treatment over time, early treatment of these lesions is very important. pulsed dye laser (PDL) is currently the treatment of choice for these lesions. In almost all aspects of the treatment of these lesions with PDL laser, disagreement and sometimes contradictory data are found among various studies. These include the uncertainty of the optimal number of treatment sessions, the appropriate age to start treatment, the optimal parameters to start treatment with and possible methods to increase the effectiveness of PDL, possible treatment side effects and how to deal with them, as well as using different methods to reduce patient discomfort during treatment. The present article collects and reviews existing studies in this field.

Onychomycosis is a nail infection caused by dermatophyte and non-dermatophyte molds and yeasts. The nail involvement is a feature of psoriasis, although skin manifestations are the most principal findings in psoriasis. Onychomycosis and psoriasis are both common disorders in communities. It is possible that in some patients these two diseases are present at the same time. A review was performed using the keywords including nail psoriasis, onychomycoses, dermatophytes, non-dermatophyte molds and yeasts in valid medical databases, such as PubMed, Google scholar, Scopus and Science direct. Articles that were most relevant to the purpose of the study were selected and studied. We investigated the incidence and pathogenic function of fungal agents in causing fungal infections in psoriasis nails.