Iranian Journal Of Dermatology
Volume:11 Issue: 2, 2008

Microdermabrasion has recently become a popular procedure among physicians and patients, whereas few studies have assessed the efficacy of different microdermabrasion protocols nowadays applied.The objective of this study was to assess the effects of microdermabrasion, as well as to compare the effects of weekly and biweekly intervals of microdermabrasion sessions on skin biophysical parameters. Ten patients entered this randomized, investigator-blind, split face study and underwent a series of six microdermabrasion treatments. One side of the face was treated every week and the other side was treated every 2 weeks, randomly. Stratum corneum hydration, sebum secretion and skin pH measurements were taken before and after the procedure on all sessions and also 1 and 4 weeks after the last treatment. After 6 sessions of microdermabrasion and following comparison to baseline, a significant decrease in sebum content and a significant increase in skin pH were observed only on the side treated with the intervals of 2 weeks. Changes in skin hydration were not significant on either side. Microdermabrasion may have noticeable effects on skin barrier functions. It is recommended to have 2 week interval between sessions.

Surgical treatments of vitiligo are punch grafting, blister grafting, flip-top transplantation, split skin grafting, etc aiming at rebuilding of melanocytic population in those patients who do not respond to medical treatment. The objective of this study was determination of efficacy of blister grafting technique in the treatment of vitiligo. This study was done on 10 patients with vitiligo of face and /or distal extremities who had received different medical treatments including PUVA and had not responded, and their diseases were stable. Blister in recipient site was created by cryotherapy and in donor site by using vacuum device. Then donor site blister was transferred to the recipient site and both sites were covered by dressing. 10 patients (8 females & 2 males) with mean age of 31.2±11.4 years entered the study. After 1-6 weeks, first signs of repigmentation were observed and after 4 months complete repigmentation occured in 7 patients (70%) In two patients, a repigmentation of more than 50% was observed while in one patient no pigmentation was seen which was related to errors in surgical technique. Blister grafting surgery in limited patches of vitiligo which have not responded to medical treatments gives excellent results of prolonged repigmentation without any scar formation

It appears that chronic lupoid leishmaniasis is the result of type 2 predominant T helper response to parasite and a defect in the down regulation of IL-4 production during infection. The objective of this study was to evaluate the underlying immune status in these patients and their predominant T helper activity we considered serum IgE as an indicator of TH2 activity and IL-4 production as it has been shown in atopic diathesis. In 34 cases of chronic lupoid leishmaniasis serum IgE level was measured and compared with 34 control cases of age and sex matched healthy individuals without atopic diathesis. P< 0.05 was considered statistically significant. There were 21 females and 13 males with a mean age of 14.35±8.3 years in the patients group. The mean age of the control group was 16.11±8.4 (P>0.05 and matched). Nine patients had atopic diathesis. Mean serum IgE level in patients and in the control group was 102.6±22.4 i.u/ml and 135.6±24.9 i.u/ml, respectively (P>0.05 with no significant difference). Mean serum IgE level in patients without atopic diathesis (25 cases) was 66.8±11.3i.u/ml which was significantly lower than the control group (P<0.05). In this study, serum IgE level in cases with chronic lupoid leishmaniasis was lower than the control group and it seems that in these patients, there is not an underlying Th2 over activity as it is seen in atopic diathesis.

Pemphigus vulgaris (PV) is an autoimmune blistering disease, caused by autoantibodies against desmoglein (Dsg) 3 and / or Dsg1 which induce the loss of adhesion between keratinocytes. Nikolsky''s sign is the ability to induce peripheral extension of a blister as a consequence of applying lateral pressure to the border of an intact blister. If the weakening of the intercellular adhesion is present but not marked, then the damage may be demonstrated only microscopically (microscopic Nikolsky’s sign and can increase the sensitivity of the histopathological studies. We studied 40 patients and divided them randomly into two groups (A, B). Group A were subjected to the tangential pressure over the perilesional skin before a biopsy specimen was taken from that site; group B patients were subjected to a biopsy without the tangential pressure technique. Histopathological changes of pemphigus vulgaris were present in 30% of the patients in group A and 5% of the patients in group B. They were not statistically different. The presence of microscopic Nikolsky’s sign was significantly higher in patients with generalized disease. Microscopic Nikolsky sign can increase the sensitivity of histologic diagnosis of PV.

Acne vulgaris is the most common cause for dermatology visits and is one of the most common diseases that people experience during their lives. Although this disease is not life-threatening, it may affect the life quality of the patients because of developing irreparable complications on the skin. Dermatologists are in agreement about topical treatment in the mild to moderate acne vulgaris, but extensive using of tropical antibiotics and drug resistance have decreased their therapeutic benefits. In this study, we tried to compare the therapeutic effects of tropical azithromycin and clindamycin. This study was designed and performed as a double blind, randomized clinical trial. Thirty two patients with mild to moderate acne were treated with azithromycin and 30 patients, who were matched with the former group based on age, sex and severity of the disease, were treated with clindamycin for 12 weeks and results of their treatment were compared with each other. results of this study showed that ratio of response to treatment and decreasing the grade of the disease and number of nodules, papules and pustules were not significantly different in the first month of the treatment in both groups while just the number of nodules in the group on azithromycin showed more decrease in the last months of treatment in comparison with clindamycin (0.88±0.75 vs. 0.25±0.75, p=0.015). Also, clindamycin had more side effects, but the rate of satisfaction with both drugs were high and showed no difference. In this study, no significant association was found between sex and response to treatment and evaluation of association between age and response to treatment showed a significant reverse association between age and decreasing the number of pustules (p=0.002, r= - 0.492). sum of findings in this study show that topical azithromycin is an effective antibiotic with acceptable side effects and high degree of satisfaction in patients and it can be used for the treatment of mild forms of acne.

Basal cell carcinoma (BCC) is the most common cutaneous malignancy. UV light is an important risk factor for BCC, as well as X-ray and other ionizing radiations. The aim of this study was evaluation and risk factor assessment of BCC cases referred to Razi hospital tumor clinic. Patients referred from general clinics with skin biopsies consistent with Basal Cell Carcinoma were enrolled. A questionnaire including epidemiologic data, risk factor exposure and specification of skin lesions was completed for each patient. From October 2005 to October 2006, a total of 476 patients with cutaneous malignancy referred to Tumor clinic of Razi hospital. Of them, 367 patients had BCC. 215 were male (58%) and 152 were female (42%). Mean age of patients was 62 (±12.7) and 62 (±13.4) years for men and women, respectively. The most common risk factors for BCC were radiotherapy and chronic sun exposure. The most common tumor sites were scalp, nose and ears. Of different clinico-pathologic types, noduloulcerative type was the most common. It seems that radiotherapy is an important risk factor in Iranian BCC patients and it is useful to have a screening program for case finding and treating patients in early stages.

In a number of important clinical issues such as evaluation of the efficacy or effectiveness of therapeutic or preventive interventions as well as for comparing the harms of interventions, randomized controlled trials (RCTs) provide the highest levels of evidence, either directly or indirectly. It is obvious that critical appraisal of these studies to assess their validity and precision is of paramount importance. The aim of this review is to provide the readership an outline about different types of RCTs, the importance of proper appraisal of RCTs, an overview of the most important factors that have an influence on the validity of an RCT and a strategy for systematic evaluation of those factors, and to introduce some useful methods for improving design, implementation and reporting of RCTs as well as some tools that are used for the evaluation of these studies. It is expected that after reading this review, the reader obtains some knowledge about different phases and types of RCTs, as well as being enabled to evaluate the four major factors: randomization sequence generation, randomization concealment, blinding and intention to treat analysis that affect the validity of an RCT.

Lichen sclerosus (LS) is a chronic benign inflammatory disorder of skin and mucosa which affects patients of all age groups, sex and race, particularly caucasian prepubertal girls and postmenopausal women. The etiology of LS is unknown, but it has been suggested that genetic predisposition to inflammatory disorders, immunological constitutions, hormonal influences and local factors might play a role. Extragenital LS are most common on the neck, shoulders and upper portion of the trunk. It is generally asymptomatic, but occasionally pruritic. The Koebner sign is a well-known diagnostic marker in LS. Typical lesions have been noted to occur following surgical operations, infections, rubbing of skin, in old thermal burn scar, sexual abuse and under tight clothing. We describe a 25-year-old Iranian woman presented with a 2-month history of extragenital LS. The multiple classical lesions of disease were presented over her neck, shoulders, upper part of trunk, the medial area of her thighs and feet at the dorsal site. The diagnosis of LS was confirmed by histological findings. Beside LS classical lesions on her back, linear lesions including Koebner phenomenon were observed at the sites of rubbing and itching of skin.

We report a 61-year-old man with multiple colored skin papules with central crusts in an archiform and linear pattern on his forehead as well as verrucus and hyperkeratotic plaques with central perforation on hands. Histologic examination of the lesions demonstrated a narrow channel of epidermal perforation containing notrophils, basophilic debris and elastic fibers with eosinophilic degeneration compatible with the diagnosis of elastosis perforans serpiginosa.