Journal of Skin and Stem Cell Journal of Skin and Stem Cell J Skin Stem Cell http://www.journalssc.com 2423-7086 10.5812/jssc. en jalali 2017 6 24 gregorian 2017 6 24 1 1
en 10.17795/jssc16313 Topical Anesthetic Effect of EMLA and Iranian Products in Preventing Pain During Intravenous Blood Sampling Procedures: a Double-Blind Randomized Clinical Trial Topical Anesthetic Effect of EMLA and Iranian Products in Preventing Pain During Intravenous Blood Sampling Procedures: a Double-Blind Randomized Clinical Trial research-article research-article Conclusions

Although the results of this study showed superiority of application of EMLA cream as a topical anesthetic for pain relief of blood sampling, both lidocaine 5% and benzocaine 5% offer considerable efficacy in pain relief of venipuncture.

Results

At the end of study, the EMLA products (A and B) caused a significant decrease in pain (P < 0.05) in comparison with the products C (lidocaine) and D (benzocaine) while there was no differences between benzocaine and lidocaine. In this study, no significant side effect was observed.

Objectives

This double-blind randomized clinical trial was designed to compare the anesthetic effect of topical EMLA 5% cream with Iranian lidocaine 5% and benzocaine 5% creams.

Patients and Methods

Sixty-four healthy volunteers were randomly allocated into two groups. In each individual, EMLA cream and one of Iranian topical anesthetic products, namely lidocaine 5% and benzocaine 5%, were tested. One hour before blood sampling, a predetermined amount of A or B cream was used on the right cubital fossa and the same amount of C or D cream on the left cubital fossa. Blood sampling was done via cubital fossa veins with a 2 cc syringe. The pain of blood sampling was recorded using visual analogue scale (VAS). Data were analyzed by student t-test and ANOVA using SPSS version 11.

Background

The patients’ concerns about injection pain can cause some unwanted adverse reactions such as hypotension, vasovagal shock, syncope, and unconsciousness. Therefore, using a skin anesthetic can facilitate performing many medical procedures.

Conclusions

Although the results of this study showed superiority of application of EMLA cream as a topical anesthetic for pain relief of blood sampling, both lidocaine 5% and benzocaine 5% offer considerable efficacy in pain relief of venipuncture.

Results

At the end of study, the EMLA products (A and B) caused a significant decrease in pain (P < 0.05) in comparison with the products C (lidocaine) and D (benzocaine) while there was no differences between benzocaine and lidocaine. In this study, no significant side effect was observed.

Objectives

This double-blind randomized clinical trial was designed to compare the anesthetic effect of topical EMLA 5% cream with Iranian lidocaine 5% and benzocaine 5% creams.

Patients and Methods

Sixty-four healthy volunteers were randomly allocated into two groups. In each individual, EMLA cream and one of Iranian topical anesthetic products, namely lidocaine 5% and benzocaine 5%, were tested. One hour before blood sampling, a predetermined amount of A or B cream was used on the right cubital fossa and the same amount of C or D cream on the left cubital fossa. Blood sampling was done via cubital fossa veins with a 2 cc syringe. The pain of blood sampling was recorded using visual analogue scale (VAS). Data were analyzed by student t-test and ANOVA using SPSS version 11.

Background

The patients’ concerns about injection pain can cause some unwanted adverse reactions such as hypotension, vasovagal shock, syncope, and unconsciousness. Therefore, using a skin anesthetic can facilitate performing many medical procedures.

Pain Management;EMLA;Anesthetics,Topical Pain Management;EMLA;Anesthetics,Topical http://www.journalssc.com/index.php?page=article&article_id=16313 Fariba Jaffary Fariba Jaffary Skin Diseases and Leishmaniasis Research Center Isfahan University of Medical Sciences Isfahan, Iran; Skin and Stem Cell Research Center Tehran University of Medical Sciences Tehran, Iran Skin Diseases and Leishmaniasis Research Center Isfahan University of Medical Sciences Isfahan, Iran; Skin and Stem Cell Research Center Tehran University of Medical Sciences Tehran, Iran Mohammad Ali Nilforoushzadeh Mohammad Ali Nilforoushzadeh Skin Diseases and Leishmaniasis Research Center Isfahan University of Medical Sciences Isfahan, Iran; Skin and Stem Cell Research Center Tehran University of Medical Sciences Tehran, Iran; Skin and Stem Cell Research Center Tehran University of Medical Sciences Tehran, Iran. Tel: +98-9133137166, Fax: +98-2122201710 Skin Diseases and Leishmaniasis Research Center Isfahan University of Medical Sciences Isfahan, Iran; Skin and Stem Cell Research Center Tehran University of Medical Sciences Tehran, Iran; Skin and Stem Cell Research Center Tehran University of Medical Sciences Tehran, Iran. Tel: +98-9133137166, Fax: +98-2122201710 Parviz Toossi Parviz Toossi Skin Research Center, Shahid-Beheshti University of Medical Sciences, Tehran, Iran Skin Research Center, Shahid-Beheshti University of Medical Sciences, Tehran, Iran Hajar Zarkoob Hajar Zarkoob Skin and Stem Cell Research Center Tehran University of Medical Sciences Tehran, Iran Skin and Stem Cell Research Center Tehran University of Medical Sciences Tehran, Iran Foroud Shahbazi Foroud Shahbazi School of Pharmacy Isfahan University of Medical Sciences Isfahan, Iran School of Pharmacy Isfahan University of Medical Sciences Isfahan, Iran
en 10.17795/jssc16633 Comparison Between Intralesional Meglumine Antimoniate and Combination of Trichloroacetic Acid 50% and Intralesional Meglumine Antimoniate in the Treatment of Acute Cutaneous Leishmaniasis: A Randomized Clinical Trial Comparison Between Intralesional Meglumine Antimoniate and Combination of Trichloroacetic Acid 50% and Intralesional Meglumine Antimoniate in the Treatment of Acute Cutaneous Leishmaniasis: A Randomized Clinical Trial research-article research-article Background

Cutaneous leishmaniasis (CL) is an endemic disease in Iran. Pentavalent antimonials including meglumine antimoniate (MA) are still the gold standard treatment. Trichloroacetic acid (TCA) is used in treatment of acne scar, photodamaged skin, and some other dermatologic diseases. Considering the TCA potential to induce collagen synthesis and its efficacy in the treatment of papular CL lesions, this study was conducted to assess the efficacy of combined intralesional MA and TCA in comparison to MA alone in treatment of CL.

Objectives

This study was designed to compare the efficacy of the combination therapy of intralesional MA and TCA with intralesional MA alone in the treatment of CL.

Patients and Methods

A total of 200 patients with confirmed CL were selected and randomized into two treatment groups. Both groups were treated with intralesional injection of MA twice a week until complete resolution of the lesions or end of the eighth week. In combination therapy group, TCA was applied to the lesions fortnightly for eight weeks. Data were analyzed statistically using chi-square, student t, and Kaplan-Meier tests.

Results

Complete resolution of the lesions was achieved in 79.2% of patients treated with MA and 85.7% of patients receiving combination therapy (P > 0.05). There was a significant difference in time to achieve the complete resolution between the groups with an accelerated resolution rate in the combination therapy group (P < 0.05).

Conclusions

According to the results of this study, combination therapy with intralesional MA and TCA 50% could accelerated the resolution of CL lesions with no significant difference in complete resolution rate in comparison to the patients treated with intralesional MA alone. Topical application of TCA 50% as an adjuvant therapy might have some advantages in decreasinge the resolution time of the lesions in patients with CL.

Background

Cutaneous leishmaniasis (CL) is an endemic disease in Iran. Pentavalent antimonials including meglumine antimoniate (MA) are still the gold standard treatment. Trichloroacetic acid (TCA) is used in treatment of acne scar, photodamaged skin, and some other dermatologic diseases. Considering the TCA potential to induce collagen synthesis and its efficacy in the treatment of papular CL lesions, this study was conducted to assess the efficacy of combined intralesional MA and TCA in comparison to MA alone in treatment of CL.

Objectives

This study was designed to compare the efficacy of the combination therapy of intralesional MA and TCA with intralesional MA alone in the treatment of CL.

Patients and Methods

A total of 200 patients with confirmed CL were selected and randomized into two treatment groups. Both groups were treated with intralesional injection of MA twice a week until complete resolution of the lesions or end of the eighth week. In combination therapy group, TCA was applied to the lesions fortnightly for eight weeks. Data were analyzed statistically using chi-square, student t, and Kaplan-Meier tests.

Results

Complete resolution of the lesions was achieved in 79.2% of patients treated with MA and 85.7% of patients receiving combination therapy (P > 0.05). There was a significant difference in time to achieve the complete resolution between the groups with an accelerated resolution rate in the combination therapy group (P < 0.05).

Conclusions

According to the results of this study, combination therapy with intralesional MA and TCA 50% could accelerated the resolution of CL lesions with no significant difference in complete resolution rate in comparison to the patients treated with intralesional MA alone. Topical application of TCA 50% as an adjuvant therapy might have some advantages in decreasinge the resolution time of the lesions in patients with CL.

Leishmaniasis, Cutaneous;Meglumine Antimoniate;Trichloroacetic acid;Combined Modality Therapy Leishmaniasis, Cutaneous;Meglumine Antimoniate;Trichloroacetic acid;Combined Modality Therapy http://www.journalssc.com/index.php?page=article&article_id=16633 Mohammad Ali Nilforoushzadeh Mohammad Ali Nilforoushzadeh Skin and Stem cell Research Center, Tehran University of Medical Sciences, Tehran, Iran; Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Skin and Stem cell Research Center, Tehran University of Medical Sciences, Tehran, Iran; Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Fariba Jaffary Fariba Jaffary Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Tel: +98-9133137166, Fax: +98-2122201710 Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Tel: +98-9133137166, Fax: +98-2122201710 Roya Derakhshan Roya Derakhshan Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Elaheh Haftbaradaran Elaheh Haftbaradaran Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
en 10.17795/jssc17793 Analysis of Laser-Fat Interaction Through Comparing 980 nm Diode Laser With 1064 nm Nd:YAG Laser Analysis of Laser-Fat Interaction Through Comparing 980 nm Diode Laser With 1064 nm Nd:YAG Laser research-article research-article Results

The simulation results showed that the penetration depth and temperature rise of 980 nm wavelengths were different from those of 1064 nm wavelength. It appeared that 1064 nm wavelength penetrated to deeper layers of tissue compared with 980 nm. Moreover, temperature rise during 1064 nm irradiation led to temperature increase in allowable ranges. The findings proved the reason why 1064 nm wavelength are commonly used in laser lipolysis in comparison with 980 nm wavelength.

Conclusions

The simulation indicated that temperature rise in 980 nm wavelength was 70.802 ℃, which was higher than that of 1064 nm wavelength. Therefore, 980 nm laser can leave unwanted negative effects on tissues including hyperthermia.

Materials and Methods

In this study, penetration depth and tissue heating following laser irradiation with a 980 nm diode laser were investigated. This laser is different from 1064 nm Nd:YAG in terms of absorption and scattering coefficient. Hence, dissimilar results for beam penetration and tissue heating were expected. Monte Carlo method was used to simulate radiation (photons) propagation in tissues. Using such simulation can be useful in evaluating penetration depth, absorption, scattering and reflection of the photon within the tissue and across the tissue borders. Temperature rise was simulated using Comsol Multiphysics software.

Objectives

The study aimed at evaluating the effects of these highly important parameters of lipolysis operations.

Background

Liposuction nowadays is the most popular way of weight loss and body contouring. It is a mechanical procedure to reduce fat through the back-and-forth movement of a heavy metal called cannula. The thick cannula, essential for efficient fat removal and subsequent suctioning, causes some undesirable effects such as bruise, scars, heavy blood loss, skin laxity and long-run recovery. While, the new method of liposuction using a 100-300 µm fiber laser inserted into a thin cannula of 1 mm diameter causes less distress and bleeding. Simultaneous interaction between laser radiation and tissue causes faster skin tightening and coagulation of small blood vessels.

Results

The simulation results showed that the penetration depth and temperature rise of 980 nm wavelengths were different from those of 1064 nm wavelength. It appeared that 1064 nm wavelength penetrated to deeper layers of tissue compared with 980 nm. Moreover, temperature rise during 1064 nm irradiation led to temperature increase in allowable ranges. The findings proved the reason why 1064 nm wavelength are commonly used in laser lipolysis in comparison with 980 nm wavelength.

Conclusions

The simulation indicated that temperature rise in 980 nm wavelength was 70.802 ℃, which was higher than that of 1064 nm wavelength. Therefore, 980 nm laser can leave unwanted negative effects on tissues including hyperthermia.

Materials and Methods

In this study, penetration depth and tissue heating following laser irradiation with a 980 nm diode laser were investigated. This laser is different from 1064 nm Nd:YAG in terms of absorption and scattering coefficient. Hence, dissimilar results for beam penetration and tissue heating were expected. Monte Carlo method was used to simulate radiation (photons) propagation in tissues. Using such simulation can be useful in evaluating penetration depth, absorption, scattering and reflection of the photon within the tissue and across the tissue borders. Temperature rise was simulated using Comsol Multiphysics software.

Objectives

The study aimed at evaluating the effects of these highly important parameters of lipolysis operations.

Background

Liposuction nowadays is the most popular way of weight loss and body contouring. It is a mechanical procedure to reduce fat through the back-and-forth movement of a heavy metal called cannula. The thick cannula, essential for efficient fat removal and subsequent suctioning, causes some undesirable effects such as bruise, scars, heavy blood loss, skin laxity and long-run recovery. While, the new method of liposuction using a 100-300 µm fiber laser inserted into a thin cannula of 1 mm diameter causes less distress and bleeding. Simultaneous interaction between laser radiation and tissue causes faster skin tightening and coagulation of small blood vessels.

Laser Lipolysis;Semiconductor;Fat Tissue, Penetration Depth Laser Lipolysis;Semiconductor;Fat Tissue, Penetration Depth http://www.journalssc.com/index.php?page=article&article_id=17793 Abbas Majdabadi Abbas Majdabadi Department of Gaseous Lasers, Atomic Energy Organization of Iran, Tehran, Iran Department of Gaseous Lasers, Atomic Energy Organization of Iran, Tehran, Iran Mohammed Abazari Mohammed Abazari Faculty of Energy Engineering and Physics, Amirkabir University of Technology, Tehran, Iran; Faculty of Energy Engineering and Physics, Amirkabir University of Technology, P.O. Box: 15875-4413, Tehran, Iran. Tel: +98-9377326811, Fax: +98- 6641 4113 Faculty of Energy Engineering and Physics, Amirkabir University of Technology, Tehran, Iran; Faculty of Energy Engineering and Physics, Amirkabir University of Technology, P.O. Box: 15875-4413, Tehran, Iran. Tel: +98-9377326811, Fax: +98- 6641 4113
en 10.17795/jssc16631 Concentrated Extracts of Cassia fistula Versus Intralesional Injection of Meglumine Antimoniate in Treatment of Acute Cutaneous Leishmaniasis Concentrated Extracts of <italic>Cassia fistula</italic> Versus Intralesional Injection of Meglumine Antimoniate in Treatment of Acute Cutaneous Leishmaniasis research-article research-article Background

Cutaneous leishmaniasis is an endemic disease in Iran. Although there are several treatment modalities for this disease, pentavalent antimonials are still considered as first line agents. There have been several reports concerning the effectiveness of Cassia fistula plant for leishmaniasis treatment.

Objectives

This study was designed to assess the effectiveness of concentrated boiled and hydroalcoholic extracts of C. fistula on leishmaniasis lesions in comparison with intralesional injection of meglumine antimoniate (MA).

Patients and Methods

In this randomized parallel clinical trial, 165 patients, 6-60 years old, with positive results of leishmaniasis smear tests were selected amongst the patients referred to the Skin Diseases and Leishmaniasis Research Center (SDLRC), Isfahan, Iran. They were randomly allocated to three groups for treatment with concentrated boiled extract of C. fistula, hydroalcoholic extract of C. fistula, and intralesional injection of MA. Patients were assessed at weeks one, two, three, four, and 16. Results of the treatment were reported as complete, partial, and no improvement.

Results

complete resolution of the lesions at week 16 was observed in 22 (40%), 20 (36.4%), and 36 (65.5%) patients, in those treated with concentrated boiled extract of C. fistula, hydroalcoholic extract of C. fistula, and intralesional injection of MA, respectively. The efficacy of intralesional injection of MA was significantly more than concentrated boiled extract of the C. fistula application (P = 0.02). In addition, the efficacy of intralesional injection of MA was significantly more than hydroalcoholic extract of the C. fistula application (P = 0.005). There was no significant difference between the efficacy of concentrated boiled extract and the hydroalcoholic extract of the C. fistula (P = 0.61).

Conclusions

Our study showed that almost 40% of the patients treated with C. fistula achieved complete resolution of the lesions. We recommend further evaluation of the effect of combined intralesional injection of MA and topical therapy with this plant, to assess the accelerating resolution of leishmaniasis lesions, and possibly decrease the applied dose of MA.

Background

Cutaneous leishmaniasis is an endemic disease in Iran. Although there are several treatment modalities for this disease, pentavalent antimonials are still considered as first line agents. There have been several reports concerning the effectiveness of Cassia fistula plant for leishmaniasis treatment.

Objectives

This study was designed to assess the effectiveness of concentrated boiled and hydroalcoholic extracts of C. fistula on leishmaniasis lesions in comparison with intralesional injection of meglumine antimoniate (MA).

Patients and Methods

In this randomized parallel clinical trial, 165 patients, 6-60 years old, with positive results of leishmaniasis smear tests were selected amongst the patients referred to the Skin Diseases and Leishmaniasis Research Center (SDLRC), Isfahan, Iran. They were randomly allocated to three groups for treatment with concentrated boiled extract of C. fistula, hydroalcoholic extract of C. fistula, and intralesional injection of MA. Patients were assessed at weeks one, two, three, four, and 16. Results of the treatment were reported as complete, partial, and no improvement.

Results

complete resolution of the lesions at week 16 was observed in 22 (40%), 20 (36.4%), and 36 (65.5%) patients, in those treated with concentrated boiled extract of C. fistula, hydroalcoholic extract of C. fistula, and intralesional injection of MA, respectively. The efficacy of intralesional injection of MA was significantly more than concentrated boiled extract of the C. fistula application (P = 0.02). In addition, the efficacy of intralesional injection of MA was significantly more than hydroalcoholic extract of the C. fistula application (P = 0.005). There was no significant difference between the efficacy of concentrated boiled extract and the hydroalcoholic extract of the C. fistula (P = 0.61).

Conclusions

Our study showed that almost 40% of the patients treated with C. fistula achieved complete resolution of the lesions. We recommend further evaluation of the effect of combined intralesional injection of MA and topical therapy with this plant, to assess the accelerating resolution of leishmaniasis lesions, and possibly decrease the applied dose of MA.

Leishmaniasis,Cutaneous;Cassia Fistula;Meglumine Antimoniate Leishmaniasis,Cutaneous;Cassia Fistula;Meglumine Antimoniate http://www.journalssc.com/index.php?page=article&article_id=16631 Fariba Jaffary Fariba Jaffary Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Mohammad Ali Nilforoushzadeh Mohammad Ali Nilforoushzadeh Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran; Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-2122201710, Fax: +98-2122201710 Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran; Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-2122201710, Fax: +98-2122201710 Shahram Moradi Shahram Moradi Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Roya Derakhshan Roya Derakhshan Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Nazli Ansari Nazli Ansari Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
en 10.17795/jssc16639 Determination of Whether Vitiligo is a Contraindication to Interferon Therapy in Chronic Hepatitis C Determination of Whether Vitiligo is a Contraindication to Interferon Therapy in Chronic Hepatitis C editorial editorial Hepatitis B;Vaccination;Military Medicine;Primary Prevention;Vitiligo Hepatitis B;Vaccination;Military Medicine;Primary Prevention;Vitiligo http://www.journalssc.com/index.php?page=article&article_id=16639 Seyed Moayed Alavian Seyed Moayed Alavian Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran; Middle East Liver Disease Center, Tehran, Iran; Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Mollasadra St., Vanak Sq., P.O. Box: 14155/3651, Tehran, Iran. Tel/Fax: +98-2188945186 Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran; Middle East Liver Disease Center, Tehran, Iran; Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Mollasadra St., Vanak Sq., P.O. Box: 14155/3651, Tehran, Iran. Tel/Fax: +98-2188945186
en 10.17795/jssc18875 Efficacy of Intralesional Bleomycin in the Treatment of Resistant Warts Efficacy of Intralesional Bleomycin in the Treatment of Resistant Warts research-article research-article Background

Warts are benign tumors of the skin and mucosa and are caused by human papilloma virus (HPV). They are one of the most common skin diseases found mainly in children and adolescents. Although most of the warts disappear spontaneously or respond to the usual therapeutic measures, resistant forms of the warts impose a problem in dermatology. Intralesional injection of bleomycin has been tried in the treatment of resistant warts with variable results in different studies.

Objectives

This study aimed to assess the efficacy of intralesional injection of bleomycin in resistant warts.

Patients and Methods

In this cross-sectional study, a total of 130 warts in 30 patients were treated with 1 mg/mL intralesional injection of bleomycin. Patients received one to three doses of bleomycin every four weeks, and were followed for six months. Response to the treatment was categorized as complete resolution, partial resolution, and nonresponsive. We employed SPSS version 13 to perform t test and analysis of variance (Anova) as statistical methods for analyzing the data.

Results

Out of 130 warts, 126 (97%) cases showed resolution after bleomycin injections. Ninety-five warts (73%) showed complete resolution and 31 (24%) cases showed incomplete resolution. The cure rate (80%) was better in warts with the size smaller than 20 mm in diameter in comparison with larger lesions (46%). After six months follow-up, 7 patients showed recurrence. Recurrence was seen more among those with greater number of warts.

Conclusions

This form of treatment for resistant warts would be reliable, safe, and acceptable to the patients if it is performed under care and with proper dose and concentration.

Background

Warts are benign tumors of the skin and mucosa and are caused by human papilloma virus (HPV). They are one of the most common skin diseases found mainly in children and adolescents. Although most of the warts disappear spontaneously or respond to the usual therapeutic measures, resistant forms of the warts impose a problem in dermatology. Intralesional injection of bleomycin has been tried in the treatment of resistant warts with variable results in different studies.

Objectives

This study aimed to assess the efficacy of intralesional injection of bleomycin in resistant warts.

Patients and Methods

In this cross-sectional study, a total of 130 warts in 30 patients were treated with 1 mg/mL intralesional injection of bleomycin. Patients received one to three doses of bleomycin every four weeks, and were followed for six months. Response to the treatment was categorized as complete resolution, partial resolution, and nonresponsive. We employed SPSS version 13 to perform t test and analysis of variance (Anova) as statistical methods for analyzing the data.

Results

Out of 130 warts, 126 (97%) cases showed resolution after bleomycin injections. Ninety-five warts (73%) showed complete resolution and 31 (24%) cases showed incomplete resolution. The cure rate (80%) was better in warts with the size smaller than 20 mm in diameter in comparison with larger lesions (46%). After six months follow-up, 7 patients showed recurrence. Recurrence was seen more among those with greater number of warts.

Conclusions

This form of treatment for resistant warts would be reliable, safe, and acceptable to the patients if it is performed under care and with proper dose and concentration.

Bleomycin;Injections,Intralesional;Papilloma Virus Bleomycin;Injections,Intralesional;Papilloma Virus http://www.journalssc.com/index.php?page=article&article_id=18875 Mir-Hadi Aziz-Jalali Mir-Hadi Aziz-Jalali Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Rassoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Rassoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran Gholamhossein Ghafarpour Gholamhossein Ghafarpour Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Rassoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Rassoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran Mohammad Reza Rezaei Mohammad Reza Rezaei Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Rassoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Rassoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran Ashkan Heshmatzadeh Behzadi Ashkan Heshmatzadeh Behzadi Department of Dermatology, Iran University of Medical Sciences, Tehran, Iran Department of Dermatology, Iran University of Medical Sciences, Tehran, Iran Masoumeh Rohani Nasab Masoumeh Rohani Nasab Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran Mohammad Ali Nilforoushzadeh Mohammad Ali Nilforoushzadeh Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran; Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-2122201710, Fax: +98-2122201710 Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran; Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-2122201710, Fax: +98-2122201710
en 10.17795/jssc16333 Bath PUVA in Severe and Refractory Atopic Dermatitis Bath PUVA in Severe and Refractory Atopic Dermatitis research-article research-article Background

Atopic dermatitis (AD) is a chronic inflammatory skin disease. Phototherapy is considered as an effective treatment modality in severe cases.

Objectives

In this study, we proposed to evaluate the efficacy of bath PUVA (psoralen plus ultraviolet A) in the treatment of severe and atopic dermatitis.

Patients and Methods

Twenty-eight patients with severe atopic dermatitis were included in this quasi-experimental study. Four patients left the study. Remained cases underwent a three-month (thrice weekly, a total of 39 sessions) phototherapy protocol. We started phototherapy with 0.7 J/cm2 and increased 0.5 J/cm2 every two sessions to reach a maximum of 12 J/cm2. For assessing the efficacy, SCORAD score was determined before starting phototherapy and then at the end of the first, second, and third months after intervention. All adverse effects were recorded during the investigation period.

Results

Twenty-four patients included 16 females and eight males were evaluated. Their mean age was 29.39 ± 15.17 years (ranging from 10 to 65 years). Mean of SCORAD was 65.16 ± 11.18 at the beginning of study, 52.04 ± 14.95 at the end of the first month, 40.17 ± 15.90 at the end of the second month, and 30.14 ± 20.84 at the end of the study. Decreasing in SCORAD scores was statistically significant (P < 0.0001). The most common adverse events during the study were hyperpigmentation (83.3%) and xerosis (58.3%).

Conclusions

Bath PUVA was effective in the treatment of severe and refractory atopic dermatitis.

Background

Atopic dermatitis (AD) is a chronic inflammatory skin disease. Phototherapy is considered as an effective treatment modality in severe cases.

Objectives

In this study, we proposed to evaluate the efficacy of bath PUVA (psoralen plus ultraviolet A) in the treatment of severe and atopic dermatitis.

Patients and Methods

Twenty-eight patients with severe atopic dermatitis were included in this quasi-experimental study. Four patients left the study. Remained cases underwent a three-month (thrice weekly, a total of 39 sessions) phototherapy protocol. We started phototherapy with 0.7 J/cm2 and increased 0.5 J/cm2 every two sessions to reach a maximum of 12 J/cm2. For assessing the efficacy, SCORAD score was determined before starting phototherapy and then at the end of the first, second, and third months after intervention. All adverse effects were recorded during the investigation period.

Results

Twenty-four patients included 16 females and eight males were evaluated. Their mean age was 29.39 ± 15.17 years (ranging from 10 to 65 years). Mean of SCORAD was 65.16 ± 11.18 at the beginning of study, 52.04 ± 14.95 at the end of the first month, 40.17 ± 15.90 at the end of the second month, and 30.14 ± 20.84 at the end of the study. Decreasing in SCORAD scores was statistically significant (P < 0.0001). The most common adverse events during the study were hyperpigmentation (83.3%) and xerosis (58.3%).

Conclusions

Bath PUVA was effective in the treatment of severe and refractory atopic dermatitis.

PUVA Therapy;Phototherapy;Atopic Dermatitis PUVA Therapy;Phototherapy;Atopic Dermatitis http://www.journalssc.com/index.php?page=article&article_id=16333 Hasan Seirafi Hasan Seirafi Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran Kamran Balighi Kamran Balighi Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran Amir Hooshang Ehsani Amir Hooshang Ehsani Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran Farshid Farnaghi Farshid Farnaghi Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran Shahab Abtahi Shahab Abtahi Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran Amirreza Hanifnia Amirreza Hanifnia Department of Dermatology, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Department of Dermatology, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Masoomeh Rohani Nasab Masoomeh Rohani Nasab Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran Pezhman Mobasher Pezhman Mobasher Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran; Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran. , +98-2122201710 Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran; Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran. , +98-2122201710 Ghazaleh Ahmadi Jazi Ghazaleh Ahmadi Jazi Department of Dermatology, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Department of Dermatology, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
en 10.17795/jssc19045 Prevalence of Ocular Findings in Patients with Vitiligo Prevalence of Ocular Findings in Patients with Vitiligo research-article research-article Results

This cross-sectional study included 92 patients (47 male and 45 female) with mean age of 32.1 ± 13.16 years (ranging from nine to 61 years of age). Mean duration of vitiligo was 10.84 ± 10.17 years. The most common distribution of the lesions was on the upper limbs (60.8%) and the least was on the genital region (10.8%). Positive family history was found in 26 (28.3%) patients. Diabetes and Hypothyroidism were found in 10 (10.86%) and 9 (9.87%) patients, respectively. Ocular problems were discovered in 19 (20.7%) patients with mean age of 41.26 ± 10.7 years, including uveitis in 10 (10.9%), optic atrophy in 4 (4.3%) and retinal hypopigmentation in 5 (5.4%) patients. Mean age of cases with positive ocular findings was significantly higher than those without ocular findings (29.6 ± 12.7 years, P < 0.0001). Mean duration of vitiligo was significantly longer in patients with positive ocular findings than in those without ocular problems (8.84 ± 9.08 years, P < 0.0001). No statistical correlation was found between sex and ocular findings (P > 0.05). Ocular findings were statistically more in patients with positive family history of vitiligo (P = 0.001) and with associated autoimmune diseases (P = 0.01). No significant association was found between anatomical distribution of depigmented macules and ocular findings (P > 0.05).

Background

Vitiligo involves 1% of the population and is equally seen in all races and in both genders. It is a multifactorial polygenic disorder, although various hypotheses have been proposed including autoimmunity, viral infection, biochemical, neural and oxidant/antioxidant theories (oxygen radical species), yet the exact mechanism of the disease has not been yet established.

Conclusions

Ocular findings are important and assessable in patients with vitiligo. Older age and duration of vitiligo can increase the risk of ocular abnormalities and patients with positive family history and autoimmune disorders should be prioritized for screening.

Objectives

To evaluate the prevalence of ocular findings in patients with vitiligo and reveal risk factors or possible associations that might increase the risk of ocular manifestations.

Patients and Methods

In this cross-sectional study, 92 patients previously diagnosed as cutaneous vitiligo referred to the dermatology clinic of Rassoul Akram Hospital from April 2007 to September 2008, were examined for ocular abnormalities. The data of the patients including age, gender, duration of vitiligo, positive family history, association with autoimmune diseases, and anatomic distribution of depigmented macules were recorded. Next, an ophthalmologist at the hospital’s ophthalmology clinic examined the patients to detect depigmentation of eyelids, poliosis and signs of uveitis as well as signs of retinal atrophy or hypopigmentation by a direct ophthalmoscope. Corneal sensation and intraocular pressure (IOP) were evaluated to rule out infection and glaucoma in patients with uveitis. All recorded data were analyzed by the Social Sciences Statistical Software (SPSS version 15) using Chi-square tests and t-test.

Results

This cross-sectional study included 92 patients (47 male and 45 female) with mean age of 32.1 ± 13.16 years (ranging from nine to 61 years of age). Mean duration of vitiligo was 10.84 ± 10.17 years. The most common distribution of the lesions was on the upper limbs (60.8%) and the least was on the genital region (10.8%). Positive family history was found in 26 (28.3%) patients. Diabetes and Hypothyroidism were found in 10 (10.86%) and 9 (9.87%) patients, respectively. Ocular problems were discovered in 19 (20.7%) patients with mean age of 41.26 ± 10.7 years, including uveitis in 10 (10.9%), optic atrophy in 4 (4.3%) and retinal hypopigmentation in 5 (5.4%) patients. Mean age of cases with positive ocular findings was significantly higher than those without ocular findings (29.6 ± 12.7 years, P < 0.0001). Mean duration of vitiligo was significantly longer in patients with positive ocular findings than in those without ocular problems (8.84 ± 9.08 years, P < 0.0001). No statistical correlation was found between sex and ocular findings (P > 0.05). Ocular findings were statistically more in patients with positive family history of vitiligo (P = 0.001) and with associated autoimmune diseases (P = 0.01). No significant association was found between anatomical distribution of depigmented macules and ocular findings (P > 0.05).

Background

Vitiligo involves 1% of the population and is equally seen in all races and in both genders. It is a multifactorial polygenic disorder, although various hypotheses have been proposed including autoimmunity, viral infection, biochemical, neural and oxidant/antioxidant theories (oxygen radical species), yet the exact mechanism of the disease has not been yet established.

Conclusions

Ocular findings are important and assessable in patients with vitiligo. Older age and duration of vitiligo can increase the risk of ocular abnormalities and patients with positive family history and autoimmune disorders should be prioritized for screening.

Objectives

To evaluate the prevalence of ocular findings in patients with vitiligo and reveal risk factors or possible associations that might increase the risk of ocular manifestations.

Patients and Methods

In this cross-sectional study, 92 patients previously diagnosed as cutaneous vitiligo referred to the dermatology clinic of Rassoul Akram Hospital from April 2007 to September 2008, were examined for ocular abnormalities. The data of the patients including age, gender, duration of vitiligo, positive family history, association with autoimmune diseases, and anatomic distribution of depigmented macules were recorded. Next, an ophthalmologist at the hospital’s ophthalmology clinic examined the patients to detect depigmentation of eyelids, poliosis and signs of uveitis as well as signs of retinal atrophy or hypopigmentation by a direct ophthalmoscope. Corneal sensation and intraocular pressure (IOP) were evaluated to rule out infection and glaucoma in patients with uveitis. All recorded data were analyzed by the Social Sciences Statistical Software (SPSS version 15) using Chi-square tests and t-test.

Uveitis;Vitiligo;Ocular Findings;Cutaneous;Depigmented Macules Uveitis;Vitiligo;Ocular Findings;Cutaneous;Depigmented Macules http://www.journalssc.com/index.php?page=article&article_id=19045 Golnaz Mehran Golnaz Mehran Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran Masoumeh Rohani Nasab Masoumeh Rohani Nasab Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Rassoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran; Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Tel: +98-9126977043, Fax: +98-2122144291 Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Rassoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran; Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Tel: +98-9126977043, Fax: +98-2122144291 Amir Reza Hanifnia Amir Reza Hanifnia Department of Dermatology, Rassoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran Department of Dermatology, Rassoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran Ali Reza Foroutan Ali Reza Foroutan Eye Research Center, Rassoul Akram Hospital, Tehran University, Tehran, Iran Eye Research Center, Rassoul Akram Hospital, Tehran University, Tehran, Iran Zahra Mehrnahad Zahra Mehrnahad Department of Dermatology, Rassoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran Department of Dermatology, Rassoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran Ali Ahadian Ali Ahadian Eye Research Center, Rassoul Akram Hospital, Tehran University, Tehran, Iran Eye Research Center, Rassoul Akram Hospital, Tehran University, Tehran, Iran Sahar Mohammadpour Sahar Mohammadpour Eye Research Center, Rassoul Akram Hospital, Tehran University, Tehran, Iran Eye Research Center, Rassoul Akram Hospital, Tehran University, Tehran, Iran