Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 Patient Satisfaction and Efficacy of Accent Radiofrequency for Facial Wrinkle Reduction Patient Satisfaction and Efficacy of Accent Radiofrequency for Facial Wrinkle Reduction 2915 2928 13693 FA Mohammad Ali Nilforoushzadeh Associate Professor, Skin Disease and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan And Skin and Stem cell Research Center, Tehran University of Medical Sciences, Tehran, Iran Fariba Jaffary Associate Professor, Skin Disease and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan And Skin and Stem cell Research Center, Tehran University of Medical Sciences, Tehran, Iran Hajar Zarkoob General Practitioner, Rsearcher, Skin Disease and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan And Skin and Stem cell Research Center, Tehran University of Medical Sciences, Tehran, Iran Journal Article 2011 04 23 Background: Radiofrequency (RF) is a new technique to treat facial wrinkles. This study was designed to assess the efficacy of Accent RF in wrinkle reduction of different areas of the face..Methods: Patients with mild to severe facial wrinkles were treated with Accent using RF energies of 35 to 145 watts. The average energy used in this study was 83.11 watts. Patients received 4 subsequent weekly RF sessions. Wrinkle improvement was rated by two double- blinded physicians comparing 6-month post-treatment and pre-treatment photographs. Moreover, patient satisfaction was assessed at 1 and 6 months after the last session of the treatment.Findings: Overall, 45 women participated in this study. One month after the last treatment, 8.9% of the patients declared their dissatisfaction, 53.3% were relatively satisfied, 33.3% were satisfied, and 4.4% were very satisfied. At the 6th month, 4.4% of the patients were dissatisfied, 31.1% were relatively satisfied, 46.7% were satisfied, and 17.8% were very satisfied. Patient satisfaction 6 months after the last treatment was significantly higher than 1 month post-treatment. After 6 months, patient satisfaction was not more than 75% in any treatment areas of the face.Conclusion: Comparing the findings of this study with previous studies suggests using higher energy levels and more treatment sessions to result in better clinical improvement of facial wrinkles. Background: Radiofrequency (RF) is a new technique to treat facial wrinkles. This study was designed to assess the efficacy of Accent RF in wrinkle reduction of different areas of the face..Methods: Patients with mild to severe facial wrinkles were treated with Accent using RF energies of 35 to 145 watts. The average energy used in this study was 83.11 watts. Patients received 4 subsequent weekly RF sessions. Wrinkle improvement was rated by two double- blinded physicians comparing 6-month post-treatment and pre-treatment photographs. Moreover, patient satisfaction was assessed at 1 and 6 months after the last session of the treatment.Findings: Overall, 45 women participated in this study. One month after the last treatment, 8.9% of the patients declared their dissatisfaction, 53.3% were relatively satisfied, 33.3% were satisfied, and 4.4% were very satisfied. At the 6th month, 4.4% of the patients were dissatisfied, 31.1% were relatively satisfied, 46.7% were satisfied, and 17.8% were very satisfied. Patient satisfaction 6 months after the last treatment was significantly higher than 1 month post-treatment. After 6 months, patient satisfaction was not more than 75% in any treatment areas of the face.Conclusion: Comparing the findings of this study with previous studies suggests using higher energy levels and more treatment sessions to result in better clinical improvement of facial wrinkles. https://jims.mui.ac.ir/article_13693_455a9ce9e0c8e8a0c7745eecd6a64be4.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 Thyroid Function and Antithyroid Antibodies in Vitiligo: A Case Control Study Thyroid Function and Antithyroid Antibodies in Vitiligo: A Case Control Study 2929 2635 13694 FA Samar Asgharzadeh Moghaddam General Practitioner, Skin Disease and Leishmaniasis Research Center, Isfahan University of Medical Sciences And School of Medicine, Najafabad Branch, Islamic Azad University, Isfahan, Iran Fariba Jaffary Associate Professor, Skin Disease and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Mohammad Ali Nilforoushzadeh Associate Professor, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran Mahrokhsar Nazarian Assistant Professor, Department of Dermatology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Journal Article 2011 05 24 Background: Vitiligo is a skin disease charachterized with loss of skin pigmentation and the lack of melanocytes in the epidermis.Its prevalence is estimated as 1-2% of the world population. The cause of this disease is not clear, but the immunologic etiology is strongly suggested due to coincidence of other autoimmune diseases such as thyroid disorders. Thyroid screening tests are not considered as routine tests for vitiligo patients. This study was designed to further study of thyroid function in vitiligo patients.Methods: 63 patients with vitiligo and 63 non-vitiligo from the patients referred to DrShariati Hospital and Skin Disease and Leishmaniasis Research Center (SDLRC) were studied. Thyroid function tests including TSH, T3, T4, and thyroid antibodies (anti TPO and anti Tg) were investigated. Data was analyzed by Chi square and Fisher’s exact test using SPSS18.Findings: Frequency of TSH, T4 in both groups were examined and no significant difference between the two groups did not exist (P = 0.09 and P = 0.11). In terms of distribution of T3, Anti-TPO and Anti-Tg between the two groups, significant differences between There were two groups (P= 0.001, P = 0.04 and P = 0.07 respectively). Conclusion: Based n the results of this study there was no correlation between vitiligo and clinical disorders of thyroid. However doing T3, AntiTPO, AntiTg tests is warranted in vitilgo patients for advance diagnosis of any thrroiddisfunction and prevemt their complications. Background: Vitiligo is a skin disease charachterized with loss of skin pigmentation and the lack of melanocytes in the epidermis.Its prevalence is estimated as 1-2% of the world population. The cause of this disease is not clear, but the immunologic etiology is strongly suggested due to coincidence of other autoimmune diseases such as thyroid disorders. Thyroid screening tests are not considered as routine tests for vitiligo patients. This study was designed to further study of thyroid function in vitiligo patients.Methods: 63 patients with vitiligo and 63 non-vitiligo from the patients referred to DrShariati Hospital and Skin Disease and Leishmaniasis Research Center (SDLRC) were studied. Thyroid function tests including TSH, T3, T4, and thyroid antibodies (anti TPO and anti Tg) were investigated. Data was analyzed by Chi square and Fisher’s exact test using SPSS18.Findings: Frequency of TSH, T4 in both groups were examined and no significant difference between the two groups did not exist (P = 0.09 and P = 0.11). In terms of distribution of T3, Anti-TPO and Anti-Tg between the two groups, significant differences between There were two groups (P= 0.001, P = 0.04 and P = 0.07 respectively). Conclusion: Based n the results of this study there was no correlation between vitiligo and clinical disorders of thyroid. However doing T3, AntiTPO, AntiTg tests is warranted in vitilgo patients for advance diagnosis of any thrroiddisfunction and prevemt their complications. https://jims.mui.ac.ir/article_13694_42ae58924107d3be8c6b7b7e3cfd4164.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 Efficacy of Integrated Pest Management in Controlling and Preventing Zoonotic Cutaneous Leishmaniasis in Isfahan Province, Iran Efficacy of Integrated Pest Management in Controlling and Preventing Zoonotic Cutaneous Leishmaniasis in Isfahan Province, Iran 2936 2944 13695 FA Mohammad Ali Nilforoushzadeh Associate Professor, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran Alireza Firooz Associate Professor, Research Center and Training of Leprosy and Skin Diseases, Department of Dermatology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Leila Shirani- Bidabadi Researcher, Department of Medical Entomology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Sedigheh Saberi PhD Student, Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0003-2217-8945 Shahram Moradi Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Seyed Mohsen Hosseini Associate professor, Department of Biostatics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2011 07 07 Background: Cutaneous leishmaniasis (CL) is still considered as a health problem in the world. Several methods of control in different regions together with obtaining integrated information on its natural foci are needed to decrease its prevalence. This study was designed to evaluate the effects of simultaneous interventions on CL control.Methods: A standard questionnaire was used to identify patients among pilgrims of Emamzadeh Agha Ali Abbas (Isfahan Province, Iran). Afterward, three methods of controlling the disease including spraying residential buildings with Baygon, baiting with anticoagulant poisons, changing the vegetative cover of the region, improving the environment, and mounting mesh on all doors and windows of buildings in residential parts. The control measures were then evaluated by comparing the numbers of pilgrims affected by CL after and before the interventions.Findings: While 23 pilgrims (1.4%) were affected with CL before the intervention (pretest),  5 (0.3%) persons were found to have CL after taking control measures. Chi-square test did not indicate any significant difference in relative frequency of CL (P = 0.731). Conclusion: The only scientific way for preventing and controlling zoonotic CL is a combination of control methods (improving environment, fighting off the disease districts and vectors) together with changing the vegetative cover of the region. Any measure for controlling disease must be taken and programmed in accordance with the relevant experts' views, in coordination with other organizations, and with the society's participation. Background: Cutaneous leishmaniasis (CL) is still considered as a health problem in the world. Several methods of control in different regions together with obtaining integrated information on its natural foci are needed to decrease its prevalence. This study was designed to evaluate the effects of simultaneous interventions on CL control.Methods: A standard questionnaire was used to identify patients among pilgrims of Emamzadeh Agha Ali Abbas (Isfahan Province, Iran). Afterward, three methods of controlling the disease including spraying residential buildings with Baygon, baiting with anticoagulant poisons, changing the vegetative cover of the region, improving the environment, and mounting mesh on all doors and windows of buildings in residential parts. The control measures were then evaluated by comparing the numbers of pilgrims affected by CL after and before the interventions.Findings: While 23 pilgrims (1.4%) were affected with CL before the intervention (pretest),  5 (0.3%) persons were found to have CL after taking control measures. Chi-square test did not indicate any significant difference in relative frequency of CL (P = 0.731). Conclusion: The only scientific way for preventing and controlling zoonotic CL is a combination of control methods (improving environment, fighting off the disease districts and vectors) together with changing the vegetative cover of the region. Any measure for controlling disease must be taken and programmed in accordance with the relevant experts' views, in coordination with other organizations, and with the society's participation. https://jims.mui.ac.ir/article_13695_a8bf0da1f92e868795401cb281371ed7.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 Anti-Itching and Healing Effects of Ointments Containing Herbal Essential Oils of Mentha Piperita, Eucalyptus Globulus, Caryophyllus Aromaticus, Cinnamomum Ceylanicom in Skin Eczema Anti-Itching and Healing Effects of Ointments Containing Herbal Essential Oils of Mentha Piperita, Eucalyptus Globulus, Caryophyllus Aromaticus, Cinnamomum Ceylanicom in Skin Eczema 2945 2953 13696 FA Mohammad Ali Nilforoushzadeh Associate professor, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran GholamReza Asghari Associate Professor, Department of Pharmacognosy, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0001-5867-6829 Fariba Jaffary Associate Professor, Skin Disease and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Maliheh Tabrizchi General Practitioner, Skin Disease and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2011 08 17 Background: Eczema is one of the most common dermatologic disorders with specific clinical characteristics, unknown etiology, and not yet known curative treatment. Introducing any kind of treatment to relieve itching and inflammation will be considered as therapeutic success. The use of herbal essential oils has attracted widespread attention as a new natural treatment of dermatologic diseases and thus a step for revival of traditional medicine.Methods: In this study, essential oils of peppermint (Mentha piperita), eucalyptus (Eucalyptus globulus), clove (Eugenia caryophyllata) and cinnamon (Cinnamomum ceylanicom) were selected as potential therapeutic candidates for eczema. Different concentrations of menthol and camphor were also added to increase the skin penetration and anti-itching effects of the ointment. Hydrocarbons were used as ointment base due to high solubility, stability, and good covering properties of essential oils in this base. A combination of 27% liquid paraffin and 35% paraffin wax was used as the best base of the ointments. Clinical evaluations were then performed on 110 patients among whom 50 patients received herbal ointment.Findings: Complete improvement was observed in 66% of the herbal group compared to 43.3% of the standard care and 13% of the placebo groups. Patients who received the herbal ointment experienced fast and stable relief of itching (after 1-2 weeks of using the ointment). Mild and transient side effects such as irritation and redness were seen in 20% of the cases in the herbal group.Conclusion: Fast relief of itching and short treatment period were some advantages of herbal ointment. Different concentrations of the active ingredients were prepared and some modifications were made to increase penetration, accelerate relief of itching, and decrease skin irritation induced by essential oils. This herbal ointment was most effective in chronic eczema and its efficacy on exogenous eczema was less than endogenous eczema. Background: Eczema is one of the most common dermatologic disorders with specific clinical characteristics, unknown etiology, and not yet known curative treatment. Introducing any kind of treatment to relieve itching and inflammation will be considered as therapeutic success. The use of herbal essential oils has attracted widespread attention as a new natural treatment of dermatologic diseases and thus a step for revival of traditional medicine.Methods: In this study, essential oils of peppermint (Mentha piperita), eucalyptus (Eucalyptus globulus), clove (Eugenia caryophyllata) and cinnamon (Cinnamomum ceylanicom) were selected as potential therapeutic candidates for eczema. Different concentrations of menthol and camphor were also added to increase the skin penetration and anti-itching effects of the ointment. Hydrocarbons were used as ointment base due to high solubility, stability, and good covering properties of essential oils in this base. A combination of 27% liquid paraffin and 35% paraffin wax was used as the best base of the ointments. Clinical evaluations were then performed on 110 patients among whom 50 patients received herbal ointment.Findings: Complete improvement was observed in 66% of the herbal group compared to 43.3% of the standard care and 13% of the placebo groups. Patients who received the herbal ointment experienced fast and stable relief of itching (after 1-2 weeks of using the ointment). Mild and transient side effects such as irritation and redness were seen in 20% of the cases in the herbal group.Conclusion: Fast relief of itching and short treatment period were some advantages of herbal ointment. Different concentrations of the active ingredients were prepared and some modifications were made to increase penetration, accelerate relief of itching, and decrease skin irritation induced by essential oils. This herbal ointment was most effective in chronic eczema and its efficacy on exogenous eczema was less than endogenous eczema. https://jims.mui.ac.ir/article_13696_bc264522d8cc7a47fb5e8f606a6013a9.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 Evaluation of Anti-desmoglein 1 Antibody in Cutaneous Leishmaniasis Patients Evaluation of Anti-desmoglein 1 Antibody in Cutaneous Leishmaniasis Patients 2954 2961 13697 FA Fariba Jaffary Associate Professor, Skin Disease and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Talitha De Vries Student of Medicine, University Hospital Groningen, Groningen, Netherlands Mohammad Ali Niloroushzadeh Associate Professor, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran And , Skin Disease and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran, Iran Noshin Lotfi Department of Clinical Immunology, Skin Disease and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan Iran Henri Pas Associate Professor, Department of Dermatology, University Hospital Groningen, Groningen, Netherlands Journal Article 2011 11 11 Background: Pemphigus foliaceus (PF) is a cutaneous autoimmune bullous disease characterized by the presence of anti-desmoglein 1 (DSG1) antibodies. As non-pathogenic variants of these antibodies were found in patients with parasitic diseases, including leishmaniasis, the trigger for the formation of these antibodies is thought to consist of the vector insects of parasitic diseasesfound in endemic regions of PF. This hypothesis has been confirmed by the finding of the non-pathogenic antibodies in patients with one of these parasitic diseases in non-endemic regions for pemphigus foliaceus. The aim of this study was the evaluation of anti-DSG1 antibody in patients suffering fromzoonotic cutaneous leishmaniasis in Isfahan city of Iran.Methods: Blood sera of 58 patients with zoonotic cutaneous leishmaniasis, confirmed by clinical signs and direct blood smear, were collected and enzyme-linked immunosorbent assay for anti-DSG1 antibodies was performed on these samples.Findings: 56 out of 58 serum samples of patients with cutaneous leishmaniasis were negative for anti-DSG1 antibodies, with one sample having an indeterminate value and one sample being positive. Conclusion: Our results reject our initial hypothesis regarding the role of leishmaniasis in triggering the formation of anti-DSG1 antibodies. Several alternate explanations are possible, including the role of the black fly Simuliumnigrimanum. Background: Pemphigus foliaceus (PF) is a cutaneous autoimmune bullous disease characterized by the presence of anti-desmoglein 1 (DSG1) antibodies. As non-pathogenic variants of these antibodies were found in patients with parasitic diseases, including leishmaniasis, the trigger for the formation of these antibodies is thought to consist of the vector insects of parasitic diseasesfound in endemic regions of PF. This hypothesis has been confirmed by the finding of the non-pathogenic antibodies in patients with one of these parasitic diseases in non-endemic regions for pemphigus foliaceus. The aim of this study was the evaluation of anti-DSG1 antibody in patients suffering fromzoonotic cutaneous leishmaniasis in Isfahan city of Iran.Methods: Blood sera of 58 patients with zoonotic cutaneous leishmaniasis, confirmed by clinical signs and direct blood smear, were collected and enzyme-linked immunosorbent assay for anti-DSG1 antibodies was performed on these samples.Findings: 56 out of 58 serum samples of patients with cutaneous leishmaniasis were negative for anti-DSG1 antibodies, with one sample having an indeterminate value and one sample being positive. Conclusion: Our results reject our initial hypothesis regarding the role of leishmaniasis in triggering the formation of anti-DSG1 antibodies. Several alternate explanations are possible, including the role of the black fly Simuliumnigrimanum. https://jims.mui.ac.ir/article_13697_e5a5d1fa6871e3e01b1cb0d41dc5ffce.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 Evaluation of students’Knowledge, Attitude and Practice in Relation to Preventive Strategies against Leishmaniasis in the Hyperendemic Region of Shahid Babaie Airbase Evaluation of students’Knowledge, Attitude and Practice in Relation to Preventive Strategies against Leishmaniasis in the Hyperendemic Region of Shahid Babaie Airbase 1962 2970 13692 FA Sedighe Saberi PhD Student, Department of Mycology and Parasitology, School of Medicine And Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran Ahmad Reza Zamani Associate Professor, Department of community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Neda Moatamedi Assistant Professor, Department of community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Mohammad Ail Nilforoushzadeh Associate Professor, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran Fariba Jaffary Associate Professor, Skin Disease and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan And Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran Ezatolah Rahimi General Practitioner, Shahid Babaie Airbase Hospital, Isfahan, Iran Seyed Hossein Hejezi Associate Professor, Department of Mycology and Parasitology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2012 03 12 Background: Shahid Babaie airbase is one of the most important centers of leishmaniasis in Isfahan province. It has been suggested that the training of high risk communities about preventive methods is one of the most effective strategies against leishmaniasis. Regarding the higher incidence rates of the disease among the youth and their sensitivity to the infection, we decided to examine the knowledge, attitude and practice of guidance and high school students in relation to preventive strategies in that region. We also aim to provide training programs to improve preventive behaviors against leishmaniasis in the next phase of the project.Methods: The target population of this cross-sectional study was the students of guidance and high schools in Shahid Babaie Airbase region of Isfahan. Sampling was done by consensus method. The questionnaires consisted of items about knowledge, attitude and practice which were categorized into 3 grades (weak, intermediate and strong) on the basis of collected scores. The questionnaires were filled out during personal interviews.Findings: From 450 subjects enrolled, 245 were high school (126 males and 119 females) and 215 were guidance school (91 males and 124 females) students. Mean knowledge score was 17.47 (score range: 0-30) which corresponds to intermediate grade. Mean attitude score was 37 (score range: 13-52) which corresponds to the intermediate grade. Finally and corresponding to a weak grade, their mean practice score was 1.8 (score range: 0-6). Attitude and knowledge showed statistically significant correlation with gender with higher scores in female students. Specific knowledge about leishmaniasis symptoms, carriers and reservoirs were higher than the knowledge about preventive methods. Our results showed that 47.2% of students believed in “fortune” in getting the infection. Although 97.9% of students knew that sand-fly is the carrier, only 28.6% knew what exactly the sand-fly is. Conclusion: Increasing knowledge by giving direct and face to face training to students (the high risk community), teachers and mothers who have a significant role in changing the behavior of the youth is essential. In conclusion, improved knowledge will result in the promotion of the attitude level and especially the behavior of the students to prevent leishmaniasis. Background: Shahid Babaie airbase is one of the most important centers of leishmaniasis in Isfahan province. It has been suggested that the training of high risk communities about preventive methods is one of the most effective strategies against leishmaniasis. Regarding the higher incidence rates of the disease among the youth and their sensitivity to the infection, we decided to examine the knowledge, attitude and practice of guidance and high school students in relation to preventive strategies in that region. We also aim to provide training programs to improve preventive behaviors against leishmaniasis in the next phase of the project.Methods: The target population of this cross-sectional study was the students of guidance and high schools in Shahid Babaie Airbase region of Isfahan. Sampling was done by consensus method. The questionnaires consisted of items about knowledge, attitude and practice which were categorized into 3 grades (weak, intermediate and strong) on the basis of collected scores. The questionnaires were filled out during personal interviews.Findings: From 450 subjects enrolled, 245 were high school (126 males and 119 females) and 215 were guidance school (91 males and 124 females) students. Mean knowledge score was 17.47 (score range: 0-30) which corresponds to intermediate grade. Mean attitude score was 37 (score range: 13-52) which corresponds to the intermediate grade. Finally and corresponding to a weak grade, their mean practice score was 1.8 (score range: 0-6). Attitude and knowledge showed statistically significant correlation with gender with higher scores in female students. Specific knowledge about leishmaniasis symptoms, carriers and reservoirs were higher than the knowledge about preventive methods. Our results showed that 47.2% of students believed in “fortune” in getting the infection. Although 97.9% of students knew that sand-fly is the carrier, only 28.6% knew what exactly the sand-fly is. Conclusion: Increasing knowledge by giving direct and face to face training to students (the high risk community), teachers and mothers who have a significant role in changing the behavior of the youth is essential. In conclusion, improved knowledge will result in the promotion of the attitude level and especially the behavior of the students to prevent leishmaniasis. https://jims.mui.ac.ir/article_13692_1288625a4bdcf1109ff5adca3bd33753.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 Comparison between the Efficacy of Photodynamic Therapy and Topical Paromomycin in the Treatment of Old World Cutaneous Leishmaniasis: A Placebo-controlled, Randomized Clinical Trial Comparison between the Efficacy of Photodynamic Therapy and Topical Paromomycin in the Treatment of Old World Cutaneous Leishmaniasis: A Placebo-controlled, Randomized Clinical Trial 2971 2977 13698 FA ALi Asilian Professor, Skin Disease and Cutaneous Leishmaniasis Research Center And Department of Dermatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Majid Davami Resident, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran And Department of Dermatology, School of Medicine And Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2012 03 12 Background: The optimal treatment for cutaneous leishmaniasis (CL) has not been established. Topical paromomycin is one of the many drugs that have been suggested for the treatment of CL caused by leishmania major. Recently, photodynamic therapy (PDT) has been reported to be effective in the treatment of CL. The aim of the present study was to compare the parasitological and clinical efficacy of PDT versus topical paromomycin in patients with old world CL caused by leishmania major in Iran.Methods: In this trial, 60 patients with the clinical and parasitological diagnosis of CL were recruited and were randomly divided in to three treatment groups of 20 subjects each. Group 1 was treated with weekly topical PDT, and groups 2 and 3 received twice-daily topical paromomycin and placebo, respectively. The duration of treatment was 4 weeks for all groups. These groups were followed for 2 months after termination of treatment.Findings: In total, 57 patients with 95 lesions completed the study. At the end of thestudy, complete improvement was seen in 29 out of 31 (93.5%), 14 out of 34 (41.2%) and 4 out of 30 lesions (13.3%) in groups 1, 2 and 3, respectively (P < 0.001). At the same timepoint, 100%, 64.7%, and 20% of the lesions had parasitological cure in groups 1, 2 and 3, respectively (P < 0.001). Conclusion: Topical PDT can be used safely as a rapid and highly effective alternative treatment choice for old world CL in selected patients. Background: The optimal treatment for cutaneous leishmaniasis (CL) has not been established. Topical paromomycin is one of the many drugs that have been suggested for the treatment of CL caused by leishmania major. Recently, photodynamic therapy (PDT) has been reported to be effective in the treatment of CL. The aim of the present study was to compare the parasitological and clinical efficacy of PDT versus topical paromomycin in patients with old world CL caused by leishmania major in Iran.Methods: In this trial, 60 patients with the clinical and parasitological diagnosis of CL were recruited and were randomly divided in to three treatment groups of 20 subjects each. Group 1 was treated with weekly topical PDT, and groups 2 and 3 received twice-daily topical paromomycin and placebo, respectively. The duration of treatment was 4 weeks for all groups. These groups were followed for 2 months after termination of treatment.Findings: In total, 57 patients with 95 lesions completed the study. At the end of thestudy, complete improvement was seen in 29 out of 31 (93.5%), 14 out of 34 (41.2%) and 4 out of 30 lesions (13.3%) in groups 1, 2 and 3, respectively (P < 0.001). At the same timepoint, 100%, 64.7%, and 20% of the lesions had parasitological cure in groups 1, 2 and 3, respectively (P < 0.001). Conclusion: Topical PDT can be used safely as a rapid and highly effective alternative treatment choice for old world CL in selected patients. https://jims.mui.ac.ir/article_13698_ac4ff5e8dcf9daa23c293b96d8ea9ef5.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 Rothmund-Thomson Syndrome Associated with Malignant Fibrous Histiocytoma: Report of a Case and Review of Literature Rothmund-Thomson Syndrome Associated with Malignant Fibrous Histiocytoma: Report of a Case and Review of Literature 3104 3108 13717 FA Mir Hadi Aziz Jalali Associate Professor, Department of Dermatology, School of Medicine, Skin and Stem Cell Research Center, Tehran University of Medical Sciences,Tehran,Iran Mehdi Tabaie General Practitioner, Skin Disease and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan Iran Journal Article 2012 03 12 Background: Rothmund–Thomson syndrome is a rare autosomal recessive genodermatosis characterized by the early onset of poikiloderma, and several other cutaneous layers and organ involvements.Case Report: This is a report of a 14-year-old girl who has been diagnosed with Rothmund–Thomson syndrome since she was 3 years old. She has been suffering from pain and swelling of the right elbow and forearm for about 6 months. She was hospitalized because of a swollen, tender erythematous mass on her right elbow that had appeared one year earlier and had enlarged gradually. On physical examination, she had a bird-like appearance. Scalp hair, eyebrows and lashes were sparse.Conclusion: There are few previous reports on Rothmund–Thomson syndrome associated with malignant fibrous histiocytoma. We decided to report this case as another supporting document for this association. Background: Rothmund–Thomson syndrome is a rare autosomal recessive genodermatosis characterized by the early onset of poikiloderma, and several other cutaneous layers and organ involvements.Case Report: This is a report of a 14-year-old girl who has been diagnosed with Rothmund–Thomson syndrome since she was 3 years old. She has been suffering from pain and swelling of the right elbow and forearm for about 6 months. She was hospitalized because of a swollen, tender erythematous mass on her right elbow that had appeared one year earlier and had enlarged gradually. On physical examination, she had a bird-like appearance. Scalp hair, eyebrows and lashes were sparse.Conclusion: There are few previous reports on Rothmund–Thomson syndrome associated with malignant fibrous histiocytoma. We decided to report this case as another supporting document for this association. https://jims.mui.ac.ir/article_13717_e3fc72518f213ad1f39ed9306da322b0.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 Scalp Myiasis Associated with Advanced Basal Cell Carcinoma Scalp Myiasis Associated with Advanced Basal Cell Carcinoma 3109 3112 13718 FA Ali Asilian Professor, Skin Disease and Leishmaniasis Research Center And Department of Dermatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Fateme Andalib Resident, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran And Department of Dermatology, School of Medicine And Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2012 03 18 Background: Myiasis is a term derived from the Greek word ‘‘myia’’ which means fly. The flies deposit their eggs, which then hatch into larvae, which in turn infiltrate the tissue and destroy it. This disease is generally associated with traumatic injury, erosive or ulcerative lesions, or hemorrhage. However, the association with basal cell carcinoma has been extremely rare.Case Report: The patient is a 64-year-old woman, widow, living in a rural area, who was accompanied by her neighbour to the dermatology clinic. There is a large ulcerative and hemorrhagic area on the scalp which in some parts is covered by larvae (arrowheads). She did not suffer any pain but it smelled foul. Miyasis was treated by mechanical removal. The biopsy of the ulcerated area confirmed the diagnosis of basal cell carcinoma and the patient was referred to a plastic surgeon for resection and graft.Conclusion: It is said that incidental finding of myiasis may be actually of some benefit to the patient. The natural debridement performed by the larvae helps to keep the amount of necrotic tissue and the infection at a minimal level. Background: Myiasis is a term derived from the Greek word ‘‘myia’’ which means fly. The flies deposit their eggs, which then hatch into larvae, which in turn infiltrate the tissue and destroy it. This disease is generally associated with traumatic injury, erosive or ulcerative lesions, or hemorrhage. However, the association with basal cell carcinoma has been extremely rare.Case Report: The patient is a 64-year-old woman, widow, living in a rural area, who was accompanied by her neighbour to the dermatology clinic. There is a large ulcerative and hemorrhagic area on the scalp which in some parts is covered by larvae (arrowheads). She did not suffer any pain but it smelled foul. Miyasis was treated by mechanical removal. The biopsy of the ulcerated area confirmed the diagnosis of basal cell carcinoma and the patient was referred to a plastic surgeon for resection and graft.Conclusion: It is said that incidental finding of myiasis may be actually of some benefit to the patient. The natural debridement performed by the larvae helps to keep the amount of necrotic tissue and the infection at a minimal level. https://jims.mui.ac.ir/article_13718_17463ec465317dc0558d5a5234b7b8ba.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 Naevoid Basal Cell Carcinoma Syndrome Naevoid Basal Cell Carcinoma Syndrome 3113 3116 13719 FA Zabihollah Shahmoradi Associate Professor, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran And Department of Dermatology, School of Medicine, Isfahan University School of Medical Sciences, Isfahan, Iran 0000-0001-6019-8985 Fateme Andalib Resident, Skin Diseases and Leishmaniasis Research Center, Department of Dermatology, School of Medicine And Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran Amir Hossein Siadat Assistant Professor, Skin Disease and Leishmaniasis Research Center And Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2012 03 18 Nevoid basal cell carcinoma syndrome (NBCCS), also known as Gorlin syndrome, is a hereditary condition characterized by a wide range of developmental abnormalities and a predisposition to neoplasms. The estimated prevalence varies from 1/57,000 to 1/256,000, with a male-to-female ratio of 1:1. Main clinical manifestations include multiple basal cell carcinomas (BCCs), odontogenic keratocysts of the jaw, hyperkeratosis of palms and soles, skeletal abnormalities, intracranial ectopic calcifications, and facial dysmorphism (macrocephaly, cleft lip/palate and severe eye anomalies). This paper introduces three NBCCS patients and describes their symptoms. In our first case, two major (multiple BCCs in younger than 30 years of age, and palmar pits) and one minor (medulloblastoma) criteria were met, which were indicative of Gorlin syndrome. The second case had two major criteria (multiple BCCs in younger than 30 years of age and odontogenic keratocyst), which confirmed Gorlin syndrome. The third case had one major criterion (multiple BCCs) and two minor criteria (congenital skeletal anomaly and frontal bossing) which confirmed Gorlin syndrome. Early diagnosis and treatment is important in preventing long term squeals of this syndrome that include malignancy and oromaxillofacial deformation and destruction. Nevoid basal cell carcinoma syndrome (NBCCS), also known as Gorlin syndrome, is a hereditary condition characterized by a wide range of developmental abnormalities and a predisposition to neoplasms. The estimated prevalence varies from 1/57,000 to 1/256,000, with a male-to-female ratio of 1:1. Main clinical manifestations include multiple basal cell carcinomas (BCCs), odontogenic keratocysts of the jaw, hyperkeratosis of palms and soles, skeletal abnormalities, intracranial ectopic calcifications, and facial dysmorphism (macrocephaly, cleft lip/palate and severe eye anomalies). This paper introduces three NBCCS patients and describes their symptoms. In our first case, two major (multiple BCCs in younger than 30 years of age, and palmar pits) and one minor (medulloblastoma) criteria were met, which were indicative of Gorlin syndrome. The second case had two major criteria (multiple BCCs in younger than 30 years of age and odontogenic keratocyst), which confirmed Gorlin syndrome. The third case had one major criterion (multiple BCCs) and two minor criteria (congenital skeletal anomaly and frontal bossing) which confirmed Gorlin syndrome. Early diagnosis and treatment is important in preventing long term squeals of this syndrome that include malignancy and oromaxillofacial deformation and destruction. https://jims.mui.ac.ir/article_13719_b4eb391ccdb1a22629fbf8a3b7950cb9.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 New Combination of Triamcinolone, 5-Fluorouracil, and Pulsed-Dye Laser for the Treatment of Keloid andHypertrophic Scars New Combination of Triamcinolone, 5-Fluorouracil, and Pulsed-Dye Laser for the Treatment of Keloid andHypertrophic Scars 2978 2989 13699 FA Ali Asilian Professor, Skin Diseases and Cutaneous Leishmaniasis Research Center And Department of Dermatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Afshin Darougheh Resident, Skin Diseases and Cutaneous Leishmaniasis Research Center And Department of Dermatology, School of Medicine And Student Research Committee, IsfahanUniversity of Medical Sciences, Isfahan, Iran Fazlolah Shariati Department of Dermatology, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran Journal Article 2012 03 12 Background: Keloids and hypertrophic scars are benign growths of dermal collagen that usually cause major physical, psychological and cosmetic problems.Methods: In this 12-week single-blinded clinical trial, 69 patients were randomly assigned into three study groups. In Group 1, intralesional triamcinolone acetonide (TAC, 10 mg/mL) was injected at one-week intervals for a total of 8 weeks. In Group 2, 0.1 mL of 40 mg/mL TAC was added to 0.9 mL of 5-Fluorouracil (5FU, 50mg/mL). This combination was injected weekly for 8 weeks. In Group 3, in addition to weekly TAC and 5FU injections for 8 weeks, lesions were irradiated by 585-nm flashlamp-pumped pulsed-dye laser (PDL, 5–7.5 J/cm2) at the 1st, 4th, and 8th weeks. Lesions were assessed for erythema, pruritus, pliability, height, length and width.Findings: Sixty patients completed the study. At the 8- and 12-week follow-up visits, all groups showed improvements in nearly all of the outcome measures; but in comparison between groups, the improvements were statistically more significant in the TAC-5FU and TAC-5FU-PDL groups (P < 0.05 for all outcome measures). At the end of the study, the erythema score was significantly lower, and itch reduction was statistically higher in the TAC-5FU-PDL group (P = 0.05 for both). The percent of the patients who reported good to excellent improvements (50% improvement) were as follows: 20% in Group 1, 55% in Group 2, and 75% in Group 3 (P = 0.05). Good to excellent responses in each group that were reported by a blinded observer were as follows: 15% in Group 1, 40% in Group 2, and 70% in Group 3 (P = 0.05). Atrophy and telangiectasia were seen in 37% of patients in TAC group.Conclusion: Overall efficacy of TAC-5FU was comparable with TAC-5FU-PDL; but the TAC-5FU-PDL combination was better tolerated by the patients and produced better results. Its reducing effect on the erythema of the lesions was also promising. The TAC-5FU-PDL combination seems to be the best approach for treatment of keloid and hypertrophic scars. Background: Keloids and hypertrophic scars are benign growths of dermal collagen that usually cause major physical, psychological and cosmetic problems.Methods: In this 12-week single-blinded clinical trial, 69 patients were randomly assigned into three study groups. In Group 1, intralesional triamcinolone acetonide (TAC, 10 mg/mL) was injected at one-week intervals for a total of 8 weeks. In Group 2, 0.1 mL of 40 mg/mL TAC was added to 0.9 mL of 5-Fluorouracil (5FU, 50mg/mL). This combination was injected weekly for 8 weeks. In Group 3, in addition to weekly TAC and 5FU injections for 8 weeks, lesions were irradiated by 585-nm flashlamp-pumped pulsed-dye laser (PDL, 5–7.5 J/cm2) at the 1st, 4th, and 8th weeks. Lesions were assessed for erythema, pruritus, pliability, height, length and width.Findings: Sixty patients completed the study. At the 8- and 12-week follow-up visits, all groups showed improvements in nearly all of the outcome measures; but in comparison between groups, the improvements were statistically more significant in the TAC-5FU and TAC-5FU-PDL groups (P < 0.05 for all outcome measures). At the end of the study, the erythema score was significantly lower, and itch reduction was statistically higher in the TAC-5FU-PDL group (P = 0.05 for both). The percent of the patients who reported good to excellent improvements (50% improvement) were as follows: 20% in Group 1, 55% in Group 2, and 75% in Group 3 (P = 0.05). Good to excellent responses in each group that were reported by a blinded observer were as follows: 15% in Group 1, 40% in Group 2, and 70% in Group 3 (P = 0.05). Atrophy and telangiectasia were seen in 37% of patients in TAC group.Conclusion: Overall efficacy of TAC-5FU was comparable with TAC-5FU-PDL; but the TAC-5FU-PDL combination was better tolerated by the patients and produced better results. Its reducing effect on the erythema of the lesions was also promising. The TAC-5FU-PDL combination seems to be the best approach for treatment of keloid and hypertrophic scars. https://jims.mui.ac.ir/article_13699_30270b7a8f7d456b15e65e299b5bf199.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 A Placebo-controlled Comparative Study of Topical Flocinolone Acetonide Ointment versus Topical 0.1% Tacrolimus Ointment in the Treatment of vitiligo Lesions of Upper Extremities A Placebo-controlled Comparative Study of Topical Flocinolone Acetonide Ointment versus Topical 0.1% Tacrolimus Ointment in the Treatment of vitiligo Lesions of Upper Extremities 2990 2995 13700 FA Mir Hadi Aziz Jalali Associate Professor, Skin and Stem Cell Research Center And Department of Dermatology, Hazrat Rasoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran Alireza Faghihi Resident, Skin Disease and Leishmaniasis Research Center And Student Research committee, Isfahan University of Medical Sciences, Isfahan And Department of Dermatology, Hazrat Rasoul Akram Hospital, Tehran University of Medical Sciences, Tehran ,Iran Hossein Eshghi Resident Department of Dermatology, Hazrat Rasoul Akram Hospital, Tehran University of Medical Sciences, Tehran ,Iran Journal Article 2012 03 12 Background: Topical flocinolone acetonide and tacrolimus have been used to treat vitiligo for a long time, but there is not enough data available to conduct management decision for these patients. Tacrolimus and corticosteroid have been used for head and neck lesions successfully, and have been accepted as standard treatment. The present study is designed to compare the therapeutic effects of flocinolone acetonide and tacrolimus with each other and with the placebo in the treatment of vitiligo lesions of upper extremities.Methods: The current study was carried out on 28 patients of 16-53 years of age with 150 depigmented lesions of upper extremities. The lesions ranged from 3 to 6 cm. 50 lesions were treated with flocinolone acetonide in isopropyl alcohol (50 grams in 50 cc), 50 lesions with tacrolimus, and 50 control lesions with placebo. Patients were followed for 6 months and visited at 2, 4 and 6 months. Disease response was evaluated by approach of clinical criteria. We considered complete or partial repigmentation as the most important clinical criteria. No systemic treatment or phototherapy was used in this study. Moreover, patients were assessed for any possible drug side- effects. Standard photography was applied in order to follow any changes in lesions. The repigmentation achieved for each group and at each follow-up visit were analyzed and compared to the other groups.Findings: The response rate for the tacrolimus group was: 5 lesions showed complete response, 10 lesions showed partial repigmentation, 3 patches worsened, and 32 showed no alteration. In the flocinolone group 8 lesions had complete response, 24 lesions showed repigmentation, 3 lesions showed partial repigmentation, 3 lesions worsened, and 40 lesions showed no alteration. In the placebo group 1 lesion showed complete response, 3 showed partial response, 6 lesions worsened, and 40 showed no alteration. In our study the response rate of both flocinolone acetonide and tacrolimus groups showed a significant difference to the placebo group (P = 0.049 and P = 0.034, respectively), but no significant difference was observed between the two groups (P = 0.67).Conclusion: Topical flocinolone acetonide and tacrolimus showed no significant differences in the treatment of vitiligo Lesions; therefore, further studies are needed for treatment guidelines. Background: Topical flocinolone acetonide and tacrolimus have been used to treat vitiligo for a long time, but there is not enough data available to conduct management decision for these patients. Tacrolimus and corticosteroid have been used for head and neck lesions successfully, and have been accepted as standard treatment. The present study is designed to compare the therapeutic effects of flocinolone acetonide and tacrolimus with each other and with the placebo in the treatment of vitiligo lesions of upper extremities.Methods: The current study was carried out on 28 patients of 16-53 years of age with 150 depigmented lesions of upper extremities. The lesions ranged from 3 to 6 cm. 50 lesions were treated with flocinolone acetonide in isopropyl alcohol (50 grams in 50 cc), 50 lesions with tacrolimus, and 50 control lesions with placebo. Patients were followed for 6 months and visited at 2, 4 and 6 months. Disease response was evaluated by approach of clinical criteria. We considered complete or partial repigmentation as the most important clinical criteria. No systemic treatment or phototherapy was used in this study. Moreover, patients were assessed for any possible drug side- effects. Standard photography was applied in order to follow any changes in lesions. The repigmentation achieved for each group and at each follow-up visit were analyzed and compared to the other groups.Findings: The response rate for the tacrolimus group was: 5 lesions showed complete response, 10 lesions showed partial repigmentation, 3 patches worsened, and 32 showed no alteration. In the flocinolone group 8 lesions had complete response, 24 lesions showed repigmentation, 3 lesions showed partial repigmentation, 3 lesions worsened, and 40 lesions showed no alteration. In the placebo group 1 lesion showed complete response, 3 showed partial response, 6 lesions worsened, and 40 showed no alteration. In our study the response rate of both flocinolone acetonide and tacrolimus groups showed a significant difference to the placebo group (P = 0.049 and P = 0.034, respectively), but no significant difference was observed between the two groups (P = 0.67).Conclusion: Topical flocinolone acetonide and tacrolimus showed no significant differences in the treatment of vitiligo Lesions; therefore, further studies are needed for treatment guidelines. https://jims.mui.ac.ir/article_13700_ccbaefcc48cd5f8ec9309165ea694eb2.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 Comparison between 1% Tretinoin Peeling Versus 70% Glycolic Acid Peeling in the Treatment of Female Patients with Melasma Comparison between 1% Tretinoin Peeling Versus 70% Glycolic Acid Peeling in the Treatment of Female Patients with Melasma 2996 3002 13701 FA Gita Faghihi Associate professor, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran 0000-0002-9106-3052 Anahita Shahingohar Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan,Iran Amir Hossein Siadat Assistant professor, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan,Iran Journal Article 2012 03 12 Background: Melasma is an irregular brownish pigmentation that appears on the face of young to middle-aged women, especially of Asian races, which may contribute to various emotional disturbances. Although no favorable treatment option has been approved yet, one appropriate approach is peeling with glycolic acid 70% (GA 70%). Considering the efficiency of tretinoin in lower concentrations as an over-the-counter lightening agent, peeling with higher concentrations may effectively diminish the pigmentation of melasma. Our main purpose was to compare the efficiency and safety of GA 70% with tretinoin 1% peelingin the treatment of melasma.Methods: The present study was arandomized, double-blind clinical trial performed on 63 female patients with bilateral melasma. One facial side was treated with drug A (GA 70%) and the opposite side with agent B (Tretinoin 1%) for four sessions with two-week intervals. Changes in Melasma Area and Severity Index (MASI) scores, patients' discomfort and untoward complications following peeling during the study period were evaluated and compared.Findings: The efficiency of tretinoin 1% peelings in reducing the MASI score and the rate of unwanted complications were similar to GA 70%. However, the patients' discomfort following the procedures was significantly lower in the tretinoin 1% group compared with the GA 70% group. Patients' satisfaction with each intervention was statistically similar. Furthermore, participants of both groups experienced comparable times of onset of the therapeutic responses. Conclusion: Compared to GA 70%, tretinoin 1% may cause more comfort and satisfaction in treatment of melasma. Background: Melasma is an irregular brownish pigmentation that appears on the face of young to middle-aged women, especially of Asian races, which may contribute to various emotional disturbances. Although no favorable treatment option has been approved yet, one appropriate approach is peeling with glycolic acid 70% (GA 70%). Considering the efficiency of tretinoin in lower concentrations as an over-the-counter lightening agent, peeling with higher concentrations may effectively diminish the pigmentation of melasma. Our main purpose was to compare the efficiency and safety of GA 70% with tretinoin 1% peelingin the treatment of melasma.Methods: The present study was arandomized, double-blind clinical trial performed on 63 female patients with bilateral melasma. One facial side was treated with drug A (GA 70%) and the opposite side with agent B (Tretinoin 1%) for four sessions with two-week intervals. Changes in Melasma Area and Severity Index (MASI) scores, patients' discomfort and untoward complications following peeling during the study period were evaluated and compared.Findings: The efficiency of tretinoin 1% peelings in reducing the MASI score and the rate of unwanted complications were similar to GA 70%. However, the patients' discomfort following the procedures was significantly lower in the tretinoin 1% group compared with the GA 70% group. Patients' satisfaction with each intervention was statistically similar. Furthermore, participants of both groups experienced comparable times of onset of the therapeutic responses. Conclusion: Compared to GA 70%, tretinoin 1% may cause more comfort and satisfaction in treatment of melasma. https://jims.mui.ac.ir/article_13701_bb9caf96076d335da9c6d368c385dcd3.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 The Efficacy of Latanoprost in the Treatment of Alopecia Areata of Eyelashes and Eyebrows The Efficacy of Latanoprost in the Treatment of Alopecia Areata of Eyelashes and Eyebrows 3003 3007 13702 FA Gita Faghihi Associate Professor, Skin Disease and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-9106-3052 Fatemeh Andalib Resident, Skin Disease and Leishmaniasis Research Center And Department of Dermatology, School of Medicine And Student Research committee, Isfahan University of Medical Sciences, Isfahan, Iran Ali Asilian Professor, Skin Disease and Leishmaniasis Research Center And Department of Dermatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan Iran Journal Article 2012 03 12 Background: Latanoprost is an analogue of prostaglandin F2a which is used to treat glaucoma. Increases in eyelash number, thickness, and pigmentation have been reported as latanoprost side effects. The aim of this study was to evaluate if topical use of this drug can be used as a treatment of alopecia areata of eyebrows and eyelashes or not.Methods: In an experimental study, 26 patients with symmetrical eyelash and eyebrow alopecia areata were treated over 4 months. While one side of each patient's face was treated with topical latanoprost, the other side was left untreated. At the end of the treatment, the results were compared.Findings: Only one of the latanoprost-treated cases showed partial hair regrowth on the treated side. The relationship between hair regrowth and latanoprost application was not statistically significant (P = 1.0) according to Fisher's exact test.Conclusion: Based on our findings, topical latanoprost is not effective in the treatment of alopecia areata. More studies with larger sample size, longer duration, and higher concentration of medication are suggested. Background: Latanoprost is an analogue of prostaglandin F2a which is used to treat glaucoma. Increases in eyelash number, thickness, and pigmentation have been reported as latanoprost side effects. The aim of this study was to evaluate if topical use of this drug can be used as a treatment of alopecia areata of eyebrows and eyelashes or not.Methods: In an experimental study, 26 patients with symmetrical eyelash and eyebrow alopecia areata were treated over 4 months. While one side of each patient's face was treated with topical latanoprost, the other side was left untreated. At the end of the treatment, the results were compared.Findings: Only one of the latanoprost-treated cases showed partial hair regrowth on the treated side. The relationship between hair regrowth and latanoprost application was not statistically significant (P = 1.0) according to Fisher's exact test.Conclusion: Based on our findings, topical latanoprost is not effective in the treatment of alopecia areata. More studies with larger sample size, longer duration, and higher concentration of medication are suggested. https://jims.mui.ac.ir/article_13702_5113fbbf6c62901a412b2d5d24daff63.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 The Association of Zinc Serum Level with Age, Sex and Disease Severity in Acne Vulgaris Patients The Association of Zinc Serum Level with Age, Sex and Disease Severity in Acne Vulgaris Patients 3008 3015 13703 FA Gholam Hossein Ghafarpour Associate Professor, Skin and Stem Cell Research Center And Department of Dermatology, Hazrat Rasoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran Vahid Ebrahimi Resident, Skin Disease and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan And Department of Dermatology, Hazrat Rasoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran Mir Hadi Aziz Jalali Associate Professor, Skin and Stem Cell Research Center And Department of Dermatology, Hazrat Rasoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran Journal Article 2012 03 12 Background: Acne vulgaris is a chronic inflammatory disease of pilosebaceous follicles. It is one of the most important skin disorders during adolescence. Zinc is one of essential trace elements in the body that has major roles in maintaining health. The main objectives of this study were to measure zinc serum levels and assess its relationship with age, sex, and disease severity in patients with acne vulgaris.Methods: 100 consecutive patients with acne vulgaris referred to Hazrat-Rassoul-Akram hospital in 2010 were enrolled as a non-random sample. Fasting blood specimens were taken at 9 am and serum zinc level was measured by atomic absorption spectrophotometry method.Findings: Mean serum zinc level of acne patients in this study was 106.78 ± 22.2 µg/dl. Mean levels of serum zinc were significantly lower in women compared to men (104.54 ± 2.72 µg/dl and 115.19 ±1.71 µg/dl, respectively; P < 0.05). There was no significant correlation between serum zinc and acne history or severity. Conclusion: According to our findings, there is no link between serum zinc level and acne severity. Further evaluation of other contributing factors is suggested. Background: Acne vulgaris is a chronic inflammatory disease of pilosebaceous follicles. It is one of the most important skin disorders during adolescence. Zinc is one of essential trace elements in the body that has major roles in maintaining health. The main objectives of this study were to measure zinc serum levels and assess its relationship with age, sex, and disease severity in patients with acne vulgaris.Methods: 100 consecutive patients with acne vulgaris referred to Hazrat-Rassoul-Akram hospital in 2010 were enrolled as a non-random sample. Fasting blood specimens were taken at 9 am and serum zinc level was measured by atomic absorption spectrophotometry method.Findings: Mean serum zinc level of acne patients in this study was 106.78 ± 22.2 µg/dl. Mean levels of serum zinc were significantly lower in women compared to men (104.54 ± 2.72 µg/dl and 115.19 ±1.71 µg/dl, respectively; P < 0.05). There was no significant correlation between serum zinc and acne history or severity. Conclusion: According to our findings, there is no link between serum zinc level and acne severity. Further evaluation of other contributing factors is suggested. https://jims.mui.ac.ir/article_13703_967162a0b2dc0483ad3d0f47dfb1e9ac.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 CO2 Laser Therapy versus Cryotherapy in Treatment of Genital Warts: A Randomized Controlled Trial CO2 Laser Therapy versus Cryotherapy in Treatment of Genital Warts: A Randomized Controlled Trial 3016 3022 13704 FA Mir Haddi Aziz Jalali Associate Professor, Skin and Stem Cell Research Center, Department of Dermatology, Hazrat Rassoul Akram Hospital, Tehran University of Medical Sciences, Tehran ,Iran Gholam Hossein Ghafarpour Associate Professor, Skin and Stem Cell Research Center, Department of Dermatology, Hazrat Rassoul Akram Hospital, Tehran University of Medical Sciences, Tehran ,Iran Babak Mousavifard Student of Medicine, Skin Diseases and Leishmaniasis Research Center And Student Research Committee, Isfahan University of Medical Sciences, Isfahan And School of Medicine,Tehran University of Medical sciences, Tehran, Iran Journal Article 2012 03 12 Background: External genital warts are among the common causes of sexually transmitted diseases. Human papillomavirus is known as the main etiology of genital warts and the role of specific types of this virus in pathogenesis of cervical cancer has been recognized for decades. However, there are still many controversies regarding the best treatment of this infectious disease.Methods: In this randomized controlled trial, 160 patients with genital warts were enrolled into the study. Eighty patients were treated with CO2 laser and 80 patients were treated with cryotherapy. They were evaluated for clearance rate, complications and recurrence rate during a 3-month follow-up period.Findings: Seventy six lesions (95%) in CO2 laser therapy group and 37 lesions (46.2%) in cryotherapy group were completely cleared. The clearance rate was significantly different between groups (P < 0.001). 12% and 12.2% of the lesions in cryotherapy group required second and third applications to completely clear, respectively. However, in CO2 laser group, lesions just required one session of therapy to clear. The CO2 laser therapy was associated with less recurrence rate compared to the cryotherapy (0.05% vs. 0.18%). Conclusion: The overall efficacy of CO2 laser in the treatment of external genital warts was approximately two-folds greater than that of cryotherapy. In addition, CO2 laser therapy was associated with lower recurrence rate than cryotherapy. Background: External genital warts are among the common causes of sexually transmitted diseases. Human papillomavirus is known as the main etiology of genital warts and the role of specific types of this virus in pathogenesis of cervical cancer has been recognized for decades. However, there are still many controversies regarding the best treatment of this infectious disease.Methods: In this randomized controlled trial, 160 patients with genital warts were enrolled into the study. Eighty patients were treated with CO2 laser and 80 patients were treated with cryotherapy. They were evaluated for clearance rate, complications and recurrence rate during a 3-month follow-up period.Findings: Seventy six lesions (95%) in CO2 laser therapy group and 37 lesions (46.2%) in cryotherapy group were completely cleared. The clearance rate was significantly different between groups (P < 0.001). 12% and 12.2% of the lesions in cryotherapy group required second and third applications to completely clear, respectively. However, in CO2 laser group, lesions just required one session of therapy to clear. The CO2 laser therapy was associated with less recurrence rate compared to the cryotherapy (0.05% vs. 0.18%). Conclusion: The overall efficacy of CO2 laser in the treatment of external genital warts was approximately two-folds greater than that of cryotherapy. In addition, CO2 laser therapy was associated with lower recurrence rate than cryotherapy. https://jims.mui.ac.ir/article_13704_11997aab46c754fb90f36b9d8e4eaf99.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 A Double-Blind, Randomized Trial on Topical Formic Acid Puncture Technique in the Treatment of Common Warts A Double-Blind, Randomized Trial on Topical Formic Acid Puncture Technique in the Treatment of Common Warts 3023 3027 13705 FA Gita Faghihi Associate Professor, Skin Diseases and Leishmaniasis Research Center And Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-9106-3052 Anahita Vali Dermatologist, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran And Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran Mohammad Reza Raddan General Practitioner, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran And Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran Gholam Reza Eslamieh General Practitioner, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Shadi Tajamoli General Practitioner, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2012 03 12 Background: Viral warts are a common problem especially in young people. They are important as they are transmittable and cause social embarrassment. Though there are several treatments for viral warts, none offer a fast, simple, complete cure by itself. A simple and inexpensive way of treatment would be outstanding, especially in developing countries. We aimed to determine the efficacy and safety of topical puncture with 85% formic acid solution in patients with warts.Methods: A placebo-controlled, clinical trial was performed on patients with common viral warts who were referred to Khorshid and Beheshti Dermatology Centers (Isfahan, Iran) during 2003-04. A total of 34 patients received 85% formic acid solution on their lesion on one side of the body and distilled water as placebo on the other side every other day. Both sides were injected using needle puncture technique. Patients were followed up every two weeks until three months.Findings: Formic acid application resulted in complete disappearance of 91% of warts. This rate was 10% after the application of placebo.Conclusion: The application of 85% formic acid solution is a safe and effective treatment for common warts with few side effects and good compliance. Background: Viral warts are a common problem especially in young people. They are important as they are transmittable and cause social embarrassment. Though there are several treatments for viral warts, none offer a fast, simple, complete cure by itself. A simple and inexpensive way of treatment would be outstanding, especially in developing countries. We aimed to determine the efficacy and safety of topical puncture with 85% formic acid solution in patients with warts.Methods: A placebo-controlled, clinical trial was performed on patients with common viral warts who were referred to Khorshid and Beheshti Dermatology Centers (Isfahan, Iran) during 2003-04. A total of 34 patients received 85% formic acid solution on their lesion on one side of the body and distilled water as placebo on the other side every other day. Both sides were injected using needle puncture technique. Patients were followed up every two weeks until three months.Findings: Formic acid application resulted in complete disappearance of 91% of warts. This rate was 10% after the application of placebo.Conclusion: The application of 85% formic acid solution is a safe and effective treatment for common warts with few side effects and good compliance. https://jims.mui.ac.ir/article_13705_9fa315bff7fae22608236c2aa527fbd8.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 Comparison of Three Different Regimens of Oral Azithromycin in the Treatment of Acne Vulgaris Comparison of Three Different Regimens of Oral Azithromycin in the Treatment of Acne Vulgaris 3028 3033 13706 FA Farahnaz Fatemi Naeini Associate Professor, Skin Diseases and Leishmaniasis Research Center And Department of Dermatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Hooman Akrami Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran And Department of Dermatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2012 03 12 Background: Acne vulgaris is a common skin disease that involves pilosebaceous units. Orally administered antibiotics are the most widely systemic therapeutics prescribed for the treatment of moderate to severe acne vulgaris. Azithromycin is among the antibiotics that have been recently used in acne treatment. There are several protocols for oral administration of azithromycin. Our aim was to compare three different oral regimens of azithromycin in the treatment of acne vulgaris.Methods: Sixty-four patients with moderate to severe acne were divided into three groups randomly. First group (21 patients) received azithromycin as follows: five consecutive days per month, 500 mg on the first day and 250 mg daily for the next four days. Second group (22 patients) received 500 mg daily for four consecutive days per month and the last group (21 patients) was administered 250 mg daily thrice weekly. After the baseline visit, patients were scheduled to return at four-weekly intervals for 12 weeks.Findings: Oral azithromycin in all groups resulted in a significant decrease in acne grading score in consecutive visits (P < 0.001). There was no difference between the three groups in the decreasing trend of acne grading score (P > 0.05). The efficacy of the minimum dose was equal to the maximum dose of azithromycin in our experiment. Conclusion: Because of the high cost of azithromycin, we recommend administering lower doses (1500 mg/month), which is as effective as higher doses (3000 mg/month) and has better compliance and fewer side-effects. Background: Acne vulgaris is a common skin disease that involves pilosebaceous units. Orally administered antibiotics are the most widely systemic therapeutics prescribed for the treatment of moderate to severe acne vulgaris. Azithromycin is among the antibiotics that have been recently used in acne treatment. There are several protocols for oral administration of azithromycin. Our aim was to compare three different oral regimens of azithromycin in the treatment of acne vulgaris.Methods: Sixty-four patients with moderate to severe acne were divided into three groups randomly. First group (21 patients) received azithromycin as follows: five consecutive days per month, 500 mg on the first day and 250 mg daily for the next four days. Second group (22 patients) received 500 mg daily for four consecutive days per month and the last group (21 patients) was administered 250 mg daily thrice weekly. After the baseline visit, patients were scheduled to return at four-weekly intervals for 12 weeks.Findings: Oral azithromycin in all groups resulted in a significant decrease in acne grading score in consecutive visits (P < 0.001). There was no difference between the three groups in the decreasing trend of acne grading score (P > 0.05). The efficacy of the minimum dose was equal to the maximum dose of azithromycin in our experiment. Conclusion: Because of the high cost of azithromycin, we recommend administering lower doses (1500 mg/month), which is as effective as higher doses (3000 mg/month) and has better compliance and fewer side-effects. https://jims.mui.ac.ir/article_13706_0af62754d41faf4cabd69b68b2d0368f.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 Association of ABO and Rhesus Blood Groups with Acne Vulgaris Association of ABO and Rhesus Blood Groups with Acne Vulgaris 3034 3039 13707 FA Gholam Hossein Ghafarpour Associate Professor, Skin and Stem Cell Research Center And Department of Dermatology, Hazrat Rasoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran Gelareh Ghafarpour Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan And Student of Medicine Department of Dermatology, Tehran University of Medical Sciences, Tehran, Iran Mohammad Reza Ghasemi Resident, Department of Dermatology, School of Medicine, Jundishahpour University of Medical sciences, Ahvaz, Iran Journal Article 2012 03 12 Background: Acne vulgaris is one of the most common skin disorders worldwide, affecting 85% of adolescents. Acne has significant effects on psychosocial and emotional health particularly in young patients with facial involvement. Much attention has been devoted to find different predisposing factors of acne vulgaris thus far. In this study, we evaluate the association of severe acne vulgaris with ABO and Rh blood groups.Methods: This cross-sectional study recruited 500 consecutive patients with severe acne vulgaris referred to our university hospital dermatology clinic between April 2005 and April 2010. ABO and Rh blood groups of the patients were compared to the previously reported data of 1,300,000 healthy subjects from general population.Findings: Mean age of the patients was 24.11 ± 6.8 years (24.33 ± 6.9 years for women and 22.14 ± 5.0 years for men). Peak age of the disease presentation was 22 in both sexes. Distribution of ABO and Rh blood groups between male and female patients were not significantly different (P = 0.55 and P = 0.33, respectively). ABO blood group distribution among the patients was as follows: blood group O in 44%, A in 25.6%, B in 20.8% and AB in 9.6%. In addition, 92% of patients were Rh positive. When comparing patients with severe acne vulgaris to the control group, there was no statistically significant difference between groups according to ABO/Rh blood groups (P = 0.72 and P = 0.80, respectively). Conclusion: There was no association between ABO/Rh blood groups and the severe form of acne vulgaris. Further studies with greater sample size are recommended for confirming our findings. Background: Acne vulgaris is one of the most common skin disorders worldwide, affecting 85% of adolescents. Acne has significant effects on psychosocial and emotional health particularly in young patients with facial involvement. Much attention has been devoted to find different predisposing factors of acne vulgaris thus far. In this study, we evaluate the association of severe acne vulgaris with ABO and Rh blood groups.Methods: This cross-sectional study recruited 500 consecutive patients with severe acne vulgaris referred to our university hospital dermatology clinic between April 2005 and April 2010. ABO and Rh blood groups of the patients were compared to the previously reported data of 1,300,000 healthy subjects from general population.Findings: Mean age of the patients was 24.11 ± 6.8 years (24.33 ± 6.9 years for women and 22.14 ± 5.0 years for men). Peak age of the disease presentation was 22 in both sexes. Distribution of ABO and Rh blood groups between male and female patients were not significantly different (P = 0.55 and P = 0.33, respectively). ABO blood group distribution among the patients was as follows: blood group O in 44%, A in 25.6%, B in 20.8% and AB in 9.6%. In addition, 92% of patients were Rh positive. When comparing patients with severe acne vulgaris to the control group, there was no statistically significant difference between groups according to ABO/Rh blood groups (P = 0.72 and P = 0.80, respectively). Conclusion: There was no association between ABO/Rh blood groups and the severe form of acne vulgaris. Further studies with greater sample size are recommended for confirming our findings. https://jims.mui.ac.ir/article_13707_74322d3ea58d8c6643c5508ae0a33af5.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 Skin Reactions with Losartan and Enalapril in Cardiac Patients Skin Reactions with Losartan and Enalapril in Cardiac Patients 3040 3045 13708 FA Fariba Iraji Professor, Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Mohammad Garekyaraghi Associate Professor, Department of Cardiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Zohreh Ahmadi Student of Medicine, Skin Diseases and Leishmaniasis Research Center And Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran Mohammad Ali Nilforoushzadeh Associate Professor, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran Gita Faghihi Associate Professor, Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-9106-3052 Journal Article 2012 03 12 Background: Numerous reports have been published about the skin reaction after using angiotensin II converting enzyme inhibitors (ACEIs) such as enalapril and angiotensin II receptor blockers (ARBs) such as losartan. However, no such investigations have been conducted to evaluate skin complications after ACEIs and ARBs intake. According to racial differences in reaction to medications and high rate prescription of theses mentioned drugs, we aimed to design the present study.Methods: This cross-sectional study was performed on hospitalized or referred patients who were taking losartan or enalapril in University Hospitals of the Isfahan University of Medical Sciences in 2008. 200 patients were randomly enrolled to the study.Findings: Skin reactions developed in 4.5% of the participants (4.5% in losartan and 5% in enalapril users). The most common skin complications were urticaria, maculopapular rashes and angioedema. The average time from taking the medication to the development of skin complications was 6.1 months, which appeared between 1-2 months from drug prescription in 88.8% of the cases. Age and gender were not associated with the development of skin reactions. Conclusion: Our results showed similar development rates of skin reactions in both groups, except for the timing which was faster for enalapril. Background: Numerous reports have been published about the skin reaction after using angiotensin II converting enzyme inhibitors (ACEIs) such as enalapril and angiotensin II receptor blockers (ARBs) such as losartan. However, no such investigations have been conducted to evaluate skin complications after ACEIs and ARBs intake. According to racial differences in reaction to medications and high rate prescription of theses mentioned drugs, we aimed to design the present study.Methods: This cross-sectional study was performed on hospitalized or referred patients who were taking losartan or enalapril in University Hospitals of the Isfahan University of Medical Sciences in 2008. 200 patients were randomly enrolled to the study.Findings: Skin reactions developed in 4.5% of the participants (4.5% in losartan and 5% in enalapril users). The most common skin complications were urticaria, maculopapular rashes and angioedema. The average time from taking the medication to the development of skin complications was 6.1 months, which appeared between 1-2 months from drug prescription in 88.8% of the cases. Age and gender were not associated with the development of skin reactions. Conclusion: Our results showed similar development rates of skin reactions in both groups, except for the timing which was faster for enalapril. https://jims.mui.ac.ir/article_13708_a0f1a0686c4ecffbf795ea2d2a42817e.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 Comparison of Quality of Life in Women Suffering from Cutaneous Leishmaniasis Treated with Topical and Systemic Glucantime along with Psychiatric Consultation Compared with the Group without Psychiatric Consultation Comparison of Quality of Life in Women Suffering from Cutaneous Leishmaniasis Treated with Topical and Systemic Glucantime along with Psychiatric Consultation Compared with the Group without Psychiatric Consultation 3046 3052 13709 FA Mohammad Ali Nilforoushzadeh Associate Professor, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran Hamid Reza Roohafza Assistant Professor, Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Fariba Jaffary Associate Professor , Skin Disease and Leishmaniasis Research Center, Department of Pharmacology and Toxicology, School of Pharmacy, Isfahan University of Medical Sciences, Isfahan Iran Mehdi Khatuni Student of Medicine, Skin Disease and Leishmaniasis Research Center And Student Research Committee, Isfahan University of Medical Sciences, Isfahan Iran Journal Article 2012 03 12 Background: Cutaneous leishmaniasis (CL) is a parasitic disease which is endemic in Iran. Isfahan is one of the main centers of this disease. The aim of this study was to evaluate the effect of psychotherapy on quality of life (QOL) in women with CL treated with glucantime.Methods: In this study, 80 patients were randomly allocated to two groups, drug therapy and drug therapy plus psychotherapy. QOL was measured by dermatology life quality index (DLQI) and was compared at the beginning and the end of the intervention.Findings: The DLQI score before and after intervention in the group of drug therapy plus psychotherapy was 10.6 ± 5.7 and 7.7 ± 4.6, respectively, and their difference was statistically significant (P = 0.001). The score in drug therapy group before and after intervention was 10 ± 5.1 and 11 ± 5.1, respectively, which was not a significant difference. The mean difference of quality of life score before and after the treatment in the drug therapy plus psychotherapy group was 2.9 ± 5 and in the drug therapy group was 1.4 ± 4.2 (P < 0.001). Therefore, the quality of life was significantly higher in the patients treated with the combination of drug therapy and psychotherapy.Conclusion: Given the higher quality of life improvement by combination of psychotherapy and drug therapy in women with CL, psychiatric consultation is recommended. Background: Cutaneous leishmaniasis (CL) is a parasitic disease which is endemic in Iran. Isfahan is one of the main centers of this disease. The aim of this study was to evaluate the effect of psychotherapy on quality of life (QOL) in women with CL treated with glucantime.Methods: In this study, 80 patients were randomly allocated to two groups, drug therapy and drug therapy plus psychotherapy. QOL was measured by dermatology life quality index (DLQI) and was compared at the beginning and the end of the intervention.Findings: The DLQI score before and after intervention in the group of drug therapy plus psychotherapy was 10.6 ± 5.7 and 7.7 ± 4.6, respectively, and their difference was statistically significant (P = 0.001). The score in drug therapy group before and after intervention was 10 ± 5.1 and 11 ± 5.1, respectively, which was not a significant difference. The mean difference of quality of life score before and after the treatment in the drug therapy plus psychotherapy group was 2.9 ± 5 and in the drug therapy group was 1.4 ± 4.2 (P < 0.001). Therefore, the quality of life was significantly higher in the patients treated with the combination of drug therapy and psychotherapy.Conclusion: Given the higher quality of life improvement by combination of psychotherapy and drug therapy in women with CL, psychiatric consultation is recommended. https://jims.mui.ac.ir/article_13709_3f64b203421386156d5ef92c600045c6.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 The Impact of Recent Life Events on Patients with Alopecia Areata: A Study from Iran The Impact of Recent Life Events on Patients with Alopecia Areata: A Study from Iran 3053 3058 13710 FA Mir Hadi Aziz Jalali Associate Professor, Skin and Stem Cell Research Center And Department of Dermatology, Rasoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran Golnaz Mehran Assistant Professor, Department of Dermatology, Rasoul Akram Hospital ,Tehran University of Medical Sciences, Tehran, Iran Mehran-Ahad Zahra Resident, Department of Dermatology, Rasoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran Alireza Hanifnia Resident, Skin Diseases and Leishmaniasis Research Center And Student Research Committee, Isfahan University of Medical Sciences, Isfahan And Department of Dermatology, Rassoul Akram Hospital, Tehran University of Medical sciences, Tehran, Iran Journal Article 2012 03 12 Background: Alopecia areata (AA) affects 0.1%-0.2% of the general population, and occurs in both males and females. Initial presentation occurs most commonly in the late teenage years, early childhood or young adulthood, but can happen in all ages. In the present study, we aimed to find an association between the onset of AA and preceding emotional stress.Methods: A total of 47 patients diagnosed with AA and 47 controls (healthy subjects matched on age and gender) were enrolled to the study at the dermatology clinic of Hazrat Rasoul Akram Hospital, Tehran, Iran. Participants were administered Paykel's questionnaire for recent life events, and the demographic data of all subjects was also collected simultaneously.Findings: The distribution of AA was as follows: 30 (63.8%) subjects in head, beard in 16 (34%) and body in 1 (2.1%) subject. The total score of recent life events (during the last 12 months) was not significantly different between the AA patients (6.9 ± 1.01) and the control subjects (7.12 ± 0.91) (P = 0.95). Conclusion: Our findings do not support the hypothesis that stressful life events are associated with the occurrence of AA. Background: Alopecia areata (AA) affects 0.1%-0.2% of the general population, and occurs in both males and females. Initial presentation occurs most commonly in the late teenage years, early childhood or young adulthood, but can happen in all ages. In the present study, we aimed to find an association between the onset of AA and preceding emotional stress.Methods: A total of 47 patients diagnosed with AA and 47 controls (healthy subjects matched on age and gender) were enrolled to the study at the dermatology clinic of Hazrat Rasoul Akram Hospital, Tehran, Iran. Participants were administered Paykel's questionnaire for recent life events, and the demographic data of all subjects was also collected simultaneously.Findings: The distribution of AA was as follows: 30 (63.8%) subjects in head, beard in 16 (34%) and body in 1 (2.1%) subject. The total score of recent life events (during the last 12 months) was not significantly different between the AA patients (6.9 ± 1.01) and the control subjects (7.12 ± 0.91) (P = 0.95). Conclusion: Our findings do not support the hypothesis that stressful life events are associated with the occurrence of AA. https://jims.mui.ac.ir/article_13710_5456133e67453a4c86d63b50d1f8bc2e.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 Prevalence of Skin Drug Eruptions in Dermatology Departments of Tehran Hospitals Prevalence of Skin Drug Eruptions in Dermatology Departments of Tehran Hospitals 3059 3064 13711 FA Saviz Saghari Student of Medicine, Skin Diseases and Leishmaniasis Research Center And Student Research committee, Isfahan University of Medical Sciences, Isfahan And School of Medicine, Tehran University of Medical sciences, Tehran, Iran Mir Hadi Aziz Jalali Associate Professor, Skin and Stem Cell Research Center, And Department of Dermatology, Rassoul-e-Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran Journal Article 2012 03 12 Background: The most common drug side effects are skin reactions. These reactions range from simple maculopapular eruptions to massive epidermal necrosis. There are still not enough data about drug eruptions in Iran, because minor side effects resolve spontaneously or are treated in outpatient settings. In this survey, we studied skin drug eruptions among patients admitted to dermatology departments of two hospital centers in Tehran.Methods: This was a descriptive study and included all cases who were admitted in Rassoul-e-Akram and Loghman-Hakim Hospitals for skin drug reactions between 2001 and 2009. We derived demographic data and other information from medical records.Findings: Our samples included 150 patients (90 females and 60 males). Frequency of different skin reactions was as follows: maculopapular eruptions 82 cases, Steven Johnson syndrome 31 cases, urticarial reactions 10 cases, toxic epidermal necrolysis reactions 5 cases, erythrodermal eruptions 8 cases, edematous eruptions 4 cases and multiform erythema 2 cases. The most common drugs that created reactions were (in order): phenytoin, carbamazepine, lamotrigine, penicillin, and co-trimoxazole. These five drugs were responsible for 50 percent of all cases. Most of the drugs were prescribed for urinary tract infections, convulsions, and diarrhea.  Conclusion: Skin drug reactions in this study varied tremendously from the simplest types i.e., maculopapular eruptions, which is the most common form worldwide, to the most complex ones i.e., toxic epidermal necrolysis. According to our findings, maculopapular eruptions and Steven Johnson syndrome are the most common forms of skin drug reactions in hospitalized patients.  Background: The most common drug side effects are skin reactions. These reactions range from simple maculopapular eruptions to massive epidermal necrosis. There are still not enough data about drug eruptions in Iran, because minor side effects resolve spontaneously or are treated in outpatient settings. In this survey, we studied skin drug eruptions among patients admitted to dermatology departments of two hospital centers in Tehran.Methods: This was a descriptive study and included all cases who were admitted in Rassoul-e-Akram and Loghman-Hakim Hospitals for skin drug reactions between 2001 and 2009. We derived demographic data and other information from medical records.Findings: Our samples included 150 patients (90 females and 60 males). Frequency of different skin reactions was as follows: maculopapular eruptions 82 cases, Steven Johnson syndrome 31 cases, urticarial reactions 10 cases, toxic epidermal necrolysis reactions 5 cases, erythrodermal eruptions 8 cases, edematous eruptions 4 cases and multiform erythema 2 cases. The most common drugs that created reactions were (in order): phenytoin, carbamazepine, lamotrigine, penicillin, and co-trimoxazole. These five drugs were responsible for 50 percent of all cases. Most of the drugs were prescribed for urinary tract infections, convulsions, and diarrhea.  Conclusion: Skin drug reactions in this study varied tremendously from the simplest types i.e., maculopapular eruptions, which is the most common form worldwide, to the most complex ones i.e., toxic epidermal necrolysis. According to our findings, maculopapular eruptions and Steven Johnson syndrome are the most common forms of skin drug reactions in hospitalized patients.  https://jims.mui.ac.ir/article_13711_e3537ccce7b6d7ed1b54f9a585985716.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 Comparison between Sequentional Treatment with Diode and Alexandrite Lasers versus Alexandrite Laser Alone in the Treatment of Hirsutism Comparison between Sequentional Treatment with Diode and Alexandrite Lasers versus Alexandrite Laser Alone in the Treatment of Hirsutism 3065 3071 13712 FA Mohammad Ali Nilforoushzadeh Associate Professor, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran Farahnaz Fatemi Naieni Associate Professor, Skin Diseases and Leishmaniasis Research Center And Department of Dermatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Amir Hossein Siadat Assistant Professor, Skin Diseases and Leishmaniasis Research Center And Department of Dermatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Rad Leili Student of Medicine, Skin Diseases and Leishmaniasis Research Center And Department of Dermatology, School of Medicine And Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2012 03 12 Background: Laser systems that are commonly used for the treatment of hirsutism include the ruby laser (694 nm), the diode laser (800 nm), the alexandrite laser (755 nm) and the Nd: YAG laser (1084 nm). The diode laser and alexandrite laser are considered effective in treatment of hirsutism in dark-skinned patients. The response of hairs to these laser systems is variable and not complete. In this study, we compared the efficacy of these two laser systems for permanent hair removal.Methods: This was a randomized controlled clinical trial in women with age range 15-45 years old. After obtaining an informed consent, the subjects were randomized into two groups using random allocation software. The first group was treated with alexandrite laser alone (four sessions, two months apart). The second group was treated sequentially with diode laser for the first and alexandrite laser for the next two sessions.Findings: Overall, 111 patients (57 patients in the alexandrite laser group and 54 patients in the sequential diode-alexandrite laser group) were evaluated. There was no statistically significant difference in the mean hair reduction of the two groups during the treatment. Except for the first session, there was no significant difference in patient satisfaction between the two groups (P > 0.05). No significant difference was found between groups one month, three months and six months after the last treatment (P > 0.05). Conclusion: There was no significant difference between sequential treatment with diode and alexandrite lasers versus alexandrite laser alone in the treatment of hirsutism. We suggest that the efficacy of sequential treatment with other laser systems should be evaluated against single treatment methods in the future studies. Background: Laser systems that are commonly used for the treatment of hirsutism include the ruby laser (694 nm), the diode laser (800 nm), the alexandrite laser (755 nm) and the Nd: YAG laser (1084 nm). The diode laser and alexandrite laser are considered effective in treatment of hirsutism in dark-skinned patients. The response of hairs to these laser systems is variable and not complete. In this study, we compared the efficacy of these two laser systems for permanent hair removal.Methods: This was a randomized controlled clinical trial in women with age range 15-45 years old. After obtaining an informed consent, the subjects were randomized into two groups using random allocation software. The first group was treated with alexandrite laser alone (four sessions, two months apart). The second group was treated sequentially with diode laser for the first and alexandrite laser for the next two sessions.Findings: Overall, 111 patients (57 patients in the alexandrite laser group and 54 patients in the sequential diode-alexandrite laser group) were evaluated. There was no statistically significant difference in the mean hair reduction of the two groups during the treatment. Except for the first session, there was no significant difference in patient satisfaction between the two groups (P > 0.05). No significant difference was found between groups one month, three months and six months after the last treatment (P > 0.05). Conclusion: There was no significant difference between sequential treatment with diode and alexandrite lasers versus alexandrite laser alone in the treatment of hirsutism. We suggest that the efficacy of sequential treatment with other laser systems should be evaluated against single treatment methods in the future studies. https://jims.mui.ac.ir/article_13712_76edf3aeec7870bdbf0d146a95e611cc.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 Use of Topical Finasteride in Hirsutism: A Double-blind, Randomized Clinical Trial on Women Use of Topical Finasteride in Hirsutism: A Double-blind, Randomized Clinical Trial on Women 3072 3079 13713 FA Fariba Iraji Professor, Skin Diseases and Leishmaniasis Research Center And Department of Dermatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Samira Karbasioun Resident, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran And Department of Dermatology, School of Medicine And Student Research committee, Isfahan University of Medical Sciences, Isfahan, Iran Ashraf Aminorroaya Professor, Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2012 03 18 Background: Finasteride partially blocks the conversion of testosterone to dihydrotestosterone through inhibition of 5α-reductase in hair follicles. Finasteride cream can penetrate into the dermis and the hair follicle due to its solubility. Therefore, it is expected to be used in the treatment of hirsutism with fewer systemic adverse side effects. This study was designed to determine the efficacy of finasteride cream 0.5% in the management of idiopathic hirsutism.Methods: Finasteride (0.5%) and placebo creams were administered to 35 women with facial hirsutism. Medication and placebo creams were each used on one side of the face in an area of excessive hair growth, which were not necessarily symmetrical. The side of the face for the finasteride and placebo creams was chosen randomly and blindly in 1cm2 areas on each side of the face. The hairs were counted and their thickness was also measured by micrometer, and their mean was calculated at the start of therapy and after 6 months. Statistical analysis was done in SPSS software using Paired and Student t-tests. P-values less than 0.05 were considered significant.Findings: The mean of hair numbers decreased on the placebo-applied side from 12.20 ± 6.15 to 10.50 ± 4.90 (P < 0.001), and on the finasteride-treated side from 11.37 ± 6.15 to 8.47 ± 4.62 (P < 0.001). Mean of hair thickness on the placebo side decreased from 2.92 ± 0.84 µm to 2.72 ± 0.79 µm (P < 0.001), and on the finasteride side from 3.17 ± 0.90 µm to 2.37 ± 0.79 µm (P < 0.001). Comparison of hair number and thickness showed no statistically significant changes in finasteride versus placebo treated sides. However, according to the patients' view points, hair growth rate was diminished and hair was thinner on the finasteride-treated side. Conclusion: Six months of topically applied finasteride (0.5%) does not affect the number and thickness of facial hirsutism significantly. Despite the lack of changes, on questioning, most patients in the finastride group perceived a decrease in hair growth over time. Background: Finasteride partially blocks the conversion of testosterone to dihydrotestosterone through inhibition of 5α-reductase in hair follicles. Finasteride cream can penetrate into the dermis and the hair follicle due to its solubility. Therefore, it is expected to be used in the treatment of hirsutism with fewer systemic adverse side effects. This study was designed to determine the efficacy of finasteride cream 0.5% in the management of idiopathic hirsutism.Methods: Finasteride (0.5%) and placebo creams were administered to 35 women with facial hirsutism. Medication and placebo creams were each used on one side of the face in an area of excessive hair growth, which were not necessarily symmetrical. The side of the face for the finasteride and placebo creams was chosen randomly and blindly in 1cm2 areas on each side of the face. The hairs were counted and their thickness was also measured by micrometer, and their mean was calculated at the start of therapy and after 6 months. Statistical analysis was done in SPSS software using Paired and Student t-tests. P-values less than 0.05 were considered significant.Findings: The mean of hair numbers decreased on the placebo-applied side from 12.20 ± 6.15 to 10.50 ± 4.90 (P < 0.001), and on the finasteride-treated side from 11.37 ± 6.15 to 8.47 ± 4.62 (P < 0.001). Mean of hair thickness on the placebo side decreased from 2.92 ± 0.84 µm to 2.72 ± 0.79 µm (P < 0.001), and on the finasteride side from 3.17 ± 0.90 µm to 2.37 ± 0.79 µm (P < 0.001). Comparison of hair number and thickness showed no statistically significant changes in finasteride versus placebo treated sides. However, according to the patients' view points, hair growth rate was diminished and hair was thinner on the finasteride-treated side. Conclusion: Six months of topically applied finasteride (0.5%) does not affect the number and thickness of facial hirsutism significantly. Despite the lack of changes, on questioning, most patients in the finastride group perceived a decrease in hair growth over time. https://jims.mui.ac.ir/article_13713_8dfe8cee5c46c3c42f3bfa933035d7aa.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 The Efficacy of Achillea Millefolium Topical Gel Along with Intralesional Injection of Glucantime in the Treatment of Acute Cutaneous Leishmaniasis The Efficacy of Achillea Millefolium Topical Gel Along with Intralesional Injection of Glucantime in the Treatment of Acute Cutaneous Leishmaniasis 3080 3086 13714 FA Fariba Jaffary Associate Professor, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Mohammad Ali Nilforoushzadeh Associate professor, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran Naser Tavakoli Associate Professor, Department of Pharmacognosy, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran Behzad Zolfaghari Associate Professor, Department of Pharmacognosy, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran Foroud Shahbazi Student of Pharmacy, Skin Diseases and Leishmaniasis Research Center And Student Research committee, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2012 03 18 Background: Leishmaniasis is still one of the endemic parasitic infections in many countries, such as Iran. During the past decades, many reaserches have studied medical and surgical approaches to treatment of cutaneous leishmaniasis in Iran and the world in order to achieve the best option. However, there is still no single definite and unique approach available for treatment of this disease with optimal safety and efficacy. Some clinical studies have focused on topical use of traditional herbs, such as Achilles millefolium (Yarrow), as an adjutant treatment of cutaneous leishmaniasis along with other approaches, and showed its suitable impact on the healing of lesions. This study was carried out to evaluate the effect of topical Achilles millefolium in conjunction with intralesional glucantime on acute cutaneous leishmanial lesions.Methods: sixty patients with confirmed acute cutaneous leishmaniasis were recruited in this study. Patients were randomly allocated to two groups to receive topical gel of Achilles millefolium 5% twice daily (containing 5% polyphenol) (group A) or placebo (group B) for four weeks along with a weekly injection of intralesional Glucantime.Findings: There was no significant difference between the two groups according to age, gender, and duration of the disease. Moreover, there was no significant difference in complete and relative cure rates between the two groups (P = 0.35). Application site reactions occurred in 12 patients; including redness in 8 cases in group A and 2 cases in group B, severe itching in 1 case in group A, and increasing of wound secretion in another case in group A (P = 0.014). Conclusion: Given the results of the present study, there is no significant difference in cure rates of lesions between yarrow and placebo topical gels as adjuvant drugs with intralesional glucantime in the treatment of acute cutaneous leishmanial lesions. Background: Leishmaniasis is still one of the endemic parasitic infections in many countries, such as Iran. During the past decades, many reaserches have studied medical and surgical approaches to treatment of cutaneous leishmaniasis in Iran and the world in order to achieve the best option. However, there is still no single definite and unique approach available for treatment of this disease with optimal safety and efficacy. Some clinical studies have focused on topical use of traditional herbs, such as Achilles millefolium (Yarrow), as an adjutant treatment of cutaneous leishmaniasis along with other approaches, and showed its suitable impact on the healing of lesions. This study was carried out to evaluate the effect of topical Achilles millefolium in conjunction with intralesional glucantime on acute cutaneous leishmanial lesions.Methods: sixty patients with confirmed acute cutaneous leishmaniasis were recruited in this study. Patients were randomly allocated to two groups to receive topical gel of Achilles millefolium 5% twice daily (containing 5% polyphenol) (group A) or placebo (group B) for four weeks along with a weekly injection of intralesional Glucantime.Findings: There was no significant difference between the two groups according to age, gender, and duration of the disease. Moreover, there was no significant difference in complete and relative cure rates between the two groups (P = 0.35). Application site reactions occurred in 12 patients; including redness in 8 cases in group A and 2 cases in group B, severe itching in 1 case in group A, and increasing of wound secretion in another case in group A (P = 0.014). Conclusion: Given the results of the present study, there is no significant difference in cure rates of lesions between yarrow and placebo topical gels as adjuvant drugs with intralesional glucantime in the treatment of acute cutaneous leishmanial lesions. https://jims.mui.ac.ir/article_13714_5695dd7bfdf01700983a66a5f2d57698.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 The Effect of Methotrexate 1% Topical Gel on Psoriasis The Effect of Methotrexate 1% Topical Gel on Psoriasis 3087 3092 13715 FA Gita Faghihi Associate Professor, Skin Diseases and Leishmaniasis Research Center And Department of Dermatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-9106-3052 Taghi Ghafghazi Professor, Department of Pharmacology and Toxicology, School of Pharmacy, Isfahan University of Medical Sciences, Isfahan Iran Mohammad Ali Nilforoushzadeh Associate Professor, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran Journal Article 2012 03 18 Background: Psoriasis is one of the most important chronic inflammatory skin diseases, which affects about 3% of people all over the world. However, there is still no unique approach available for treatment of this disease, despite several studies which were performed regarding efficacy and safety of various drugs including methotrexate.Methods: This randomized double-blind study recruited 65 patients with documented psoriasis. Patients were randomly divided into two groups to receive a daily dose of topical gel of methotrexate 1% (group A) or placebo gel (group B) for two months. Patients were followed up to four months.Findings: There were 65 patients, 48 male (75.3%) and 17 female (24.7%), with the mean age of 31 ± 15.7 years and the mean disease duration of 5.5 ± 3.3 years. No significant difference was detected between the two groups of patients according to the response scale after four months. Conclusion: The present study showed that the topical gel methotrexate 1%, when prepared on a base of glycerin, is not effective in improvement of the psoriasis lesions and can not be considered as a first line treatment option in this disease. Background: Psoriasis is one of the most important chronic inflammatory skin diseases, which affects about 3% of people all over the world. However, there is still no unique approach available for treatment of this disease, despite several studies which were performed regarding efficacy and safety of various drugs including methotrexate.Methods: This randomized double-blind study recruited 65 patients with documented psoriasis. Patients were randomly divided into two groups to receive a daily dose of topical gel of methotrexate 1% (group A) or placebo gel (group B) for two months. Patients were followed up to four months.Findings: There were 65 patients, 48 male (75.3%) and 17 female (24.7%), with the mean age of 31 ± 15.7 years and the mean disease duration of 5.5 ± 3.3 years. No significant difference was detected between the two groups of patients according to the response scale after four months. Conclusion: The present study showed that the topical gel methotrexate 1%, when prepared on a base of glycerin, is not effective in improvement of the psoriasis lesions and can not be considered as a first line treatment option in this disease. https://jims.mui.ac.ir/article_13715_c5a264a82289018331673285e24d9dd8.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 29 173 2012 02 20 Development of Bioadhesive Chitosan Gels for Topical Delivery of Lidocaine Development of Bioadhesive Chitosan Gels for Topical Delivery of Lidocaine 3093 3103 13716 FA Jaleh Varshosaz Associate Professor, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran And Department of Pharmacognosy, School of Pharmacy, Isfahan University of Medical Sciences, Isfahan Iran Fariba Jaffary Associate Professor, Skin Disease and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan Iran Sara Karimzadeh Student of Pharmacy, Skin Disease and Leishmaniasis Research Center And Student Research Committee, Isfahan University of Medical Sciences, Isfahan Iran Journal Article 2012 03 18 Background: Lidocaine (LC) is a local anesthetic agent. The aim of this study is the prolonging of the anesthetic effect of this drug for transdermal delivery. Methods: LC hydrochloride gels were prepared with three different molecular weights (MW) and concentrations of chitosan. Lecithin was used as permeation enhancer. Viscosity, bioadhesion, drug release from synthetic membranes, drug permeation through the biological barrier (rat skin) and antinociceptive effect of gels were studied. Increasing the concentration of chitosan caused a decrease in the bioadhesion.Findings: Studing drug release in gels showed that increasing the concentration and MW of chitosan caused an increase in the amount, extent, and rate of influx of the drug. This is probably due to the increase in repulsive forces between LC and chitosan cations. The flux of the drug through the rat skin was higher for 3% high MW chitosan gel (H3) compared to the standard gel. LC was effective topically in hind paw formalin assay. It was most active immediately after its administration. The analgesic activity of LC in H3 gel could cover the duration of the formalin nociception. The maximal response of LC in comparable doses of H3 and standard gel was about 52% and 36% analgesia in the second phase, respectively compared to the control group. Conclusion: The higher response of the H3 gel may be attributed to the bioadhesive effect of the chitosan base and the higher concentrations of LC compared to the standard gel. Background: Lidocaine (LC) is a local anesthetic agent. The aim of this study is the prolonging of the anesthetic effect of this drug for transdermal delivery. Methods: LC hydrochloride gels were prepared with three different molecular weights (MW) and concentrations of chitosan. Lecithin was used as permeation enhancer. Viscosity, bioadhesion, drug release from synthetic membranes, drug permeation through the biological barrier (rat skin) and antinociceptive effect of gels were studied. Increasing the concentration of chitosan caused a decrease in the bioadhesion.Findings: Studing drug release in gels showed that increasing the concentration and MW of chitosan caused an increase in the amount, extent, and rate of influx of the drug. This is probably due to the increase in repulsive forces between LC and chitosan cations. The flux of the drug through the rat skin was higher for 3% high MW chitosan gel (H3) compared to the standard gel. LC was effective topically in hind paw formalin assay. It was most active immediately after its administration. The analgesic activity of LC in H3 gel could cover the duration of the formalin nociception. The maximal response of LC in comparable doses of H3 and standard gel was about 52% and 36% analgesia in the second phase, respectively compared to the control group. Conclusion: The higher response of the H3 gel may be attributed to the bioadhesive effect of the chitosan base and the higher concentrations of LC compared to the standard gel. https://jims.mui.ac.ir/article_13716_1d221442f2e2158c01747714f9bb00f5.pdf