Iranian Journal of Dermatology
Year:2004 | Volume:8 | Issue:1|Papers Count:16

Background: The theory of selective photothermolysis led to the development of a variety of different laser systems which range from the shorter spectrum of 694 nm ruby laser to the middle with the 755 nm alexandriteand 810 nm diode lasers to the longendwith the 1064nm (Nd: YAG) laser. Objective: A systematic review on the clinical trials with use of various laser sources for hair removal Methods: All clinical trials related to hair removal lasers in 1998-2003 were selected. After elimination of heterogenicity sources in data,results were synthesizedon the basis of laser type and were compared using ANOVA and t tests, p value < 0.05 was considered as significant. Results: Hair reduction at least 6 treatment months after the last treatment and after 3 sessions were 57.5% ± 14% , 42.3%±24%, 54.7%± 17%, 52.8%±6% for diode, Nd: YAG, alexandrite and ruby lasers, respectively. Diode laser was the most effective and Nd: YAG had the least effect in hair removal. Conclusion: The most effective laser for hair removal is diode, but higher fluences is needed in the darker skin types and this is accompanied with more complications, so it is advised to use this laser for light skin types.

Background: Acne vulgaris is a chronic inflammatory disease of pilosebaceous unit. The role of Pityrosporum ovale (p.ovale) in the exacerbation of acne is still under debate. Objective: To determine the efficacy of topical 2% ketoconazole cream in comparison to placebo in the treatment of acne vulgaris in patients with positive smear for P.ovale. Patients & Methods: A smear was obtained from lesions of 84 patients with acne vulgaris referred to Razi Hospital, Tehran. After determination of clinical and mycological grading, patients with positive smear for P.ovale were randomly treated with topical 2% ketoconazole cream or placebo. After 4 weeks the patients were evaluated for the clinical and mycological grading and treated with traditional anti-acne drugs. Results:Fifty-six of 84 patients had positive smears, 29 of them were treated with ketoconazole cream and 27 patients received placebo. Clinical grading before teatment was 2.60 and 2.21 in ketoconazole and placebo groups, which was reduced to 2.16 and 2.05, respectively. Mycological grading reduced from 1.4 to 0.44 in ketoconazole group, but did not change in placebo group (1.42). Conclusion: 2% ketoconazole cream was more effective than placebo in reduction of mycological grading but did not have any effect on clinical grading of acne.

Background: Epidermal nevus IS a common skin hamartoma. Its definite treatment is difficult and in most cases the disease has recurrence. Objective: Evaluation of topical tretinoin 0.05%and 5 Fluorouracil(5FU) 5% in the Teannent of epidermal nevus Patients and Methods: Fifteen patients with epidermalnevus referred to skin clinic in Razi Hospital in Tehran whose diagnoses were confirmed by pathology examination, were ITeatedwith topical tretinoin 0.05% and 5FU 5%. Five patients were excluded because of loss to follow up and 10 patients were regularlyfollowed. Results: Four patients were male and 6 of them were female. Their age ranged from 12 to 40 years. After 10 weeks, their nevi were flattened considerably so the patients were satisfied. There was no complication that needed to stop the treatment completely. Maintenance treatment was recommended and no recurrence was seen until the end of follow up duration. Conclusion: Topical tretinoin 0.05% and 5FU 5% are easy and inexpensive treatments for epidermal nevi, with satisfactory results and long maintenance therapy will prevent recurrence.

Background: The incidence of oral cancers is different worldwide. Objective: To evaluate the rate of oral cancers in Khouzestan Province Patients and Methods: The data were collected from the pathologic reports of pathology laboratories all around the province, during the time period of 1992- 2002. Results: Among the total received specimens, 305 cases of oral cancers were detected. Onehundred ninety-three cases (63.2%) were male and 112 cases (36.8%) were female. Male to female ratio was 1.7 and mean age was 55.04±16.60 years. Squamous cell carcmoma was the most common malignancy (75% of total) , and then standed the nasopharyngeal carcinoma (10.8%) and lymphoma (7.5%). The most common sites were lower lip (29.2%), tongue (19%) and nasopharynx (15.7%). Conclusion: Regardless of some mmor differences, most of our findings were similar to other previous studies.

Background: Numerous lasers are currently available for hair removal. Objective: To study the efficacy of a pulsed diodelaser for removing unwanted hair Patients & Methods: In this quasiexperimental clinical trial, 39 patients with unwanted hairs on chin referred to Novin- Didegan Laser Center in Tehran were treated with a diode laser system (Palomar, 81Onm). Fluences ranging from 40 to 64 J/cm2(mean, 48.3 J/cm2) were used and 3 to 7 treatment sessions with 4-6 weeks apart were performed. Evaluation of hair reduction was performed 6 months after the last treatment usingpaired t test. Results: Six months after the last treatment hair reduction was more than 75% in 23 patients. The mean hair reduction was 74.7%±20.5. Transient hyperpigmentation was observed in 9 patients(23%). Conclusion: The 810 nm diode laser is an efficient and a safe modality for hair removal in all skin types.

Background: Urticaria is a common skin disease characterized by transient and itchy swelling. The spectrum of etiologic factors in urticaria is very wide and contain external factors such as drugs, foods and internal diseases such as infections, SLE, hormonal factors and even lymphoma. Objective: To determine different kinds of urticaria and different etiologic and provocational factors in patients with urticaria Patients & Methods: This descriptive study was carried on 120 patients with urticaria referred to Razi Hospital in Tehran in year 1376. They were evaluated in two groups: acute and chronic urticaria, duration of 6 weeks was the limit between them. Results: About 30% of patients had acute urticaria and causes were determined in 58% of them. Upper respiratory tract infections, drugs and foods were the most common etiologic factors. In only 22% of patients with chronic urticaria, the causes were found, which included infections (sinusitis, hepatitis B, intestinal parasitic infections), drugs (NSAIDs and Codein) and food. Fifty percent of these patients had common urticaria, 22% of them were affected with one of the physical urticarias and in 22% of them a combination of two or more kinds of urticaria were founded. Conclusion: The most important factor in determining the cause and provocation of determining etiology of urticaria.

Background: Tinea pedis is the most common fungal infection in adults. It is a common problem in communal areas such as swimmingpools and hotels. Objective: To detennine the frequency of tinea pedis in adult Muslims regularly attending mosques and to compare it with a controlgroup Patients & Methods: In a case-control study in 4 randomly selected mosques in Kennan, 99 adult Muslims praying in the mosque at least once a day on at least 5 days a week and 101 Muslims praying less than once a month in mosque (as control), were clinically examined for tinea pedis. Clinically suspicious individuals were further subjected to skin scraping for direct smear and culture. Samples were also taken from 12 areas of the carpets of mosques for direct smear and culture. Results: Only 6 individuals (3 in each group) had clinical signs of fungal infection and the culture confinned diagnosis in 2 of them ( one in each group). Smears and cultures from carpets were all negative. Conclusion: We did not find any differences in tinea pedis between Muslims regularly praying in mosques and the control group.

Nowadays viral hepatitis is one of the most common and important causes of chronic liver disorders in the world. Extrahepatic manifestations of viral hepatitis consist a main part of the disease. The main viruses causing hepatitis include Hepatitis A, B, and C viruses. Herein common skin manifestations in hepatitis C virus (HCV) is discussed. Chronic hepatitis causes skin disorders both directly and indirectly. HCV is a RNA virus and is considered as one of the most important causes of acute and chronic hepatitis. HCV is mainly transmitted through blood transfusion or using shared infected needles. People who inject narcotics, cocaine users and health personnels are at risk more than others.

Although lichen planus is a fairly common disorder, its familial occurrence is uncommon and varies between 1.5 and 10.7%. In most reports, only two or three members of the family have had disease but occasionally morefamily members may be affected. We present a case of lichen planus, whose father, mother, and maternal aunt also had this disease.

Pigmented Bowen s disease is an in situ squamous cell carcinoma, which is seldom reported in white patients. Herein we report a 20-year-old woman with type III skin, who had this lesion on the fourth finger of her right hand, similar to superficial malignant melanoma, clinically. Although dermoscopic evaluation could be helpful, correct diagnosis of nonmelanotic origin is done by histological examination. In spite of its rarity, pigmented Bowens disease should be considered in the differential diagnosis of malignant melanoma.

Acne rosacea is a relatively common disease, which usually manifests in the third and fourth decades of life. It has an inflammatory condition (papules and pustules) associated with telangiectasis, rythema and sometimes rhinophyma at the end stage of the disease.Pulsed- dye- laser (PDL),which has been designed for treatment of vascular lesions, may be used in treatment of acne rosacea. We present a 64-year-old man with a chronic and resistant form of acne rosacea, who underwent multiple sessions of PDL(Candela,Scleroplus) with pulse duration = 1500 Jis , 600 nm long waves and 13-14 J/cm2 with 6-8 weeks intervals. Clinical follow up showed not only a reduction in edema, erythrosis and telangiectasis but also a control of inflammatory components and regression of rhinophyma. The patient didn not take any medication during treatment and follow up period. PDL (585nm, 6-7.5 J/cm2) treatment of telangiectasis associated with rosacea had already be known, however it is the first report of successful management of chronic and resistant acne rosacea with PDL treatment by different parameters.

Background: The publication of articles in peer-reviewed scientific journals is a fairly complex and stepwise process that involves responding to referees" comments. Little guidence is available in the biomedical literature on how to deal with such comments. Objective: The objective of this article is to provide guidance to notice writers on dealing with peer review comments in a way that maxImIzes the chance of subsequent acceptance. Methods: This will be a literature review and review of the author"s experience as a writer and referee Results: Where possible, the author should consider revising and resubmitting rather than sending an article elsewhere. A structured layout for responding to referees" comments is suggested that includes the 3 golden rules: 1) respond completely; 2)respond politely; and 3)respond with evidence. Conclusion: Responding to referees" comments requires the writer to overcome any feeling of personal attack, and to instead concentrate on addressing referees" concerns in a courteous, objective, and evidence based way. (J Am Acad Deramtol 2004; 51: 79-83).