Background: Microneedling has been shown to be a clinically effective and safe treatment for comedonal acne vulgaris. The aim of the present study was to compare the clinical effect of microneedling and the most commonly used topical drug, tretinoin, in the treatment of comedonal acne. Methods: Patients with comedonal acne (n = 82) were randomized to receive topical tretinoin (n = 41) or 6 sessions of microneedling (n = 41) over a period of 3 months. Objective assessments such as changes in acne severity score by global acne grading system (GAGS) and patients’ subjective satisfaction were investigated at the baseline, at the end of the treatment period, and at the 3-month follow up. Results: GAGS was significantly reduced in both microneedling (7. 8± 3. 8 to 3. 5± 2. 6) and tretinoin (8± 3. 8 to 6. 6± 3. 2) groups at the end of the treatment course compared with the baseline. The overall acne severity index reduction in microneedling group was significantly higher than that of the tretinoin group (P<0. 001). Improvement in acne severity was also more permanent by microneedling. The severity of acne in tretinoin recipients was increased to 8. 2± 3. 2 at the follow-up visit, while it remained nearly unchanged in the microneedling group. (3. 3± 2. 4). Patients’ subjective assessment concerning acne improvement was significantly more satisfactory in microneedling group (P<0. 001). Conclusion: Compared with tretinoin, microneedling seems to be a more effective, permanent and satisfactory treatment in the treatment of comedonal acne.

Background: COMEDONE formation has an essential role in pathophysiology of acne, therefore destroying of COMEDONEs and preventing of COMEDONE formation is very important in acne treatment. Objective: To determine the effect of superficial peeling with 70% glycolic acid in the improvement of acne. Patients & Methods: In this open clinical trial without control group, 30 patients with acne referred to Razi Hospital in Tehran (mean age 18) years were treated with 70% glycolic acid and their clinical improvement was evaluated. Results: Mean numbers of COMEDONEs were 24.4± 15.2 and 2.6±5.9 in first & last visits respectively (P<0.005). Moreover, 18 patients (60%) and 12 patients (40%) had complete and relative improvement, respectively. The side effects of this treatment were minimum and transient. Conclusion: Superficial peeling with 70% glycolic acid is effective in treatment of mild acne.      

Background: Adequate control of acne is difficult, regardless of the various conventional modalities. Intense Pulsed Light (IPL) system is one of the emerging options that are become increasingly useful.Methods: To achieve the best IPL parameters we evaluated the efficacy and tolerability of IPL at 752-nm wavelength, 35 j/cm2 fluence, 55-ms pulse duration in comparison with 572-nm wavelength, 35 j/cm2 fluence, 101-ms pulse duration, in a 5 week, controlled, double-blind, split-face clinical trial. Final assessment was made by comparison of the changes in inflammatory and non-inflammatory acne lesions count and the Acne Global Severity Scale (AGSS) between two groups, based on standardized photography.Result: Fifteen female patients, with mean age of 23.53±2.47 years (range 20-28) completed the 5-week therapy period. For both therapies, significant reductions (approximately 30%) in the COMEDONE and inflammatory lesions count were observed (p=0.0024). There was no significant difference in the efficacy of the two treatments in reducing the percentage of COMEDONE and inflammatory lesions count from baseline to 5th week (p=0.76 and p=0.61, respectively). Based on acne global severity scale (AGSS), no significant difference in the severity of acne lesions of the two treatments was observed at 5th-week visit (p=0.26).Conclusion: Considering the lack of significant difference between the two tratments and since greater risks are associated with lower pulse duration, the use of longer pulse durations is recommended, especially in darker skin phenotype. Further studies with larger number of patients are required to fully comparison of efficacy of these parameters in IPL systems for acne vulgaris.

Background: So far seven types of the genus malassezia have been known. Except for one kind, the rest are normal flora of human skin which, under certain circumstances, cause or trigger eleven diseases. One of the side effects of topical and systemic steroid is steroid acne. Objective: This study was conducted to evaluate the association of pityrosporum ovale (malassezia) and steroid acne. Patients & Methods: Skin smears were prepared by comedo ne extractor from 20 patients with steroid acne and 12 acne patients without history of steroid usage, referred to dermatology clinic of Qaem Hospital and checked for the presence of malassezia. The reports of 2+ or more were considered as positive. The skin smears were positive in 80 percent of patients with steroid acne, and 66 percent of control group patients (P<0.05). 16 patients of steroid acne group responded well to antifungal drugs. Conclusion: Considering the clinical symp toms of steroid acne, positive skin smears and clear response of the patients to antifungal drugs, some of the steroid acne lesions are pityrosporum folliculitis.

Purpose: Acne vulgaris is a chronic inflammatory condition affecting the pilosebaceous units. With the rise of antibiotic resistance and the potential side effects associated with conventional treatments, there is increasing interest in exploring natural alternatives for treating acne. This study aimed to formulate and clinically evaluate a topical gel containing clove oil and curcumin in patients with mild to moderate acne vulgaris, using topical clindamycin as a standard comparator. Methods: The antibacterial activity of clove oil and curcumin against Propionibacterium acnes and Staphylococcus epidermidis was assessed by determining their minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). Based on these findings, semisolid gel formulations were developed and subjected to in vitro evaluations. Subsequently, a single-blind, randomized, comparative clinical study was conducted in 31 participants diagnosed with mild to moderate acne. Volunteers applied clindamycin gel in the morning and the clove oil–curcumin gel in the evening, or vice versa, over a 4-week period. Clinical outcomes, including acne lesion counts, Acne Severity Index (ASI), and patient satisfaction, were assessed. Results: The clove oil-curcumin gel demonstrated comparable efficacy to clindamycin in reducing acne lesions, papules, and ASI. While no significant differences were observed between the two groups in COMEDONE reduction, patient satisfaction increased in clove oil-curcumin gel group. Conclusion: Topical application of a gel containing clove oil and curcumin demonstrated promising results as an effective and well-tolerated alternative or adjunctive therapy for acne vulgaris. These findings support the potential of plant-based formulations in acne management.

Background: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous follicles and one of the most common skin diseases. The peeling method has been recently found to be effective for acne treatment. This study aimed to compare the efficacy of pyruvic acid 50% and salicylic acid 30% peeling in the treatment of mild to moderate acne. Materials and Methods: In a prospective single-blinded clinical trial, 86 patients with acne were randomly assigned into two groups. In both groups, the routine treatment of acne (topical solution of erythromycin 4%, triclorocarban soap, and sunscreen) were used twice a day for 8 weeks. In addition, salicylic acid 30% for the control group and pyruvic acid 50% for the case group were used. In both groups, acne severity index (ASI) was calculated before and at week 2, 4, 6, and 8 of the treatment. Patient satisfaction was assessed at the end of the treatment. Side effects were recorded using a checklist.Results: In both groups, the reduction in the number of COMEDONEs, papules, and ASI were statistically significant (P<0.001) in the course of treatment. However, it was not significant regarding the number of pustules (P=0.09). None of the number of COMEDONE, papules, pustules, and ASI was statistically different between study groups. Both treatment groups had similar side effects except for scaling in the fifth session, which was significantly lower in salicylic acid – treated patients (P=0.015).Conclusion: Both pyruvic acid 50% and salicylic acid 30% are effective in the improvement of mild to moderate acne with no significant difference in efficacy and side effects.

Background: Eyelid tumors are common in the daily practice of skin tumors and are composed of benign and malignant lesions. Methods: This retrospective case series study collected histopathologic reports of eyelid tumors of patients treated between 2022 and 2023 in Razi and Farabi hospitals (Tehran, Iran). Patient data, including patient age, sex, location of the lesion, and recurrence, were collected. Descriptive and inferential statistics were used to characterize the subgroups. Results: The sample was composed of 154 eyelid tumor specimens, including 72 (47%) malignant cases, 80 (52%) benign cases, and 2 (1%) premalignant cases. Malignant tumors included 81.9% basal cell carcinomas (BCC), 15.3% basosquamous cell carcinomas (BSC), and 1.4% squamous cell carcinoma (SCC). The benign eyelid lesions were comprised of 20% intradermal melanocytic nevus, 11.3% epidermal cyst, 7.6% dermoid cyst, 10% seborrheic keratosis, 6.3% xanthelasma, 2.5% wart, 3.8% compound nevus, 5% fibroconnective tissue, 3.8% squamous papilloma, 3.8% neurofibroma, 2.5% COMEDONE,2.5% apocrine hidrocystoma, 2.5% foreign body type granuloma, and 1.3% of others (arteriovenous hemangioma, cavernous hemangioma, cutaneous horn, etc.) The premalignant lesions were 2 cases of actinic keratosis. Benign lesions had an equal frequency of occurrence in the upper and lower lids. Malignant lesions were seen more in the lower lid. Premalignant lesions were seen in the lower lid. The mean age at diagnosis was 45.8 ± 23.06 years for patients with benign lesions and 63.5 ± 16.7 years for patients with malignant lesions. The mean age for patients with premalignant lesions was 81.5 ± 9.19 years (P < 0.001). Conclusions: In our study, benign lesions were seen predominantly in young persons and malignant lesions were mostly seen in elderly persons. There is an equal occurrence of malignant lesions in males and females, and recurrence after excision was infrequent.

Introduction: Acne is a disorder of the pilosebaceous unit of the skin and can present as non inflammatory and or inflammatory lesions. Tretinoin has been used therapeutically for over three decades. It is best known for its comedolytic effects on acne. It also inhibits COMEDONE rupture, thus decreasing inflammatory events. Tretinoin is available in 0.01% to 0.1% as cream, gel or lotion. The objective of this investigation was to evaluate the physicochemical stability of various dermatological preparations of tretinoin marketed in Iran. Methods: The in vitro release and penetration characteristics of tretinoin from different formulations (Stieva-A solution, Retin-A cream, Retin-A gel and three Iranian brands) were studied through a hydrophilic Dora pore diffusion barrier and membrane excised rat skin using Franz cell over a period of 5th.The amount of drug released from topical preparations were determined spectrophotometrically at Amax=352 nm. Furthermore, the physicochemical stability of each formulation including drug assay, content uniformity, viscosity, pH, cyclical temperature test and centrifugal separation test were investigated.Results: The obtained results showed that the formulations studied presented both good chemical and physical stabilities. The generated rank order for the drug release from different preparations using membrane was observed to be Stieva A solution> IR-tretinoin lotion> Retin A cream> Retin A gel> IR-tretinoin gel> IR-tretinoin cream. The in vitro penetration of tretinoin through excised rat skin showed that the cumulative percent of penetrated drug at the end of each experiment were 10.8%, 14.75% and 25.2% for IR-cream, IR-gel, Retin A cream and Retin A gel respectively.Conclusion: The in vitro release kinetics of tretinoin is affected by the kind of pharmaceutical dosage form. The release of drug from gel formulation obeyed higuchi's kinetics, whereas the kinetic of drug release from cream was first order model.

Introduction & Objective: Acne vulgaris is one of the most prevalent skin diseases which is common in adolescent of both sexes. Tretinoin has been used therapeutically for its comedolitic effects and inhibition of COMEDONE rupture in acne. It is available in 0.01% to 0.1% as cream, gel or lotion. There have been a few clinical reports of the positive effects of iontophoresis with tretinoin on acne scars. The aim of this study was to investigate the effect of iontophoresis field on transport of tretinoin across synthetic membrane and excised rat skin.Materials & Methods: Topical formulations of tretinoin marketed in Iran ( Retin-A cream, Retin-A gel, Tretinoin cream 0.025% and Tretinoin gel 0.025%) were assessed in terms of drug assay and content uniformity. The in vitro release and penetration characteristics of tretinoin from dermatological preparation was studied through a hydrophilic Dora pore diffusion barriers and membrane excised rat skin using Franz diffusion cell over a period of 2h. These two tests were also accomplished either with or without the presence of an iontophoresis field. The current density of iontophoresis applied field was constant, 0.5 mA/cm2.The amount of drug released from preparations was determined spectrophotometrically at lmax =352nm.Results: The in vitro release of tretinoin through synthetic barrier with an iontophoresis field showed that the cumulative percent of released drug at the end of each experiment was 17.5%, 26.5%, 19% and 54% for Tretinoin gel, Retin-A gel, Tretinoin cream and Retin-A cream, respectively. This was significantly higher than the observed one for release of tretinoin without application of a DC electric field. In addition, the results showed a significantly higher iontophoretic transport of tretinoin compared to passive flux for excised rat skin.Conclusion: The application of an electric current for a limited period of time produced higher post-iontophoresis fluxes of tretinoin than passive diffusion. With application of iontophoresis field, the in vitro release and transport of drug for different formulations of tretinoin follow the zero order kinetics.