Behrangi Elham; Sadeghi Somayeh; Sadeghzadeh-Bazargan Afsaneh; Goodarzi Azadeh; Ghassemi Mohammadreza; Sepasgozar Saba; Rohaninasab Masoomeh
Abstract
Background: Insulin resistance and increased insulin-like growth factor (IGF)-1 with consequent mammalian target of rapamycin complex (mTORC) 1 overexpression is responsible for acne pathogenesis, especially in women with polycystic ovary syndrome (PCOS). Metformin is shown to improve acne as an adjunct ...
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Background: Insulin resistance and increased insulin-like growth factor (IGF)-1 with consequent mammalian target of rapamycin complex (mTORC) 1 overexpression is responsible for acne pathogenesis, especially in women with polycystic ovary syndrome (PCOS). Metformin is shown to improve acne as an adjunct therapy in females with PCOS and males with altered metabolic profile. We evaluated the use of metformin in the treatment of resistant and late-onset acne in females, and compared it with isotretinoin.
Methods: Females with late-onset acne or acne resistant to common therapies (n=70) were randomized to receive metformin (n=35) or isotretinoin (n=35) for 6 months. Changes in acne severity were scored by global acne grading system (GAGS) which was the primary outcome. Other endpoints were changes in the components of metabolic profile.
Results: Six-month treatment with metformin and isotretinoin significantly reduced the GAGS from 31.9 to 24.6 and from 34.1 to 13.3, respectively, indicating the superior impact of isotretinoin. Metfromin was more effective in decreasing the GAGS score in those with PCOS (13.5±7.1 vs. 24.2±19.4, P<0.05). Furthermore, patients with hirsutism had a higher reduction score with metformin compared to patients without hirsutism (21.1±9.1 vs. 30.2±6.4) (P<0.05). Lipid profile and fasting blood sugar were improved following the 6-month treatment with metformin, and isotretinoin increased the levels of liver enzymes and bilirubin (P<0.05).
Conclusion: Metformin is effective in treating late-onset or resistant acne and improving metabolic status, without serious side effects. In patients with altered metabolic profiles such as PCOS, metformin seems to be superior to isotretinoin regarding acne treatment.
Mehran Golnaz; Fotooei Mahrokh; Goodarzi Azadeh; Forghani Siamak Farokh; Rohaninasab Masoomeh; Ghassemi Mohammadreza; Sadeghi Somayeh; Behrangi Elham
Abstract
Background: Microneedling is recently used to treat skin scars mostly atrophic scars; however, there are limited data about its effectiveness on hypertrophic burn scars. Carbon dioxide (CO2) laser is an effective method for the treatment of burn scars. Here, we aim to compare the efficacy of microneedling ...
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Background: Microneedling is recently used to treat skin scars mostly atrophic scars; however, there are limited data about its effectiveness on hypertrophic burn scars. Carbon dioxide (CO2) laser is an effective method for the treatment of burn scars. Here, we aim to compare the efficacy of microneedling to CO2 laser in the treatment of hypertrophic burn scars in a randomized clinical trial. Methods: Patients with second and third-degree burn scars (n=60) were randomized to receive 3 sessions of microneedling (n=30) or CO2 laser (n=30), 4-6 weeks apart. The outcomes, including physical characteristics of the scar scored by Vancouver Scar Scale (VSS) and patients’ satisfaction with the treatment measured by Visual Analogue Scale (VAS), were investigated at baseline, at the end of the treatment period, and at the 3-month follow-up. Results: The VSS score at the follow-up visit showed a significant reduction from 6.63±1.95 to 3.8±2.3 in the microneedling group and from 7.1+2.3 to 5.6±1.7 in the CO2 laser group; while, the reduced VSS score was significantly higher in the microneedling group (P<0.05), especially in reducing the thickness (P=0.001) and pliability (P=0.001) scores. The patients’ subjective assessments for acne improvement were significantly more satisfactory in the microneedling group (P=0.025).
Conclusion: Microneedling seems to be an effective method to improve hypertrophic burn scars. It also causes better scores in the physical characteristics of scar and the patients’ satisfaction compared to the CO2 laser at the 3-month follow-up.
Lajevardi Vahideh; Ghiasi Maryam; Falahati Ali Asghar; Goodarzi Azadeh
Volume 20, Issue 3 , 2017, , Pages 69-74
Abstract
Background: Vitiligo is an acquired skin discoloration with melanocytic destruction. Vitiligo is associated with other autoimmune disorders; hence, an autoimmune etiology is among the most important theories for this disorder. The nails can be involved in numerous cutaneous or systemic non-cutaneous ...
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Background: Vitiligo is an acquired skin discoloration with melanocytic destruction. Vitiligo is associated with other autoimmune disorders; hence, an autoimmune etiology is among the most important theories for this disorder. The nails can be involved in numerous cutaneous or systemic non-cutaneous disorders. We have taken into consideration previous studies on nail abnormalities in vitiligo and alopecia areata (AA), which are ethologically closely-related, in addition to the few, notwell designed studies on nail changes in vitiligo, and lack of similar studies in Iran. This case-control study was conducted to evaluate the autoimmune etiology of vitiligo with a larger number of participants.Methods: In this case-control study, we assessed the nail characteristics of 303 participants at Razi Hospital, Tehran, Iran from 2013-2014. These changes were also assessed in terms of diseases properties of the case group and included distribution, duration, and presence of other concomitant cutaneous disorders.Results: There was a statistically significant odd’s ratio (OR) for leukonychia in the case and control groups. The relationship between the prevalence of leukonychia and disease duration was meaningful (P0.05). There was no other significant difference between each type of nail abnormality in the case and control groups. We observed no association between these abnormalities and disease duration. None of the nail abnormalities, including leukonychia, had an association with distributionpattern of the disorder.Conclusion: Leukonychia was the most common abnormality in nails of vitiligo patients that had a relation to disease duration.
Balighi Kamran; Ghodsi Zahra; Iravani Masoud; Damavandi Maede Rayati; Goodarzi Azadeh; Lajevardi Vahide; Saburi Sara; Kashani Alireza Faghihi
Volume 19, Issue 75 , 2016, , Pages 21-24
Abstract
Background: Chronic graft versus host disease (cGVHD) is a major cutaneous complication of bone marrow transplantation (BMT). Although milder forms of this process may be associated with a lower incidence of tumor recurrences, it is mandatory to develop a more efficient and less harmful therapeutic approach.Methods: ...
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Background: Chronic graft versus host disease (cGVHD) is a major cutaneous complication of bone marrow transplantation (BMT). Although milder forms of this process may be associated with a lower incidence of tumor recurrences, it is mandatory to develop a more efficient and less harmful therapeutic approach.Methods: This case-series study enrolled 7 patients diagnosed with chronic mucocutaneous GVHD. We divided the patients into three major categories based on the type of skin lesions: sclerodermoid, lichenoid, and mixed. Patients received several packs of narrow band UVB (NBUVB) phototherapy. Each pack contained ten sessions of NBUVB (311 nm) with a duration of at least ten seconds and a fixed radiation dosage (6 mj/cm2) during the treatment.Results: There were 3 patients diagnosed with lichenoid skin lesions, 2 with sclerodermoid lesions, and 2 had mixed cGVHD lesions. During the follow up period one patient was excluded due to a lower respiratory tract infection. The mean response ratio was 42% with a mean satisfaction level of 5.5 out of 10. The lichenoid group had the best, most rapid response. There were no serious adverse effects reported.Conclusion: Narrow band UVB phototherapy is useful as an adjuvant therapeutic modality in cutaneous lichenoid and intraoral cGVHD with no serious adverse effects.
Ehsani Amir Houshang; Noormohammadpour Pedram; Nasiri Nafiseh; Faraz Parastoo Tavasoli; Goodarzi Azadeh
Volume 19, Issue 2 , 2016, , Pages 45-49
Abstract
Background: Approximately 0.77% to 2% of cutaneous ulcers and post-burn scars will develop malignant degeneration. When squamous cell carcinoma (SCC) emerges in a chronic scar or ulcer, it often is referred to as Marjolin’s ulcer (MU). Methods: This cross-sectional study assessed demographic information ...
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Background: Approximately 0.77% to 2% of cutaneous ulcers and post-burn scars will develop malignant degeneration. When squamous cell carcinoma (SCC) emerges in a chronic scar or ulcer, it often is referred to as Marjolin’s ulcer (MU). Methods: This cross-sectional study assessed demographic information and pathological features of MU in Razi Hospital during 2009 to 2014. We reviewed 5150 chronic scar/ulcer cases and found 30 MU cases. Results: Patients had an average age of 59.2±19.9 years. Most cases were males Among 30 cases of MU, well-differential SCC accounted for 43.3% of cases. Moderately-differentiated SCC comprised 13.3% of cases, whereas there was invasive SCC in 10% of MUs. Only 3.3% of patients showed poorly-differentiated SCC and 9 (30%) had undifferentiated SCC. The average latency between burn and malignancy was 32.4±18.5 years In the majority (90%) of cases, the initial injury was a burn. The lower and upper limbs comprised 53.3% and 26.7% of cases, respectively. There was one case with a history of melanoma. Among the 4 measured concurrent risk factors for malignancy, sun exposure was the most prevalent. Conclusion: Since there is a high possibility of SCC formation in burn lesions and other identical lesions, rapid follow-up and appropriate treatment in acute burn lesions is necessary.
Ghandi Narges; Daklan Soroush; Goodarzi Azadeh; Hesari Kambiz Kamyab; Ghanadan Alireza
Volume 18, Issue 1 , 2015, , Pages 33-35
Abstract
The histiocytoses are a group of proliferative disorders of themonocyte-macrophage lineage that are neoplastic or reactive innature. Based on immunophenotyping and electron microscopy,two main groups have been recognized namely 1) Langerhanscell histiocytosis (LCH) and 2) non- Langerhans cell histiocytosis(non-LCH). ...
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The histiocytoses are a group of proliferative disorders of themonocyte-macrophage lineage that are neoplastic or reactive innature. Based on immunophenotyping and electron microscopy,two main groups have been recognized namely 1) Langerhanscell histiocytosis (LCH) and 2) non- Langerhans cell histiocytosis(non-LCH). In this study, a fairly rare disease of the non-LCHgroup, generalized eruptive histiocytosis, has been reported.
Lajevardi Vahide; Ghiasi Maryam; Hejazi Pardis; Ansari Mahsa; Akbari Zahra; Shakiba Hasan; Goodarzi Azadeh
Volume 18, Issue 1 , 2015, , Pages 36-37
Abstract
Folate plays an important role in metabolism and its deficiency can lead to cardiovascular problems or carcinogenesis. Some studies show that narrow band UVB (NBUVB) causes folate deficiency by photolysis , while others have different opinions or even the contrary. With regard to paradoxes in this context, ...
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Folate plays an important role in metabolism and its deficiency can lead to cardiovascular problems or carcinogenesis. Some studies show that narrow band UVB (NBUVB) causes folate deficiency by photolysis , while others have different opinions or even the contrary. With regard to paradoxes in this context, we decided to study the effect of NBUVB on folate levels in patients with dermatologic disorders.
Ehsani Amirhoushang; Mortazavi Hossein; Azizpour Arghavan; Ansari Mahsa; Teimori Edris; Goodarzi Azadeh; Rahbar Ziba; Aryanian Zeinab
Volume 17, Issue 2 , 2014, , Pages 63-67
Abstract
Background: Although most cases of drug eruptions are mildand self-limited and are relieved after discontinuation of theresponsible drugs, statistics of life threatening outcomes shouldbe kept in mind. Moreover, it is important to identify the mostcommon age and sex groups, and the most vulnerable groupsin ...
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Background: Although most cases of drug eruptions are mildand self-limited and are relieved after discontinuation of theresponsible drugs, statistics of life threatening outcomes shouldbe kept in mind. Moreover, it is important to identify the mostcommon age and sex groups, and the most vulnerable groupsin any area related to offending drugs. Thus, we collected thebasic information of patients with skin drug reactions who wereadmitted to Razi Hospital, Tehran, Iran, during 2010-2012 (18months).Method: In this study, all patients with a diagnosis of drugreactions who were admitted to Razi Hospital, Tehran, Iran,during 2010-2012 (18 months) were enrolled. The types of drugsand skin reaction manifestations were reported.Result: One hundred and thirty one patients were admitted witha diagnosis of drug reactions. The mean age of the participantswas 40 years. Forty one patients were male (31.3%) and 90 werefemale (68.3%). Antibiotics and anticonvulsants were the mostcommon drugs associated with reactions. Carbamazepine wasthe most common drug that caused reactions (21 cases, 17.4%)followed by penicillin (20 cases, 16.5%), and lamotrigine (16 cases,13.2%). Morbilliform rash (40 cases, 30.5%), erythroderma (18cases, 13.7%), and urticaria/angioedema (14 cases, 10.7%) werethe most common patterns of skin involvement.Conclusion: The results of our study are consistent with the resultsof other studies. It is recommended that drugs that commonlycause adverse reactions be prescribed with more precautionin females aged 20-40 years, and if possible, be replaced withappropriate drugs. Moreover, it is recommended that patients whoare allergic to these drugs carry a certain card that demonstratestheir sensitivity.