Successful treatment of earlobe keloids with imiquimod after shave excision

There are various methods to treat keloid. However, the recurrence of keloidal lesions seems important in this regard. Herein, we report a case of successful treatment of earlobe keloids with imiquimod after shave excision

Patterns of admissions to a referral skin hospital in Iran

Inpatient therapy in dermatology offers a number of advantages in several ways i.e. careful monitoring of patients' conditions, improvement of their skin lesions under the supervision of trained staff, absence of domestic pressure and increasing the quality of patients' life index. The objective of this study was to describe the patterns of admission for patients with dermatological diseases in Iran. In this retrospective study, data were collected by completing a questionnaire for 481 patients admitted to Razi skin hospital in Tehran during 18 months. The mean age of admitted patients was 44.03 years +/- 19.15. Bullous diseases [39.92%], psoriasis [20.79%], dermatitis [9.56%] and neoplasms [6.65%] were found as the most common reasons for admission. The mean duration of hospitalization was 22.79 days and neoplasms had the highest mean hospitalization period. Patient's admission patterns differ from country to country and there should be prioritizing plans to reach better results

effects of different intervals of microdermabrasion sessions on skin biophysical parameters: a randomized, assessor-blind, within-patient trial

Microdermabrasion has recently become a popular procedure among physicians and patients, whereas few studies have assessed the efficacy of different microdermabrasion protocols nowadays applied. The objective of this study was to assess the effects of microdermabrasion, as well as to compare the effects of weekly and biweekly intervals of microdermabrasion sessions on skin biophysical parameters. Ten patients entered this randomized, investigator-blind, split face study and underwent a series of six microdermabrasion treatments. One side of the face was treated every week and the other side was treated every 2 weeks, randomly. Stratum corneum hydration, sebum secretion and skin pH measurements were taken before and after the procedure on all sessions and also 1 and 4 weeks after the last treatment. After 6 sessions of microdermabrasion and following comparison to baseline, a significant decrease in sebum content and a significant increase in skin pH were observed only on the side treated with the intervals of 2 weeks. Changes in skin hydration were not significant on either side. Microdermabrasion may have noticeable effects on skin barrier functions. It is recommended to have 2 week interval between sessions

Laser-assisted hair removal: comparison of long-pulsed alexandrite and long-pulsed Nd: YAG lasers, individually and in combination

Laser is one of the most recent techniques which has widespread use in the treatment of many skin diseases. This technique has been successfully used to remove unwanted hairs in hirsutism. The aim of this study was to evaluate and compare the efficacy and safety of long-pulsed 755 nm alex and rite and long-pulsed 1064 nm Nd: YAG lasers individually and in combination for permanent hair removal. This single-blind r and omized clinical trial was conducted on 25 patients. They were treated by alex and rite or Nd: YAG or combination of them in 4 sessions with 8 weeks intervals. The treatment was applied on their medial and lateral sides of both legs. All the parameters of the systems were set on the company defaults. Subjects were evaluated 1 and 8 months after completion of the treatment. Hair count was measured by Visiomed device and digital camera photographs every session. To calculate mean hair reduction, the difference between hair count before and after treatment was divided by hair count before treatment. Pain severity, measured by Visual Analogue Scale [VAS], and side effects [bullae, scar and pigmentation changes] were recorded every session. The data were analyzed with ANOVA, post hoc Tukey and chi square tests. Fifteen patients completed the study and 10 patients were excluded due to appearance of bullae in 2 patients and refuse to continue in 8 patients. The mean hair reduction measured by Visiomed 8 months after last treatment was: 61.96 21.09, 60.03 23.40 and 68.05 21.23 percent for alex and rite, Nd: YAG and combination therapy, respectively. When digital camera photos were used for measurement of hair reduction these values were 85.99 11.62, 73.60 16.57 and 79.61 18.08 percent, respectively. The differences between the systems were not significant [ANOVA, P>0.05]. In paired comparison of the systems, no significant differences were observed either [Tukey test]. The incidence of adverse effects [hyperpigmentation] and pain severity were significantly greater in area received combination therapy [P<0.001]. Both alex and rite and Nd: YAG laser systems were effective in hair removal. In contrast, combination therapy did not have more efficacy and also caused more side effects

Opinions of experts from Asia on the diagnosis and treatment of pemphigus vulgaris

Pemphigus vulgaris [PV] is the most common blistering disease in Iran and many other Asian countries with a relatively high incidence and involvement of both skin and mucous membranes in majority of patients. The aim of this study was to assess the opinions of Asian experts on the diagnosis and management of PV. A questionaire-based mailed/emailed survey was conducted. The questionnaire was sent to 29 dermatologists from different countries of Asia [23 from Iran and 6 from India, Kuwait, Turkey and Bangladesh] who are in charge of the treatment of autoimmune blistering disorders with at least 5 years experience in this field who visit at least five new PV patients annually. Questions induced duration of experience, number of patients treated and diagnostic and treatment approaches for PV. Descriptive data were reported using SPSS 11.5 and some data are reported as mean SD. All 29 physicians participated in the survey. Among them, 79.3% visit their patients within 6 months after the onset of symptoms. Diagnosis of PV is confirmed by histologic and direct immunofluorescence examinations by 65.5% of physicians. All of them initiate the treatment with corticosteroids [48.3% with a dose of at least 2 mg/kg/day prednisolone] and 89.7% add adjuvant immunosuppressors at the same time. Of the adjuvant agents used, azathioprine is used by 82.8% of physicians. Different trends in diagnostic techniques and treatment options for PV among the experienced authorities emphasize the urgent need for large-scale controlled trials to reach consensus st and ards in this field. In addition, regional and worldwide consensus meetings to consider all regional and genetic similarities and differences are highly recommended

[Cardio-pulmonary Resuscitation due to CO[2] gas embolism during a laparoscopic Cholecystectomy surgery: A case report]

Background: in Recent years, general application of laparoscopic surgeries increases due to the improvement of laparoscopic instruments and techniques which in the other hand has its own complications

Case presentation: the case was a 32 year old woman that was candidated for laparoscopic Cholecystectomy. By the initiation of surgeon's work, ET[CO2] suddenly switches from 37 mmHg to 15 mmHg and made the patient to had progressive bradycardia and consequently cardiac arrest. Cardiac massage immediately initiates and advanced resuscitation continued. Fortunately, the resuscitation process was successful and therapeutic interventions for complete recovery and preventing from neurological defects was continued. Currently, the patient has not have any sensory or movement disorders

Conclusions: hydrating the patient, good positioning during the operation and complete patient monitoring are the essential principles for preventing such complication

comparison between systemic PUVA therapy alone and combined with topical calciporiol in the treatment of generalized vitiligo

Vitiligo is a relatively common acquired depigmentary disorder affecting approximately 1% of general population. PUVA therapy is the most effective modality and commonly used as the primary treatment of generalized vitiligo. To evaluate the synergistic effect of topical calcipotriol and oral methoxalene plus PUVA in treatment of generalized vitiligo. In this clinical trial, 47 patients with generalized vitiligo [<40% involvement of skin surface area] were randomly assigned to two treatment groups. Both groups were treated with systemic PUVA three times weekly. One group was also treated with topical calcipotriol [0.005%]. Patients were evaluated for treatment response and possible side effects. The mean response rate at the end of the study was 63.9% +/- 24.1 in the calcipotriol and PUVA group and 60.6% +/- 23 in the PUVA group [P>0.05]. The number of PUVA sessions and the mean cumulative UVA dose for maximum response were 96. 6 +/- 22.7 and 584.1 +/- 118.1 J/cm [2] in the calcipotriol and PUVA group and 116.3 +/- 26.1 and 685.1 +/- 168.0 J/cm [2] in the PUVA group [P<0.05]. In patients with generalized vitiligo, combination of PUVA with calcipotriol is an effective and safe treatment. This method decreases number of PUVA sessions and UVA dosage compared to PUVA treatment alone and accelerates repigmentation