[Comparison between therapeutic effects of doxepine and hydroxyzine on resistant pruritic lesions due to sulfur mustard]

Chronic pruritus is one of the major complaints in chemically-injured patients. It may cause many psychological problems and consequently, decrease the patient's quality of life. The aim of this study is to compare the safety and efficacy of Doxepin and Hydroxyzine in treatment of chronic pruritus due to Sulfur Mustard. This randomized, double-blind clinical trial was carried out in Baqiyatallah hospital on 50 chemically-injured patients for a period of 4 weeks. Patients randomly divided into 2 groups, first group [mean age of 42.3 +/- 5.4 years old] received Doxepin capsules [10 mg/day] and the second group [mean age of 41.1 +/- 6.2 years old] received Hydroxyzine capsules [25 mg/day]. Pruritus score was measured by a standard questionnaire and Visual Analogue Scale [VAS]. The mean before and after-treatment puritus scores of Hydroxyzine, were 34.6 +/- 3.4 and 25.9 +/- 3.1, respectively [P<0.001] and those of Doxepin were 33.8 +/- 4.4 and 24.5 +/- 4.1, respectively [P<0.001]. Both drugs decreased pruritus, similarly [P = 0.245]. 18 patients in the hydroxyzine-received group and 11 patients in the Doxepin-received group were complaining from sedation as a side-effect [P=0.035]. Both drugs are of significant effectiveness in decreasing pruritus. However, considering its fewer side effects, Doxepin seems to be more useful in these conditions

Comparison of efficacy of topical tretinoin 0.05% cream with placebo in treatment of melasma

Melasma is a common disorder of macular hyperpigmentation, which involves mostly in sun-exposed areas of face and neck. Women are more affected. Multiple factors have been postulated to involve in the etiology and pathogenesis of melasma including pregnancy, oral contraceptives, genetics, sun exposure, cosmetics and race. Fifty women completed a randomized, double blind vehicle controlled clinical trial, in which they applied 0.05% tretinoin [n=25] or vehicle cream [n=25] once daily on the face for 12 weeks. 2 weeks after treatment 6 out of 25[24%] tretinoin-treated patients [group 1] were clinically improved, compared with 0 out of 25[0%] in the vehicle group [group2][p=0.022]. 4 weeks after treatment 14[56%] of groupl and 5[20%] of group2 improved [p=0.006]. After 12 weeks, 21 [84%] of groupl and 6[24%] ofgroup2 were improved [p=0.0001] which demonstrated significant improvement in the tretinoin-treated patients compared with the vehicle group. This controlled study demonstrates that topical 0.05% tretinoin alone is considered to be effective in the treatment of melasma patients