Successful treatment of unilateral klippel-trenaunay syndrome with pulsed-dye laser in a 2-week old infant

Introduction: Klippel-Trenaunay syndrome [KTS] is a rare congenital mesodermal abnormality characterized by varicose veins, cutaneous capillary malformation, as well as bone and soft tissue hypertrophy

Case Report: A 2-week-old female infant presented to our clinic because of vascular nevus and progressive enlargement of her right extremities and trunk since birth. The patient was treated with 595-nm pulsed-dye laser [PDL]. Her port-wine stain [PWS] disappeared completely after third PDL session and the soft tissue hypertrophy stopped. The patient experienced neither recurrence nor any change in size after 7 years of follow up

Conclusion: PDL can treat KTS completely with no reccurence if it is used in "early stage" of disease

Laser irradiation on growth of trichophyton rubrum: an in vitro study

Trichophyton rubrum is one of the most common species of dermatophytes which affects superficial keratinous tissue. It is not especially virulent but it can be responsible for considerable morbidity. Although there are different therapeutic modalities to treat fungal infections, clinicians are searching for alternative treatment because of the various side effects of the present therapeutic methods. As a new procedure, Laser therapy has brought on many advantages in clinical management of dermatophytes. Possible inhibitory potential of laser irradiation on fungal colonies was investigated invitro in this study. A total of 240 fungal plates of standard size of trichophyton rubrum colonies that had been cultured from the lesions of different patients at the mycology laboratory, were selected. Each fungal plate was assigned as control or experimental group. Experimental plates were irradiated by a laser system [low power laser or different wavelength of high power laser]. The effects of different laser wavelengths and energies on isolated colonies were assessed. After laser irradiation, final size of colonies was measured on the first, the 7[th] and the 14[th] day after laser irradiation. Although low power laser irradiation did not have any inhibitory effect on fungal growth, the Q-Switched Neodymium-Doped Yttrium Aluminium Garnet [Nd:YAG] laser 532nm at 8j/cm[2], Q-Switched Nd:YAG laser 1064nm at 4j/cm[2] to 8j/cm[2] and Pulsed dye laser 595nm at 8j/cm[2] to 14j/cm[2] significantly inhibited growth of trichophyton rubrum in vitro. Q-Switched Nd:YAG 532nm at 8j/cm[2], Q-Switched Nd:YAG laser 1064nm at 4j/cm[2] to 8j/cm[2] and pulsed dye laser [PDL] 595nm at 8j/cm[2] to 14j/cm[2] can be effective to suppress trichophyton rubrum growth

Cutaneous leishmaniasis with unusual clinical and histological presentation: report of four cases

Old world cutaneous leishmaniasis [OWCL] usually causes a single, self-healing and uncomplicated lesion mainly on the exposed area of body. This report presents four cases of OWCL from Iran that misdiagnosed with sarcoidosis, lymphoma, and acne agminata. Two out of four patients showed a history of purplish red plaques for at least 5 years who misdiagnosed as sarcoidosis because of histological and clinical characteristics. The other one presented with flesh-colored nodules disseminated all over his skin that was misdiagnosed as lymphoma for ten years. The last patient was misdiagnosed as acne agminata due to tuberculoid reactions in examination of the lesion biopsy. All the patients responded to the treatment with meglumine antimonate

Does pimecrolimus cream enhance the effect of excimer laser on eyelid vitiligo?

Vitiligo is a cutaneous disorder of pigmentation, for which, there are some proven modalities of treatment. In this study, we evaluated the efficacy of the addition of topical pimecrolimus to 308nm Excimer laser in reducing treatment duration and improving the response rate of eyelid vitiligo, compared with 308nm Excimer laser monotherapy. Fifty two symmetrically localized lesions of eyelid vitiligo in 26 patients were observed. Each of vitiliginous patches was treated with 308nm Excimer laser twice a week for a total of 30 sessions. Topical pimecrolimus 1% cream was applied to the patches of right eyelid[group A lesions] and eucerine cream as a placebo to the left side patches[group B lesions]twice daily, throughout the study. Photographs were taken at baseline, 6 and 15 weeks after starting the treatment. Twenty two patients [44 lesions] completed the study. Repigmentation was appeared in all [100%] of groups A and B lesions. A 75% or more repigmentation was achieved in 17 [78%] of group A versus 14 [64%] of group B lesions. The average number of sessions needed for the appearance of repigmentation was 8 for group A lesions and 12 for group. The repigmentaion of 50% or more in patients with disease duration of 2 years or less and those with more than 2 years duration ere 100% and 59.2%, respectively. Repigmentation rate obtained by the combination therapy of eyelid vitiligo with 308nm Excimer laser and topical Pimecrolimus 1%cream is significantly higher, and obtained in fewer sessions in comparison with 308nm Excimer laser and placebo combination therapy

Nonablative fractional laser resurfacing

The desire to achieve cosmetic rejuvenation and reduce effects of aging and photodamage urged scientists to develop effectual techniques which have minimal side effects and impressive long-term efficacy. Traditional ablative resurfacing laser therapy has been used for several years;however, it has harmful side effects on the patient's skin such as dyspigmentation, persistent erythema, infections, acneiform eruptions and scarring. It also prolongs downtime, so it puts a significant burden on society. Nonablative resurfacing laser therapy declines side effects of traditional therapies, although it has lower effectiveness in comparison with ablative one. Nonablative fractional resurfacing laser therapy commenced a modern technique which diminished side effects, while maintains the efficacy of traditional methods. The aim of of this current review is to sum up nonablative fractional laser therapies used for skin photorejuvenation at the past and present time and to evaluate the indications, advantages and classification of it and non-fractional resurfacing laser therapy

Intense pulsed light and red light photo rejuvenation for skin rejuvenation; a split face clinical trial

Intense pulsed light [IPL] has long been used for skin rejuvenation. Photo rejuvenation with red light [with or without photo sensitizer] is a newer noninvasive way for this purpose; but, until now few comparative studies between these modalities have been performed. The aim of this study was comparing efficacy, adverse effects, and compliance of intense pulsed light rejuvenation and red light photo rejuvenation in a homogeneous group of women. In this clinical trial, ten female volunteers with Fitzpatrick skin type I, II, and III were enrolled. Patients underwent 6 sessions of IPL rejuvenation at 4-week intervals on one side, and 30 photo rejuvenation session [2 times a week] with red light on the other side of their face. Improvement of the skin texture and reduction in the wrinkles were determined in two ways. Firstly, by comparing the photographs, and secondly, by measuring the skin elasticity with Reviscometer MPA 9 system, before and after the procedure. Both treatments were associated with improvement in the skin texture and wrinkle depth, but red light was more effective on the nasolabial fold and IPL was more effective on the fine wrinkles. Red light photo rejuvenation without the use of photosensitizer can be a new, effective and safe procedure for rejuvenation

Soluble Fas in pemphigus vulgaris

The Fas/Fas ligand [FasL] system has been recognized as an important pathway for apoptosis induction in cells and tissues. It has recently been shown that skin lesions of pemphigus vulgaris are associated with Fas mediated apoptosis. The aim of this study was to evaluated the level of serum soluble Fas of ten newly diagnosed patients with pemphigus vulgaris. Sera were collected from ten patients with pemphigus vulgaris. Commercial sandwich enzyme-linked immunosorbent assay [ELISA] for quantitative detection of soluble Fas was applied. Patients with mucosal skin involvement had higher median values in contrast to patients with cutaneous involvement. Elevation of soluble Fas in our study may give insights for the pathogenesis of pemphigus vulgaris. Suppression of this underlying mechanism may be an important target for novel therapies and relapse prevention

Development of an allogeneic cultured dermal substitute using a standard human fibroblast bank

Fibroblasts are mesenchymal cells that can be readily cultured in the laboratory and play a significant role in epithelialmesenchymal interactions, secreting various growth factors and cytokines that have a direct effect on epidermal proliferation, differentiation and formation of extracellular matrix. They have been incorporated into various tissue-engineered and used for a variety of clinical applications, including the treatment of burns, chronic venous ulcers and several other clinical applications in dermatology and plastic surgery. Isolated fibroblasts by the enzymatic process from foreskin were cultivated successively in a culture medium to establish cell banking. Foreskin and the last subcultured cells were checked for HBV, HCV, HIV, HSV I, HSV II, HTLV I, HTLV II, EBV, CMV, Treponema Pallidum, Mycoplasma sp. and Clamydia. The 1[st], 5[th] and 10[th] subcultured cells were processed for immunocytochemistry studies using a panel of monoclonal antibodies including antibodies to MHC class I and II antigens for ensuring the elimination of superficial cell antigens during cultivation. Subcultured cells were karyotyped to find any chromosomal abnormalities. The best passages were chosen for culturing on silicone sheets provided by the Iran Polymer and Petrochemical Institute. Evaluation for bacteria and viruses by molecular methods was negative. Karyotyping of cultured fibroblasts after the 10[th] passage showed some abnormalities. HLA expression was imperceptible in the cells obtained from the 10[th] sub-culture. The best passages were from 5th to 10[th] for banking and culturing on silicone sheets. Expression of HLA on fibroblast surfaces was diminished during subculturing. To prevent chromosomal abnormalities in fibroblast passaging, we should select the best colony that is expected to be chromosomally stable with the least antigenicity. In our study, the 5[th] to 10[th] sub-cultures were the best cells for the purpose of grafting and acceleration of the wound healing

Establishment of a primary cell culture of human fibroblast in Iran

Human fibroblasts are the part of the dermis that secrete extracellular matrix for the purpose of tissue repair. Culturing fibroblasts, which leads to formation of a monolayer of these cells, is used for treating various conditions including thermal burns and other skin defects such as diabetic and varicose vein leg ulcers. Therefore, we aimed at developing a fibroblast bank to accomplish multiple goals including skin repair in defects such as burns and ulcers and also performing various research projects on these cells in order to further study of the mechanisms involved in wound healing, rejuvenation and medication effects. We initially developed primary cultures of skin fibroblasts in a DMEM medium. These primary cultures were formed by washing and trypsinizing foreskin specimens followed by separation of epidermis from dermis and cutting the dermis into small pieces. In about 10 days, a monolayer of fibroblasts was formed. We were able to develop the fibroblast bank successfully and to initiate other projects utilizing this bank. With these cultured cells, we would be able to perform different research projects including studying the mechanisms of wound healing, rejuvenation, drug affects, inflammatory mediators, growth factors, etc. Moreover, further progress in this field will result in our independence from requesting these cells from external sources

case of lipomembranous panniculitis associated with rheumatoid arthritis

Lipomembranous panniculitis is a special type of fat necrosis which has been associated with several clinical conditions, mainly chronic venous insufficiency and connective tissue disorders such as lupus profundus, morphea, systemic sclerosis, and dermatomyositis .We report a 50 year old woman with known rheumatoid arthritis who presented with a painful indurated erythematous plaque on her right leg. Histologic examination demonstrated cystic areas of fat necrosis lined by wavy eosinophilic hyaline membrane with convoluted projections of the membrane into the cysts. This finding is diagnostic of lipomembranous panniculitis. To our knowledge, this is the first report on lipomembranous panniculitis associated with rheumatoid arthritis