Evaluation of the efficacy of the Q switched ruby laser in the treatment of benign pigmented skin lesions

It is possible to use light sources such as lasers to destruct melanosomes and treat pigmented skin lesions. One of the most commonly used laser systems is Q switched ruby laser with a wave-length of 694 nm. This study was performed to evaluate the efficacy of the Q switched ruby laser in the treatment of pigmented skin lesions including lentigines [simplex or solar] and cafe-au-lait macules. After physical examination for ruling out the possibility of malignancy by two dermatologists, patients were treated with Q switched ruby laser. Response to treatment was categorized in four groups of equal interval according to the 0-100% lesion lightening. Ninety patients including 81 patients with solar lentigo and 9 cases of lentigo simplex were recruited into this study. Mean st and ard deviation [SD] of the number of treatment sessions for solar lentigo and lentigo simplex cases were 1.0 0.5 and 3.6 1.3 respectively. Although the mean of sessions was increased in darker skin types, there was no statistically significant difference between different skin types [p=0.335]. In addition, there was no significant relation between mean treatment sessions and location of the lesions [p=0.685]. Cure rate was 100% in all lentigo cases and after a mean SD of 8.7 2.3 months follow up there was no recurrence. Also, there was neither pigmentary change nor folliculitis during treatment. In 7 cases with cafe-au-lait macules, the mean SD score of improvement was 2.4 0.8, which was achieved after 3.1 0.4 treatment sessions. In 6 cases whom were followed up for 10.2 3.1 months, despite primary disappearance, recurrence of cafe-au-lait macules was observed. It seems Q switched ruby laser is an appropriate method for treatment of lentiginous lesions in Caucasians with Fitzpatrick's skin types II to IV

Evaluation of the efficacy of intermittent isotretinoin doses in acne patients

Oral isotretinoin is the only treatment that has an effect on all the major etiological factors involved in acne [increased sebum production, alterations in microbial flora, hyperkeratinization of pilosebaceous duct, and inflammation]. Considering complications and relative expense, several treatment regimens have been suggested. The objective of this study was to evaluate the efficacy of intermittent doses of isotretinoin in acne patients. We made a quasi-experimental clinical trial in the acne patients without nodular and cystic lesions that were recalcitrant to conventional therapy. Therapeutic regimen included 0.5 mg/kg isotretinoin per day for a week every month; so we use 21 mg/kg as total dosage. Acne severity decreased in entire patients at the end of treatment course. After six months follow up recurrence rate was 19.3% and partially recurrence rate was 44%. It seems that intermittent isotretinoin treatment with a total dose of 21 mg/kg has led to good therpeutic results in patients without nodulocystic lesions

Association of androgenetic alopecia and hyperlipidemia

Several studies have indicated that vertex type androgenetic alopecia have a higher-than-normal risk for coronary heart disease but few studies focused on lipid profiles which are important in the pathogenesis of coronary heart disease. This study was designed to investigate the relation between vertex type androgenetic alopecia [grade III and higher according to Hamilton-Norwood] and hyperlipidemia. In this case-control study, lipid parameters [total cholesterol, triglyceride, LDL cholesterol, HDL cholesterol, total cholesterol/HDL cholesterol ratio] of 50 men with vertex type androgenetic alopecia [study group] were compared with 50 men with normal hair status [control group]. Study group matched according to the age, BMI and habit of smoking with control group. Study group had a higher triglyceride and lower HDL cholesterol levels than control group. Total cholesterol/HDL cholesterol ratio was significantly higher in study group [P<0.05]. Vertex type androgenetic alopecia could be a clinical marker of hyperlipidemia and dermatologists should investigate lipid profile in these patients