Relieving pain in oral lesions of pemphigus vulgaris using the non-ablative, non-thermal, co2 laser therapy [NTCLT]: preliminary results of a novel approach

Introduction: Pemphigus vulgaris [PV] is a chronic, serious autoimmune mucocutaneous bullous disease. Oral lesions in PV may be extremely painful. This pain may adversely affect the patients' oral intake and quality of life. This before-after clinical trial was designed to assess the pain relieving effects of single session of non-ablative, non-thermal CO2 laser therapy [NTCLT] in oral lesions of PV

Methods: Fifty painful oral lesions of fourteen patients with PV were illuminated by CO2 laser [power: 1 W, scanning the lesions with rapid circular motion of the handpiece] passing through a thick layer of transparent gel with high water content. The pain severity of the oral lesions was reported by the patients up to the fourth postoperative day. They were also asked to continue their existing systemic treatment during the course of this study as a precondition for the participation

Results: The severity of contact and non-stimulate [non-contact] pain declined immediately and significantly after NTCLT [P < 0.001]. The pain relieving effect was sustained during the four successive days of follow-up. The procedure was pain free and no kind of analgesics was required. Following NTCLT, there were no visible thermal complications such as destruction, ablation or irritation of the oral lesions

Conclusion: The results of the trial proposed that single session of NTCLT could immediately and significantly relieve pain in oral lesions of PV, without any visible thermal complications

Safety and efficacy of tacrolimus 0.03% ointment in the treatment of atopic dermatitis: a randomized, double-blind, placebo controlled clinical trial

Atopic dermatitis [AD] is a chronic, relapsing, pruritic skin disease more common in infancy and childhood. Emollients, topical corticosteroids, and avoidance of irritating factors are the mainstay of its treatment, but fear of side effects has limited the use of topical corticosteroids. The objective of this study was to evaluate the safety and efficacy of topical tacrolimus 0.03% ointment in the treatment of AD. In this randomized, double-blind, clinical trial, 76 patients with AD older than 2 years were randomly allocated in two groups and treated with either tacrolimus 0.03% ointment [Abu-Rayhan Co., Iran] or placebo, twice a day for 6 weeks. Responses to treatment were compared every 2 weeks using SCORAD. Twenty-nine patients in tacrolimus group and 26 in placebo group completed the trial. The reduction in SCORAD after 2 and 4 weeks in tacrolimus group was significantly higher than placebo group [P<0.05]. The frequency of treatment-induced pruritus and burning sensation was similar in both groups but erythema was more observed in the placebo group [P<0.05]. Tacrolimus 0.03% ointment is more effective than placebo in the treatment of AD