Mohammad Ali Nilforoushzadeh

Background: Infraorbital area significantly affects perceived age and patient quality of life. Although regenerative treatments such as platelet‐rich plasma (PRP) are widely used for under‐eye, evidence comparing PRP with platelet‐rich fibrin (PRF) is limited. This study aims to compare PRP to PRF for periorbital area. Methods: In this clinical trial, each participant randomly received PRP on one side and PRF on the contralateral side in three sessions. A tear‐trough‐based approach with sandwich technique was utilized. Outcomes were assessed at baseline, 3, 4, and 7 months using biometric indices (TEWL, melanin, erythema, elasticity parameters, colorimeter), standardized grading scales (hyperpigmentation, wrinkles, and hollowness, patient satisfaction scores), and ultrasonography. Statistical analysis was conducted with significance set at p < 0.05. Results: Twenty‐four patients completed the study (mean age 40.71 ± 10.9 years; 95.8% female). TEWL and colorimeter decreased in both groups, without statistically significant differences between groups ( p > 0.05). Melanin and erythema demonstrated a consistent decreasing trend in the PRF group beginning at Month 3, whereas both indices paradoxically increased at Month 3 in the PRP group before declining thereafter. Sonographic parameters, POH grade, wrinkle grade at 3 and 4 months, and Allergan grade at 4 months improved significantly in both groups ( p < 0.05), with no significant differences between groups. Patient satisfaction increased in both groups and reached statistical significance between Months 3 and 4 ( p = 0.037). Both treatments were tolerated, with no major adverse effects. Conclusion: Both PRP and PRF significantly improved periorbital hyperpigmentation, fine wrinkles, and mild hollowness. PRF demonstrated more stable reduction in melanin and erythema and showed earlier improvement in certain elasticity parameters. Neither treatment provided sufficient correction for severe hollowness. Repeated sessions every 3–4 months may be required to maintain results. Trial Registration: Iranian Registry of Clinical Trials (IRCT): IRCT20200127046282N51

The combination of Endolift laser therapy and injectable platelet‐rich fibrin (i‐PRF) is an emerging strategy in aesthetic medicine, but the optimal scheduling of these modalities remains unexplored. This case report highlights a novel treatment schedule combining i‐PRF and Endolift laser therapy, resulting in noticeable short‐term facial rejuvenation in a 56‐year‐old female. A 56‐year‐old woman presented with concerns regarding facial skin laxity and aging. A unique treatment schedule was implemented: i‐PRF injections were administered 1 day before (Day −1), 1 week after (Day +7), and 1 month after (Day +30) a single Endolift laser session (Day 0). At the 4‐week follow‐up, the patient demonstrated marked improvement in skin tightness, texture, and overall facial appearance, as assessed by clinical examination, standardized photography, and high patient‐reported satisfaction. Only mild, transient adverse effects were observed, with no delayed complications. This novel schedule combining i‐PRF and the Endolift laser demonstrates promising synergistic effects, resulting in significant short‐term skin rejuvenation. While these initial findings suggest that the precise timing of i‐PRF enhances the regenerative impact of Endolift therapy, further large‐scale studies utilizing objective measurement scales and extended follow‐up periods (3–6 months) are warranted to validate long‐term durability and establish standardized protocols.

Psoriasis is an immune‐mediated skin disease in which genetic and environmental factors have a significant role. Olive oil with antioxidant properties is an effective adjunct treatment for skin diseases. Furthermore, ozone by introducing O ₂ into the bloodstream controls the response of cell‐mediated immunity and leads to improve disease. So, the aim of this study was to evaluate the efficacy of ozone therapy in the treatment of Psoriasis. Topical therapy of lesions of a man suffering from psoriasis was carried out using ozonate olive oil two times a day and ozone sauna once a week during a month. Patient showed considerable improvement after about twenty days. As the itching and silvery‐white scaling decreased, the lesions began to resolve after three weeks. Furthermore, no recurrence was noted after 3 months of follow‐up. It is suggested that ozone therapy, in appropriate formulations and in controlled cases, has a role in the treatment of patients with psoriasis by inhibiting the inflammatory pathways and prompting regenerative characteristics, without significant adverse effects and the necessity for systemic pharmacological agents. So, more studies on a greater population are needed to confirm this finding.

The combination of Renuvion helium plasma and Icoone Multi Micro Alveolar Stimulation is an effective, minimally invasive approach for reducing upper arm fat and improving skin texture. This synergistic treatment provides aesthetic improvements with minimal risk and recovery time.

Background and Aims: Androgenetic alopecia (AGA) is a common and distressing medical condition that negatively affects the patient’s quality of life. The conditioned medium (CM) contains secreted proteins and has been investigated for several therapeutic applications. This study sought to assess the efficacy of human foreskin fibroblast (HFF)–CM in AGA treatment. Methods: A pilot trial was conducted on eligible AGA patients. Initially, HFFs were isolated, expanded under sterile GMP‐compliant conditions, and characterized by mesenchymal surface marker expression prior to HFF–CM preparation. The resulting HFF–CM was collected after serum‐reduced culture, cleared of cellular debris, sterilized by filtration, and analyzed by ELISA to quantify key growth factors. Subjects received four injections of HFF–CM at 4‐week intervals. The cases were followed up for 6 months, and structural changes were evaluated by sonography, VisioFace software, and trichoscopy. Moreover, subjective satisfaction was assessed. Results: During HFF–CM preparation, HFF exhibited MSC‐like morphology and mesenchymal marker expression, and the resulting CM contained a diverse growth factor profile, with IGF‐1 and KGF/FGF‐7 present at the highest levels. Fourteen eligible cases were included in this study (mean age: 34.8 ± 8.1 years, female: 78.6%). The pre‐ and post‐treatment results indicated significant changes in Ludwig’s score ( p = 0.38). Sonography showed notable changes from baseline in complete and dermal density ( p < 0.001), as well as significant improvements in trichosan at both × 60 and × 150 magnification ( p < 0.001). Physician and patient satisfaction assessments revealed excellent and good results in most cases. Conclusion: AGA treatment with HFF–CM led to improvement in both objective and subjective parameters. However, large‐scale clinical studies with long‐term follow‐ups are recommended. Trial Registration: Iranian Registry of Clinical Trials: IRCT20221026056309N1

Background Acne is a common skin condition that often leads to atrophic scars, a major concern for patients. Treatments for these scars include fractional CO₂ laser, subcision, and regenerative therapies like platelet-rich plasma (PRP) and hyaluronic acid injections. PRP, which concentrates platelets from the patient’s blood to release growth factors for enhanced healing, is prepared through centrifugation. Hyaluronic acid products provide hydration and have anti-inflammatory, antibacterial, and antioxidant benefits. This study investigates the effectiveness of PRP, non-cross-linked hyaluronic acid, and their combination in treating acne scars, addressing the significant impact of these scars on patients' quality of life. Method Between 2023 and 2024, a double-blind, randomized clinical trial was conducted involving 15 patients aged 18 to 65 with atrophic acne scars at a dermatology clinic. Participants were divided into three groups: one group received a combination of platelet-rich plasma (PRP) and non-cross-linked hyaluronic acid on one side of the face, while the opposite side received either PRP alone, hyaluronic acid alone, or normal saline as a placebo. Two therapy sessions were held, with evaluations conducted at baseline, one month after the first session, and three months later, using biometric and ultrasound measurements to assess treatment efficacy. Results Results indicated that while no significant differences were found in colorimetry, tewametry, and corneometry across groups, the PRP group had higher erythema and melanin indices in the third evaluation (three months after the first treatment session) compared to the PRP+non-cross-linked hyaluronic acid (HA) group. Conversely, the non-cross-linked HA group demonstrated superior scores in tewametry and melanin index compared to the PRP+HA group. In post-treatment evaluations, both patients and physicians reported higher satisfaction rates for the PRP+HA group compared to the PRP alone or the non-cross-linked HA group, highlighting a preference for the combination treatment. Conclusion The combination of platelet-rich plasma and non-cross-linked hyaluronic acid presents a promising approach for the treatment of atrophic acne scars, demonstrating enhanced satisfaction rates and biometric improvements over individual treatments. Further studies are warranted to solidify these findings and refine treatment protocols. Level of Evidence I Therapeutic study This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Morphea is a chronic autoimmune condition characterized by sclerosis and scar‐like changes in the skin and underlying tissues. En coup de sabre represents a rare and severe linear variant of morphea, primarily affecting the frontoparietal scalp and forehead, with a higher prevalence among children and women. The disease often leads to significant cosmetic and functional impairments, posing therapeutic challenges due to its unpredictable course and varying responses to conventional treatments. Current management strategies include topical steroids, calcineurin inhibitors, systemic therapies, such as methotrexate, and ultraviolet (UV) therapy. Additionally, interventions like fat grafting and hyaluronic acid injections have demonstrated some efficacy in restoring tissue volume and improving skin texture. This case report explores an innovative approach using autologous fibroblast cell injection combined with platelet‐rich plasma (PRP) as a novel therapeutic option for a 40‐year‐old woman diagnosed with inactive‐phase en coup de sabre. After harvesting fibroblast cells from a superficial skin biopsy and isolating PRP through centrifugation, the combined solution was administered via three monthly subcutaneous injections. No adverse effects were observed throughout the treatment period. At a 3‐month follow‐up, significant improvements were noted in skin elasticity, hydration, and overall cosmetic appearance. Ultrasound imaging revealed enhanced dermal thickness and density, while cutometric and colorimetric assessments confirmed increased skin viscoelastic properties and brightness. The promising results observed in this case suggest that the combination of autologous fibroblasts and PRP may offer a safe, effective, and minimally invasive therapeutic alternative for managing en coup de sabre morphea. However, larger studies and controlled clinical trials are essential to validate these findings, optimize treatment protocols, and further understand the underlying mechanisms driving tissue regeneration and repair in morphea.

Introduction: Diabetic foot ulcer (DFU) is a severe complication of diabetes mellitus, affecting up to 15% of diabetic patients and leading to high rates of hospitalization, morbidity, and lower limb amputation. Case Presentation: This case study details the management of a 67-year-old diabetic male patient with a DFU complicated by osteomyelitis. The patient, with a long history of diabetes and multiple comorbidities, was treated with a comprehensive regimen that included antibiotics, debridement, and platelet-rich plasma (PRP) therapy. PRP was administered weekly for 15 weeks. Clinical, laboratory, and imaging data were employed for the evaluation of the disease improvement. As a result, a marked improvement in wound healing was observed, characterized by reduced wound size, accelerated closure of the wound, and enhanced tissue regeneration. However, the patient developed deep vein thrombosis, which was successfully managed with anticoagulants. Conclusion: The study highlights PRP';s potential in DFU treatment due to its regenerative properties despite the risk of adverse effects. The efficacy of PRP aligns with previous studies, showing improved healing rates and infection control. Future research should focus on large-scale trials to optimize PRP protocols and confirm the safety and efficacy of this therapeutic method in DFU.

Background and Aims: The skin serves essential protective and regulatory functions. In severe injuries such as burns, keratinocytes—being the main epidermal cells—play a pivotal role in skin regeneration through secretion of growth factors and cytokines. This review explores the biology of keratinocytes and their application in treating skin disorders and developing skin substitutes. Methods: A comprehensive literature review was conducted, analyzing studies on the therapeutic use of allogeneic and autologous keratinocytes in wound healing and skin regeneration. Research on cultured epidermal substitutes, including keratinocyte‐based grafts and engineered skin constructs, was also reviewed. Results: Findings indicate that autologous keratinocyte transplantation—such as auto‐dermatoplasty using a patient's own skin—has been highly effective in treating extensive burns and postsurgical wounds. However, in cases where sufficient donor skin is unavailable, alternative approaches such as keratinocyte culture combined with collagen gel and fibroblasts have shown promising results. Clinical studies demonstrate that epidermal keratinocyte‐based therapies significantly reduce scarring, enhance wound healing, and improve survival rates in patients with severe burns. Conclusion: Given their high proliferation capacity, accessibility, and ability to differentiate into epidermal layers, keratinocytes represent a valuable tool for tissue engineering and regenerative medicine. Future advancements in keratinocyte‐based therapies and bioengineered skin substitutes hold significant potential for improving outcomes in patients with critical skin injuries.

Adipose‐derived exosomes may offer a novel therapeutic approach for lichen planopilaris (LPP) unresponsive to standard treatments, with preliminary evidence suggesting potential benefits in symptom control and hair preservation.