Amir Hossein Siadat

Background: Personal protective equipment (PPE) is essential in intensive care units, especially when caring for patients with severe respiratory infections. At the same time, prolonged use of respirators, gloves, gowns, and face shields, together with frequent hand hygiene, can irritate the skin and weaken the skin barrier. These reactions may affect comfort during long shifts and make continued PPE use more difficult. Objective: This study evaluated the prevalence, clinical characteristics, morphology, symptoms, and anatomical distribution of PPE-associated skin lesions among ICU healthcare workers. Methods: This cross-sectional observational study included physicians and nurses working in respiratory infection ICUs of governmental hospitals affiliated with Isfahan University of Medical Sciences, Iran. Demographic and occupational data were collected using a structured questionnaire. All participants were examined by board-certified dermatologists, and lesion type, morphology, symptoms, and anatomical distribution were recorded. Results: Among 68 ICU healthcare workers, 61 participants (89.7%; 95% CI, 80.0–95.8) had at least one PPE-associated skin lesion. Clinically diagnosed contact dermatitis was the most frequent diagnosis (77.9%), followed by acne (10.3%) and eczema (7.4%). Erythema was the most frequent morphological finding (70.6%), pruritus was the most frequently reported symptom (88.2%), and the hands were the most commonly affected anatomical site (83.8%). Conclusion: PPE-associated skin lesions were common in this regional ICU cohort. Clinically diagnosed contact dermatitis, pruritus, erythema, and hand involvement were the predominant findings. Because the cross-sectional design does not establish causality, these findings should be interpreted as clinically probable occupational associations and require confirmation in larger longitudinal studies.

One of the symptoms of skin aging is the appearance of wrinkles on the face, which have a significant impact on appearance, self-esteem, and quality of life, especially in women. Delaying this process has been the subject of much research for many years. The study aimed to evaluate the effectiveness of oil-in-water (O/W) emulsions based on argireline peptide and inexpensive raw materials available in Iran. Their anti-wrinkle effect was evaluated in twenty women. According to the results obtained, the use of the emulsion contributed to a reduction in wrinkles without causing an allergic reaction. The argireline peptide has anti-aging properties and may be a suitable choice for improving the appearance of the skin.

Background: Androgenetic alopecia is defined as a patterned hair loss resulting from the effect of androgen on hair follicles and characterized by non‐scarring, progressive miniaturization of the hair follicles. Minoxidil and finasteride are regarded as the first‐line treatments with antiandrogens and flutamide are considered as the alternative choices. In the current study, we evaluated the efficacy of combination therapy with topical 2%flutamide plus 5% minoxidil vs. %5 minoxidil alone in the treatment of the androgenetic alopecia.Material and Methods: This was a randomized, double‐blinded clinical trial in 40 patients with androgenetic alopecia. Patients were randomized to receive either topical minoxidil vs. topical flutamide plus minoxidil for 6 months. At the end of study, patients were compared regarding mean hair density and mean hair thickness and patient's satisfaction. Collected data were analyzed using t‐test, Ki square, and Kolmogorov–Smirnov tests.Results: Topical flutamide plus minoxidil solution was significantly more effective than minoxidil in terms of hair density, hair thickness, and patient's satisfaction (p < 0.05).Conclusion: Topical hydroalcoholic solution of flutamide plus minoxidil may be promising treatment for the androgenetic alopecia. To better evaluate the efficacy of topical flutamide, more prolonged studies with higher number of patients and use of different vehicles and different ingredients are recommended.

Objective. Vitiligo is a common, autoimmune disease that results in the destruction of the melanocytes and manifests as depigmented macules on various areas of the skin. Numerous treatment options have been proposed for vitiligo. The purpose of this study was to compare the efficacy of microneedling plus topical pimecrolimus 1% versus the sole use of topical pimecrolimus 1% for the treatment of vitiligo. Methods. This clinical trial was conducted on 30 skin lesions on 15 Al‐Zahra hospital patients. Each patient had two similar lesions in the limb area, and each lesion was considered a separate treatment group. The left or right side of the patient’s lesion was randomly assigned to receive microneedling plus topical pimecrolimus for three months, while the other side received only topical pimecrolimus 1%. As part of the follow‐up, digital photography was taken at the baseline and biweekly for three months after treatment and six months’ follow‐up. The following methods were used to evaluate the results: DLQI questionnaires, patient satisfaction questionnaires, and two independent dermatologists comparing the improvement rate for each group. Results. Topical pimecrolimus 1% treatment led to unsatisfactory results, whereas the combination of microneedling and topical pimecrolimus1% treatment produced a more favorable overall outcome (P < 0.001). Conclusion. This study established that combination therapy results in more significant patient improvement. Additionally, one patient experienced mild skin irritation as a side effect of topical pimecrolimus.

Background: Cutaneous leishmaniasis (CL) is an endemic disease of Iran and despite self‐healing nature of this disease and many suggested treatments, scar is usually inevitable results of the affection with this cutaneous infection. CO₂ laser in CL has a specific thermolysis effect on infected tissues and application of trichloroacetic acid (TCA) 50% solution for treatment of leishmaniasis scars showed promising results.Aim: To evaluate CO₂ laser plus TCA 50% versus CO₂ laser alone for treatment of CL.Patients/Methods: In the current report, we present 6 cases of noduloulcerative CL that were treated successfully by the combination of the continuous wave CO₂ laser plus topical application of TCA 50%.Results: Five patients improved after 3 weeks of starting treatment, and 1 patient needed to repeat treatment. The scars were flat and good.Conclusions: The CO₂ laser plus topical TCA 50% may be more effective in treatment of the cutaneous leishmaniasis and results in shorter healing time.

Trichilemmal cyst or pilar cyst is defined as a cyst containing keratin and its breakdown products. It is usually situated on the scalp with a wall resembling external hair root sheath. In this case report we present a 55-year-old man with multiple giant pilar cysts that were distributed over the whole body since childhood. One of the cyst on the chest was transformed to squamous cell carcinoma (SCC).

Background: Fractionated carbon dioxide (CO ₂ ) can treat hypopigmented scars. Latanoprost is a prostaglandin analog used to treat glaucoma. It can cause adverse effects, such as periocular hyperpigmentation. The aim of this study was to assess the efficacy and safety of latanoprost plus CO ₂ laser on the repigmentation of hypopigmented scars. Patients and Methods: 28 patients with hypopigmented scars were divided randomly into two groups. The patients in group A were treated in six sessions (1-month intervals) with 10600-nm fractional CO ₂ laser plus latanoprost 0.005% and those of group B fractionated CO ₂ laser plus placebo (distilled water). Digital photographs were taken at baseline and 3 months after the last treatment session. The blinded dermatologist compared the photographs and evaluated the efficacy of treatment in the hypopigmented scars using a 4-scale point (grade 1-4). Patient satisfaction was scored from 0 to 10 on a visual analog scale. Results: Follow-up results 12 weeks after the last treatment session demonstrated that 11 of the 14 patients in group A had more than 50% improvement in hypopigmentation The difference in improvement of the two groups was statistically significant (P = 0.027). The mean of the VAS scores of patients in group A was 6.50 ± 1.45 and in group B 4.57 ± 1.6. The difference in mean satisfaction of the two groups was statistically significant (P = 0.003). Side effects were mild and resolved within 1 to 5 days. Conclusion: The fractional CO ₂ laser resurfacing plus topical latanoprost can be used as a safe and efficacious method to treat hypopigmented scars.