Afsaneh Sadeghzadeh Bazargan

The internal electrocautery‐assisted lid‐tightening maneuver, combined with transconjunctival blepharoplasty, offers a scarless and effective approach to improve lower eyelid contour and stability, minimizing the risk of postoperative malposition.

Introduction: Pemphigus vulgaris (PV) is a rare, severe autoimmune disorder characterized by the production of autoantibodies that cause blistering of the skin and mucous membranes, often presenting with oral lesions in 50%–70% of cases. It has a global incidence of 0.5–3.2 per 100,000 people, with variations across regions, and in Iran, the rate is about 1 per 100,000 annually. PV affects both sexes equally and typically manifests in the sixth decade of life, though the age of onset varies internationally, tending to be younger in India and Western countries. Methodology: In this cross‐sectional study, data were collected from 63 patients diagnosed with PV via telephone interviews. This project was approved by the Research Ethics Committee of Iran University of Medical Sciences. Statistical analyses were performed using SPSS software, version 22.0 (IBM Corp., Armonk, NY, USA). Results: Among 63 PV patients, 56% were female, and 44% were male, with an average age of 50.17 years and a mean age of onset of 44.91 years (SD = 14.77). Most patients (70%) initially presented with mucosal symptoms, and the average time to diagnosis was approximately 17 months. Common misdiagnoses included aphthous ulcers, lichen planus, and allergic reactions. After diagnosis, most patients (82%) received multiple medications. The most frequently used medications were prednisolone (50 patients, 84.75%), methylprednisolone (10 patients, 16.9%), and rituximab (34 patients, 57.63%). Discussion: PV in this cohort most often began with mucosal symptoms and was frequently preceded by consultations with non‐dermatology clinicians, contributing to diagnostic delays. Such delays may negatively affect.

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 and Aims: Androgenetic alopecia is the most common cause of hair loss in both men and women. The aim of this case‐control study was to investigate the role of phenotype (hair shape, thickness, and color) and demographic characteristics, including smoking history, in the development of androgenetic alopecia. Methods: In this case‐control study, participants were divided into two groups: patients diagnosed with androgenetic alopecia (case group) and individuals without hair loss (control group). Data on demographic characteristics (age, gender), hair phenotype (shape, thickness, and color), and smoking history were collected. The case group consisted of individuals diagnosed with androgenetic alopecia at a skin and hair clinic, while the control group included patients visiting the clinic for other skin conditions. Data were analyzed using SPSS software. Results: The study compared data from 50 patients with androgenetic alopecia and 50 control participants. Smoking was found to increase susceptibility to alopecia, and a significant association was observed between lighter hair color and androgenetic alopecia. No significant relationship was found between hair thickness or shape and alopecia. Additionally, women had a higher prevalence of alopecia than men. Individuals with alopecia were significantly older, with a higher frequency of alopecia observed in those over the age of 25 ( p ‐value = 0.002). Conclusion: Age, hair color, smoking, and gender were found to significantly influence the development of androgenetic alopecia. These findings suggest the importance of considering demographic and phenotypic factors in understanding the pathogenesis of this condition.

Burn scars are significant consequence of thermal burn injuries, causing cosmetic concerns and potentially leading to symptomatic discomfort or functional limitations; therefore, continuous adoption of novel methods is warranted to improve outcomes. This study aims to assess and compare the effectiveness, safety, and satisfaction of fractional CO2 laser treatment alone versus its combination with oral pentoxifylline at a dosage of 400 mg twice daily for four months in patients with hypertrophic/keloid burn scars. In a assessor and analyst blinded randomized controlled trial, patients with hypertrophic/keloidal thermal burn scars were allocated into two intervention groups. Both groups underwent treatment with a fractional CO2 laser, while one group additionally received oral pentoxifylline at a dosage of 400 mg twice daily for four months. The assessment of scar improvement was performed using the modified Vancouver Scar Scale (mVSS) at baseline and during subsequent follow-up sessions. Significant improvements were noted within both groups, with mVSS scores decreasing from 7.73 to 4.73 in the CO2 laser group and from 7.36 to 3.91 in the combination therapy group (p < 0.001 for both). However, the between-group difference in mVSS score reduction was not statistically significant (p = 0.39). Confidence intervals for the mean change in mVSS scores from baseline to endpoint were [2.45, 3.10] for the CO2 laser group and [3.15, 3.85] for the combination therapy group. The combination therapy group also showed a more pronounced improvement in pigmentation subscore of mVSS and higher patient satisfaction rates. No adverse effects were reported in either group. Fractional CO2 laser with or without Pentoxifylline appears to be an effective and safe option for the improvement of hypertrophic/keloidal burn scars. Patient satisfaction seems to increase when the laser is combined with oral Pentoxifylline. Nevertheless, further studies involving larger patient cohorts are warranted to draw more robust conclusions.

Burn scars present psychological and social challenges for patients, classified into atrophic and hypertrophic types. Treatments like corticosteroid inject

Background and Aims: This study aimed to evaluate the effectiveness, safety, and satisfaction rates of three different lateral matricectomy methods for treating ingrown toenails: 90% phenol, 100% trichloroacetic acid (TCA), and radiofrequency (RF) ablation. Our objective was to identify which method offers superior outcomes regarding postoperative pain, healing time, aesthetic results, and complication rates. Methods: Conducted between August 2022 and June 2023, the study included 12 eligible patients divided into three groups: Group 1 underwent lateral matricectomy with 90% phenol, Group 2 with 100% TCA, and Group 3 with RF treatment. Preoperative assessments were conducted, and patients were followed up on the day after surgery and at Weeks 1, 2, and 3, as well as at Months 1, 2, 6, and 9 postoperatively (totaling nine assessments). Pain levels were measured using the Visual Analog Scale (VAS), while wound discharge and bleeding were rated on specified scales. Results: Mean pre‐ and postoperative (second day) pain scores were 6.0 ± 3.3 and 0.75 ± 0.67 for Group 1, 6.25 ± 4.92 and 1.75 ± 0.58 for Group 2, and 6.25 ± 2.25 and 3.50 ± 0.50 for Group 3, with significant differences observed. RF treatment showed higher moderate postoperative pain compared to mild pain in the phenol and TCA groups. Average healing time was 22.75 ± 3.50 days (phenol), 40 ± 12.91 days (TCA), and 26.25 ± 6.70 days (RF), with phenol demonstrating faster healing, although differences were statistically insignificant. The median aesthetic outcomes favored phenol with a score of 5.0. Conclusion: Lateral matricectomy with 90% phenol, 100% TCA, and RF all provide unique advantages for ingrown toenail treatment. Phenol exhibited high success rates, minimal complications, faster healing, and excellent aesthetic outcomes. Trial Registration: IRCT, IRCT20220228054152N1. Registered 03 January 2023, https://www.irct.behdasht.gov.ir/trial/65907 .

Managing burn scars in children presents significant challenges. This study investigates effective treatment methods for burn scars, focusing on efficacy, safety, standard protocols and tolerability. Major databases such as PubMed, Scopus and Web of Science were thoroughly searched up to August 2024, emphasizing procedural treatments for burn scars in children. Key data collected included participant demographics, sample sizes, intervention methods, follow‐up protocols, treatment effectiveness and reported adverse events. A total of 256 children were assessed, with all procedural treatments yielding satisfactory outcomes. Among the various methods, trapeze‐flap plasty and percutaneous collagen induction showed improvements in all patients. In the laser treatment group, which included 161 children, the Vancouver Scar Scale (VSS) score reduction ranged from 55.55% to 76.31%, with outcomes rated as good (24.61%) to excellent (60%). Laser treatment using local anaesthesia proved to be well tolerated by children. Our findings indicate that various methods—including trapeze‐flap plasty, percutaneous collagen induction, phototherapy and fractional CO₂ laser—demonstrate a relatively good response and an acceptable safety profile. Notably, light‐based therapies/lasers may serve as safe, effective and tolerable options for scar treatment in this age group, often eliminating the need for general anaesthesia.

Key Clinical Message: Pulsed dye laser (PDL) has proven effective in resolving lupus miliaris disseminatus faciei (LMDF) where drug therapies have failed with a lack of treatment consensus for LMDF, considering early PDL intervention is crucial to achieve resolution without scarring, prevent relapse, and enhance overall treatment outcomes. Lupus miliaris disseminatus faciei (LMDF) is a rare inflammatory and granulomatous dermatologic disease that primarily affects the face. The optimal treatment for LMDF remains controversial, and there is a lack of consensus on the most effective therapy. This case report highlights the successful use of a 595 nm pulsed dye laser (PDL) in the treatment of LMDF following unsuccessful drug therapy. A 28‐year‐old male presented with reddish‐brown eruptions on his face that had persisted for several months. Clinical examination revealed discrete dome‐shaped eruptions in clusters on the central area of the face. Histopathological examination confirmed the diagnosis of LMDF, based on the presence of epithelioid granulomas with central caseous necrosis. Previous treatment with an oral isotretinoin and methotrexate combination also failed to yield satisfactory results. After discontinuing drug therapy, the patient underwent five sessions of PDL treatment. Ten days after the first session, the eruptions began to regress without scarring. Subsequent PDL sessions led to the complete resolution of the eruptions. The patient experienced no relapse during the follow‐up period. This case report suggests that PDL treatment may be an effective option for LMDF, particularly in cases where drug therapy has failed. Early initiation of laser treatment may prevent scarring, minimize the adverse effects associated with drug therapy, and reduce the risk of disease relapse. Further research and controlled trials are needed to establish the efficacy of laser therapy in the treatment of LMDF.