Promotion of cutaneous diabetic wound healing by subcutaneous administration of Wharton's jelly mesenchymal stem cells derived from umbilical cord.

Wound healing is a major problem in diabetic patients, and current treatments have been confronted with limited success. The present study examined the benefit of Wharton's jelly mesenchymal stem cells (WJ-MSCs) derived from the human umbilical cord (UC) in wound healing in diabetic rats. Thirty days after inducing diabetes, a circular excision was created in the skin of rats, and the treatments were performed for 21 days. Two groups were studied, which included the Control group and WJ-MSCs group. The studied groups were sampled on the 7th, 14th, and 21st days after wounding. Histological ultrasound imaging of dermis and epidermis in the wound area for thickness and density measurement and skin elasticity were evaluated. Our results on post-wounding days 7, 14, and 21 showed that the wound closure, thickness, and density of new epidermis and dermis, as well as skin elasticity in the healed wound, were significantly higher in the WJ-MSCs group compared to the Control group. Subcutaneous administration of WJ-MSCs in diabetic wounds can effectively accelerate healing. Based on this, these cells can be used along with other treatment methods in the healing of different types of chronic wounds.

Acne scar treatment using combination therapy: Subcision and human autologous fibroblast injection.

BACKGROUND: Acne scar treatment is a problem for both the dermatologist and the dermatologic surgeon. Many therapies have been advanced to improve acne scars over the past years. Nevertheless, they were often related to adverse side effects like hyperpigmentation. These combination therapy using subcision and autologous fibroblast injection can provide a better technique for the acne scar treatment. MATERIAL AND METHODS: In this study, we describe nine patients with the age of 25 to 48 and rolling acne scars (moderate to severe) that were treated with combination therapy using subcision (cannula, 18 gauge) and autologous fibroblast injection. Finally, before and 6 months after the final injection, the patients' biometric characteristics were evaluated by Visioface 1000D and Mexameter and a skin ultrasound imaging system. RESULTS: The results show a significant improvement in the acne scars in the patients. The Visioface results showed that the size and number of skin pores and spots were reduced after combination therapy. Also, the results of skin ultrasonography exhibited denser skin layers both in the epidermis and dermis. CONCLUSION: In summary, the combination therapy of autologous fibroblast injection and subcision can be considered as a new alternative, safe, and useful method for acne scar treatment.

Combination of epidermal keratinocyte-melanocyte cells suspension and microneedling: Safe surgical approach in vitiligo.

INTRODUCTION: Vitiligo is a skin disease that is associated with impaired skin immune systems and pigment degradation in skin melanocyte cells. Despite the significant impact of the disease on the quality of life of patients, treatment of the disease using an effective method such as the transplantation of uncultivated melanocytes was considered by researchers around the world. The goal of this research was to use microneedling to transplant epidermal keratinocyte-melanocyte cells suspension for the treatment of vitiligo patients. METHODS: In this study, 15 male and female vitiligo in face region patients aged 18-45 years were studied. In this study, melanocyte-keratinocyte cells suspension was sprayed. Patients underwent microneedling treatment after spraying the cells. Before and after transplantation, patients were biometrically examined, and the quantity of pigmentation and changes in the transplanted region were documented. Statistical software was used to examine the results. RESULTS: The color difference between the lesion area and normal skin in one, two, and six months after treatment with cell suspension was significantly reduced compared with before treatment (by 48.95%). Moreover, the amount of melanin was significantly increased 6 months after treatment compared with before treatment (129.8 ± 4.16 vs. 195.2 ± 3.54, p = 0.000). A significant decrease in skin brightness in the skin of the lesion area was observed compared with normal skin, 6 months after treatment compared with before treatment (43.7 ± 1.44 vs. 27.9 ± 1.24, p = 0.000). CONCLUSION: Epidermal keratinocyte-melanocyte cells suspension in combination with microneedling could be considered as an effective treatment of vitiligo.

Transplantation of autologous fat, stromal vascular fraction (SVF) cell, and platelet-rich plasma (PRP) for cell therapy of atrophic acne scars: Clinical evaluation and biometric assessment.

BACKGROUND: Scarring is an unfortunate result of acne because it causes the psychological and cosmetic problems for the patients. Unfortunately, no single treatment is suitable, and using multiple methods may have a better result. The autologous fat and stromal vascular fraction (SVF) cells and their secretory factors can enhance the angiogenesis, collagen synthesis, and migration of fibroblasts, therefore regenerate hurt tissues. Moreover, other treatments for acne scarring, such as platelet-rich plasma (PRP), induce the increase in scare. AIMS: This study aimed to verify the effectiveness of transplantation of autologous fat, SVF cells, and PRP as cell therapy techniques on atrophic acne scars. PATIENTS/METHODS: This study included 9 adult patients with atrophic acne scars on face. All patients received the transplantation of autologous fat, stromal vascular fraction (SVF) cells, and PRP. The treatment outcome was measured by biometric assessment (VisioFace 1000 D, Colorimeter, multi-probe adapter Cutometer, Tewameter, Mexameter, and skin ultrasound imaging system), and also, the satisfaction of patients was evaluated. The patients were followed 6 months after the treatment. RESULTS: There was a significant improvement in the skin pores, spots, skin lightness and melanin content of skin, skin elasticity, and TEWL (transepidermal water loss) after 6 months of the treatment. Furthermore, denser skin layers were observed both in the epidermis and in the dermis. Moreover, 66.6% of patients showed good satisfaction after the treatment. CONCLUSION: In brief, the transplantation of autologous fat, SVF cells, and PRP is an effective cell therapy for atrophic acne scars.

Clinical, biometric, and ultrasound assessment of the effects of the autologous fibroblast cells transplantation on nasolabial fold wrinkles.

BACKGROUND: Feeling beautiful and staying young have always been important to the people. Therefore, an extensive body of research has focused on the efforts made to remove the skin problems, especially wrinkles. Fibroblast cells of the skin are the various autologous cells currently used in repairing several wounds, scars, and skin aging. Thus, the present study was conducted to assess the efficacy of the transplantation of the fibroblast cells in eliminating the facial wrinkles using the biometric assessment and to optimize the application of this technique in this treatment. METHODS: The present study was conducted on 22 male and female patients aged between 35 and 60 years old. Samples were collected from the retro-auricular region, and the fibroblast cells were isolated and cultured. Subjects received three injections with autologous fibroblasts at 2-week intervals. The patients were followed up for 6 months, and structural changes in their wrinkles were assessed by the sonography and the VisioFace software, cutometer, tewameter, and colorimeter. RESULTS: The results obtained using the VisioFace software showed the significant phenotypic changes in the patients after the nasolabial injections (81.42 ± 23.97 vs. 60.91 ± 21.91, p = 0.0001). The results showed a significant increase in the total skin density (13.73 ± 6.30 vs. 26.27 ± 7.93, p = 0.0001), dermis density (11.28 ± 5.21 vs. 31.88 ± 7.96, p = 0.0001), epidermis density (27.68 ± 23.15 vs. 49.21 ± 45.68, p = 0.046), and dermis thickness (798.09 ± 133.51 µm vs. 905.59 ± 240.67 µm, p = 0.036) compared to pre-treatment. CONCLUSION: The findings of the study revealed that the injection of autologous fibroblasts can be effective in restoring the aging skin, especially in the nasolabial region, and can be used as a safe rejuvenating strategy.

Comparison of carboxy therapy and fractional Q-switched ND:YAG laser on periorbital dark circles treatment: a clinical trial.

Treatment of the periorbital dark circles (PDCs) is a current challenge, with most treatment methods failing to yield promising results. The effectiveness of two common methods for periorbital dark circle treatment was compared in 28 patients with PDC. The patients were randomly divided into two groups of equal numbers: the first group received carboxy therapy, and the second group fractional 10,64 nm Q-switched Nd:YAG laser. In the carboxy therapy group, the treatment was performed six times, with 1-week intervals between sessions. In the group treated by Nd:YAG laser, the treatment was conducted in four sessions, with 1-month intervals between sessions. The results were evaluated through biometric evaluation, scoring on the visual analog scale (VAS) by both physicians and patients, and patients' satisfaction. Side effects of the treatments were also evaluated. The results showed that both carboxy therapy and Nd:YAG laser are effective in the treatment of periorbital dark circles, but carboxy therapy is significantly more effective. An increase in the skin lightness and a decrease in the melanin content of the periorbital skin was observed in the group receiving carboxy therapy, and these changes were more pronounced in this group compared to the group of Nd:YAG laser. In addition, side effects, such as erythema and post-inflammatory hyperpigmentation, were less in carboxy therapy than in Nd:YAG laser. Furthermore, the procedure was less expensive and easier to perform compared to Nd:YAG laser. Carboxy therapy is significantly more effective than Nd:YAG laser in PDC treatment.Trial registration: IRCT20080901001159N24.

Assessing the effectiveness of the combination therapy with fractional Er-YAG laser and platelet-rich plasma in treatment of periorbital dark circles patients: A clinical trial.

BACKGROUND: Numerous therapeutic techniques for periorbital hyperpigmentation have been suggested. AIM: In this comparative intrapatient study, the effectiveness of combination therapy included fractional Er: YAG laser and autologous platelet-rich plasma (PRP) compared to Er: YAG laser in periorbital hyperpigmentation treatment. PATIENTS/METHODS: Thirty-two patients were enrolled. The right periorbital sides of patients received combination of Er: YAG laser and autologous platelet-rich plasma (PRP) and the left side received Er: YAG laser (three sessions with 4 weeks' intervals). PRP was used in two ways included injection and topical. Patients were evaluated by biometric characteristics, patients, and physician assessments. Also, the patient's satisfaction was assessed and side effects were evaluated. RESULTS: The mexameter results showed that the melanin content in the right side of the periorbital of the patients was significantly decreased compared to left side. Also, significant increase was observed in the skin lightness of the right side in compare to left. The visioface results showed the decrease in the percent change of the color and wrinkle in both sides, but in the right side these changes were significantly more than left side. The patients and physician assessment confirmed the measured results. CONCLUSION: Combination of Er: YAG laser and PRP is significantly effective for periorbital hyperpigmentation.

Biometric changes of skin parameters in using of microneedling fractional radiofrequency for skin tightening and rejuvenation facial.

BACKGROUND: Fractional radiofrequency (RF) has been used for skin rejuvenation and tightening by dermatologists and cosmetic surgeons in recent years. METHODS: Twenty female patients (mean age of 51.9 years) with Fitzpatrick III to VI skin phototypes who desired to undergo skin lift/tightening received six sessions of fractional microneedle RF treatment and were assessed at baseline and then 3 months after the last session for biometric characteristics using a Colorimeter, Visioface 1000D, Tewameter, Cutometer, Mexameter, and Sebumeter and a skin ultrasound imaging system to evaluate the transepidermal water loss (TEWL), skin pores, color, melanin content, erythema, sebaceous content, and thickness and density of the epidermis and dermis. Patient satisfaction with visual analog scale (VAS) was also measured. RESULTS: The results showed that skin pores and spots decreased significantly. TEWL also decreased significantly (by 18.44%). Meanwhile, skin density increased significantly (R7, by 44.41%). The ultrasonographic assessments showed that both the density and thickness of the dermis and epidermis were increased. The changes in the other parameters were not significant. CONCLUSION: FR increases the density and thickness of the dermis and thus also increases the collagen content and decreases skin pores and TEWL.

A comparative study of the efficacy of fractional neodymium-doped yttrium aluminum garnet (Nd:YAG) laser therapy alone and in combination with erbium:YAG laser therapy: tracing and objective measurement of melanin index in macular amyloidosis.

Macular amyloidosis (MA) is a common form of primary localized cutaneous amyloidosis, characterized by the eruption of brown pigments of the skin with a rippled pattern. MA can be of cosmetic concern for patients, and its treatment is challenging. In this study, we aimed to find new effective approaches for MA treatment. A total of 39 patients with the clinical diagnosis of MA were treated with two types of laser therapy, and the effectiveness of each approach was examined. Fractional Q-switched 10.64 nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser therapy was compared with a combination of fractional Q-switched 10.64 nm Nd:YAG laser and long-pulsed fractional erbium:YAG laser therapy. Melanin biometric measurements were performed using a Mexameter, objective image-based evaluation was carried out, and the itching score and patient satisfaction were examined. Mexameter-based analysis showed that both types of laser therapy were effective in the treatment of MA, causing a significant decrease in the amount of melanin in the treated areas (P < 0.05). Also, combination of two types of laser therapy was significantly more effective than one type alone (P < 0.05). The itching score significantly decreased in patients undergoing a combination of laser therapies. Also, a positive correlation was observed between the amount of melanin and degree of itching in the treated areas. Moreover, analysis of patient satisfaction showed that more than 90% of patients had excellent satisfaction with combination laser therapy. The results confirmed the significant positive effects of both fractional Nd:YAG laser alone and in combination with fractional erbium:YAG laser therapy considering the reduction in melanin content; however, combination of two types of laser therapy was more effective than one type alone. Trial registration: IRCT20080901001159N23.

Comparing cannula-based subcision with the common needle method: A clinical trial.

OF TRIAL DESIGN: Treatment of depressed acne scars requires multiple modalities. Although needle subcision is a valuable method, it exhibits mild to moderate efficacy in treatment of deep acne scars owing to the high recurrence rate and other side effects. A total of 100 patients with rolling acne scars were randomly treated using the standard technique of 18 gauge cannula and 27 gauge needle subcision in two parallel groups, and the effect of cannula subcision instead of needle subcision was evaluated in the treatment of rolling acne scars. METHODS: A total of 100 patients were randomly treated using the standard technique of 18 gauge cannula and 27 gauge needle subcision. The outcomes of these procedures were assessed by three blinded dermatologists and by patients' satisfaction. RESULTS: Subcision using the cannula showed good and very good improvement in about 83% of patients (n = 50, P < .05) based on dermatologists investigation and almost no side effects were observed in compared with needle subcision. The response rate was significantly different while using cannula subcision. CONCLUSION: Cannula subcision appears to be a safe and practical technique that can enhance the efficacy of subcision without considerable complications.