Evaluation of treatment of acne scars with 25% trichloroacetic acid chemical peel followed by manual dermasanding.

BACKGROUND: Acne scars are common problems encountered in daily dermatologic practice. AIMS: To evaluate the effectiveness and safety of 25% trichloroacetic acid (TCA) alone or followed by manual dermasanding in repeated sessions for the treatment of mild and moderate acne scars. PATIENTS/METHODS: Thirteen patients (nine females and four males) were enrolled. Twenty-five percent TCA superficial peel was performed in all patients, followed in 11 of them by manual dermasanding. Thirteen sessions of TCA peeling, one session for each patient, were done, and twenty-four sessions of dermasanding with different numbers for each patient. Acne scars were graded into a score ranging from 0 to 20, the score was recorded at each visit, and the results were compared. RESULTS: The score of scarring acne decreased after TCA peeling and each dermasanding session. The improvement was statistically significant. The improvement continued after the last dermasanding session. After both procedures, no significant complications were recorded except persistent erythema and post-inflammatory hyperpigmentation, which disappeared in all patients at 3-month follow-up visit. CONCLUSION: Trichloroacetic acid superficial peel followed by manual dermasanding in separate sessions was effective and the improvement became more significant after repeated dermasanding sessions for the treatment of mild and moderate acne scars.

Comparative study of the effect of narrowband ultraviolet B phototherapy plus methotrexate vs. narrowband ultraviolet B alone and methotrexate alone in the treatment of plaque-type psoriasis.

BACKGROUND: Widespread psoriasis has great effects on life. Effective and rapid response in the treatment is needed. So this study was done to compare the efficacy of combined narrowband ultraviolet-B (NBUVB) plus methotrexate (MTX) versus each one alone in the treatment of psoriasis. METHODS: A total of 120 patients with widespread plaque-type psoriasis were enrolled, but only 113 patients completed the study. They were divided into three groups randomly, group MN (38) received NBUVB plus MTX, group N (38) received NBUVB alone, and group M (37) received MTX only. End point of treatment (clearance) was 90% reduction in Psoriasis Area and Severity Index (PASI) Score or up to six months, whichever was earlier; follow-up was done for one year. RESULTS: The mean number of weeks required for achieving clearance was 6.11 ± 1.28 weeks in group MN, 11.42 ± 2.36 weeks in group N, and 20.87 ± 4.21 weeks in group M (P < 0.0001). The mean number of phototherapy sessions was 17.86 ± 3.74 sessions in group MN, and 33.51 ± 6.9 sessions in group N (P < 0.0001). The mean total cumulative dose of NBUVB for achieving clearance was 12.13 ± 4.02 J/cm(2) in group MN, compared with 34.48 ± 13.13 J/cm(2) in group N (P < 0.0001), while the mean total cumulative dose of MTX was 116.04 ± 20.47 mg in group MN compared with 298.63 ± 60.26 mg in group M (P < 0.0001). CONCLUSIONS: Combination of NBUVB plus MTX provided rapid improvement with less cumulative doses of both therapies compared with each one alone in the treatment of psoriasis.

Autologous serum skin test as a diagnostic aid in chronic idiopathic urticaria.

Background. Chronic urticaria is defined as urticaria persisting daily for more than six weeks. A significant number of patients had autoimmune basis where autologous serum skin test is widely used for detection of chronic autoimmune urticaria. Objectives. To estimate the frequency of autoimmune urticarial in Iraqi patients utilizing the autologous serum skin test and to evaluate its results with the variable clinical features of chronic idiopathic urticaria. Methods. In this prospective study, 54 patients with chronic idiopathic urticaria were investigated with autologous serum skin test where its results were examined with the different clinical parameters of chronic autoimmune urticaria. Results. Twenty two patients (40.7%) out of 54 patients with chronic idiopathic urticarial had positive autologous serum skin test. Statistical analysis of the clinical variables did not show a significant difference between patients with positive and negative autologous serum skin test except for the distribution of wheals on the face and extremities which was significantly associated with positive autologous serum skin test results (P value 0.004). Conclusion. Autologous serum skin test is a simple, office-based test for detecting chronic autoimmune urticaria patients who have no distinctive clinical features differentiating them from chronic idiopathic urticaria patients.

Treatment of plane warts with a low-dose oral isotretinoin.

Objective. To assess the efficacy of a low-dose oral isotretinoin in the treatment of plane warts. Patients and Methods. Thirty-one patients with recalcitrant facial plane warts were enrolled. A cumulative dose of 30 mg/kg for two months of treatment was calculated; this was equal to a mean of 0.5 mg/kg/day. Each patient was seen every two weeks during the treatment period. Response to treatment was either complete or no response. Patients with complete response were followed up monthly for four months to record the relapse rate. Results. Twenty-six patients completed the study; their ages range from 5 to 35 with a mean ± SD 15.28 ± 8.51 years. Fifteen (57.69%) patients were females and eleven (42.30%) were males. Nineteen (73.07%) patients showed complete response and seven (26.92%) patients showed no response at the end of two months of therapy. The difference was statistically significant; P value <0.0001. Fifteen (78.94%) out of nineteen patients, who had complete response, were still free from warts at the end of four-month followup. Conclusion. Oral isotretinoin is effective in the treatment of recalcitrant facial plane warts.