Background: Acne vulgaris is a common skin problem that is encountered in daily clinical work, affecting mostly the adolescent and young adult age group. Many topical therapies have been used in the treatment of mild to moderate types of acne vulgaris. However, none of these modalities is uniformly effective; furthermore, acne vulgaris is also associated with relapse and many topical side effects.Objective: To compare the effectiveness and side effects of topical 2% spironolactone solution and 1.5% clindamycin solution in the treatment of mild to moderate acne vulgaris.Material and methods: This was a single-blinded therapeutic clinical comparative study conducted at the Dermatology Center at Medical City in Baghdad, Iraq, from April 2019 to March 2020. Sixty-eight patients with mild to moderate acne vulgaris on the face were included. All sociodemographic data related to the disease were recorded for each patient. Patients were divided into two groups according to the type of therapy: group A (35 patients) used 2% spironolactone solution and group B (33 patients) used 1.5% clindamycin solution. All cases in both groups were instructed to use the solutions twice a day for 12 weeks in the same manner. Patients were seen every two weeks to evaluate the response to therapy and to report any topical side effects; then, follow-up was carried out for one month after cessation of therapy to evaluate relapse.Results: Spironolactone solution significantly decreased comedone count (p < 0.0001), while the clindamycin solution had no effect on comedones. Although spironolactone was slower than clindamycin solution in reaching the maximum therapeutic effect, the reduction in papules was comparable to that of clindamycin, but it exhibited a greater reduction of pustules (p > 0.05) and the Acne Severity Index (ASI; p > 0.05). Patients in the spironolactone group were more satisfied than those in the clindamycin group. Only minimal local side effects were reported in both groups that did not require cessation of therapy.Conclusion: Spironolactone solution is an effective and well-tolerated topical treatment for mild to moderate acne vulgaris and is superior to clindamycin solution.

Background: Alopecia areata is a common autoimmune disease that encountered world-wide. Many modalities have been used but no one was universally effective. Zinc sulphate has been used in the treatment of many skin diseases.Objective: To establish the effectiveness of oral zinc sulphate in the treatment of patchy alopecia areata Patients and Methods: Patients with alopecia areata who attended the Department of Dermatology-Baghdad Teaching Hospital was recruited into randomized, placebo-controlled, double-blind cross-over trial between February 2008 and September 2009. Patients were randomly allocated to receive either zinc sulphate 5mg /kg/day in three divided doses (Group A) or identical placebo capsules (Group B). Zinc sulphate and placebo capsules were given in a double-blind manner, following 3 months of starting the treatment, the patients crossed over, i.e. patients on zinc sulphate shifted to placebo and vice versa. Results:One hundred patients (60 males and 40 females) with patchy AA met the inclusion criteria and enrolled for the study. Sixty-seven patients completed the study, 41(61%) males and 26 (39%) females, their ages ranged from 1.6 -68 (22.031 ± 14.8505) years. Duration of the disease ranged from 1 -48 (14.4 ±14.8875) weeks. In group A, at the end of third month, complete hair re-growth with terminal hairs have been obtained in 22 (59.45%) patients. After shifting to placebo treatment the hair continued to grow without relapse and at the end of sixth month, the complete hair re-growth was occurred in 23(62.16%) patients. In group B, at the end of third month, complete hair re-growth had been obtained in 3 (10%) patients. While, after shifting to zinc sulphate the complete hair re-growth obtained in 20 (66.67%) patients. No important side effects were reported apart from mild gastric upset in 8 (11.9%) patients. Conclusion:Oral zinc sulphate is one of the effective treatment options for AA with low relapse rate after stopping of the treatment.

Background: BCG vaccine as an antigen has proved its effectiveness as an immunotherapy for viral warts. Tuberculin is an antigenic extract of M. tuberculosis capable of eliciting an immunological skin reaction. Objective: To assess the efficacy of tuberculin intralesional injection in the treatment of viral warts. Patients and Methods: This single ,blind, placebo controlled study was conducted at the Department of Dermatology, Baghdad Teaching Hospital, Baghdad, Iraq from March 2010 to July 2011.Forty-one patients with different types of viral warts were enrolled in this study; tuberculin test was done to patients prior to instillation of intralesional treatment. Then the patients treated by intralesional tuberculin in each lesion located on the right side of the body, and intralesional distilled water in each lesion located on the left side of to a maximum of 3 injections, at 2 weeks interval or until full resolution of these lesions. Patients were evaluated every 2 weeks to assess the regression of their lesions and to record any local and systemic adverse effects. The response to treatment was evaluated by decrease in size and reduction in number of warts. Scoring of response to treatment was as follow: 1) Responders: including patients who showed complete cure or those with good response (>50% reduction). 2) Non responders: including patients who showed minimal response (<50% reduction), or those with no improvement (stable disease and disease progression). The follow up period lasted up to 2 months after the last dose. Results: Thirty out of 41 patients had completed the study, of them 14 (46.66%) patients showed response of their lesions on the right side of the body that were treated with tuberculin; 15 patients showed no response, 1 patient showed minimal response, 7 patients showed good response and 7 patients showed complete cure (23.

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