Background. Acne vulgaris is an inflammatory disease of pilosebaceous units which may cause permanent dyspigmentation and/or scars if not treated. Isotretinoin is recommended in the treatment of recalcitrant or severe acne, but it is associated with common adverse effects that frequently result in patients incompliance and discontinuation of the drug. The present study was designed to assess the efficacy of oral omega-3 in decreasing the adverse effects of isotretinoin. Materials and Methods. In this randomized double-blind clinical trial, a total of 118 patients with moderate or severe acne were randomly divided into two (case and control) groups. The control group was treated with isotretinoin 0.5 mg/kg, and the case group was treated with the same dose of isotretinoin combined with oral omega-3 (1 g/day). The treatment was lasted for 16 weeks and mucocutaneous side effects of isotretinoin were recorded and compared between the two groups in weeks 4, 8, 12, and 16. Results. Cheilitis (at weeks 4, 8, and 12), xerosis, dryness of nose at all weeks, and dryness of eyes (at week 4) were less frequent in the group that received isotretinoin combined with oral omega-3 compared to the group that received isotretinoin alone. Conclusion. Administration of oral omega-3 in acne patients who are receiving isotretinoin decreases the mucocutaneous side effects of isotretinoin. This trial is registered with  IRCT201306238241N2.

Background. More than 90% of human immunodeficiency virus- (HIV-) infected patients show at least one mucocutaneous manifestation during the course of their disease. The frequency, pattern, and associated factors of these complications vary among different populations. Objective. This study was planned to evaluate the frequency of cutaneous presentations in HIV-infected patients and their association with the count of CD4 cells. Methods. A cross-sectional study was conducted on eighty-four HIV-positive patients, who attended the Behavior Consultation Center of Arak University of Medical Sciences. All subjects had a complete physical examination by an expert dermatologist. Further diagnostic procedures were performed, if necessary. Counts of CD4 were determined using flow cytometry. Results. From 84 patients who enrolled in this study, 95.2% manifested at least one type of mucocutaneous lesions. The most common presentation was xerosis, followed by seborrheic dermatitis, herpes simplex, and oral candidiasis. Oral candidiasis and furuncle were significantly associated with decrease in CD4 cell counts. Conclusions. Cutaneous manifestations are common in HIV-positive patients, some of which (oral candidiasis and furuncle) could be applicable as useful clinical indicators to predict the immune status of the patients. Therefore, regular skin examinations are recommended as routine HIV-infected patients’ healthcare programs.

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The aim of the present study was to investigate the effect of silymarin (Livergol) on liver enzymes in patients taking isotretinoin (Roaccutane). In this double‐blind clinical trial, 74 patients with acne and taking isotretinoin were randomly assigned into intervention (N = 37) and control (N = 37) groups. The intervention group received a 140 mg Livergol capsule per day for 30 days. The control group received a starch‐containing capsule as a placebo once a day for 30 days. Liver enzyme levels were measured before and after the intervention. The data were analyzed using chi‐square test, Independent t test, paired sample t test and analysis of covariance (ANCOVA). The results showed no statistically significant difference between the intervention and control groups at the beginning of study in levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP) (p > .05). At the end of the study, a statistically significant difference was observed between the two groups in levels of AST and ALT (p < .05). Livergol prevented liver enzymes from increasing, so it can be used as an effective, low‐cost, and low‐complication treatment for the problem of increased levels of liver enzymes following the use of isotretinoin.

Melasma is an acquired hyperpigmentation disorder. Its main characteristics are bilateral irregular brown macules and patches on sun-exposed areas occurring most commonly on the face. 1 Its exact pathogenesis is not clear. However, some etiologic factors have been suggested as the major cause, such as ultraviolet radiation, hormonal alterations like those evident during pregnancy, use of oral contraceptives and other steroids, thyroid dysfunction, phototoxic drugs, ovarian tumors, use of cosmetics and photosensitizing drugs, and stressful events. 2,3 Recent investigations have demonstrated that enhanced free oxygen radicals and reactive oxygen species (ROS) have a role in the pathogenesis of many dermatoses such as lichen planus, alopecia areata, atopic dermatitis, pemphigus vulgaris, psoriasis, and vitiligo. [4][5][6][7][8] Antioxidants, either intracellular or extracellular, can inactivate the damage caused by free radicals. The intracellular antioxidants are mainly composed of free radical scavenging enzymes such as glutathione peroxidase (GPX), glutathione-S-transferase, superoxide dismutase (SOD), cytochrome oxidase, glutathione reductase, and catalase. 7,9 Two major extracellular antioxidants are bilirubin (Bil) and uric acid (UA).