Systemic sclerosis (SSc) is a rare systemic autoimmune disease, characterized by progressive cutaneous and internal organ fibrosis. Orofacial manifestations of systemic sclerosis are extremely disabling and treatment options are limited. In this study, we aimed to assess the safety and efficacy of autologous fat grafting in the face of patients with systemic sclerosis. We enrolled 16 SSc patients suffering from facial sclerosis and limited mouth opening capacity. Autologous fat injection ranging from 15 to 40 ml was administered per patient, based on their face morphology. The patients were evaluated at baseline and 3 months after fat injection. Evaluations included mouth opening capacity, mouth handicap in systemic sclerosis (MHISS), Rodnan skin sclerosis score, skin biophysical properties using a sensitive biometrologic device with the assessment of cutaneous resonance running time (CRRT), volumizing and aesthetic effects based on pre- and posttreatment photographs, possible side effects, and global patient satisfaction. Clinical assessment showed autologous fat transfer significantly improved mouth opening capacity and the MHISS and Rodnan score of patients with facial scleroderma (p value <.001). The aesthetic and/or functional results of fat injection were satisfying to about 80% of the patients. The changes in CRRT values were not significant. Our findings support the possible therapeutic role of autologous fat grafting in improving facial scleroderma both in aesthetic and in functional aspects. This trial is registered with IRCT20180209038677N1.

Acral warts are considered as prevalent reasons for dermatologic consultations and remain an important continuing challenge until now because there is no consensus about optimal therapeutic modality. This study investigated the efficacy of long-pulsed Nd: YAG laser therapy and cryotherapy in treatment of acral warts. Patients who underwent treatment with cryotherapy or long-pulsed Nd: YAG laser therapy for symmetrical and bilateral warts on the extremities (hand and foot) that is confirmed by an expert dermatologist from May 2016 until March 2018 were assessed for enrollment in our study. Laser and cryotherapy sessions were applied every 2 weeks for a maximum of six sessions. Patients followed up and evaluated 3 months after the last treatment. Data were analyzed by SPSS (v.21. IBM Inc. IL). The P value less than 0.05 was considered significant. From 60 enrolled patients, 134 lesions were treated using cryotherapy and 114 other lesions treated with laser beam. Thirty-four males (average age 26.85 ± 7.528 years) and 26 females (average age 26.73 ± 5.640 years) participated. Finally, it was a significant reduction in both lesion width (P = 0.000) and length (P = 0.000) after the sessions of cryotherapy. The width and length of lesions is reduced significantly after each session of laser therapy similarly (P = 0.000). Cryotherapy and long-pulsed Nd: YAG laser are effective on the reduction of both width and length of lesions. Clinically, the methods are not different in their ultimate effects.

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