ABSTRACT:BACKGROUND:Dermabrasion is an abrasive process used to remove the epidermis and superficial dermis to treat a variety of skin conditions.OBJECTIVE:To evaluate sandpaper as a tool for dermabrasion for the treatment of acne scar and amateur tattoo.PATIENTS AND METHODS:This is an open labeled therapeutic trial. It was conducted at the outpatient department of Dermatology and Venereology - Baghdad Teaching Hospital, during the period between January 2003 and December 2004.Ten patients (seven males and 3 females) were enrolled in this work. Their ages ranged from 20-34 years with the a mean ± SD of 26.80 ± 4.34 years. Five with acne scars on their faces and 5 with amateur tattoos in the upper extremities.. From each patient history was taken and physical examination was performed. Pre-operative medications and instructions were given to each patient. The procedure was done under local anesthesia. Postoperatively all patients were instructed to use steroid-antibiotic ointment and hydroquinon-tretinoin thereafter. Follow up was done after 1weak, 1month, and 3 months. Repeated sessions may be needed 1 month apart.Acne scars: Lesions were assessed for correction of contour (unchanged, partially changed, or completely changed), and for complications that might follow.Amateur tattoos: Lesions were assessed for percentage of pigments removal (70%, 80%, 90%, and 100%), and for complications that might follow.RESULTS:Ten patients completed the study.Acne scar group: Three patients achieved partial change of contour after 2 sessions, while complete change of contour was noticed in 2 patients after 4, and 6 sessions respectively. The procedure resulted in very fine, less noticeable scar with smooth contour of the skin which was acceptable in all patients.Amateur tattoos group: Complete removal of pigments was achieved in one patient, more than 90% in 3 patients, and more than 80% in 1 patient.No significant complications were seen apart from mild erythema and mild infection in one patient with amateur tattoo. Temporary post inflammatory hypopigmentation in two patients with tattoo. Three patients had mild scar after removal of tattoo.CONCLUSION:Sandpaper dermabrasion is an effective mode of treatment for acne scar and amateur tattoo. It is safe in dark skinned people.

dermabrasion --- acne scars --- tattoo

This study was designed to determine the percentage and the main causative agent causing acne among Iraqi patients aged between 15 to 40 years and complaining from different stages of acne in Baghdad. Results showed that the percentage of infection was 47 % the main causative agents were Staphylococcus spp. including (S.aureus , S. epidermedis) and other than Staphylococcus which includes(Spedomonas , E.coli , Klebsiella and ά-hemolytic streptococci ) .Regarding the age factor ,results showed that the highest infection rate was among the age group (15-20 years ) and (20 -25 years ) (64.89%)and (15.95%)respectively while the lowest was in (25 – 30 years ) and (30 -40 years) (12.76%) and( 6.38) respectively . All bacterial strains isolated from patient were submitted to sensitivity test, results showed various reactions towards different types of antibiotics used in the study.

صممت هذه الدراسة لتحديد نسبة الاصابة وألاحياء المجهرية المسببة لمرض حب الشباب عند المرضىمن عمر 15-40 سنة والذين يعانون من مستويات مختلفة من الاصابة في مدينة بغداد , أظهرت النتائج ان نسبة الإصابة 64.19 % من مجموع المرضى المشمولين بالدراسة وقد تم تحديد نوع الاحياء المجهرية المسببة للمرض عن طريق زرع الدم فوجد انها, بالدرجة الاساس الى عائلة البكتريا المعوية والتي شملت تعود Enterobacter, Klebsiella , E.coli, Pseudomonas) وتم ايضا عزل أنواع بكتيرية لا تعود الى العائلة المعوية مثل Streptococcus pneumonia , Staphylococcus aureus , Staphylococcus epidermidis , _ hemolytic streptococci. بالنسبة الى عامل العمر أظهرت النتائج اان الفئة العمرية (15-20 سنة ) شهر كانت ألاكثر عرضة للأصابة بنسبة بلغت 64,89 % تلتها الفئة العمرية الاكبر قليلا (20-25 سنة ) بنسبة بلغت 15,95% فيما كانت الفئة العمرية (30-40 سنة ) ألاقل عرضة للأصابة بنسبة بلغت 6,38% كل السلالات البكتيرية المعزولة تم أخضاعها للأختبار الحساسية لتقدير مدى أستجابتها لأنواع مختلفة من مضادات الحياة وقد أظهرت النتائج أن كل سلالة استجابت بشكل مختلف عن غيرها من السلالات وتم الحصول على مدى واسع من ألاستجابات للأنواع المستعملة في هذه الدراسة .

Acne --- حب الشباب

ABSTRACT:BACKGROUND:Acne vulgaris(AV)is chronic inflammatory disease of pilosebaceous unit of young people. Patients with acne with or with out scarring might differ in regard to their immunological background from those free from acne.OBJECTIVES:To evaluate the problem of facial AV especially patients with scarring and to determine the frequency of associated skin diseases and to be compared with acne free control.METHODS:A cross sectional randomized controlled epidemiological study was conducted from Oct.2005-Oct. 2006.Three hundred students from Basra University; 132 (44%) males and 168 (56%) females were enrolled, their ages ranged from 18-25 (20.9±1.8) years. They were divided into: Group A those free from acne (98 individuals),Group B with non scarring facial AV (96 patients), and Group C with scarring facial AV (106 patients). History and examination were done for their acne, scarring acne and associated skin diseases. Allen and Smith grading system for AV were used, and a new invented multiparametric scoring system for scarring acne was applied.RESULTS:AV was in 98(73.24%) males and 104 (61.9%) females. Scarring was 54 (50.95%) males and 52 (49.05%) females. Greasy skin was the most common type among Group B 67 (69.8%) versus 39 (39.8%) among Group A(P=0.000029) and was more common among Group C 84(79.2%) (P=0.00000001).Family history of AV was nearly similar in A and B Groups 55(57.29%) and 56 (52.83%) respectively, while in Group A was 39 (39.79%). Family history of scarring acne was in 35(33.02 %) of Group C, 16 (16.66 %) of Group B, and 3 (3.1%) in Group A; (P=0.00000017). The age of onset was similar in A and B Groups between 15-16 years. Majority of patients in Group B had non inflammatory type or mild inflammatory (papular) 65 (67.8%) patients, most of case were mild and moderate 86 (89.58%) patients, while high percent in Group C had inflammatory type 95 (89.62%), and more than half of them had severe and very severe types upon grading 56 (52.8%). The aggravating factors were similar in A and B Groups with stress and hot weather being the leading aggravating factors. Squeezing and digging habit was in 53 (50%) in Group C versus 23 (23.95%) in Group B (P=0.00024). In most cases of scarring acne, scarring was mild and moderate 85 (80.19%), and the most common type scars was the flat hyperpigmented [50 (47.17%) and 66 (62.26%) respectively].The most common effect of scarring acne on psyche was mild discomfort and mild dysmorphophobia 75 (70.75%).Associated skin diseases were more common among Group A 31 (31. 63%) than among Group B 22 (22.91%) and least common among Group C 14 (13.20%) (P=0.0067) and they were mainly dermatitis and skin infections.CONCLUSION:AV might reflect the immunological status especially among patients with scarring. The frequency of skin diseases was much less among patients with scarring acne

acne --- skin diseases --- immunity --- scoring system for scarring acne.

Recently on the dermatological fields, the serum levels and the roles of Zn, Cu and Mg have been studied especially in acne vulgaris, but the results were controversial. The aim of the present study is to investigate a relationship between the severity of acne and the serum levels of zinc (Zn), copper (Cu) and magnesium (Mg) and to demonstrate the status of serum levels of zinc, copper, and magnesium in Iraqi male patients with acne vulgaris and to compare it with those of healthy controls.This case controlled study was conducted in the Department of Dermatology and Venerology and in the Poisoning Consultation Center of Baghdad Teaching Hospital between May 2009 to January 2010. Forty- five male patients with acne vulgaris, their ages ranged from 18-30 (21.82±3.77) years and 45 healthy male subjects as controls, their ages ranged from 18-30 (22.18±3.85) years were included in this study. Patients were subdivided into three groups according to the severity of their acne; mild acne group (n=15), moderate (n=15) and severe acne group (n=15). Investigations included serum estimation of Zn, Cu and Mg in both patient and control groups.The data obtained from this study showed that the (mean±SD) values of serum levels of Zn was significantly decreased in severe acne group compared with controls, mild and moderate type of acne group (P< 0.05). Serum Mg concentration was significantly lower in severe acne group compared with mild and moderate acne group (P< 0.05). With regard to serum Cu, there were no significant differences among groups of patients with acne vulgaris.This study revealed a significant association between serum levels of either Zn or Mg with the severity of acne.

أن مستوى وأھمیة الخارصین والنحاس والمغنیسیوم في مصول المرضى المصابین بالأمراض الجلدیة, وخاصة مرض حبالشباب تم دراستھ ولكن النتائج كانت متباینة.أن ھدف ھذه الدراسة ھو تقییم مستوى العناصر المعدنیة(الخارصین, النحاس, المغنیسیوم)في مصول الذكور العراقیین المصابین بمرض حب الشباب والذكور الأصحاء ودراسة العلاقة بین مستوى ھذه العناصر وشدة حبالشباب.لقد تم أجراء ھذه الدراسة في قسم الأمراض الجلدیة و التناسلیة والمركز الاستشاري للسموم في مستشفى بغداد التعلیمي للفترة٤٥ ذكر مصاب بحب الشباب تتراوح أعمارھم بین ( ١8 30 سنة), المعدل . ٢ ولغایة كانون الثاني ٢٠١٠ ٠٠ من أیار ٩٣,٧٧ ) سنة و ٤٥ ذكر صحیح(مجموعة السیطرة) بنفس الفئة العمریة ( 18 30 – ٢ +الانحراف المعیاري لأعمارھم ھو ( ١,٨٢٣,٨٥ سنة) تم شمولھم في ھذه الدراسة. أن مجموعة المرضى تم تقسیمھا - سنة), المعدل +الانحراف المعیاري لأعمارھم ھو( ٢٢,18إلى ثلاث فئات حسب شدة حب الشباب: فئة حب الشباب النوع البسیط وعددھم ١٥ , فئة حب الشباب النوع المتوسط وعددھم ١٥ , فئةحب الشباب النوع الشدید وعددھم ١٣ . الفحوص تشمل تحدید مستوى الخارصین, النحاس, والمغنیسیوم ي في مصول الأشخاصالأصحاء والمرضى. أظھرت نتائج الدراسة عدم وجود فرق إحصائي معنوي في مستوى العناصر(الخارصین, النحاس, المغنیسیوم)بین مجموعتي المرضى والأصحاء. لكن, مستوى الخارصین قد أنخفض بمستوى إحصائي معنوي لدى فئة حب الشباب النوع الشدیدكذلك أظھرت الدراسة انخفاض إحصائي .( P< مقارنة مع مجموعة الأصحاء ومجموعة فئة حب الشباب النوع البسیط( 0.05وفي ما یخص .(P< معنوي في مستوى المغنیسیوم لدى فئة حب الشباب النوع الشدید مقارنة مع فئة حب الشباب النوع البسیط( 0.05مستوى النحاس , لایوجد فرق معنوي بین فئات حب الشباب . یمكن الاستنتاج من ھذه الدراسة بأن ھناك علاقة معنویة بین مستوى كلمن الخارصین والمغنیسیوم في مصول المرضى المصابین بحب الشباب مع شدة المرض.

Acne vulgaris --- zinc --- copper --- magnesium

ABSTRACT:BACKGROUND:Acne is a multifactorial disease with multiple pathogenic factors, hence combination therapies are needed. Combination therapies using agents with complementary mechanisms of action increasingly are recognized as an effective strategy for treating acne.OBJECTIVE:The rationale of utilizing topical retinoids with azithromycin in treating facial acne vulgaris will be highlighted, particularly in relation to improvement.METHODS:A randomized, clinical trial was carried out at the outpatient Department of Dermatology and Venereology, Baghdad Teaching Hospital between April 2007 and August 2008.A total of 48 patients with moderate to severe papulopustular acne vulgaris were allocated to two groups, azithromycin and azithromycin plus isotretinoin gel, both groups received Azithromycin for two months. Azithromycin 250 mg was prescribed every day for one month and every other day for the following month. Patients in second group were instructed to apply Isotretinoin gel 0.05% once daily over a 3 months treatment period. The clinical assessment was done by counting the number of inflammatory lesions in three occasions: baseline, two months and three months.RESULT:After two months, both groups showed a statistically significant difference from the baseline in reducing inflammatory lesions and improving acne. Adding topical isotretinoin gel produced a higher percentage of reduction in their lesional counts, but differences between the two groups were not statistically significant. After three months, regression in the percentage of reduction of the lesional count from 57.7% to 32.4% in the first group. While in the second group the reduction was maintain in 69.8%.CONCLUSION:Adding topical 0.05 per cent isotretinoin gel to oral azithromycin enhances and maintains the rate of improvement of facial acne vulgaris.

acne vulgaris --- azithromycin --- isotretinoin gel