Iranian Journal Of Dermatology
Volume:2 Issue: 1, 1998

Many investigators believe that immunotherapy will be the only selected treatment for leishmaniasis in the future. Leishmanization, vaccination or injection of stimulating mediators are among various forms of immunotherapy. In this pilot study, 5 volunteers with cutaneous leishmaniasis due to L.tropica were treated with 4 weekly intralesional injections of autologous buffy coat. Cytological and histopathological changes showed the importance of the infiltration of neutrophils and lymphocytes and cytoplasmic degenerative changes in macrophages containing the parasite and cellular necrosis in destroying the parasites. These were correlated with clinical improvement and reduction in size of erythema and induration.

Atopic dermatitis is one of the commonest childhood diseases. Large variations in the prevalence of the disease have been observed in different studies. This variation in the prevalence may be not only from genetic and environmental factors but also from methodology of estimating prevalence of the disease. In this study, Hanifin and UKWP criteria have been used in determining prevalence of the atopic dermatitis in school children. Firstly, the educational areas and schools were chosen by the systematic random sample. Then, the disease prevalence of the first and fifth grade students was determined by considering the parental questionnaires and physical examination. The prevalence of AD was 0.8% with Hanifin and 1.5% with UKWP criteria. The overall prevalence of dermatitis was 7.9%. Therefore, the prevalence of AD in a population varies based on the method used. It is very important for a researcher to use the standard methodology where it is possible or define the disease carefully. There is still some needs in determining more sensitive, specific and practical criteria for the diagnosis of AD.

Atopic dermatitis (AD) is a pruritic, relapsing, chronic disease that arises most commonly during infancy, childhood, or adolescence. It is clear that genetic factors are important in AD, a family history of AD, allergic rhinitis, and/or asthma and other “Atopic” phenomena being common in patient with AD. The two main pathogenetic characteristic of AD are: I) IgE-mediated antigen dependent “Specific” reactivity, and II) altered non-immunological “Non-specific” reactivity. Because there are no single distinguishing features of AD, the clinical diagnosis is based on a combination of historic and morphologic finding. In this article the immunological aspects in patients with AD will be briefly reviewed.

Hypersensitivity to anticonvulsant drugs have been reported many times. But anticonvulsant hypersensitivity syndrome (AHS) is a potentially fatal drug reaction with cutaneous and systemic reaction to the arene oxide-producing anticonvulsants, phenytoin, carbamazepine, and Phenobarbital sodium. The hall-mark features of this syndrome are: Fever, rash and lymphadenopathy. The epoxide hydrolase enzyme may be lacking or mutated in persons in whom AHS develops. The reaction may be genetically determined and familial occurrence of hypersensitivity was observed. The timely recognition of AHS is important, because accurate diagnosis avoids potentially fatal re-exposure and affects subsequent anticonvulsant treatment options. We report two cases of AHS and review the clinical and pathophysiologic features.

During 12 months survey on 33 patients with onychomycosis, only one of them showed infection due to scopulariopsis brevicalis. The case was a 38-year-old male with great toe nail lesion which was diagnosed as Trichophyton rubrum based on smear and culture. The patient was treated with 3 weekly pulses of itraconazole, 200mg twice daily during 3 months and showed marked clinical improvement. But 6 months after treatment the case relapsed and this time smear and culture showed infection due to Scopulariopsis brevicalis.