فهرست مطالب

Iranian Journal Of Dermatology
Volume:14 Issue: 2, Summer 2011

  • تاریخ انتشار: 1390/05/01
  • تعداد عناوین: 10
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  • Shamsi Meymandi Simin, Shamsi Meymandi Manzumeh, Zandi Soodabeh, Dabiri Shahriar, Aflatoonian Mahin Page 42
    Background
    Cutaneous leishmaniasis (CL) is a major world problem. Several types of treatment regimens have been suggested. Imiquimod demonstrated a leishmanicidal activity by increasing local cytokine production. The aim of this study was to determine the efficacy of topical 5% imiquimod with cryotherapy vs. intralesional meglumine antimoniate (MA) in treatment of anthroponotic (dry type) CL.
    Method
    This is a prospective, randomized, open trial study (from Iran) from September 2008 to September 2010, including 50 patients (25 patients in the combined imiquimod and cryotherapy group and 25 patients in the intralesional MA group). Patients were randomly assigned to receive combined cryotherapy biweekly with imiquimod three times per week or intralesional MA weekly until complete cure or up to 12 weeks, whichever earlier. The primary end point was clinical cure, defined as complete re-epitelialization of 100%, complete flattening of induration compared with baseline at weeks 2, 6, 12 and follow up were done 1, 2 and 3 months after complete cure.
    Results
    50 participants divided into 25 patients in group A and 25 patients in group B completed the study. Complete cure was 65.5% (16/24 patients) in group A and 83.3% (19/23 patients) in group B. No complication was detected in patients treated with MA. Pain and eczematous reaction were detected by 4 patients and local infection in 1 patient treated with imiquimod.
    Conclusion
    Although Meguimine antimoniate seems to be a more effective therapy for cutaneous leishmaniasis, this study revealed no significant difference in clinical response between combination of imiquimod and cryotherapy with intralesional MA in patients with cutaneous leishmaniasis in an endemic area of L. tropica.
  • Hamidizadeh Nasrin, Barikbin Behrooz, Yousefi Maryam, Sahraei Abbas, Khamesipour Ali, Younespour Shima, Sadeghitehrani Hanif Page 48
    Introduction
    Cutaneous Leishmaniasis (CL) is a parasitic disease caused by Leishmania species. Currently accessible treatments remain insufficient, and there is pressure to develop suitable and effectual options. In this study, we used different concentrations of podophyllin in vitro on leishmania parasites and then on leishmaniasis lesions in mice and compared their efficacy.
    Method
    We used podophyllin (14.3 µg/ml) in vitro against leishmania major parasites, then in experimental animals in different concentrations.
    Results
    Podophyllin (14.3 µg/ml) that used in vitro eradicated leishmania major parasites, but, in mice after four weeks was not effective and the diameter of the lesions increase with use of topical podophyllin.
    Conclusion
    Despite the lethal effect on leishmania in vitro, treatment with different doses of podophyllin could not accelerate the healing process of the leishmaniasis lesions of the experimental rats.
  • Achar Arun, Chakraborty Partha Pratim, Ghosh Tarapada, Naskar Biswanath, Guharay Tapobrata, Bisai Samiran Page 52
    Background
    Acyclovir, a specific and selective inhibitor of replication of herpesviridae family, has well documented efficacy for speedy rash healing and decreasing pain of herpes zoster. Limited oral bioavailability of acyclovir requires frequent dosing. Valacyclovir is rapidly and almost completely converted to acyclovir in vivo and gives three to fivefold increase in acyclovir bioavailability. The aim of this study was to assess the clinical efficacy, safety and tolerability of oral valacyclovir versus standard oral acyclovir in the treatment of herpes zoster.
    Methods
    A blind randomized prospective study was performed during May 2007 to August 2007 in Midnapore Medical College. Immunocompetent patients, aged ≥40yrs presenting with herpes zoster within 72 hours after onset of rash were enrolled and randomized to receive one of the following treatments: 1000 mg of valacyclovir thrice daily for 7 days or acyclovir 800 mg 5 times daily for 7 days. A total of 60 patients were included and randomized to receive either valacyclovir (n=30) or acyclovir (n=30) and they were evaluated at 8 days, 15 days and 29 days, respectively.
    Results
    A statistically significant reduction of skin lesion and zoster associated pain were noticed in valacyclovir compared to acyclovir group. However, presence of post herpetic neuralgia on the 29th day was less in acyclovir compared to valacyclovir group (70.0% vs. 83.3%, P>0.05). Only one patient on valacyclovir and two patients on acyclovir complained of nausea and mild abdominal pain.
    Conclusion
    We conclude that for the management of herpes zoster, valacyclovir might be superior to acyclovir in respect to reduction of skin lesions and pain.
  • Seirafi Hassan, Daneshpazhouh Maryam, Khezri Somayeh, Kiani Pardis, Sabouri Rad Sara, Moghadam Khadijeh, Khezri Farzaneh Page 58
    Background
    There is a large variety of therapeutic agents for the treatment of vitiligo, but it still remains a challenge. Narrow-band UVB phototherapy and 308-nm excimer laser have been shown to be safe and effective for the treatment of vitiligo. Topical calcipotriol has recently been reported to enhance the efficacy of phototherapy, especially 8-methoxypsoralen plus UVA (PUVA). The goal of this study was to evaluate whether the addition of topical calcipotriol enhances the efficacy of 308-nm excimer laser in the treatment of vitiligo.
    Methods
    The patients with symmetrical vitiliginous lesions received 308-nm excimer laser plus Calcipotriol ointment 0.005% (Daivonex®) as the intervention group and 308 nm excimer laser plus vaselin as the control group on the lesions of the right side. All patients in the two groups applied vaselin on the lesions of the left side. The evaluation of the patients was performed at baseline and at 12th week (the last laser session). SPSS version 15.0 package software was used for statistical analysis. P-values< 0.05 were accepted as statistically significant.
    Results
    Seventy out of 83 patients completed the study. The diameter of the right side lesions (308nm excimer laser + calcipotriol) changed from 27.21 cm2 to 15.82 cm2 in the intervention group and from 27.86 cm2 to 16.02 cm2 in the control group; This difference was not statistically significant (p-value=0.74).
    Conclusion
    Our findings showed that 308-nm excimer laser was effective and safe in the treatment of vitiligo, and that topical calcipotriol had no additive or synergistic effect.
  • Mapar Mohammad Ali, Roozbeh Amir Hosein, Mohammad Hasani Mohammad Bagher Page 64
    Bachground: Erythroderma is a rare but serious skin disorder that may result from different causes. There are many publications on this subject, with a different incidence rate for each etiology. The aim of this study was to determine the frequency of erythroderma, and describe the incidence of each etiologic cause in patients indigenous to Khuzestan.
    Methods
    In a retrospective study, we reviewed the files of patients diagnosed with erythroderma who were admitted to the dermatology ward of Sina Hospital, affiliated to Jondishapour Medical University of Ahvaz, southwest of Iran, in a period of 9 years from 1980 to 1989. We studied the clinical and pathology reports of patients and the final etiologic diagnosis.
    Results
    Total admission was 6210 patients and the total number of erythrodermic patients was 85. The frequency of erythroderma in our dermatology department was 1.37%. The most common causes in order of frequency were eczema (32.94%), drug reaction (23.52%), psoriasis (21/18%), and malignancy (8.23%). Previous history of skin disease was found in 44 of 85 patients (51.76%) and 28 (32.9%) of them were suffering from eczema. The mean age of our patients was 49.11 years and the male-female ratio was 1.6:1.
    Conclusion
    Erythroderma is a rare condition. The most common causes in our study were eczema and drug reactions; the high incidence of drug reactions in our patients compared to studies in other countries may be due to more administration of drugs in Iran, especially in Khuzestan.
  • Rahimi Hoda, Yousefi Maryam, Mirnezami Mina, Asadi-Kani Zahra Page 68
    A 24-year-old woman presented with asymptomatic hyperpigmented bilateral patches on her temples, eyelids and forehead since birth. Furthermore, the patient had a congenital grey patch, compatible with Mongolian spot, on her buttock. She had no vascular or other cutaneous lesion. Histopathologic examination revealed bipolar dendritic melanocytes dispersed in a ribbon-like pattern between the collagen fibers and around the neurovascular bundles of the dermis. As far as we know, this is the first case of bilateral “congenital” nevus of Ota in association with a Mongolian spot reported in a patient.
  • Ramezanpour Afshar, Feizi Abdolamir Page 71
    Bullous pemphigoid (BP) is an autoimmune bullous disorder with urticarial pruritic papules and plaques and tense bullae in flexural surfaces of body. The localized form of the disease is a rare variant which can be triggered by different stimuli. Hereunder, we report a patient with the local type involving genitalia without any triggering factors.
  • Ozturk Perihan Page 73
    Morphea is a localized form of scleroderma characterized by sclerotic plaques limited to the skin. Although its cause is unknown, genetic, infectious and autoimmune mechanisms have been suggessed in the pathogenesis of the morphea. It is more common among childen and young women. Although the prognosis is generally good, it sometimes causes significant morbidity. Morphea has five subtypes as plaque, generalized, bullosa, deep and linear. Unilateral forms of generalized morphea have rarely been reported in the literature. Our case has been presented because it is very rarely seen.
  • Layegh Pouran, Zabolinejad Nona, Zabolinejad Naghmeh, Momenzadeh Akram Page 76
    case: A 3.5-year-old girl presented with a 1-year history of a slow growing pigmented lesion on the dorsal aspect of her right foot. Physical examination revealed the presence of a pigmented patch with color distribution from pink to tan to dark brown, relatively well circumscribed and approximately 1.5 × 2cm with irregular borders, and especially a single dark central papule superimposed in the middle of it (Figure 1). The lesion had a soft consistency and the child did not have any other symptoms. During the last year, it had increased in dimensions and thickness. The remainder of her physical examination was insignificant. Also, there was no positive family history of a particular disease or any history of trauma or drug usage. A 3 mm punch biopsy was obtained from the central dark papule and the specimen was sent for histopathologic examination
  • Wiwanitkit Viroj Page 79