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Cutaneous leishmaniasis (CL) is a parasitic disease, which is hyperendemic in Isfahan, usually caused by L.major and L.tropica. Herein we report a patient with post-mastectomy lymphedema on right upper limb accompanying with the lesions of cutaneous leishmaniasis on the right and left forearms. Following radiotherapy, the lesions on the limb with lymphedema were disseminated. But the lesions on left side showed no change. This finding may be the result of immune disorder due lymphedema and radiotherapy.

Palmoplantar eczema is a common clinical problem involving 2% of the population. There are many treatment modalities for palmoplantar eczema, each with specific local and systemic side effects.

To evaluate methoxsalen bath in the treatment of palmoplantar eczema.

In a randomized, double-blind, placebo controlled clinical trial, 60 patients with palmoplantar eczema referred to skin clinics of Isfahan University in 1376-78 were divided in two equal groups. One group received PUVA-bath and the other one received placebo-bath. Hands or feet or both were soaked for 15 minutes in warm water containing 0.0001% 8-methoxypsoralen or placebo. Then the skin was exposed to sun for 30 minutes. This was performed 4 times a week up to a total of 25 treatments.

Excellent or good therapeutic effects were achieved in 86.7% of PUVA bath group but only in 6.7% of placebo (P=0). No phototoxic reactions were observed.

PUVA-bath is a safe, cheap, effective and comfortable method in the management of palmoplantar eczema.

Considering the prevalence of skin lesions and drug eruptions in intensive care units and the absence of research about it, we decided to study skin lesions of patients admitted in intensive care unit.

In this descriptive study all patients admitted in intensive care units of Al-Zahra Hospital in Isfahan in 1376-78 were observed and examined by a resident in Dermatology. Skin biopsy and bacterial and fungal smears were done in selected cases. Data were collected, entered in SPSS and analyzed by ANOVA, Chi-square and Discriminant methods.

197 of a total of 406 patients had skin lesions. Skin lesions were most frequent in the age range of 21-40 years (37%) and least frequent in age groups under 10 years (2.5%) and over 80 years (3%). 116 of patients (58.9%) were male and 81 (41.1%) were female. The most common skin lesions were hemorrhagic cutaneous lesions (23.4%) and steroid acne (22.8%). The rarest was toxic epidermal necrolysis (0.5%). The most common causes of hospitalization were intracranial and subarachnoid hemorrhage (11.2% each).

Skin lesions are common in patients admitted in ICUs. Frequent and continuous examinations of these patients are recommended in order to prevent and treat them promptly.

Cutaneous leishmaniasis may present as unusual manifestations in renal transplant patients receiving immunosuppressive therapy. This misleading presentation, may delay the diagnosis and treatment. Moreover special caution must be taken in renal transplant recipients because of possible interactions between antimony compounds and cyclosporine metabolites. We report a 45-year old man with 5 years history of kidney transplantation receiving immunosuppressive drugs who had an extensive, painful ulcer on the left and upper side of his chest. Laboratory evaluation confirmed the diagnosis of cutaneous leishmaniasis. The patient was treated successfully with a 3-week period of intramuscular Glucantime.

A 24-year old female patient with the history of pressure ulcers in distal extremities resulted in severe deformity will be reported. Her disease started when she was 9 years old and a similar history was found in her brother. In physical examination, pain and temperature sensations were impaired in distal extremities. Nerve conduction velocity showed impaired sensory and normal motor responses confirming the diagnosis of hereditary sensory-autonomic neuropathy.

A 9-year old boy had severe muscle weakness and typical skin rash and EMG with diagnosis of dermatomyositis associated with erythrodermia with islands of normal skin and palmoplantar hyperkeratosis, which was reported. As PRP in skin biopsy. Association dermatomyositis with PRP is very rare.

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.