Iranian Journal of Dermatology
Year:2000 | Volume:4 | Issue:1 (13)|Papers Count:11

Background: Isfahan is one of the major foci of cutaneous leishmaniasis in Iran. According to the epidemioligical studies, both urban and rural forms have been reported in Isfahan. Accurate identification and characterization of Leishmania is essential for the control of the disease. Several different molecular techniques for Leishmania identification are developed including use of monoclonal antibodies.Objective: In the present study specific monoclonal antibodies against L.major (T1, T9), L.tropica (T10, T11) and L.Donovani (D2) were used to identify and characterize the Leishmania parasites isolated from patients with cutaneous leishmaniasis in Isfahan. Patients & Methods: Samples were obtained from borders of lesions suspicious of leishmaniasis in 298 patients, stained with Giemsa and cultured in NNN and RPMI 1640 media supplemented with %10 fetal colf serum. The promastigotes were then purified, counted and used as antigen in ELISA test. Results: Mass production of promastigotes was successful in 120 cases. L.major was identified as the causative agent of the disease in 100 cases and L.tropica in 8 patients. In 12 cases the results were inconclusive as the antigens reacted with either 2 or 3 specific monoclonal antibodies. Conclusion: L.major is the most common cause of leishmaniasis in Isfahan.      

Background: Bullous pemphigoid (BP) is the prototype of subepidermal autoimmune bullous dermatoses (SABDs). Direct immunofluorescence on salt split skin substrate (DIF-SS) is one of the methods used to differentiate this group of dermatoses. Objective: We conducted this study in order to delineate the results of DIF-SS in SABD patients. Patients & Methods: Seventeen patients with a BP - like clinical picture referred to Razi Hospital In 1378, who had linear immunodeposits along basement membrane zone in direct immunofluorescence, were studied. Considering only histopathologic and clinical data, a final diagnosis was established for each patient. DIF-SS was performed on perilesional skin sample of patients. DIF-SS and histopathology results and the final diagnosis were recorded and compared for each patient. Results: In DIF-SS, eleven patients (65%) had combined (epidermal & dermal), two patients (12%) had epidermal and four patients (23%) had dermal pattern. The final diagnoses were BP in ten patients and epidermolysis bullosa acquisita (EBA) in two others. We were unable to differentiate BP from EBA in two patients. In ten patients who were diagnosed finally as BP, nine patients (90%) had combined pattern and only one case (10%) showed epidermal staining in DIF-SS. Conclusion: Surprisingly, in contrast to the results of the previous studies on pemphigoid patients using either IIF-SS or DIF-SS in which the epidermal pattern had been reported to be much more common than the combined pattern, the combined pattern was nine times more frequent than the epidermal pattern in this study. Perhaps, the difference in target antigens in our patients may be the underlying reason for the difference in our results.      

Background: Living in colonies and public places may cause increase in infectious diseases. Prisons are places with high density population. Prisoners don't persist on moral and social dictim bases and usually have low educational and cultural levels. So they are at high risk of several diseases including, contagious skin diseases. Objective: As contagious skin diseases are important for social health care, this study was done to determine the prevalence of this diseases in a prison in Kerman. Patients & Methods: This cross-sectional Study was done on 3525 prisoners, comprising about half of the prisoners, in the Central Prison of Kerman. Results: 2851 of the case were male and 674 were female. The mean age of male cases was 36.05 +/-11.3 years and for female were 35.5 +/-14.0 years. Among all prisoners 4.6% had pediculosis. 1.2% had scabies and 3.7% had tinea pedis. Among the prisoners 55.8% were addict and 73.6% were smokers. There were, no meaningful relationship between addiction or smoking and the diseases (p= 0.576 and p=0.660). Conclusion: Contagious skin diseases are common in prisons. Health and security authorities should plan for a community free of drugs, prisons and prisoners.      

Background: Pityriasis rubra pilaris (PRP) is a rare skin disease characterized by follicular hyperkeratosis, perifollicular erythema with islands of normal skin scattered over the sheets of erythroderma, palmoplantar hyperkeratosis and pityriasis capitis with unknown aetiology. Objective: This study has been done in order to determine the demographics, clinical and therapeutic aspects of PRP patients who were admitted to the dermatology ward of Sina Hospital is Hamadan in 1991-1999. Patients & Methods: This was a case series study which the essential information was gathered by referring to the patients files. Then the obtained information was analyzed by SPSS software. Results: As PRP is a rare diseases, only 8 patients were identified. Five of them (61.5%) were men and 3 (37.5%) were women. The highest age of PRP patients was 66 years and the lowest was seven. The mean age of the patients was 32+/- 19.4 years. None of the patients mentioned a positive family history. Six (75%) of the PRP patients suffered from Type I and two patients (25%) from Type III. Five patients (62.5%) were completely, cured, all treated with retinoids, and three patients (37.5%) were partially cured, all treated with methotrexate. There was no case showing failure of the treatment. Conclusion: In this study the number of men was more than women. All of our patients suffered from Type 1 adult onset (classic) or Type III juvenile onset. Retinoids showed more efficacy than methotrexate in the treatment of PRP.      

Background: Urticaria is very common and most of the current treatments are only partially successful. Objective: As the efficacy of acupuncture in the treatment of chronic urticaria has not been studied in Iran, we decided to do this study. Patients & Methods: In a randomized, controlled, double-blind clinical trial, 40 patients with chronic urticaria referred to skin clinics of Isfahan University in 1378 were studied, The patients had idiopathic urticaria, resistant to conventional treatment, and had not received any medication in the last month. We randomly divided them in two equal groups. One group was treated with acupuncture and the other with placebo for 3 weeks. Data entry and analysis was performed by Systat and T- test was used for data analysis. Results: The mean numbers of the episodes of urticaria in 3 weeks were 4.81 times in the control group and 3.62 times in the acupuncture group (P/value = 0.01). The mean duration of urticarial episodes in the third week was 5.08 hours in the control group and in received acupuncture group was 2.37 hours in the acupuncture group (P value=0.03). Conclusion: Acupuncture induced remission of chronic urticaria in the majority of the patients. Its efficacy was greatest in the third week of treatment.      

Dapsone first came into medicine as an antibacterial agent but was found to be less effective than other sulfonamides. Likewise its activity against tuberculosis was disappointing. Nevertheless, it has been the main stay in the treatment of leprosy. It also has some action against malaria and other parasites. Nowadays, after leprosy, dapsone has proved as a valuable drug in the treatment of a wide range of mainly uncommon and rare dermatoses. In this article, we present a comprehensive review of the mechanisms of action, pharmacokinetics, uses, adverse reactions and management of side effects of dapsone.    

In this report, a 32 year-old patient is reported who was suffering from recurrent genital herpes for 3 years and her disease could not be controlled with conventional treatment methods. But, application of Imiquimod 5% cream, 3 times a week for 3 months, proved very effective with no recurrence for up to 7 months. Since recurrent genital herpes is the result of some immunologic dysfunctions caused by, herpes virus, it appears that immunoregulation of the region can diminish or reduce the disease recurrence. Imiquimod is a regulator of immune system with potency of anti-tumor and anti-viral activities. It is a stimulator for IFN- and IL-1 production in blood system and human keratinocytes after topical application. On the other hand, it increases mRNA of IL-2, IL-6 and IL-8. Therefore, it is effective for curing resistant genital warts. However, this disease may also regress spontaneously. Therefore, for a final and more certain conclusion, it is essential to do further studies.      

Neurofibroma is a tumor composed of a complex proliferation of neuromesenchymal tissue (schwann cells, perineural cells, fibroblasts, and mast cells). We report a 45- year-old female who had a slow growing, large, soft, pedunculated mass on her left lateral neck. A skin biopsy confirmed the diagnosis of nevrofibroma.