Efficacy of Systemic Treatment for Leishmania tropica Cutaneous Leishmaniasis.

The effectiveness of systemic treatment for Leishmania tropica cutaneous leishmaniasis remains unclear. The purpose of the study is to evaluate the efficacy and safety of systemic treatments for L. tropica cutaneous leishmaniasis. This retrospective study was performed in 114 patients. Systemic treatments included liposomal amphotericin B and sodium stibogluconate. All patients underwent systemic treatment for L. tropica cutaneous leishmaniasis. Favourable treatment responses were recorded in 72.5% and 70.2% of the patients in the liposomal amphotericin B and sodium stibogluconate groups, respectively; 25.3% and 46% of those in the liposomal amphotericin B and sodium stibogluconate groups respectively, experienced at least one adverse effect. Lesions in cartilaginous areas were associated with higher treatment failure. Prior topical or systemic treatment increased the chance of future systemic treatment success. Liposomal amphotericin B was associated with a shorter intravenous treatment duration and better safety profile. Thus, liposomal amphotericin B is the treatment of choice for L. tropica cutaneous leishmaniasis.

Prevalence of tinea pedis in psoriasis, compared to atopic dermatitis and normal controls--a prospective study.

There are discrepancies in the literature regarding the prevalence of tinea pedis in psoriasis. The aim of this investigation was to conduct a cross-sectional study of the prevalence of tinea pedis in psoriasis compared to atopic dermatitis patients and normal controls. We enrolled 232 psoriatic patients, 190 atopic dermatitis patients and 202 normal controls, between the years 2010 and 2013. The prevalence of tinea pedis was 13.8% in psoriasis patients, not significantly different from that in atopic dermatitis patients 8.4% (P = 0.092)), but significantly higher than in normal controls 7.4% (P = 0.043). Both gender and age affected the prevalence of tinea pedis in psoriasis and normal controls, while only age affected the prevalence of tinea pedis in atopic dermatitis. Regarding gender, there was higher prevalence of tinea pedis in men: 19.1% (P = 0.019) in psoriasis and 12.1% (P = 0.013) in normal controls. Age affected the prevalence of tinea pedis in normal controls (P < 0.001), psoriasis patients (P = 0.001) and atopic dermatitis patients (P = 0.001), with higher prevalence with increasing age. Trichophyton rubrum was the most common species in psoriasis (71.9%), atopic dermatitis (75.0%) and normal controls (73.3%). Our study found a relatively high prevalence of tinea pedis among psoriasis patients.

Phototherapy decreases red blood cell deformability in patients with psoriasis.

BACKGROUND: Alternations in erythrocyte deformability (ED), namley, the ability of erythrocytes to change shape under flow in the microcirculation, can contribute to cardiovascular diseases. Psoriasis, a systemic inflammatory skin disorder, is associated with an increased cardiovascular risk. The effect of psoriasis and psoriasis treatment on ED was only scarcely evaluated. OBJECTIVE: To evaluate ED changes in psoriasis patients following narrow band-ultraviolet B (NB-UVB) treatment. METHODS: Erythrocyte deformability was determined using a computerized cell flow properties analyzer in 9 patients with psoriasis before and after a course of Goeckerman regimen. ED was quantified using two parameters: average elongation ratio (AER) in the cell population, and the fraction of low deformable cells (% LDFC). RESULTS: All 9 patients showed decreased ED (i.e. impaired deformability) following NB-UVB treatment. There was a significant (p = 0.003) decrease in AER after treatment (AER±SD; 1.58±0.06) compared to the starting values (1.69±0.1). Additionally, there was a significant (p = 0.002) increase in the fraction of low deformable cells (% LDFC±SD; 60.00±9.05) compared to their fraction before treatment (34.86±11.44). CONCLUSIONS: The decreased ED observed following phototherapy could have clinical influences on psoriasis patients, and may partially explain why phototherapy does not decrease the cardiovascular risk in psoriasis compared to other treatments.

Excoriation (skin picking) disorder in Israeli University students: prevalence and associated mental health correlates.

OBJECTIVE: The purpose of the study was to examine the prevalence of excoriation (skin picking) disorder (SPD) and associated physical and mental health correlates in a sample of Israeli university students. METHODS: Five thousand Israeli students were given questionnaires screening for SPD, depression, obsessive-compulsive disorder, body dysmorphic disorder and disruptive, impulse control and conduct disorders. A total of 2176 participants (43.6%) responded and were included in the analysis. Mean age was 25.1 ± 4.8 (range 17-60) years, and 64.3% were female. RESULTS: The proportion of students who were screened positive for SPD was 3.03%, with a nearly equal gender distribution (3.0% in females and 3.1% in males). There was a trend toward significantly higher rates of psychiatric problems such as generalized anxiety, compulsive sexual behavior and eating disorders in these students. Within the group of students screening positive for SPD, alcohol intake was higher in male students, while female students perceived themselves as less attractive. No association was found between depression and SPD. A high prevalence rate of skin picking was found within first-degree family members of the participants screening positive for SPD. CONCLUSIONS: Clinicians and public health officials within university settings should screen for SPD as it is common and associated with psychosocial dysfunction.

Pemphigus vulgaris with loss of hair on the scalp.

Pemphigus vulgaris is an autoimmune disease, which leads to flaccid bullae and erosions. Although the scalp is commonly involved, hair loss is rarely seen. We herein report a case of 32-year-old female patient with a 2-year history of pemphigus vulgaris, involving the skin and mucosa. Although clinical improvement was achieved with oral corticosteroids and mycophenolate mofetil, the patient developed tender plaques on her scalp, accompanied by hair loss. Histopathology and direct immunofluorescence were consistent with pemphigus vulgaris. Skin swab cultured Staphylococcus aureus. Treatment with oral and topical corticosteroids combined with mycophenolate mofetil resulted in clinical remission, with regrowth of scalp hair. Alopecia is an unusual clinical manifestation of pemphigus vulgaris. Our case supports the hypothesis that hair loss is induced by antibody-mediated outer root sheath keratinocyte acantholysis, in combination with skin infection, that together lead to the observed hair loss.