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1.
BMJ Paediatr Open ; 7(1)2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-37616066

RESUMEN

BACKGROUND: Childhood vitiligo differs from adult vitiligo in many aspects. To the best of the authors' knowledge, there is no systematic review of different clinicoepidemiological patterns of vitiligo in children. This study aimed to review the characteristics of vitiligo among the paediatric population. METHODS: In June 2022, a comprehensive search was conducted using MeSh-based keywords on online databases including PubMed, Scopus and Web of Sciences. The papers were assessed, and the eligible articles were selected. The selection of articles followed three distinct steps. The extracted clinicoepidemiological data were then imported into the STATA software for meta-analysis. RESULTS: The meta-analysis of 17 studies with 4365 subjects yielded 2475 women (estimated=56.8%, 95% CI 54.45 to 59.22). The female-to-male ratio was determined to be 1.3:1. Meta-regression demonstrated a significant relationship between continents and gender (p=0.03). The most prevalent types of non-segmental vitiligo were vulgaris (42.49%), focal (27.21%) and acrofacial (17.8%). The pooled ratio of non-segmental to segmental was 4.6:1. The highest and lowest ratios were found in Africa with one study (estimated=11.56%, 95% CI -0.98 to 24.10) and America with two studies (estimated=3.02%, 95% CI 1.54 to 4.50), respectively. Using meta-regression, the relationship between continents and vitiligo type was found to be insignificant (p=0.47). Positive family history was recorded in 657 patients (estimated = 16.88%, 95% CI 13.37 to 20.39). Positive family history varied by country of study from 13.91% (Asia with 11 studies) to 27.01% (Europe with two studies) (p=0.11). Kobner phenomena and leukotrichia were noted in 687 (25.47%) and 461 (18.52%) patients, respectively. CONCLUSION: The review indicated that childhood vitiligo is more prevalent in women. Non-segmental forms of childhood vitiligo were the most common, including vulgaris, focal and acrofacial. The clinicoepidemiological pattern of childhood vitiligo is variable in different geographic areas.


Asunto(s)
Hipopigmentación , Vitíligo , Adulto , Niño , Femenino , Humanos , Masculino , Vitíligo/epidemiología , África , Asia , Bases de Datos Factuales
3.
Dermatol Ther ; 35(2): e15229, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34820974

RESUMEN

Carboxytherapy has been used in the treatment of autoimmune skin diseases such as psoriasis and morphea. Carboxytherapy has antioxidant effects, and leads to better tissue oxygenation, and release of growth factors. In this article, we decided to evaluate efficacy of combined carboxytherapy and narrowband-ultraviolet B (NB-UVB) compared to NB-UVB alone in the treatment of vitiligo. This is a prospective, split-body double-blind comparative study performed in patients with generalized stable vitiligo in acral areas and extremities referred to dermatology clinic of Afzalipour hospital in Kerman University of Medical Sciences. NB-UVB was performed three times a week in non-consecutive days for 4 months. In each patient, one lesion was randomly treated with carboxytherapy (weekly sessions for total of 16 sessions). Efficacy of treatment was evaluated by percentage of repigmentation of the lesions. Chi-square test and analysis of variance test (ANOVA) were used to compare efficacy of treatment based on demographic features of the patients and clinical features of the lesions, respectively. Twenty-eight patients with mean age of 32.35 ± 7.37 years old completed the study. At the end of the treatment, 37% of the patients in combination therapy group demonstrated more than 75% improvement compared to 0% in the monotherapy group (p = 0.001). There was no significant difference between either demographic features of the patients (age, sex, and skin phototypes) or duration of disease with efficacy of the treatment in both groups. Combination of carboxytherapy with NB-UVB leads to higher percentage of repigmentation and patients' satisfaction compared to monotherapy with NB-UVB.


Asunto(s)
Terapia Ultravioleta , Vitíligo , Adulto , Terapia Combinada , Humanos , Estudios Prospectivos , Piel/patología , Resultado del Tratamiento , Terapia Ultravioleta/efectos adversos , Vitíligo/diagnóstico , Vitíligo/tratamiento farmacológico , Vitíligo/radioterapia , Adulto Joven
4.
Dermatol Ther ; 34(6): e15157, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-34628708

RESUMEN

COVID-19-associated cutaneous manifestations are one of the most important and relatively common extra-respiratory presentations of SARS-COV-2 infection. The exact identification and classification of these lesions can facilitate the accurate diagnosis and treatment. There are several case reports and small case series which describe cutaneous lesions in hands and feet. Currently, there is no scoping review about acral skin manifestations associated with COVID-19. This paper covers the COVID-related acral skin manifestations in 10 entities including acral papulo-vesicular eruption, acral urticarial lesion, acral non-inflammatory purpura and necrosis, acro-ischemia associated COVID-19, acral vasculitis, chilblain-like lesion (COVID Toe), acral erythema multiform (EM) like lesion, hand and foot skin lesions associated with multisystem inflammatory syndrome in children (MISC), acral peeling conditions and red half-moon nail sign. Future studies should focus on exact investigation of etiologies of these lesions including role of immune senescence, environment, gender, immunogenetics and relation of these lesion with major organ involvements.


Asunto(s)
COVID-19 , Exantema , COVID-19/complicaciones , Niño , Eritema/diagnóstico , Eritema/etiología , Humanos , SARS-CoV-2 , Síndrome de Respuesta Inflamatoria Sistémica
5.
Clin Case Rep ; 9(5): e04249, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-34026201

RESUMEN

Cyclosporine is an effective and safe immunosuppressant in the management of Toxic epidermal necrolysis (TEN) during COVID-19 outbreak for patients that intravenous immunoglobulin (IVIG) is contraindicated or is not affordable.

6.
Adv Pharm Bull ; 9(4): 578-583, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31857961

RESUMEN

Purpose: Combination of benzoyl peroxide (BPO) with topical antibiotics can lead to higher efficacy and less bacterial resistance, but it in turn increases adverse effects such as skin irritability and dryness. In this study, the efficacy of combination therapy of niosomal BPO 1% and clindamycin (CL) 1% is compared with niosomal CL in acne vulgaris. Methods: This is a double-blind clinical trial study on 100 patients with acne vulgaris in Afzalipour hospital in Kerman. Patients were randomly divided into 2 groups (case and control). The case group received niosomal combination of BPO 1% and CL 1%.The control group received niosomal CL1%. The efficacy of treatment protocols was evaluated in 2nd, 4th, 8th and 12th weeks of treatment by counting lesions (severity and grading acne lesions) and quality of life (QoL). Furthermore, side effect were evaluated at each treatment visits. Results: The reduction in mean percentage of acne lesions in case group (treated with BPO 1% and CL1%) (64.21%) was higher than control group (treated with niosomal CL 1%) (59.04%), but the statistical difference was not significant. Sum of excellent and good results were found in 80% and 76.1% of case and control groups, respectively (P=0.377). Also adding BPO to the treatment formulation in case group did not increase adverse effects, as statistical difference between 2 groups was not significant. Conclusion: Combination of niosomal BPO 1% and CL 1% in treatment of acne vulgaris showed higher efficacy with no increase in adverse effects in comparison with niosomal CL 1%, but the statistical difference was not significant.

7.
Korean J Parasitol ; 57(4): 359-368, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31533402

RESUMEN

In this study, we carried out extensive in vitro studies on various concentrations of tioxolone along with benzoxonium chloride and their niosomal forms against Leishmania tropica. Niosomes were prepared by the hydration method and were evaluated for morphology, size, release study, and encapsulation efficiency. This study measured leishmanicidal activity against promastigote and amastigote, apoptosis and gene expression levels of free solution and niosomal-encapsulated tioxolone along with benzoxonium chloride. Span/Tween 60 niosome had good physical stability and high encapsulation efficiency (more than 97%). The release profile of the entrapped compound showed that a gradual release rate. The combination of niosomal forms on promastigote and amastigote were more effective than glucantime. Also, the niosomal form of this compound was significantly less toxic than glucantime (P≤0.05). The flowcytometric analysis on niosomal form of drugs showed that higher number of early apoptotic event as the principal mode of action (89.13% in 200 µg/ml). Also, the niosomal compound increased the expression level of IL-12 and metacaspase genes and decreased the expression level of the IL-10 gene, which further confirming the immunomodulatory role as the mechanism of action. We observed the synergistic effects of these 2 drugs that induced the apoptotic pathways and also up regulation of an immunomodulatory role against as the main mode of action. Also, niosomal form of this combination was safe and demonstrated strong anti-leishmaniasis effects highlights further therapeutic approaches against anthroponotic cutaneous leishmaniasis in future planning.


Asunto(s)
Antiprotozoarios/farmacología , Compuestos de Benzalconio/farmacología , Lactonas/farmacología , Leishmania tropica/efectos de los fármacos , Animales , Antiprotozoarios/administración & dosificación , Antiprotozoarios/química , Compuestos de Benzalconio/administración & dosificación , Compuestos de Benzalconio/química , Línea Celular , Quimioterapia Combinada , Citometría de Flujo , Humanos , Lactonas/administración & dosificación , Lactonas/química , Liposomas
8.
J Parasit Dis ; 43(3): 406-415, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31406406

RESUMEN

Benzoxonium chloride is an anti-infective agent that is used as anti-septic drugs for disinfection of the mucus membrane, skin surface and anti-bacterial, and it is also found to be effective against cutaneous leishmaniasis. The present study aims to evaluate the leishmanicidal activity of benzoxonium chloride and niosomal forms against Leishmania tropica stages. Benzoxonium chloride niosomes were prepared by the thin film hydration method and evaluated for morphology, particle size and release study and encapsulation efficiency. This study measured the cytotoxicity, leishmanicidal activity against promastigote and intra macrophage amastigote, apoptosis, and mRNA transcripts by quantitative real time PCR (qPCR) of free solution and niosomal-encapsulated benzoxonium chloride. Span/Tween 60 niosomal formulation of benzoxonium chloride showed superior physical stability and high encapsulation efficiency (96%) than the other forms. Release from the formulations showed that the Span/Tween 60 containing drug had a milder gradient so that 10% of the drug was not released after 4 h. The benzoxonium chloride and niosomal forms inhibited the in vitro growth of promastigote and amastigote forms of L. tropica after 48 h of incubation and represented IC50 values of 90.7 ± 2.7 and 25.4 ± 0.6 µg/ mL, respectively. The rate of apoptosis in niosomal formulations was approximately equal to the positive control (meglumine antimoniate) at the same concentration. Also, an increase in the concentration of this drug reduced the expression of IL-10, but increased the expression of IL-12. The niosomal formulations provided improved anti-leishmanial activities of benzoxonium chloride and played an immunomodulatory role as the mode of action in the treatment of anthroponotic CL.

9.
J Parasit Dis ; 43(2): 176-185, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31263321

RESUMEN

The strategy for improving the treatment of leishmaniasis by the World Health Organization, is the development of new drugs and combination therapy. The aim of this survey was to investigate the effect of amphotericin B (AmB) in combination with selenium, in a simple or niosomal form, on Leishmania tropica (L. tropica) by in vitro advanced assays. In this study, a niosomal formulation of AmB with selenium was prepared and characterized based on size and morphology. Using MTT assay, macrophage model, flow cytometry, and qPCR, the cytotoxicity and efficiency of the niosomal formulation and simple form of combination were evaluated. No toxicity was reported for both the niosomal and simple form of the combination. The niosomal formulation significantly showed higher inhibitory effect on the promastigote and amastigote forms of L. tropica than simple combination form. Interleukin (IL)-10 significantly decreased while the level of IL-12 and metacasoase as Th-1 activator significantly increased (P < 0.001). The findings of this study indicated that niosomes are the stable carriers for this combination, easy to produce and provide promising results as an effective formulation in the inhibition of extracellular and intracellular forms of L. tropica in compared with simple combination form.

10.
Biomed Pharmacother ; 116: 108942, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31152929

RESUMEN

This study aimed to evaluate the efficacy of glucantime and amphotericin B (AmB) encapsulated in niosome against cutaneous leishmaniasis (CL) using in vitro and in vivo models. The niosomal formulations of the drugs alone and in combination were prepared and characterized. Subsequent to the examination of their cytotoxicity, their efficacy was evaluated using an in vitro MTT assay, macrophage model, flow cytometry, and gene expression profiling. For evaluation of therapeutic effect of niosomal combination on the lesion induced by Leishmania major in inbred BALB/c mice, the size of lesions and number of parasites in spleen was assessed. The niosomal formulations demonstrated significantly greater inhibitory effects compared with the non-niosomal forms when the IC50 was considered. The niosomal combination showed an increase in the apoptotic values and gene expression levels of IL-12 and metacaspase and a decrease in the levels of IL-10 with a dose-response effect. The niosomal combination was also effective in reducing the lesion size and splenic parasite burden in mice. Our findings indicated that there is a synergistic effect between AmB and glucantime in niosomal form in the inhibition of intracellular and extracellular forms of L. tropica. Additionally, the in vivo results on L. major suggest that topical niosomal formulation could be useful in the treatment of CL.


Asunto(s)
Anfotericina B/farmacología , Antiprotozoarios/farmacología , Antimoniato de Meglumina/farmacología , Animales , Apoptosis/efectos de los fármacos , Línea Celular , Quimioterapia Combinada , Regulación de la Expresión Génica/efectos de los fármacos , Concentración 50 Inhibidora , Leishmania major/efectos de los fármacos , Liposomas , Macrófagos/efectos de los fármacos , Macrófagos/metabolismo , Ratones Endogámicos BALB C , Parásitos/efectos de los fármacos , Bazo/efectos de los fármacos , Bazo/parasitología
11.
Korean J Parasitol ; 57(1): 1-8, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30840792

RESUMEN

There is no effective treatment modality available against different forms of leishmaniasis. Therefore, the aim of this study was to improve the penetration and efficacy of selenium and glucantime coupled with niosomes and compared them with their simple forms alone on in vitro susceptibility assays. In this study, the niosomal formulations of selenium and in combination with glucantime were prepared. The size and morphology of the niosomal formulations were characterized and the effectivity of the new formulation was also evaluated using in vitro MTT assay, intra-macrophage model, and gene expression profile. From the results obtained, no cytotoxicity effect was observed for niosomal and simple forms of drugs, as alone or in combination. Niosomal formulations of the drugs significantly showed more inhibitory effects (P ≤ 0.001) than the simple drugs when the selectivity index was considered. The gene expression levels of Interleukin (IL-10) significantly decreased, while the level of IL-12 and metacaspase significantly increased (P ≤ 0.001). The results of the present study showed that selenium plus glucantime niosome possess a potent anti-leishmanial effect and enhanced their lethal activity as evidenced by the in vitro experiments.


Asunto(s)
Antiprotozoarios/farmacología , Sistemas de Liberación de Medicamentos , Sinergismo Farmacológico , Leishmania tropica/efectos de los fármacos , Antimoniato de Meglumina/farmacología , Selenio/farmacología , Animales , Antiprotozoarios/administración & dosificación , Línea Celular , Supervivencia Celular/efectos de los fármacos , Citocinas/biosíntesis , Formazáns/análisis , Perfilación de la Expresión Génica , Leishmania tropica/fisiología , Leishmaniasis Cutánea/parasitología , Macrófagos/inmunología , Macrófagos/parasitología , Antimoniato de Meglumina/química , Ratones , Pruebas de Sensibilidad Parasitaria , Selenio/química , Sales de Tetrazolio/análisis
12.
Dermatol Ther ; 32(2): e12796, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30520195

RESUMEN

Recently, advances in understanding the etiology of urticaria and updates of diagnostic and therapeutic management guidelines have drawn attention to chronic urticaria (CU) morbidity. The present study aimed to evaluate Iranian dermatologists' practice and real life management of CU patients. A total of 35 dermatologists and 443 patients were included in the study. Number of female patients was 321 (72.5%). Mean (standard deviation) age of the study patients was 38 (13) years and the median (inter quartile range) of disease duration was 12 (6-48) months. Severity of patients' symptoms was mild for 32.1%, moderate for 38.7%, severe for 18.8%, and 10.4% of them had no evident signs or symptoms. The most common diagnostic methods were physical examination (96.6%), differential blood count (83.5%), erythrocyte sedimentation rate (77.4%), and C-reactive protein (62.8%). The number of dermatologists prescribed nonsedating antihistamines (nsAH) in regular dose and high dose mono therapy were 26 (74%) and 6 (17%), respectively. About 66% of dermatologists were familiar with British Association of Dermatologists (BAD) guideline. The most common first-line treatment for CU by Iranian dermatologists was nonsedating antihistamines in regular or high doses. The real-life management of patients with CU in Iran was in accordance with the available practice guidelines.


Asunto(s)
Dermatólogos/estadística & datos numéricos , Antagonistas de los Receptores Histamínicos H1 no Sedantes/administración & dosificación , Pautas de la Práctica en Medicina/estadística & datos numéricos , Urticaria/tratamiento farmacológico , Adulto , Enfermedad Crónica , Estudios Transversales , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Irán , Masculino , Persona de Mediana Edad , Guías de Práctica Clínica como Asunto , Índice de Severidad de la Enfermedad , Urticaria/diagnóstico , Adulto Joven
13.
J Parasit Dis ; 42(4): 616-620, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30538362

RESUMEN

Current treatment modalities in cutaneous leishmaniasis have low efficacy and high toxicity as well as high rate of resistance to treatment. In this study, for the first time we decided to evaluate efficacy of intralesional Glucantime plus niosomal zinc sulphate in comparison with intralesional Glucantime plus cryotherapy in the treatment of acute cutaneous leishmaniasis. This is a case-control study on 64 patients with cutaneous leishmaniasis in Kerman-Iran. Patients were categorized in 2 groups A and B whom were treated with weekly intralesional meglumine antimonite plus twice daily niosomal topical zinc sulphate versus weekly intralesional Glucantime plus every other week cryotherapy, respectively. We assessed the efficacy of treatment modalities (as partial and complete response) and their adverse effects by measuring size of the lesions every 2 weeks up to maximum of 12 weeks and 3 months after the end of the treatment. Partial response rate was 16.6% and 12.9% in group A and B, respectively (P = 0.784). Complete response rate was 73.3% and 80.6% in group A and B, respectively (P = 0.784). Complete response rate was achieved in 4.73 ± 0.29 weeks and 4.69 ± 0.28 weeks in group A and B, respectively (P = 0.925). Partial response rate was achieved in 2.92 ± 0.23 weeks and 2.65 ± 0.18 weeks, respectively (P = 0.365). Combination of niosomal zinc sulphate with intralesional Glucantime has equal efficacy versus combination of cryotherapy plus intralesional Glucantime in the treatment of acute cutaneous leishmaniasis. So, it can be used in cases that have resistance to first-line treatments.

14.
J Parasit Dis ; 40(4): 1159-1164, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27876906

RESUMEN

Leishmaniasis is a spectrum of disease condition with considerable health impacts, caused by different species of Leishmania. This disease is currently endemic in 98 countries and territories in the world. There are many treatment modalities for cutaneous leishmaniasis. The use of topical terbinafine in the treatment of cutaneous leishmaniasis has recently been considered. Eighty-eight participants more than two years old with proven acute CL by a positive direct smear were randomly allocated to one of the two study arms: first group received meglumine antimoniate (Glucantime) 20 mg/kg/day intramuscular injection (IM) plus a placebo ointment (Mahan Vaseline) for 20 days. The second group received meglumine antimoniate (Glucantime) 20 mg/kg/day IM plus topical terbinafine, for 20 days and were monitored closely by dermatologist during the course of the study. Crude regression analysis showed that there was no significant difference between placebo and intervention group regarding partial or complete treatment (partial treatment: HRcrude = 1.1, CI 95 % = 0.7-1.7; complete treatment: HRcrude = 1.1, CI 95 % = 0.8-1.7). Although, there was no statistically significant different between the two treatment groups, but clinically it seems that the treatment rate in those who receive glucantime plus terbinafine was more effective than the other group. However this rate depended on the type of lesions. As data indicated ulcerated nodules, papules and plaque in experimental group have been completely improved two times faster than placebo group. Ulcerated nodules, nodules and plaque were partially improved faster in those used tebinafine than placebo ointment.

15.
J Parasit Dis ; 40(3): 935-9, 2016 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-27605813

RESUMEN

Zinc sulfate (ZS) has been used for the treatment of acute cutaneous leishmaniasis (CL) in both forms of in vivo and in vitro recently. The aim of the present study was to compare the efficacy of intralesional injection of ZS 2 % solution with intralesional glucantime in the treatment of acute CL. In this double-blind randomized clinical trial, 80 cases with acute old world dry type CL were enrolled in the study. The treatment protocol in the first group consisted of intralesional injection of ZS 2 % vials once a week for 10 weeks or sooner in case of complete resolution of the lesions. In the second group, intralesional glucantime once a week for 10 weeks or sooner in case of complete resolution of the lesions were used. In both groups cryotherapy was performed once every other week for 10 weeks. In ZS versus second group, partial and complete clinical response was observed with fewer injections although this difference was not statistically significant. In addition, we found that the trend of treatment in second group was faster but again it was not significant [partial treatment: hazard ratio (HR) 1.4, 95 % CI 0.7-2.9; complete treatment: HR 1.3, 95 % CI 0.6-2.8]. The results of this study showed that the intralesional injection of ZS 2 % solution was as effective as glucantime on the healing of the acute old world dry type CL.

16.
Iran J Parasitol ; 10(1): 1-8, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25904940

RESUMEN

BACKGROUND: Leishmaniasis is a parasitic infection that may lead to a variety of manifestations. In Iran, cutaneous leishmaniasis (CL) has a high prevalence. There are many treatment modalities for CL. The use of oral terbinafine in the treatment of CL has recently been considered. The aim of this study was to compare combination of oral terbinafine plus cryotherapy versus systemic meglumine antimoniate plus cryotherapy in CL. METHODS: Patients with proven direct smear for CL were divided randomly in 2 groups of 40 cases. For the first group systemic glucantime prescribed (IM, 15 mg/kg/day) for 3 weeks. For the second group oral terbinafine as two folds of usual dose in the treatment of fungal diseases prescribed [125 mg/day for body weight (BW) <20 kg, 250 mg/day for BW 20-40 kg, 500 mg/day for BW>40 kg] for 4 weeks. Both groups received cryotherapy every 2 weeks for 4 weeks. The patients were followed monthly for 3 months after the treatment. RESULTS: Partial (HR= 0.55, CI 95%= 0.3-1.1) and complete (HR= 0.53, CI 95%= 0.3-0.98) clinical improvement in terbinafine group was much slower than glucantime group, although at the end of treatment protocols no significant difference between groups were statistically observed (P=0.27). CONCLUSION: Considering more convenient suitable route of administration and approximately comparable results, it seems that terbinafine can be used as an alternative treatment, especially in the case of allergy or resistance to systemic glucantime.

17.
Ann Dermatol ; 26(1): 26-34, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24648683

RESUMEN

BACKGROUND: Epidemiologic studies of atopic dermatitis (AD) in desert areas are still lacking. OBJECTIVE: The aim of this study was to investigate the epidemiology of AD in children in Kerman city, a desert area in Iran. METHODS: We evaluated preschool children (age, 2 to 7 years) and primary school students (age, greater than 7 up to 12 years) in Kerman. We selected 865 students to estimate the prevalence and assess other features of AD such as distribution of lesions, personal history, family history of atopy, aggravating factors, associated symptoms, and morphological variants. RESULTS: The prevalence of AD was 9.1% in our study population. The prevalence of AD was 9.17% and 9.09% in males and females, respectively. The prevalence of AD in the age range of 2 to 7 years was 13.53% and 8.33% among children aged greater than 7 up to 12 years. In total, 82.27% of the patients were in chronic stage of the disease, and 31.6% had a personal history of other atopic diseases. At least one first-degree family member with atopy was seen in 46.83% of the patients. The most common sites of involvement were the head and neck. The most involved areas in the limbs were extensor surfaces. The most frequent morphological variant of AD was the common type. CONCLUSION: The prevalence of AD in Kerman was higher than in other Iranian cities but lower than that in developed countries. Diversity in the clinical features of AD has been observed among different studies, and the diagnostic criteria of AD should be adapted in proportion to the studied area.

18.
Int J Dermatol ; 51(10): 1221-5, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22994669

RESUMEN

OBJECTIVES: Intralesional injection of pentavalent antimoniate is recommended by the World Health Organization for the treatment of cutaneous leishmaniasis (CL). This study aimed to evaluate the adverse effects of intralesional injection of meglumine antimoniate (Glucantime(®) ) and its influence on clinical laboratory parameters. METHODS: A total of 105 patients with suspected lesions and therapeutic features of CL diagnosed by direct smear or skin biopsy were included in this study. Intralesional injection of Glucantime(®) was administered to treat CL. Fifty-five of the 105 patients were checked for hematological features, liver and kidney function, and fasting blood sugar levels before and after treatment. RESULTS: The observed side effects included pain (89.5%), burning sensation (81.9%), erythema (45.7%), pruritus (28.6%), secondary infection (17.1%), nausea (11.4%), vomiting (7.6%), urticaria (5.7%), necrosis (2.9%), sporotrichoid lesions (2.9%), dizziness (1.9%), dyspnea (1.9%), and anaphylactic shock (0.9%). No statistically significant differences were found in occurrences of adverse effects according to the part of the body affected, patient sex or age group, except for pruritus, which appeared more frequently in extremities than in other parts of the body (P < 0.001), and secondary infection, which was observed more frequently in people aged >45 years (P < 0.042). All clinical parameters remained normal after treatment. CONCLUSIONS: The occurrence of severe adverse reactions, particularly of anaphylactic shock, should be considered before treatment with Glucantime(®) is initiated. Thus, it is important that intralesional Glucantime(®) injections are administered in centers that are well equipped with appropriate resuscitation and support apparatus.


Asunto(s)
Antiprotozoarios/efectos adversos , Leishmaniasis Cutánea/tratamiento farmacológico , Meglumina/efectos adversos , Compuestos Organometálicos/efectos adversos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Anafilaxia/inducido químicamente , Antiprotozoarios/uso terapéutico , Niño , Preescolar , Estudios Transversales , Eritema/inducido químicamente , Femenino , Humanos , Lactante , Inyecciones Intralesiones/efectos adversos , Irán , Leishmaniasis Cutánea/sangre , Leishmaniasis Cutánea/diagnóstico , Masculino , Meglumina/uso terapéutico , Antimoniato de Meglumina , Persona de Mediana Edad , Compuestos Organometálicos/uso terapéutico , Dolor/inducido químicamente , Prurito/inducido químicamente , Resultado del Tratamiento , Vómitos/inducido químicamente , Adulto Joven
19.
Pediatr Dermatol ; 26(3): 286-91, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19706089

RESUMEN

Recently, topical immunomodulators have been successfully used in monotherapy or in combination with other therapeutic modalities in vitiligo. To determine whether combination pimecrolimus 1% cream and microdermabrasion enhances response time and repigmentation rate in children with vitiligo. Sixty-five children diagnosed with vitiligo enrolled in this randomized placebo-controlled study. Three vitiliginous patches were chosen in each patient. The first lesion was treated by pimecrolimus 1% cream. On the second lesion after doing microdermabrasion on day 1, pimecrolimus 1% cream was applied. On the third lesion placebo was applied. The course of treatment was 10 days. Vitiliginous patches were measured at baseline, day 10, and months 1, 2, and 3. Sixty patients completed the 3-month study period. Clinical response (pigmentation >50%) was observed in 60.4% of the patches treated by combined pimecrolimus plus microdermabrasion at the third month of follow-up, compared with 32.1% and 1.7% for pimecrolimus alone and placebo, respectively (p = 0.000). No significant side effect was observed. Microdermabrasion exerts an additive effect in enhancing the rate and degree of repigmentation by pimecrolimus. This new combined approach appears to be safe and effective in childhood vitiligo.


Asunto(s)
Dermabrasión , Fármacos Dermatológicos/administración & dosificación , Inmunosupresores/administración & dosificación , Tacrolimus/análogos & derivados , Vitíligo/terapia , Administración Cutánea , Adolescente , Niño , Preescolar , Terapia Combinada , Femenino , Humanos , Masculino , Pomadas , Método Simple Ciego , Pigmentación de la Piel/efectos de los fármacos , Tacrolimus/administración & dosificación , Vitíligo/patología
20.
Iran J Allergy Asthma Immunol ; 8(4): 211-4, 2009 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-20404392

RESUMEN

Atopic dermatitis (AD) is one of the most common infantile diseases. Immunological dysfunctions in AD patients may predispose them to infections. The aim of this study was to evaluate the relationship between infantile AD and urinary tract infection (UTI).In this cross sectional study, we enrolled 57 patients with AD aged 1 to 24 months that referred to dermatology clinic, and 57 healthy controls who were referred to pediatric clinic. The groups were matched according to age and gender. Urine samples were collected by clean-voided bag method. If a single organism was cultured at concentration of > or = 105 organisms per millimeter and the existence of white blood cells more than 10 per microscopic field was seen the patients underwent suprapubic aspiration. The presence of one organism in suprapubic aspiration sample was regarded as positive culture. Data were analyzed using SPSS version 15 software. P value <0.05 was considered as the level of significance. Twelve (21.1%) of AD patients and 1(1.8%) of normal controls had positive urine culture tests. The difference between two groups was statistically significant (p = 0.001). The most common bacteria was E-coli. Infants with AD showed a higher frequency of UTI in this study. So, we suggest screening all AD infants for urinary tract infection.


Asunto(s)
Dermatitis Atópica , Infecciones Urinarias , Preescolar , Estudios Transversales , Dermatitis Atópica/sangre , Dermatitis Atópica/complicaciones , Dermatitis Atópica/epidemiología , Dermatitis Atópica/microbiología , Dermatitis Atópica/orina , Femenino , Humanos , Lactante , Recuento de Leucocitos , Masculino , Infecciones Urinarias/sangre , Infecciones Urinarias/complicaciones , Infecciones Urinarias/epidemiología , Infecciones Urinarias/microbiología , Infecciones Urinarias/orina
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