Unusual presentation of disseminated cutaneous leishmaniasis due to Leishmania major: case reports of four Iranian patients.

We report four disseminated cutaneous leishmaniasis(DCL) cases referred to leishmaniasis laboratory at the School of Public Health, Tehran University of Medical Sciences with multiple nodular, ulcerative and crusted lesions extended on the face, trunk, and extremities. None of the patients had any complication and historical involvement in their immunological system conditions that suggest as the criteria for DCL. Direct smears of ulcers were positive for Leishmania parasite. The parasite was isolated from the active lesions and identified as Leishmania major (L. major) using PCR-RFLP assay and sequencing analysis.

Comparison of therapeutic effect of topical Nigella with Betamethasone and Eucerin in hand eczema.

BACKGROUND: Nigella sativa has been used in traditional medicine. Although it was investigated in different studies, its effect on hand eczema has not been studied yet. OBJECTIVE: To compare the effects of Nigella, Betamethasone and Eucerin on severity of hand eczema and patients' life quality. METHODS: In this randomized, controlled, double-blinded clinical trial, we allocated new cases of hand eczema with 18-60 years of age in three therapeutic groups (Nigella, Betamethasone and Eucerin) by using permuted blocks for randomization. Patients applied medications twice a day and followed in a 4-week period. The primary outcome of the study was changes in severity and life quality, which were assessed at the beginning, 14th and 28th days of the study by Hand Eczema Severity index (HECSI) and Dermatology Life Quality Index (DLQI) respectively. RESULTS: Sixty patients recruited in the study with 20 patients allocated in each study arm. Eighteen, 19 and 15 patients in Eucerin, Nigella and Betamethasone groups, respectively, attended at least one of the therapy sessions. Nigella and Betamethasone showed significantly more rapid improvement in hand eczema compared with Eucerin (P = 0.003 and P = 0.012 respectively); Nigella and Betamethasone ointments caused significant decreases in DLQI scores compared with Eucerin (P < 0.0001 and P = 0.007 respectively). No significant difference was detected in mean DLQI and HECSI of the Nigella and Betamethasone groups over time (P = 0.38 and P = 0.99 respectively). CONCLUSION: It seems that Nigella might have the same efficacy as Betamethasone in improvement of life quality and decreasing severity of hand eczema.

Antioxidant status in patients with lichen planus.

BACKGROUND: Lichen planus (LP) is an autoimmune inflammatory disease of the mucocutaneous tissue, whose exact pathological course is not yet understood. Many studies have implicated the role of reactive oxygen species (ROS) and the protective role of antioxidants in several autoimmune skin disorders. In this study, serum levels of antioxidants in patients with LP were determined and compared with those of healthy controls. METHODS: In total, 30 patients with LP (mean ± SD age 41.63 ± 13.03), who had never received treatment for their disease, were enrolled; 30 healthy people (aged 41.17 ± 13.24) were recruited as the control group. Serum levels of glutathione peroxidase (GPX), vitamin C, selenium, bilirubin and uric acid were determined. RESULTS: The mean plasma level of vitamin C was significantly lower (P < 0.001) in patients compared with controls. A significant positive correlation was found between selenium and GPX in both patients (Spearman ρ = 0.99, P < 0.001) and controls (ρ = 0.10, P < 0.001). CONCLUSIONS: Lower serum levels of vitamin C in patients with LP indicates that free radicals and the resulting oxidative damage may be important in the pathogenesis of LP lesions.

Pimecrolimus 1% cream versus betamethasone 17-valerate 0.1% cream in the treatment of facial discoid lupus erythematosus: a double-blind, randomized pilot study.

BACKGROUND: Discoid lupus erythematosus (DLE) is commonly treated with topical agents, the most important of which are glucocorticosteroids. However, prolonged use of these agents, especially on sensitive areas such as the face, may result in side-effects (e.g. atrophy and telangiectases) by altering collagen synthesis. Therefore, alternative treatments are needed for these patients. AIM: To investigate and compare the efficacy of topical pimecrolimus 1% cream and topical betamethasone 17-valerate 0.1% cream on facial lesions of DLE. METHODS: This was a randomized double-blind pilot study, performed in outpatient clinics of two major referral hospitals. Ten patients aged 20-53 years with moderate to severe DLE of the face were randomized into two groups for 8 weeks of treatment and 8 weeks of follow-up after treatment. In this double-blind study, one group applied pimecrolimus 1% cream twice daily and the other group applied betamethasone valerate 0.1% cream twice daily to facial lesions. Efficacy end-points included a combined score based on evaluation of erythema, infiltration and presence of scale. RESULTS: Efficacy end-points showed significant improvement in both groups. A decrease of 86% and 73% in clinical severity scores was obtained for pimecrolimus and betamethasone, respectively (P = 0.043). There was no significant difference between the two groups in terms of efficacy (P = 0.1). No adverse effect was found at the end of the 8-week trial in any of our patients. CONCLUSIONS: The efficacy of pimecrolimus 1% cream is comparable with that of betamethasone valerate 0.1% cream in treating facial DLE.