A case report of cutaneous infection with Mycobacterium neoaurum.

Cutaneous infection due to Mycobacterium neoaurum in immune-competent individuals had only been reported in limited cases. The point that makes our case very impressive was its cutaneous infection, and presentation in the immune-competent patient. Abstract: Cutaneous infections caused by nontuberculous mycobacteria usually occur in immunocompromised hosts. We report a rare case of cutaneous infection caused by Mycobacterium neoaurum in an immune-competent patient.

Fractional CO2 laser as an effective modality in treatment of striae alba in skin types III and IV.

CONTEXT: Rapid stretching of the skin over the weak connective tissue leads to development of striae distensae. Recently, researchers have shown special interest towards use of fractional photothermolysis in treatment of striae and several studies have shown its usefulness. Our aim was to assess the efficacy of Fractional CO2 laser in treatment of striae alba. MATERIALS AND METHODS: A randomized clinical trial was carried out in female patients with striae alba. Ninety two striae were randomly selected and divided into two groups. Five sessions of laser resurfacing, were performed in Group 1, every 2-4 weeks. Group 2 was treated with 10% glycolic acid+0.05% tretinoin cream nightly during the study. Photographs were taken from the striae before and two weeks after the end of treatment. Mean surface area of striae compared between two groups. Patients' views regarding the degree of improvement were assessed via visual analogue scale (VAS). RESULTS: Forty six striae in Group 1 underwent laser resurfacing and 46 matched striae in Group 2, were treated with topical cream. Mean difference of striae surface area, was significantly decreased after treatment in Group 1 (-37.1±15.6 cm(2)) in comparison with Group 2(-7.9±9 cm(2)) (P value >0.001). Mean VAS was significantly higher in Group 1 (3.05±0.74) compared to Group 2 (0.63±0.66) (P value >0.001). CONCLUSIONS: Fractional photothermolysis via Fractional CO2 laser seems to be an effective method for treatment of striae alba.

Efficacy of viable BCG vaccine paste in the treatment of common warts: a double-blind randomized control trial.

BACKGROUND: Treatment of common warts may be painful or leaves scars, mainly using traditional destructive methods. This study aimed to evaluate the efficacy of the viable Bacillus Calmette-Guérin (BCG) vaccine in paste formula as an immunotherapeutic modality for common warts treatment. METHODS: This double-blind and randomized, parallel-group, placebo-controlled trial was conducted at the Ahvaz Imam Hospital Dermatology Department from November 2014 to 2015. Overall 80 patients with common warts in two groups (case and control) received BCG vaccine paste once weekly for eight consecutive weeks. Follow-up was done every two weeks during treatment and six months after the treatment to evaluate recurrence in patients with complete resolution. RESULTS: In group A, eight patients (20%) had a complete response, 15 patients (37.5%) partial response, four patients (10%) low response, and 13 patients (32.5%) no response (p < .001). All patients in group B had no response to treatment (p < .001). After six months of follow-up, no recurrence was seen. Duration of disease less than 12 months (p = .001) and the number of lesions less than three (p = .01) were determining factors of response to treatment. CONCLUSION: Topical BCG vaccine paste was an effective treatment for common warts, without recurrence and significant complications.

Co-existence of various clinical and histopathological features of mycosis fungoides in a young female.

Mycosis fungoides is the most common type of cutaneous T-cell lymphoma (CTCL) and a rare disorder that typically affects older adults with erythematous scaling patches and plaques. Hypopigmented patches are a rare clinical variant of the disease. Granulomatous mycosis fungoides (GMF) is also a rare type of CTCL. No particular clinical criteria are available for the diagnosis of GMF, because of its variable presentations, and so the detection of GMF is primarily considered as a histopathological diagnosis. Rarely, a co-existence of more than one clinical or histopathological feature of mycosis fungoides may be present. To the best of our knowledge this is the first report of MF that shows the simultaneous co-existence of more than one clinical and histopathological variant of MF. We present a 29-year-old female with clinical presentations of both classic and hypopigmented mycosis fungoides (MF), and also the histopathological features of the classic and granulomatous types of the disease.

Can a trial of motivational lifestyle counseling be effective for controlling childhood obesity and the associated cardiometabolic risk factors?

OBJECTIVES: This study was conducted to assess the effectiveness of a simple office-based program for encouraging healthy lifestyle on controlling childhood obesity and associated cardiometabolic risk factors. METHODS: This non-randomized 24-week lifestyle modification trial was conducted among 457 obese children and adolescents, aged 2-18 years, who had at least one cardiometabolic risk factor in addition to obesity. This trial included three components of exercise, diet education and behavior modification, with all recommendations provided by a pediatrician, two general physicians and a nurse. Instead of strict inhibitory recommendations, healthier lifestyle was encouraged. RESULTS: Overall 448 (98.04%) of enrolled children completed the trial with a mean age of 9.6 ± 2.9 years. After the trial, the mean of anthropometric measures and cardiometabolic risk factors decreased significantly, the mean high-density lipoprotein cholesterol (HDL-C) increased significantly, and the prevalence of the metabolic syndrome decreased from 20.8% to 1.8%. Triglycerides, LDL-C, diastolic blood pressure and WC had the highest decrease in all age groups, with the most prominent changes in the 14-18-year age group. By each -1SD decline in BMI and WC, risk factors had significant improvement. CONCLUSION: Motivational office-based counseling can be effective in treatment of childhood obesity and its associated cardio-metabolic risk factors. Such approach can be implemented in the primary health care system; and can be of special concern in low- and middle-income countries with limited human and financial resources. We suggest that expanding the roles of non-physician clinicians such as nurse practitioners can help to increase the amount of time available for such services.