Non-Ablative Fractional 1,540-nm Er:Glass Laser in the Treatment of Atrophic Cutaneous Leishmaniasis Scars.

OBJECTIVES: To evaluate the efficacy of nonablative fractional 1,540 nm laser to treat the atrophic scars caused by the cutaneous leishmaniasis (CL). METHODS: This clinical trial with a pre- and a posttreatment measurement was conducted on patients with atrophic CL scars. The lesions were treated with nonablative fractional 1,540 nm laser. We evaluated the patients initially and then monthly, before each treatment session. The final follow-up was done 6 months after the end of study for all patients. Patient assessment was performed by two physicians using the modified Manchester Scar Scale (MSS) as well as the interpretation of captured digital photographs. Moreover, the patients performed a self-assessment by filling in a researcher-made questionnaire. The data were statistically analyzed by SPSS software. P < 0.05 was considered statistically significant. RESULTS: Thirty patients with 37 skin lesions participated in the study. The pairwise comparison demonstrated a statistically significant difference between the modified MSS parameters (P < 0.05); however, no significant difference was observed between the modified MSS of the third and fourth (P = 0.82) as well as fourth and fifth (P = 0.636) sessions. The lesions improvement was significant based on the physician's evaluation (P < 0.001). Furthermore, patients' level of satisfaction was significantly increased in all six follow-ups (P < 0.001). No persistent complication was found. CONCLUSIONS: Nonablative fractional 1,540 nm laser is an effective and safe therapeutic choice for atrophic CL, even in darker skins. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

Evaluation of the oxidant-antioxidant balance, isoprostane and quantitative CRP in patients with cutaneous leishmaniasis.

INTRODUCTION: Cutaneous leishmaniasis is a dermal disease caused by several species of the genus Leishmania. It is an endemic disease with 1.2 million new cases occurring annually and mostly in developing countries. Oxidative stress is a condition of an imbalance in oxidant/antioxidant which may play a role in many different pathologic conditions. For the first time in this study, we introduced isoprostane as a reliable index for oxidative stress in patients suffering from leishmaniasis. We also investigated the possible relation between quantitative CRP and this disease. METHOD AND MATERIAL: We collected 5 ml blood of 30 patients in addition to the same sample of the control healthy group. After applying appropriate methods, the plasma and serum specimens were extracted in order to conduct oxidant-antioxidant balance and CRP tests in serum as well as measuring isoprostane factor in plasma. STATISTICAL ANALYSIS: We used T-student, ANOVA as well as linear regression to analyze the gathered data with a 0.05 confidence interval in SPSS environment. RESULTS: The results showed a significant difference between the two groups in terms of the oxidant-antioxidant balance. Also, isoprostane and quantitative CRP levels were substantially higher in patients. There was no significant relationship between the mentioned factors and wound size and number. CONCLUSION: Leishmania Amastigotes plays an important role in disturbing the oxidant-antioxidant balance resulting in inflammation and stress in patients. Furthermore, isoprostane was confirmed as a reliable index for evaluating oxidative stress in patients.

Electrophysiologic evaluation of retinal function in patients with psoriasis and vitiligo.

PURPOSE: To investigate the relation between psoriasis and vitiligo with the electrophysiologic function of the retinal photoreceptors. METHODS: Patients with psoriasis or vitiligo referred for PUVA therapy were enrolled. Complete eye examination was performed. Patients with any drug or familial history or abnormal eye examination that might affect the retinal function were excluded. Standardized full-field electroretinogram (ERG) elicited with Ganzfeld stimuli using the commercial ERG system (Retiport32; Roland Consult) according to International Society for Clinical Electrophysiology of Vision guidelines was performed. The outcome measures were the difference between the mean rod response, standard combined response, single-flash cone response and 30-Hz flicker wave amplitudes of the patients and normal population. RESULTS: Seventy-six eyes of 38 patients (vitiligo: 21; psoriasis: 17) and 40 eyes of 20 normal subjects were enrolled in this study. The mean age of patients was 31.3 ± 11.3 years (range 16-54 years). Twenty-two patients (58 %) were female. The mean rod response b-wave, standard combined a- and b-waves, single-flash cone response b-wave and the 30-Hz flicker (N1-P1) amplitudes were significantly lower than the normal population in the same range of age as the study group. There was no significant difference between the patients with vitiligo and those with psoriasis in all wave amplitudes (P = 0.094). CONCLUSION: This study showed that overall retinal electrophysiologic function in patients with vitiligo or psoriasis is significantly impaired compared with normal population, independent of age and sex.

The Application of Umbilical Cord Blood-derived Platelet Gel for Skin Ulcers Associated With Chronic Graft-Versus-Host Disease in Pediatrics: A Randomized Trial.

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative strategy against a variety of malignant and nonmalignant disorders. However, acute and chronic graft-versus-host disease (aGVHD and cGVHD, respectively) commonly complicate this approach, culminating in substantial morbidities and mortalities. The integumentary system is the preponderant organ involved in cGVHD, and its response to existing treatments, including well-versed immunosuppressants and novel targeted therapies, is not desirable. Despite the rarity, ulcers of sclerotic skin cGVHD are treatment-refractory and associated with significant morbidities and an exaggerated risk of infectious complications. Platelet-rich plasma (PRP) and its derivatives are endowed with growth factors and proangiogenic molecules and hold regenerative potential. This study aimed to assess the safety and efficacy of the application of platelet gel-containing dressing against ulcerative skin cGVHD in pediatric patients. This randomized trial is conducted at the hematopoietic stem cell transplantation unit of the Children's Medical Center Hospital in Tehran, Iran. Twenty-one pediatric patients (aged between 5 and 15 years) were initially enrolled, and 16 met the inclusion criteria. All cases (4 females) were recipients of allo-HSCT who had been complicated with symmetrically or near-symmetrically ulcerative sclerotic skin cGVHD. Fresh umbilical cord blood (UCB) was obtained from healthy donors and underwent centrifugation using a novel PRP preparation kit in a single-step process. Platelet gel was produced by adding thrombin to the isolated buffy coat layer. Two similar ulcers of each patient were randomized to receive either conventional dressing or platelet gels up to 6 times. At each time point evaluation, ulcer size and its relative reduction compared to the basal size were recorded. Included patients received a total of 80 platelet gel-containing dressings. While the mean sizes of randomized ulcers at the beginning of the study were similar, their differences became significant 15 days after the initiation of intervention (P = .019). In addition, the mean reduction in the ulcers' surface area (in comparison to their baseline values) was significantly higher for the intervention arm at all evaluation points (P = .001 for day 5 and P < .001 for subsequent time points). At the end of the trial, the number of ulcers with a more than 50% reduction in size was 14 (87.5%) in the intervention arm (including 6 completely healed ulcers) versus 1 (6.25%, which was not completely healed) in the control arm (P < .001). None of the patients exhibited any localized or systemic treatment-related adverse events. In this study, using a relatively large number of cases, we showed that UCB-derived platelet gel is a safe, feasible, and effective curative approach for skin ulcers of sclerotic skin cGVHD in pediatric patients. Designing upcoming trials on the efficacy of this therapeutic approach for ocular, mucosal, and acute skin GVHD is prudent. Retrospectively registered at the Iranian Registry of Clinical Trials (registration number IRCT20190101042197N1) on August 24, 2020.

Antiparasitic effects of gold nanoparticles with microwave radiation on promastigots and amastigotes of Leishmania major.

PURPOSE: This study aimed to determine the efficacy of thermotherapy in the presence of gold nanoparticles (GNPs) and microwave (MW) radiation at a frequency of 2450 MHz on the survival of Leishmania major promastigotes and amastigotes. MATERIALS AND METHODS: L. major promastigotes (strain MRHO/IR/75/ER) were cultured in RPMI-1640 medium supplemented with foetal bovine serum and antibiotic. The promastigotes were incubated with GNPs for 2 h. After washing, thermotherapy was performed by MW irradiation. After 48 h the promastigote survival rate was assessed using Alamar Blue assay. In the second part of the study, after culture and proliferation of J744 cells, the infected macrophages were incubated with the GNPs and were inserted under MW irradiation. After 24 h, the number of amastigotes in the macrophages was determined after Giemsa staining by a light microscope. RESULT: Increased exposure time of the microwave to the parasites in the presence of GNPs induced a significant decline in promastigotes survival rate in comparison to similar samples without GNPs. The least survival of amastigotes was also recorded in the groups containing GNPs. The presence of GNPs during MW irradiation was more lethal for promastigotes and amastigotes in comparison to MW alone. CONCLUSION: Thermotherapy using MW radiation in the presence of GNPs may be proposed as a new approach to treat leishmaniasis in future studies.

Therapeutic effects of acoustic cavitation in the presence of gold nanoparticles on a colon tumor model.

OBJECTIVES: Acoustic cavitation can be fatal to cells and is used to destroy cancerous tumors. The particles in a liquid decrease the ultrasonic intensity threshold needed for onset of cavitation. Bubble generation from intense pulsed light-irradiated gold nanoparticles was investigated as a means of providing nucleation sites for acoustic cavitation in cancer tissues. METHODS: This study was conducted on colon carcinoma tumors in BALB/c mice. The tumor-bearing mice were randomly divided into 7 groups (each containing 15 mice): (1) control, (2) gold nanoparticles, (3) intense pulsed light irradiation, (4) intense pulsed light + gold nanoparticles, (5) ultrasound alone, (6) ultrasound + gold nanoparticles, and (7) intense pulsed light + ultrasound + gold nanoparticles. In the respective groups, gold nanoparticles were injected into tumors. Intense pulsed light and ultrasound irradiation were performed on the tumors 24 hours after injection. Antitumor effects were estimated by evaluation of the relative tumor volume, doubling time, and 5-folding time for tumors after treatment. The cumulative survival fraction of the mice and percentage of the lost tissue volume (treated) were also assessed in different groups. RESULTS: A significant difference in the average relative tumor volumes 15 days after treatment was found between the intense pulsed light + ultrasound + gold nanoparticle group and the other groups (P < .05). The longest doubling and 5-folding times were observed in the intense pulsed light + ultrasound + gold nanoparticles and ultrasound + gold nanoparticle groups. CONCLUSIONS: Acoustic cavitation in the presence of gold nanoparticles and intense pulsed light has been introduced as a new way for improving therapeutic effects on tumors by reducing the relative tumor volume and increasing the cumulative survival fraction.

Evaluating the efficacy of photodynamic therapy with indocyanine green in the treatment of keloid.

BACKGROUND: This study aimed to evaluate the efficacy of photodynamic therapy (PDT) with topical indocyanine green (ICG) in the treatment of keloid lesions. METHODS: In this pilot study, fifteen keloids (6 lesions on the sternal area, 3 on the shoulders, 2 on the abdomen, 2 on the legs, and 2 on the forearms) were selected. To enhance drug penetration, pretreatment with CO2 laser was performed. Then Lesions were covered with 0.2% transfersomal ICG gel with 1 mm thickness and occluded with light-proof plastic nylon for 2 h. Afterward, it was wiped off and underwent photodynamic therapy with source LumaCare with 730 nm probe and fluence of 23 J/cm2 every week for 6 sessions. Patients were also assessed 6 and 12 weeks after the treatment for any recurrences. The Patient and Observer Scar Assessment Scale (POSAS) was used to evaluate the scars. RESULTS: The mean POSAS score significantly reduced by 23.69% from 46.86 at baseline to 35.76 at the 6th treatment session (P< 0.001). The mean scores of patient and observer overall opinion significantly decreased by 16.35% (P< 0.001) and 12.31% (P = 0.001) respectively. No side effects were observed during treatment and after 3 months of follow-ups. After discontinuation of therapy, the mean score of POSAS significantly increased by 13.77% to 40.80. (P = 0.001) CONCLUSION: According to our study, ICG-PDT is an effective and safe treatment for keloid. However, due to the recurrence following discontinuation of treatment, further studies are needed.

Fabrication and characterization of bilayer scaffolds - nanocellulosic cryogels - for skin tissue engineering by co-culturing of fibroblasts and keratinocytes.

This study focuses on developing a microarchitectural bilayer structure for stimulating the two top layers of skin tissue (epidermis and dermis) fabricated using a one-step freeze-drying method. Cellulose nanofibers (CNFs) and poly (vinyl) alcohol (PVA) were used as a biocompatible scaffolding material, and the composition was designed in such a way that it provides physical and biological property attributes. In this work, scaffolding materials with integrated layer structures and well interconnected and open pore structures were obtained. This bilayer structure had porosity with a pore size of 19.72 µm and 90.71 µm for the simulation of the epidermis and dermis, respectively. The production and expression of laminin, collagen IV, and keratin 10 proteins in the bilayer cryogel scaffolds obtained from the immunofluorescence study were 49.7 %, 63.8 %, and 49.3 %, respectively. The extracellular matrix (ECM) was produced in each scaffold layer. The observations confirmed that the porosity and pore size of both N1 and N2 layers were appropriate for the fibroblast and keratinocyte cells, respectively. H&E stained cross-sections of bilayer cryogel scaffolds illustrated epidermal and dermal layers produced by co-culturing keratinocytes and fibroblasts. Based on the results, the bilayer CNF/PVA scaffold can be used in skin tissue engineering applications. However, more experiments and in vivo evaluations are needed to express this conclusion more accurately.

The study of dry eye and meibomian glands in psoriasis.

BACKGROUND: To investigate aqueous and lipid layers of the tear film as well as meibomian gland structure by meibography in psoriatic patients in the Iranian population. METHODS: This case-control study was conducted on 31 psoriasis patients and 31 controls in Birjand University of Medical Sciences in 2018. The sampling method was available from the date of approval of the proposal in the Ethics Committee until it reached the sample size. After entering the study, patients were examined individually with a slit lamp. Then, Ocular Surface Disease Index (OSDI) score assessment, Schirmer test 1, lacrimal measurement with SM tube, tear break-up time (TBUT), and meibomian glands imaging by SBM Sistemi were done. Finally, the obtained data were entered into SPSS 15 software and analyzed at a significant level of less than 0.05. RESULTS: The two groups were matched according to age and gender (p = 0.39 and p = 0.80; respectively). With the exception of the SM Tube score, the mean of all tear film and meibomian glands functional and structural parameters including Schirmer test 1, TBUT, and meibography were significantly different between patients and control groups. Moreover, the proportion of abnormal OSDI (OSDI ⩾ 13) and the dry eye was significantly higher in psoriasis patients. CONCLUSIONS: Psoriasis is associated with dry eye as well as meibomian glands atrophy and dysfunction.

Dry Eye and Meibomian Glands in Vitiligo

Objectives: To evaluate aqueous and lipid tear film parameters and the meibomian glands (MGs) with non-contact meibography in patients with vitiligo. Materials and Methods: This case-control study was conducted in the right (OD) and left (OS) eyes of 43 patients with vitiligo and 43 controls in Birjand, Iran. In addition to demographic information and skin disease characteristics, the Ocular Surface Disease Index (OSDI) questionnaire was completed for each patient, followed by eye examinations including slit lamp examination, Schirmer test, strip meniscometry (SMTube), and tear break-up time (TBUT) measurement. The MGs were also imaged using a non-contact meibography system (SBM System, Italy). The data were analyzed using SPSS version 22.0 with a significant level of less than 0.05. Results: Patients had higher OSDI score than controls but it was not significant (10.90±13.03 vs. 5.57±6.85; p=0.07). There were significant differences between the groups in mean Schirmer test values for both eyes (OD: 8.07±5.47 vs. 17.37±6.52; OS: 7.60±5.00 vs. 17.30±6.44, p<0.001) and mean SMTube results (OD: 4.49±2.40 vs. 9.74±3.67; OS: 4.30±2.81 vs. 9.65±4.52; p<0.001). However, mean TBUT did not differ between the groups (OD: 9.14±3.17 vs. 10.12±2.08, p=0.27; OS: 9.16±3.30 vs. 10.05±2.10, p=0.25). Meibography also showed no significant difference in MG dropout between the groups (OD: 20.86±9.79 vs. 21.05±12.07; p=0.74; OS: 18.16±8.83 vs. 19.53±10.30; p=0.51). Conclusion: Vitiligo is associated with a reduction in the production of aqueous tear film, but does not affect the structure and function of the MGs.

Nutritional Intake and Chronicity Associated with the Old World Cutaneous Leishmaniasis: Role of Vitamin A.

BACKGROUND: Old world cutaneous leishmaniasis (CL) is known as a self-healing cutaneous parasitic infection. Host immunity has a fundamental role in the course of this infection. This study was designed to investigate the relationship between nutritional status and vitamin A intake with the clinical course of CL. METHODS: Overall, 250 patients with CL attending a dermatology clinic in Imam Reza Hospital Mashhad, Iran, were enrolled from Apr 2011 to Aug 2012. For data gathering, a semi-quantitative 302-item food frequency questionnaire was utilized. They received routine treatment protocols for leishmaniasis and 1 year of follow-up. RESULTS: As for the 149 patients who completed the study, a deficiency of macro and micronutrients, particularly vitamin A, was significantly related to a chronic clinical disease course. CONCLUSION: Imbalanced or insufficient nutritional intake including vitamin A deficiency, may influence the clinical course of CL.

Fabrication and characterization of novel bilayer scaffold from nanocellulose based aerogel for skin tissue engineering applications.

The aim of this study was to fabricate a novel bilayer scaffold containing cellulose nanofiber/poly (vinyl) alcohol (CNF/PVA) to evaluate its potential use in skin tissue engineering. Here, the scaffolds were fabricated using a novel one-step freeze-drying technique with two different concentrations of the aforementioned polymers. FE-SEM analysis indicated that the fabricated scaffolds had interconnected pores with two defined pore size in each layer of the bilayer scaffolds that can recapitulate the two layers of the dermis and epidermis of the skin. Lower concentration of polymers causes higher porosity with larger pore size and increased water uptake and decreased mechanical strength. FTIR proved the presence of functional groups and strong hydrogen bonding between the molecules of CNF/PVA and the efficient crosslinking. The MTT assay showed that these nanofibrous scaffolds meet the requirement as a biocompatible material for skin repair. Here, for the first time, we fabricated bilayer scaffold using a novel one-step freeze-drying technique only by controlling the polymer concentration with spending less time and energy.

Digital volumetric measurement of cutaneous leishmaniasis lesions: Blur estimation method.

BACKGROUND: Cutaneous leishmaniasis is a common parasitic infestation in Iran. With recent advantages in digital imaging, we have devised a novel non-contact objective method of measuring lesions. AIM: The aim of the study was to design a software system that analyzes images of cutaneous leishmaniasis lesions, objectively assess and monitor volume. METHODS: A photographic technique along with an image processing algorithm was applied to extract a three-dimensional map of the lesion from a simple two-dimensional picture. This method recovers depth on the basis of blur estimation. A macro lens with a low depth of field was used to blur the objects out of focus. To assess and compare the results, a polymer mold of the corresponding lesion was made and filled with liquid. The volume of liquid corresponded to the volume of the lesion. A total of thirty-seven patients were enrolled, and 48 lesions were analyzed. RESULTS: The mean volume measured by image processing was 159 µl (range: 8-685 µl), in comparison to an average of 170 µl (range: 6-800 µl) obtained from the molds. This was not significantly different. Statistical analysis by the Pearson correlation test showed a 'very good fit' correlation between these measured volumes (P < 0.001, r = 0.938). LIMITATION: The location and height of lesions were two important limitations in implementing this technique. If the lesion location is in the curvature region of body or the lesion height is less than 1 mm or more than 1 cm, this method will lose precision and accuracy. CONCLUSION: Image processing with blur estimation technique is an accurate and precise method to measure the volume of lesions in cutaneous leishmaniasis.

The Effect of Steri-Strip Dressing on Patients' Satisfaction and Reduction of Ecchymosis in Lower Eyelid, Malar and Cheek Following Rhinoplasty.

BACKGROUND: Early postoperative edema and ecchymosis are the most common factors to complicate initial patient perceptions about rhinoplasty. The current study was conducted to determine the effects of longer steri-strip tape on patient malar and cheek in terms of ecchymosis control and reduction. METHODS: Through a randomized controlled clinical trial, 64 patients who underwent rhinoplasty were randomly enrolled. One side of the patients' face was randomly selected for different experience of dressing while the main intervention was different length of tape and steri-strip dressing. In one group, the right side and in the rest, the left side of face was applied with steri-stip from the nose to lateral malar and cheek. In the opposite side of the face, steri-strip taping was done from the nose to medical malar and cheek. RESULTS: The mean area of ecchymosis after rhinoplasty through our trial was 1.55 mm and 2.31 mm, respectively in sides with and without steri-strip which differed significantly. When patients' age and sex were taken into account, the distribution of ecchymosis had no significant difference in this regard. CONCLUSION: The present study showed significant reduction in the area of post-rhinoplasty ecchymosis in lower lid, malar and cheek soft tissues as well as the obvious increase in satisfaction rate among intervention side of face in comparison to the control side. But longer steri-strip tape failed to control sub conjunctival bleeding or decrease it.

Ocular Leishmaniasis Treated by Intralesional Amphotericin B.

Leishmaniasis is a group of diseases with varied clinical manifestations. Ocular involvement is an unusual presentation of leishmaniasis, and the eyelid is not a common site of cutaneous lesions, likely due to the mobility of the lids. Some case reports of conjunctival involvement are either a contiguous dissemination from lid margin or in the setting of disseminated leishmaniasis in an immunocompromised host. To our knowledge, isolated involvement of the bulbar conjunctiva has not been reported. We present the first case in the literature of a patient with an erythematous fibrovascular lesion in the interpalpebral zone that was clinically diagnosed as pterygium, but recurred at the site of surgical excision. After histopathologic diagnosis, the lesion was treated with intralesional injection of amphotericin B and improved completely within a few weeks. An accurate diagnosis of leishmaniasis in the eye may be challenging in many clinical settings. To our knowledge, an isolated pterygium.like lesion has not been reported in literature. In addition, intralesional injection of amphotericin B is a novel treatment method in this setting.

The activity and tissue distribution of thioredoxin reductase in basal cell carcinoma.

PURPOSE: Basal cell carcinoma (BCC) is the most prevalent cancer worldwide. Different mechanisms are proposed to be involved in its pathogenesis such as oxidative stress. Oxidative stress, which is the consequence of the disruption of redox balance in favor of oxidants, is involved in the initiation or progression of many tumors. Thioredoxin reductase (TrxR) is a key enzyme of the thioredoxin (Trx) system, containing Trx and TrxR and NADPH, which is one of the main cellular oxidoreductases with an essential role in cellular health and survival through providing and maintaining redox balance. Therefore, we aimed to study and compare the activity and tissue distribution of TrxR in tumoral tissue and its healthy margin in patients with BCC. METHODS: After biopsy and taking samples from 18 patients, TrxR activity was measured using a commercial kit and its tissue distribution was assessed immunohistochemically. RESULTS: Both the activity and tissue distribution of TrxR in tumoral tissues were significantly higher compared to their healthy margins. Regarding the tissue distribution, this significant increase in TrxR in tumoral tissues was documented based on both staining intensity and abundance of positive cells in immunohistochemistry. CONCLUSIONS: Based on these results, it is concluded that TrxR is involved in the pathogenesis of BCC; however, more investigations are required to clarify whether this increase is a consequence of BCC or it is an initiating mechanism.

The Satisfaction Rate among Patients and Surgeons after Periareolar Surgical Approach to Gynecomastia along with Liposuction.

BACKGROUND: Surgery, as the main approach in higher stages of gynecomastia, has different techniques regarding the staging of the disease. The more the grade of gynecomastia, the more complicated the used surgical techniques, conventionally. This study assessed the success rate of the simplest surgical technique in higher grades of gynecology as well as the satisfaction rate in patients and surgeon to offer using the technique for higher grades of the disease. METHODS: To evaluate the success and the satisfaction rates of periareolar incision and liposuction among patients with grade II and III gynecomastia, this cross-sectional study was conducted. RESULTS: The satisfaction rate was the main concern of the present study. The patients had a mean satisfaction score of 8.1±1.396 with the range of 5-10 from total 10 score. The majority of the patients expressed their satisfaction by 9 score. The total mean of physician satisfaction score was 8.36 at all levels. CONCLUSION: Like aesthetic reasons which lead individuals to seek solutions for their annoying gynecomastia, aesthetic satisfaction is a prominent concern for people who undergo surgical approach. So, the least surgical scar and complications are absolutely the most area of focus in this regard.

Ultraviolet B efficacy in improving antileishmanial effects of silver nanoparticles.

OBJECTIVES: Cutaneous Leishmaniasis (CL) is a parasitic disease caused by various species of the flagellated protozoan, Leishmania. Regardless of the numerous studies, there are still serious challenges in the treatment of CL. This study aimed at evaluating the influence of a low dose ultraviolet B (UVB) radiation along with silver nanoparticles (AgNPs) on a mouse model of CL induced by Leishmania major. MATERIALS AND METHODS: L. major promastigotes (MRHO/IR/75/ER) were extracted from infected mice spleens. Two months after subcutaneous injection of 2×10(6) promastigotes into the footpad of BALB/c mice, when the lesions were developed, the animals were divided into 4 groups including one control group and three study groups: AgNPs, UVB and UVB plus AgNPs. Spleen parasite burden was assessed on day 40 after the first treatment. The data were analyzed by Instat, Elida and SPSS 16 software programs. RESULTS: The results showed the highest pronounced inhibitory effect in the group receiving AgNPs plus UVB. In addition, a significant difference was obtained between the group receiving AgNPs alone and the one with combinational therapy. The findings on parasite burden showed a significant difference between the control group and other treatment groups. CONCLUSION: It could be suggested that UVB in the presence of AgNPs, by inhibiting the spread of CL lesions and reducing the rate of visceral progression of the disease, provides a serious anti-leishmanial effect.

Plasma levels of interlukin-4 and Interferon-γ in patients with chronic or healed cutaneous leishmaniasis.

OBJECTIVE(S): In this study, the serum level of interferon-γ (IFN- γ) and interlukin-4 (IL-4) was evaluated as a marker of Th1 and Th2 immune response that influence the clinical course of cutaneous leishmaniasis . MATERIALS AND METHODS: This cross-sectional study was conducted on 44 cases of cutaneous leishmaniasis (21 cases with healed lesions and 23 cases with chronic non-healing lesions. Thirty-two non-infected persons living in the area were considered as controls. Serum levels of IFN- γ and IL-4 were determined using ELISA, and the results along with clinical data were analyzed using SPSS 11.5. RESULTS: Serum IFN-γ level was not significantly different between various patient groups and control (P=0.27), but the serum level of IL-4 in patient groups was higher than in healthy subjects, and it was higher in patients with non-healed chronic cutaneous leishmaniasis than those with healed lesions (P<0.01). CONCLUSION: Serum IL-4 level is a good marker for evaluation of the clinical course of cutaneous leishmaniasis.