The effect of pyrithione zinc in emollient base in the treatment of psoriasis

چکیده: زمینه و هدف: پسوریازیس یک بیماری مزمن التهابی شایع پوست است که به بسیاری از روش های درمانی مقاوم می باشد. این مطالعه با هدف بررسی اثر فرمولاسیون موضعی پیریتیون زینک در پایه نرم کننده در مقایسه با پایه نرم کننده به تنهایی در درمان پسوریازیس انجام شد. روش بررسی: در این مطالعه کارآزمایی بالینی دوسوکور بیماران مبتلا به پسوریازیس با گرفتاری کمتر از 10 سطح پوست به روش دردسترس انتخاب و بطور تصادفی به دو گروه، آزمون و کنترل تقسیم شدند. گروه آزمون با کرم 25/0 پیریتیون زینک در پایه نرم کننده و گروه کنترل با پایه نرم کننده به تنهایی روزانه دو بار به مدت 3 ماه درمان و پیگیری شدند. قبل و بعد از درمان شدت ایندوراسیون، اریتم و پوسته ریزی بر اساس PASI score (Psoriasis Area Severity Index) محاسبه گردید. اطلاعات به دست آمده بین دو گروه با کمک آزمون آماری t مستقل و t زوجی مقایسه گردید. یافته ها: PASI score قبل و بعد از درمان در گروه آزمون 8/1±4/3 و 3/1±9/0 (01/0P) بود. میانگین کاهش PASI score در گروه آزمون و کنترل به ترتیب 1/0±4/0 و 2±4/2 بود (01/0

Pimecrolimus versus Placebo in Minor, Recurrent Aphthous Stomatitis: A Randomized Double-blind Controlled Trial

<p><strong><em>Background: </em></strong>Oral aphthous is one of the most common oral mucosal inflammatory disorders which are very painful. There is no definite medical strategy up to now for aphthous treatment. Recently, some researchers have focused on immunomodulatory drugs such as tacrolimus and pimecrolimus in preventing aphthus recurrences. The aim of this study is to assess the effect of pimecrolimus cream against placebo in management of oral minor aphthous.</p><p><strong><em>Methods: </em></strong>The study is a randomized clinical trial, was done in “Shariati” hospital and Isfahan Skin Research Center. 62 patients with minor aphthuos were included and divided randomly to two groups (31 in each). In experimental group, pimecrolimus cream was applied for two weeks and cold cream for the same duration in control group. Patients were followed for 3 and one week; results were assessed in recovery after drug administration. Compared variables between two groups were including: the size of lesions, the time to recovery and pain intensity.</p><p><strong><em>Results: </em></strong>Results showed that mean size lesion in experimental and placebo group after complete recovery reduced (23.6 ±15.3 and 24.8 ±15 mm respectively) but it was not significant (P: 0.1). Mean time for recovery in both groups was 8±2.2 and 9.5±2.5 respectively which was significant in pimecrolimus treated patients (P: 0.014). Also mean degree for pain intensity measured by pain scale method was reduced significantly in test group (6 ± 1.2 before treatment and 5.3 ± 1.1 after treatment, P&lt;0.001).</p><p><strong><em>Conclusion: </em></strong>This study stated that pimecrolimus cream has an appropriate effect in reduction of recovery time and pain in minor aphthous compared to placebo but more clinical studies are needed to better conclusion.</p

Evaluation of leishmanin skin test reaction in different variants of cutaneous leishmaniasis

Introduction: Cutaneous leishmaniasis (CL) is a parasitic disease which has different clinical forms. The aim of this study is to compare the response to leishmanin skin test (LST) in three forms of CL including plaque type, lupoid type, and sporotrichoid type. Materials and Methods: This was a descriptive cross-sectional study. The patients enrolled in this study had three clinical forms of CL confirmed by positive smear of their lesions and then LST was performed for them. Results were categorized as negative (0-5 mm induration), positive (6-14 mm), and strongly positive (≥15 mm). The data were documented in the patients′ files and analyzed with SPSS windows software version 16 (Inc.Chicago, USA). Results: 200 patients were enrolled in the study. In the group with plaque type, 86% had a positive LST, 13.3% were negative, and 0.7% were strongly positive. In the lupoid group, these figures were 45.8%, 8.4%, 45.8%, respectively. In the sporotrichoid group, LST was positive in 27.3%, negative in 72.7%, and none of the patients had a strongly positive reaction ( P < 0.05). Discussion: The most of the positive LST were belong to plaque and lupoid groups, the most of strongly positive were belong to lupoid, and the most of negative LST were related with sporotrichoid type. Conclusion: It can be suggested that lupoid and sporotrichoid types of CL are parts of a continuous spectrum of the disease with an enhanced cellular immunity in lupoid form and a decreased state in sporotrichoid type

Distribution Frequency of Pathogenic Bacteria Isolated from Cutaneus Leishmaniasis Lesions

Cutaneous leishmaniasis (CL) is a parasitic disease characterized by single or multiple ulcerations. Secondary bacterial infections are one of the complications that can increase the tissue destruction and the resulting scar. To better determine the incidence of real secondary bacterial infections in CL, we designed the current study. This was a cross-sectional study performed in Skin Diseases and Leishmaniasis Research Centre, Isfahan, Iran. A total of 1,255 patients with confirmed CL enrolled in the study. Sterile swaps were achieved for ulcer exudates and scraping was used for non-ulcerated lesions. All samples were transferred to tryptic soy broth medium. After 24 hr of incubation at 37℃ they were transferred to eosin methylene blue agar (EMB) and blood agar. Laboratory tests were used to determine the species of bacteria. Among 1,255 confirmed CL patients, 274 (21.8%) had positive cultures for secondary bacterial infections. The bacteria isolated from the lesions were Staphylococcus aureus in 190 cases (69.3%), coagulase negative Staphylococcus in 63 cases (23.0%), E. coli in 10 cases (3.6%), Proteus sp. in 6 cases (2.2%), and Klebsiella sp. in 5 cases (1.9%). The results show that the overall incidence of secondary bacterial infections in the lesions of CL was 21.8%, considerably high. The incidence of secondary bacterial infections was significantly higher in ulcerated lesions compared with non-ulcerated lesions

The Effectiveness of a 5% Retinoic Acid Peel Combined with Microdermabrasion for Facial Photoaging: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

Background. Tretinoin has been shown to improve photoaged skin. This study was designed to evaluate the efficacy and tolerability of a 5% retinoic acid peel combined with microdermabrasion for facial photoaging. Materials and Methods. Forty-five patients, aged 35–70, affected by moderate-to-severe photodamage were enrolled in this trial. All patients received 3 sessions of full facial microdermabrasion and 3 sessions of either 5% retinoic acid peel or placebo after the microdermabrasion. Efficacy was measured using the Glogau scale. Patients were assessed at 2 weeks and 1, 2, and 6 months after treatment initiation. Results. The mean ± SD age of participants was 49.55±11.61 years, and the majorities (73.3%) were female. Between 1 month and 2 months, participants reported slight but statistically significant improvements for all parameters (P<0.001). In terms of adverse effects, there were statistically significant differences reported between the 5% retinoic acid peel groups and the control group (P<0.001). The majority of adverse effects reported in the study were described as mild and transient. Conclusion. This study demonstrated that 5% retinoic acid peel cream combined with microdermabrasion was safe and effective in the treatment of photoaging in the Iranian population. This trial is registered with IRCT2015121112782N8

Successful Treatment of Lupoid Cutaneous Leishmaniasis with Glucantime and Topical Trichloroacetic Acid (A Case Report)

Lupoid leishmaniasis is a unique form of cutaneous leishmaniasis characterized by unusual clinical features and a chronic relapsing course, mostly caused by infection with Leishmania tropica. In this clinical form, 1-2 yr after healing of the acute lesion, new papules and nodules appear at the margin of the remaining scar. Herein, we describe a case of this clinical form that was resistant to 2 courses of treatments: systemic glucantime and then a combination therapy with allopurinol and systemic glucantime. However, marked improvement was seen after a combination therapy with topical trichloroacetic acid solution (50%) and systemic glucantime, and there were no signs of recurrence after 1 yr of follow-up