Cutaneous Leishmaniasis: Report of Two Atypical Cases

Multiple and unusual clinical features of cutaneous leishmaniasis (CL) had been reported as hyperkeratotic, psoriasiform, eczematoid, zosteriform pattern, warty lesions, erysipeloid, and acneiform lesions. The clinical features of CL primarily depend on the host's cell-mediated response and the species of Leishmania being involved. In this paper we reported two cases of atypical CL from Iran, Shohada-e-Tajrish and Loghman-e-Hakim hospitals presented with infiltrative erythematous lesions covering the perioral region and the lower limb, respectively. The diagnosis of cutaneous leishmaniasis was confirmed with skin smears and biopsies

The Potential of Algae in Treating Celiac Disease

Compounds found in algae, such as bioactive substances, sulfated polysaccharides, and polyunsaturated fatty acids, have been found to have positive effects on the immune system. Previous research has shown that algae can also benefit digestive system disorders. They possess antioxidant and anti-inflammatory properties and can influence the balance of gut microbiota and maintain the integrity of the intestinal lining. Celiac disease (CD), a disorder caused by an abnormal immune response to gluten, results in inflammation and damage to the intestinal lining, leading to problems with nutrient absorption. Although a lifelong gluten-free diet is the only treatment option for this disease, it is challenging to adhere to. Therefore, recent studies have focused on finding supplementary or alternative therapies for celiac disease patients. Traditional medical treatments, like anti-inflammatory and biological drugs, are associated with significant side effects and are not suitable for supplementary therapy for this group of patients. Algae shows promise as a potential research area for treating CD; however, their specific effects on this condition have not been widely studied. The aim of this study was to gather current information and draw attention to the potential use of algae extracts in treating CD to encourage further research in this field

A Novel Missense Mutation in Oncostatin M Receptor Beta Causing Primary Localized Cutaneous Amyloidosis

Primary localized cutaneous amyloidosis (PLCA) is a chronic skin disorder, caused by amyloid material deposition in the upper dermis. Autosomal dominant PLCA has been mapped earlier to pathogenic missense mutations in the OSMR gene, which encodes the oncostatin M receptor ß subunit (OSMRß). OSMRß is interleukin-6 family cytokine receptors and possesses two ligands, oncostatin M and interleukin-31, which both have biologic roles in inflammation and keratinocyte cell proliferation, differentiation, and apoptosis. Here, we identified a new OSMR mutation in a Kurdish family for the first time. Blood samples were taken from all the affected individuals in the family. DNA extraction was performed using salting out technique. Primers were designed for intron flanking individual exons of OSMR gene which were subjected to direct sequencing after PCR amplification for each sample. Sequencing showed a C/T substitution at position 613 in the proband. This mutation results in an L613S (leucine 613 to serine) amino acid change. The identified mutation was observed in all affected family members but not in 100 ethnically matched healthy controls. Elucidating the molecular basis of familial PLCA provides new insight into mechanisms of itch in human skin and may lead to new therapeutic targets for pruritus

Toxicology and Metabolic Effects of Methanol and Formaldehyde on the Brain, a Review Article

Background: Methanol is a toxic alcohol for the human body. The molecular biology of methanol metabolites affecting different organs, such as the brain, is under investigation. This systematic review aimed to consider methanol toxic molecular biology, based on the original articles obtained from data banks to figure out recent achievements.Methods: Scientific articles regarding the toxic effects and metabolites of methanol on the central nervous system (CNS) were collected from valid databases and classified based on their validity. Exclusion criteria were articles with duplicates, no available full text, review articles, case reports, and letters.Results: Current metabolic reactions were addressed in the development of CNS diseases, such as optic neuropathy, basal ganglia lesions, and Alzheimer’s disease. However, proteomic investigations introduced new metabolic changes, and serum proteins regarding blood coagulation, vitamin A metabolism, and immune responses were suggested for early detection of toxicity.Conclusion: Besides CNS disorders introduced for methanol toxicity, there is no exact proteomic serum marker to diagnose toxicity soon; however, the interleukin-1 beta system is suggested as a candidate, and more investigation is required to improve its competency

Acellular Fish Skin for Deep Dermal Traumatic Wounds Management; Introducing a Novel Dressing

The optimal therapy for deep wounds is based on the early debridement of necrotic tissue followed by wound coverage to avoid a systemic inflammatory response and optimize scar-free healing. The outcomes are affected by available resources and underlying patient factors, which cause challenges in wound care and suboptimal outcomes. Here we report a patient with deep dermal injury wounds, who was treated with platelet-rich fibrin (PRF) gel, plasma rich in growth factor (PRGF) gel, and acellular fish skin. Patient’s outcomes regarding healing and scar quality were collected objectively and subjectively for one year after the injury. Wounds treated with acellular fish skin demonstrated accelerated wound healing, a significantly higher water-storage capacity, and better pain relief. Furthermore, improved functional and cosmetic outcomes, such as elasticity, skin thickness, and pigmentation, were demonstrated. It seems that, the PRGF gel and PRF in combination with acellular fish skin grafts resulted in the faster healing of wounds and better functional and aesthetic outcomes than split-thickness skin grafts treatment

The Main Targets of Okadaic Acid Toxin in Human Intestinal Caco-2 Cells: An Investigation of Biological Systems

Background: Okadaic acid (OA) is a toxin of polluted shellfish. Consuming the contaminated shellfish is accompanied by diarrhea and paralytic and amnesic disorders. There is a correlation between diarrhea and the consumed OA. Determining the critical targeted genes by OA was the aim of this study. Methods: The transcriptomic data about the effect of OA on human intestinal caco-2 cells were extracted from gene expression omnibus (GEO) and evaluated via the GEO2R program. The significant differentially expressed genes (DEGs) were included in a protein-protein interaction (PPI) network and the central nodes were enriched via gene ontology to find the crucial affected biological terms. Results: Among the 178 significant DEGs plus 50 added first neighbors, four hub-bottleneck genes (ALB, FOS, JUN, and MYC) were determined. Twenty-eight critical biological terms were identified as the dysregulated individuals in response to the presence of OA. “ERK1/2-activator protein-1 (AP-1) complex binds KDM6B promoter” was highlighted as the major class of biological terms. Conclusion: It can be concluded that down-regulation of ALB as a potent central gene leads to impairment of blood homeostasis in the presence of OA. Up-regulation of the other three central genes (JUN, FOS, and MYC) grossly affects the vital pathways in the human body

The p.Arg435His Variation of IgG3 With High Affinity to FcRn Is Associated With Susceptibility for Pemphigus Vulgaris—Analysis of Four Different Ethnic Cohorts

IgG3 is the IgG subclass with the strongest effector functions among all four IgG subclasses and the highest degree of allelic variability among all constant immunoglobulin genes. Due to its genetic position, IgG3 is often the first isotype an antibody switches to before IgG1 or IgG4. Compared with the other IgG subclasses, it has a reduced half-life which is probably connected to a decreased affinity to the neonatal Fc receptor (FcRn). However, a few allelic variants harbor an amino acid replacement of His435 to Arg that reverts the half-life of the resulting IgG3 to the same level as the other IgG subclasses. Because of its functional impact, we hypothesized that the p.Arg435His variation could be associated with susceptibility to autoantibody-mediated diseases like pemphigus vulgaris (PV) and bullous pemphigoid (BP). Using a set of samples from German, Turkish, Egyptian, and Iranian patients and controls, we were able to demonstrate a genetic association of the p.Arg435His variation with PV risk, but not with BP risk. Our results suggest a hitherto unknown role for the function of IgG3 in the pathogenesis of PV

Serum Leptin Levels in Pemphigus: A Case Control Study

Background. Pemphigus is an autoimmune blistering disease mediated by autoantibodies directed against keratinocyte adhesion molecules. Leptin, an adipocyte-derived hormone, plays a role in immune responses and promotes autoimmunity. Objectives. This study was conducted to determine whether serum leptin levels are altered in pemphigus patients and whether there is any correlation between leptin levels and the severity of disease. Methods. This study included 47 newly diagnosed patients with pemphigus and 43 age- and sex-matched healthy controls. Clinical characteristics and pemphigus area and activity score (PAAS) were assessed. Serum leptin levels (ng/mL) were measured by a commercial enzyme-linked immunosorbent assay (ELISA). Results. Patients did not differ significantly in serum leptin levels from healthy controls (median (range): 10.8 (0.1–110) ng/mL versus 12 (0.5–69.9) ng/mL and P=0.53). There was no significant association between serum leptin concentrations and severity of disease measured by PAAS (rs=0.06, P=0.70). Conclusion. The results suggest that pemphigus does not have a direct influence on serum leptin levels and the pathogenesis of pemphigus seems to be not dependent on the connection with adipose tissue

Efficacy and safety of fractional CO2 laser and tranexamic acid versus microneedling and tranexamic acid in the treatment of infraorbital hyperpigmentation

Objective To compare the efficacy and safety of microneedling and fractional CO2 laser in combination with tranexamic acid (TA) in the treatment of infra-orbital hyperpigmentation. Patients and methods This split-face clinical trial performed on 30 volunteers. The patients were randomly assigned to treat with fractional CO2 laser and microneedling, both combined with TA topically. Three monthly treatment sessions were performed. Two blinded dermatologists evaluated the response after each treatment session and one and three months after the last session. We also asked patients to evaluate their overall satisfaction at the final follow up. Adverse effects have also been documented. Results Both methods showed significant improvement in all sessions comparing with the baseline state (p value <.05). There were no significant differences between two methods on the days 30, 90, and 150. But the laser showed significantly higher improvement on day 60. The patients’ satisfaction did not reveal any significant difference between the two sides. Adverse events were temporary with no significant difference between both sides except for erythema that lasts longer with microneedling. Conclusions Both fractional CO2 laser and microneedling in combination with topical TA seem to be effective modalities in the treatment of infraorbital hyperpigmentation with no significant side effects

Serum angiotensin converting enzyme in pemphigus vulgaris

Background: Pemphigus vulgaris is an autoimmune blistering skin disease with unknown etiology. Drugs such as angiotensin-converting enzyme (ACE) inhibitors may contribute in the pathogenesis of pemphigus. Objective: We plan this essay to evaluate the serum ACE level in pemphigus vulgaris patients in comparison with healthy controls to recognize its possible role in disease pathogenesis or activity. Methods: This study was planned and performed in the dermatology clinics of Shahid Beheshti University of MedicalSciences′ Hospitals between July 2010 and June 2011. Patients with new onset of pemphigus vulgaris were enrolled in our study. Control subjects were frequency-matched to cases by sex and age. Serum ACE was determined by the spectrophotometric method. Results: Thirty-four patients with pemphigus vulgaris and 35 healthy individuals were recruited in the study. No statistical significant difference was detected in the mean level of serum ACE of the two groups (t-test, P = 0.11). The mean ACE level was significantly lower in male patients compared with male controls (P = 0.04). Moreover, a significant higher serum ACE level of patients with cutaneous involvement was observed compared to patients with mucosal involvement (P = 0.02). Conclusions: Despite lack of any significant difference of serum ACE level between pemphigus and control group, the serum ACE level was considerably lower in male pemphigus vulgaris patients compared with male controls. Therefore, ACE might have some association with pemphigus vulgaris especially in male patients; however, further studies are required to confirm this association