Journal of

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Background and Aim: Treatment of cutaneous leishmaniasis, especially when caused by L. tropica, is challenging. Meglumine antimoniate (Glucantime^®) is used as the standard treatment, but multiple injectiond are necessary. The objective of this study was to compare the efficacy of weekly intralesional injections with twice weekly injections of Glucantime for the treatment of anthroponotic cutaneous leishmaniasis (ACL).
Methods: This randomized open clinical trial was conducted, in Bam, Kerman province, Iran. 96 eligible patients according to inclusion and exclusion criteria who were willing to participate were included. The included patients were randomly assigned into two groups, one group treated with weekly intralesional injections of Glucantime^® and the other group treated with intralesional Glucantime^® twice a week. Type and size of each lesion (induration, ulcer and scar) were recorded weekly. Complete healing was defined as complete re-epithelialization and absence of induration in all lesions and was considered as the primary outcome measure.
Results: A total of 48 patients completed the study complete cure was seen in 24 of 27 (89%) patients who received weekly intralesional MA with a mean duration of healing equals to 70±10 days. Complete cure was seen in 24 of 31 (77%) patients who received intralesional MA twice a week, the mean duration of healing in the latter group was 58±5 days. There was no significant difference between the two groups (P=0.23).
Conclusion: It seems that the efficacy of intralesional injections of Glucantime^® once a week is similar to efficacy of twice a week Glucantime^® injections.

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Background and Aim: Adverse drug reactions are inevitable outcomes of drug therapy, which may cause mortality and morbidity for those whom are treated in this way. Cutanous adverse drug reactions are abserved in 2% to 3% of inpatients but only 2% of them are considered serious and may cause death. The aim of this study was to determine the cause and clinical forms of adverse drug reactions referred to department of dermatology.

Methods: This cross-sectional study that was done on patients with diagnosis of cutanous adverse drug reactions in 2007 and 2009. All patients suspected with diagnosis of adverse drug reactions were examined by an experienced dermatologist for determination of different kinds of clinical manifestations.

Results: During the study period, 308 patients were recruited. Cutanous adverse drug reactions were found to be more frequent in females (63%) than in males (37%). Betalactam antibiotics were found to be the most frequent cause of adverse cutaneous drug reactions (42.7%), followed by non-steroidal anti-inflammatory drugs (16.5%). Acute urticaria was the most frequent observed drug reaction (59.2%) followed by fixed drug eruption (18.5%) and maculopapular rashes (14.9%).

Conclusion: In this study adverse cutaneous drug reactions was mainly induced by betalactam antibiotics and non-steroidal anti-inflammatory drugs. The most common forms of cutaneous adverse drug reactions were found to be: acute urticaria, fixed drug eruption and maculopapular rashes.

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Background and Aim: Hirsutism is defined as the presence of terminal hairs in androgen dependent areas like upper lip, cheeks, chin, breasts, lower area of abdomen and thigh in women. The aim of this study was to determine the etiologic factors and clinical features of hirsutism in premenopausal women.

Methods: In this cross-sectional study, 180 premenopausal women with hirsutism who were admitted at a referral dermatologic clinic in a 1-year period were investigated. After taking full medical history and performing physical examinations, a transabdominal ultrasonography of the ovaries, and laboratory evaluation including early morning total and free serum testosterone, prolactin, dehydroepiandrosterone sulfate, FSH, LH and 17-hydroxyprogestron in all patients were performed.

Results: The most common causes of hirsutism were idiopathic (51.1%), polycystic ovarian syndrome (37.7%), hyperprolactinemia (4.4%), adrenal hyperplasia (3.8%), and drug-induced (2.8%). Hirsutism was mild in 93 (51.6%) patients, moderate in 78 (43.3%) patients and severe in 9  (5%) patients. Family history of hirsutism was present in 100 patients. Clinical conditions associated with hirsutism were: acne (58.3%), obesity (55.5%), menstrual irregularity (38.8%), androgenic alopecia (17.7%) and acanthosis negricans (8.4%).

Conclusion: Idiopathic hirsutism and polycystic ovary syndrome were the most common causes of the hirsutism in premenopausal women. Obesity also had a significant role in hirsutism occurrence.

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Background and Aim: Hand, foot, and mouth disease (HFMD) is a common contagious infectious disease. Because of the current limited knowledge about the etiology of this disease and its associated complications, especially nails lesions, we conducted this study to determine the prevalence of the nail disorders in children with HFMD.

Methods: In this cross-sectional study, 84 children whom were referred to Bo Ali Sina Hospital in Sari, in 2013 and 2014, and were diagnosed as HFMD, were recruited using a census sampling method. Diagnosis of HFMD was made by a dermatologist or a pediatrician based on the clinical findings. Then, the skin lesions were recorded and the nails of all HFMD patients were examined to detect any nail disorder (onychomadesis, transverse ridging, etc.). Nail examinations were repeated fortnightly up to 8 weeks after the first visit. During this follow-up period, through using a questionnaire, the type of the nail lesions and their relationship with HFMD were recorded.

Results: The mean±standard deviation (SD) age of the patients was 38.2±19.5 months, and 58.3% of the patients were male. At the time of HFMD diagnosis, 30 (35.7%) patients had hand and nail involvement. Thirty-one cases (36.9%) had toenails involvement. Onychomadesis frequency was higher 4 weeks after initiation of the disease in comparison with 2 weeks after the onset of illness (15.5% vs. 1.2%, P<0.001) and 6 weeks after the beginning of the disease compared to 4 weeks after the disease onset (29.8% vs. 15.5%, P=0.001) the frequency of nail involvement at 8 weeks after the disease onset compared to 6 weeks after the beginning of HFMD was decreased (17.9% vs. 29.8%, P=0.007).

Conclusion: It is necessary to take measures for early detection and treatment of involved nails in HFMD. Periodic follow-up visits is recommended too.

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Background and Aim: Trichotillomania (hair pulling disorder) is a chronic disorder, characterized by frequent hair pulling leading to hair loss. This disorder despite having multiple physical, economic and social consequences, is less likely to be diagnosed and treated. In the present study, we investigated the efficacy of emotion regulation therapy (ERT) on symptom’s severity, anxiety, depression, stress and quality of life in individuals with trichotillomania.

Methods: Six patients were selected by available sampling method, and Massachusettes General Hospital (MGH-HPS) scale, Depression, Anxiety, Stress-DASS-21 scale, WHOQOL-26 Quality of Life questionnaire, and DERS Emotion Regulation questionnaire were used. Gross 8-session protocol (each session 90 minutes) was delivered on a weekly basis for each participant individually. Data were analyzed by visual analysis, percent of recovery, Freidman nonparametric test and Wilcoxon test.

Results: ERT lead to significant reduction in symptoms of hair pulling, depression, anxiety, stress, difficulty in regulating emotion and improved quality of life in patients with trichotillomania.

Conclusion: ERT significantly improves emotional problems and symptoms of hair pulling in the patients with trichotillomania. As a result, this treatment can be used as an effective treatment for this disorder.

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Background and Aim: Pruritus is one of the most common problems of chronic kidney diseases. Different treatment modalities, while extending the life span of patients, can lead to changes in their lifestyle, health status and ultimately change their quality of life (QOL). Understanding the different aspects of patients' QOL leads to better services provided by health care teams to improve the patients' QOL. The aim of this study was to evaluate the quality of life of hemodialysis patients with uremic pruritus in Mashhad in 1396 with a view to Iranian Medicine.

Methods: This descriptive-analytical study was performed on 52 patients. Data collection was done by the World Health Organization QOL and researcher-made demographic Questionnaire and SPSS 16 software was used for data analysis.

Results: The mean age of patients was 51.73 years and mean duration of dialysis was 41.42 months. Total score of life quality was 56. The lowest and highest scores were seen in physical and environmental dimensions. There was an inverse significant relationship between some aspects of QOL with hemoglobin and creatinine and a direct significant relationship with age, diabetes, hypertension and hyperlipidemia (P<0.005).

Conclusion: Hemodialysis patients' QOL is lower than others and several factors can improve it. Special attention to the individual characteristics of hemodialysis patients can be helpful in predicting their basic needs.

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Bed bug (Cimex lectularius) is an nocturnal insect that feeding on human blood at all stages of them life, and known as a human ectoparasite. Bed bug is usually feeding from the face, neck, arms, arms, shoulders, legs, and especially parts of the body that are bare during sleep. Persons reaction differently to bed bug bites and may experience minor itching to severe allergies. Symptoms usually appear after 1 to 24 hours and usually include small red cluster papules less than 5 mm in diameter and at a short distance from each other, with severe inflammation and itching. In general, the most important characteristic of those three points is a linear or curve sequence on the body, which is called “breakfast, lunch and dinner” pattern. There are numerous reports of house infestation and the bite of this blood-feeding insect on the body of persons in the country annually, and in initial the majority of the public is unable to correctly identify the symptoms of bed bug bites. So, this article by presenting the key points can be guide for identifying the bite symptoms of this allergenic insect, by doctors and specialists, especially dermatologists, for the timely treatment of the patient.

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Background and Aim: Considering the increase of dermatophytosis trough the Iran and world as well, especially ringworm of the body and groin due to terbinafine-resistant species and the high speed of disease transmission, in order to choose the appropriate treatment, considering the time required for the treatment of the disease and early detection of resistant cases treatment is required. The present study was conducted to determine the antifungal sensitivity of Trichophyton rubrum, Microsporum canis and Epidermophyton flucosum strains to common antifungal drugs.
 

Methods: Antifungal sensitivity test (broth microdilution) was performed for 20 specimens obtained from patients according to CLSI (Clinical and Laboratory Standard Institute) M38-3^rd ED protocol, for terbinafine, itraconazole and voriconazole.
 

Results: According to the antifungal susceptibility test results, 5 patients were resistant to terbinafine and showed a minimum inhibitory concentration more than 2, 3 patients were tolerant to terbinafine and showed a minimum inhibitory concentration between 0.5 and 1. Based on the results of the antifungal susceptibility test, 7 patients were tolerant to itraconazole and showed the minimum inhibitory concentration between 0.5 and 1. All isolates responded well to voriconazole.
 

Conclusion: The results of the antifungal sensitivity test highlight the importance of mycological tests on dermatophytic skin lesions to prevent the spread of drug-resistant species.

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Background and Aim: Marine seaweeds are a valuable source of bioactive ingeredients with the possibility of different effects in cosmeceutical industries such as skin health products. One of the main characteristics of the skin is moisture which plays an important role in maintaining metabolism, enzymatic activity, mechanical properties, appearance and protective barrier. The objective of the present study was to formulate the water extract of brown algae Sargassum tenerrimum with antioxidant and antibacterial properties as a moisturizing cream to evaluate physicochemical stability and microbial growth.
 

Methods: Algae were collected from the Persian Gulf intertidal zone and was washed with seawater, then transferd to Seafood Processing Laboratory in Gorgan University of Agricultural Sciences and Natural Resources for extraction process, after that formulation of 1% moisturizing cream was made at Center for Research and Training in Skin Diseases and LeprosyTehran University of Medical Scinces. Statistical analysis of antibacterial properties of water extract was performed by SPSS software version 22 and one way ANONA was used to analyse the data. The comparison between the means were investigated by Duncan’s test used for measuring significant differences at 5 percent level. Finally, the charts were created by using Excel software. The results of the study were reported as mean ± standard deviation.
 

Results: According to the results, the prepared 1% cream was completely stable and homogeneous in room temperature and oven for 6 months and successfully passed microbial tests.
 

Conclusion: In view of the above mentioned, the manufactured cream efficacy was well done and can be introduce as a skin moisturizing agent.