Journal of

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Vitiligo is a common disorder in skin pigmentation and has an important role in patient’s quality of life. It may also cause severe emotional stress which makes its treatment necessary. As conventional therapeutic strategies are ineffective, there is an increasing tendency to use complementary medicine in the management of vitiligo. This article has been written with the aim of describing Iranian Traditional Medicine (ITM) approach to vitiligo mechanisms, prognosis and natural therapeutics. It is a product of a library study in the main ITM references and also related articles using mentioned keywords.

According to ITM text books human body consists of four substantial humors, each has a very specific quality and quantity. Any excess or deficit of these humors may result in different disorders. Changing in phlegm humor and also improper function of “expulsive faculty” are the main causes of vitiligo from the viewpoint of ITM.

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Mycetoma usually involves the skin, the subcutaneous tissues and deep structures such as the muscle and bone, but infection can also spread to more distant sites through the blood and lymph. If left untreated, the disease leads to deformity and loss of function, which may be fatal. The disease has a severe medical and socioeconomic impact on individuals, communities and health authorities. Elaborating a public health strategy for the prevention and control of mycetoma will require collection of epidemiological data on its burden as well as precise diagnosis and early treatment strategies.

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Background and Aim: Psoriasis is a systemic and non-transmissible chronic inflammatory autoimmune skin disease that about 2-3% of Iranians suffer from it. Cost of management and budgeting and planning for the treatment of patients with psoriasis requires accurate information. The present study estimates the direct and indirect costs for one-year treatment of patients admitted in Razi Dermatology Hospital.

Methods: In this descriptive-analytical study, treatment costs of 170 patients with psoriasis, including direct (medical and non-medical) and indirect costs were evaluated by census method and using a researcher-made checklist, from October 2017 to October 2018. The fee was collected through reviewing patients' bills in the hospital information system and through telephone interviews with patients.

Results: The average cost of one year was 9037480 Tomans ($ 758), of which direct cost of treatment was 90.22% (8178681 Tomans) and indirect cost of treatment was 9.78% (858799 Tomans). The highest cost of treatment was related to pharmaceutical services with 5825233 Tomans. Also, the total direct medical cost was equal to 7069890 Tomans, of which 62% was the insurance share and 38% was the patient share. The findings showed that injecting biological drugs and accommodation had a significant effect on the direct cost of treatment. Supplementary insurance and accommodation variables also affect out-of-pocket costs.

Conclusion: Drugs made up most of the costs. The high price of biologics and the low coverage of these drugs by insurance companies have caused many economic problems for these patients. According to the findings of this study, it seems necessary to review the more complete insurance coverage of these drugs as well as the use of charitable assistance to cover part of the cost for treatment.