Journal of

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Background and Aim: Cutaneous tuberculosis (TB) is a relatively uncommon form of extra pulmonary TB. Even in countries where TB still commonly occurs, cutaneous TB is rare. In our country accurate statistics of the forms of cutaneous tuberculosis are not available. The aim of this study was to assess the frequency of cutaneous tuberculosis during the years 1997 to 2012 in Gorgan, Iran.
Methods: In this retrospective cross-sectional study, patients affected with cutaneous tuberculosis referred to 5 Azar Hospital in Gorgan from April 1997 to September 2012 were studied. Data collected from the medical records of patients were statistically described and analyzed.
Results: In this study, 30 cases of cutaneous TB were found that 18 (60%) of them were women. The disease was most commonly observed in age group of 21 to 40 years. Lupus vulgaris (18, 60%), papulonecrotic tuberculid (6, 20%) and scrofuloderma (3, 10%) were the most common types of cutaneous tuberculosis in these patients.
Conclusion: Lupus vulgaris is the most frequent form of cutaneous tuberculosis in Gorgan.

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Background and Aim: Trichomonas vaginalis infection is one of the most common sexually transmitted diseases of women and men in the world. To the best of our knowledge, there has been no previous report of the prevalence and complications of trichomoniasis in women of Qom.

Methods: In this cross-sectional study, the prevalence of T. vaginalis in women whom were admitted to a referral gynecology clinic in the city of Qom. For this purpose, two diagnostic methods, wet mount and ITS-PCR, were used to examin the vaginal swabs taken from the participants. Microscopic examination of cellular morphology and bacteria was also conducted on the stained smear.

Results: Three hundered volunteers were enrolled. Of 300 specimens, 7 (2.67%) by wet mount and 34 (11.3%) by ITS-PCR method were positive. The positive results of ITS-PCR were confirmed by sequencing of PCR products. In comparison with women without T. vaginalis infection, infection with T. vaginalis was associated with increased the risks of low birth weight (OR=43.3; 95% CI=2.8-671.9), in women with history of abortion (OR=91.8; 95% CI=15.5-544.2), and in women with premature rupture of membrane (PROM) (OR=21.6; 95% CI=2.1-22.9). Probability of finding of epithelial cells (OR=36.9; 95% CI=6.9-197.3) and white blood cells (OR=43.3; 95% CI=2.8-665.1) in stained smear were higher in women with T. vaginalis compared to those without T. vaginalis.

Conclusion: Comparing with wet mount, ITS-PCR seems to be a more sensitive and reliable technique in detection of T. vaginalis infection in women. The high prevalence of trichomoniasis emphasizes the need for screening of women in Qom. Early examination and accurate diagnosis of T. vaginalis, especially in middle-aged women, could prevent pregnancy-related complications of T. vaginalis.

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Background and Aim: Bacteria are one of the causes of nail infections. Although nail infections are not always associated with a major health problem, their treatment, particularly in immunosuppressed patients could be chalenging. This study was conducted to investigate the prevalence of bacterial agents in patients with dystrophic nails referred  to mycology laboratory of Razi Hospital, Tehran.

Methods: This was a cross-sectional study on patients with dystrophic nail. Samples were examined by both direct examination and culture. Blood agar and eosin methylene blue (EMB) agar media were used to culture and differentiate bacteria.

Results: Of 700 dystrophic nail samples, 183 (26.1%) samples were diagnosed as onychomycosis. One hundred and four (56.8%) of the patients were female. One hundred and eighty-one patients had bacterial nail infection (25.9%), of whom 109 (60.2%) were female. Forty-six (6.6%) patients had both bacterial and fungul infections, of whom 32 (69.6%) were female. The most common detected agent was Staphylococci.

Conclusion: Bacterial infections can result in dystrophioc nails. If these infections remain untreated they can lead to nail loss. In most cases, treatment of bacterial nail infections is easier than fungul nail infections.

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Background and Aim: Staphylococcus aureus is the second cause of hospital acquired infections, and responsible for 80% of purulent infections, and majority of skin infections. About 30 to 50 percent of normal people carry staph in their nose or groin and armpits. VanA, VanB, VanC1, VanC2/C3, VanG, VanL, and VanX are genes responsible for encoding resistance to vancomycin, TychoPlanyn and Avoparcyn, among them vanBand vanAare the most common cause of resistance that could be located on a plasmid or a chromosome and can be transferred via conjugation. The aim of this study was to The aim of this study was to investigatethe role of VanA and VanB genes in Cefoxitin resistant Staphylococci aureuscausing skin infections in patients admitted to Razi Hospital in Tehran using real time PCR method.

Methods: The samples were collected from Khordad 1394 for one year in the Microbiology Department of the Clinical Laboratory of Razi Hospital. Exudative skin lesions were sampled by sterile swab and cultured on the blood agar and EMB medium. Then catalase, oxidase and coagulase tests were performed on the gram-positive cocci and the sensitivity to vancomycinin Cefoxitin-resistant Staphylococcus aureus was determined using the E-test method. The presence of vanAand vanBgenes were investigated by Real Time PCR.

Results: Out of 978 patients with infected skin lesions, 733 samples of Staphylococcus aureus were isolated. Of these, 124 were Cefoxitin resistant, among them 8 samples had a high response rate of 3, and 5had high response above 16. But VanA and VanB genes were not responsible for resistance in any of them.

Conclusion: Due to the development of resistant strains of Staphylococcus in skin and hospital infections, identification of its encoding genes are necessary in order to use appropriate antibiotics to reduce the course of treatment and the side effects of taking antibiotics.

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Since the beginning of COVID-19 pandemic on December 2019, challenges on economic, political, social, hygiene- therapeutic and life style have emerged in many countries. Many researches are investigating on virus characteristics and its behavior and also preventive and therapeutic measures. Despite the virus not being dermatotropic, several skin manifestations have been observed. In this review, overall informations on this viral infection with focus on skin manifestations are presented.

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Kerion Celsi is a severe inflammatory fungal infection of the scalp that affects deeper layers of the skin. While it is uncommon in newborns, its incidence increases in children aged 3 years and older. It typically presents with swelling, spongy or boggy lesions, tenderness, hair loss (alopecia), and purulent discharge. Secondary bacterial infections are frequently seen following skin breakdown or maceration. Systemic symptoms may include enlarged lymph nodes, fever, and in very rare instances, fungal bloodstream infection (fungemia). Hypersensitivity reactions (Id reactions) can also occur. Diagnosis is guided by clinical evaluation, including patient history and physical examination, and must be confirmed using microscopy, fungal culture, and molecular diagnostic techniques. The most commonly isolated pathogens are anthropophilic Trichophyton tonsurans and zoophilic Microsporum canis. In contrast, geophilic fungi and molds are rarely implicated. Treatment is non-surgical, involving a combination of systemic and topical antifungal agents, with systemic antibiotics added when bacterial coinfection is suspected. Surgery should be avoided. Early and adequate therapy is critical to prevent permanent scarring and hair loss. The primary differential diagnosis includes bacterial infections of the skin and soft tissue.

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Skin infections caused by pathogenic bacteria such as Staphylococcus aureus and Pseudomonas aeruginosa have become a serious challenge in the field of antibacterial therapies, especially in the context of antibiotic resistance. In this regard, the simultaneous use of classical antibiotic combinations with advanced nanostructures is considered a novel and effective approach. Narasin, an ionophore antibiotic of natural origin, has a high potential in inhibiting bacterial growth due to its ability to disrupt cell membrane function and ion transport. On the other hand, silica nanostructures, especially mesoporous silica nanoparticles, play an important role in enhancing antibacterial activity due to their properties such as biocompatibility, drug loading capability, controlled release, and production of reactive oxygen species.
Recent studies have shown that the combination of narasin with silica nanostructures enhances the synergistic antibacterial effects, increases drug stability, and improves penetration into bacterial biofilms. This combination has also been effective in reducing the dosage and systemic toxicity. Despite promising results in laboratory and animal models, challenges such as the assessment of cytotoxicity, precise release control, and the need for extensive clinical studies remain.
In this article, while comprehensively reviewing the properties and functions of narasin and silica nanostructures, the mechanisms of their combined effects on skin pathogenic bacteria are discussed and future prospects in the development of nanobiotechnological therapies are reviewed.