[Comparison of efficacy of intralesional injection of meglumine anti-moniate once-weekly with twice-weekly in the treatment of anthroponotic cutaneous leishmaniasis in Mashhad: a randomized clinical trial]

Cutaneous leishmaniasis [CL] is endemic in Iran, where it is one of the most important health problems. Both anthroponotic CL [ACL] caused by L. tropica and zoonnotic CL [ZCL] caused by L. major are reported. Antimoniate derivatives as the standard therapy for CL need multiple injections and are not easy to tolerate for the patients. This study was conducted in Mashhad to compare the efficacy of weekly versus twice a week intralesional injections of meglumine antimoniate [MA] in the treatment of ACL. This randomized controlled trial was performed during 2006 to 2008 in Mashhad, Iran. Using computerized sequence of random numbers, participants were randomly allocated in the two arms of the study: one receiving weekly and the other receiving twice-a-week intralesional injections of MA. The lesion size, induration and healing rate were assessed, recorded and compared. Healing was defined as complete re-epithelialisation and disappearance of duration. A total of 252 suspected CL patients with 372 lesions were screened. 82 parasitologically proven cases with 121 lesions caused by L. tropica were included and 74 patients with 113 lesions completed the study. At 12[th] week after initiation of treatment, complete healing was observed in 38 out of 44 lesions [86.4%] in the group which received weekly intralesional MA injection. The median time-to-heal in this group was 36 days [95% confidence interval [CI]: 32.0-39.9]. Complete healing was recorded in 60 out of 69 lesions [86.9%] in the group which received twice a week intralesional injections of MA with a median time-to-heal of 25 days [95% CI:20.9-29.1]. While no significant difference was observed between the two groups in terms of complete healing rate [P=0.999], time-to-heal was significantly different between the 2 groups [P=0.003]. It seems that the effectiveness of twice-weekly intralesional injections of MA is similar to once-weekly regimen while the former regimen causes more rapid healing of lesions

[ review of mastocytosis with best practices]

Mastocytosis most frequently manifests in the skin, so most often is diagnosed by dermatologists at first. Low threshold in clinical suspicion helps early detection of these cases. Cutaneous mastocytosis is an increase of cutaneous mast cells without known underlying disease or inflammatory infiltrate. A skin biopsy with staining specific for mast cells [toluidine blue, Wright-Giemsa] and tryptase immunohistochemical analysis should be considered in all patients with characteristic skin lesions. There is no treatment that cures cutaneous matocytosis and the major concern in the treatment is patient's quality of life. Although systemic mastocytosis occurs in greater than 25% of cases of cutaneous matocytosis in adults, there is little evidence that symptomatic therapy substantially alters the course of the disease. Almost all patients with cutaneous matocytosis belong to the indolent category of the consensus revised classification and have a good prognosis. This review aimed to provide best practices recommendations based on the evidence and patients perspectives

[Evaluation of skin pH in normal population and its relationship with age, sex and anatomic location]

Everal studies have been conducted to evaluate skin pH in various diseases, but there are few reports in normal population. The aim of this study was to evaluate skin pH in healthy individuals. Fifty healthy volunteers were enrolled in this study. The subjects were divided by age into 5 groups, i.e., 10-20, 21-30, 31-40, 41-50 and 51-60 years old. In each group, 5 females and 5 males were examined. A pH meter [Courage and Khazaka electronic GmbH, Germany] was used to measure pH in 8 different locations of the body [forehead, cheek, nasolabial fold, neck, forearm, dorsal side of hand, palm and leg]. The mean values for pH in these locations were 5.25, 5.15, 5.06, 4.90, 4.75, 4.80, 4.69, and 4.83 respectively. pH was significantly higher in women [P<0.001]. There was a significant difference between skin pH in different age groups [P=0.002]. The highest and lowest amounts of pH belonged to the forehead [5.26 +/- 0.68] and leg [4.69 +/- 0.40], respectively. Age and sex and location have remarkable effects on skin pH