Mucosal psoriasis

Geographic tongue and fissured tongue are mucosal manifestations of generalized pustular psoriaris [GPP]. Mucosal lesions with psoriasis vulgaris [PV] has been a controversial issue. The lips [mainly the lower] are commonly involved in Egyptian patients with PV. The occurrence of mucosal lesions did not correlated with the extent of skin involvement. The lesions were usually symptomless. The possibility of systemic causes being responsible for the tongue condition was excluded. Fissured tongue can occur as a development defect in 2.5% of normal persons. Its high prevalence in psoriatic patients can hardly be coincidental. Again, histopathological examination confirmed the psoriatic nature of the lesions. It is suggested that, tongue affection can occur with PV. Its high prevalence in cases of the study is probably due to some genetic inheritance which can manifest as a fissure tongue. Smoking does not seem to have any role since the incidence was almost the same in smokers and non-smokers. A high consumption of spicy food or bad dental hygiene may act as Koebner phenomenon in initiating the psoriatic process

Rifampicin and metronidazole as a combined treatment for cutaneous leishmaniasis

16 patients [fifteen males and one female] suffering from cutaneous leishmaniasis [CL] were included in this study. The ages of the patients ranged from 19-46 years [mean age = 32.87 years +/- st. D. 8.57]. All patients were given a combined treatment consisting of rifampicin 600 mg daily for 2 months uninterrupted plus metronidazole 1500 mg daily for 4 weeks [metronidazole was given in 2-two week courses interrupted by two-weeks rest period to avoid gastritis]. Two patients dropped out due to reasons unconnected with the trial. The remaining fourteen patients continued the treatment for a period of 2 months. One of the fourteen patients who received the combined treatment for 3 months did not respond and was treated later on by cryotherapy. Diagnosis depended on the clinical picture and on histopathology. All patients were followed for one year after the completion of treatment. Lesions that healed completely at three months and remained healed during follow-up were considered to be cured. Clinical resolution was attained in a period of 11/2 -2 months. The marked clinical improvement and the lack of disfiguring scarring and of side effects were quite impressive with this combined treatment

Evaluation of different therapeutic regimens for the treatment of uremic pruritus

115 uremic patients [72 males and 43 females] undergoing hemodialysis in 3 different dialysis units during the period December 1992-March 1994, and suffering from severe pruritus, were selected for the present study. The ages of the patients ranged from 28 to 57 years [mean age 39.5 years +/- SD 8.34]. They were randomly distributed in 4 therapeutic regimens: Activated charcoal, cholestyramine resin, ultraviolet light B [UV B] and erythropoietin [EPO]. Thirty patients who received only oral antihistaminic [loratadine 10 mg] and a topical antipruritic [menthol 0.6, paraffin oil 1.2 and cold cream to 120] for their pruritus served as control. The results showed that the highest response was with UV B 86.36% followed by EPO [85.71%], followed by activated charcoal [72.73%]; the weakest response being with cholestyramine resin [60%]. The response in the control group was 13.33%. It is possible that further studies in the near future may show that combined therapy using two or three of the above therapeutic regimens may even yield higher percentage of response