Evaluation of quality of life in patients with psoriasis

Psoriasis is a chronic, relapsing disease of the skin with psychological and somatic impacts that leads to substantial effects on the quality of life. The aim of this study was to determine the quality of life in psoriatic patients. This cross-sectional study was conducted on 97 psoriatic patients in dermatology and PUVA clinic in Afzalipour hospital in Kerman from March 2009 to March 2010. Quality of life and disease severity were Dermatology Life Quality Index [DLQI] and Psoriasis Area Severity Index [PASI]. Data analysis was done through conducting, chi-square and one-way AVONA tests and P<0.05 was considered as significant. 55.7% of patients were male and mean age of them was 35.3 years [range: 16-75 years]. Psoriasis vulgaris was the most common type [76.3%], and arthropathy was seen in 3.1% of patients .The mean duration of the disease was 21 months [range: 11 months-30 years].The mean of DLQI score was 14.1 [range: 1-29] and mean PASI score was 18.6 [range: 0.6-66.6]. DLOI score correlated with severity of disease [PASI], marital status, and type of the disease [P<0.05]. Psoriasis has a severe negative impact on the quality of life of the patients. Therefore, supportive social and spiritual efforts are necessary to decrease these effects

Comparative histological and immunohistochemical changes of dry type cutaneous leishmaniasis after administration of meglumine antimoniate, imiquimod or combination therapy

This study compared histological and immunohistochemical changes of cutaneous leishmaniasis treated with meglumine antimoniate, imiquimod, and the combination of both therapies. Single blind clinicopathological studies of fifteen patients with old world cutaneous leishmaniasis in Kerman, Iran were included. A total of four patients received a combination of imiquimod [5% cream] and intra-lesional meglumine antimoniate weekly for four weeks. Monotherapy with imiquimod was given to seven patients and four patients were treated with meglumine antimoniate intralesionally. Histological confirmation was performed before and during therapy. Semi-quantitative histological parameters such as numbers of mixed inflammatory cells [cells/mm[2]] and percentages of Langerhans cells [CD1a+], T-cells [CD3+], B-cells [CD20+], and macrophages [CD68+] were calculated immunohistochemically in the dermis and adjacent epidermis. Topical imiquimod significantly reduced mean histiocytic cellular aggregation size [P<0.05]. Meglumine antimoniate reduced parasite load and infected activated histiocytes in the dermis [P<0.05]. Meglumine antimoniate therapy decreased epidermal CD3+ lymphocytes but increased them in the dermis, within the granulomas [P<0.05]. During topical application of imiquimod a depletion of CD1a+ dendritic cells in the epidermis [P<0.05] and slight predominance of dendritic cells in the dermis were observed. Combined therapy and imiquimod monotherapy decreased CD68+ macrophages in the dermis [P<0.05]. Meglumine antimoniate decreases parasite load with considerable effect on up-regulation of T-cells, which demonstrates that meglumine antimoniate works as parasitocidal and immunomodulator, which could be as the first line of treatment. Imiquimod, accentuates the host immune response and reduces granuloma size which could be effective immunomodulator for combination therapy. Monotherapy of imiquimod is less effective than the two other regimens in decreasing parasite load, inflammation and congestion at the inoculated site

[Quality of life in women with melasma]

Melasma is an acquired symmetrical brown hyperpigmentation of the face or neck. Melasma has been shown to have a significant emotional and psychologic distress on affected patients. Although this pigmentary disorder is more prevalent among women of reproductive age, the effect of melasma on quality of life in this population is unknown. The aim of this study was to evaluate health-related quality of life in patients with melasma attending to dermatology clinics in Kerman city, Iran. A cross-sectional study was carried out by clinical examination and questionnaire on 200 patients with melasma. Melasma area and severity index [MASI], Dermatology Life Quality Index [DLQI] and Melasma Quality of Life Scale [MELASQOL] were used to assess melasma severity and quality of life. There were 200 women with mean age 31.86 +/- 6.42 years old [range: 18-55 years]. The mean score of DLQI and MELASQOL were 6.90 +/- 4.48 and 40.24 +/- 14.95, respectively. In 113 [56.5%] patients, melasma had very large effect on their quality of life. There was a significant correlation between the scores of quality of life questionnaires and MASI [P<0.001]. In DLQI scale the most frequent impairment was related to emotional well-being and based on MELASQOL questionnaire, embarrassment due to skin appearance had an important impact on quality of life. This study revealed that physicians must consider the devastating psychosocial impact of pigmentary imperfections in addition to pharmacological and physical treatment

cytologic study of macrophages in cutaneous leishmaniasis

Exfoliative cytology smears from the lesions of 179 patients with cutaneous leishmaniasis due to L. tropica were studied with specific reference to cellular reactions and their effect on the parasite. Aggregates of the parasite [so-called Leishman bodies] were present within macrophages and in some fibroblasts. The nature of the inflammatory cells present in the smears was correlated with the number of Leishman bodies contained within them and the percentages of small lymphocytes, neutrophils and type I macrophages present. It is postulated that aggregates of activated macrophages [designated types II and III] and the Leishman milieu [sticky matrix] protect the Leishman parasites from being eradicated by the inflammatory and immune reactions