[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

[Langerhans cell histiocytosis: a case report]

Langerhans cell histiocytosis [LCH] is a proliferative disorder of langerhans cells and lymphocytes having different subtypes and a wide range of clinical manifestations and severity ranging from a unifocal self-limited disorder to multi-system involvement and even death. Along with clinical manifestations, diagnosis is made through existence of specific immunohistochemistry markers. Where treatment is necessary, different treatment modalities have been proposed; though none have found to be optimal. This paper introduces a 23-year old girl with an extensive yellowish to red-brown maculopapular rash over her face accompanied with polyuria, polydipsia, and fatigue

Comparison of skin erythema and melanin level in sulfur mustard induced chronic skin lesions and normal skin

Sulfur mustard gas is a chemical agent that has been used in many wars, especially in Iran-Iraq war. This chemical agent affects many organs including lungs, eyes and skin, causing numerous acute and chronic lesions including erythema and hyperpigmentation, respectively. This study was conducted to evaluate erythema and melanin in subjects with a history of exposure to sulfur mustard. This case-control study was done on 309 subjects. They were divided into four groups: sulfur mustard-exposed patients with skin lesions [n=87], sulfur mustard-exposed cases without current skin lesions [n=71], non sulfur mustard-exposed patients with dermatitis [n=78] and normal controls [n=74]. Erythema and melanin were measured in 4 areas [forehead, suprasternal, palm and back of hands] by Mexameter MX18 [Courage-Khazaka, Germany]. Erythema was significantly lower in suprasternal and palmar aspect of hands in sulfur mustard-exposed patients with dermatitis [P<0.05] while there was no significant difference in other areas. In terms of melanin, there was a significant difference in the dorsal aspect of hands in all four groups [P<0.05], where patients with dermatitis [both sulfur mustard exposed and normal population] had higher levels of melanin, probably due to pruritus in such areas. Forehead melanin of the normal population was also significantly lower than other three groups [P<0.05] while there was no significant difference between the melanin level of sulfur mustard exposed subjects [with or without dermatitis] and patients with dermatitis. Sulfur mustard contact can affect erythema and melanin content of the skin

effects of dopamine receptor agents on swim stress-induced inhibition of naloxone-induced jumping behavior in morphine-dependent mice

In the present study, interactions of dopamine receptor agonists and antagonists with water swimming stress [WSS] on naloxone-induced jumping in morphine-dependent mice were examined. Mice were rendered dependent as described in the methods section. The opioid receptor antagonist, naloxone [1 mg/kg], was injected to elicit jumping [as a withdrawal sign]. The first group exposed to WSS in the presence or absence of dopamine receptor drugs, before naloxone injection, in order to test the interaction of dopamine receptor mechanisms with WSS on expression of jumping behavior. When the animals were exposed to WSS for periods of 0.5, 1 or 3 min, 15 min prior to naloxone injection, WSS administration for a period of 3 min decreased the expression of jumping, but not diarrhea induced by naloxone. The Dl receptor agonist, SKF38393 [l-phenyl-7,8-dihydroxy-2,3,4,5-tetrahydro-lH-3-benzazepine hydrochloride; 8 and 16 mg/kg], Dl receptor antagonist, SCH 23390 [R-[+]-8-chloro-2,3,4,5-tetrahydro-3-methyl-5-phenyl-lHbenzazepine=7-ol maleate; 0.0025 and 0.005 mg/kg], D2 receptor agonist, quinpirole [0.3 and 0.5 mg/kg] and D2 receptor antagonist, sulpiride [50 mg/kg], potentiated the inhibition of jumping induced by WSS. Quinpirole, but not other dopamine receptor agents, increased diarrhea. In the second group of animals, effects of the dopamine receptor drugs; during development of morphine dependence, in the presence of WSS administration were tested. Administration of apomorphine [1 and 2 mg/kg] or SKF 38393 [8 mg/kg] in the presence of WSS, during the development of morphine dependence increased jumping, while quinpirole [0.5 mg/kg] decreased diarrhea. In contrary, neither sulpiride nor SCH 23390 did not alter jumping or diarrhea induced by naloxone. It could be concluded that dopamine receptor mechanism[s] and/or WSS could be related the development of morphine dependency