Relieving pain in oral lesions of pemphigus vulgaris using the non-ablative, non-thermal, co2 laser therapy [NTCLT]: preliminary results of a novel approach

Introduction: Pemphigus vulgaris [PV] is a chronic, serious autoimmune mucocutaneous bullous disease. Oral lesions in PV may be extremely painful. This pain may adversely affect the patients' oral intake and quality of life. This before-after clinical trial was designed to assess the pain relieving effects of single session of non-ablative, non-thermal CO2 laser therapy [NTCLT] in oral lesions of PV

Methods: Fifty painful oral lesions of fourteen patients with PV were illuminated by CO2 laser [power: 1 W, scanning the lesions with rapid circular motion of the handpiece] passing through a thick layer of transparent gel with high water content. The pain severity of the oral lesions was reported by the patients up to the fourth postoperative day. They were also asked to continue their existing systemic treatment during the course of this study as a precondition for the participation

Results: The severity of contact and non-stimulate [non-contact] pain declined immediately and significantly after NTCLT [P < 0.001]. The pain relieving effect was sustained during the four successive days of follow-up. The procedure was pain free and no kind of analgesics was required. Following NTCLT, there were no visible thermal complications such as destruction, ablation or irritation of the oral lesions

Conclusion: The results of the trial proposed that single session of NTCLT could immediately and significantly relieve pain in oral lesions of PV, without any visible thermal complications

Anti-gliadin antibody in psoriasis: a case-control study

Psoriasis is a chronic inflammatory skin disorder with a wide variety of clinical presentations. Presence of anti gliadin antibody [AGA] has been reported in 16% of psoriatic patients. This study was designed to determine the frequency of the presence of AGA in psoriatic patients. After recording the demographic data and the severity of disease according to PASI scoring system, serum of 100 psoriatic patients and 100 healthy controls were studied for the presence of AGA using indirect immunofluorescence method. AGA was present in sera of 4 [3 males and one female] psoriatic patients while all controls were negative. Three patients were from 20 to 40 years of age. All four AGA positive patients sufferred from plaque type psoriasis. The disease severity was mild in one, moderate in two, and severe in one patient. None of them sufferred from gastrointestinal problems. Although AGA may be present in the serum of some psoriatic cases, a significant relation between skin lesion and hypersensivity to gluten has not been determined yet. More studies using more specific and sensitive assessment methods and larger sample sizes are suggested

[Coexistence of sezary syndrome with kaposi's sarcoma: report of a case with concurrent generalized dermatophyte infection]

Immunosuppression is known to be associated with increased rate of malignancies and widespread dermatophytosis in the patients with sezary syndrome and this may account for the occurrence of Kaposi's sarcoma and generalized dermatophytosis in patients in this report. Herein, we report a 58-year-old farmer man, who admitted with two months history of severely pruritic skin lesions, which progressed to erythroderma. Concurrently some vascular lesions were observed on glans penis off the patient suggestive of Kaposi's sarcoma. Leukocytosis with eosinophilia [20%] and atypical lymphocytosis [More than 10%] were present. Microscopic examination of biopsy of erythrodermic skin lesions on trunk revealed pautrier micro abscess with dermal lymphocytic infiltration and cellular atypia, and the peripheral blood sample showing sezary cells and high ratio of CD4/CD8 [45] lymphocyte were in favor of diagnosis of sezary syndrome. The pathologic evaluation of the vascular lesion of glans penis proved the diagnosis of Kaposi's sarcoma. During the progression of disease, the patient was invaded by generalized dermatophyte infection. KOH smear of annular skin lesion showed mycelia of dermatophyte and culture proved trichophytonrubrum to be the pathogenic agent