Topical liposomal azithromycin in the treatment of acute cutaneous leishmaniasis.

Cutaneous leishmaniasis (CL) treatment is based on pentavalant antimony (sbv) drugs which are accompanied by many side effects and are facing ever-increasing resistance. Topical treatment of CL is an attractive alternative avoiding toxicities of parenteral therapy while being administered through a simple painless route. The liposomal formulations of different drugs have recently been increasingly used in the treatment of several types of leishmaniasis. The efficacy of a topical liposomal azithromycin formulation was compared with intralesional meglumine antimoniate (glucantime) in the treatment of CL. Sixty-six patients with 97 lesions who met our inclusion criteria were randomly divided into two groups. One group was administered with the topical liposomal form of azithromycin twice daily. The other group was treated by weekly intralesional injections of glucantime with a volume of 0.5-2 cm3 into each lesion till complete blanching of the lesion occurred. Clinical evaluations were performed weekly during the treatment course (8 weeks) by a single dermatologist for both groups. Per-protocol analysis showed no statistically significant difference between the two groups (p = 0.84, 95% confidence interval (CI) = 0.764 (0.714-0.821). Serious drug side effects were not observed in either group. Topical liposomal azithromycin has the same efficacy as intralesional glucantime in the treatment of CL.

Serum zinc and copper status in Iranian patients with pemphigus vulgaris.

BACKGROUND: The role of nutritional factors including trace elements has been reported in the pathogenesis of many autoimmune diseases. OBJECTIVE: Regarding the relatively high prevalence of pemphigus vulgaris in Iran, we investigated the serum levels of zinc and copper as two important trace elements, together with the oxidative stress status in patients with pemphigus vulgaris. MATERIALS AND METHODS: This case-control study was performed on 25 patients with newly diagnosed pemphigus vulgaris and 25 age- and sex-matched healthy control subjects. Serum concentrations of zinc, copper, ceruloplasmin as well as copper/zinc ratio were determined for each subject. Oxidative stress was also measured using a novel assay of peroxidant-antioxidant balance (PAB). RESULTS: Mean serum concentrations of zinc and copper as well as copper/zinc ratio were significantly lower in patients (mean age: 47.2±16.2 years; male/female: 14/11) compared with the controls (mean age: 47.3±12.8 years; male/female: 14/11; P<0.001). In contrast, PAB values were significantly elevated in patients compared with controls (P<0.01). No significant difference in serum ceruloplasmin concentrations was observed between the groups (P>0.05). CONCLUSION: Our findings indicate that low serum zinc and copper and increased oxidative stress may be associated with pemphigus vulgaris.