Leprosy profile in Isfahan (A province of Iran).

In Iran, there have been a few cases of leprosy in several provinces, however, native physicians believe that leprosy is not present primarily in an Isfahan endemic area. We performed an investigation either to approve or rule out this idea. We found 25 lepra patients who were registered and followed in Isfahan Leprosy Health Registeration Center, all of whom were infected in other regions and migrated to Isfahan city at a later time. Final analysis proved that there are not any cases of leprosy by itself in Isfahan as an endemic region at the time of this study (1975 to 2002).

Treatment of cutaneous leishmaniasis with itraconazole. Randomized double-blind study.

OBJECTIVE: To compare the efficacy of itraconazole with placebo in the treatment of cutaneous leishmaniasis caused by Leishmania major. DESIGN: Double-blind placebo-controlled study. SETTING: Patients were selected from volunteers wit cutaneous leishmaniasis who lived in a hyperendemic area. PATIENTS: One hundred forty patients were randomly selected for this double-blind study. Exclusion criteria were pregnancy, gestation, age younger than 12 years, and duration of disease of more than 4 months. INTERVENTION: Each patient received itraconazole (7 mg/kg per day) or placebo for a 3-week period. The patients were kept under observation for an additional 30-day period. OUTCOME. The study was completed as planned in 131 patients. RESULTS: Complete healing occurred in 59% of the itraconazole group in comparison with 44.3% of the patients who were treated with placebo capsules. No difference was found between the 2 groups with respect to adverse effects. CONCLUSIONS: Although itraconazole has the advantage of being an oral agent that is used in the treatment of cutaneous leishmaniasis, the low response rate in patients receiving itraconazole indicates that itraconazole cannot be used as the single agent in the treatment of patients with cutaneous leishmaniasis caused by L. major.

Skin manifestations of mustard gas. A clinical study of 535 patients exposed to mustard gas.

BACKGROUND: During the Iraq-Iran war (1980-1988), 535 patients who were exposed to mustard gas (one of the chemical warfare agents used by Iraq) were referred to our dermatology department. In this article, we have tried to review the skin manifestations of these patients. OBSERVATIONS: The skin lesions were of early or late onset. The early onset lesions consisted of erythema (76%), bulla (55%), and purpura (1.1%). These lesions were mostly found on the face and skin folds. The late-onset manifestations were pigmentation (20.4%) and desquamation (11.2%). Other complications were ophthalmic (85%), pulmonary (15%), and gastrointestinal (10%). Lymphopenia (7%) was the most serious laboratory disorder reported. Biopsy specimens of the lesions showed subepidermal bullae with mild dermal and epidermal necrosis. CONCLUSIONS: All patients were treated as for burns using sulfadiazine and furacine. All patients were cured in a period of 15 to 45 days. During a 6-month follow-up, no mortality was observed.