Epidermal hydration and skin surface lipids in patients with long-term complications of sulfur mustard poisoning.

BACKGROUND: Despite almost the three decades passed since the chemical attacks of Iraqi's army against the Iranian troops, some veterans are still suffering from long-term complications of sulfur mustard (SM) poisoning, including certain skin complaints specially dryness, burning, and pruritus. We thus aimed to evaluate the skin's water and lipid content in patients with a disability of >25% due to complications of SM poisoning and compare them with a matched control group. MATERIALS AND METHODS: Sixty-nine male participants were included in this study; 43 SM-exposed patients, and 26 normal controls from their close relatives. The water and lipid content was measured in four different locations: Extensor and flexor sides of forearms and lateral and medial sides of legs by the Corneometer CM 820/Sebumeter SM 810. Collected data was analyzed and P ≤ 0.05 was considered as statistically significant. RESULTS: The mean age of the patients and controls was 49.53 ± 11.34 (ranges: 40-71) and 29.08 ± 8.836 (ranges: 15-49 years), respectively. In the veterans group, the main cutaneous complaint was itching and skin dryness. Cherry angioma, dry skin, and pruritus were significantly more common in the SM-exposed cases than in the controls. (P = 0.01, 0.05, and 0.04, respectively). The moisture and lipid content of all areas were lower in the SM-exposed group, but it was only significant in skin sebum of lateral sides of legs (P = 0.02). CONCLUSION: Exposure to SM could decrease the function of stratum corneum and lipid production as a barrier, even after several years of its exposure.

Efficacy of intralesional amphotericin B for the treatment of cutaneous leishmaniasis.

BACKGROUND: Antimoniate compounds have been used as gold standard treatment for cutaneous leishmaniasis since many years ago, but with increase in incidence of drug as well as individual contraindications, more attention has been given to alternative treatments. AIM: The aim of this study was to evaluate the efficacy of intralesional amphotericin B as an alternative treatment for cutaneous leishmaniasis in Mashhad, Iran, during 2007-2009. MATERIALS AND METHODS: Non-random sampling from both sexes and without any age limitation of cases eligible for this alternative treatment was done. Size and induration of lesions were measured before beginning and weakly during the treatment. Amphotericin B (2 mg/ml) was injected into lesions weekly for up to 12 weeks and the cases were followed up for the treatment responses, possible side effects and recurrence of the disease. RESULTS: A total of 93 patients with a mean age of 20.81 ± 15.26 years were included in this study. At the end of 12(th) week, 61.4% of the patients were recovered completely (more than 90% reduction in size and induration), 21.6% had partial remission (60-90% reduction in size and induration), and 17% had less than 60% reduction in size and induration of skin lesions. Injection side effects were insignificant and did not lead to premature discontinuation of treatment in any patients. CONCLUSION: Weekly intralesional injection of amphotericin B looks promising, considering the fact that most of the patients in this study were resistant to antimoniates.

Fitness for work evaluation of firefighters in Tehran.

Firefighting is extremely strenuous and physically demanding work and involves ability to cope with emergency life-or-death situations. Because of the high physical demands of firefighting, successful job performance and minimizing of morbidity and mortality depends on fitness for duty. The firefighting department of Tehran does not perform periodic medical assessment for firefighters. The aim of this study was to evaluate medical fitness among firefighters in Tehran. In this cross sectional study we examined 147 firefighters. Medical and occupational history obtained by interview, then we performed physical examination, blood tests, ECG, spirometry and audiometry. Then results compared with guidelines for firefighters in the USA, Australia and the United Kingdom. Seven percent of our participants had a kind of pulmonary dysfunction and 25% had some degrees of hearing loss. A considerable percent of them had modifiable coronary heart disease risk factors. Thirteen participitants were unfit for this job that among them; ten firefighters were unfit based on vision capability, one case due to hypertention and two cases because of pulmonary dysfunction. Because of hazardouse nature of firefighting; preplacement, periodic medical evaluations and assesment of fitness for firefighters in Iran is highly recommended. Establishment of fitness criteria for firefighters in Iran is necessery to perform assigned functions safely.

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.

Simvastatin treatment reduces heat shock protein 60, 65, and 70 antibody titers in dyslipidemic patients: A randomized, double-blind, placebo-controlled, cross-over trial.

OBJECTIVE: This study aimed to evaluate the effects of statin therapy on serum levels of antibodies to several specific heat shock proteins (HSPs) in dyslipidemic patients. DESIGN AND METHODS: Participants (n=102) were treated with simvastatin (40mg/day), or placebo in a randomized, double-blind, placebo-controlled, cross-over trial. Anti-HSP60, 65, 70, and hs-CRP levels were measured before and after each treatment period. Seventy-seven subjects completed the study. RESULTS: Treatment with simvastatin was associated with significant reductions in serum anti-HSP60, 65, and 70 titers in the dyslipidemic patients (10%, 14%, and 15% decrease, respectively) (p<0.001). There have been previous reports of reductions in serum CRP with statin treatment, and although median CRP levels were 9% lower on simvastatin treatment, this did not achieve statistical significance. CONCLUSION: While it is unclear whether HSP antibodies are directly involved in atherogenesis, our findings suggest that simvastatin inhibits autoimmune responses that may contribute to the development of cardiovascular disease.