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Metformin is a commonly used medication in diabetic patients. It can cause different complications including cutaneous adverse reactions. Metformin-induced fixed-drug eruption (FDE) has been reported in limited cases. Due to the popularity of metformin, clinicians need to be aware of uncommon drug reactions for proper diagnosis and treatment. Herein, we report a 43-year-old man with generalized bullous lesions with a positive dechallenge-rechallenge test diagnosed as metformin-induced generalized bullous fixed-drug eruption. Metformin dosage was stopped and lesions were treated with topical clobetasol propionate and oral prednisolone and cyclosporine-A. After a 6-month follow-up, he was well without any relapsing episodes.

Objectives. To investigate the histopathological characteristics of cutaneous melanoma in Isfahan from 2013 to 2018, according to histopathological subtype, lesions location, Clark level, and Breslow thickness. Methods. A descriptive, retrospective study in reports of Alzahra Hospital and Dr. Rajabi Pathology Laboratory in Isfahan. Results. In total, 45 patients were included in this study. The most prevalent histopathological subtype was acral lentiginous melanoma (48.89%), followed by lentigo maligna melanoma (17.78%), nodular melanoma (11.11%), and superficial spreading melanoma (8.89%). Most malignant lesions were on the foot and toes (31.1%) and face (24.4%). Tumor invasion level was mainly at Clark level IV (42.2%). Furthermore, the mean depth of tumor penetration (Breslow thickness) was 3.87 ± 3.35. Conclusions. Our study revealed the characteristics of melanoma in the Iranian population. Our results showed a similar trend with previous studies in the Asian population. Further investigations are needed to elucidate the role of ethnic and environmental risk factors for developing melanoma in different populations.

Introduction. The elderly population is commonly affected by balance and gait disorders that increase the risk of falls. Pivotal systems for efficient postural control are sensory, motor, visual, vestibular, and cognitive. Disruption in any of these systems could lead to postural instability. Vestibular rehabilitation is a set of exercises that positively affect the primary components of the central sensory-motor integration, including somatosensory, visual, and vestibular systems. Accordingly, we hypothesized that vestibular rehabilitation exercises might improve both oculomotor functions and upright postural control in patients with Parkinson’s disease. Materials and Methods. 11 idiopathic Parkinson’s patients voluntarily participated in this study based on inclusion criteria: central vestibular dysfunction and the Hoehn and Yahr scale scores less than or equal to 3. Videonystagmography (VNG) and the Berg Balance Scale (BBS) scores were measured at the baseline. Then, the patients underwent vestibular rehabilitation training for 24 sessions (3 sessions per week). The VNG and BBS were measured again after 48 hours of the completion of the last session of the training. Result. After completing vestibular rehabilitation sessions, there were significant improvements in balance P≤0.001. Eye-tracking and gaze function statistically improved in 7 patients and 6 patients, respectively. Conclusion. Vestibular rehabilitation produced positive effects on oculomotor function and balance in a small cohort of people with PD. Consequently, it could be considered as a possible effective intervention for Parkinson’s patients. This trial is registered with IRCT201709123551N6.

Eruptive syringoma is a rare variant of syringoma presenting with skin-colored or slightly pigmented papules mostly before or during puberty. In this report, we presented a rare case of eruptive syringoma in a 30-year-old woman. She exhibited multiple skin lesions in dorsal areas of her both hands, developed from the age of 15.

Background. Hypertension and its complications are among the major health problems all over the world, particularly in developing countries. The aims of this study were to show that, weather the hypertensive patients follow the expertise recommendations and differences between men and women in their levels of knowledge and behavior in salt taking. Methods. The present cross-sectional study was conducted among all hypertensive patients in rural health centers of Tabriz, Iran, in Feb–May; 2016. Data were collected by an interviewer-administrated questionnaire, along with anthropometric, blood pressure, and 24-hour urinary sodium excretion measurements. Multivariate logistic regression analysis was used to compute adjusted odds ratio (OR). Results. In all 205 patients, 62.9% female, 40.5% aged over 60 years, and 53.7% with low or moderate socioeconomic status, 49.3% body mass index (BMI) 30 kg/m2 and above, 10.2% of the patients had systolic/diastolic equal and above (≥) 40/90 mmHg, participated in the study. In total, 16.6% were aware of the daily salt allowance for healthy people with sex difference (P

One of the most disabling nonmotor symptoms in persons with Parkinson’s disease is fatigue, which can decrease the quality of life by restricting the function and activities of daily living (ADL). Nonetheless, sufficient evidence for treating fatigue, including drug or nondrug treatment, is not available. In this study, we evaluated the probable effects of vestibular rehabilitation on fatigue and ADL in patients with Parkinson’s disease. Methods. This was a single-blind clinical trial study in which patients with Parkinson’s disease voluntarily participated based on the inclusion and exclusion criteria. The patients were randomly assigned to the case and control groups. The case group received 24 sessions of vestibular rehabilitation protocol, and conventional rehabilitation was performed in the control group (i.e., 3 sessions each week, each lasted about 60 minutes). Both groups were also given fatigue management advice. Fatigue was measured by the Parkinson Fatigue Scale (PFS) and the Modified Fatigue Impact Scale (MFIS). ADL was measured by the Functional Independence Measure (FIM). All changes were measured from the baseline at the completion of the intervention. Results. Both fatigue (P≤0.001) and ADL (P≤0.001) improved significantly more in the vestibular intervention group than in the control one. Conclusion. Vestibular rehabilitation may improve fatigue and ADL and therefore can be used as an effective intervention for patients with Parkinson’s disease, which was also found to be well tolerated.