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Background: Treatment of vitiligo is still a big challenge for dermatologists. The efficacy of statins in the treatment of vitiligo is controversial. Aim and Objective: We studied possible therapeutic effect of topical 1% niosomal atorvastatin ointment combined with topical 0.1% tacrolimus in treatment of non‐segmental vitiligo. Methods: This is a triple blind, pilot, randomized placebo‐controlled trial (RCT) that was performed in dermatology clinic. All the patients used topical 0.1% tacrolimus cream twice daily (BD). Moreover, the intervention group participants used topical 1% niosomal atorvastatin ointment, and control group participants were prescribed placebo ointment, BD. Patients were evaluated using vitiligo area surface index (VASI) score and patients' satisfaction at baseline and after 3 months treatment. Results: The mean patient satisfaction in the intervention and control groups were 5 ± 1.4 and 3.5 ± 1.9; the difference between groups was not statistically significant (p = 0.9). We found statistically significant difference in VASI score before and after treatment in both intervention and control groups (p = 0.01 and p = 0.03, respectively). However, comparison of the VASI score between groups was not statistically significant (p = 0.62). We also found no significant correlation between VASI score and other variables. Conclusion: The result of this study indicates that adding of niosomal atorvastatin 1% ointment to topical calcineurin inhibitor has no additional effect on non‐segmental type of vitiligo. Further large studies with different combinations are recommended before any conclusive result can be concluded on efficacy of statins in vitiligo. [ABSTRACT FROM AUTHOR]

The systemic and respiratory clinical manifestations of coronavirus disease 2019 (COVID‐19) include fever, coughing, sneezing, sore throat, rhinitis, dyspnea, chest pain, malaise, fatigue, anorexia and headache. Moreover, cutaneous manifestations have been reported in 0.2% to 20.4% of cases. Early diagnosis of COVID‐19 leads to a better prognosis; knowledge of its cutaneous manifestations is one way that may help fulfil this goal. In this review, PubMed and Medline were searched with the terms "dermatology", "skin" and "cutaneous", each in combination with "SARS‐CoV‐2" or "COVID‐19". All articles, including original articles, case reports, case series and review articles published from the emergence of the disease to the time of submission, were included. In this comprehensive narrative review, we tried to provide an analysis of the cutaneous manifestations associated with COVID‐19, including maculopapular rash, urticaria, Chilblain‐like, vesicular lesions, livedo reticularis and petechiae in asymptomatic/symptomatic COVID‐19 patients that might be the first complication of infection after respiratory symptoms. Immune dysregulation, cytokine storms, side effects of antiviral drugs, environmental conditions and high‐dose intravenous immunoglobulin (IVIG) therapy might be involved in the pathogenesis of the cutaneous manifestations in COVID‐19 patients. Therefore, knowledge of cutaneous COVID‐19 manifestations might be vital in achieving a quick diagnosis in some COVID‐19 patients, which would help control the pandemic. Further research is very much warranted to clarify this issue. [ABSTRACT FROM AUTHOR]

Background and Aim: Common wart is a viral infection of epithelial tissues caused by human papiloma virus (HPV). In order to increase the efficacy and concurrent reduction of complications, different types of combination therapies have been recommended. One of them is the combination of cryotherapy with cantharidin. As cantharidin causes little pain and leaves small scars, we decided to design and conduct a randomized, controlled trial to investigate the efficacy of combined cryotherapy and topical cantharidin versus cryotherapy and a topical placebo. The mean number of the treatment sessions and complications of treatments were also compared between the two groups. Methods: This study was a randomized, controlled double blind clinical trial in which 110 patients with verruca vulgaris were randomly allocated into two groups. After cryotherapy in both groups, topical lotion of cantharidin 0.7% (Canthacur) and flexible collodion as placebo were applied topically in the intervention and control groups, respectively. Patients were followed for healing rates, complications and recurrence of the lesions. Results: The healing rates of lesions in both groups were 100%. The mean number of treatment sessions in the intervention and control groups were 3.4 and 4.7, respectively (P<0.001). The incidence of hyperpigmentation in the intervention and control group were 29.1% and 10.9%, respectively (P=0.017). Atrophic scars in the case group were less common than the control group (9.1% versus 29.1%). Within 4 weeks of follow up after completion of the treatment protocol, the frequency of other complications and recurrence of the lesions showed no statistically significant difference between the two groups. Conclusions: Combination of cryotherapy and cantharidin reduced the number of treatment sessions and atrophic scars, but increased the hyperpigmentation. Also, this combination therapy was ineffective in reducing other complications and the recurrence rate of the lesions. [ABSTRACT FROM AUTHOR]

Background: Leishmaniasis is a zoonotic infection caused by a protozoa belonging to the genus Leishmania. Its clinical manifestations range from a self-healing cutaneous leishmaniasis (CL) to lethal visceral leishmaniasis. We aim to examine the quality of life of patients with CL in Kerman. Iran. Methods: In this cross-sectional study we evaluated 124 patients with CL. The Dermatology Life Quality Index (DLQI) questionnaire was used for measuring quality of life. Data on demographics and characteristics of the lesions also were collected. Mann-Whitney U-test and Kruskai-Wallis were used for data analyses. Results: The mean DLQI score was 5.87 ± 5.96. We observed the highest effect in the symptoms and feelings domains; the lowest effect was seen in the treatment domain of the DLQI. There was no significant difference in DLQI scores between men and women. Patients with ulcerated lesions had lower quality of life (P < 0.05). Conclusion: CL significantly affects the quality of life of patients. Further studies are suggested to examine the effect of its treatment on the quality of life in these patients. [ABSTRACT FROM AUTHOR]

The history of leishmaniasis dates back to the distant past; however, its etiologic agent was unidentified until the mid-19th century. Here is an overview of some historical aspects of leishmaniasis in Iran mainly focused on the cutaneous form, from the mid-19th century onwards. In addition, short biographies of several contemporary researchers and experts of leishmaniasis and their achievements in the past decades are presented.

Background: A rare variant of Leishmaniasis is Localized Leishmania Lymphadenitis which has been occasionally reported from south-eastern parts of Iran. So far, no molecular assay has been performed for diagnosing this variety of Leishmaniasis., Methods: Nineteen lymph node paraffin blocks were collected from 1994 to 2007. Parasite load count and histopathological patterns reported on Hematoxylin-Eosin and Giemsa stained slides.DNA extraction was carried out just on the remaining available 7 lymph node paraffin blocks according to QIAamp DNA FFPE kit instructions. A pair of primers and a probe were designed for rRNA ITS region with Allele ID 6.0 software, followed by real time PCR amplification., Result: The most common histopathological pattern was necrotizing granuloma with few Leishman bodies. Parasite load was the highest in submental lymph node (3 ± 1.41 per oil field) which was significantly higher compared to cervical and inguinal nodes (P < 0.05). Absolute load of parasite DNA was detectable in all 7 cases. The positive cases revealed a 201 bpamplicon after electrophoresis of end product which was confirmative for Leishmania tropica., Conclusion: Real time PCR revealed Leishmania tropica as the etiologic agent of Localized Leishmania Lymphadenitis. Although this molecular method is a sensitive diagnostic tool, histopathological findings are still important.

Background: This study compared histological and immunohistochemical changes of cutaneous leishmaniasis treated with meglumine antimoniate, imiquimod, and the combination of both therapies., Methods: Single blind clinicopathological studies of fifteen patients with old world cutaneous leishmaniasis in Kerman, Iran were included. A total of four patients received a combination of imiquimod (5% cream) and intra-lesional meglumine antimoniate weekly for four weeks. Monotherapy with imiquimod was given to seven patients and four patients were treated with meglumine antimoniate intralesionally. Histological confirmation was performed before and during therapy. Semi-quantitative histological parameters such as numbers of mixed inflammatory cells (cells/mm(2)) and percentages of Langerhans cells (CD1a+), T-cells (CD3+), B-cells (CD20+), and macrophages (CD68+) were calculated immunohistochemically in the dermis and adjacent epidermis., Results: Topical imiquimod significantly reduced mean histiocytic cellular aggregation size (P<0.05). Meglumine antimoniate reduced parasite load and infected activated histiocytes in the dermis (P<0.05). Meglumine antimoniate therapy decreased epidermal CD3+ lymphocytes but increased them in the dermis, within the granulomas (P<0.05). During topical application of imiquimod a depletion of CD1a+ dendritic cells in the epidermis (P<0.05) and slight predominance of dendritic cells in the dermis were observed. Combined therapy and imiquimod monotherapy decreased CD68+ macrophages in the dermis (P<0.05)., Conclusion: Meglumine antimoniate decreases parasite load with considerable effect on up-regulation of T-cells, which demonstrates that meglumine antimoniate works as parasitocidal and immunomodulator, which could be a first line of treatment. Imiquimod accentuates the host immune response and reduces granuloma size which could be effective immunomodulator for combination therapy. Monotherapy of imiquimod is less effective than the two other regimens in decreasing parasite load, inflammation and congestion at the inoculated site.