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Cutaneous leishmaniasis is a prevalent parasitic infection in humans. According to the reports published in several localities across the world, leishmaniasis is an endemic disease in certain regions in Iran. Leishmaniasis is transmitted through sandfly bites and is often diagnosed through the smear examination of the affected area using a microscope. The treatments of choice for leishmaniasis involve the use of pentavalent antimony compounds, such as meglumine antimoniate and sodium stibogluconate. However, other medications have been proposed for the treatment of leishmaniasis, and there is ongoing research for effective, less harmful treatments. This narrative review aimed to summarize various systemic treatments for leishmaniasis. [ABSTRACT FROM AUTHOR]

Background: Cutaneous leishmaniasis is a common parasitic infestation in Iran. With recent advantages in digital imaging, we have devised a novel non-contact objective method of measuring lesions.Aim: The aim of the study was to design a software system that analyzes images of cutaneous leishmaniasis lesions, objectively assess and monitor volume.Methods: A photographic technique along with an image processing algorithm was applied to extract a three-dimensional map of the lesion from a simple two-dimensional picture. This method recovers depth on the basis of blur estimation. A macro lens with a low depth of field was used to blur the objects out of focus. To assess and compare the results, a polymer mold of the corresponding lesion was made and filled with liquid. The volume of liquid corresponded to the volume of the lesion. A total of thirty-seven patients were enrolled, and 48 lesions were analyzed.Results: The mean volume measured by image processing was 159 μl (range: 8-685 μl), in comparison to an average of 170 μl (range: 6-800 μl) obtained from the molds. This was not significantly different. Statistical analysis by the Pearson correlation test showed a 'very good fit' correlation between these measured volumes (P < 0.001, r = 0.938).Limitation: The location and height of lesions were two important limitations in implementing this technique. If the lesion location is in the curvature region of body or the lesion height is less than 1 mm or more than 1 cm, this method will lose precision and accuracy.Conclusion: Image processing with blur estimation technique is an accurate and precise method to measure the volume of lesions in cutaneous leishmaniasis. [ABSTRACT FROM AUTHOR]

Introduction: Psoriasis is a chronic inflammatory skin disease characterized by plaques covered with silvery scales. Psoriasis is highly prevalent in different countries in the world, including Iran. Several studies have reported a significant association between psoriasis and cardiovascular diseases. This study aimed to evaluate the relationship between psoriasis and cardiac disease using echocardiography. Materials and Methods: This cross-sectional study was conducted in Imam Reza Hospital of Mashhad, Iran during 2013-2014 on patients with clinical diagnosis of psoriasis confirmed via biopsy. In addition, healthy volunteers homogenous in terms of age and gender were selected as the control group. Echocardiography was performed on patients and control subjects. Size of the left and right ventricles, left ventricle ejection fraction, diastolic function, and pulmonary artery pressure were recorded. In addition, patients were assessed in terms of the presence of valve regurgitation and disease severity. Results: In total, 23 patients with psoriasis and 23 control subjects were enrolled in this study. Mean duration of psoriasis was 7.0±9.1 years (range: 1-25 years), and disease severity ranged between moderate and severe. Left ventricular end-diastolic and systolic diameters were significantly higher in patients with psoriasis (P=0.030 and P=0.016, respectively). Moreover, left ventricular diastolic dysfunction was observed in 14 psoriasis patients (60.8%) and 3 control subjects (13.4%) (P<0.001), all of whom were presented with grade I diastolic dysfunction. No significant difference was observed in the left atrial volume, mid-right-ventricular diameter, and pulmonary artery pressure. If present, valvular regurgitation was reported to be mild, while the prevalence of mild aortic regurgitation was significantly higher in psoriatic patients compared to control subjects (P=0.032). In addition, no statistically significant difference was observed in mitral or tricuspid valve abnormalities. Conclusion: According to the results of this study, patients with psoriasis commonly present with echocardiographic abnormalities, even in the absence of cardiovascular symptoms. [ABSTRACT FROM AUTHOR]

Objective(s): Cutaneous Leishmaniasis (CL) is a parasitic disease caused by various species of the flagellated protozoan, Leishmania. Regardless of the numerous studies, there are still serious challenges in the treatment of CL. This study aimed at evaluating the influence of a low dose ultraviolet B (UVB) radiation along with silver nanoparticles (AgNPs) on a mouse model of CL induced by Leishmania major. Materials and Methods: L. major promastigotes (MRHO/IR/75/ER) were extracted from infected mice spleens. Two months after subcutaneous injection of 2×106 promastigotes into the footpad of BALB/c mice, when the lesions were developed, the animals were divided into 4 groups including one control group and three study groups: AgNPs, UVB and UVB plus AgNPs. Spleen parasite burden was assessed on day 40 after the first treatment. The data were analyzed by Instat, Elida and SPSS 16 software programs. Results: The results showed the highest pronounced inhibitory effect in the group receiving AgNPs plus UVB. In addition, a significant difference was obtained between the group receiving AgNPs alone and the one with combinational therapy. The findings on parasite burden showed a significant difference between the control group and other treatment groups. Conclusion:It could be suggested that UVB in the presence of AgNPs, by inhibiting the spread of CL lesions and reducing the rate of visceral progression of the disease, provides a serious antileishmanial effect. [ABSTRACT FROM AUTHOR]

Introduction Application of near-infrared absorbing nanostructures can induce hyperthermia, in addition to providing more efficient photothermal effects. Gold-gold sulfide (GGS) is considered as one of these nanostructures. This study was performed on a tissue-equivalent optical-thermal phantom to determine the temperature profile in the presence and absence of GGS and millisecond pulses of a near-infrared laser. Moreover, the feasibility of hyperthermia induction was investigated in a simulated tumor. Materials and Methods A tumor with its surrounding tissues was simulated in a phantom made of Agarose and Intralipid. The tumor was irradiated by 30 laser pulses with durations of 30, 100, and 400 ms and fluences of 40 and 60 J/cm2. Temperature variations in the phantom with and without GGS were recorded, using fast-response sensors of a digital thermometer, placed at different distances from the central axis at three depths. The temperature rise was recorded by varying duration and fluence of the laser pulses. Results The rise in temperature was recorded by increasing laser fluence and number of pulses for three durations. The temperature profile was obtained at each depth. The presence of GGS resulted in a significant increase in temperature in all cases (P<0.035). Also, the laser temperature had a slower reduction in the presence of GGS, compared to its absence after turning the laser off (P<0.001). Conclusion The millisecond laser pulses could induce hyperthermia in a relatively large target tissue volume. GGS as a simple and cost-effective synthesized nanostructure could induce localized hyperthermia in the desired region during near-infrared laser irradiation. [ABSTRACT FROM AUTHOR]

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 12th 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. [ABSTRACT FROM AUTHOR]

Objective(s): In this study, the serum level of interferon-γ (IFN- γ) and interlukin-4 (IL-4) was evaluated as a marker of Th1 and Th2 immune response that influence the clinical course of cutaneous leishmaniasis. Materials and Methods: This cross-sectional study was conducted on 44 cases of cutaneous leishmaniasis (21 cases with healed lesions and 23 cases with chronic non-healing lesions. Thirty-two non-infected persons living in the area were considered as controls. Serum levels of IFN- γ and IL-4 were determined using ELISA, and the results along with clinical data were analyzed using SPSS 11.5. Results: Serum IFN-γ level was not significantly different between various patient groups and control (P=0.27), but the serum level of IL-4 in patient groups was higher than in healthy subjects, and it was higher in patients with non-healed chronic cutaneous leishmaniasis than those with healed lesions (P<0.01). Conclusion: Serum IL-4 level is a good marker for evaluation of the clinical course of cutaneous leishmaniasis. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to determine the efficacy of thermotherapy in the presence of gold nanoparticles (GNPs) and microwave (MW) radiation at a frequency of 2450 MHz on the survival of Leishmania major promastigotes and amastigotes. Materials and methods: L. major promastigotes (strain MRHO/IR/75/ER) were cultured in RPMI-1640 medium supplemented with foetal bovine serum and antibiotic. The promastigotes were incubated with GNPs for 2 h. After washing, thermotherapy was performed by MW irradiation. After 48 h the promastigote survival rate was assessed using Alamar Blue assay. In the second part of the study, after culture and proliferation of J744 cells, the infected macrophages were incubated with the GNPs and were inserted under MW irradiation. After 24 h, the number of amastigotes in the macrophages was determined after Giemsa staining by a light microscope. Result: Increased exposure time of the microwave to the parasites in the presence of GNPs induced a significant decline in promastigotes survival rate in comparison to similar samples without GNPs. The least survival of amastigotes was also recorded in the groups containing GNPs. The presence of GNPs during MW irradiation was more lethal for promastigotes and amastigotes in comparison to MW alone. Conclusion: Thermotherapy using MW radiation in the presence of GNPs may be proposed as a new approach to treat leishmaniasis in future studies. [ABSTRACT FROM AUTHOR]

Leishmaniasis is a group of diseases with varied clinical manifestations. Ocular involvement is an unusual presentation of leishmaniasis, and the eyelid is not a common site of cutaneous lesions, likely due to the mobility of the lids. Some case reports of conjunctival involvement are either a contiguous dissemination from lid margin or in the setting of disseminated leishmaniasis in an immunocompromised host. To our knowledge, isolated involvement of the bulbar conjunctiva has not been reported. We present the first case in the literature of a patient with an erythematous fibrovascular lesion in the interpalpebral zone that was clinically diagnosed as pterygium, but recurred at the site of surgical excision. After histopathologic diagnosis, the lesion was treated with intralesional injection of amphotericin B and improved completely within a few weeks. An accurate diagnosis of leishmaniasis in the eye may be challenging in many clinical settings. To our knowledge, an isolated pterygium‑like lesion has not been reported in literature. In addition, intralesional injection of amphotericin B is a novel treatment method in this setting. [ABSTRACT FROM AUTHOR]

Background: Old world cutaneous leishmaniasis (CL) is known as a self-healing cutaneous parasitic infection. Host immunity has a fundamental role in the course of this infection. This study was designed to investigate the relationship between nutritional status and vitamin A intake with the clinical course of CL., Methods: Overall, 250 patients with CL attending a dermatology clinic in Imam Reza Hospital Mashhad, Iran, were enrolled from Apr 2011 to Aug 2012. For data gathering, a semi-quantitative 302-item food frequency questionnaire was utilized. They received routine treatment protocols for leishmaniasis and 1 year of follow-up., Results: As for the 149 patients who completed the study, a deficiency of macro and micronutrients, particularly vitamin A, was significantly related to a chronic clinical disease course., Conclusion: Imbalanced or insufficient nutritional intake including vitamin A deficiency, may influence the clinical course of CL., Competing Interests: Conflict of interest The authors declare that there is no conflict of interests., (Copyright© Iranian Public Health Association & Tehran University of Medical Sciences.)

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.