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The article focuses on assessing whether sites of primary lesions in pemphigus vulgaris (PV) are more susceptible to relapse. It identifies the anatomical locations where initial lesions occur and determines if these same sites are more likely to experience relapses. It suggests that tissue-resident memory T cells may play a significant role in this phenomenon, potentially explaining why certain sites are recurrently affected.

Background: Helicobacter pylori (H. pylori) colonizes human gastric mucosa and is classified as class one carcinogenic bacteria. In this regard, this study aimed to detect major virulence factors in H. pylori strains recovered from gastric biopsy in patients referred to Aras Clinique in Ardabil, northwest of Iran (2019–2021). Materials and methods: In this descriptive-cross sectional study, 287 dyspeptic patients were included. For bacterial isolation, gastric biopsy specimens (n=287) were taken from gastric antrum, then aseptically were cultured on the selective medium and incubated at 37C in microaerophilic conditions for 3-5 days. Results: 25.18% of all (n = 70) patients were found to be infected with H. pylori upon endoscopy. Of them, 9 patients (12.857%) and 2 patients (2.875%) had peptic ulcer disease and gastric cancer respectively. According to the different patterns of virulence factors, 57 virutypes were identified in which oipA-vacAs1-vacAm2 (3, 4.28% n =) and oipA-vacAs1-vacAs2-vacAm2 (3, 4.28% n =) were the most common patterns. The simultaneous presence of vacAS2, vacAm2 and hopQ2 genes was observed in both patients with gastric cancer. OipA (n = 562.5%), VacAs1 (n = 6.75%), VacAs2 (n = 6.75%), and VacAm2 (n = 787.5%) were found to be the most prevalent virulence factor. Conclusion: According previous studies, it is confirmed that the cagPAI gene cluster and vacA gene alleles are strongly correlated with gastritis and gastrointestinal tract adenocarcinomas. Our study indicated that 50% of the indigenous strains of H. pylori harbor these oncogenic genes and they are hypervirulent. [ABSTRACT FROM AUTHOR]

Evaluation and monitoring of pemphigus vulgaris (PV) typically involve autoantibody detection by enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescence (IIF). We aimed to determine the levels of antipemphigus immunoglobulin (Ig) G autoantibodies using ELISA and IIF (as standard biomarkers), and compare it to prolactin, macrophage migration inhibitory factor (MIF), and Creactive protein (CRP) (as nonstandard biomarkers) to determine which of these non-standard biomarkers is appropriate for PV monitoring. The experiment was performed before and during therapy. Anti-Dsg immunoglobulin G autoantibodies were measured using ELISA and IIF (as standard biomarkers) versus prolactin, MIF, and CRP (nonstandard), before 1 and 3 months after the treatment. Before beginning the treatment, the severity of the disease was determined using the pemphigus disease area Index (PDAI). We enrolled 60 newly diagnosed patients with PV (32 men and 28 women; mean age=43.8±14.2 years). Before treatment, the levels of anti-Dsg1, anti-Dsg3, and IIF were high and had a significant relationship with PDAI. PDAI also had a connection with the levels of CRP and prolactin. The anti-Dsg1, anti-Dsg3, IIF, and CRP titers decreased in patients treated with conventional (prednisolone plus azathioprine) and rituximab therapy during and after treatment. In conclusion, anti-Dsg1, anti-Dsg3, and IIF autoantibody titers remain standard biomarkers for assessing disease activity, severity, and PV monitoring. The trend of CRP was similar to that of anti-Dsg1, anti-Dsg3, and IIF. Thus, CRP may be used for PV monitoring. [ABSTRACT FROM AUTHOR]

Background: Rituximab is widely used for treatment of pemphigus patients. B‐cell activating factor (BAFF) and a proliferation‐inducing ligand (APRIL) play key roles in B cell survival, maturation, and differentiation. Here, the effect of rituximab on BAFF and APRIL in patients with pemphigus vulgaris (PV) was studied. Methods: Fifty PV cases and 56 healthy individuals were recruited. Patients received rituximab for a period of 6 months. The levels of BAFF and APRIL were measured in the serum samples. The frequency of CD19+ B cells was measured by flow cytometry. Results: The level of BAFF was significantly higher in the patients at the baseline level than controls (P = 0.0005). The level of BAFF was significantly higher at the 3rd month follow‐up compared to the baseline (P = 0.033). There was a significant increase in the BAFF level at the 6th month follow‐up compared to baseline (P = 0.0134). There was no significant difference in the CD19+ B cells/total lymphocytes ratio in the PV patients between the 3rd and 6th month follow‐ups. Conclusions: Elevated BAFF in the sera could be associated with PV immunopathogenesis. Inhibition of BAFF after rituximab therapy might interfere with repopulation of B cells and confer a therapeutic approach in PV. [ABSTRACT FROM AUTHOR]

Actinic keratosis (AK) is a pre-cancerous skin lesion, associated with development of squamous cell carcinoma. Current treatment options are limited. To compare the efficacy and safety of topical 5-fluorouracil cream (5-FU) and potassium hydroxide 5% (KOH) in the treatment of AK. Eighteen patients with AK applied KOH solution or 5-FU on each side of their scalp/face, randomly. The efficacy and safety of these treatments were compared. Thirteen (118 lesions) and ten (83 lesions) patients were successfully followed for one and three months, respectively. After one month, KOH showed a better clinical response (81% vs. 58%; p-value = 0.007) and dermoscopic response (KOH, 65% vs. 5-FU, 46%; p-value = 0.04); while no differences were noted after three months (clinical response, 83% vs.70%, p-value = 0.1; dermoscopic response, 76% vs. 59%, p-value = 0.1). No significant differences in the recurrence rate of the lesion between the two groups were noted at the end of the third month (p-value = 0.5). Regarding the safety of the treatments, the risk of developing erythema, scaling, sand swelling was higher in 5-FU group (p-value < 0.0001, for all), while more patients in KOH group had erosion and ulcer (p-value < 0.001 for both). KOH was up to 96% less expensive than 5-FU. Low number of patients and short-term follow-up limited the analysis. KOH solution offers a faster and less expensive resolution of AK lesions than does 5-FU. IRCT20180909040978N1 [ABSTRACT FROM AUTHOR]

Frontal fibrosing alopecia (FFA) is a scarring alopecia with no promising treatment. To evaluate the additive efficacy of oral isotretinoin to topical treatments. Between November 2017 and August 2018, FFA patients were randomly assigned to receive either isotretinoin (20 mg/d) plus topical treatments (clobetasol 0.05% and tacrolimus 0.1%) or monotherapy with topical treatments. Treatments' efficacy was evaluated through Frontal Fibrosing Alopecia Severity Index (FFASI) after two and 6 months. From 38 participants, 28 patients completed the study. Facial papules improved after 6 months (p value <.001) in the isotretinoin group. Moreover, frontotemporal hairline (p values for frontal <.001; R lateral: 0.03; L Lateral: 0.02), total scalp margins, total additional features' scores, and total combined (p value <.001 for all) improved more in the isotretinoin group than in the control group. Frontal band improved in the treatment group (p value:.02). Frontal margin (p value:.01), R lateral (p value:.01), total scalp (p value <.01), and combined total scores (p value:.01) worsened in the control group. Isotretinoin-related side-effects included lip dryness, telogen effluvium, and malaise. Small sample size and lost to follow-up. Isotretinoin combined with topical treatments is more effective than monotherapy with clobetasol and tacrolimus for FFA. (IRCT.ir) IRCT2017091736173N1. [ABSTRACT FROM AUTHOR]

Background and Aim: Integrons play an essential role in disseminating drug resistance genes among bacteria. The aim of this study was to determine the prevalence of integrons, and Extended-Spectrum β-Lactamase (ESBL) genes in Escherichia coli (E. coli) isolates collected from patients with urinary tract infection (UTI) referred to teaching hospitals in Ardabil, Iran. Materials and Methods: In this descriptive, cross-sectional study (2017-2018), 163 isolates of E.coli were collected from patients with UTI. The drug susceptibility pattern of these isolates to 12 common antibiotics was investigated using the disk diffusion method based on CLSI guidelines. The prevalence of class 1, 2,3 integrons and ESBL genes was verified by the PCR method. Finally, the genetic variation of isolates was analyzed using the ERIC-PCR method. Results: Of 163 isolates, 138 (84.7%) isolates were multidrug-resistance (MDR) strains. The lowest and highest antibiotic resistance was reported to nitrofurantoin and ampicillin, with a resistance rate of 1.2% and 89.6%, respectively. The incidence of class 1 and 2 integrons was obtained in 39.9% and 14.1% of the isolates, respectively. Class 3 integron was not found in any of the isolates. Based on the ERIC-PCR fingerprinting method, 4 ERIC types were detected. Conclusion: Our study showed that E. coli isolates taken from patients mainly were MDR strain and resistant to many of the common antibiotics used to treat urinary tract infections. Using the correct dose of medication and multidrug therapy would be effective in reducing the incidence of antibiotic resistance. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate changes in some laboratory parameters in response to four independent variables (COVID-19, diabetes, gender, and age) using univariate and multivariate analysis. Methods: We measured WBC (neutrophil and lymphocytes), RBC and platelet counts, and hemoglobin, lactate dehydrogenase, C-reactive protein, IL-2, IL-4, and vitamin D3 levels in 30 hospitalized patients with severe COVID- 19 and in 30 healthy people in terms of COVID-19. The population was divided into groups based on each of the variables of age, gender, COVID-19, and type 2 diabetes. Then they were subjected to univariate and multivariate analysis of logistic regression. Results: Based on CBC data, leukocytosis (in 70% of COVID-19 patients, 61.1% of diabetic patients, and 70.9 ± 18 years old), neutrophilia (in 73.3% of patients with COVID-19, 61.1% of diabetic patients, and 66 ± 18.6 years old), neutropenia (in 6.7% of patients with COVID-19, 27.8% of diabetic patients, and 33.6 ± 12.7 years old), lymphocytosis (10% of patients with COVID-19, 33.3% of diabetic patients, and 35.4 ± 15.5 years old), and lymphocytopenia (in 76.7% of patients with COVID-19, 66.7% of diabetic patients, and 67.1 ± 18.8 years old) were observed in the population. The elderly and those with COVID-19 had significant abnormal RBC and platelet counts. Increased LDH and CRP levels and abnormal hemoglobin level were related to elderly, COVID-19, and diabetes conditions. Although the levels of IL-2 and -4 were significant in patients with COVID-19 and elderly; however, the changes were not significant in diabetic patients. Changes in serum vitamin D levels were not significant in any of the sub-groups. Conclusions: We showed that leukocytosis, neutrophilia, lymphocytopenia, abnormal counts of RBCs and platelets, the elevated levels of LDH and CRP, and abnormal hemoglobin levels in blood are considered as poor prognostic factors for COVID-19. [ABSTRACT FROM AUTHOR]

Introduction: Vitiligo is a common pigmentation disorder manifested by white macules and patches. It is accompanied by some autoimmune and neurological diseases. Recently, it has been suggested that multiple sclerosis (MS) is more common in vitiligo patients and that they have a higher risk of developing MS during their lifetime., Objectives: In this study, we aimed to determine the prevalence of MS in patients with vitiligo and their first-degree relatives and compare it with the prevalence in the population., Methods: In this cross-sectional study, data were consecutively collected from patients referred to Razi Hospital from March 2020 to December 2021., Results: Seven hundred and nine patients with vitiligo participated in this study, and 15 reported a history of MS (2.12%, 95% confidence interval [CI] 1.06%-3.17%). This rate was significantly higher than the prevalence of MS in the average population of Tehran (P < 0.001). Of the 2886 first-degree relatives of the patients, 10 had MS (0.35%, 95%CI 0.13&-0.56%), which was higher than the prevalence of MS, yet not statistically significant., Conclusions: A significant association between vitiligo and MS was observed, which should be of clinical and therapeutic importance. However, the prevalence of MS in first-degree relatives of vitiligo patients was higher than the average rate, yet not statistically significant.