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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]

The aim of this study is to evaluate the frequency and the distribution of symptoms and complications of oculocutaneous and respiratory systems among the individuals with a history of toxic exposure to probably sulfur mustard (SM) gas in Kirkuk, Iraq by the Islamic State of Iraq and Syria (ISIS) also known as "Daesh." In this cross-sectional study, victims of chemical weapons used by Daesh in TazaKhurmatu, Kirkuk, Iraq on March 9 2016 were evaluated 2 days after exposure by the Iranian medical team, with a focus on skin, eye, and lung lesions using a standardized medical evaluation sheet. A total of 1024 Iraqi who are of the ages 2 through 86 claimed exposure to SM were evaluated. Of this number, 480 were male (46.87%) and 544 patients were female (53.13%). We found 66 and 30 subjects who had a moderate or severe injury on cutaneous, ocular, and respiratory organs respectively. The cutaneous injury was the most severe medical complaint, and 24 cases had severe skin lesions including erythema, bulla, and necrosis in folds (groin and genitalia), and the dependent areas. The evidence of environmental contamination with mustard gas includes the smell of garlic odor and the presence of black oil in the environment (ground, soil, and wall). The high number of chemical victims with severe skin lesions rather than eye and lung lesions can be attributed to the transformation of mustard gas to the liquid form at low temperatures in the winter season in Kirkuk. Additionally, increased skin lesions in the buttock and lumbosacral area were probably owing to indirect exposure to the contaminated tools and environment. [ABSTRACT FROM AUTHOR]

Byline: Maryam. Daneshpazhooh, Javad. Khorassani, Kamran. Balighi, Narges. Ghandi, Hamidreza. Mahmoudi, Hamidreza. Tohidinik, Shahin. Hamzelou, Cheyda. Chams-Davatchi Introduction: Neurological diseases are important co-morbidities found in association with bullous pemphigoid. Various [...]

Challenges in the treatment of a patient with toxic epidermal necrolysis associated with COVID-19: A case report In December 2019, a new coronavirus emerged in China and rapidly spread.1 Currently, the outcome of COVID-19 patients treated with immunosuppression drugs is still unknown. On the other hand, COVID-19 produces an inflammatory environment that may reduce the threshold of drug reactions and may predispose the COVID patients to TEN. [Extracted from the article]

BACKGROUND: Cutaneous leishmaniasis is endemic in Iran. OBJECTIVE: We sought to investigate the therapeutic outcomes and complications of treatment in patients with cutaneous leishmaniasis. METHODS: This case series enrolled patients with smear-proven cutaneous leishmaniasis who visited our center in Iran from 2018 to 2019. RESULTS: In total, 36 patients were treated with intralesional meglumine antimoniate, intramuscular meglumine antimoniate, sodium stibogluconate, and amphotericin B. Overall, this treatment was effective in 81.8 percent of patients. Relapse and treatment failure occurred in 6.1 percent and 12.1 percent of patients, respectively. Treatment with intralesional meglumine antimoniate, intramuscular meglumine antimoniate, sodium stibogluconate, and amphotericin B yielded a clearance rate of 80.8 percent, 92.3 percent, 75 percent, and 85.7 percent, respectively. Clearance was associated with a shorter time interval between injections of intralesional meglumine antimoniate (p=0.006) and relapse was associated with a longer time interval between injections (p=0.018). The average number of side effects per patient for intralesional meglumine antimoniate, sodium stibogluconate, intramuscular meglumine antimoniate, and amphotericin B was 0.62, 1.4, 1.6, and 2.8, respectively. The most common side effect of intralesional meglumine antimoniate, intramuscular meglumine antimoniate, and amphotericin B was local pain, arthralgia, and hypokalemia, respectively. LIMITATIONS: Low sample size was the limitation of this study. CONCLUSION: The cure rate of intramuscular meglumine antimoniate was higher than amphotericin B, which was higher than the cure rate of sodium stibogluconate. In patients treated with intralesional meglumine antimoniate, reducing the time interval between injections increased the clearance rate and decreased the rate of relapse. [ABSTRACT FROM AUTHOR]

Toxic epidermal necrolysis (TEN) is an uncommon, life-threatening hypersensitivity drug reaction with a high mortality rate that involves the skin and mucous membranes. Most reported cases involving pregnant patients were seen in those with human immunodeficiency virus. Here, we discuss a 21-year-old Iranian woman who presented at 18 weeks' gestation with extensive TEN following the administration of ondansetron with no any other risk factors. [ABSTRACT FROM AUTHOR]