Z Hallaji; Sh Shams Davatchi; M Vali Khani; N Ghandi; M Kar Bakhsh Davari; M Hedayati; AR Firooz
Volume 9, Issue 3 , 2006, , Pages 204-210
Abstract
Background and aim: Azathioprine is the most widely used immunosuppressive agent as an adjunct to corticosteroids in the treatment of pemphigus vulgaris (PV). Thiopurine methyl transferase (TPMT) is a key enzyme in azathioprine metabolism and a genetic polymorphism controls its activity in human tissue. ...
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Background and aim: Azathioprine is the most widely used immunosuppressive agent as an adjunct to corticosteroids in the treatment of pemphigus vulgaris (PV). Thiopurine methyl transferase (TPMT) is a key enzyme in azathioprine metabolism and a genetic polymorphism controls its activity in human tissue. TPMT activity can provide a rational basis to determine suitable dose of azathioprine, theoretically. The aim of this study was to evaluate the clinical relevancy of this hypothesis in PV patients.Materials and Methods: In this cross sectional study in Razi Hospital, the activity of TPMT in the red blood cells of 52 PV patients who received azathioprine for at least 12 months and 29 PV patients who did not receive this drug was measured and correlated to the clinical response and side effects observed.Results:The mean of TPMT activity was not significantly different in patients with unfavourable response, comparing to patients with favorable response to azathioprine (P=0.087). No relationship was observed between total dose of corticosteroid and TPMT activity (r=0.089, P=0.583). There was no difference between the mean of TPMT activity in patients receiving azathioprine and those not receiving this drug (P=0.36).Conclusion: A direct relationship was not observed between TPMT activity and clinical efficacy and side effects in PV patients under treatment with azathioprine. Larger prospective studies in more homogenous patients are needed to evaluate the clinical relevance of TPMT polymorphism and to determine accurate azathioprine dosing guidelines based on TPMT activity.
M Vali Khani; H Ghani Nejad; M Barzegari; Z Hallaji; S Toosi
Volume 8, suppl , 2005, , Pages 18-23
Abstract
This is a report of a 40- year- old woman presented to our outpatient dermatology clinic. She had a 40- day history of sudden development of skin lesions on the exposed. Dermatologic examination revealed relatively limited brown – reddish plaques on the hands, feet, face, one elbow and groin regions. ...
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This is a report of a 40- year- old woman presented to our outpatient dermatology clinic. She had a 40- day history of sudden development of skin lesions on the exposed. Dermatologic examination revealed relatively limited brown – reddish plaques on the hands, feet, face, one elbow and groin regions. She has been taking carbamazepine (200 mg/ day) for 13 years. Otherwise, no serious problems were found. A clinical diagnosis of drug- induced pellagra was made based on the morphology. After discontinuing carbamazepine, treatment with nicotinamide (500 mg/day) was initiated and the eruption faded away and resolved within 3 weeks. Pellagra is a disease caused by a deficiency of the niacin and may occur with certain drugs.
M Akhyani; Z Hallaji; AH Ehsani; T Mokarrami; F Gorouhi
Volume 8, Issue 3 , 2005, , Pages 171-176
Abstract
Background: Vitiligo is a relatively common acquired depigmentary disorder affecting approximately 1% of general population. PUVA therapy is the most effective modality and commonly used as the primary treatment of generalized Vitiligo. Objective: To evaluate the synergistic effect of topical Calcipotriol ...
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Background: Vitiligo is a relatively common acquired depigmentary disorder affecting approximately 1% of general population. PUVA therapy is the most effective modality and commonly used as the primary treatment of generalized Vitiligo. Objective: To evaluate the synergistic effect of topical Calcipotriol and oral methoxalene plus PUVA in treatment of generalized Vitiligo. Patients and Methods: In this clinical trial, 47 patients with generalized Vitiligo (<40% involvement of skin surface area) were randomly assigned to 2 treatment groups. Both groups were treated with systemic PUVA three times weekly. One group was also treated with topical Calcipotriol (0.005%). Patients were evaluated for treatment response and possible side effects. Results: The mean response rate at the end of the study was 63.9%±24.1 in the Calcipotriol and PUVA group and 60.6%±23 in the PUVA group (P>0.05). The number of PUVA sessions and the mean cumulative UVA dose for maximum response were 96.6±22.7 and 584.1±118.1 J/cm² in the Calcipotriol and PUVA group and 116.3±26.1 and 685.1±168.0 J.cm² in the PUVA group (P<0.05). Conclusion: In patients with generalized Vitiligo, combination of PUVA with Calcipotriol is an effective and safe treatment. This method decreases number of PUVA sessions and UVA dosage compared to PUVA treatment alone and accelerates repigmentation.
H Mortazavi; A Khamesipour; Z Hallaji; H Bakhshi; A Miramin Mohammadi
Volume 5, Issue 4 , 2002, , Pages 3-9
Abstract
Background: Cutaneous leishmaniasis (CL) is a self-healing disease, but due to unknown causes, a few cases of CL could get a chronic or non-healing course. These cases of chronic and recurrent leishmaniasis are defined as non-healing. Objectives: Comparison of the production of interferon-γ (IFN-γ) ...
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Background: Cutaneous leishmaniasis (CL) is a self-healing disease, but due to unknown causes, a few cases of CL could get a chronic or non-healing course. These cases of chronic and recurrent leishmaniasis are defined as non-healing. Objectives: Comparison of the production of interferon-γ (IFN-γ) and Leishmanin skin test (LST) between non-healing and healed patients of CL. Patients and Methods: Fifteen patients with non-healing CL suffering for more than two years, and eight individuals cured from CL were enrolled in this study. The rate of IFN-γ production by peripheral blood mononuclear cells assessed by ELISA and results of LST were compared in both groups. Results: The mean level of the IFN-γ production in non-healing patients and cured individuals were 729 pg/ml, and 4229 pg/ml, respectively (T- test, P<0.01). Four patients in non-healing group had negative LST and all cured patients had positive LST. Conclusion: The low level of the IFN-γ in non-healing patients and high level of IFN-γ in healed individuals are in favour of the lack of TH1 response, which is usually seen in healed patients. Comparing the results of LST between two groups is not conclusive.
Z Safaei Naraghi; Z Hallaji; M Danesh Pajooh; H Moslehi; K Jazayeri
Volume 4, Issue 1 , 2000, , Pages 12-18
Abstract
Background: Bullous pemphigoid (BP) is the prototype of subepidermal autoimmune bullous dermatoses (SABDs). Direct immunofluorescence on salt split skin substrate (DIF-SS) is one of the methods used to differentiate this group of dermatoses. Objective: We conducted this study in order to delineate the ...
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Background: Bullous pemphigoid (BP) is the prototype of subepidermal autoimmune bullous dermatoses (SABDs). Direct immunofluorescence on salt split skin substrate (DIF-SS) is one of the methods used to differentiate this group of dermatoses. Objective: We conducted this study in order to delineate the results of DIF-SS in SABD patients. Patients and Methods: Seventeen patients with a BP-like clinical picture referred to Razi Hospital in 1378, who had linear immunodeposits along basement membrane zone in direct immunofluorescence, were studied. Considering only histopathologic and clinical data, a final diagnosis was established for each patient. DIF-SS was performed on perilesional skin sample of patients. DIF-SS and histopathology results and the final diagnosis were recorded and compared for each patient. Results: In DIF-SS, eleven patients (65%) had combined (Epidermal and dermal), two patients (12%) had epidermal and four patients (23%) had dermal pattern. The final diagnoses were BP in ten patients and epidermolysis bullosa acquisita (EBA) in two others. We were unable to differentiate BP from EBA in two patients. In ten patients who were diagnosed finally as BP, nine patients (90%) had combined pattern and only one case (10%) showed epidermal staining in DIF-SS. Conclusion: Surprisingly, in contrast to the results of the previous studies on pemphigoid patients using either IIF-SS or DIF-SS in which the epidermal pattern had been reported to be much more common than the combined pattern, the combined pattern was nine times more frequent than the epidermal pattern in this study. Perhaps, the difference in target antigens in our patients may be the underlying reason for the difference in our results.
