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Background/Objectives Side effects of current treatments and the need for a safe treatment with higher efficiency necessitate seeking new treatment options for vitiligo. Few studies have investigated the combination of psoralen with narrowband ultraviolet B (NBUVB). In this study, we compared the efficacy and safety of psoralen and NBUVB combination (P‐NBUVB) with NBUVB alone in treatment of vitiligo. Methods This randomised clinical trial was carried out during 2015–2017 in dermatology clinics of Ghaem and Imam Reza hospitals, Mashhad, Iran on 40 vitiligo patients with 5–60% body involvement. The patients were randomly divided into two groups of NBUVB alone and P‐NBUVB. Both groups underwent 60 phototherapy sessions (three sessions per week), and the repigmentation rate was measured using vitiligo area severity index (VASI) score. SPSS v. 16 software and appropriate statistical tests were used to analyse the data. P < 0.05 was considered statistically significant. Results The mean age of patients was 33.9 ± 11.3 years. Twenty patients (50%) were females. The P‐NBUVB group showed greater VASI improvement in lower extremities (P = 0.003) and overall (P = 0.026) compared with NBUVB group. Moreover, the treatment response appeared sooner in P‐NUVB group. Conclusion Based on our results, we can conclude that adding psoralen to NBUVB phototherapy can result in increased efficacy. However, more studies are needed to evaluate the long‐term effects and side effects of this treatment.

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Despite Radiation‐induced dermatitis is a self‐limiting complication, it can be complicated if inappropriate self‐medications have been used such as opium latex traditional extract.

Pruritus is one of the most common complaints among patients referred to a dermatology clinic. “Chronic generalized pruritus” is described as the sensation of itching on the entire body surface, which lasts at least 6 or more weeks. This symptom can be a disabling phenomenon for patients and may sometimes interfere with daily activities such as sleep. If specific dermatological findings are observed, the physician easily comes to a diagnosis and treats the condition, whereas, when primary lesions are not detected, the diagnosis can become challenging, and some patients have to undergo extensive evaluations. The association between some systemic disorders and chronic generalized pruritus is widely known and confirmed. Many infections have been associated with pruritus, but few are considered to cause chronic generalized pruritus without any characteristic skin lesions. We aimed to gather all the available data on infectious causes of chronic generalized pruritus with no diagnostic cutaneous lesions to assist fellow physicians in the process of evaluation of these challenging cases.

Background:In different tissues, the endothelin is produced by vascular endothelium. They are potent vasoconstrictor peptides. There is a little information about the role of endothelin in reflux nephropathy. Objectives: The aim of this study is to evaluate urinary levels of endothelin in patients with vesicoureteral reflux (VUR). Patients and Methods: It was a cross-sectional study that conducted on 81 children who received voiding cystourethrogram (VCUG). Based on VCUG reports, patients were divided into two groups; with reflux (40 persons) and without reflux (41 persons). We got a urine sample from patients with mid-stream or urine bag method. The endothelin level was assessed with ELISA immunoassay. Data was analyzed using SPSS 16. Results: Based on VCUG reports, 40 patients (49.4%) had urinary reflux, of them 20 cases suffered from unilateral urinary reflux and others from bilateral. Of 40 patients with reflux, 23 cases (57.5% of reflux group) had kidney scar and seven individuals (17.5%) had abnormal kidney sonography. Of patients with urinary reflux, 13 cases (32.5%) had grade1 urinary reflux, 8 cases (20%) grade 2, and 5 cases (12.5%) grade 3 and finally 14 cases (35%) grade 4. The UET-1 levels were significantly higher in VUR patients compared to the control group (P < 0.001). Comparison of mean endothelin levels between two groups was done using Mann-Whitney U test and was statistically significance (P < 0.001). We used Kruskal-Wallis for comparison of endothelin levels in different grades of reflux (P < 0.001). Conclusions: Urine endothelin-1 level can be considered as an alternative to VCUG for screening vesicourethral reflux. ABSTRACT Implication for health policy/practice/research/medical education:Urine endothelin-1 level can be considered as an alternative to VCUG for screening VUR. According to significant changes in the different grades of reflux, it is helpful in determining the severity of VUR. It can at least prevent performing unnecessary VCUG in low-risk patients. Please cite this paper as: Azarfar A, Esmaeeli M, Naseri M, Badiee Aval S, Ghanee Sharbaf F, Ravanshad S, et al. The level of urinary endothelin in patients with urinary reflux.

BackgroundLupoid cutaneous leishmaniasis (LCL) is known as a rare but serious complication of anthroponotic cutaneous leishmaniasis (ACL) resistant to conventional treatments. Sodium chlorosum, a pro-oxidative preparation of pharmaceutical sodium chlorite (NaClO2), has been successfully used for the treatment of Old World cutaneous leishmaniasis lesions (OWCL) and of some LCL cases in Afghanistan. This clinical trial study aimed to evaluate the effect of a last resort therapy with topical 0.09% sodium chlorosum on LCL in Iran.MethodsTwenty Iranian patients (12 women and 8 men) with LCL refractory to treatment were included in this salvage study. A magistral preparation of sodium chlorosum (10 mM NaClO2 in amphiphilic basic cream) was applied twice daily to the lesions for 6 weeks and continued up to 12 weeks in patients who showed a clinical response within the first 6 weeks. Responders were followed up for a maximum of 1 year. Lesions were photographed during weekly visits. Disappearance of erythema and indurated lesions were rated as complete clinical response.ResultsPatients with a mean age of 28.6 (±24.3) and with an ACL proven lesion history of 3.8 (±1.4) years were treated for an average of 7.9 (±1.8) weeks. At the end of the treatment period (12th week), a complete response was observed in 9 of 20 patients (45%). During the one-year follow-up period, LCL lesions recurred in 4 of these 9 patients (with one patient showing only a tiny lesion) and one case lost to follow up whereas the other four remained completely lesion-free. Mild temporary side-effects such as erythema and itching were seen in 4 of 20 patients (20%).ConclusionsTopical sodium chlorosum showed promising therapeutic results and can be considered as safe, painless, and relatively effective treatment for LCL, an ethical prerequisite for a two-armed controlled trial.Trial registrationThis study was registered in Iranian registry of clinical trials on 2019-02-02 with registration number IRCT20190114042356N1.