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Blastocystis, urticaria, and skin disorders: review of the current evidences

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Abstract

Blastocystis is one of the most common intestinal protozoan parasites worldwide, which is linked to cutaneous lesions and urticaria. In a setting of systematic review, the data on the association of Blastocystis infection with cutaneous lesions were searched in order to summarize the main clinical symptoms, diagnostic methods, treatment, and outcome of the patients. The search identified 28 eligible articles, including 12 cross-sectional studies and 16 case reports/case series (including 23 cases). A diverse spectrum of skin symptoms, mainly urticaria, rash, and itching, was reported from the studies. Of the 23 infected cases with the skin symptoms, gastrointestinal symptoms were reported from the 16 cases, whereas 7 cases with urticaria had asymptomatic infection. The most frequent subtypes were ST1, ST2, and ST3, respectively. Metronidazole, paromomycin, and tinidazole were the most prescribed drugs in patients with single Blastocystis infection. Notably, urticaria and other cutaneous symptoms of all treated patients were resolved after treatment. In conclusion, this study indicates that Blastocystis infection can be a neglected cause of urticaria and skin disorders. Since the treatment of Blastocystis infection is simple, screening and treatment of this infection should be considered in patients with urticaria and other skin disorders.

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Acknowledgments

We give thanks to Dr. Zahra Asadgol (Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran) for her great technical assistance in designing some graphs.

Funding sources

This study was supported by Kurdistan University of Medical Sciences, Sanandaj, Iran, and Jahrom University of Medical Sciences, Jahrom, Iran.

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Authors and Affiliations

  1. Zoonoses Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran

    Fares Bahrami

  2. Department of Immunology & Hematology, Kurdistan University of Medical Sciences, Sanandaj, Iran

    Erfan Babaei

  3. Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

    Alireza Badirzadeh

  4. Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Tahereh Rezaei Riabi

  5. Department of Parasitology and Mycology, Jahrom University of Medical Sciences, Jahrom, Iran

    Amir Abdoli

  6. Zoonoses Research Center, School of Medicine, Jahrom University of Medical Sciences, 74148-46199, Ostad Motahari Ave, Jahrom, Iran

    Amir Abdoli

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Contributions

FB and AA conceived the study design and performed the initial search for inclusion; FB and EB screened the articles according to title and abstract; FB, EB, AB, and TRR prepared the tables; FB and AA designed the figures; FB and EB wrote the draft of the paper; FB, AB, and AA revised the paper according to the reviewer’s comments; and AA performed a final revision for submission.

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Correspondence to Amir Abdoli.

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Bahrami, F., Babaei, E., Badirzadeh, A. et al. Blastocystis, urticaria, and skin disorders: review of the current evidences. Eur J Clin Microbiol Infect Dis 39, 1027–1042 (2020). https://doi.org/10.1007/s10096-019-03793-8

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