Previous studies have found an association between HLA‐B*1502 allele and lamotrigine‐induced Stevens‐Johnson syndrome (SJS)/ toxic epidermal necrosis (TEN) spectrum in Han Chinese populations. This study aims to investigate the association between HLA‐B*1502 and lamotrigine‐ or phenytoin‐ induced SJS/TEN in an Iranian population. The medical records of twenty‐eight lamotrigine‐induced SJS/TEN patients and twenty‐five lamotrigine‐tolerant controls as well as eight phenytoin‐induced SJS/TEN and twelve phenytoin‐tolerant controls were extracted between March 2013 and March 2019 from the university hospitals in Mashhad, Iran. The presence of HLA‐B*1502 allele was determined using real‐time polymerase chain reaction (PCR). Among lamotrigine‐induced patients with SJS/TEN, 11 (39.3%) patients tested positive for the HLA‐B*1502 while only 3 (12.0%) of the lamotrigine‐tolerant controls tested positive for this allele. The risk of lamotrigine‐induced SJS/TEN was significantly higher in patients with HLA‐B*1502, with an odds ratio (OR) of 4.74 [95% confidence interval (CI) 1.14–19.73, p = 0.032]. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of HLA‐B*1502 for lamotrigine‐induced SJS/TEN was 39.29%, 88.00%, 78.57% and 56.41%, respectively. The HLA‐B*1502 allele was present in 2 (25.0%) of phenytoin‐induced SJS/TEN cases and 5 (41.7%) of the phenytoin‐tolerant controls tested positive for HLA‐B*1502 allele. The risk of phenytoin‐induced SJS/TEN was not higher in the patients with HLA‐B*1502 (OR = 0.467 [95% confidence interval (CI) 0.065‐3.34, p = 0.642]). Lamotrigine‐induced SJS/TEN is associated with HLA‐B*1502 allele in an Iranian population but this is not the case for phenytoin‐induced SJS/TEN.

A recent study in Psychosomatic Medicine by Smith and colleagues (1) showed the effectiveness of expressive writing on lung function, quality of life, medication use, and symptoms in individuals with asthma. These findings suggest that cognitive and emotional processes might be involved in physiological demands associated with asthma. Therefore, behavioral and pharmacological interventions targeting psychological disorders could result in improved asthma control. Asthma and depression are two major health problems particularly in adolescence, with several impacts such as negative and poor school performance, and impaired social, work, and family functioning (2,3). The prevalence of major depressive disorder is increased significantly across adolescence (3). Regarding the high prevalence of asthma and mood disorders in adolescents in our area (3-6), we evaluated the frequency of depression in adolescents with asthma in comparison to adolescents without asthma in the city of Zanjan, Iran.Our study consisted of 1500 children aged 13 to 14 years who had been randomly selected by multivariate cluster sampling from 20 guidance schools of the city of Zanjan from March to July 2013. After written informed consent was provided by participants and their parents, the children completed the International Study of Asthma and Allergies in Childhood (7) questionnaire modified for face-to-face interview. Asthma was defined as present if the participant reported the presence of a physician-based diagnosis of asthma, or if the International Study of Asthma and Allergies in Childhood revealed a) symptoms of dry cough with a duration of longer than two weeks, b) symptoms also occurring at night; and c) symptoms of wheezing or whistling sounds in the chest that were not attributable to the common cold or other diseases. The severity of asthma was assessed and classified into mild ("as waking up at night less than one night per week and no limitation in activity") and moderate to severe asthma ("as having wheezing attack in the last 12 months, sleep disturbance more than one night per week and limitation in speaking and activity.) The control group consisted of randomly selected classmates who did not suffer from atopy and asthma. The depression status and its severity in students with asthma and controls were measured by using the Beck Depression Inventory.Two hundred twenty-five (15%) students had asthma symptoms, with a prevalence of 13.7% and 16.2% in boys and girls, respectively. One hundred ninety-four (86%) adolescents had mild and 31 (13.7%) had moderate asthma. The frequency of depression among adolescents with asthma and controls was 61.8% and 36%, respectively ( p < .001). Major depression was found in 20% and 7.6% of asthmatic patients and controls ( p < .001). There was a significant correlation between severity of asthma and depression ( p < .001). The odds ratio (OR) for depression associated with asthma was 2.82 (95% confidence interval [CI] = 1.96-4.21), which was higher in girls (OR = 4.55, 95% CI = 2.54-7-44) than i...

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