Amira El Tawdy

Percutaneous Collagen Induction Versus Full-Concentration Trichloroacetic Acid in the Treatment of Atrophic Acne Scars

BACKGROUND Percutaneous collagen induction (PCI) promotes removal of damaged collagen and induces more collagen immediately under the epidermis. The chemical reconstruction of skin scars (CROSS) method is a focal application of full‐concentration trichloroacetic acid (TCA) to atrophic acne scars. The CROSS method has the advantage of reconstructing acne scars by increasing dermal thickening and collagen production. OBJECTIVE To compare the safety and efficacy of PCI and the 100% TCA CROSS method for the treatment of atrophic acne scars. MATERIALS AND METHODS Thirty participants were randomly equally divided into two groups; group 1 underwent four sessions (4 weeks apart) of PCI, and group 2 underwent four sessions (4 weeks apart) of 100% TCA CROSS. RESULTS Acne scarring improved in 100% of patients. Scar severity scores improved by a mean of 68.3% (p<.001) in group 1 and a mean of 75.3% (p<.001) in group 2. The difference in the degree of improvement was not statistically significant between the groups (p=.47). CONCLUSIONS PCI and 100% TCA CROSS were effective in the treatment of atrophic acne scars. The authors have indicated no significant interest with commercial supporters.

The role of systemic steroids and phototherapy in the treatment of stable vitiligo: a randomized controlled trial

Pathogenesis of vitiligo is believed to be multifactorial disease with a wide variety of therapeutic modalities. The aim of this work is to assess the efficacy of oral mini‐pulse steroids (OMP) plus Nb‐U.V.B in comparison to OMP alone and Nb‐U.V.B alone in treating stable vitiligo. A prospective randomized controlled study including 45 patients categorized into three groups receiving therapy for 3 months; Group A received Nb‐U.V.B plus OMP, Group B received OMP alone while Group C received Nb‐U.V.B alone. Clinical assessment and PCR evaluation of bFGF, ICAM1, and ELISA for AMA were done. Patients receiving Nb‐U.V.B plus OMP and using Nb‐U.V.B alone gave statistically significant clinical response than those treated with OMP alone. Statistically significant rise of BFGF was noticed after treatment with Nb‐U.V.B plus OMP and with Nb‐U.V.B alone. Patients treated with OMP alone and with Nb‐U.V.B alone showed statistically significant drop of ICAM‐1 after therapy. NB‐U.V.B plus OMP and Nb‐U.V.B alone were found to be clinically superior over OMP alone in treating stable vitiligo patients, hence suggesting that adding OMP to Nb‐U.V.B can maintain clinical and laboratory success for a longer period of time and with less relapse.

Subclinical Onychomycosis in Patients With Type II Diabetes.

Fungal organisms could be present in the nail without any clinical manifestations. As onychomycosis in diabetics has more serious complications, early detection of such infection could be helpful to prevent them. We aim in this study to assess the possibility of detecting subclinical onychomycosis in type II diabetic patients and addressing possible associated neuropathy. A cross sectional, observational study included patients with type II diabetes with normal big toe nail. All were subjected to nail clipping of the big toe nail, followed by staining with Hematoxylin and Eosin and Periodic-Acid-Schiff (PAS) stains and examined microscopically. A total of 106 patients were included, fungal infection was identified in eight specimens, all were uncontrolled diabetes, and six had neuropathy. Using the nail clipping and microscopic examination with PAS stain to detect such subclinical infection could be an applicable screening test for diabetic patients, for early detection and management of onychomycosis.

Downregulation of TLR‐7 receptor in hepatic and non‐hepatic patients with lichen planus

Background  Lichen planus (LP) is an inflammatory disease of the skin and oral mucosa. The association of LP and chronic hepatitis C virus (HCV) is well established, with variable prevalence rates among different populations. Toll‐like receptors (TLRs) are key regulators of both the innate response and the adaptive response. However, TLRs also interact with endogenous ligands released by necrotic cells, and this process can intensify autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus.

Hair loss at injection sites of mesotherapy for alopecia

The side effects of mesotherapy for treatment of various forms of alopecia are often underreported, while scientific data for its efficacy are severely lacking.

A 15-Patient Pilot Trial of Lipolysis of the Hips and Thighs Using a Phosphatidylcholine and Deoxycholate Formulation

Preservation of the recipient area blood supply has been shown to result in higher graft survival. Needles or blades without depth control can penetrate deep into the subcutaneous fat and damage the underlying blood vessels. The handle was designed to accommodate surgical instruments used in hair transplantation procedure. The handle consists of a handle body (including a distal and proximal end) and a chucking mechanism that includes an elongated lengthwise slot for receiving the mini-blade and a cylindrical central bore for cylindrical punch and needle.

Effect of oral isotretinoin on the nucleo-cytoplasmic distribution of FoxO1 and FoxO3 proteins in sebaceous glands of patients with acne vulgaris

Oral isotretinoin is the most effective anti‐acne drug with the strongest sebum‐suppressive effect caused by sebocyte apoptosis. It has been hypothesized that upregulation of nuclear FoxO transcription factors and p53 mediate isotretinoin‐induced sebocyte apoptosis in vivo. It is the aim of our study to analyse the distribution of the pro‐apoptotic transcription factors FoxO1 and FoxO3 in the nuclear and cytoplasmic compartments of human sebocytes in vivo before and during isotretinoin treatment of acne patients. Immunohistochemical analysis of skin biopsies with antibodies distinguishing phosphorylated and non‐phosphorylated human FoxO1 and FoxO3 proteins was performed before isotretinoin treatment, six weeks after initiation of isotretinoin therapy, and in acne‐free control patients not treated with isotretinoin. Our in vivo study demonstrates a significant increase in the nucleo‐cytoplasmic ratio of non‐phosphorylated FoxO1 and FoxO3 during isotretinoin treatment of acne patients. Translational and presented experimental evidence indicates that upregulation of nuclear FoxO1 and FoxO3 proteins is involved in isotretinoin‐induced pro‐apoptotic signalling in sebocytes confirming the scientific hypothesis of isotretinoin‐mediated upregulation of FoxO expression.

Granular cell tumor: a report of three cases with different clinical presentations

Granular cell tumor is an uncommon benign tumor of disputed histogenesis that was first described by Abrikossof. It can be found in the skin, subcutaneous tissue, and visceral organs. It shows female predominance. We report three cases of granular cell tumor that showed different clinical presentations.

Assessment of Tissue Level of Histone Deactylase-2 (HDAC-2) in Patients With Mycosis Fungoides

Background: Histone deactylases (HDAC) have a role in the pathogenesis of mycosis fungoides (MF) through their actions on different apoptosis pathways. Objective: To assess the possible role played by HDAC-2 in MF by estimating the tissue expression of HDAC2 mRNA in different stages of MF. Methods: This study included 28 MF patients and 30 controls. The HDAC-2 levels were detected by real-time polymerase chain reaction (PCR). Correlations of HDAC-2 levels with clinical presentation and different stages of MF were analyzed. Results: Mean HDAC-2 level was significantly higher in patients (P < .001) than in controls. HDAC-2 highest mean value was significantly detected in patients with stage IIb, and the lowest mean value was detected in patients with stage Ia (P < .001). Conclusion: Up-regulation of tissue HDAC-2 in MF patients might develop a new approach in the understanding of the pathogenesis of MF. Histone deactylases are important targets for molecular cancer therapeutics.

Fas/FasL pathway is the main mechanism of CD8-induced cytotoxicity in cutaneous lichen planus

BackgroundLichen planus (LP) is an inflammatory dermatosis involving either the skin and/or the mucosal epithelial surfaces. Apoptosis of keratinocytes by cluster of differentiation (CD) 8+ T cells may be mediated by the release of cytotoxic molecules such as perforin and granzyme B or by the Fas/Fas ligand (FasL) system. ObjectiveTo evaluate the degree of expression of both Fas/FasL and granzyme B in CD8+ infiltrating cells in lichen planus. Patients and methodsSkin biopsies were taken from lesional skin of LP patients and from normal skin of normal control individuals. Immunofluorescence staining of CD8 with Fas/FasL or granzyme B (double markers) as well as TUNEL assay were performed. ResultsImmunofluorescence staining showed that CD8+ cells were strongly represented in the dermal infiltrate of LP patients. The difference in the mean number of FasL+ CD8+ cells between LP patients and healthy controls was significant (P=0.013), whereas the difference for granzyme B was not significant (P=0.11). Although apoptotic cells were significantly higher in LP patients (P=0.031), there was no significant correlation between FasL expression and the number of these apoptotic keratinocytes in the lesions. Comparison within the LP group revealed significant difference between FasL+ CD8+ cells and granzyme B+ CD8+ cells in LP dermal infiltrate (P=0.002). ConclusionThe Fas/FasL pathway has the upper hand over the perforin/granzyme pathway in CD8+-mediated cytotoxicity in cutaneous LP.