Eman El-Nabarawy

Different narrowband UVB dosage regimens in dark skinned psoriatics : a preliminary study

Background: Psoriasis is a common and relapsing disease, which is both physically and psychologically disabling. Narrowband UVB (NB‐UVB) is used in fair‐skinned population in suberythemogenic doses with good results; however, in the darker skin population (skin types III, IV, V) erythemogenic doses have not been thoroughly investigated.

Leukocytoclastic vasculitis and necrolytic acral erythema in patients with hepatitis C infection: Do viral load and viral genotype play a role?

BACKGROUND Leukocytoclastic vasculitis (LCV) and necrolytic acral erythema (NAE) are skin disorders associated with hepatitis C virus (HCV) infection. However, they have not been found to occur simultaneously in the same patient. OBJECTIVE We sought to analyze the role of serum HCV-RNA levels and HCV genotype in the pathogenesis of both LCV and NAE in an attempt to assess whether these two parameters play a role in mutual exclusivity of LCV and NAE in the same patient. METHODS The study included 11 patients with LCV and 13 with NAE, all of whom were infected with HCV. All 24 patients were evaluated for the quantitative levels of HCV-RNA, using real-time polymerase chain reaction. HCV genotyping was performed on 10 patients in each group (N = 20). RESULTS Patients with LCV had a higher prevalence of moderate and high levels of HCV-RNA viremia (P = .038) than those with NAE. However, there was no significant difference in HCV genotype between LCV and NAE groups (P = .211). LIMITATIONS Small number of cases is a limitation. CONCLUSION Viral load seems to play a role in determining the response of the skin to HCV infection. High levels of HCV viremia were found to be significantly associated with LCV but not with NAE. HCV viremia may play a role in the development of LCV in HCV-infected patients.

Comparative study of the effect of a daily steroid regimen versus a weekly oral pulse steroid regimen on morphological changes, blood sugar, bone mineral density and suprarenal gland activity.

Abstract Background: The most serious side effects of systemic steroids include osteoporosis and suprarenal suppression. Many steroid regimens have been suggested to minimize these side effects; one of them is oral steroid pulse therapy. Objective: To compare the side effects of a daily oral steroid regimen versus a weekly oral steroid pulse regimen on bone mineral density and suprarenal suppression. Methods: Thirty patients with different skin diseases were divided into two groups: 15 for oral daily steroids (ODS) (group 1) and 15 for weekly oral pulse steroids (WOPS) (group 2). They were evaluated for bone mineral density (measured by DEXA) and suprarenal suppression (measured by serum cortisol level), morphological changes and blood sugar. Treatment was continued for 6 months to 3 years. Results: Cushingoid features in group 1 were observed in 73%, yet they were not detectable in group 2. Disturbed blood sugar in group 1 was 33% and 0% in group 2. The serum cortisol level was lower in patients on ODS than those on WOPS. The effect of WOPS on bone mineral density was very limited in comparison with the ODS. Conclusion: Weekly oral steroid pulse therapy induces no significant bone loss and no suprarenal suppression and can be an alternative option in the treatment of chronic disorders requiring long-term oral steroid therapy.

Association with HLA-DRB1 in Egyptian and German pemphigus vulgaris patients.

Association with HLA-DRB1 in Egyptian and German pemphigus vulgaris patients O. Haase1,†, R. Alneebari1,†, M.A. Eldarouti2, M. Abd El Hady2, D. Dorgham2, E. El-Nabarawy2, S. B. El Din Mahmoud2, H. Mosaad El Sayed3, M. Darwish3, F. Abbas3, S. Salah3, Y. Mosaad3, F. El-Chennawi3, S. Al Mongy4, A. M. Abdelaziz4, S. Abd El Gaber4, M. Hertl5, R. Eming5, A. Recke1, S. Möller1, E. Schmidt1, D. Zillikens1 & S. Ibrahim1

Serum 25-hydroxy vitamin D3 level in Egyptian patients with alopecia areata

BackgroundVitamin D has multiple effects on innate and adaptive immune responses. The relation between vitamin D levels and alopecia areata (AA), a tissue-specific autoimmune disease, represents an attractive area of research. ObjectiveThe objective of the study was to estimate the serum level of 25-hydroxy vitamin D (25-OH Vit D) in AA patients and explore a probable relation. Patients and methodsA total of 140 individuals from the Egyptian population were recruited into a case–control study, of whom 70 were patients with AA of various types and 70 were healthy controls. Serum 25-OH Vit D levels were measured. Correlations with disease duration and severity, positive family history, age and sex were made. ResultsAA patients comprised 37 male and 33 female patients (13–50 years). The healthy controls comprised 44 male and 26 female individuals (12–50 years). Serum 25-OH Vit D levels were significantly decreased in AA patients than in controls (P=0.023). The female participants in both groups (patients and controls) showed significantly lower vitamin D levels compared with male participants (P=0.005). There was no significant relationship between serum 25-OH Vit D levels and age, duration, severity or positive family history. ConclusionAA is associated with low levels of 25-OH Vit D, especially in female participants. More studies are required to prove its possible role in AA pathogenesis.

Prevalence of photosensitivity in chronic hepatitis C virus patients and its relation to serum and urinary porphyrins.

HCV is a major cause of chronic liver disease in Egypt. The aim was to study the prevalence of photosensitivity among asymptomatic HCV‐infected patients and its possible relation to porphyrins levels and whether it can be considered an alarm for early diagnosis of the disease, which is the most important goal in the management.

An immunohistochemical study of laminin in basal cell carcinoma

Background: Laminins are components of the extracellular matrix that mediate cell adhesion, growth, migration, proliferation and differentiation. Basement membrane (BM) laminins, in particular, may play a role in enhancing carcinoma cell motility.

Frequency of Hypopigmented Mycosis Fungoides in Egyptian Patients Presenting With Hypopigmented Lesions of the Trunk

Abstract:Hypopigmented mycosis fungoides (HMF) is an uncommon variant of mycosis fungoides with an unknown exact frequency. We aimed to study the frequency of HMF in a cohort of Egyptian patients presenting to a tertiary care center in Cairo, Egypt, with hypopigmented lesions of the trunk. Hundred patients with hypopigmented lesions involving the trunk (with or without other sites involvement) were subjected to thorough clinical and histopathological examination. Immunohistochemical studies (S100, CD4, and CD8) were performed when indicated. Constellation of findings was used to reach a final diagnosis. Sixteen cases had HMF (16%). Other than HMF, our cohort included hypopigmented parapsoriasis en plaque (42 cases), postinflammatory hypopigmentation (28 cases), progressive macular hypomelanosis (12 cases), and pityriasis alba (2 cases). In comparison with other hypopigmented disorders, HMF was significantly associated with progressive disease course (P = 0.004), affection of distal upper limbs (P = 0.005), proximal lower limbs (P = 0.003), large-sized lesions (>5 cm) (P < 0.0001), well-defined margin (P < 0.0001), scaliness (P = 0.002), erythema (P < 0.0001), atrophy (P = 0.012), and mottled pigmentation (P < 0.0001). Awareness of HMF and its characteristic clinical features is mandatory to avoid underdiagnosis or overdiagnosis with subsequent morbidity or unnecessary aggressive therapy, respectively.

Diagnostic accuracy of immunohistochemical markers in differentiation between basal cell carcinoma and trichoepithelioma in small biopsy specimens

The distinction of trichoepithelioma from basal cell carcinoma in small superficial biopsies is important but often challenging. This has inspired many scientists to test the validity of immunohistochemical markers in the differential diagnosis.

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.