Eman Nofal

Platelet-Rich Plasma Versus CROSS Technique With 100% Trichloroacetic Acid Versus Combined Skin Needling and Platelet Rich Plasma in the Treatment of Atrophic Acne Scars: A Comparative Study

BACKGROUND Platelet-rich plasma (PRP) is an autologous preparation of platelets in concentrated plasma that may be beneficial in the treatment of atrophic acne scars by promoting collagen deposition. Skin needling is a technique that uses a sterile dermaroller to puncture the skin and release growth factors. The combination of skin needling and PRP could enhance the efficacy of both modalities. Chemical reconstruction of skin scars technique consists of focal application of high concentration of trichloroacetic acid (TCA) on the acne scars to stimulate collagen production. OBJECTIVE To evaluate the efficacy and safety of intradermal injection of PRP, 100% focal TCA, and combined skin needling plus topical PRP in the treatment of atrophic acne scars. PATIENTS AND METHODS Forty-five patients with atrophic acne scars were randomly assigned to 3 equal groups; Group A received intradermal injection of PRP, Group B received chemical reconstruction of skin scars technique with TCA 100%, and Group C was treated by combined skin needling and PRP. Each patient underwent 3 sessions at 2-week interval. RESULTS All the patients completed the study. The 3 groups showed statistically highly significant improvement in the degree of acne scars after treatment (p < .001). No major adverse effects were observed in the studied groups. CONCLUSION This is the first study to use intradermal injection of PRP alone for the treatment of atrophic acne scars. The 3 modalities showed a promising efficacy and safety in the treatment of atrophic acne scars.

Necrolytic acral erythema: a variant of necrolytic migratory erythema or a distinct entity?

Background  Hepatitis C is a major health problem in Egypt. Necrolytic acral erythema (NAE) is a recently described necrolytic erythema that has a distinctive acral distribution and a uniform association with hepatitis C. Some authors believe that NAE is a distinct entity and others consider it as a variant of necrolytic migratory erythema (NME).

Paederus dermatitis in Egypt: a clinicopathological and ultrastructural study

Background  Outbreaks of paederus dermatitis (PD) have been observed in different parts of the world, yet the histopathological and ultrastructural changes and their relationship to pederin toxin have not been described.

Treatment of recalcitrant warts with intralesional measles, mumps, and rubella vaccine: a promising approach

Recalcitrant warts represent a frustrating challenge for both patients and physicians. Although many destructive and immunotherapeutic modalities are available for the treatment of warts, an ideal, universally effective approach has not been explored to date. Recently, intralesional antigen immunotherapy has shown promising efficacy in the treatment of warts. The aim of the study was to evaluate the efficacy and safety of intralesional measles, mumps, and rubella (MMR) vaccine in the treatment of recalcitrant warts.

Gabapentin: A promising therapy for uremic pruritus in hemodialysis patients: A randomized-controlled trial and review of literature

Abstract Background: Treatment of uremic pruritus (UP) is a big challenge. Objectives: To evaluate efficacy, appropriate dosing regimen and safety of gabapentin on UP in hemodialysis (HD) patients. Patients and methods: Fifty-four uremic patients undergoing HD and complaining of UP were randomly classified into two equal groups. Gabapentin group: 27 patients received gabapentin capsules starting with 100 mg and gradually titrated up to a maximum of 300 mg after each HD session for one month. Placebo group: 27 patients received placebo thrice weekly after each HD session. Severity of pruritus was measured by visual analog scale (VAS) and 5-D pruritus scale. Results: In gabapentin group, 88.9% of patients responded well to gabapentin versus 22.2% in placebo group. A highly statistical difference was detected in favor of gabapentin group (p< 0.001). The frequency of the use of the lowest dose (100 mg thrice weekly) was significantly higher than other doses (p < 0.0001). Adverse effects were mild and tolerated. Conclusion: Gabapentin is a promising and a well-tolerated treatment option for patients with UP. We recommend it as a first line therapy with a maintenance post-HD dose of 100–300 mg. We also recommend the 5-D scale in the assessment of the severity of pruritus.

Kindler syndrome: a study of five Egyptian cases with evaluation of severity

Background  Kindler syndrome (KS) is a rare genodermatosis characterized by four major features (acral blisters, photosensitivity, poikiloderma, and cutaneous atrophy) and many associated findings. The diagnosis of KS includes clinical features, ultrastructural findings, and, recently, immunostaining and genetic studies. Varying degrees of severity of the syndrome have been described.

Progressive nodular histiocytosis: a case report and literature review

Progressive nodular histiocytosis (PNH) is a rare normolipemic macrophage disorder first described by Taunton et al. in 1978. Since then, 14 cases, including that described here, have been reported. Progressive nodular histiocytosis belongs to a subgroup of nonLangerhans cell histiocytoses (LCHs), the juvenile xanthogranuloma (JXG) family, which includes xanthoma disseminatum (XD), benign cephalic histiocytosis (BCH), adult xanthogranuloma, and generalized eruptive histiocytosis (GEH). These disorders seem to overlap and probably represent a spectrum of manifestations deriving from a single underlying process that may take one or more of several clinical forms depending on the patient’s immune status and the triggers of macrophage proliferation. Herein, we present a new case of PNH associated with retinitis pigmentosa and optic atrophy, review the literature, and discuss the diagnostic criteria, the differential diagnosis, and the classification of this rare entity.

Lichen myxedematosus: diagnostic criteria, classification, and severity grading

Lichen myxedematosus (LM) is a rare, chronic idiopathic disorder characterized clinically by waxy, closely set papules and histopathologically by diffuse dermal mucin deposition and fibroblast proliferation. The most recent classification of LM was proposed in 2001; however, it seems to be complex, confusing, and imprecise. Herein, we present seven cases of LM to evaluate the validity of the current classification, to propose new diagnostic criteria and classification, and to suggest a clinically relevant severity grading system for this rare disorder.

Neutrophilic dermatosis of the dorsal hands: a localized variant of Sweet's syndrome or a distinct entity?

References 1 Pazzaglia M, Lucente P, Vincenzi C, et al. Contact dermatitis from nickel in mobile phones. Contact Dermatitis 2000; 42: 362–363. 2 Kluger N, Pecquet C. Dermatoses associated with high technology (cell phones, computers and video games). Ann Dermatol Venereol 2012; 139: 230–238. 3 Gasenzer ER, Neugebauer EA. Contact allergies in musicians. Dtsch Med Wochenschr 2012; 137: 2715– 2721. 4 Friis UF, Menn e T, Jellesen MS, et al. Allergic nickel dermatitis caused by playing the guitar: case report and assessment of nickel release from guitar strings. Contact Dermatitis 2012; 67: 101–103. 5 Jensen P, Jellesen MS, M1⁄2ller P, et al. Nickel may be released from laptop computers. Contact Dermatitis 2012; 67: 384–385. Neutrophilic dermatosis of the dorsal hands: a localized

Generalized eruptive keratoacanthoma: proposed diagnostic criteria and therapeutic evaluation.

Generalized eruptive keratoacanthoma (GEKA) of Grzybowski is a sporadically occurring, extremely rare variant of keratoacanthoma characterized clinically by severely pruritic, generalized eruption of numerous small follicular papules, often with a central keratotic plug, and histologically by typical features of solitary keratoacanthoma. Despite the continuous addition of new case reports, no definite diagnostic criteria have been established, and an optimum treatment is not yet determined. Herein, we review the different aspects of this rare entity, including pathogenesis, clinical and histopathological features, differential diagnosis, course and prognosis. Different therapeutic approaches and their impact on the course and prognosis of the disease are also evaluated and presented. We propose two sets of diagnostic criteria to define the disease more precisely and to avoid overlapping and confusion with other types of multiple keratoacanthoma. The first set comprises constant clinical and histopathological features that almost always present in every case and the second set includes variable features that were reported in some patients, and to which any emerging finding could be added to avoid missing cases. Although different therapeutic options have been used, either as single agents or in combinations, there is no standard therapy for GEKA and the disease still represents a therapeutic challenge.