Mohammed Al-Jamal

Role of Recipient-site Preparation Techniques and Post-operative Wound Dressing in the Surgical Management of Vitiligo.

Vitiligo is an acquired skin disorder characterized by the destruction of melanocytes resulting in achromic macules and patches involving the affected skin. Multiple methods of treatments have emerged to manage vitiligo, including medical and surgical techniques. Among the surgical techniques described in the management of vitiligo are minipunch grafting, split-thickness skin grafting, hair follicle transplantation, suction blister grafting, and cultured and non-cultured autologous melanocyte transplantation. However, prior to grafting optimal recipient-site preparation is needed for graft survival and successful repigmentation outcomes. Similarly, post-operative care of the recipient site is vital to yielding a viable graft irrespective of the transplantation technique employed. This article reviews the multiple methods employed to prepare the recipient site in vitiligo surgeries and the post-surgical conditions which optimize graft viability. A pubmed search was conducted utilizing the key words listed below.

The impact of oral Polypodium leucotomos extract on ultraviolet B response: A human clinical study

Background There is a rationale for adding systemic photoprotective agents to the current photoprotection regimen. Objective This study was designed to objectively evaluate the molecular and photobiologic effects of oral administration of Polypodium leucotomos extract (PLE). Methods In all, 22 subjects with Fitzpatrick skin phototype I to III were enrolled. On day 1, subjects were irradiated with visible light, ultraviolet (UV) A1, and UVB (using 308‐nm excimer laser). Evaluation was done immediately and 24 hours after irradiation. On days 3 and 4, irradiation and evaluation process was repeated after ingestion of PLE. Results Clinical assessments and colorimetry data showed a decrease in UVB‐induced changes in 17 of 22 subjects post‐PLE administration; histology findings demonstrated such a decrease in all 22 subjects. Limitations Only 2 doses of PLE were given. Furthermore, subjects with skin phototypes I to III only were studied. Conclusion The results suggest that PLE can potentially be used as an adjunctive agent to lessen the negative photobiologic effects of UVB. Abbreviations used: COX‐2: cyclooxygenase‐2; IGA: Investigator Global Assessment; MED: minimal erythema dose; PLE: Polypodium leucotomos extract; UV: ultraviolet.

Exploring the gaps in the evidence‐based application of narrowband UVB for the treatment of vitiligo

While narrowband ultraviolet light B (NB‐UVB) has become integral to the treatment of diffuse vitiligo, evidence‐based guidelines have been lacking with regard to dosing and administration. This is largely the result of heterogeneous study designs, ambiguous methodologies, disparate dosing strategies, and the use of varied, and somewhat arbitrary, outcome measures. In the absence of prospective trials to address each of these concerns, the available literature regarding the application of NB‐UVB for vitiligo was reviewed and the authors now pose a set of questions to the phototherapy community in an attempt to highlight gaps within our understanding. We aim to stimulate discussion, elicit expert opinion, and identify areas for future research to move toward a unified and safe treatment guideline for patients afflicted by this disease.

Three‐dimensional imaging of vitiligo

Keywords: body Surface Area (BSA); imaging; Measurement error; three dimensional; vitiligo

Photoprotection and vitamin D.

Vitamin D is a fat-soluble hormone obtained from sun exposure, diet, and oral supplements with implications on skeletal and extra-skeletal disease. Thus, concern has developed whether photoprotection would affect vitamin D status. This chapter will discuss how humans acquire vitamin D, vitamin D’s physiologic effects, associations with disease, risk factors for deficiencies, and impact of photoprotection, as well as recommendations on vitamin D screening and supplementation.

Clinical and Biological Relevance of Visible and Infrared Radiation

Visible and infrared radiation spectra have numerous biological and clinical effects on the skin. Visible spectrum radiation can induce transient erythema and persistent pigmentation and can also induce free radical production along with DNA damage. Visible light also plays a role in the pathogenesis of solar urticarial, chronic actinic dermatitis, and porphyrias and is used in the treatment of hyperbilirubinemia and acne vulgaris. Infrared radiation is capable of inducing erythema, thermal pain, and photoaging in addition to cytotoxicity, DNA damage, and oxidative stress. Infrared radiation can also cause erythema ab igne and plays a role in the treatment of acne vulgaris. Lasers in the visible and infrared spectrum have been widely used in the treatment of a variety of dermatologic conditions such as vascular and pigmented lesions and keloids. Photoprotection from visible and infrared radiation and diagnostic imaging using visible and infrared radiation are important topics that have recently been explored.

Automated Melasma Area and Severity Index scoring

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