Nevien Samy

Functionalized formazans: A review on recent progress in their pharmacological activities.

Graphical abstract

Hydrazonoyl Halides: Their Versatile Biological Activities

The various biological activities namely anthelmintic, antiarthropodal, antiviral, antimicrobial, herbicidal, antisarcoptic, acaricidal, insecticidal and miticidal activities exhibited by the hydrazonoyl halides are surveyed. Also, the uses of such halides as pesticides, weed controlling and antihypertensive agents as well as lipoxygenase and cyclooxy- genase inhibitors are presented. Furthermore, their contact dermatitis and phytotoxicity effects are pointed out in addition to their metabolic fate.

Topical colloidal indocyanine green-mediated photodynamic therapy for treatment of basal cell carcinoma

Abstract Indocyanine green (ICG) is a near-IR fluorescent dye with a great potential for application as photosensitizer in topical photodynamic therapy (PDT) of skin diseases. Despite its merits, its use has been hampered by its high degradation rate. Therefore, in the current article, ICG was encapsulated in a vesicular colloidal nanocarrier (transfersomes), with the aim of enhancing its therapeutic efficacy. Transfersomes were characterized for their entrapment efficiency, particle size, zeta potential, morphology, in vitro release and histopathological effect on mice skin. A pilot clinical study was conducted to test its therapeutic potential for PDT of basal cell carcinoma (BCC). Transfersomal ICG displayed particle size (∼125 nm) and a negative zeta potential (∼−31 mV). Transfersomes were also able to sustain the release of ICG >2 h. Upon incorporation of transfersomal ICG in gel form, it was found to maintain the normal histology of mice skin post-irradiation with diode laser 820 nm. Moreover, ICG transfersomal PDT achieved 80% clearance rate for BCC patients with minimal pain reported during treatment. The previous findings suggest that transfersomal nanoencapsulated ICG is a promising treatment modality for BCC.

Comparative study between excimer light and topical antioxidant versus excimer light alone for treatment of vitiligo.

Background: Vitiligo is an acquired idiopathic cutaneous disease characterized by pearly white patches of variable shapes and sizes. Various medical and surgical therapeutic options have been proposed to achieve repigmentation; phototherapy is one of the most efficient options. Topical therapies have been a mainstay of vitiligo treatment, with or without phototherapy. Aim of the work: To compare the efficacy of combined topical antioxidant hydrogel and excimer light versus excimer light alone in treating vitiligo. Patients and Methods: Thirty patients were included in this comparative, prospective, randomized study. For each patient, at least 2–4 vitiliginous macules were randomly selected and treated while an untreated vitiliginous macule served as control. Lesions were divided into two groups: Group A received combination therapy of daily topical antioxidant plus excimer light, while Group B received only excimer light. Lesions were treated twice a week for a maximum of 24 sessions. Initial fluencies were adjusted individually according to the minimal erythema dose in vitiliginous skin. Efficacy based on repigmentation percentages were blindly evaluated by two independent physicians. Results: Group A lesions showed significant efficacy than group B (p < 0.001), specially on treating UV-sensitive lesions with no side effects. Conclusion: Topical antioxidant and excimer light represents a valuable, effective therapy for localized vitiligo.

Combined cryotherapy and topical 5-fluorouracil for treatment of basal cell carcinoma

Background Cryotherapy (Cryo) and topical 5-fluorouracil (5FU) are both considered as successful noninvasive therapeutic options for basal cell carcinoma (BCC). Objective The aim of the study was to investigate the efficacy of combined Cryo and topical 5FU (Cryo+5FU) in patients suffering from BCC. Design This was a prospective clinical trial with a 6-month follow-up. Duration The study was carried out during a period of 11 months from March 2012 to February 2013. Patients and methods Fifteen patients complaining of BCC were included. Intervention Intervention included combined weekly regimen of Cryo followed after 3 days by twice daily 5FU application for four successive days for a maximum of 6 weeks. Main outcome measures Assessments of clinical improvement by examination, dermatological photography, and skin biopsy were the main outcome. Results All 15 patients achieved complete response with minimal side effects, good cosmetic outcome, and relatively shorter duration of treatment. Conclusion Combined Cryo+5FU offers a new effective modality for treatment of BCC.

Evaluation of Topical Capislow Extract and Long Pulsed Nd-YAG Laser in the Treatment of Idiopathic Hirsutism

Introduction: Hirsutism is a condition that affects 10% of women worldwide. In many cultures, hirsutism is regarded as loss of femininity and can be psychologically traumatizing to the suffering females. The aim of the present study was to evaluate how topical capislow would affect or enhance the efficacy of laser hair removal. Methods: A randomized, monoblinded, placebo controlled split face study of combined topical capislow and long pulsed Nd-YAG laser on one side of the face versus long pulsed Nd-YAG laser alone on the opposite side of the face. Laser sessions were done at 4 weeks interval for maximum seven sessions. Topical capislow and placebo were applied once daily from the day of the first laser session to the day of the last laser session. Patients were evaluated both subjectively and objectively in each laser session and for six months after the last laser session. Results: Both treatment modalities were well tolerated and accepted with significantly better results in combined capislow and laser group versus laser alone. Conclusion: Topical capislow can represent a safe and effective synergistic method for laser with faster results but this is a temporary effect retained only to the time of its application.

Comparison of pulsed dye laser versus combined pulsed dye laser and Nd:YAG laser in the treatment of inflammatory acne vulgaris

ABSTRACT Background: Both pulsed dye laser and combined 585/1064-nm (sequential dual-wavelength PDL and Nd:YAG) laser improves inflammatory skin disorders including acne vulgaris. Objective: To compare the efficacy of 585-nm pulsed dye laser versus sequential dual-wavelength PDL and Nd:YAG in treatment of acne vulgaris. Patients and method: Thirty patients with acne vulgaris were treated by PDL alone on half of the face while contra lateral half was treated by combined 585/1064 nm laser. Results: The study showed that inflammatory acne lesions count was significantly reduced by 82.5% (p 0.0001) on PDL sides and by 83.5% (p 0.00001) on combined 585/1064-nm side after 8 weeks, while reduction of non-inflammatory acne lesions was observed at 8 weeks by 58.4% and 71.5% respectively. However, difference between the two modalities was not statistically significant. Conclusion: PDL and combined PDL/Nd:YAG laser treatment were found to be an effective, safe and well-tolerated treatment option for inflammatory and non-inflammatory acne vulgaris.

A randomized, controlled, double-blind study evaluating photodynamic white hair removal using topical liposomal Rose Bengal

One of the challenges of OMICS research is the integration of new data into the preexisting, and then re-interpretation of the integrated data. We used readily available meta-analysis computational methods to integrate new data on the transcriptomic effects of EGF in primary human epidermal keratinocytes with the preexisting transcriptomics data in keratinocytes. We separately addressed the consequences of adding EGF to keratinocyte cultures and its reverse, blocking the EGFR kinase with Tyrphostin AG1478. We first starved primary human epidermal keratinocytes for 24 hrs and next treated them with EGF. Then, we compared the genes expressed in the treated and control cultures in parallel, using Affymetrix microarrays. We find that the addition of EGF promotes keratinocyte proliferation, attachment and motility and, surprisingly, induces DUSPs, the phosphatases that attenuate the EGF signal. Using metaanalysis, we identified overlapping effects of EGF with those of IL-1 and IFNg, both activators of keratinocyte in wound healing and inflammation. We also identified and characterized the genes and pathways which are suppressed by EGF but are induced by agents promoting epidermal differentiation, such as Ephrins and JNK inhibitors. EGFR activation is important in many malignancies, including cutaneous SCC, lung, colon and other cancers, and targeting the EGFR is currently used to treat such cancers. However, a significant drawback to EGFR targeted therapies is the skin toxicity side effect. This toxicity usually presents as hair and nails abnormalities, papular or pustular folliculitis and pruritic dry skin. These limit the usefulness of EGFR targeting therapies. Surprisingly, the transcriptional effects of EGFR inhibition have not been extensively explored in epidermal keratinocytes. Therefore, we treated primary human epidermal keratinocytes with Tyrphostin AG1478, a specific inhibitor of the EGFR kinase, and compared the treated and control cultures using Affymetrix microarrays. The observed changes were integrated with the preexisting data on transcriptional profiling in epidermal keratinocytes. We find that the inhibition of EGFR suppresses the transcription of genes linked to keratinocyte proliferation, attachment and motility. Interestingly, inhibiting EGFR promotes apoptosis by both induction of proapoptotic and suppression of antiapoptotic genes. Certain transcriptional effects of EGFR inhibition counter the transcriptional effects of retinoids. Surprisingly, EGFR inhibition strongly and specifically induces expression of markers of epidermal differentiation. Overall, our work defines the yin-yang of EGF signaling in human epidermis, namely both the changes responding to activation of the EGF receptor, and its inhibition. Moreover, this work can serve as a paradigm for integration and analysis of new omics data with the large bodies of data in public repositories.Nowadays facial wasting is considered a stigma of HIV-infection; well-known are the devastant effects on facial features of the drugs used for the higly active anti-retroviral therapy. Years after years, several techniques and filling devices have been proposed to restore facial features of these patients. Several authors stated that when facial wasting is associated with trunk lipohypertrophy (another side effect related to the drugs intake), structural fat graft is the best option achievable, because at the same time, removing the lipohypertrophied fat of the body, and using it to fill the face, let to reach a great improvement both at the face and the body. However, often and often, the injected fat can be resorbed in a very high percentage, so the use of dermal filler is quite frequent to help the physicians in treating these patients in removing facial wasting’s stigma. Several fillers have been proposed for this purpose, however, HIV-infected patients presenting facial wasting are not like cosmetic patients seeking a little improvement, these patients need a treatment more reconstructive than cosmetic; this is why long lasting or permanent fillers are often used, and in these cases the physician need different skills. Furthermore, it is very important how these fillers act once injected, and if late side effects can be seen; so, only long follow-up let a physician, involved in this tretament, to really understand what works and what doesn’t. The author presents what he learned by its own experince, in using fillers for facial wasting rehabilitation.M has been used to treat inflammatory skin conditions; however, there is limited data with regard to pharmacokinetic, dosage adjustment, and clinical response. The methotrexate polyglutamate (MTX PG3) assay was developed as a marker to measure methotrexate activity in vivo in determining the optimal therapeutic range in patient management. Our objective was to evaluate the methotrexate polyglutamte assay in assessing whether the measurable methotrexate metabolite correlates with a clinical response in pediatrics patients with inflammatory skin diseases treated with methotrexate. A retrospective chart review was performed on 47 children from SSM Cardinal Glennon Children’s Medical Center with a median age of 8 years (range, 2-17 years) and mean treatment duration of 363.42 days over a 24 month period. MTX PG3 levels were recorded from the MTX PG3 assay. Clinical treatment was evaluated using a Physician Global Assessment scale (0=clear, 1=almost clear, 2=mild, 3=moderate, and 4=severe) re-classified into 0=poor/fair and 1=good/excellent. Patients were categorized into responders, defined as patients changing from poor/fair to good/excellent, and non-responders, defined as patients remaining at poor/fair. Late-responders, defined as children responding after 12 months, were compared with non-responders using mean maximum and mean percent change in MTX PG3 levels. Data analyzed using statistical t-tests. Of the 47 patients, stratified into two groups: responders 38/47 (81%) and non-responders 9/47 (19%). Responders and non-responders had a mean MTX PG3 level of 31.5 and 22.3, respectively, p=0.138. Late-responders and non-responders had a mean change of 42.6% and 19.1% and mean maximum of 41.9 and 22.3 MTX PG3 levels, respectively, p=0.01. This study has been limit primarily by a small sample size. MTX PG3 levels do not correlate with clinical response between responders and non-responders. However, amongst late and non-responders, MTX PG3 assay remains a viable test in adjusting dosage in association with clinical response. In the end, MTXPG3 levels are more predictive for late than early responders.Laser hair removal of blond and white hair is acomplicated task with often unsatisfactory results as a result of lack of laser-absorbing chromophore. In the present study, we investigated if repetitive sessions of photodynamic therapy (PDT) using Topicall application of liposomal rose bengal (RB) hydrogel followed by intense pulsed light (IPL) exposure enables removal of white and gray hair. Liposomal RB in hydrogel was prepared and pharmaceutically characterized. Fifteen adult females, skin phenotypes III–IV were entered into the study. They were determined to have white terminal hair. Unwanted facial hair was treated for three sessions at 4–6 week intervals using intense pulsed light (IPL). At each treatment: the treatment area was pre-treated with topical liposomal rose RB gel. While a control group of another 15 patients applied Placebo gel before IPL treatment. Hair regrowth was measured 4 weeks after each treatment and additionally 6months after the last treatment by counting the number of terminal hair compared with baseline pretreatment values. Rate of hair regrowth, complications and treatment outcomes were documented. Mean regrowth in the liposomal RB group was 63%after 3 treatment cycles. Six months after therapy, average terminal hair count compared with baseline pretreatment showed 40% reduction, and no recorded side effects. Also significant difference was seen compared with the control group, the clinical outcome was promising. As a conclusions photodynamic therapy using liposomal RB hydrogel in combination with IPL treatment showed significant efficacy in the treatment of white hair compared with a control group.