Sherif Shoukry Awad

Chinese Cupping: A Simple Method to Obtain Epithelial Grafts for the Management of Resistant Localized Vitiligo

BACKGROUND The introduction of surgical techniques provided a major development in the management of resistant vitiligo and replaced other conventional unsuccessful therapies. Most of these procedures require special devices and experience that prevent many dermatologists from utilizing them. OBJECTIVES The aim of this work is to evaluate the introduction of a new simple technique that can be used in epithelial grafting for recalcitrant patches of vitiligo. METHODS Twenty vitiligo patients, nonresponding to classic phototherapy, were candidates in this study. A simple Chinese cupping device was used to induce blisters on the inner aspect of the thighs of the patients and the resulting blister roofs were used for grafting on dermabraded vitiliginous patches. The patients were followed up for 1 year. RESULTS Blister roofs induced by Chinese cupping were able to repigment vitiliginous patches in 80% of the patients with admirable coloring match, and the donor areas did not show any cosmetic disfigurement at the end of the study. CONCLUSION In conclusion, Chinese cupping is a simple and easy-to-use method to obtain epithelial grafts for vitiligo management.

Epithelial grafting for vitiligo requires ultraviolet A phototherapy to increase success rate

Background  Phototherapeutic techniques were introduced into medical practice by the ancient Egyptians. It is considered a cornerstone in the management of resistant vitiligo; yet, failures are very well known. Recently, the introduction of surgical techniques provided a major development in the management of vitiligo and replaced other conventional unsuccessful therapies.

Multiple microneedling sessions for minimally invasive facial rejuvenation: an objective assessment

Microneedling or percutaneous collagen induction is a new modality used for skin rejuvenation, tightening, and scar remodeling. It offers a simple and effective treatment for photoaged skin with minimal disruption of the epidermis, thus limiting adverse effects and minimizing downtime.

Dermabrasion may repigment vitiligo through stimulation of melanocyte precursors and elimination of hyperkeratosis

The observation of successful repigmentation of recalcitrant vitiligo patches in spite of rejection of epithelial grafts from the dermabraded skin presented a query about possible efficiency of dermabrasion itself in the repigmentation process.

Repigmentation of Poliosis After Epithelial Grafting for Vitiligo

Background Vitiligo is a disease of color loss from skin and possibly also from hair. The presence of white hair follicles is known to be a bad prognostic sign. Objectives To evaluate the possibility of repigmentation of white hair follicles after epithelial grafting. Methods Patients with recalcitrant vitiligo with loss of hair pigment were treated using Chinese cupping blisters or ultrathin Thiersch grafting after de‐epithelialization of vitiliginous patches by dermabrasion. Phototherapy was used afterward to enhance success. Results Repigmentation of the skin surface was obtained with as little as 1 to 2 months of phototherapy, as expected, and further follow‐up of cases revealed the re‐coloring of hair follicles after 4 to 11 months. Conclusion Re‐coloring of poliosis with vitiligo is possible but was unexpected because of the difference in mechanism and signaling required between hair bulb melanization and the surface skin. One likely mechanism to explain this change is that melanocyte stem cells are stimulated and migrate to supply hair bulbs with new mature melanocytes. Epithelial grafting of vitiligo with poliosis in hairy areas should be a treatment of choice when white hair tufts cause cosmetic disfigurement.

Loose anagen hair syndrome in children of Upper Egypt

Background  Loose anagen hair (LAH) syndrome is a phenomenon in early childhood characterized by the presence of easily pluckable hair, where hair tufts can be pulled out easily and painlessly.

Management of resistant halo nevi

ABSTRACT Background: Halo nevus (HN) is a rare dermatologic disorder characterized by typical whitish rim surrounding an existing melanocytic nevus resembling halo. It is a cosmetic problem that may be linked to vitiligo, and it is advised to remove these nevi in order to avoid development of vitiligo. Objectives: The aim of the present study is to evaluate the cosmetic outcome after nevus removal and leukoderma dermabrasion with epithelial graft followed by narrow-band ultraviolet B (NB-UVB) phototherapy as management of resistant halo nevi and avoidance of development of vitiligo. Patients and Methods: Ten patients with persisting halo nevi were selected as candidates in this study. Superficial dermabrasion was carried out using proper diamond fraises on depigmented rim and then punch biopsy probes with suitable size were used to harvest the nevus. Thiersch graft was prepared and applied on the dermabraded depigmented area. After 1 week of the procedure, patients were exposed to NB-UVB twice weekly and were followed up for 3 months. Results: Repigmentation was noticed in 2 weeks and was nearly fully accomplished in all 10 patients within the 3-month period. No other vitiligo lesions developed during this period in all patients except for one case. Conclusion: Excision of Sutton’s nevus with combined dermabrasion and Thiersch grafting followed by phototherapy is a good aesthetic maneuver in treating halo nevi and helps in avoiding further vitiligo depigmentation.

Depigmentation during vitiligo activity spares epithelial grafted areas.

Vitiligo is a depigmenting disease characterized by episodes of stability and activity without a fixed sequence, and active phases demonstrate immune attacks toward vulnerable melanocytes. Epithelial grafts were introduced to treat recalcitrant vitiligo patches aiming to provide new generations of melanocytes.

Epithelial expression of cytokeratins 15 and 19 in vitiligo.

Cytokeratins (CK) belong to the family of intermediate filament proteins, and among them specific epithelial keratins are considered markers for stem cells activation.