Wedad Z. Mostafa

Homozygosity Mapping Places the Acrodermatitis Enteropathica Gene on Chromosomal Region 8q24.3

Acrodermatitis enteropathica (AE) is a rare autosomal recessive pediatric disease characterized by dermatitis, diarrhea, alopecia, and growth failure. The disease results from insufficient uptake of zinc by the intestine and can be fatal unless the diet is supplemented with zinc. To map the gene responsible for AE, a genomewide screen was performed on 17 individuals, including 4 affected individuals, in a consanguineous Jordanian family. Three markers-D8S373, D10S212, and D6S1021-had a pattern consistent with tight linkage to a recessive disease: one allele in the affected sibs and multiple alleles in unaffected sibs and parents. Two-point parametric linkage analysis using FASTLINK identified one region, D8S373, with a maximum LOD score >1.5 (1.94 at D8S373: recombination fraction.001). Twelve additional markers flanking D8S373 were used to genotype the extended family, to fine-map the AE gene. All five affected individuals-including one who was not genotyped in the genomewide screen-were found to be homozygous for a common haplotype, spanning approximately 3.5 cM, defined by markers D8S1713 and D8S2334 on chromosomal region 8q24.3. To support these mapping data, seven consanguineous Egyptian families with eight patients with AE were genotyped using these markers, and six patients from five families were found to be homozygous in this region. Multipoint analysis with all consanguineous families, by Mapmaker/Homoz, resulted in a maximum LOD score of 3.89 between D8S1713 and D8S373. Sliding three-point analysis resulted in a maximum LOD score of 5.16 between markers D8S1727 and D8S1744.

Suggested mechanisms of action of UVA phototherapy in morphea: a molecular study

Background: Ultraviolet A (UVA) phototherapy proved to be an efficient line of treatment of scleroderma. The mechanism through which it acts is still not clear.

Different low doses of broad-band UVA in the treatment of morphea and systemic sclerosis.

Background: Numerous treatment modalities, some with potentially hazardous side effects, are currently used for morphea (M) and systemic sclerosis (SS) with limited success. Low‐dose ultraviolet A (UVA) phototherapy (20 J/cm2) was found to be highly effective for sclerotic patches, even in patients with advanced and rapidly evolving lesions.

Narrow band Ultraviolet B 311 nm in the treatment of vitiligo : two right-left comparison studies

Aim: Evaluation of narrow band ultraviolet B (NB UVB 311 nm) in the treatment of vitiligo by two independent studies. The first study compared NB UVB with a well‐established therapeutic modality, psoralen ultraviolet A (PUVA), and the second study was conducted to find out whether psoralen might add to its efficacy.

Ultraviolet A in vitiligo

Both types of Ultraviolet (UV), UVB (290–320 nm) and UVA (320–400 nm), produce increased pigmentation or tanning. However, no evaluation of UVA alone in the treatment of vitiligo has been reported. Therefore, it was the purpose of this work to study the pigmentogenic effect of UVA (5 and 15 J/cm2) in vitiligo. The study included 20 randomly selected patients with vitiligo involving more than 30% of the body surface area with a bilateral/symmetrical distribution. They were equally divided into two groups each of 10 patients. All patients received three weekly sessions of UVA, 15 J/cm2 in group I and 5 J/cm2 in group II, a total of 48 sessions over 16 weeks. Overall pigmentation of 60% and above was recorded in 50% and 10% of patients in groups I and II, respectively. We conclude that broadband UVA alone, without psoralens, and in appropriate doses may be of important therapeutic value in vitiligo.

Detection of Herpes Simplex Virus DNA in Serum and Oral Secretions during Acute Recurrent Herpes Labialis

Although herpes simplex virus (HSV) has been detected in the peripheral blood of immunocompromised patients and in neonates with disseminated disease, the extent to which the virus may be present in the blood during a localized infection in otherwise healthy patients is still unknown. Literature on patterns of HSV shedding into the oral cavity at the prodromal stage of the disease, during recurrences, and also during asymptomatic periods is still lacking. The present study aims at the detection of HSV DNA in the serum and oral secretions during acute herpes labialis using a highly sensitive technique, the polymerase chain reaction (PCR). The study included 10 patients with acute herpes labialis and five healthy controls. Using PCR, herpes simplex virus DNA was detected in the serum of seven patients (70%) and in the saliva of nine patients (90%). One of the control cases showed positive HSV DNA in the saliva (20%). There was good statistical agreement between the presence of HSV DNA in the serum and saliva. Frequency of attacks, patients age, and gender had no statistically significant effect on the presence of the virus in serum or in saliva. It is concluded that HSV viremia during attacks of recurrent herpes simplex is more frequent than previously appreciated.

Vitamin D and the skin: Focus on a complex relationship: A review

Graphical abstract

BB-UVA vs. NB-UVB in the treatment of vitiligo: a randomized controlled clinical study (single blinded).

Vitiligo is an acquired pigmentary disorder that affects between 1% and 2% of the general population. Phototherapy remains the cornerstone of treatment, with NB‐UVB being the most frequently used. BB‐UVA can be a plausible alternative for darker population; skin photo type III and IV.

An Epidemiologic Study of Perianal Dermatitis Among Children in Egypt

Abstract: Perianal dermatitis is a common problem occurring among infants and children. Streptococci, particularly β‐hemolytic group A organisms, play a major role in its causation. An epidemiologic association between perianal dermatitis caused by group A β chemolytic streptococci in some patients and pharyngeal colonization with the same organisms seems to exist. A similar relation is also true for other organisms, including non‐group A β‐hemolytic streptococci and Staphylococcus aureus. This was the main conclusion of a hospital‐based study performed on 150 children with perianal dermatitis. All patients were subjected to a questionnaire, clinical examination, two perianal cswabs, and two throat swabs. The bacterlologic examination of the perianal swabs revealed the presence of β‐hemolytic streptococci in 35.3% of the cases, half of which were of the group A β‐hemolytic strain (17.3%) and half of which were nongroup A (18%). Throat swabs revealed the presence of β‐hemolytic streptococci In 44% of cases, half of which were found to belong to group A (21.3%) and half to non group A (22.7%). Among patients with perianal dermatitis caused by group A β‐hemolytic streptococci, 53.8% had associated pharyngeal colonization by the same organism. S. aureus was isolated from the perianal skin in five patients (3.4%); in four of whom the same organism also grew in cultures from throat swabs. A relatively good association between pharyngeal colonization by β‐hemolytic streptococci and Staphylococci and the presence of perianal dermatitis caused by the same organisms was demonstrated using the Kappa test of agreement (K= 0.4)

Hair loss in pityriasis versicolor lesions: A descriptive clinicopathological study

BACKGROUND We have observed that hair thinning and/or loss occur at times as a presenting symptom or sign in patients with pityriasis versicolor (PV). OBJECTIVE Our objective was to verify and explore this clinical observation and depict its underlying pathology. METHODS A total of 39 patients with PV were examined during a period of 11 months and skin biopsy specimens were taken from lesional and nonlesional skin. Hematoxylin-eosin- and periodic acid-Schiff-stained sections were examined and described. Results were statistically analyzed. RESULTS Hair loss and/or thinning within PV lesions was shown in 61.5% of patients (P value < .0005), appearing most commonly on forearms, abdomen, and neck as well as the beard area (only in male participants). Histopathologically, in addition to the classically described features of PV, basal hydropic degeneration, follicular degeneration, miniaturization, atrophy, plugging, and/or hair shaft absence occurred in 46% of lesional versus 20.5% of nonlesional biopsy specimens (P value < .05); these changes appeared to be directly or indirectly related to the presence of Malassezia organisms in hair follicles and/or stratum corneum. LIMITATIONS Some patients with PV lesions on the face did not approve facial biopsy. CONCLUSION This study provides clinical and histopathological evidence that PV lesions may be associated with hair thinning and/or loss.