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Background A variety of therapeutic approaches have been introduced for striae distensae (SD) with modest outcomes. Fractional carbon dioxide laser (FCL) and platelet-rich plasma (PRP) are effective separately in improving SD. Objective To assess the safety and efficacy of topically applied PRP combined with FCL in the management of SD. Patients and methods In this prospective, single-blinded, randomized, comparative intrapatient study, 24 patients with bilateral SD lesions were subjected to FCL on both sides and followed by topical application of PRP on one side only allocated by simple randomization. The sessions were performed biweekly for a total of six sessions. Overall clinical improvement was graded using the Quartile Grading Scale. Biopsies, before and after treatment, were stained with H and E, Masson’s trichrome, and Orcein stains. In addition, collagen I and elastin immunohistochemical staining were performed. Results In this study of 24 SD patients (19 females, 5 males; aged 19–39 years), topical PRP with FCL achieved moderate to excellent outcomes 3 months after the last session. Early striae rubra improved after the initial session, reaching marked excellent outcomes within a month after the second session. Manageable side effects were reported. Histological examination showed improved epidermal and dermal thickness, collagen, and elastic fiber quality after treatment, with the combined PRP and FCL side exhibiting more significant outcomes than the FCL-treated side. Conclusion Topical PRP application post-FCL proves to be a highly effective therapeutic approach for SD, expressing superior treatment outcomes, and heightened patient satisfaction compared with the use of FCL alone. In additio, topical application is preferred over intradermal injection, offering practicality, effectiveness, and noninvasiveness.

Background Nevus of Ota is a dermal hamartoma that presents as bluish/slate gray pigmentation along first or second branch of trigeminal nerve. Patients search for treatment early in life due to psychological trauma and cosmetic disfigurement. The establishment of high power, short pulse Q switched (QS) lasers has provided a tool for substantial therapeutic advances in the management of dermal pigmented lesions. Objectives The aim of the present study was to correlate the clinical efficacy of QS Nd : YAG laser with histological, as well as histometric findings through studying the quantitative changes of dermal melanocyte surface area in nevus of Ota patients after treatment. Patients and methods Twelve patients with nevus of Ota were subjected to multiple treatment sessions with 1064 nm QS Nd : YAG laser at 2 months interval accomplished over a period of 2 years. Skin types treated included phototypes III and IV. All patients were photographed before, after each session and at the end of treatment. Skin biopsies were taken from all patients before treatment and after six sessions to perform histological and histometric analysis. Results Excellent improvement was noticed in four (33.3%) patients, good improvement in five (41.6%) patients, and one (8.3%) patient showed fair response. While, poor response was seen only in two (16.7%) patients. Hematoxylin and eosin and Fontana-Masson stained sections showed significant decrease in the number of elongated spindle-shaped dermal melanocytes throughout the dermis. Meanwhile, histometric study revealed significantly decreased dermal melanocyte surface area after treatment. Conclusion QS Nd : YAG laser is an effective and easy-to-perform treatment in cases of nevus of Ota in Egyptian patients with minimal side effects. Histological and histometric findings correlated with the clinical improvement attained.

Background: Hepatitis-C virus (HCV) infection is considered a major worldwide public health problem with a global prevalence. Maintenance of skin homeostasis requires a delicate balance between proliferation, differentiation, and apoptosis. Meanwhile, it is unclear if there is an altered keratinocyte proliferation/apoptosis balance in advanced liver disease with HCV infection. Aim: This work aimed to evaluate the epidermal thickness and changes in the expression of apoptosis regulatory markers as well as apoptotic index in skin samples of advanced HCV liver patients compared to normal controls. Materials and Methods: Twenty biopsies were taken from apparently normal skin of advanced HCV liver disease patients, as well as five healthy control subjects. These specimens were used for histometric epidermal measurement, immunohistochemical staining of apoptosis regulatory proteins (Bax, Fas, p53, Caspase-3, Bcl-2, Bcl-xL) as well as the TUNEL technique for detection of apoptotic cells. Results: The mean epidermal thickness was significantly lower than the control group (P=0.000). There were significant overexpression of pro-apoptotic markers (Bax, Fas, P53, and Caspase-3) in patients (P=0.03, 0.03, 0.003, 0.003 respectively), with increased apoptotic index in HCV liver patients (P=0.002) when compared to normal controls. On the other hand, no statistically significant difference were encountered in the expression of antiapoptotic markers (Bcl-2, Bcl-xL) in HCV patients when compared to normal controls (P=0.5, 0.9, respectively). Conclusion: These findings suggest that an alteration in the proliferation/apoptosis balance is present in the skin of HCV liver patients.

Objectives: Electro-optical synergy technology is one of the most recently described methods for nonablative skin rejuvenation. The aim of this study is to evaluate the effects of electro-optical synergy on connective tissue composition by histological and immunohistochemical techniques coupled with computerized morphometric analysis. Design: A prospective clinical study. Participants: Six volunteers with Fitzpatrick skin types 3 to 4 and Glogau class I to II wrinkles were subjected to three months (6 sessions at 2-week intervals) of electro-optical synergy treatment. Measurements: Standard photographs and skin biopsies were obtained at baseline as well as three and six months after the start of treatment. The authors performed quantitative evaluation of total elastin, tropoelastin, collagen types I, III, and VII, and newly synthesized collagen. Results: Noticeable clinical and histological improvement was observed after electro-optical synergy treatment. A statistically significant increase in the means of collagen types I, III, and VII, as well as newly synthesized collagen, together with increased levels of tropoelastin, were detected, while the mean level of total elastin was significantly decreased at the end of treatment and three months post-treatment. Conclusion: Electro-optical synergy is an effective treatment for contouring facial skin laxity. This modality stimulates the repair processes and reverses the clinical, as well as the histopathological, signs of aging with the advantage of being a relatively risk-free procedure with minimal patient recovery time. [ABSTRACT FROM AUTHOR]