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Background Viral warts are known for their persistence and recurrence, causing frustration to patients and treating physicians. Researchers recently proposed the hypothesis that intralesional vitamin D3 would be an effective treatment option for warts. Objective To assess the efficacy of intralesional injection of vitamin D3 in the treatment of cutaneous warts by clinical and dermoscopic evaluation. Patients and methods Sixty-two patients with single or multiple warts were randomized into two groups, groups I and II, who were treated with intralesional vitamin D3 and normal saline, respectively. Injections were performed every 2 weeks for a maximum of four sessions. All patients were followed up for 6 months. Results Complete cure was reported in 56.25% of patients treated by intralesional vitamin D3. No serious adverse effects or allergic reactions were reported. None of the healed wart recurred by the end of follow-up period. Conclusion Vitamin D3 is an effective and safe treatment option in treating cutaneous warts. The use of dermoscopy adds a great value in evaluating treatment response and in decreasing the incidence of recurrence.

Background Acne vulgaris is a multifactorial inflammatory disease. Resistin gene is believed to play a role in inflammatory diseases by triggering the release of some cytokines. Objective The aim was to investigate resistin gene polymorphisms in patients with acne and the relation between the gene polymorphisms and serum lipid levels in Egyptian patients with acne. Patients and methods A total of 50 Egyptian patients with acne vulgaris and 50 healthy controls were enrolled in this case–control study. Global acne grading system was used to assess the severity of acne. PCR-RFLP technique was used to detect polymorphisms of RETN +299G>A and RETN −420C>G, and the serum lipids are measured in all patients and controls. Results RETN gene polymorphisms at −420C>G genotype distribution showed a significant difference between patients and control groups in CG and GG genotypes. Participants carrying G allele were significantly more likely to develop acne vulgaris. There was a significant difference between patients and control groups in the frequency of distribution of GA and AA genotypes in RETN gene polymorphisms at +299G>A. There were significant positive correlations between both RETN gene polymorphisms and acne severity, total cholesterol, and low-density lipoprotein. Conclusion RETN gene polymorphisms at −420C>G and +299G>A are significantly associated with serum lipids and severity of acne vulgaris in Egyptian populations. Thus, RETN may play a central role in acne pathogenesis through its dual effects on both lipid metabolism and inflammation.

Background Melasma is an acquired disorder of symmetrical hypermelanosis that involves sun-exposed areas of the skin. Although multiple therapeutic modalities have previously been tried, successful, truly effective treatment options for this condition have been few and quite elusive. Objectives To compare the therapeutic efficacy of topical tranexamic acid (TXA) with microneedling versus microneedling alone in the treatment of melasma and to evaluate the changes that occur clinically, histologically, and immunohistochemically. Patients and methods This study was conducted on 42 patients with melasma, randomly divided into two groups. In group I, each patient was subjected to a series of six sessions of skin microneedling and TXA application, whereas in group II, six sessions of microneedling alone were performed, with 2-week interval. Results Clinically, the mean melasma area and severity index (MASI) score was significantly decreased in both groups with statistically significant higher reduction scores in group I compared with group II. Histopathologically, epidermal hyperpigmentation and dermal melanophages were significantly reduced after treatment with more obvious reduction in group I. The number of melanoma antigen recognized by T cells-1-positive cells showed significant reduction in both groups; this reduction was statistically higher in group I than group II. Conclusions Although microneedling alone produced significant lightening effect, topical TXA combined with microneedling achieved more satisfactory results.

Abstract In our pursuit of enhancing acne treatment while minimizing side effects, we developed tailored Adapalene microsponges (MS) optimized using a Box–Behnken design 33. The independent variables, Eudragit RS100 percentage in the polymer mixture, organic phase volume, and drug to polymer percentage, were explored. The optimized formulation exhibited remarkable characteristics, with a 98.3% ± 1.6 production yield, 97.3% ± 1.64 entrapment efficiency, and a particle size of 31.8 ± 1.1 µm. Notably, it achieved a 24 h cumulative drug release of 75.1% ± 1.4. To delve deeper into its efficacy, we evaluated the optimized microspongeal-gel in vitro, in vivo, and clinically. It demonstrated impressive retention in the pilosebaceous unit, a target for acne treatment. Comparative studies between our optimized Adapalene microspongeal gel and marketed Adapalene revealed superior performance. In vivo studies on Propionibacterium acnes-infected mice ears showed a remarkable 97% reduction in ear thickness, accompanied by a significant decrease in inflammatory signs and NF-κB levels, as confirmed by histopathological and histochemical examination. Moreover, in preliminary clinical evaluation, it demonstrated outstanding effectiveness in reducing comedonal lesions while causing fewer irritations. This not only indicates its potential for clinical application but also underscores its ability to enhance patient satisfaction, paving the way for future commercialization.

Topical conveyance of antifungal agents like itraconazole ITZ has been giving good grounds for expecting felicitous antifungal medicines. The defiance of topical delivery of this poorly water soluble and high-molecular-weight drug, however, mightily entail an adequate vehiculation. ITZ aspasomes, newer antioxidant generation of liposomes, have been designed and enclosed in a cream to ameliorate skin deposition. The proposed creams containing non-formulated ITZ or encapsulated in aspasomes (0.1% or 0.5%) were topically applied in patients with diagnosed diaper dermatitis complicated by candidiasis, tinea corporis (TC), and tinea versicolor (TVC). Placebos (void aspasomal cream and cream base) were also utilized. The obtained results for diaper rash revealed that aspasomal cream (0.5% ITZ) was eminent with respect to complete cure and negative candida culture after 10-day therapy relative to counterparts containing 0.1% ITZ aspasomes or non-formulated ITZ (0.1% and 0.5%). For tinea, the same trend was manifested in terms of ‘cleared’ clinical response in 90% of patients and absence of fungal elements after 4-week treatment. Relative to non-formulated ITZ, ITZ aspasomal cream was endorsed to be auspicious especially when ITZ concentration was lowered to half commercially available cream concentration (1%), pushing further exploitation in other dermal fungal infections.

The current investigation aimed for loading fenticonazole nitrate (FTN), an antifungal agent with low aqueous solubility, into trans-novasomes (TNs) for management of tinea corporis topically. TNs contain Brij® as an edge activator besides the components of novasomes (cholesterol, Span 60, and oleic acid) owing to augment the topical delivery of FTN. TNs were fabricated applying ethanol injection method based on D-optimal experiment. TNs were evaluated with regard to entrapment efficiency percent (EE%), particle size (PS), polydispersity index (PDI), and zeta potential (ZP). Further explorations were conducted on the optimum formulation (F7). F7 showed spherical appearance with EE%, PS, PDI, and ZP of 100.00 ± 1.10%, 358.60 ± 10.76 nm, 0.51 ± 0.004, and −30.00 ± 0.80 mV, respectively. The in silico study revealed the ability of the FTN–cholesterol complex to maintain favorable interactions throughout the molecular dynamics simulation (MDS) study. Moreover, Trichophyton mentagrophytes growth was inhibited effectively by F7 than by FTN suspension applying 2,3-bis(2-methyloxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide (XTT) reduction assay. Furthermore, a clinical appraisal on patients with tinea corporis fungal lesions confirmed the superiority of F7 compared to Miconaz® cream in the magnitude of clinical cure of tinea corporis. Thereby, TNs could be considered as promising vesicles for enhancing the antifungal potential of FTN for the topical management of tinea corporis.

The foremost target of the current work was to formulate and optimize a novel bergamot essential oil (BEO) loaded nano-phytosomes (NPs) and then combine it with spironolactone (SP) in order to clinically compare the efficiency of both formulations against acne vulgaris. The BEO-loaded NPs formulations were fabricated by the thin-film hydration and optimized by 32 factorial design. NPs’ assessments were conducted by measuring entrapment efficiency percent (EE%), particle size (PS), polydispersity index (PDI), and zeta potential (ZP). In addition, the selected BEO-NPs formulation was further combined with SP and then examined for morphology employing transmission electron microscopy and three months storage stability. Both BEO-loaded NPs selected formula and its combination with SP (BEO-NPs-SP) were investigated clinically for their effect against acne vulgaris after an appropriate in silico study. The optimum BEO-NPs-SP showed PS of 300.40 ± 22.56 nm, PDI of 0.571 ± 0.16, EE% of 87.89 ± 4.14%, and an acceptable ZP value of −29.7 ± 1.54 mV. Molecular modeling simulations showed the beneficial role of BEO constituents as supportive/connecting platforms for favored anchoring of SP on the Phosphatidylcholine (PC) interface. Clinical studies revealed significant improvement in the therapeutic response of BEO-loaded NPs that were combined with SP over BEO-NPs alone. In conclusion, the results proved the ability to utilize NPs as a successful nanovesicle for topical BEO delivery as well as the superior synergistic effect when combined with SP in combating acne vulgaris.