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Background Different therapeutic modalities have been tried for hypertrophic scar treatment. To our knowledge, intense pulsed light (IPL) has not been previously evaluated in comparison with cryotherapy as a stand-alone treatment for hypertrophic scars. Objective We aimed to evaluate the efficacy of IPL as a monotherapy for hypertrophic scar treatment as compared with cryotherapy both clinically and histopathologically. Methods This study included 28 patients with hypertrophic scars. Patients were divided randomly and equally into two groups; group I patients received cryotherapy while group II patients received IPL. All patients received treatments for a total of six sessions or until resolution of the lesion whichever was nearer. The outcome was evaluated clinically and histopathologically. Results Scar height showed a significant decrease and scar color and pliability showed a significant improvement in group I. No significant changes were detected in group II except in scar pliability. Vancouver scar scale (VSS) mean decreased by -53.7% in group I versus -11.5% decrease in group II. Histopathologically, group I showed a significantly increased epidermal thickness and decreased dermal and collagen bundle thickness, while group II showed insignificant histopathological changes. Group I exhibited a statistically significant clinical and histopathological improvement compared to group II, yet with more complications. Conclusion Cryotherapy is more effective than IPL in the treatment of hypertrophic scars both on clinical and histopathological level yet with more complications.

Background Vitiligo is an acquired pigmentary disorder of unknown etiology, affecting approximately 1 % of the world population, without predilection for race or sex. It is characterized by white macules and patches, whose size increases over time, due to the loss of melanocytes. Vitiligo can appear at any time, and it significantly impairs the patients’ quality-of-life. Objectives The aim of the work was to study the influence of the NB-UVB radiation therapy on tissue level of IL-33 in patients with vitiligo. Patients and Methods This prospective study was carried out on 10 patients diagnosed as having non -segmental vitiligo stable for 6 months duration. All patients were selected from the dermatology outpatient clinic of vitiligo, Ain-Shams University Hospitals. All patients were subjected to full history taking, general examination and dermatological examination. The disease characteristics of vitiligo were recorded as regards stability, duration and extent of vitiliginous lesions. The activity of the disease was evaluated according to VIDA score, and the disease severity was evaluated according to VASI score. Digital photographic documentation was done. Results Hydropic degeneration of lower epidermis was also detected in (40%) of them and apoptotic keratinocytes were found in (10%) of them. After therapy, these inflammatory changes were significantly reduced this can be partially explained by immunosuppressive properties of NB-UVB as it is believed to cause a reduction of T cells by inducing apoptosis and impairs in-vitro antigen presentation by both murine DCs and human Langerhans cells. The main limitation of our study was the small cohort of the studied patients. Further large-scale studies are needed. Investigatory techniques other than immunohistochemical analysis may be also used to evaluate abnormalities of keratinocytes in vitiligo skin. Conclusion We concluded that NB-UVB has no effect on tissue expression of IL-33 and and that NB-UVB was effective in treating vitiligo as manifested by VASI score change after treatment with NB-UVB. Based on our results we recommend further studies with larger sample size and studying the effect of treatment on IL-33 expression in active vitiligo cases is also recommended.

Background Vitiligo is an acquired pigmentary disorder resulting from loss of melanocytes which causes depigmentation of the skin. Clinically, it is characterized by the progressive loss of melanocytes causing the appearance of well-circumscribed milky white cutaneous macules and patches Aim of the Work to evaluate the efficacy of PRP as an additive treatment to the minigraft/NB-UVB treatments for stable localized vitiligo and the effect of this treatment on the expression of bFGF in the lesional treated vitiliginous skin compared before and after the course of treatment. Patients and Methods The study represents a prospective interventional comparative study. It was conducted on 17 patients diagnosed as stable vitiligo. All patients were selected from the dermatology outpatient vitiligo clinic of Ain-Shams University hospital from April 2018 to June 2019. All subjects who participated in this study gave written informed consents. The study was approved by the research ethical committee of Ain-Shams University (Approval Number: FWA 000017585) and fulfilled all the ethical aspects required in human research. Results We found that the addition of PRP to minigraft resulted in earlier repigmentation as assessed by VESTA score; however, at the follow up end (one month following the end of treatment), both modalities resulted in a similar response as regards the repigmentation percent and improvement in VESTA score. The addition of the PRP to the minigraft didn’t result in a superior improvement than minigraft alone. Conclusion Both minigraft and PRP-assisted minigraft followed by NB-UVB sessions are effective method to induce repigmentation in stable vitiligo.

Summary Background Previous success rates of psoralen and ultraviolet A (PUVA) and narrowband UVB (NB-UVB) in the treatment of chronic urticaria are reported in few studies with no previous reports on the comparable efficacy of both modalities in the disease. Aim We aimed to compare the efficacy of PUVA versus NB-UVB in the treatment of chronic urticaria. Methods Twenty-four patients with chronic urticaria were included and divided into two groups: 12 patients subjected to PUVA and 12 subjected to NB-UVB. They were compared according to the urticaria Total Severity Score (TSS) before and after treatment, cumulative dose, and side effects. Results There was a statistically significant decrease in urticaria TSS in both the NB-UVB- and PUVA-treated groups after than before treatment (P 0.05). Gastrointestinal upset was reported at a significantly higher percentage in the PUVA-treated group than in the NB-UVB-treated group. Conclusion Both NB-UVB and PUVA show comparable efficacy in the treatment of chronic urticaria with minimal reversible side effects.

Background: The efficacy of a phototoxic dose of ultraviolet A (UVA) after topical application of 8-methoxypsoralen (8-MOP) in the treatment of alopecia areata (AA) was evaluated previously in only one study. However, the possibility of spontaneous regrowth of hair cannot be excluded as sessions were carried out every 3 months. Objective: To determine the efficacy of a phototoxic dose of UVA after topical application of 8-MOP in the treatment of AA resistant to other lines of treatment. Subjects/Methods: Thirty-five patients with AA were treated by topical 8-MOP application to the lesions followed by UVA irradiation using a phototoxic dose every 3 months for a maximum of four sessions. Severity grading of AA was carried out using the Severity of Alopecia Tool (SALT) score before and after treatment. Results: Fifty-seven percent of patients showed a positive treatment response (40% showed complete and 17% showed partial response) with significant improvement of SALT score. The mean cumulative UVA dose was 22±8.3 J/cm2. Mild reversible side effects were observed in 63% of patients after the first session. Conclusion: Phototoxic psoralen and ultraviolet A therapy after topical application of 0.1% 8-MOP is an effective treatment option for resistant AA, with low total cumulative UVA dose, few treatment sessions, and minimal reversible side effects.

Background: Comparative success rates of bath psoralen+ultraviolet A (PUVA) and narrow band-ultraviolet B (NB-UVB) in psoriasis treatment are variably reported with no previous studies on the possible effect of bath PUVA on circulating CD4+ and CD8+ T cells. Objective: We aimed to compare the effect of bath PUVA and NB-UVB clinically and on circulating T-helper and T-suppressor/cytotoxic cells in psoriasis. Patients and methods: Thirty-four psoriatic patients divided into a bath PUVA-treated group (18 patients) and a NB-UVB-treated group (16 patients) were compared regarding the disease severity by psoriasis area and severity index (PASI) score and percentage of circulating CD4+ and CD8+ T cells by flowcytometry before and after treatment. Results: After treatment, the bath PUVA group showed a significantly higher reduction of PASI score (85.44%) than the NB-UVB group (58.72%). Mean peripheral CD4+ T-cell percentage was significantly lower after [36.8; 95% confidence interval (CI) 33.80, 39.97] compared with before treatment (42.06; 95% CI 38.29, 45.83) (P 0.05). Conclusion: Bath PUVA therapy is superior to NB-UVB in the treatment of moderate and severe psoriasis with mild reversible side effects. Both modalities have a systemic effect decreasing peripheral CD4+ T cells, which is more with bath PUVA.

Background: Psoriasis is a proliferative disease, and human papilloma virus (HPV) may be one of the causative factors underlying its pathogenesis. Aim of the study: To study whether the presence of the virus in psoriatic patients is due to the proliferative nature of the disease or due to the immunosuppression induced in patients receiving phototherapy. Patients and methods: Using a nested polymerase chain reaction, a skin biopsy was taken and examined for HPV expression in 20 untreated psoriatic patients, 20 psoriasis patients under phototherapy [narrow band ultraviolet B (UVB)], 20 psoriasis patients under systemic photochemotherapy (psoralen and UVA), 10 healthy controls, and 10 non-psoriatic patients under UV treatment. Results: The virus detection rate in psoriatic patients under photochemotherapy (60%) was significantly higher (P

Background: The etiology of skin tags (STs) is not fully understood. A relation to diabetes mellitus and obesity was suggested. Few studies of possible mast cells (MCs) involvement were reported. Tyrptase is a mast cell mediator and a potent fibroblast growth factor. It may provide a molecular link between mast cell activation and fibrosis. Aims: The aim was to assess clinical and laboratory findings in patients with STs, and the possible link between obesity, dyslipidemia, and lesional MC count/tryptase expression. Materials and Methods: A total of 20 patients with STs were subjected to clinical examination, estimation of body mass index (BMI), fasting blood glucose (FBG), postprandial blood glucose (PPBG), serum cholesterol and triglycerides, abdominal ultrasound for fatty liver assessment, in addition to study of MCs through staining for MC tryptase in two skin biopsies; lesional and nonlesional (control). Results: All patients showed abnormally high BMI and hypertriglyceridemia, with abnormal sonographic pattern in 15 patients (75%). STs number positively correlated with the age of patients. STs showed significantly higher MC counts and tryptase expression, compared with control skin (P < 0.001), with no correlation of the STs number or MC count with BMI, FBG, PPBG or serum cholesterol. Obese patients showed a significantly higher MC count than overweight and there was a positive correlation between MC count and serum triglycerides. Axilla and under breast STs showed a higher MC count compared with other sites. Conclusions: STs seem to be related to obesity and hypertriglyceridemia. MCs with their tryptase are possibly involved in pathogenesis of STs. MC count is related to the associated factors; obesity and serum triglycerides. MC tryptase expression is a reliable method for accurate tissue MC counting.