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Background Skin tags are benign condition; however, their appearance may be associated with some risk factors. There are no studies correlating clinical criteria of skin tags with the associated comorbidities whether isolated or mixed. Objective To evaluate prevalence, clinical criteria of skin tags, and risk factors that may be associated with skin tags. Patients and methods This study included 1000 participants, who were screened for the presence of skin tags and examined to detect clinical criteria. Patients with skin tags were screened for the presence of comorbidities (obesity, hypertension, diabetes mellitus, and dyslipidemia) and were classified and those with isolated or mixed comorbidities. Results Overall, 30% of patients presented with skin tags. Most skin tags were brown (72%), small (50.8%), sessile (81.6%), and located on neck (56.6%). Comorbidities were reported in 95% of patients with skin tags, with predominance of mixed comorbidities (65.96%). In comparison with patients without associated comorbidities, skin tags with isolated comorbidities were more sessile (P=0.043) and medium sized (P=0.002). However, skin tags with mixed comorbidities were more sessile (P=0.011), more numerous (P=0.001), and with older age of onset (P<0.001) compared with those without comorbidities. On comparing the two groups of comorbidities, skin tags with mixed comorbidities were more black (P=0.001), large (P=0.011), more numerous (P=0.001), and older age of onset (P=0.001). There was a significant correlation between lesion duration and numbers and age, BMI, random blood sugar, hemoglobin A1c, and dyslipidemia. Conclusion Skin tags are very common and considered as cutaneous markers for risk factors such as age, BMI, random blood sugar, hemoglobin A1c, cholesterol, and lowdensity lipoproteins. Presence of mixed comorbidities can increase the liability of skin tags to be more numerous, larger, and with late age of onset compared with presence of isolated comorbidity or even absence of comorbidity. [ABSTRACT FROM AUTHOR]

Melasma is a common esthetic problem affecting the face with a lot of risk factors being incriminated. Although several treatment options are available, none of them is satisfactory. This split face prospective study aimed to compare the efficacy of microneedling with vitamin C versus with platelet‐rich plasma (PRP) in the management of mixed melasma. Ten females with bilateral mixed facial melasma were treated with six sessions of microneedling. After the needling vitamin C was applied on the right side of the face and PRP was applied on the left side. Clinical, dermoscopic, and histological assessment of the used treatments was done 1 month after the last session. The clinical and dermoscopic clearance of melasma was proved significantly on both sides of the face but was more significant with vitamin C (P = 0.005). Reduction of epidermal melanin and dermal melanophages was more observed with vitamin C. Moreover, MART‐1 stain revealed a more significant reduction in the epidermal, dermal, and the total MART‐1 positive cells with vitamin C (P = 0.044, 0.039, and 0.035, respectively). Microneedling with vitamin C was more efficient in treating mixed melasma than with PRP. [ABSTRACT FROM AUTHOR]

Background: Suction blister grafting (SBG) technique has been used for long to treat various skin conditions. Different suction methods have been used such as syringes, Chinese cups, and suction device. There are some limitations of its use as time consumption, failure of induction or incomplete blister formation and pain. Aim: The aim of this work was to evaluate the outcome of using two different suction techniques, namely the syringes and the Chinese cups in induction of suction blisters. The effect of the device diameter and preheating of the donor area on the suction blister induction time (SBIT) was studied. The effect of saline injection in the blister formation and its completion was also evaluated. Methods: The study was a left‐right comparative study that included 50 patients with stable nonsegmental vitiligo. They were classified into four groups: Group 1 included 15 patients where different diameters of syringes (1.3, 1.7, and 2 cm) were compared against each other, group 2 included 15 patients where different diameters of cups (2, 3.5, and 5 cm) were compared against each other, group 3 included 20 patients subdivided into two groups; 10 patients each, where the effect of preheating the skin on blister induction was tested with use of cups (3a) and syringes (3b). Lastly, group 4 included randomly chosen 40 incomplete or multilocular blisters where the effect of saline injection on blister completion and coalescence of multilobulation was examined. SBIT was calculated in all patients. Results: The use of the small diameter syringes or cups gave shorter SBIT; however, the difference, which was significant between all sizes of cups, was significant between the 1.3‐ and 2‐cm‐diameter syringes only. Preheating of the donor area shorten SBIT significantly. No complications were reported at the donor site except for transient postinflammatory hyperpigmentation in all patients. Conclusion: The small diameter syringes or cups and preheating of the donor area shorten the SBIT, while intra‐blister saline injection increased the blister size and turns the multilocular blisters to unilocular ones. [ABSTRACT FROM AUTHOR]

Objective: Otitis media with effusion (OME) in early childhood may cause a central auditory processing disorder. The aim of the present study was to investigate the effect of prolonged OME in children on central auditory function using speech-ABR. Study design: Fifty-five children (31 males, 24 females) with bilateral OME were included in the present study. Their ages ranged from five to 11 years. According to the duration of the OME, the study group was divided into two groups: Group I (25 subjects with OME of long duration) and Group II (30 subjects with recent-onset OME). Responses to click evoked auditory brainstem response (click-ABR) and speech evoked auditory brainstem response (speech-ABR) were collected from the study groups I and II. Results: A Student's t-test revealed non-significant differences between groups I and II regarding different click-ABR parameters; absolute and interpeak latencies (I–III, III–V, and I–V). There were significant temporally delayed speech-ABR responses for the onset and offset of the stimulus (waves V, A and O), and reduction in VA slope in Group I compared to Group II. Conclusion: The findings suggest that OME of long duration in children is associated with deficient neural timing in response to the onset and offset of transient speech stimuli, resulting in a subtle impairment of speech encoding at the brainstem. [ABSTRACT FROM AUTHOR]

Background: Histamine was found to stimulate melanogenesis in cultured human melanocytes specifically mediated by histamine H 2 receptors via protein kinase A activation. Based on this finding, the effect of topically applied H 2 antagonist on UVB-irradiated Guinea pigs' skin was examined and found to be suppressive on the post-irradiation melanogenesis.Aims: In this study, we tried to explore the role of topically applied H 1 and H 2 receptor antagonists, in inhibition of UVB-induced melanization.Methods: The effect of topically applied H 1 and H 2 receptor antagonists in inhibition of melanization was done clinically and histochemically using Fontana Masson and DOPA reactions compared with placebo.Results: The post-irradiation pigmentation was found to be brownish/black instead of the original light brown color. This color change occurred below the shaved orange-red fur suggesting a switch of melanogenesis from pheomelanin to eumelanin. The induced pigmentation was suppressed by topically applied H 2 antagonist while both H 1 antagonist and vehicle had no effect. The microscopic examination showed that the keratinocytes in the H 2 antagonist-treated areas contained few melanosomes while the nearby dendrites are full of them.Conclusion: H 2 antagonists' inhibition of UVB-induced pigmentation is not only due to suppression of melanization but also due to a specific action on melanosomes' transfer. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to identify if radiotherapy can be safely avoided in a selected subgroup of largely screening detected small invasive breast cancer., Methods: One hundred and eighty-eight patients with node negative invasive early breast cancer < or =1cm (< or =T1b) treated in our centre between 1990 and 2004 were retrospectively followed for local, regional and distant recurrences. Treatment involved adequate local excision by breast conserving surgery (BCS). Axillary staging was performed by a four node axillary sampling until 2000, following which sentinel lymph node sampling was employed. All sections were assessed histologically by haematoxylin and eosin stained sections. The inked margins were reported as being involved, close and clear. Radiotherapy (RT) was employed only if the resected margins were inadequate, and in those with involved axillary nodes who refused further completion axillary clearance., Results: Ninety-four patients (Group A) had BCS alone and 79 patients (Group B) had both BCS and RT. There was no ipsilateral breast tumour recurrence (IBTR) in 88 patients in Group A, corresponding to an actuarial freedom from IBTR of 96%, 91% and 88.1% at 5 years, 8 years and 9 years. In Group B, there was no IBTR in 75 patients corresponding to an actuarial freedom from IBTR of 97%, 94.9% and 90.6% at 5 years, 8 years and 10 years., Conclusion: Our experience over 14 years has shown that it is possible to safely avoid radiotherapy in a selected subgroup of small invasive breast cancer.

Aim: The study compared the accuracy and success rate of two techniques, methylene blue alone versus combined methylene blue and radioactive colloid in sentinel lymph node localisation in the management early breast cancer., Methods: Three hundred and twenty-nine patients with tumours less than 2 cm on ultrasound assessment were prospectively evaluated. One hundred and seventy-three patients (Group A) underwent sentinel lymph node localisation using 1 ml of 1% methylene blue. A combined technique of both methylene blue and radioactive colloid was used in 156 patients (Group B). Application of both was subdermal and subareolar. Sentinel lymph nodes were examined by standard microscopy. Patients underwent breast conservation surgery or mastectomy and sentinel node guided four node axillary sampling+/-clearance., Results: In Group A, the sentinel lymph node identification rate was 96.5%. The negative predictive value was 96.3%, with false negative of 3.7% and accuracy of 87.4%. In group B the identification rate for sentinel lymph node was 98.7%, with false negative of 4.1%, negative predictive value of 96%, and accuracy of 83.8%., Conclusion: Sentinel lymph node localisation using methylene blue or combined dye and radioactive tracer technique predicts the axillary lymph node status in early breast cancer with comparable success rates, accuracy and false negative rates. The combined technique facilitates quicker identification of sentinel lymph node; however the dye technique alone can be used successfully in centres without nuclear medicine facilities.