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Maha Fathy Elmasry,1 Moemena Maher Fathi Khalil,2 Ashraf Badawi,3,4 Naglaa Sameh Zaki,1 Aya Fahim1 1Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt; 2Department of Dermatology, Quesna Central Hospital, Menofia, Egypt; 3Department of Medical Laser Applications, National Institute of Laser Enhanced Sciences, Cairo University, Cairo, Egypt; 4Department of Dermatology and Allergology, Faculty of Medicine, University of Szeged, Szeged, HungaryCorrespondence: Aya Fahim, Dermatology Department, Faculty of Medicine, Cairo University, Post office Box 109, El-Malek El-Saleh, Cairo, 11562, Egypt, Tel +202 01020279628, Email ayafahim2011@cu.edu.egBackground: Acanthosis nigricans (AN) is a common chronic skin disorder clinically presents by velvety hyperpigmented lesions mainly at the flexural areas. Fractional photothermolysis has been reported to improve both pigmentary and textural changes by removing thin layers of skin with minimal thermal damage. Other options are the Q-switched (Qs) Nd:YAG (1064 nm) and Qs KTP (532 nm) lasers. Both can induce collagen remodeling by dermal photo-mechanical microdamage.Aim of the Work: The aim of this study was to assess the clinical efficacy and the safety of fractional CO2 laser versus Qs Nd:YAG and KTP lasers in the treatment of acanthosis nigricans.Methods: This randomized-controlled split neck study was conducted on 23 patients suffering from AN. For each patient, one side of the neck was randomly assigned to fractional CO2 laser and the other side to Qs Nd:YAG and KTP lasers every four weeks for four months followed by 4 monthly follow-up assessment. Acanthosis Nigricans Area and Severity Index (ANASI) score, melanin and erythema indices as well as Patient Satisfaction Scale (PSS) were used to assess improvement on each side separately.Results: There was no statistically significant difference regarding the clinical improvement between the side treated with Fractional CO2 laser and the side treated with Qs Nd:YAG and KTP lasers (P value > 0.05). In most patients, both sides showed improvement during different sessions of therapy, as regards ANASI scores, melanin indices, patient satisfaction scores, and side effects.Conclusion: In this study, we concluded that both fractional CO2 and Q-switched lasers proved to be a safe and effective line of treatment of acanthosis nigricans.Keywords: acanthosis nigricans, fractional CO2 laser, Q-switched Nd:YAG laser, ANASI score, Q-switched KTP laser

Enlarged facial pores are becoming a matter of cosmetic concern. Injections of (botulinum toxin type A) have an increasing popularity among cosmetic procedures.To determine the efficacy and safety of intradermal injection of botulinum toxin in treatment of excess sebum secretion and enlarged facial pores.This split face-controlled pilot study was conducted on 20 patients with enlarged facial pores and seborrhea. One cheek was treated by intradermal injection of botulinum toxin, and the other was injected by saline. Patient assessment was performed after 1 and then after 4 months.At 1-month assessment, both sides showed significant reduction in their sebum and pore scores (Intradermal injection of botulinum toxin is an effective and safe procedure for the management of excess sebum and facial pores with acceptable results lasting for an average of 4 months.

The aim of the study was to verify whether subablative Er:YAG laser irradiation combined with fluoride application could provide a significantly greater inhibition of enamel demineralization histologically using Polarized light microscopy and to and to compare microhardness of enamel around orthodontic brackets after treatment by either fluoride, laser, or both. Material and methods: eighty freshly extracted premolars were randomly assigned to four groups after bonding: (A) control, (B) irradiated by Er: YAG laser& Voco Bifluoride 10™ varnish, (C) treated by Voco Bifluoride 10™ varnish, (D) irradiated by Er: YAG laser before pH cycle. Caries-like lesions were created by pH-cycling. At the end of the pH cycle, each group was divided into 2 equal sub-groups: first subgroup was prepared for microhardness test and examined under polarized light microscope, second subgroup received a second application of therapeutic agents then entered a second pH cycle for another 14 days then teeth were prepared for measuring surface micro hardness and examination under polarized light microscope. Results: group B showed decrease in percentage of lesion depth compared to control group by more than 70% and there was statistically significant difference between it and the other groups. Group D showed increase in percentage of lesion depth with marked loss of enamel surface compared to control group by 29% after 14 days and 9% after 28 days. Moreover group B showed the highest microhardness values and Group D showed the lowest values. Conclusion: In this in vitro study, laser and fluoride combination enhance the resistance of sound enamel around orthodontic brackets more effectively than Er: YAG laser application alone. Keywords: Demineralization, Er:YAG, Fluoride varnish, Microhardness, pH-cycling, Polarized microscopy

BACKGROUND Alopecia areata (AA) is, an organ-specific autoimmune disease, characterized by an aberrant expression of cytokines of the T helper 1 type. Tumour necrosis factor-like weak inducer of apoptosis (TWEAK) is a multifactorial cytokine that exerts a role in the pathogenesis of inflammatory and autoimmune diseases, especially in cutaneous diseases. AIM To estimate the serum level of TWEAK in AA and to correlate it with different parameters. METHODS This case-control study enrolled 40 patients with AA and 50 clinically healthy volunteers matched for age and sex. A blood sample (5 mL) was extracted from each participant for analysis of serum TWEAK levels by ELISA. RESULTS Levels of TWEAK were significantly higher in patients with AA (mean ± SD 213.7 ± 59.2 pg/mL, range 109.1-341.6 pg/mL) than in controls (95.97 ± 13.28 pg/mL, range 80.1-152.3 pg/mL) (P

Facial freckles are a cosmetic concern to Egyptians, particularly young females. Several therapeutic lines exist with variable response rates and limitations. Fractional carbon dioxide (FCO2) laser provides minimal ablation and therefore less down time and less side effects. The efficacy and safety of this laser technology have still not been studied in freckles. The aim of this study is to assess the efficacy and safety of FCO2 laser in the treatment of unwanted facial freckles in Egyptians. Twenty patients undergone a single session of FCO2 laser and then were followed up clinically a month later. Photographs were taken before treatment and at follow-up visit and were assessed by three blinded investigators. Percent of global improvement was measured on a 4-point grading scale. Patient’s satisfaction and adverse events were recorded. Two patients (10 %) showed grade 1 improvement, while eight patients (40 %) showed grade 2 improvement. Nine patients (45 %) showed grade 3 improvement, and only one patient (5 %) showed grade 4 improvement. FCO2 laser resurfacing is effective and safe in treatment of facial freckles in skin phototypes II–IV. It can offer a more practical alternative to topical treatments, and a cheaper alternative to Q-switched lasers.