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Mahmoud A Rageh,1 Shady Mahmoud Attia Ibrahim,1 Noha Abdallah,2 Abeer Attia Tawfik2 1Department of Dermatology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; 2Department of Medical Applications of Laser, National Institute of Laser Enhanced Sciences, Cairo University, Giza, EgyptCorrespondence: Mahmoud A Rageh, Department of Dermatology, Faculty of Medicine, Al-Azhar University, Al-Darrasah, Cairo, 11633, Egypt, Email dr.mahmoudrageh@gmail.comBackground: Atrophic acne scarring is a widely prevalent condition and one of the most distressing complications of acne vulgaris. Numerous options with variable outcomes are available for the treatment of acne scarring. Laser is considered a first‐line therapy for acne scars, and recently there has been a growing interest in using stem cells and their derivatives for treating acne scars. In addition, combined therapeutic modalities often achieve more satisfactory results than a single treatment.Objective: We tried to evaluate the role of nanofat and fractional CO2 laser as a combined treatment approach for atrophic acne scarring.Methods: Twenty-five patients with atrophic acne scarring were enrolled. They received a single session of intradermal nanofat injection, at different points 1 cm apart, for acne scars. Two weeks later, they were treated with three sessions of fractional CO2 laser at monthly intervals. Patients were evaluated three months after the last session using the quantitative Goodman and Baron scoring system. Pain, side effects, and patients’ satisfaction were also evaluated.Results: There were two males and 23 females with a mean age of 25.96 years. Their skin type ranged between Fitzpatrick skin type III, IV, and V. Boxcar scars were the most common scar type in 13 patients (52%). After treatment, there was a significant reduction (p < 0.05) in the quantitative Goodman and Baron scores. The improvement was more evident in rolling scars. Seven patients reported significant improvement, and 12 reported marked improvement.Conclusion: This study showed that combining nanofat and fractional CO2 laser is a safe and effective treatment modality for atrophic acne scars.Keywords: acne scars, fractional laser, fat grafting, nanofat

Abeer Attia Tawfik,1 Maha Fathy,2 Ashraf Badawi,1,3 Noha Abdallah,1 Hisham Shokeir1 1Dermatology Unit, Department of Medical Applications of Lasers (MAL), National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt; 2Al-Houd Al Marsoud Hospital, Cairo, Egypt; 3Dermatology and Allergology Department, University of Szeged, Szeged, Hungary Background: Topical 5 fluorouracil (5-FU) has been reported as one of the standard treatments for hypertrophic scars (HTS). Ablative fractional laser was found to have promising results in the delivery of topical drugs into the skin by creating vertical channels through which the drugs can penetrate the skin. So far there have been no comparative studies performed to compare both modalities in the same patient and same anatomical region, especially in severe HTS.Objective: The aim of this study was to compare the effectiveness of topical 5-FU and combined topical 5-FU and laser in treating severe HTS.Patients and methods: Twenty-four severe HTS lesions were treated by 5-FU monotherapy and 5-FU combined with ablative fractional erbium YAG laser. Each lesion was divided into two parts. One part was treated with topical 5-FU twice weekly for 8 months. The other part was treated with combined topical 5-FU and ablative fractional erbium YAG laser once per month for 8 months. The scars’ improvement was evaluated by Vancouver scar scale (VSS) and skin analysis camera.Results: The assessment by VSS showed a significant reduction in the mean height, pliability, and vascularity of the lesions which were treated with combined approaches compared to 5-FU monotherapy. Pain and ulceration occurred at a higher rate in the combination therapy group.Conclusion: Treatment of severe HTS with combined 5-FU and ablative fractional erbium YAG laser is more effective than 5-FU alone. Keywords: hypertrophic scars, fractional erbium YAG laser, 5-FU, transcutaneous drug delivery, scar management, fractional lasers, skin ablation, wound healing

Background: The picosecond laser was primarily designed to enhance tattoo removal. Because it has a new innovative mechanism for energy delivery, it has been modified to be used in other conditions such as skin resurfacing, which was usually treated with fractional CO 2 laser. Comparing both technologies in managing postburn scars has not been widely addressed., Methods: The current prospective comparative randomized intrapatient study was done on 15 patients who presented with unsightly postburn scarring. As a split study, one-half of the affected areas were treated using the picosecond Nd: YAG laser. The other areas were treated with a fractional CO 2 laser. After three treatment sessions, the results were analyzed both objectively and subjectively., Results: The assessment by the image analysis system (Antera camera) showed improvement in all the parameters in both groups. The melanin relative variation decreased from 11.65 ± 2.86, 15.85 ± 5.63 to 10.60 ± 1.96, 12.56 ± 3.98, respectively in picosecond laser sites and fractional CO 2 sites. The percentage change in overall opinion decreased in in favor of the fractional CO 2 laser sites, which is a statistically significant improvement. Instead, color scores revealed a greater reduction in the picosecond sites in comparison with the fractional CO 2 sites, as it decreased from 7.67 ± 1.76, 7.73 ± 1.83 to 2.87 ± 1.06, 6 ± 1.2, respectively., Conclusions: When compared with fractional CO 2 lasers, picosecond Nd:YAG shows comparable improvements in scars' erythema, texture, and height, with some superiority in the management of hyperpigmented scars., Competing Interests: The authors have no financial interest to declare in relation to the content of this article., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)

Background: Cognitive decline is one of the aging health problems that strongly affects daily functioning and quality of life of older adults and threatens their independence. The aim of this study was to assess the prevalence and pattern of cognitive impairment (CI) among community-dwelling elderly in Egypt and the contribution of socioeconomic status to inequality in cognitive impairment., Methods: A cross-sectional study involved 470 community-dwelling elderly aged 60 years or older living in Kafr El-Sheikh Governorate, Egypt. Subjects were recruited from home visits, geriatric clubs, and outpatient clinics. The Montreal Cognitive Assessment tools (MoCA & MoCA-B) were used to assess the prevalence of cognitive impairment, Hachinski ischemic score (HIS) to investigate the type of cognitive impairment, Ain Shams Cognitive Assessment (ASCA) tool to assess the pattern of specific cognitive domain affection, and an Egyptian socioeconomic status (SES) scale to classify the SES of the study participants., Results: The prevalence of cognitive impairment was 50.2% distributed as 37.7% for mild cognitive impairment (MCI) and 12.5% for dementia. The most common type of cognitive impairment was the degenerative type (47.9%). Pattern of specific domain affection among cognitively impaired subjects ranged from 94% for visuospatial function to 12.7% for abstraction. Cognitive impairment was significantly higher with increasing age, female sex, marital status (single or widow), low education, higher number of comorbidities, and positive family history of cognitive impairment (p < 0.001). Also, cognitive impairment was concentrated mainly among participants with low socioeconomic score (p < 0.001)., Conclusion: In Egypt, cognitive impairment is significantly prevalent and concentrated among those who are in low socioeconomic status. Patients with mild CI were more than those with dementia, and the most common type of CI was the degenerative type. Increasing educational level of low SES population and improving their access to healthcare services are highly recommended to improve the inequity of cognitive impairment., (© 2024. The Author(s).)

Background: Atrophic acne scarring is a common problem. If left untreated, its implications can impair the quality of life. Various treatments, with differing degrees of success, are used to alleviate atrophic scars., Objective: To assess the efficacy of nanofat versus platelet-rich plasma (PRP) as an adjuvant therapy to fractional CO 2 laser (FCL) for atrophic acne scars., Methods: This study included 35 patients with atrophic acne scars who received 3 sessions of FCL at 1-month intervals on both sides of the face, followed by intradermal PRP injection on the left side. A single session of nanofat was injected into the right side of the face 2 weeks before the laser sessions. The evaluation was conducted 3 months after the final treatment session., Results: After treatment, the right side of the face showed a significant reduction in Goodman scores and the indentation index of the Antera camera. The left side showed a significant difference in Goodman scores, yet the Antera camera showed a nonsignificant improvement. Nonetheless, the difference between the 2 sides was statistically insignificant., Conclusion: Atrophic acne scars improved with both modalities. As a result, cotreatment with these techniques may synergistically affect atrophic acne scars in efficacy and safety., (Copyright © 2023 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Background: Consequently, the management of post burn hypertrophic scars and keloid in children are a great challenge for the physicians, parents, and children themselves., Purpose of the Study: To assess the efficacy and safety of treating hypertrophic and keloid scars with botulinum toxins injections., Patients and Methods: This is a randomized intra-patient comparative study was conducted on 15 children with post burn hypertrophic and keloid scars. Children were randomized to receive Intralesional injection of botulinum toxins on one part of the hypertrophic scar/keloid where the other part was left as a control. The assessment of clinical improvement was measured by the Vancouver scar scale (VSS) and by skin analysis camera system. Sessions were performed every month for 6 months., Results: Clinical and statistical dramatic improvement in the vascularity, pliability, and height of the lesions which have been injected with neuronox. Evaluation of the lesions by the Antera camera has proven marked changes in the vascularity and height. There was no correlations between Vancouver score improvement and variables such as the age, sex, skin type, and duration and lesion type., Conclusions: The botulinum toxins proved its efficacy and safety in treatment of hypertrophic scars and keloid in children. It improved the associated itching and pain. Moreover it improves the pliability, erythema, and thickness of the scars., (© 2023 The Authors. Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.)

Background: In mild psoriasis, topical agents remain the mainstay of treatment. However, the available treatments are not satisfactory for a significant proportion of patients in many terms such as efficacy and safety. Because of these deficits, augmentation of therapeutic effect seems desirable., This Study Aims: To evaluate the efficacy of topical cyclosporine cream, delivered by fractional CO 2 laser vs the efficacy of topical clobetasol cream for the treatment of mild to moderate plaque psoriasis., Patients and Methods: Twenty-two patients with chronic plaque psoriasis involving <10% BSA were included in this study. They were randomly allocated into 2 groups. In Group A, patients were instructed to apply cyclosporine cream twice daily for 5 consecutive days per week immediately after fractional carbon dioxide laser session. While in Group B, clobetasol cream was applied twice daily for 5 consecutive days per week until complete clearance or for a maximum of 10 weeks. The efficacy was objectively assisted clinically and by histopathology by using the scores and skin biopsy., Results: There was a significant improvement of erythema, plaque elevation, and scaling (p < 0.001) with the use of topical cyclosporine cream delivered by the aid of fractional CO 2 laser, compared to base line. However, the improvement was more significant with topical clobetasol cream., Conclusion: Laser-assisted delivery of topical cyclosporine can provide comparable clinical and pathological improvement to that of clobetasol in the psoriatic plaques. These findings were apparent in patients with less widespread disease. However, topical steroid showed more improvement., (© 2021 Wiley Periodicals LLC.)

Background: Although there are different treatment modalities of melasma, it remains a challenging problem. Erbium-YAG laser proved its efficacy in melasma improvement with minimal downtime. Tranexamic acid (TA) is a new promising treatment of melasma., Objective: The first objective is to compare between the efficacy of intradermal injection of TA and Erbium-YAG laser in the treatment of melasma. The second objective is to use the dermoscope as an objective evaluation method., Patients and Methods: A split face study was conducted on 28 patients. One side of the face received intradermal TA injection. The other side was treated with laser. Melasma Area and Severity Index (MASI) and the dermoscope were used for evaluation of treatment., Results: The MASI scores showed a significant decrease in TA treated side. The dermoscope assessment showed no significant difference in both treatment modalities., Conclusion: A promising results were obtained by both intradermal TA and Erbium:YAG laser; however, the TA yields a higher patient satisfaction because of its high efficiency and low cost.

Background: Different modalities have been tried for treating atrophic post traumatic scars., Objective: To compare the efficacy of microneedling combined with PRP with that of fractional erbium-doped yttrium aluminum garnet (Er: YAG) laser in treating post-traumatic atrophic scars., Methods: Forty-five patients with atrophic post traumatic scars were subdivided into three groups. Group I was subjected to four sessions of skin microneedling followed by topical application of platelet-rich plasma (PRP) immediately after each session. Group II was subjected to the same protocol of treatment but for six sessions. Group III was subjected to four sessions of fractional Er: YAG laser at 4 weeks intervals for four sessions. Response to treatment was assessed clinically using the Quartile Grading Scale and histopathologically using H&E stain, trichrome and Orcein special stains., Results: All patients showed significant clinical improvement regardless of the treatment. There was a significant difference in clinical and histopathological improvement between groups I and III, but there was no significant difference in improvement neither between groups I and II nor between groups II and III., Conclusion: microneedling could be as effective as a fractional laser when combined with PRP and when used for more sessions.

Background: Intralesional injection of corticosteroid (ILIS) and pulsed-dye laser (PDL) have been used in nail psoriasis treatment with variable outcomes., Objective: We sought to compare the efficacy of ILIS to PDL for the treatment of psoriatic fingernails using a dermoscope in the assessment and follow-up., Methods: This study included 30 patients with bilateral nail psoriasis. The fingernails of one hand were treated with PDL, whereas ILIS was used to treat the fingernails of the other hand. One psoriatic nail was left alone as a control. Every patient received four treatment sessions once every month. Efficacy was recorded clinically using the Nail Psoriasis Severity Index (NAPSI) and by a dermoscope before treatment (baseline) and at eight, 24, and 36 weeks after treatment., Results: The assessment by NAPSI revealed improvements of 22.24% and 24.11% occurred in the laser group and the intralesional steroid group, respectively. Also, the dermoscopic assessments revealed an improvement of 18.33% in the laser group versus that of 21.69% in the ILES. No significant difference was found between the two groups., Conclusion: Both PDL and ILIS are considered safe treatments for nail psoriasis, yielding nearly equal results. The dermoscope is a reliable tool for the diagnosis and follow-up of nail psoriasis treatment., Competing Interests: DISCLOSURES: The authors report no conflicts of interest relevant to the content of this article., (Copyright © 2021. Matrix Medical Communications. All rights reserved.)

Background : Bergamot oil (BO) is a photosensitizer that can be used for photodynamic therapy (PDT) of dermatological diseases such as vitiligo. Being an oil, it can be integrated within the lipidic matrix of nanostructured lipid carriers (NLCs) as the liquid lipid constituent, hence exhibiting a dual role. Research design and methods : NLCs were prepared with different emulsifiers and coemulsifiers, and the effect of the preparation method and formulation variables on the NLCs' size was elucidated. The prepared NLCs were further characterized for their in vitro release, viscosity, thermal behavior, and in vitro photostability. Furthermore, a preclinical photodynamic study on animal skin was conducted, followed by clinical experimentation on patients with vitiligo. Results : Results showed that BO was successfully incorporated within the NLCs. The selected NLCs formulation was in the nanometer range with a gel consistency, and it provided sustained release of BO for 24 h. NLCs improved the photostability and photodynamic properties of BO, and displayed promising preclinical and clinical results for the topical PDT of vitiligo. Expert Opinion : BO containing NLCs was proven to be promising means for PDT of vitiligo, and can be further explored in other dermatological diseases.

While an extensive literature base has focused on online learning, fewer studies have explored the unique implementation challenges in K-12 education. This case study addresses this gap by exploring how an urban, diverse school migrated to a fully online format through the lens of the first- and second-order barriers framework. In terms of first-order barriers, the study highlights the importance of (a) time needed to design and adapt instructional materials, (b) accountability within an online format, and (c) administrator support in the communication process. For second-order barriers, teachers commented on how they perceived online learning to impact important teaching activities (e.g., accountability, timeliness of feedback) and the teacher-student dynamic. Finally, they commented on the challenge to support the socio-emotional component of students and parents in online learning, which is important for school culture and community., Competing Interests: This work was funded in part by the University Schools Research Consortium (USRC) grant program. There are no potential conflicts of interests. The data presented in this study was completed after approval from the Institutional Review Board at the University of Memphis. All participants involved in the study completed the Institutional Review Board approved informed consent from the University of Memphis. All authors contributed to the study conception and design. All authors read and approved the final manuscript., (© Association for Educational Communications & Technology 2021.)

The impact of nanomedicine has grown in the current decade; however, only very few clinical translational attempts have been realized. Therefore in the present study, we hypothesized that bergamot oil, a psoralen-containing oil, would produce an optimized melanogenic effect in the clinical treatment of vitiligo when loaded within an elastic nanocarrier (spanlastics) and combined with PUVB for activation of psoralens. Spanlastics were prepared and characterized for particle size, physical stability, in vitro release, thermal behavior, deformability, morphology, and in vitro photostability. The efficacy of the selected formula was tested histopathologically on rat skin and clinically translated in patients suffering from vitiligo. Results revealed that the spanlastics were of reasonable nanosize, deformable, and provided sustained release of bergamot oil. The incorporation of bergamot oil within spanlastics improved its photostability and its photodynamic activity. Spanlastics exhibited promising clinical results in terms of extent and onset of repigmentation in vitiligo patients. Therefore, it can be concluded that spanlastics can be introduced as a promising nanotreatment modality for vitiligo.

Background: Fractional CO2 laser and platelet-rich plasma (PRP) treatments have been used in the treatment of acne scars. However, an objective method of assessment has been lacking., Objective: To evaluate the efficacy of CO2 laser versus the combination of PRP and fractional CO2 laser in treatment of acne scar., Patients and Methods: Thirty patients with atrophic acne scar lesions were included in this study. Patients were randomized to receive fractional CO2 laser therapy to one side of the face while the other side of the face was treated with fractional CO2 laser followed by intradermal PRP injection. Follow-up using the skin analysis camera system and photography was done for three months., Results: A dramatic improvement was observed in the scar depth on both sides of the face. However, the combined fractional CO2 laser and PRP showed more significant improvement. Improvements in the scar appearance and skin texture were reported by the patients. Although 70% of our patients were of a dark skin type, no hyperpigmentation was reported., Conclusion: The combined use of fractional CO2 laser and PRP achieved better results. It reduced the downtime of the fractional CO2 laser. The use of the skin analysis camera provided an objective assessment of the results., (© 2019 Wiley Periodicals, Inc.)

Background: Hair is an essential part of a woman's appearance and attractiveness. This is reflected in the predominantly psychological morbidity that can be associated with female pattern hair loss. Platelet-rich plasma(PRP) has been used in numerous fields of medicine. Recently, PRP has received growing attention as a potential therapeutic tool for hair loss., Objective: To evaluate the efficacy and safety of autologous platelet-rich plasma in the treatment of female pattern hair loss., Materials and Methods: Thirty female patients with female pattern hair loss were randomly assigned to receive autologous PRP injection into a selected area, and another area was injected with normal saline as a placebo. Sessions were performed weekly for a maximum total of four sessions. Patients were followed up 6 months after the end of last session. The outcome was assessed both subjectively and objectively., Results: There was a statistical significant difference between PRP and placebo areas (P<.005) regarding both hair density and hair thickness as measured by a folliscope. The hair pull test became negative in PRP-injected areas in 25 patients (83%) with average number of three hairs. Global pictures showed a significant improvement in hair volume and quality together with a high overall patient satisfaction in PRP-injected sites, and these results were maintained during the 6-month follow- up., Conclusion: Platelet-rich plasma injections can be regarded as an alternative for the treatment of female pattern hair loss with minimal morbidity and a low cost-to-benefit ratio., (© 2017 Wiley Periodicals, Inc.)

Striae distensae are common undesirable skin lesions of significant aesthetic concern. To compare the efficacy of two fluences (75 and 100 J/cm 2 ) of long-pulsed Nd:YAG laser in the treatment of striae. Forty-five patients (Fitzpatrick skin types III-V) aged between 11 and 36 years with striae (23 patients with rubra type and 22 with alba type) were enrolled in the study. Each stria was divided into three equal sections, whereby the outer sections were treated with long-pulsed 1064 nm Nd:YAG laser, at a fluence of 75 or 100 J/cm 2 , and fixed laser settings of 5 mm spot size and 15 ms pulse duration. The middle section was an untreated control. All subjects received four treatments at 3 weeks interval. Three 2-mm punch biopsies were taken from six subjects, all of the same stria, one before treatment and the other two from the outer sections, 3 months after the last session. Paraffin-embedded skin sections were subjected to histological and quantitative morphometric studies for collagen and elastic fibres. Results were assessed clinically through photographic evaluation and were considered satisfactory for both doctors and patients. A significant improvement in appearance of striae alba using 100 J/cm 2 was found while striae rubra improved more with 75 J/cm 2 . Histologically, collagen and elastin fibres increased in posttreatment samples. A satisfactory improvement in striae distensae lesions was seen through clinical and histological evaluation. Thus, long-pulsed Nd:YAG laser is a safe and effective module of laser treatment for these common skin lesions.

Background: Onychomycosis is a widespread public health problem, in which T. rubrum and T. mentagrophytes is the commenest causative organisms. Current medical therapy has many drawbacks and side effects. Methylene blue (m.b) photodynamic therapy (pdt) proved efficacy but with lengthy sessions., Objectives: Optimizing methylene blue photodynamic therapy by combination of methylene blue photosensitizer and gold nanoparticles (aunps) in a composite as gold nanoparticles are efficient delivery systems and efficient enhancers of photosensitizers for antifungal photodynamic therapy., Materials and Methods: Eighty newzealand rabbit (Oryctolagus cuniculus) were used and categorized in eight equal groups as follows; healthy and infection control, composite photodynamic therapy and five comparative groups. Photodynamic therapy was initiated at day three to five post inoculation, for four sessions forty eight hours apart. Each group divided and light exposure at two fluencies; 80J and 100J. All groups were investigated macroscopically and microscopically (histopathology and scanning electron microscope) also flowcytometry assessment for cell death and X-ray analysis for gold nanoparticles accumulation in brain and liver tissues were determined., Results: Recovery from infection approaching 96% in gold nanoparticles+light group, around 40% in methylene blue photodynamic therapy and 34% in composite photodynamic therapy. The observed findings confirmed by apparent decrease of apoptosis, however small amounts of gold nanoparticles detected in brain and liver., Conclusion: Light stimulated gold nanoparticles is a promising tool in treatment of onychomycosis., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Background: Staphylococcal aureus is the most common organism which has been encountered in impetigo infection. Gold nanoparticles can be used as a tool to deliver antimicrobials or to enhance photodynamic destruction of bacteria., Objective: To evaluate the photodynamic effect of methylene blue gold nanoparticles (MB-gold nanoparticles conjugate) on S. aureus which were isolated from impetigo lesions., Patient and Methods: Twenty children were diagnosed clinically as impetigo, and aged from 3 to 5 years of both sexes were recruited in the study. Two bacteriological samples were collected from each patient, identified and cultured. Samples of S. aureus of a concentration of 10(-1)ml were divided into four groups. S. aureus was treated by MB-gold nanoparticles conjugate, gold nanoparticles, MB, and the fourth group served as a control group. Diode laser (660 nm) was used for photoactivation. The bacterial growth inhibition was determined by two methods: the percentage of reduction of viable bacteria count and the optical density (O.D) of bacterial growth., Results: The highest significant inhibitory effect on S. aureus was obtained with MB-gold nanoparticles conjugate when irradiated by diode laser 660 nm (P < 0.0001). The percentage of viable bacteria was 3%. The photoactivated gold nanoparticles showed a significant inhibitory effect on bacterial growth (P < 0.05). A non-significant inhibitory effect was elicited in other groups., Conclusion: The photoactivated MB-gold nanoparticles conjugate showed the maximum inhibitory effect on S. aureus activity. The gold nanoparticles proved efficacy as a drug delivery system. It enhanced the photodynamic antibacterial effect of methylene blue., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Lasers, 595-nm pulsed dye and 1,064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG), have been used successfully for the treatment of infantile hemangiomas (IHs). Recently the use of a topical β-blocker, specifically timolol maleate, has been promising in the treatment of IHs. The objective of this study was to compare the effectiveness of topical timolol 5 mg/mL solution with that of combined sequential dual-wavelength laser in the treatment of IHs. Sixty children with IHs were divided randomly into two equal groups. Group 1 was treated with applications of timolol drops (5 mg/mL) twice daily. Group 2 was treated with sequential pulsed dye and Nd:Yag laser. Treatments were performed every month for a maximum of six sessions. Efficacy was evaluated clinically and by measuring the average hemoglobin level. A significant decrease in the average hemoglobin level was determined in both groups and a dramatic response was observed in superficial hemangiomas in the timolol group. The timolol group received treatment for an average of 4.0 ± 1.1 months and the laser group for 5.5 ± 0.9 months. The degree of improvement of mixed hemangiomas to laser treatment was greater than that of the timolol group. During 3 months of follow-up, no further improvement or relapse was reported in either group. Timolol solution is a safe and effective alternative to laser treatment in superficial hemangiomas. In mixed hemangiomas, the combined sequential 595-nm and 1,064-nm dual-wavelength laser provided better results than timolol solution because it penetrated deeply so that deep dermal blood vessels were reached., (© 2015 Wiley Periodicals, Inc.)

Background: Hidradenitis suppurativa (HS), is a chronic, recurrent dermatosis affecting skin that contains apocrine glands. Photodynamic therapy using aminolaevulinic acid (ALA) activated by intense pulsed light (IPL) have shown variable success rates, with some adverse effects., Aims: To evaluate the efficacy and safety of methylene blue (MB) as a photosensitizer delivered as a niosomal gel for the treatment of HS using IPL., Methods: We enrolled 11 patients with HS in the study, which was a randomized split-body study. One side of each patient's body was treated with niosomal MB (NMB) gel and the other side was treated with unloaded (free) MB (FMB) gel. The affected sites were irradiated using IPL with a 630 nm filter. Patients were followed up at 1, 3 and 6 months after treatment., Results: Drug release from the FMB gel was significantly higher (P > 0.05) than from the NMB gel. Lesions showed 77.3% and 44.1% reduction on the NMB and FMB sides, respectively. A significant reduction in the Hidradenitis Suppurativa Lesion, Area and Severity Index (HS-LASI) after treatment was elicited in both groups, with no pain, erythema or hyperpigmentation., Conclusion: The combination of MB as a photosensitizer activated with 630 nm IPL as a light source is a successful PDT for HS. Delivery of MB in niosomes was more effective for drug penetration to the dermis compared with delivery by FMB gel. The 630 nm filter was not only a source of activation of MB but also a means of hair-follicle destruction., (© 2014 British Association of Dermatologists.)

Background: Novel and promising results in acne treatment with infrared lasers have been reported. The 1,550-nm erbium glass laser is one of the infrared lasers that may be useful in the treatment of acne., Objective: The aim of this study was to evaluate the efficacy of an erbium glass laser in treatment of active acne and to study the effect of this type of laser on sebaceous glands., Patients and Methods: Twenty-four patients with active acne lesions were treated using 1,550-nm (30-40 mJ) fractional erbium glass laser. Every patient received 4 sessions with a 2-week interval. Follow-up was done every 3 months for 1 year. The image analyzer computer system was used to measure the sebaceous gland size., Results: A significant reduction (p < .0001) in the mean count of lesions was observed after treatment and in the follow-up period. A significant reduction in the size of sebaceous glands was also evident after laser treatment., Conclusion: Treatment of active acne with the 1,550-nm erbium glass laser is effective. Papules, pustules, and nodules all respond well to therapy. The sebaceous gland size decreased significantly, which accounts for the long remission period.

Background: Pulsed dye laser has been used successfully in the treatment of nail psoriasis. Intense pulsed light (IPL) has been used in the treatment of plaque psoriasis using a 550-nm filter., Objective: To study the efficacy of IPL in the treatment of nail psoriasis., Patients and Methods: Twenty patients with finger and toe nail psoriasis were treated by IPL. Sessions were performed every 2 weeks for a maximum of 6 months. The Nail Psoriasis Severity Index (NAPSI) score was calculated at baseline and 1 month after the last treatment session. Follow-up was performed at 1, 6, and 12 months., Results: Patients received a mean of 8.63 ± 3.6 IPL sessions. After treatment, there was significant improvement in the nail bed and matrix (p < .0001), and in the NAPSI (p < .0001). Nail bed showed improvement by 71.2%, whereas the nail matrix improvement was only 32.2%. The total NAPSI was 82.4%. Patient follow-up revealed relapse in 3 patients after 6 months., Conclusion: Intense pulsed light is a promising effective modality of treatment of nail psoriasis, which is easy to use, safe, and provide a long period of remission. This was confirmed by the elicited clinical improvement, NAPSI, and patient satisfaction.

Background: Localized scleroderma (morphea) is characterized by hardening and thickening of the dermis due to excessive collagen deposition. A decreased number of CD34+ cells and an increased number of Factor XIIIa+ cells are seen in the affected skin. The flashlamp pulsed dye laser (FLPDL) has been used in the treatment of localized morphea with promising results., Objective: The purpose of this study was to evaluate the therapeutic effectiveness of the pulsed dye laser in localized scleroderma and to assess its effect on CD34+ cells, Factor XIIIa+ cells, and blood vessels., Study Design: Thirty patients with plaque morphea were treated with a FLPDL (585 nm wavelength, 450 μs pulse duration). Fluence ranged from 7.5 to 8.5 J/cm(2). Sessions were performed biweekly for a maximum of 6 months. Clinical, histopathologic, and immunohistochemical assessments were performed., Results: Patients showed varying degrees of improvement of indurated skin. There was no worsening or further improvement at the treated sites during the follow-up assessments at 3, 6, and 12 months. An increased number of CD34+ cells were found in both the upper and the lower dermis, and a decreased number of Factor XIIIa+ cells were found in the lower dermis., Conclusion: The FLPDL is effective in the treatment of morphea, as confirmed by the changes in the pathologic tissue and levels of CD34+ and Factor XIIIa+ cells.

Frogs of two species, genus Rana, R. mascareniensis and R. levantina from northern Egypt, were examined using electrophoresis for 15 presumptive loci and measuring of 11 morphological characters, employing discriminate and principle component analysis. Electrophoretic and morphometric data showed clear interspecific differences. Using serum and tissue electrophoresis all individuals of R. mascareniensis had no intraspecific variabilities but R. levantina showed some intraspecific variabilities.

The compounds tested, derivatives of visnaginone and khellinone, showed antibacterial activity on gram negative and gram positive micro-organisms. Some of the compounds possess an antibacterial activity on some pathogenic bacteria, i.e. Brucella abortus, for which there is no remedy as yet. All the chalcones tested were inactive except Ib, which showed antiparasitic broad spectrum.