In severe acne vulgaris, TNF-α gene variants are connected to increased TNF-α gene expression and insulin resistance.

BACKGROUND: Acne vulgaris (AV) is a chronic inflammatory skin condition affecting the pilosebaceous unit, commonly presenting as comedones, papules, pustules, or nodules on the face, upper limbs, torso, and back, with comedones formation being the primary pathology leading to disfiguring inflammation, hyperpigmentation, scarring, and psychological impact. AIM: The purpose of this study was to investigate the significance of two genetic variants in the promoter region of the tumor necrosis factor-alpha (TNF-α) gene and their association with insulin resistance (IR) in acne patients. To understand how these variants contribute to AV and its associated IR. SUBJECTS AND METHODS: An analytical cross-sectional study with a case-control design and research evaluation was carried out on 87 AV patients and 73 healthy volunteers. The medical histories of both groups were obtained, as well as the severity and duration of inflammation among acne sufferers, as well as demographic data. Biochemical analysis was performed on both sets of participants, including fasting blood glucose levels, insulin levels while fasting, IR, and serum TNF-α. PCR-RFLP analysis identified -863 G > A (rs1800630) and -308 G > A (rs1800629) variations, and real-time PCR analysis evaluated TNF-α gene expression in both patients and healthy people. RESULTS: Acne patients exhibited significantly higher levels of IR, fasting glucose, fasting insulin, serum TNF-α, and TNF-α folding change, when compared to healthy controls. The co-dominant model for -863 G > A and -308 G > A variants exhibited significant variations between the two groups. Severe acne patients who had the A/A genotype for -308 variants exhibited higher levels of IR, serum TNF-α, and TNF-α folding change. Highly significant positive linear correlation between IR, serum TNF-α, and TNF-α folding change in severe AV. CONCLUSION: There is a correlation between AV, especially severe acne, and the -863 G > A and -308 G > A polymorphism, which influences TNF-α gene expression and serum TNF-α levels.

The role of hsa-miR-193a-5p as an important factor for control of inositol in alopecia areata.

BACKGROUND: MicroRNAs (miRNAs) are small RNA molecules that play a regulatory role in various biological processes by acting as intracellular mediators. They hold great potential as therapeutic agents for targeting human disease pathways; however, there is still much to be uncovered about their mechanism of gene regulation. Alopecia areata (AA) is a commonly occurring inflammatory condition characterized by the infiltration of T cells that specifically target the anagen-stage hair follicle. The limited understanding of its precise cellular mechanism may be the reason behind the scarcity of effective treatments for AA. AIM: The significance and function of hsa-miR-193a-5p as a genetic marker for AA and its potential influence on the advancement of the disease. SUBJECTS AND METHODS: A case-control study comprised 77 individuals diagnosed with AA who were matched with 75 healthy controls. In order to measure the expression of miR-200c-3p in both groups, the real-time PCR technique was utilized. The prediction of suitable genes for hsa-miR-193a-5p, as well as the identification of pathways and gene-gene interactions, were carried out using bioinformatic tools. RESULTS: The levels of hsa-miR-193a-5p expression were notably elevated in AA patients in comparison to healthy controls. Our prediction suggests that the involvement of hsa-miR-193a-5p in the development of AA is significant due to its influence on the inositol phosphorylation pathway and the Phosphatidylinositol signaling system, achieved through its direct impact on the IPPK gene. CONCLUSION: For the first time, our study demonstrates the significant over-expression of a new miRNA, hsa-miR-193a-5p, in the blood of AA patients compared to controls, and highlights its impact on the IPPK gene and the inositol phosphorylation and Phosphatidylinositol signaling pathways, suggesting a potential therapeutic role for hsa-miR-193a-5p in AA.

Chin reinforcement using the hyaluronic acid injectable filler VYC-20L and VYC-25L.

BACKGROUND: The chin is an essential element of the facial unit and influences how people perceive facial aesthetic appeal. Hyaluronic acid (HA) gel injections are tried-and-true therapies for regenerative therapies with a record of success in efficacy and safety. AIMS: To determine the best type of concentration of HA and way of injection for deep and superficial planes of chin. MATERIALS AND METHODS: VYC-20L and VYC-25L (Juvederm Voluma XC® Juvéderm Volux®; Allergan plc) are 20- and 25-mg/mL HA gels with lidocaine, respectively, were injected with cannulas and needles on the bone, respectively. RESULTS: Chin reinforced respecting the measures with good contouring. No serious complications. Patient was satisfied with results. DISCUSSION: We advise using VYC 20L superficially above the muscle or with a cannula for injection, and we recommend using VYC 25L in the supraperiosteal plane.

C-reactive protein as a novel biomarker for vitamin D deficiency in alopecia areata.

BACKGROUND: Alopecia areata (AA) is an autoimmune condition characterized by sudden and unpredictable hair loss, with a lifetime incidence of 2%. AA can be divided into three categories: patchy alopecia, alopecia totalis, and alopecia universalis. It can affect a person's psychological health and overall quality of life. Elevated C-reactive protein (CRP) levels in the liver may indicate an inflammatory response in autoimmune diseases. Vitamin D, essential for immune system control and skin health, may be related to AA. Hair follicles contain vitamin D receptors, which control immunological responses in the skin. However, no study has found a relationship between CRP and vitamin D in AA patients in our region. SUBJECTS AND METHODS: An analytical cross-sectional study with a case-control design research investigation of 82 AA patients and 81 healthy controls was carried out. Both groups' medical histories were taken. Biochemical analysis was done for both groups as well as the serum vitamin D levels, and CRP. Genetic analysis for CDX2 rs11568820 variant detected by PCR (T-ARMS-PCR) method and vitamin D receptor (VDR) gene expression measured by real-time PCR analysis for both patients and healthy subjects. RESULTS: CRP levels are higher in AA patients, AA patients with G/G genotypes exhibited higher concentrations of CRP when compared to those with A/A and A/G genotypes while patients with A/A genotypes have higher levels of Serum vitamin D as compared to the A/G and G/G genotypes. G allele was more abundant in AA patients. VDR gene expression was lower in AA compared to control and lower in ophiasis compared to localized and multiple patchy AA. An important inverse linear correlation was observed between vitamin D and CRP levels in ophiasis AA. CONCLUSION: CRP concentrations were found to be elevated in AA patients. The considerable accuracy of CRP in the diagnosis of AA is substantiated by a statistically significant al. A noteworthy inverse linear association was observed between serum vitamin D and CRP concentrations in ophiasis AA.

Effect of interleukin-12 gene expression on insulin resistance in patients with acne vulgaris.

BACKGROUND: Insulin resistance (IR) is a condition where cells become resistant to insulin, causing impaired glucose uptake and increased blood glucose levels. Interleukin-12 (IL-12), a cytokine, regulates the immune system. High levels of IL-12 can lead to chronic inflammation, exacerbate resistance to insulin, and contribute to type 2 diabetes. Also, link IR to acne vulgaris (AV), as it reduces tissue sensitivity to insulin, causing increased insulin levels and sebum production, which can contribute to acne development. AIM: To explore the role of IL-12 gene expression on IR in AV patients and to study the role of IL-12 gene in the development of AV. SUBJECTS AND METHODS: A case-control study was performed on 68 AV patients and 68 healthy controls. The biochemical analysis included fasting glucose, fasting insulin, (HOMA-IR), and serum IL-12 level. IL-12 gene expression was performed by quantitative real-time PCR for both two groups. In addition, folding change was calculated by using the standard 2-(∆∆Ct) method. RESULT: IL-12 level, IL-12 folding change, fasting insulin, and IR were all increased in acne patients. A highly significant linear correlation was found between IL-12 folding change and both IL-12 levels and IR. There is a substantial positive significant simple linear association between IL-12 level and IL-12 folding change, as well as IR and IL-12 folding change, in moderate and severe acne. CONCLUSION: IL-12 gene has an important role in IR and the development of acne in AV patients.

The CDX2 G allele and the FoKI F allele of the VDR gene are more prevalent and related to changes in vitamin D levels in patients with psoriasis vulgaris: A pilot study.

BACKGROUND AND AIMS: Psoriasis is a chronic, non-contagious autoimmune condition marked by dry, itchy,erythematous and scaly plaques. From modest, localized plaques to total body coverage, the severity of psoriasis varies. Plaque, guttate, inverted, pustular, and erythrodermic psoriasis are the five primary kinds. About 90% of cases are of plaque psoriasis, commonly known as psoriasis vulgaris. Study aims to determine the impact of an rs2228570 (FokI) variant and an rs11568820 (CDX2) variant on serum vitamin D levels (SVD) in patients with psoriasis, and the correlation between the two variants and disease severity. METHODS: A case-control study consisting of 95 psoriasis vulgaris patients and 84 healthy controls. The clinical investigation, molecular genetics analysis, and biochemical analysis were done for both groups. RESULTS: SVD levels were significantly decreased in psoriasis patients group. FokI genotypes analysis, we found no significant variance between groups. CDX2 G/G genotype is more prevalent in patients than controls. Moderate psoriasis vulgaris patients with CDX2 G/G genotypes have higher SVD levels than CDX2 G/A, and CDX2 A/A p = 0.003. CONCLUSION: The study found a difference in vitamin D levels between patients and healthy subjects, as well as a difference in vitamin D levels with different FoKI and CDX2 genotypes.

Role of macrophage scavenger receptor 1 in the progression of dyslipidemia in acne vulgaris patients.

BACKGROUND: Macrophage scavenger receptor 1 gene (MSR1), is responsible for producing macrophage scavenger receptors. MSR1 is primarily located on the surfaces of various macrophage types and is known to exert a range of effects on the human body. These effects include influencing innate and adaptive immunological reactions, as well as contributing to the development of conditions such as atherosclerosis, dyslipidemia, liver and lung disease, and cancer. The unregulated assimilation of lipoproteins by MSR1 leads to the creation of macrophages rich in cholesterol that manifest as foam-like cells, ultimately contributing to dyslipidemia. This occurrence highlights the significance of MSR1 as a key player in the pathophysiology of dyslipidemia. AIM: In this study, we aimed to estimate variation in lipid profile in acne vulgaris (AV) patients. Also, we aimed to investigate the role of MSR1 in lipid profile variation. SUBJECTS AND METHODS: A case-control study consisting of 100 patients with AV and 104 healthy controls. Lipid profiles were assessed using normalized enzymatic processes and genotype analyses were performed by a polymerase chain reaction and standard Sanger sequencing. Predictions of variant effects were performed using in silico tools. RESULT: Our results indicated that the levels of lipid profile were higher in patients with AV than in healthy patients. The two haplotypes that were most prevalent in the patients were TCAC (16.5%) and CAGG (15.47%), whereas the two haplotypes that were more prevalent in the controls were TAAC (16.43%) and CCAC (15.62%). IVS5.59 C > A and rs433235 A > G are in linkage disequilibrium. Additionally, rs433235 A > G has a significant linkage disequilibrium with rs3747531 C > G. In silico analysis, tools indicated that the rs433235 A > G variant was disease-causing. CONCLUSION: Patients diagnosed with TCAC and CAGG exhibited a higher prevalence compared to healthy patients with TAAC and CCAC. The linkage disequilibrium between rs433235 A > G and IVS5.59 C > A has been established. Furthermore, there appears to be significant linkage disequilibrium between rs3747531 C > G and rs433235 A > G. These findings support the notion that genetic variations may play a critical role in the pathogenesis of these conditions.

Apo B-48 gene expression and low-density lipoprotein as a factor for increased insulin resistance and severity of acne.

BACKGROUND: The contribution of insulin to acne is that it stimulates the synthesis of androgenic hormones, which are important in the development of excess sebum, hyperkeratinization, and sebaceous gland cell growth. OBJECTIVE: To ascertain whether the lipid profile abnomalies seen in acne vulgaris are genetically induced, we also seek to establish a link between insulin resistance and lipid profiles. METHODS: An analytical cross-sectional study with case-control design research investigation of 72 individuals with acne vulgaris and 72 healthy volunteers was carried out. Both groups' medical histories were taken, as were the severity and duration of the disease among acne sufferers, as well as demographic data. Anthropometry tests were performed on both groups, including their weights, height, and circumference of waist, as well as the profile of lipids, blood glucose levels after a fast, insulin levels during fasting, resistance to insulin, and Apo B-48 folding change. RESULTS: Severe acne vulgaris patients showed significantly increased TG, TC, LDL-C, blood glucose levels after a fast, fasting insulin, and resistance to insulin levels. P = 0.005 showed that Apo B-48 expression increased in patients compared to healthy people. Apo B-48 folding change and insulin resistance were found to have a substantial positive simple linear association. Acne vulgaris, whether mild, moderate, or severe, has a significant positive linear connection with insulin resistance. CONCLUSION: Acne patients had an abnormal in lipid profile. Acne individuals with severe form are more inclined to acquire resistance to insulin as well as higher glucose and insulin levels. Apo B-48 gene expression is elevated in acne individuals with severe form who have lipid abnormalities. This illustrating the importance of genetic variables in acne, insulin resistance, lipid profile modifications as well as Isotretinoin, a standard acne medication, can also cause lipid irregularities.

Alterations in lipid and hormonal titers in patients with acne and their relationship with severity: A case-control study.

Background and Aims: Acne is a frequently diagnosed skin condition that causes pilosebaceous apparatus clogs and/or inflammatory responses in the majority of teenagers. It is a multifactorial disease that can develop due to various factors. We aimed to evaluate lipid profiles and hormonal levels in patients with acne and correlate them to acne severity. We also aim to explore the alteration of lipid profiles and hormonal levels and their effect on the occurrence of acne. Methods: A case-control study was performed on 100 individuals with acne vulgaris and 100 healthy controls. The biochemical analysis included; lipid profiles such as triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C), and hormonal levels such as estradiol (E), total testosterone (TT), and free testosterone (FT) were measured for both patients and controls. Results: Comparison between patients with acne and controls disclosed that; TC, TG, LDL-C, and HDL-C levels were significantly higher in patients, especially when compared to controls (p ≤ 0.05); also, the same results were found in hormonal levels results (p ≤ 0.05). Conclusion: These altered lipid profiles and androgen levels should be considered in the pathophysiology of acne and taken into consideration when treating patients with acne.

The vitamin D receptor gene polymorphism rs1544410 T/T genotype as a predictor of factor vitamin D thresholds deficiency in patients with psoriasis vulgaris-A preliminary study.

BACKGROUND: Many clinical features of psoriasis include a rash with itchy, scaly patches, most frequently on the knees, elbows, trunk, and scalp. By studying genes involved with psoriasis receptivity, the pathologic pathways of psoriasis become clearer and more understood. AIM: To predict the participation of rs1544410 in serum vitamin D levels (SDL) in psoriasis, psoriasis susceptibility, and severity. PATIENTS/METHODS: One hundred five patients with psoriasis were categorized by body surface area as mild, moderate, and severe. SDL and genetic analysis of rs1544410 were performed using polymerase chain reaction and standard Sanger methods. RESULT: Our findings revealed that SDL were higher in healthy subjects than in patients. The rs1544410 genotype TT was more prevalent in patients, while CT was more prevalent in controls. Our findings revealed that the T alleles were frequently more in the patient group than in the controls. (p ≤ 0.001). While in healthy normal individuals, the C alleles were frequently more (p ≤ 0.001). SDL are lower in patients with the TT genotype. Patients with moderate form of psoriasis have higher SDL than those with mild or severe form. CONCLUSION: rs1544410 polymorphism has been linked to a higher probability of psoriasis and SDL deficiency. However, grander scale studies in a larger number of people are necessary.

TaqI polymorphism T/t genotypes at the vitamin D receptor gene (VDR) are associated with increased serum vitamin D levels in mild and moderate psoriasis vulgaris: A pilot study.

BACKGROUND: Several types of polymorphisms in vitamin D receptor (VDR) have been found in psoriasis. AIM: This study looked at the role of the TaqI polymorphism in the VDR gene as a factor in changing plasma 25-hydroxyvitamin D [25(OH)D] levels in psoriasis patients and to see if it had any relationship with disease severity. SUBJECTS AND METHODS: Clinical examination, serum 25(OH)D level measurement, molecular studies and TaqI genotyping by PCR and RFLP were performed for the two groups. RESULTS: The T/t genotypes of TaqI polymorphism genotypes were most common in patients, while the t/t genotypes were more abundant in healthy subjects. The T allele was high in the patient group in comparison with the normal subjects, but there were no significant differences (p = 0.421). Patients with T/t TaqI genotypes had higher levels of 25(OH)D than those with T/T and t/t (p = 0.004). Moderate psoriatic patients with the T/t genotype had relatively high 25(OH)D levels compared with moderate patients with the T/t and t/t genotypes (p = 0.001). CONCLUSION: The increase in 25(OH)D titers in moderate patients is greater than that in mild and severe patients. T/t genotypes are associated with increased 25(OH)D levels in moderate and mild patients.

Systemic immunotherapy for the treatment of warts: A literature review.

BACKGROUND: Immunotherapy has emerged as a critical therapeutic tool for the treatment of warts. Immunotherapy for warts is currently restricted to recalcitrant lesions. A small number of regimens appear to be extremely effective. Furthermore, there is a scarcity of evidence-based research. OBJECTIVE: Furthermore, in the majority of cases, their safety and effectiveness have not been evaluated in double-blind, controlled clinical trials, making the reproducibility of many of the listed treatments difficult to analyze and a possible placebo effect difficult to rule out. METHODS: Analyzing and discussing different types of systemic immunotherapy. The different types of immunotherapy for warts are mentioned in this report. RESULTS: Systemic immunotherapeutic modalities commonly used in the treatment Echinacea, propolis, oral retinoids, glycyrrhizinic acid, levamisole, cimetidine, and zinc sulfate have all been reported as effective treatment modalities for different types of warts. CONCLUSION: Immunotherapy has emerged as one of the most important therapeutic modalities for warts. Such treatment is required not only for recalcitrant or multiple lesions, but also in the majority of treated cases.

Cutaneous Manifestations of Coronavirus Disease 2019: Skin Narratives and Dialogues.

Background: Although the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is primarily responsible for respiratory symptoms, an increasing number of cutaneous manifestations have been reported. Cutaneous manifestations are reported by patients following disease recovery. Objective: We sought to document various skin lesions relating to COVID-19 symptoms either before, during, or after infection with severe acute respiratory syndrome coronavirus 2. Methods: This was a descriptive study with 273 patients who had cutaneous manifestations after recovering from COVID-19. Each patient provided a thorough medical history and underwent a general physical examination. Following polymerase chain reaction analysis, all participants were confirmed to be COVID-19 patients. Results: Acral lesions were the most common, accounting for 39% of all cases. An erythematous maculopapular rash was found in 21% of cases and was the second most common after urticaria, with fewer cases of erythema multiform, vesicular rash (9%), vascular livedo reticularis, figurate erythema, and flexural rash documented. Conclusion: The most common cutaneous changes seen in patients with COVID-19 were pseudo-chilblain acral lesions, which had a good prognosis. Vascular rashes within the spectrum of livedo/purpura/necrosis were seen with severe forms of COVID-19.

Knowledge, Attitude, and Practice of Cervical Cancer Screening, and HPV Vaccination: A Cross-Sectional Study Among Obstetricians and Gynecologists in Egypt.

BACKGROUND: Although cervical cancer is potentially preventable, lack of knowledge and poor attitude among healthcare professionals toward cervical cancer screening and Human Papilloma Virus (HPV) vaccination can result in underutilization of these preventive strategies. Then, the objective of this study was to assess the knowledge, attitude, and practice of cervical cancer and its prevention through Pap test screening and HPV vaccination among obstetricians and gynecologists (Ob-Gyns). METHODS: A cross-sectional study was conducted on 250 Egyptian attendees of a national Ob-Gyns professional conference. Data collection was performed using a pre-designed self-administered questionnaire, which tested participants' knowledge, attitude, and practices related to cervical cancer, Pap test screening, and HPV vaccination. RESULTS: The study included 41.2% Ob-Gyns specialists and 37.6% of consultants from secondary and tertiary care hospitals or centers. About 45% of participants had poor-to-fair knowledge, 57% had negative-to-fair positive attitudes toward cervical cancer screening and HPV vaccination, and 44% had ever-performed Pap test, while 45% of participants had ever-prescribed the HPV vaccine to their patients. Physicians' knowledge and attitude were significantly associated with their age, professional level, work experience, and place of work. Although performing cervical cancer screening was significantly more common among older, more experienced, and highly professional participants, HPV vaccine prescription was associated with young, less experienced participants at lower educational and professional levels. CONCLUSION: Ob-Gyns had poor-to-fair knowledge, Attitude, and practices related to cervical cancer, Pap test screening, and HPV vaccination.

Evaluation of TNF-α serum level in patients with recalcitrant multiple common warts, treated by lipid garlic extract.

No universal consensus about optimal modality for treating the recalcitrant multiple common warts (RMCW). The objective of the study was to evaluate the immunological mechanisms and clinical therapeutic effect of using lipid garlic extract (LGE) in the treatment of RMCW. The study included 50 patients with RMCW. They were randomly assigned into two groups: the first group (25 patients) received LGE, and the second group (25 patients) received saline as a control group. In both groups, treatments were made to single lesions, or largest wart in case of multiple lesions, until complete clearance of lesions or for a maximum of 4 weeks. Blood serum was taken at pre-study and at the fourth week to measure tumor necrosis factor alpha (TNF-α) level. A significant difference was found between the therapeutic responses of RMCW to LGE antigen and saline control group (p < 0.001). In the LGE group, complete response was achieved in 96% of patients presenting with RMCW. There was a statistically nonsignificant increase in TNF-α of LGE group versus saline group. No recurrence was observed in the LGE group. LGE as an immunotherapy is an inexpensive, effective, and safe modality with good cure rates for treatment of RMCWs, when other topical or physical therapies have failed.

Validity and reliability of the Arabic version of the female genital self-image scale.

INTRODUCTION: Female genital self-image is significantly related to female sexual function. It has been inadequately investigated in Egypt. AIM: To translate the original English version of the Female Genital Self-Image Scale (FGSIS) into Arabic and validate the Arabic version (AVFGSIS). METHODS: Validation was carried out for the aspects of face, content, and criterion (concurrent) validity. Studies on test-retest reliability and internal consistency were conducted using Cronbach's alpha and Pearson correlation, respectively. MAIN OUTCOME MEASURES: Main outcome measures were the validity and reliability of the AVFGSIS and its domains. Correlations between domain scores on the AVFGSIS and the Arabic version of the Female Sexual Function Index (AVFSFI) were assessed. RESULTS: A total of 244 married women aged 18-60 years participated in this study. There was a high test-retest correlation (r > 0.8). The AVFGSIS was found to have good face and content validity as a whole and for each domain. Significant positive correlations were observed with each domain of the AVFSFI: desire (r = 0.815), arousal (r = 0.861), lubrication (r = 0.855), orgasm (r = 0.820), satisfaction (r = 0.832), and pain (r = 0.884) (all P < 0.001). CONCLUSIONS: The AVFGSIS is not only valid but also reliable, as much so as the original English version. In addition, female genital self-image was found to be significantly related to female sexual function.

Topical Cyperus rotundus oil: a new therapeutic modality with comparable efficacy to Alexandrite laser photo-epilation.

BACKGROUND: Topical Cyperus rotundus oil is an effective and safe method to decrease hair growth. The oil's flavonoids have antiandrogenic activity on androgenic hair. To date, there have been no randomized controlled trials comparing topical C rotundus oil to the available allopathic modalities, such as laser-assisted hair removal. OBJECTIVES: In an open-label pilot study, the author prospectively evaluated the efficacy of C rotundus essential oil, compared with the Alexandrite laser (GentleLase; Candela Laser Corp, Wayland, Massachusetts) and saline, for reducing unwanted axillary hair. METHODS: Eligible participants (n=65) with unwanted axillary hair were assigned randomly to 1 of 3 study groups: topical C rotundus oil (group 1), saline (group 2), and Alexandrite laser (group 3). Sixty patients completed the entire study. Three methods were used to evaluate the results: hair counts, observations of independent professionals, and patient self-assessments. RESULTS: Overall results did not differ significantly between C rotundus oil and the Alexandrite laser (P>.05). However, statistically significant differences were noted with respect to decreased growth of white hair (P<.05), favoring the oil. This finding was evident by all 3 methods of assessment. No side effects were detected. CONCLUSIONS: Cyperus rotundus essential oil is as effective as the Alexandrite laser for decreasing the growth of axillary hair (both dark and white). LEVEL OF EVIDENCE: 3.