Efficacy and safety of excimer light (308 nm) in the treatment of pityriasis lichenoides chronica.

INTRODUCTION: Pityriasis lichenoides chronica is the chronic end of the spectrum of pityriasis lichenoides which have several forms of papulosuamous conditions. Several treatments obtained complete clearance of the condition including phototherapy and specifically narrow band ultraviolet B. The Excimer light 308 is a monochromatic light that acts within the ultraviolet B wavelength and used as a targeted phototherapy in several skin conditions. METHODS: Thirty-four patients with histopathologically diagnosed pityriasis lichenoides chronica underwent treatment with biweekly sessions of excimer light 308 nm. Treatment continued until complete clearance was obtained or to a maximum of 48 sessions (24 weeks). RESULTS: Thirty-one patients obtained complete clearance with no recurrence till the end of the study period, two patients had partial response and only one patient showed poor response to treatment. CONCLUSION: Excimer light can be a safe and effective treatment of pityriasis lichinoides chronica in different ages and genders.

A comparative randomized clinical trial evaluating the efficacy and safety of tacrolimus versus hydrocortisone as a topical treatment of atopic dermatitis in children.

Background: Atopic dermatitis (AD) aetiology is not exactly identified, but it is characterized by pruritic skin reactions with elevation in the levels of inflammatory markers. Despite the fact that Corticosteroids are the mainstay therapy in the management of AD, they have many local and systemic adverse effects. Objective: The aim of this study is to evaluate the efficacy and safety of topical tacrolimus ointment in comparison to topical hydrocortisone cream in the management of the AD of children diagnosed with AD. Patients and Methods: This study was conducted on 200 children with AD. They were simply randomized into two groups, the tacrolimus group treated with 0.03% topical tacrolimus ointment and the hydrocortisone group treated with 1% hydrocortisone cream twice daily during the 3 weeks study period. Results: At the end of the study, both the tacrolimus and hydrocortisone groups showed a significant decline in the mean serum level of IL-10, IL-17, and IL-23 (p < 0.05) when compared to their baseline levels. However, the tacrolimus group showed a more significant decrease (p < 0.05) in the mean serum level of IL-10, IL-17, and IL-23 as compared to the hydrocortisone group [Mean differences = 1.600, 95% CI: 0.9858-2.214; 1.300, 95% CI: 1.086-1.514 and 4.200, 95% CI: 3.321-5.079]. Moreover, the median mEASI decreased similarly from 32 to 21 in the tacrolimus group and from 30 to 22 in the hydrocortisone group (p > 0.05) [Median difference = -2.000, 95% CI: -2.651 to -1.349; Median difference = 1.000, 95% CI: 0.3489-1.651]. Mild to moderate transient stinging and erythema were the main adverse effects that showed higher incidence in the tacrolimus group than in the hydrocortisone group (p < 0.05). In most cases, they resolved within 3-4 days. Besides, tacrolimus ointment did not cause skin atrophy as compared to the hydrocortisone group (p < 0.05). Conclusion: Tacrolimus ointment is more beneficial than hydrocortisone cream in managing AD in children in terms of lowering the inflammatory markers, however, there is no difference on the dermatitis severity scale. Moreover, tacrolimus is safer with a better side effect profile compared to hydrocortisone. Trial Registration: The trial is registered at ClinicalTrials.gov (CT.gov identifier: NCT05324618).

TEN mimics: Classification and practical approach to toxic epidermal necrolysis-like dermatoses.

Toxic epidermal necrolysis (TEN) is an acute life-threatening dermatologic emergency. However, many dermatoses can present with a TEN-like eruption. Those "TEN-mimics" are a true diagnostic challenge and an alarming differential diagnosis to such a serious condition. Herein, we will expose and classify the landscape of TEN-mimics. Also, the key differentiating clinical and/or laboratory points will be highlighted to help an accurate diagnosis of either a TEN or a TEN-like presentation.

Nontoxic and Naturally Occurring Active Compounds as Potential Inhibitors of Biological Targets in Liriomyza trifolii.

In recent years, novel strategies to control insects have been based on protease inhibitors (PIs). In this regard, molecular docking and molecular dynamics simulations have been extensively used to investigate insect gut proteases and the interactions of PIs for the development of resistance against insects. We, herein, report an in silico study of (disodium 5'-inosinate and petunidin 3-glucoside), (calcium 5'-guanylate and chlorogenic acid), chlorogenic acid alone, (kaempferol-3,7-di-O-glucoside with hyperoside and delphinidin 3-glucoside), and (myricetin 3'-glucoside and hyperoside) as potential inhibitors of acetylcholinesterase receptors, actin, α-tubulin, arginine kinase, and histone receptor III subtypes, respectively. The study demonstrated that the inhibitors are capable of forming stable complexes with the corresponding proteins while also showing great potential for inhibitory activity in the proposed protein-inhibitor combinations.

Oral Zinc as a Novel Adjuvant and Sparing Therapy for Systemic Isotretinoin in Acne Vulgaris: A Preliminary Comparative Study.

Background: Systemic isotretinoin is the most effective treatment for acne vulgaris (AV). However, numerous side effects are associated with isotretinoin. Oral zinc has a better safety profile and has been used to treat AV with variable results. Objective: We sought to evaluate the safety and efficacy of combining oral zinc to low-dose systemic isotretinoin in AV patients. Methods: Sixty AV patients were divided into two groups. Group A received oral zinc sulfate plus low-dose isotretinoin and Group B received the standard isotretinoin dosage. At each visit acne severity, photos, side effects, and patient-reported satisfaction were recorded. Results: In the two groups, no significant difference in reduction of lesion count and Global Acne Grading System scores. The frequency of treatment-related side effects was (20%) in Group A and (76.7%) in Group B. Furthermore, there was no difference regarding the relapse rates between both groups (p>0.05). Finally, the patients' satisfaction rates did not differ between the two groups. Conclusion: Oral zinc plus low-dose isotretinoin resulted in satisfactory improvement in AV patients with fewer side effects. Further studies are recommended to compare the efficacy of other zinc preparations if combined with systemic isotretinoin at different concentrations.

Intrathecal adenosine enhances the antinociception of Xylazine in goats.

BACKGROUND: The role of adenosine (AD) in neuromodulation of nociceptive signaling at the level of the spinal cord has been established in both preclinical and clinical models. Recently, the signaling pathway that involves adenosine 5-monophosphate activated protein kinase has been reported to mediate the antinociceptive effects of xylazine (XYL). The objective of this study was to investigate the antinociceptive, cardiorespiratory and hematological effects of intrathecal administration of combined XYL-AD in goats as compared to XYL alone. Six clinically healthy adult goats weighing 25 ± 2 kg were randomly assigned to one of three groups in a cross-over design. Goats were sedated with XYL (0.05 mg/kg, IM) in all groups. Ten min later, 0.9% saline solution [SAL group], XYL (0.05 mg/kg) [XYL group] or a combination of XYL (0.05 mg/kg) and AD (2000 µg) [XYL-AD group] was injected intrathecally. Antinociception scores and both cardiorespiratory and hematological parameters were measured before XYL sedation and intrathecal injection (baseline), and at 5, 10, 15, 30, 60, 90, 120 and 150 min thereafter. RESULTS: The XYL-AD group showed significantly earlier onset of antinociception [5 (5-7) min] than XYL [13 (12-14.25] min (P = 0.031). The duration of complete antinociception in goats that received XYL-AD was significantly longer (P = 0.031) than that received XYL alone [65 (58.75-66.25) and 47.5 (43.75-51.25) min, respectively]. In both XYL and XYL-AD groups, heart rate (HR), arterial blood pressure (SAP, MAP and DAP) were significantly decreased (P < 0.05) compared to the baseline. Compared to the SAL group, a statistically significant reduction in HR from 10 to 150 min (P < 0.05) was detected in the XYL group contrary to the XYL-AD group. Differences in the hematological parameters among different groups were insignificant. CONCLUSIONS: AD injected intrathecally interacts synergistically with XYL to promote antinociception in goats. This discovery supports the use of AD in combination with XYL in clinical trials.

Comparative efficacy of using a combination of intralesional purified protein derivative with low dose isotretinoin in the treatment of recalcitrant common warts.

Intralesional immunotherapy with purified protein derivative (PPD) is an effective and tolerable therapeutic modality for the treatment of common warts. However, the complete clearance rates are still unsatisfactory. We thought to evaluate the efficacy and safety of adding low dose isotretinoin to intralesional PPD versus PPD monotherapy for viral warts. The study included two groups: Group (A) was treated by intralesional PPD at 2-week intervals until complete clearance or for a maximum of six sessions in addition to an oral placebo. Group (B): was treated with both intralesional PPD and low dose isotretinoin for a 3-month course. There was no statistically significant difference between both groups regarding the therapeutic response. In common warts, the low dose of isotretinoin did not add a true therapeutic value in the studied groups. Perhaps higher doses of isotretinoin could provide a better response, which warrants further investigation.

Immediate Postoperative Analgesia of Nalbuphine-Ketamine Combination Compared with Ketamine Alone in Xylazine-Sedated Goats Undergoing Left Flank Laparotomy.

Goats have been used as animal models in research, and the need for achieving safer anesthesia for research or surgical intervention is gaining much attention. The objective of this study was to evaluate intraoperative effects and the immediate postoperative analgesia of nalbuphine-ketamine regimen in goats. Twenty clinically healthy adult female crossbred goats weighing 14 ± 2 kg were allocated randomly into each of two equally sized groups. All animals were sedated with intramuscular (IM) xylazine (0.07 mg/kg), then anesthesia was intravenously (IV) induced with ketamine alone (10 mg/kg) (XK group), or a combination of nalbuphine (0.5 mg/kg) and ketamine (5 mg/kg) (XNK group). Following induction, left flank laparotomy was performed and then sutured. The quality of anesthesia and immediate postoperative analgesia was evaluated. Immediate postoperative analgesia was assessed up to 5 h after standing, using a modified Unesp-Botucatu acute composite pain scale (USAPS). Serum cortisol, glucose, insulin, and C-reactive protein (CRP) were measured at ½, 1, 2, 4, 6, 12, and 24 h, postoperatively (PO). The USAPS pain scores were significantly lower in the XNK compared to the XK group (p < 0.05). The XNK group exhibited a statistically significant difference in the level of serum cortisol at ½ and 1 h PO (p = 0.018 and 0.045, respectively) compared to the XK group. At 2, 4, 6 h PO, CRP significantly decreased (p = 0.023, 0.040 and 0.005, respectively) in the XNK compared to the XK group. Nalbuphine-ketamine produced an acceptable induction of anesthesia and recovery compared to ketamine. Recovery with nalbuphine-ketamine was faster and better quality. The USAPS pain scores were lower in nalbuphine-ketamine, indicating that this novel combination produces better postoperative pain control than ketamine alone.

Autologous plasma gel injection combined with scar subcision is a successful technique for atrophic post-acne scars: a split-face study.

BACKGROUND: Different therapeutic options can be used for post-acne scarring. Scar subcision alone or in combination with other treatments have been used by many dermatologists to treat post-acne scarring. OBJECTIVES: We thought to study and compare the efficacy and safety of scar subcision combined with platelet gel injection versus scar subcision combined with PRP injection for atrophic post-acne scarring. PATIENTS AND METHODS: Scar subcision was done 1st on both sides of the face. Plasma gel injection was done on the right side and PRP injection was done on the left side. The sessions were done monthly for 4 months followed by a 6-month follow-up period. Evaluation of the results and any complications were recorded. RESULTS: There was a significant improvement (p = .035) of the scars on the subcision-gel-side at one month following the 1st treatment session. However, along with the following sessions, there were no significant differences between both sides. Finally, at the follow-up visit after 6 months following the end of the treatment course there was a significant difference between the two sides of the face in favor of the subcision-gel-side. CONCLUSIONS: Subcision combined with autologous plasma gel injection is a successful technique for atrophic post-acne scars.

Efficacy and safety of active vitamin D supplementation in chronic spontaneous urticaria patients.

BACKGROUND: Chronic spontaneous urticaria (CSU) is a common skin disorder affecting negatively patients' lives. Vitamin D deficiency has been reported to be associated to many allergic skin disorders. OBJECTIVE: This study aimed to evaluate the association between the serum level of 25 hydroxy vitamin D and CSU and to assess the efficacy and safety of active vitamin D in management of CSU. METHODS: The study was conducted on 77 patients with CSU and 67 healthy controls, then the 77 CSU patients were randomized to either the study group that received 0.25 µg alfacalcidol daily or the placebo group that received oral placebo for 12 weeks. RESULTS: Serum 25(OH) D was significantly lower in CSU as compared to healthy controls and was negatively correlated to the urticarial severity. After alfacalcidol administration, the study group showed significant higher level of 25(OH) D compared to the placebo group. In addition, the mean serum level of IL6, hsCRP and TNFα significantly decreased in the study group in comparison to the placebo group and as compared to their baseline results. CONCLUSION: Vitamin D deficiency is more common in CSU patients as compared to healthy people and hence, alfacalcidol might have a beneficial role as add on therapy in CSU management with no reported side effects.

Morphometric study of lymphangiogenesis in different lesions of psoriasis vulgaris with correlation to disease activity.

BACKGROUND AND OBJECTIVES: In the last decades, attention to the role of lymphangiogenesis in psoriasis has been paid. Our study was conducted to evaluate podoplanin-stained lymphatic vessels and the level of lymphangiogenesis in papular psoriatic lesions and psoriatic plaques and ascertain if podoplanin provides any additional prognostic information. MATERIALS AND METHODS: Number of lymphatic vessels and total lymphatic vessel area were morphometrically analyzed in podoplanin-stained sections, using anti-D2-40, together with the immunohistochemical study of epidermal Ki-67 in psoriasis vulgaris (n = 20) (papules = 7 and plaques = 13) and control skin specimens (n = 20). RESULTS: The number of lymphatic vessels and total lymphatic vessel area were higher in psoriasis cases compared with normal skin (p = 0.01, p = 0.01 respectively). In psoriatic plaques, the number of lymphatic vessels, total lymphatic vessel area, and epidermal Ki-67 immunoreactivity were higher than in papular lesions (p = 0.002, p = 0.008, and p = 0.01, respectively). CONCLUSIONS: Psoriasis vulgaris is found to be a lymphangiogenesis-dependent disease, and the lymphatic vascular network is in remodeling and expanding process. Podoplanin may be implicated in the pathogenesis of psoriasis and could be used as a prognostic biomarker for disease severity and progression.

Determination of the Minimum Infusion Rate of Alfaxalone Combined with Electroacupuncture in Goats.

Total intravenous anesthesia (TIVA) is increasingly used in companion animals. The effect of electroacupuncture (EA) on alfaxalone-based TIVA has not been previously reported in goats. Therefore, the objective of this study was to determine the minimum infusion rate (MIR) of alfaxalone required to prevent purposeful movement of the extremities in response to standardized noxious stimulation during its combination with EA in goats. Twelve clinically healthy goats weighing 18.5 ± 2 kg were randomly assigned to two groups (six goats/group). Alfaxalone alone (ALF group) and alfaxalone combined with EA (EA-ALF group). In the EA-ALF, alfaxalone was administered 30 min after EA stimulation. For induction of anesthesia, a bolus of alfaxalone was given at 3 mg/kg IV, and an infusion dose of 9.6 mg/kg/h was initially set for maintenance. The MIR of alfaxalone in both groups was determined by testing for responses to stimulation (clamping on a digit with Vulsellum forceps) at 10-min intervals after induction of anesthesia till the entire period of the experiment. Cardiopulmonary parameters and nociceptive threshold were measured throughout anesthesia. The median alfaxalone MIR was significantly lower in the EA-ALF group than the ALF group [9 (4.8-9.6) and 12 (11.4-18)], respectively; p = 0.0035). In the ALF group, goats anesthetized with MIR showed a significant increase in heart rate and cardiac output (p < 0.0001 and 0.0312, respectively), and decrease in respiratory rate (p < 0.0001), hemoglobin oxygen saturation (p = 0.0081), and rectal temperature (p = 0.0046) compared with those in the EA-ALF. Additionally, goats in the EA-ALF showed a higher nociceptive threshold than those in the ALF group (p < 0.0001). EA provided analgesia, reduced the MIR of alfaxalone-based IV anesthesia and thereby alleviated the adverse cardiorespiratory effects associated with alfaxalone anesthesia in goats.

Cardiorespiratory Effects of Three Infusion Doses of Adenosine in Conscious Goats: A Preliminary Study.

Adenosine (AD) has been implicated in human healthcare as an endogenous signaling nucleotide in both physiologic and pathologic states. The effects of AD on cardiorespiratory parameters in ruminants has not yet been studied. The objective of this study was to evaluate the cardiac and respiratory changes that resulted from an intravenous AD infusion in goats. Six clinically healthy adult goats weighing 28 ± 2 kg were randomly assigned to one of four treatments in a crossover design with a seven day washout period. The goats received a 0.9 % saline solution (SAL treatment) and three AD treatments (AD 50, 100 and 200) intravenously at a dose rate of 50, 100 and 200 µg/kg/min. Cardiorespiratory and key cardiac parameters were measured before the treatment (baseline), during the infusion (dInf) and at 1, 3, 5 and 10 min after each infusion was discontinued. The AD 100 produced a significant increase in HR (p = 0.001) and the AD 200 resulted in significant rises in HR (p = 0.006) and RR (p = 0.001) compared with the baseline. This study concluded that the AD infusion could trigger an increase in HR and RR in a dose-dependent manner in healthy goats.

The Effect of Xylazine Premedication on the Dose and Quality of Anesthesia Induction with Alfaxalone in Goats.

Goats have been used as animal models in research and are increasingly kept as companion animals. However, information about effective anesthetic drugs is scarce in this species. The objective of this study was to evaluate the effect of xylazine premedication on alfaxalone induction. Twelve clinically healthy goats weighing 18.5 ± 2 kg were randomly assigned to two groups. Induction was performed with alfaxalone alone intravenously (ALF group) or with xylazine premedication before alfaxalone administration (XYL-ALF group). The quality of induction was scored, induction doses of alfaxalone were determined, and cardiorespiratory parameters and nociceptive thresholds were measured before any treatment(s) (baseline) and at 5, 15, 25 and 35 min after alfaxalone administration. The mean dose of alfaxalone required for induction in the ALF group was greater than that in the XYL-ALF group (p < 0.001). There were no significant changes in diastolic arterial pressure (DAP), mean arterial pressure (MAP) or systolic arterial pressure (SAP) compared to baseline in either group, while hemoglobin oxygen saturation (SpO2) was lower from 5 to 25 min (p < 0.5) in the XYL-ALF group. The nociceptive threshold was significantly higher at 5 min in the XYL-ALF group than in the ALF group (p = 0.0417). Xylazine premedication reduced the required dose of alfaxalone for anesthetic induction and produced better antinociception than alfaxalone alone. In addition, the combination of xylazine and alfaxalone allowed for successful induction; however, oxygen supplementation is necessary to counteract xylazine-associated hypoxemia.

Application of α2 -adrenergic agonists combined with anesthetics and their implication in pulmonary intravascular macrophages-insulted pulmonary edema and hypoxemia in ruminants.

Alpha2 -adrenergic agonists have been implicated in the development of pulmonary edema (PE) and sustained hypoxemia that lead to life-threatening pulmonary distress in ruminants, especially with sensitive and compromised animals. Recently, there is limited understanding of exact mechanism underlying pulmonary alterations associated with α2 -adrenergic agonist administration. Ruminants have a rich population of pulmonary intravascular macrophages (PIMs) in the pulmonary circulation, which may be involved in the development of pulmonary alveolo-capillary barrier damage. Hence, the central thesis of this review is overviewing the literatures regarding the systemic use of α2 -adrenergic agonists in domestic ruminants, focusing on their pulmonary side effects, especially on the influence of PIMs on the lung. At this moment, further studies are needed to provide a clear emphasis and better understanding of the potential role of PIMs in the lung pathophysiology associated with α2 -adrenergic agonists. These preliminary studies would be potentially to develop future medications and intervention targets that may be helpful to alleviate or prevent the critical striking pulmonary effects, and thereby improving the safety of α2 -agonist application in ruminants.

Improvement of sexual dysfunction in patients after treatment of hepatitis C virus using directly acting antivirals.

OBJECTIVE: The impact on male and female sexual dysfunction of treating hepatitis C virus (HCV) using direct-acting antiviral agents (DAAs) has not been sufficiently studied. The aim of this study was to assess the impact of HCV clearance with DAAs on sexual dysfunction (SD) in both sexes. METHODS: In chronic HCV patients who were eligible for DAAs, 100 sexually active men completed the Arabic version of the international index of erectile function questionnaire (IIEF-5), and the same number of sexually active women completed Female Sexual Function Index (FSFI), before, at the end of, and 3 months after, treatment for HCV. RESULT: The mean of the IIEF-5 scores for male patients was 16.29 ±.07 before treatment, 16.88 ± 3.63 3 months after treatment (p < .01), and was significantly higher, at 19.06 ± 3.31 6 months after treatment cessation (p < .01). In female patients, the mean total FSFI score at baseline was 19.22 ± 2.40 and after 3 months of treatment was 21.61 ± 3.45 (p < .01), with a significant increase (25.09 ± 4.52) after 6 months (p < .01). No difference in the improvement of sexual function was reported either after 3 months or at the end of treatment between males and females (p > .05). CONCLUSIONS: Significant improvement in SD associated with HCV infection in both sexes was recorded following viral clearance using DAAs treatment.

Isotretinoin Induced Hyperlipidemia and Impact of Leptin Gene rs 7799039 Polymorphism in Safety of Acne Patients.

BACKGROUND: Acne vulgaris (AV) is a chronic inflammatory disease that affects the pilosebaceous unit. Leptin (LEP) gene polymorphisms is associated with higher risk of multiple disorders. Insulin-like growth factor-1 (IGF-1) exerts comedogenic effect by stimulating the sebaceous glands. Isotretinoin is an effective oral therapy for AV with many side effects including hyperlipidemia and increased serum levels of liver enzymes. PURPOSE: To evaluate the impact of LEP gene rs7799039 polymorphism in acne patients' clinical response lipid profile and liver enzymes following 6 months oral isotretinoin therapy in Egyptian AV patients. METHODS: One hundred eligible AV patients received 0.5 mg/kg oral isotretinoin for 6 months. Patients' demographics and clinical data were obtained. Body mass index (BMI), lipid profile, liver enzymes and IGF-1 were measured at baseline and after 6 months of therapy. Genotyping was done for LEP gene rs 7799039. RESULTS: Six month administration of oral isotretinoin in Egyptian AV patients is associated with significantly elevated aspartate transaminase (AST) in CC and AC genotypes (P<0.001). Significant alanine aminotransferase (ALT) elevation was observed in CC, AC and AA genotypes (P <0.001, 0.004, 0.002, respectively). Total cholesterol (TC), triglycerides (TG) and low density lipoprotein (LDL) were elevated significantly P<0.001) in the three genotypes. IGF-1 was decreased significantly in CC and AC genotypes (P<0.001). CC genotype is associated with highest response (P<0.001). CONCLUSION: LEP rs7799039 gene had an impact on the clinical response, lipid profile and liver enzymes in AV patients treated with oral isotretinoin. LEP rs7799039 CC genotype is predicted to be the treatment candidate for 6 month oral isotretinoin.

'Cryo-immuno-therapy' is superior to intralesional Candida antigen monotherapy in the treatment of multiple common warts.

BACKGROUND: The treatment of multiple common warts can be challenging. Cryotherapy is commonly used for eradicating common warts with variable success. Intralesional Candida antigen has showed promising results in treating different human papillomavirus infections. OBJECTIVES: The aim of this study was to evaluate the safety and efficacy of combining cryotherapy with Candida antigen intralesional immunotherapy for the treatment of multiple common warts. PATIENTS AND METHODS: A total of 60 patients were randomly and equally assigined into three groups: Group Awho received intralesional Candida antigen monotherapy, Group Bwho was treated by cryotherapy alone, and Group Cwho was treated by a combination of cryotherapy with intralesional antigen immunotherapy or 'cryo-immuno-therapy.' The treatment sessions were done every 2 weeks to a maximum of five sessions. All patients were followed up for 3 months to detect possible relapses. Any adverse effects were recorded and patients' satisfaction was evaluated at the end of treatment. RESULTS: The 'cryo-immuno-therapy' group resulted in (40%) complete clearance of lesions which was significantly superior to immunotherapy monotherapy clearance rate (20%). CONCLUSIONS: 'Cryo-immuno-therapy' is a new combination therapy for multiple common warts. This combination is easy to apply, safe, of low cost, and higher efficacy in contrast to the traditional intralesional Candida antigen monotherapy.

Efficacy of long-pulsed Nd-YAG laser in the treatment of nail psoriasis: a clinical and dermoscopic evaluation.

BACKGROUND: Nail psoriasis (NP) is frequently seen in psoriatic patients. It is difficult to treat and shows unsatisfactory response to topical preparations. Recently, different types of Lasers have been shown to be effective in some nail disorders. AIM: The aim was to evaluate the efficacy and safety of long-pulsed Nd: YAG laser 1,064 nm as a method for NP treatment. METHODS: A prospective intra-patient left-to-right, randomized, placebo-controlled study conducted on 22 patients with bilateral fingernail psoriasis, randomly assigned into right or left-side therapy with either four sessions of long-pulsed Nd:YAG laser once monthly or daily topical placebo for 4 months, followed by 3 months follow-up. Evaluation was done using NP severity index at baseline, second month, fourth month and after follow-up period. Clinical and dermoscopic photographs were taken both at baseline and at 4th month. RESULTS: There was a statistically significant improvement in both NP severity index and dermoscopic features in laser side, along with significant difference between laser and placebo side. Nail bed showed obvious improvement than nail matrix. CONCLUSION: Nd:YAG laser represents an effective and safe modality for NP treatment and dermoscopy is a useful tool for treatment efficacy assessment.

Role of mannose binding lectin in response to candida antigen immunotherapy of warts.

BACKGROUND: Warts is the commonest cutaneous manifestation of human papillomavirus (HPV) infection. Intralesional Candida antigen immunotherapy is used for wart treatment. AIM: To identify the role of mannose binding lectin (MBL) in susceptibility to HPV infection and to explore the relationship between MBL and response to intralesional Candida antigen immunotherapy of wart. PATIENTS AND METHODS: A case-control study was enrolled with 96 participants; 48 wart cases and 48 healthy controls. MBL serum level assay baseline and after six settings of intralesional candida antigen injection was done by ELISA technique. MBL2 gene exon 1 codon 54 polymorphism was detected by using restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR). RESULTS: A statistically significant difference in MBL serum level between wart cases and controls was found. An association between MBL2 exon1 codon 54 polymorphism and susceptibility to HPV infection and development of warts was proved. Carriage of genotype AB was more frequent wart cases (95.8%) than in controls (20.8%). No statistical significance association could be found between the therapeutic response to Candida antigen immunotherapy in wart cases and MBL as regards its serum level and genotypes. CONCLUSIONS: MBL play an important role in host defense against HPV infection.