Color stability of nanohybrid and microhybrid composites after immersion in common coloring beverages at different times: a laboratory study.

OBJECTIVE/AIM: This in vitro study aimed to evaluate the color stability of microhybrid and nanohybrid restorative composites after exposure to immersion media common in Yemen for different periods. MATERIALS AND METHODS: Two composite materials, nanohybrid Tetric N-Ceram and microhybrid Te-Econom Plus, were investigated. Six groups of 30 cylindrical specimens (n = 5/group; diameter, 10 mm; thickness, 2 mm; shade A2) of each restorative material were immersed for 1 week in distilled water, qat solution, Yemeni coffee, traditional Yemeni coffee (qishr), red tea, and Dilsi cola. Color changes were evaluated by colorimetry. The color data and pH were measured before and 1, 3, and 7 days after immersion. The data were statistically analyzed. RESULTS: Tetric N-Ceram showed lesser discoloration than did Te-Econom Plus. Qat, coffee, and red tea caused highly significant discoloration than did Dilsi cola and distilled water (p < 0.05). The role of low pH in discoloration depended on the colorant. DISCUSSION: Nanohybrid Tetric N-Ceram composites are more resistant to discoloration than are microhybrid Te-Econom Plus composites. Qat and coffee have the highest effect on composite discoloration. CONCLUSIONS: These findings will aid in selecting composite materials and patient instruction.

Novel Treatment Approach for Deep Palmoplantar Warts Using Long-Pulsed 1064-nm Nd:YAG Laser and a Moisturizing Cream Without Prior Paring of the Wart Surface.

OBJECTIVE: The present study aimed to assess the safety and efficacy of palmoplantar wart removal using long-pulsed 1064-nm Nd:YAG laser after application of a moisturizing cream. BACKGROUND: Previously described laser treatments for wart removal are associated with negative side effects and need to pare the warts before laser treatment. PATIENTS/METHODS: Two hundred forty patients (142 males, 98 females) were treated for 1-40 palmoplantar warts by long-pulsed 1064-nm Nd:YAG laser (spot size 4-6 mm, pulse duration 20 msec, fluence 200 J/cm2) after covering the wart surface with a thin film of a moisturizing cream. The endpoint was lesion graying or whitening with or without development of a hemorrhagic bulla beneath the treated wart. Color photographs were taken before and immediately after each laser session and at 1, 4, and 16 weeks after the last session. RESULTS: The overall clearance rate was 97%, with 90% of treated patients cured after one session, 4% after two, and 3% after three. Clearance rate after three laser sessions decreased linearly with the number of warts from 100% to 95%. Less accessible wart location in interdigital spaces also decreased the cure rate after three sessions from 100% to 95%. Additionally, warts became more difficult to eradicate as they aged. Remission lasted up to 6 years, and complications were mild and infrequent (17.5%). CONCLUSIONS: This novel method is effective in removing palmoplantar warts. It is easier, time-saving, and safer than other methods described in previous studies conducted with ablative or nonablative lasers.

Long-Pulsed 532-Nm Neodymium-Doped Yttrium Aluminium Garnet Laser for Treatment of Facial Plane Warts in 160 Yemeni Patients.

BACKGROUND: Warts in general and plane warts in particular pose a therapeutic challenge for dermatologists. Many treatment modalities exist, with variable success rates, side effect profiles, and precautions. The long-pulsed 532-nm neodymium-doped yttrium aluminium garnet (LP Nd:YAG) laser has not been previously used for this indication. OBJECTIVE: This study was conducted to assess the efficacy and safety of the LP Nd:YAG laser for treating facial plane warts. MATERIALS AND METHODS: A total of 160 Yemeni patients (62 women, 98 men; age range, 5-55 years) were exposed to 1 laser treatment session with the following parameters: wavelength, 532 nm; pulse duration, 20 millisecond; spot size, 2 to 3 mm; and fluence, 25 J/cm. The end point was graying or whitening of the lesion. Color photographs were taken before and immediately after treatment and at follow-up visits 1, 4, and 16 weeks after the laser session. RESULTS: An overall clearance rate of 92% after only one session was achieved, with minimal and transient side effects. CONCLUSION: The LP Nd:YAG laser is safe and effective for treating facial plane warts, with a success rate of 92% after only one session.

Unusual Manifestations of Familial Juvenile Colloid Milium in Two Siblings.

Juvenile colloid milium is an extremely rare degenerative dermatosis of the dermal connective tissue manifesting before puberty. This chronic skin condition, detected primarily in sun-exposed areas, is clinically characterized by the development of translucent, yellowish papules and plaques containing gelatinous material and by the presence of eosinophilic, fissured material in the papillary dermis. We present two cases of juvenile colloid milium, in a 13-year-old girl and her 10-year-old brother; the condition emerged in both at approximately 6 years of age and progressively worsened. They both presented with multiple yellowish, translucent, firm, flat papules and plaques mainly over the face on the cheeks and on the perioral and periocular areas in a unique linear pattern.

A Case of Infantile Kyrle-Flegel Disease in a 6-Year-Old Yemeni Girl.

Kyrle disease (KD) and Flegel disease (FD) are rare variants of primary perforating dermatoses, characterized by transepidermal elimination of abnormal endogenous materials. We describe a 6-year-old Yemeni girl with a 2-year history of generalized asymptomatic, small, reddish-brown keratotic papules with a lenticular central keratotic plug. Although these features are synonymous with FD, the histology of a punch biopsy was consistent with KD. The patient was otherwise healthy, and no family members had a history of similar diseases. The patient was diagnosed with KD-FD, owing to the manifestation of features associated with both diseases.

Long-pulsed 532-nm Nd:YAG laser treatment for small acquired melanocytic nevi in a single session: an 8-year study on 350 Yemeni patients.

INTRODUCTION: Current laser treatments for acquired melanocytic nevi are unpredictable in terms of efficiency and cause considerable scarring. This study aimed to assess the efficacy and safety of the long-pulsed 532-nm Nd:YAG laser for removing small acquired melanocytic nevi in Yemeni patients. METHODS AND MATERIALS: From January 2004 to 2012, 350 patients (M:F; 41:309) with Fitzpatrick skin type IV and 1 or more small acquired melanocytic nevi were included in the study. The patients were exposed to the following laser parameters: wavelength, 532 nm; pulse duration, 20 ms; spot size, 2 mm; fluence, 30-50 j/cm². Photographs were taken on 0, 1, 4, and 12 weeks posttreatment. The follow-up period ranged from 12 weeks to 5 years. RESULTS: All nevi were completely removed with good to excellent cosmetic results in only one session. Side effects were seen in 30% of patients; the majority was temporary and, very mild in intensity, such as postinflammatory hyperpigmentation. Atrophic and hypertrophic scars were observed in 9.4% and 0.6% of cases, respectively. Recurrence was seen within 2-6 months after laser treatment in 25 patients. CONCLUSION: The long-pulsed, 532-nm Nd:YAG laser is safe and effective in the removal of small acquired melanocytic nevi in Yemeni patients.

New application of the long-pulsed Nd-YAG laser as an ablative resurfacing tool for skin rejuvenation: a 7-year study.

BACKGROUND: Carbon dioxide (CO2 ) and erbium-yttrium aluminum garnet (Er-YAG) lasers are the gold standards in ablative skin resurfacing. Neodymium-doped yttrium aluminum garnet (Nd-YAG) laser is considered a nonablative skin resurfacing laser whose usage is limited due to its high cost. AIM: To assess the efficacy and safety of Nd-YAG as an ablative resurfacing laser and to compare the results with those previously published for CO2 and Erbium-YAG lasers. PATIENTS/METHODS: A total of 296 patients (251 female and 45 male) with Fitzpatrick skin types III-IV and dermatological conditions amenable to ablative skin resurfacing participated in this study. Nd-YAG laser parameters assessed were wavelength (1064 nm), pulse duration (5 ms), fluence (10 J/cm(2) ), and spot size (8-10 mm). Efficacy of Nd-YAG laser was assessed by comparing pre- and posttreatment photographs. RESULTS: An improvement of 30-80% was observed in treated patients. The degree of improvement correlated positively with the number of laser sessions. The most common side effect was hyperpigmentation. Other side effects were less common and mild in intensity compared with published results for gold standard ablative lasers. CONCLUSION: Not only was the Nd-YAG laser found to be as effective as Er-YAG and CO2 lasers, but treated patients also had shorter recovery and treatment times, and at lower cost.