Study of human leukocyte antigen-cw in Egyptian patients with vitiligo.

Human leukocyte antigen (HLA) antigens vary considerably in different racial groups, and an analysis of results from several geographical locations suggests that vitiligo appears to be associated with different HLA antigens in different groups. The aim of this work was to assess the association of HLA-Cw with vitiligo in the Egyptian population. Forty unrelated patients with nonsegmental vitiligo and 20 matched controls were selected. A polymerase chain reaction sequence specific primer (PCR-SSP) method was used to determine HLA DNA typing. There was a statistically significant difference in the association of HLA-Cw6 with vitiligo in the 2 studied groups. A comparatively increased number of patients showed HLA-Cw2 and HLA-Cw7 (13.64%). However, there were no statistically significant differences. To the best of our knowledge, this is the first molecular study of HLA typing in Egyptian patients with vitiligo. Our findings are in agreement with earlier studies that reported statistically increased frequencies for allele of HLA-Cw6 in Northern Italian, Kuwaiti, Chinese Han, and Saudi populations (45.45%, P<.05).

Efficacy and safety of combined fractional ablative CO2 laser and 5 fluorouracil in the treatment of acral vitiligo: An open, uncontrolled study.

BACKGROUND: Acral lesions of vitiligo are most likely recalcitrant to the known lines of treatment. Ablative fractional CO2 has shown efficacy in treatment of vitiligo in combination with other modalities. METHODS: Thirty non-segmental vitiligo patients with acral lesion were included in the study. Each patient was subjected to fractional Carbon Dioxide Laser Treatment followed by application of 5 fluorouracil (5FU) cream for five consecutive days. Evaluation was done 3 weeks from the start of treatment and 12 weeks after the last treatment session using VESTA score, evaluation of patients' photos by blinded investigation in addition to patients' satisfaction scores. RESULTS: Patients showed significant improvement of Vitiligo extent score for a target area (VESTA) score and developed considerable degree of repigmentation as assessed by blinded investigators. CONCLUSION: The combination of fractional ablative CO2 and 5FU is an effective and safe procedure for the treatment of acral vitiligo with promising results offering patients a new therapeutic window.

The efficacy of topical 2% green tea lotion in mild-to-moderate acne vulgaris.

BACKGROUND: Botanical extracts and preparations have been used in different pathological conditions with success. An important group of phytochemical phenolic compounds are the catechins found in green tea. Acne is a widely occurring inflammatory condition that is estimated to affect 40 to 50 million Americans. Finding an effective, safe, cost-effective and well-tolerated treatment is the challenge. OBJECTIVE: To determine the efficacy of 2% green tea lotion in mild-to-moderate acne vulgaris. METHODS: Twenty patients fulfilling enrolment criteria were included. Green tea was given and applied twice daily for a period of 6 weeks. The patients were seen every 2 weeks to evaluate the lesions and any side effects. To determine efficacy on acne severity, the authors used both total lesion count (TLC) and their devised severity index (SI). Total lesions count (TLC) was calculated as papules + pustules while SI was scaled with numbers (1, 2 or 3) correlating to TLC in order of increasing intensity. TLC < 10 was given an SI of 1, TLC 10-20 was given an SI of 2 and TLC > 20 was given an SI of 3. RESULTS: The mean total lesion count (TLC) decreased from 24 before the treatment to 10 after 6 weeks after treatment, a reduction of 58.33%. The difference was statistically significant (P < 0.0001, 95% confidence interval [CI] of the difference = 8.58 - 19.42). The mean severity index (SI) decreased from 2.05 before treatment to 1.25 after 6 weeks treatment, a decrease of 39.02%. The difference was statistically significant (P < 0.0001, confidence interval [CI] of the difference = 0.54-1.26). CONCLUSION: Topical 2% green tea lotion is an effective, cost-effective treatment for mild-to-moderate acne vulgaris.

Transforming growth factor-ß1 gene polymorphism in psoriasis vulgaris.

BACKGROUND: Increased transforming growth factor beta 1 (TGF-ß1) in the epidermis and serum has been found in psoriatic patients. The mechanism for this increase remains unclear. OBJECTIVE: To study the TGF-ß1 gene polymorphism at codon 10 and its relation to psoriasis susceptibility in a sample of Egyptian patients. MATERIALS AND METHODS: This cross-sectional study involved 70 patients with psoriasis vulgaris and 100 age- and sex- comparable healthy volunteers as a control group. Genomic DNA was prepared from peripheral blood lymphocytes from all subjects using QIAamp DNA mini kit (QIAGEN Inc., Germany). The TGF-ß1 polymorphism was genotyped by PCR-based restricted fragment length polymorphism (PCR-RFLP) analysis. Amplification of codon 10, located in exon 1 of TGFß1 gene was done through PCR reaction using gene-specific primers. RESULTS: Statistically significant difference was found between psoriasis patient and controls as regards TGF-ß1 (T869C) polymorphism (P=0.045). The presence of TT genotype was associated with a 3-fold risk of psoriasis compared to CC genotype (P=0.016, OR: 3.13 95% CI: 1.24-7.88). T allele was significantly more frequent in psoriasis patients (P=0.017). TGF-ß1 gene mutation was significantly higher among psoriasis patients with positive family history (P=0.007). CONCLUSION: TGF-ß1 gene polymorphism at codon 10 (T869C) is significantly associated with susceptibility to psoriasis in Egyptian patients. This polymorphism is more common in patients with a positive family history of psoriasis.

The Evaluation of the Impact of Age, Skin Tags, Metabolic Syndrome, Body Mass Index, and Smoking on Homocysteine, Endothelin-1, High-sensitive C-reactive Protein, and on the Heart.

BACKGROUND: Skin tags (STs) are small, pedunculated skin-colored or brown papules that occur around any site where skin folds occur. The literature is short of comprehensive and controlled clinical studies aimed to evaluate the atherogenic risk factors in patients with STs. AIM OF WORK: The aim of this study is to evaluate the impact of age, STs, metabolic syndrome (METs), body mass index (BMI), and smoking on homocysteine (Hcy), endothelin-1 (ET-1), high-sensitive C-reactive protein (Hs-CRP), and on cardiovascular diseases. MATERIALS AND METHODS: This study included 30 cardiac patients with STs, 30 non-cardiac patients with STs, and 30 healthy controls with neither heart disease nor STs. History of smoking, measurement of height, weight, BMI, waist circumference (WC), blood pressure, STs number, color, acanthosis nigricans, estimation of serum level of fasting glucose, triglycerides (TGs), cholesterol, high-dense lipoproteins (HDL), Hcy, ET-1, Hs-CRP, and the presence of the METs were elicited in the three groups. RESULTS: Regarding the Hcy, ET-1, and Hs-CRP, the cardiac-STs group showed the highest levels and the control group showed the least (P < 0.001). The percents of patients with METs were 56.7% in the cardiac-STs, 40% in the non-cardiac-STs, and 0% in the control group (P < 0.001). Mean BMI exceeded the limit of obesity in the cardiac-STs group (30.9 ± 3.9) and the non-cardiac-STs group (32.6 ± 6) and was normal in the control group (24.7 ± 2.8). Hyperpigmented STs were present in 66.7% of the cardiac-STs group. Multivariate regression analysis for the independent effectors on Hcy level were the presence of STs (P < 0.001), METs (P = 0.001), and BMI (P = 0.024). Regarding ET-1, the effectors were the presence of STs and METs (P = 0.032). For Hs-CRP, effectors were the presence of STs (P < 0.001) and smoking (P = 0.040). Multivariate logistic regression of the predictors of cardiac disease showed that the independent predictors of the occurrence of cardiac disease were BMI (P < 0.001), STs (P = 0.002), and METs (P = 0.037). CONCLUSION: STs may act as a physical sign of underlying raised cardiac atherogenic factors. This may indicates an ongoing risk on coronary circulation which may indicate further corrective action, hopefully early enough. The association of ST with obesity and METs represents a Bermuda Triangle that act against the heart.

Epidemiologic study of dermatologic disorders among children in South Sinai, Egypt.

BACKGROUND: Few epidemiologic surveys have been carried out to determine the prevalence of skin diseases in the population of Egypt, particularly in the Sinai Peninsula. Thus, the necessity of such research in South Sinai is pressing. This study aimed to determine the prevalence of various skin diseases among children in South Sinai. METHODS: A community-based protocol was followed. The study included 2194 children of both genders, 18 years of age and younger, and in six different localities within South Sinai. Data were collected by taking a full history and by systemic and dermatologic clinical examination that included the site, severity, distribution, and extent of skin lesions if present. Subjects were surveyed at general morbidity consultations and campaign field visits. The study was conducted from August 2008 to August 2009. Data were tabulated and analyzed statistically using Pearson's chi-squared test. Differences were considered significant at a P-value of < 0.05. RESULTS: Findings revealed that 71.4% of the studied population had one or more skin diseases. The highest rate of prevalence applied to parasitic skin infestations (pediculosis capitis, 37.6%). Eczema or dermatitis were found in 25.8% of participants. Pityriasis alba occurred at a rate of 18.3% and seborrheic dermatitis at a rate of 6.7%. Xerosis was found in 11.8% of subjects, viral warts in 4.1%, photosensitivity in 4.1%, acne vulgaris in 2.6%, and fungal skin infections in 1.0%. Other skin diseases diagnosed in low numbers in the study children included impetigo, freckles, and scabies. Prevalences of vitiligo and psoriasis were very low (0.18% and 0.05%, respectively). CONCLUSIONS: Infective parasitic diseases are a major health problem, particularly among younger children and in subjects of low socioeconomic status.