Intralesional methotrexate in the treatment of localized vitiligo: A pilot study.

BACKGROUND/OBJECTIVES: Vitiligo is an immune-mediated skin disorder that targets epidermal melanocytes leading to the appearance of depigmented skin patches. Different treatment modalities have been reported with varied efficacy. We tried to evaluate the safety and efficacy of intralesional methotrexate in treating localized areas of vitiligo. METHODS: Thirty participants with localized patches of vitiligo were recruited. They were treated with intralesional injections of methotrexate every 2 weeks for a maximum of six sessions. At the end of the study, the degree of repigmentation was categorized into: excellent improvement (>75% repigmentation), good improvement (50%-75% repigmentation), fair improvement (25%-50% repigmentation) and poor improvement (<25% repigmentation). RESULTS: We included 7 males (23.3%) and 23 females (76.7%). Their mean age was 33.6 ± 8.6 years. The duration of the disease ranged from 1 to 22 years. Four patients had a family history of vitiligo. At the end of the study, there was a highly statistically significant improvement (p < 0.001) after treatment regarding repigmentation. CONCLUSIONS: This study showed that intralesional methotrexate is a safe and effective treatment option for patients with localized vitiligo lesions. Further studies on a larger scale are needed to evaluate the long-term effects of treatment and detect the ideal dose to be injected.

Efficacy of intralesional methotrexate in the treatment of plantar warts.

Warts are tumors or growths caused by infection with human papilloma virus (HPV). Currently, over 170 HPV types have been identified. This study aimed to evaluate the efficacy and safety of intralesional injection of methotrexate (MTX) for the treatment of plantar warts. Sixty patients presented with plantar warts were divided into two groups. Group A patients were injected with intralesional MTX (2 mg/ml). Group B patients were injected with intralesional saline as a placebo. The injections were repeated every week for a maximum of six sessions or until complete clearance, whichever was earlier. The patients were followed up for 6 months after the last injection. In the intralesional MTX group, 2 patients (6.7%) showed complete improvement, 8 patients (26.7%) showed partial improvement, and 20 patients (66.7%) showed no improvement. In the intralesional saline group, 3 patients (10%) showed complete improvement, 4 patients (13.3%) showed partial improvement, and 23 patients (76.7%) showed no improvement. Reported adverse events were local reactions in the form of swelling, pain, and infection in both groups. There was no statistically significant difference between the therapeutic responses to intralesional MTX injection and saline.

A prospective multicenter study on cutaneous reactions reported after Sinopharm COVID-19 vaccination.

BACKGROUND: The new coronavirus COVID-19 pandemic has had an unprecedented impact on global health and economic growth. A widely used vaccine is the weakened inactivated severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) virus (Sinopharm). Following major SARS-CoV-2 vaccination campaigns, cutaneous symptoms are on the rise. METHODS: This study is a prospective observational study evaluating cutaneous reactions and time of recovery after Sinopharm vaccination. The cases involved were over the age of 18. The data were anonymized. On the registry's vaccine section, we tracked vaccination dates, skin reactions, and recovery times. All respondents who reported only a cutaneous reaction to the first vaccination dose received a follow-up contact asking about a second vaccination dose cutaneous reaction. RESULTS: The study included 4560 cases. The mean age of all studied cases was 41.2 ± 6.1 years. There were dermatologic complications in 1190 patients (26.1%). There was induration at the injection site in 495 patients (10.9%), urticaria in 210 patients (4.6%), morbilliform eruption in 375 patients (8.2%), flare of skin site in 105 patients (2.3%), and angioedema in 105 patients (2.3%). The mean recovery days in all studied patients were 2.92 ± 0.94 days with a minimum recovery period of 2 days and a maximum of 7 days. CONCLUSIONS: Because Sinopharm's cutaneous reactions are frequently mild and self-limiting, vaccination should not be discouraged based on these findings. If the first vaccine dose creates a cutaneous reaction, there is no need to skip the second dose.

Intralesional Pentoxifylline Injection Versus Triamcinolone Acetonide in Treating localized Alopecia Areata: A Comparative Study.

Objective: Alopecia areata (AA) is a common form of potentially reversible non-scarring hair disorder characterized by limited patchy hair loss (alopecia areata), loss of all scalp hair (alopecia totalis), or all body hair (alopecia universalis). Several lines of treatment have been used with variable outcomes. We aimed to compare the efficacy of intralesional pentoxifylline (PTX) and triamcinolone acetonide (TRA) injection in the treatment of alopecia areata. Methods: Our study included 60 patients with localized AA recruited from the Dermatology Outpatient Clinics of Al-Azhar University Hospitals. Patients were divided into two groups of alopecia areata patches; Group A who received intralesional TRA injections while Group B received intralesional PTX. Results: The study showed that both modalities are effective in treating AA and each modality has its own advantages. According to the response, patients were grouped into three categories: partial response (0-33% terminal hair regrowth), moderate response (33-66% terminal hair regrowth), and high response (66-100% terminal hair regrowth). The high response after use of the PTX was found in 50 percent of patients. The high response was observed in 46.6 percent of patients treated with TRA. Limitations: Small sample size and short follow-up period. Conclusion: This study showed that intralesional injection of PTX seems to be effective and safe treatment for localized AA and could be used as a good alternative to triamcinolone acetonide.