Recent modalities in treatment of telogen effluvium: Comparative study.

Telogen effluvium is one of the most common forms of diffuse, non-scarring hair loss for which patients present for clinical evaluation. It is usually a reactive and reversible disorder. Identifying and correcting the underlying cause is the most important component in management, yet there is always a need for therapeutic options. This study aims to evaluate the efficacy of single session botulinum toxin A injection versus multiple sessions of multivitamins mesotherapy in the treatment of telogen effluvium. A randomized clinical trial was conducted in the Dermatology, Venereology, and Andrology Department, Faculty of Medicine, Zagazig University Hospitals. Twenty-four patients with telogen effluvium were randomly divided into two groups each group included 12 patients. Group I received a single session of Botulinum toxin A injection and group II received multiple sessions of multivitamins mesotherapy injection. Both botulinum toxin A and multivitamins mesotherapy are effective in the treatment of telogen effluvium, which was reflected on the improvement of hair parameters as terminal hair and multiple follicular units. Both treatment modalities had minimal and well-tolerated side effects. Although both therapies have equivalent success rates, single session of botulinum toxin A is a better choice than multiple mesotherapy sessions.

Efficacy of botulinum toxin A injection in the treatment of androgenic alopecia: A Comparative Controlled Study.

INTRODUCTION: Scalp injection with mesotherapy (LC cell hair essence) helps in anchoring hair follicles and might have good therapeutic efficacy and lower side effects than Botox in the treatment of androgenetic alopecia (AGA). OBJECTIVE: To assess the trichoscopy and the clinical therapeutic response of LC hair essence serum injection vs. botulinum toxin (A) injection in the treatment of androgenetic alopecia. PATIENTS AND METHODS: Sixty-two AGA patients were included in the present study. Group I consisted of 31 patients who were injected with 1 ml of LC hair essence serum diluted with 0.5 ml of 0.9% normal saline once weekly for 8 weeks, and Group II involved 31 patients who were injected with 50 units of botulinum toxin A. Trichoscopic examination and photo documentation were done for every case before starting treatment (baseline) and after treatment with monthly follow-up to the patients. RESULTS: There was a significant difference between baseline trichoscopy findings and at the end of sixth month in Botox group, and the difference was highly significant in LC group; there was a statistically significant increase in the frequency of side effects (irritation and headache) among Group II compared with that of Group I. CONCLUSION: Botox can induce significant results in the treatment of AGA with mild and tolerable side effects but with high cost, while LC hair serum exhibit excellent results with fewer side effects.

Efficacy of 1064 Q switched Nd:YAG laser in the treatment of oral lichen planus.

Background: The erosive-atrophic form of oral lichen planus (OLP) is usually presented with severe pain and burning sensation that is usually refractory to traditional treatment. Topical corticosteroid is considered the first line despite their adverse effects. Therefore, new therapeutic approaches are required.Aim: This study aimed to examine the effectiveness of Nd:YAG laser in the treatment of long-standing erosive-atrophic OLP.Patients and methods: Twenty-four patients diagnosed with OLP were included in this study. A total of 59 lesions was assessed as regards to the degree of pain by visual analog scale and clinical scores by Thongprasom sign scoring system before and after treatment. All patients were treated by Nd:YAG laser therapy with (1064 nm 0.5 W, 30 s, 1.2 J/cm2) three times weekly and for 1 month. Treatment efficacy index was determined after the end of therapy.Results: A significant pain reduction was detected after Nd:YAG laser treatment (p < .0001). In addition to that, complete resolution was achieved in about 37.3% of the lesions and improvement in clinical signs was found in 59.3% of the lesions. By the end of therapy, about 30.5% showed score 1 while 11.9% of them were scored 3. Also, 8.5% of the lesion was scored 2, 6.8% were scored 4 and 5.1% were scored 5. Actually, all of the participating patients showed some degree of improvement and most of them achieved moderate recovery.Conclusion: The results of this study can indicate that Nd:YAG laser is an effective modality that can be used safely in the management of erosive-atrophic OLP.

Evaluation of combined excimer laser and platelet-rich plasma for the treatment of nonsegmental vitiligo: A prospective comparative study.

BACKGROUND: Excimer laser therapy of vitiligo generally takes months to years to achieve excellent outcomes. Platelet-rich plasma is an autologous preparation with a focus on various growth factors that can help with vitiligo repigmentation. OBJECTIVES: To assess the additive effect of PRP in the therapy of vitiligo on the results of the excimer laser. PATIENTS AND METHODS: A comparative study included 52 patients (8 males and 44 females) in two groups with stable (no new lesion for 6 months), nonsegmental and symmetrical vitiligo. Group I (26 patients): The patient was treated by intradermal PRP injection and the excimer laser, while group II (26 patients) was treated with the excimer laser only. The PRP injection was repeated every 3 weeks for 4 months and excimer laser two times a week and for 16 weeks till complete response. VAS for patient's satisfaction assessment, safety assessment for complications, and follow-up for 3 months was done. Clinical (repigmentation response) and histopathological assessment was done. RESULTS: There was a higher statistically significant treatment response in group I compared with group II. In addition, a statistically significant correlation between the treatment response and the lesion site in group I (P < .000). A significant difference in VAS between both groups (P < .000). Few the side effects were reported. CONCLUSION: The combination of PRP and excimer laser phototherapy is an efficient vitiligo treatment as PRP increases the excimer laser impact and also improves the result.

Evaluation of Galectin3 levels in psoriatic patients treated by narrow-band UVB phototherapy.

Background: Psoriasis-specific proteins dysregulated in keratinocytes and involved in the pathophysiological process of psoriasis remains elusive.Objective: This study aimed to investigate the serum and tissue levels of Galectin3 in patients with psoriasis vulgaris before and after narrow-band ultraviolet B (NB-UVB) phototherapy.Methods: This study was designed as a cross-sectional case-control. This study included 30 patients with psoriasis Vulgaris and 20 healthy individuals. Psoriasis Area and Severity Index (PASI) score were used to evaluate the patients with psoriasis Vulgaris before and after treatment. All patients were treated two times per week for 3 months with NB-UVB phototherapy. Enzyme-linked immunosorbent assay (ELISA) was used to assess serum levels of galectin 3 of the healthy control subjects and psoriatic patients before and after treatment by NB-UVB phototherapy.Results: The serum level of galectin 3 was significantly lower in patients with psoriasis Vulgaris versus healthy control subjects (p value < .001). There was a significant increase in the serum levels of Galectin 3 and decrease in PASI scores after 3 months of treatment with NB-UVB phototherapy in patients with psoriasis Vulgaris (p value < .001).Conclusions: This study concluded that NB-UVB phototherapy for 3 months in patients with psoriasis Vulgaris was an essential method for decreasing PASI scores and an increase in the serum levels of galectin 3.

Treatment of striae distensae with needling therapy versus CO2 fractional laser.

BACKGROUND AND OBJECTIVES: Striae are atrophic dermal scars with overlying epidermal atrophy causing cosmetic concern. This study assesses and compares the efficacy and safety of needling therapy versus CO2 fractional laser in treatment of striae. METHODS: Twenty Egyptian female patients with striae in the abdomen and lower limbs were involved in the study. The patients were treated with needling therapy and CO2 laser every 1 month for 3 sessions. Follow-up by digital photography and skin biopsy was conducted at baseline and 6 months after treatment. Clinical improvement was assessed by comparing photographs and patient's satisfaction before and after treatment. RESULTS: Nine of 10 (90%) needle-treated patients showed improvement. Among them, 3 (30%) had good, 4 (40%) had fair, and 2 (20%) had poor improvements; however, 1 (10%) did not show any improvement after the treatment. In CO2-laser treated patients, 5 of 10 (50%) of the patients showed clinical improvement; 1 (10%) were good, 3 (30%) were fair, and 1 (10%) were poor; however, 5 (50%) did not show improvement. CONCLUSION: The results support the use of microneedle therapy over CO2 lasers for striae treatment.