Dermabrasion Versus Microneedling in Transplantation of Autologous Noncultured Melanocyte-Keratinocyte Cell Suspension in Patients With Vitiligo.

BACKGROUND: Autologous noncultured melanocyte-keratinocyte transplantation is one of the procedures used to treat stable vitiligo with varying reported results. Recipient site preparation is one of the variables that could affect repigmentation outcomes. OBJECTIVE: To assess the effectiveness of transplanting autologous melanocyte-keratinocyte suspension in patients with stable vitiligo and to compare recipient site preparation using dermabrasion versus microneedling. METHODS: From March 2020 to September 2022, this randomized comparative study included 40 patients with 40 stable vitiligo lesions managed by suspension transplants of melanocytes. Patients were divided into 2 groups: group A, where the recipient site was prepared using dermabrasion, and group B, which was done by microneedling. The assessment was performed 3 months after the treatment based on the degree of repigmentation (excellent, ≥90%; good, 50%-89%; fair, 20%-49%; and poor response, <20%). RESULTS: Both modalities resulted in effective repigmentation, but the dermabrasion group showed a statistically significant improvement and a satisfactory repigmentation rate. CONCLUSION: Autologous melanocyte transplantation is a safe and effective treatment method for stable vitiligo lesions that have not responded to other therapies. When compared with microneedling, dermabrasion produced better outcomes for recipient site preparation.

Dermoscopy of subclinical nail involvement in patients with diabetes mellitus: a case-control study.

BACKGROUND: Diabetes mellitus (DM) is a chronic disease characterized by elevated blood glucose levels that can lead to serious complications. Nails are a mirror for general health so changes in nails can be an indicator of disease progression in patients with DM. AIM: To detect subclinical nail changes in patients with DM using dermoscopy. METHODS: In total, 100 participants were recruited, all of them from outpatient clinics, made up of a group with DM (n = 50) and an age- and sex-matched control group without DM (n = 50). All patients had clinically apparently normal nails. In both groups, dermoscopic examinations were conducted and compared. RESULTS: It was found that 33 patients in the DM group (66%) had dermoscopic nail findings in the form of microhaemorrhage (26%), longitudinal striations (24%), distal subungual onychomycosis (24%), superficial pitting (20%), distal onycholysis (18%), splinter haemorrhage (14%), subungual hyperkeratosis (12%), dilated vessels (10%) and distal yellowish discoloration (8%). CONCLUSION: Nail examination can be accomplished with the help of dermoscopy to detect subclinical nail changes in patients diagnosed with DM and, therefore, can give us an idea about disease progression and help with control of DM and treatment plans.

Ocular changes of non-segmental vitiligo: A case-control study.

BACKGROUND/OBJECTIVES: Vitiligo is a skin disorder in which the melanocytes are destroyed. Melanocytes can be destroyed anywhere in the body, compromising the function of the organs where they are found. Melanocytes in the epidermis and the uveal tract share a common embryological origin in addition to physiological and morphological similarities. Our aim was to detect ocular changes in non-segmental vitiligo patients. METHODS: This study included 40 non-segmental vitiligo patients and 40 healthy volunteers as a control. Visual acuity testing, slit lamp examination and optical coherence tomography were performed on all patients as well as controls. RESULTS: Patients with non-segmental vitiligo had a considerably greater incidence of ocular alterations than controls, although there was no significant difference in visual acuity. CONCLUSIONS: Vitiligo is a systemic condition that can affect the activity of melanocytes in organs besides the skin. The depigmentation process can influence ocular melanocytes. Ocular problems may be closely connected to vitiligo. Because ocular melanocytes aren't involved in the detection or transmission of visual pathway, there is no vision impairment.

The effect of alpha lipoic acid supplementation on sperm functions in idiopathic asthenozoospermic patients: a case-controlled study.

Alpha-lipoic acid (ALA) is a natural short chain fatty acid containing sulfhydryl groups generated from octanoic acid and cysteine in the mitochondria, and is found in both the aqueous and lipid phases. The present study aimed to assess the efficacy of ALA supplementation in primary infertile males complaining of idiopathic asthenozoospermia. Eighty patients were randomly allocated to treatment group A (n = 40) and control group B (n = 40) groups, receiving daily doses of 600 mg (divided into two daily doses of 300 mg each) of alpha lipoic acid (ALA) or an identical placebo for 90 days. Semen analysis, anthropometric and total antioxidant capacity were analysed and compared before and after treatment. Daily supplementation with ALA improved total motility and progressive motility of the spermatozoa. In the ALA-treated group, sperm motility and progressive motility increased significantly, similarly, the mean percentage of sperm vitality demonstrated a significant increase among the ALA treated group (p < 0.001). Analysis revealed a statistically significant increase in semen volume and sperm concentration in the ALA supplemented group, while abnormal morphology decreased significantly (p < 0.001). ALA supplementation significantly improved sperm parameters and functional tests in group A patients. ALA supplementation in patients with idiopathic asthenozoospermic thus enhanced sperm quality and viability, which could therefore be considered as an adjunct therapy pending further verification of its association and mechanisms involved.

Diagnostic and therapeutic implications of vitamin D deficiency in patients with warts: A case-controlled study.

BACKGROUND: Cutaneous warts are frequent conditions that possess much challenge to treat. OBJECTIVE: To verify the potential role of vitamin D in the pathogenesis of viral warts by measuring the serum levels of vitamin D in patients diagnosed with viral warts compared to healthy controls and to verify whether oral vitamin D supplementation of those vitamin D-deficient patients would result in wart clearance. METHODS: To evaluate the serum vitamin D levels, the study recruited 80 subjects, including 40 patients diagnosed with viral warts and 40 age- and sex-matched healthy controls. All patients were subjected to detailed history taking and examination to detect duration and type of warts. Serum vitamin D levels were measured using ELISA. RESULTS: Thirty-five percent of patients had sufficient vitamin D levels (54-90 nmol/L), and 40% of patients had insufficient levels (50-80 nmol/L), while 25% of them had deficient levels (<50 nmol/L). In healthy group, 30% had sufficient levels, and 45% had insufficient levels, while 25% had deficient levels. There was an insignificantly lower serum level of vitamin D as well as an insignificantly deficient vitamin D status among patients compared to healthy controls. CONCLUSION: Vitamin D serum levels appear to be lower among viral wart patients, and oral supplementation studies need to be more intensely investigated before elucidating its role; if any, in wart clearance.

Prevalence and predictors of colon polyps in patients with skin tags: A cross sectional study.

BACKGROUND: Acrochordons (fibroepithelial polyps, skin tags, papillomas) are common benign neoplasms of the skin. AIM: To identify the prevalence of colonic polyps among patients presenting with skin tags and to determine a useful criteria for screening with colonoscopy. METHODS: Two hundred patients who fulfilled the selection criteria underwent physical, biochemical evaluation (fasting blood sugar (FBS), body mass index (BMI) calculation, occult blood in stool), and histopathological examination of the skin tags. Colonoscopy was performed in patients with positive blood in stool, and any polyps identified were resected or biopsied. RESULTS: Occult blood in stool was insignificantly detected in 12 (6%) of the 200 subjects (p < 0.001), and they were referred for colonoscopy. A prevalence rate of 3.5% was reported, and of twelve colonoscopies performed, three patients were polyp-free, two were diagnosed with ulcerative colitis (UC), and seven patients were diagnosed with polyps that were removed and/or biopsied (p = 0.421). Of the seven polyps, three were hemorrhoidal polyps and the four other polyps were adenomatous polyps (villous adenoma). CONCLUSION: The mere presence of skin tags does not significantly correlate with existence of colonic polyps and does not justify screening colonoscopy unless other metabolic, GIT, and biochemical markers are identified.

Implication of COVID-19 on the mental health of Egyptian dermatologists: A cross-sectional study.

BACKGROUND: Major epidemic outbreaks create an increased demand for healthcare workers (HCWs) and pose increased health risk and psychological distress to them as well. AIM: The aim of this cross sectional study was to find out the prevalence of depression, anxiety and stress among Egyptian dermatologists and their possible predictor factors. PATIENTS/METHODS: A cross sectional study was designed and data were collected using structured self-administered online depression, anxiety, and stress scale (DASS-21). RESULTS: The depression scale of DASS was 18.98 ± 9.56 among which 38% of dermatologists had either severe or extremely severe depression and 34.2% complained of moderate depression. Meanwhile, the anxiety scale was 12.92 ± 7.75 and 35.4 % of surveyed dermatologists had either severe or extremely severe anxiety. Thirty three percent of dermatologists were normal on stress score. Female dermatologists possessed more significant depression and stress than males (19.70 ± 9.71 vs. 16.62 ± 8.68, p = 0.003; 21.42 ± 9.53 vs. 17.40 ± 8.49, p <0.001 respectively). On the contrary, male dermatologists expressed more anxiety than female dermatologists however this was not statistically significant (13.26 ± 7.99 vs. 12.82 ± 7.69, p = 0.625). CONCLUSION: To our knowledge, this is the first study to explore the differential impacts of the COVID-19 pandemic on Egyptian dermatologists. Mental health care and support are of extreme importance to physicians mid this pandemic.

Assessment of enthesopathy in patients with acne vulgaris: A case-controlled trial.

AIM: This case-controlled study aimed at evaluating whether enthesitis is possibly associated with acne vulgaris. METHODS: This study was carried out on 90 patients with acne vulgaris and 30 normal individuals who were subjected to full history talking, acne scoring system, general, dermatological, musculoskeletal examination, and musculoskeletal ultrasonography with Doppler flow. RESULTS: A significant relation (P < 0.05) was discovered between left femoral condyle tenderness, which increased left femoral condyle hypoechogenicity on ultrasound. Moreover, a highly significant relation (P < 0.001) was established between tenderness on clinical examination and hypoechogenicity on ultrasound at three sites (right humerus epicondyle, right femoral condyle, and left humerus epicondyle). An association between tenderness and ultrasound increased thickness was significantly reported in the left femoral condyle (P < 0.05). Hypoechogenicity on ultrasound examination was more statistically evident with increased acne severity at the left Achilles tendon (LA), while enthesis calcifications (enthesophytes) were significantly associated with increased acne severity in the left humerus epicondyle (LA) and the right Achilles tendon (RA) (P < 0.05). CONCLUSION: There is a solid possibility acne is a systemic disease triggering other co-morbidities beyond skin which needs to be fully elucidated by further research evidence.

Pumpkin seed oil vs. minoxidil 5% topical foam for the treatment of female pattern hair loss: A randomized comparative trial.

BACKGROUND: Pumpkin (Cucurbita pepo L.) is an annual climber plant, and its seeds have considerable amount of oil with nutritional and medicinal importance. AIM: The present study aimed to investigate the clinical efficacy of pumpkin seed oil (PSO) in the treatment of female pattern hair loss (FPHL) and compare its effects with minoxidil 5% foam. METHODS: Patients with FPHL were randomly assigned to pumpkin seed oil (n = 30; group A) or minoxidil 5% foam (n = 30; group B) for a period of 3 months. Patients were evaluated clinically and dermoscopically at baseline, at one and half months, and at the end of the 3-month study. RESULTS: Among group A (pumpkin seed oil) candidates, a significant decrease was observed in hair shaft diversity before and after treatment (30.5 ± 6.2%, 24.0 ± 4.02, P < .001, respectively) as well as in the vellus hairs (22.5 ± 4.9, 15.8 ± 2.2, P < .001, respectively). Upright regrowing hairs significantly increased from (0.13 ± 0.5) before treatment to (0.9 ± 1.0) after treatment (P < .001). In group B (minoxidil applying) candidates, a significant decrease was observed in hair shaft diversity before and after treatment (31.5 ± 6.3%, 21.3 ± 2.2, P < .001, respectively) as well as in the vellus hairs (24.7 ± 6.4, 19.5 ± 5.4, P = .02, respectively). Conclusion Findings of the present trial provide evidence of a promising potential role of PSO in treating FPHL.

Psychodermatology knowledge and awareness: A cross-sectional Egyptian perspective.

The merging of psychiatry and dermatology has resulted in a relatively newer emerging field known as psychodermatology (PD). The aim of this cross sectional study was to assess knowledge, attitudes, and practice patterns of Egyptian dermatologists towards psychodermatology. A cross sectional study was designed and data were collected using structured self-administered online questionnaires. A total of 212 dermatologists completed the full questionnaire. Those with incomplete or partially answered responses were excluded. 171 (81.1%) were females and 40 (18.9%) were males. The majority (n = 109;51.4%) of dermatologists completing the survey were between 30 and 40 years age group while those between 40 and 50 years of age accounted for 48 (22.6%). The vast majority of respondent dermatologists never referred (n = 87; 41%) or very rarely referred (n = 58; 27.5%) any psychocutaneous patients to a psychiatrist. Almost 75% of responding dermatologists were not aware of available community or educational resources for PD and 157 (74.1%) expressed interest in receiving continuing medical education (CME) programs. In conclusion, psychodermatology training among dermatologists shall enhance and improve their approach to psychocutaneous conditions.