Vitamin D Receptor Expression in Chronic Plaque Psoriasis Before and After Narrowband Ultraviolet B Phototherapy.

Background/Purpose: Psoriasis is a multifactorial disease. It is a combination of genetic, immunological, and environmental factors. Vitamin D receptor (VDR) is a nuclear receptor that regulates epidermal cell growth through the inhibition of proliferation and induction of keratinocytes terminal differentiation. Aim of the study was to investigate the effect of Narrow-band UVB (NB-UVB) therapy on VDR expression in the skin of psoriasis patients. Materials and Methods: Forty patients with different severities of psoriasis were assessed using the psoriasis area and severity index (PASI) score. Lesional and non-lesional skin biopsies were obtained from each patient before NB-UVB therapy, and then a third lesional biopsy was performed after completing 24 sessions of NB-UVB. Immunohistochemistry for VDR was performed on all specimens. Results: There was a significant decrease in VDR expression in psoriatic lesions compared to that in non-lesional skin before treatment. A statistically negative correlation was detected between the degree of VDR expression before treatment and PASI score, family history, and duration of psoriasis. There was a significant increase in VDR expression at the sites of psoriasis lesions post-NB-UVB therapy compared to pretreatment lesional skin. Conclusion: VDR expression was down-regulated in psoriatic lesions compared to non-lesional skin, and NB-UVB therapy improved VDR expression in psoriasis skin lesions.

Efficacy of platelet-poor plasma gel in combination with fractional CO2 laser in striae distensae: A clinical, histological, and immunohistochemical study.

BACKGROUND: Platelet-poor plasma gel is a semi-solid plasma formulation that recently recommended as autologous bio-filler for treatment of atrophic dermal scars. AIM: To compare the therapeutic efficacy and safety of intradermal injection of plasma gel in combination with fractional CO2 laser versus fractional CO2 laser alone in striae distensae (SD). PATIENTS AND METHODS: This study included 36 SD patients treated by three sessions (one session/1.5 months) of fractional CO2 laser on all SD lesions following intradermal injection of plasma gel on one side and saline (as placebo) on the other side. RESULTS: Significant clinical improvements associated with remarkable narrowing of SD lesions and prominent enhancement of skin texture were observed on both treatment sides. Obviously, higher degrees of clinical improvements of SD lesions were reported following combined therapy with fractional CO2 laser and plasma gel rather than fractional CO2 laser monotherapy. However, post-inflammatory hyperpigmentation (PIH) was reported more frequently with fractional CO2 laser monotherapy. Histopathological and immunohistochemical examinations revealed significant epidermal improvement, and homogenization, and orientation of dermal collagen bundles as a result of both therapeutic procedures. CONCLUSION: Plasma gel in combination with fractional CO2 laser could be considered a promising novel treatment modality for SD. Plasma gel not only improves the efficacy of fractional CO2 laser but also decreases the frequency of PIH.

Pulsed dye laser versus intense pulsed light in melasma: a split-face comparative study.

BACKGROUND: Recent reports suggest that melasma may have a vascular component. Vascular targeting lasers and light treatment can be a therapeutic option that will provide benefits to the patients. OBJECTIVES: To compare the efficacy and tolerability of pulsed dye laser (PDL) and intense pulsed light in treatment of melasma. PATIENTS AND METHODS: Twenty-eight Egyptian female patients with melasma were treated with PDL on the right hemiface (Group A) and with the intense pulsed light on the left hemiface (Group B). Clinical assessment was performed according to the hemifacial modified Melasma Area and Severity Index score (mMASI). Tissue biopsies were taken from patients for immunohistochemical staining with vascular endothelial growth factor (VEGF) antibody. RESULTS: The hemifacial mMASI score was significantly reduced after treatment in studied groups with no statistically significant difference. Intense pulsed light (IPL) group showed higher efficacy of treatment than PDL group in the epidermal melasma and in melasma lesions which had a vascular component. The expression level and intensity score of VEGF were significantly reduced after treatment in both groups. CONCLUSIONS: Both PDL and IPL were effective and safe treatment modalities for lightening of melasma. VEGF can be proved as a possible mechanism underlying the action of both PDL and IPL on melasma.

Immunohistochemical expression of AQP-3 in vitiligo: a new potential guide for disease activity.

BACKGROUND: Vitiligo is a depigmenting skin disorder, with disappearance of functioning epidermal melanocytes. Aquaporin-3 (AQP-3) is an aquaglyceroporin expressed in epidermal keratinocytes, where it shares in regulating their proliferation and differentiation, and so it might affect melanocytes indirectly. So far, little is known regarding its possible role in vitiligo. This work aimed to study the changes in immunohistochemical expression of AQP-3 protein in vitiligo to detect its possible role in disease pathogenesis. METHODS: Skin biopsies were taken from lesional skin of 30 vitiligo patients in addition to 20 normal controls. Epidermal immunohistochemical expression of AQP-3 was assessed as: +3 = strong expression, +2 = moderate, +1= weak and 0= negative expression. RESULTS: AQP-3 was significantly less expressed in vitiligo epidermis than control (P<0.001) with an inverse correlation with Vitiligo Index of Disease Activity (r =-0.505, P=0.004). CONCLUSIONS: Reduced epidermal AQP-3 may have a role in impaired melanocyte survival in vitiligo, and might be a potential negative biological marker for vitiligo activity. Larger trials should further elucidate the effect of changes in epidermal AQP-3 expression in development of vitiligo, and that might pave the road for discovering new therapeutic modalities for the disease.