Study of autologous platelet-rich-plasma versus its combination with intense pulsed light in treatment of melasma.

Melasma is a common acquired hypermelanosis of variably successful therapies with frequent relapse. Platelet-rich-plasma (PRP) is a promising treatment in melasma, alone or combined with other treatments. We evaluated efficacy of autologous PRP in melasma treatment and the effect of combined intense pulsed light (IPL). Study included 20 Egyptian female melasma patients. PRP was injected in all melasma area and IPL was used on the right hemi-face. Melasma Area and Scoring Index (MASI) of melasma area, modified-MASI (mMASI) of PRP-IPL side and of PRP side significantly decreased after treatments (p-value < 0.05). There was no statistically significant difference between both sides regarding mMASI score or patient and physician satisfaction (p-value > 0.05). Our study provides the first comparison between PRP versus its combination with IPL in melasma treatment. We think the improvement of melasma with regression of melasma scores after PRP treatment is an important finding.

Cutaneous manifestations in Egyptian children with beta-thalassemia major: Relationship with serum ferritin, thyroid profile, and treatment modalities.

BACKGROUND: Cutaneous manifestations can be found in many patients with hematologic disorders, including thalassemia. METHODS: Patients with beta-thalassemia major attending the pediatric department of Fayoum University Hospital from April 2016 to October 2016 (n = 100) were compared with controls (n = 100). Both groups underwent detailed history evaluation, clinical examination, and laboratory investigations, including complete blood count, liver and kidney function, serum ferritin, and thyroid profile. A single dermatologist conducted a clinical dermatologic examination for all participants. RESULTS: Children with thalassemia had a greater prevalence of xerosis (72%), pruritus (52%), idiopathic guttate hypomelanosis (22%), urticaria (16%), ephelides (freckles; 13%), and scars (13%) than controls (P ≤ .001). We detected a significant relationship between serum ferritin and pruritus, xerosis, ephelides, idiopathic guttate hypomelanosis, urticaria, and age of patients with thalassemia (P < .05). Children without thyroid abnormalities were more likely to have xerosis, pruritus, idiopathic guttate hypomelanosis, urticaria, and ephelides (86%) than controls (P < .05). Although there was no significant difference in skin findings between patients who did and did not receive chelating agents (P > .05), a significant association was found between xerosis and the use of deferoxamine and deferiprone, whereas ephelides and urticaria were more common in patients receiving deferasirox. CONCLUSION: Because cutaneous manifestations are common in Egyptian patients with beta thalassemia major, regular dermatologic follow-up is recommended for early management.