The role of autologous micrografts injection from the scalp tissue in the treatment of COVID-19 associated telogen effluvium: Clinical and trichoscopic evaluation.

The clinical presentation of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2 COVID-19) varies from asymptomatic infection to a life-threatening, multiorgan disease. One of these manifestations is telogen effluvium (TE) which is characterized by diffuse hair loss occurring in patients previously infected with SARS-CoV-2 and lasts ~3 months, after which excessive hair loss follows. Hair follicles are known to contain a well-characterized niche for adult stem cells which is the bulge containing epithelial and melanocytic stem cells. Stem cells in the hair bulge, a demarcated structure within the lower permanent portion of hair follicles, can generate the interfollicular epidermis, hair follicle structures, and sebaceous glands. This study aims to evaluate autologous micrografts from scalp tissues as a therapeutic modality in the management of TE caused by COVID-19. Twenty patients of previous COVID-19 infection suffered from TE were included in this study for human follicle stem cells micrograft scalp treatment and they were evaluated after 3 months of treatment and after 6 months. There was significant improvement of the hair thickness and density compared with the start of the treatment and 6 months of follow-up. Autologous micrograft of the scalp showed marked improvement in the treatment of COVID-19 TE.

Split-face comparative study between intradermal tranexamic acid injection alone versus intradermal tranexamic acid injection combined with Q-switched Nd:YAG laser in melasma treatment: dermoscopic and clinical evaluation.

Melasma is a chronic, dark brown-pigmented patches and macules commonly on the face. Many treatment modalities for melasma have been used as hydroquinone, laser treatment, and recently tranexamic acid. Dermoscopy is used to diagnose and follow up the treatment of melasma and to detect underlying invisible vessels and their change with treatment. Melasma treatment evaluation by using combined Q-switched Nd:YAG laser with intradermal tranexamic acid injection versus tranexamic acid intradermal injection alone. This study was conducted on 40 female patients aged 35-45 years. It was a split-face study; for 12 weeks, the right side of the face was treated with low fluence Q-switched Nd:YAG laser combined with intradermal injection of tranexamic acid, while the left side was treated with an injection of tranexamic acid intradermal alone. The patients were clinically evaluated by using the modified melasma area and severity index (mMASI) score, and underwent dermoscopic evaluation before treatment, at the end of the treatment (12 weeks), and at (24 weeks) as follow-up. The efficacy, adverse effects, and recurrence after treatment were reported. There was a statistically significant decrease in mMASI score with combination treatment than with intradermal injection of tranexamic acid alone after treatment at 12 weeks and at the end of follow-up at 24 weeks. Combination of an injection of tranexamic acid intradermal and low fluence Q-switched Nd:YAG laser is an effective and safe treatment for melasma with minimal side effects more than the intradermal tranexamic acid injection alone.

The clinical and electron microscopic evaluation of the impact of pulsed dye laser techniques on solar lentigines (randomized clinical trial).

BACKGROUND: Solar lentigines are skin lesions manifested by benign dark pigmentation causing a cosmetic problem in many patients. Several treatment modalities used for the management of solar lentigines. Side effects and rates of recurrence may be associated with them. OBJECTIVE: Treating solar lentigines with two different techniques of pulsed dye laser (PDL) and evaluation of the results both clinically and via the examination of ultrastructural changes by electron microscopy. PATIENTS AND METHODS: This study was conducted on 22 subjects with solar lentigines and having Fitzpatrick III-IV skin types, was managed by the use of PDL after enrolling them into two groups. Group I (one stacked PDL was used) and Group II (treated by stacked PDL in two sessions, 1 month apart). At baseline and 6 months after treatment, two punch biopsies with a diameter of 2 mm were taken from all patients. All taken biopsies were prepared for light and electron microscopic examinations. RESULTS: Both PDL techniques induced significant better clinical and histological outcomes. No one demonstrated any postoperative complications such as post-inflammatory hyperpigmentation and scarring. CONCLUSIONS: The two techniques of PDL are efficient for solar lentigines treatment.

Efficacy and Safety of tranexamic acid versus vitamin c after microneedling in treatment of melasma: Clinical and Dermoscopic study.

BACKGROUND: Melasma is a common acquired symmetrically distributed hyperpigmented macules of sun-exposed skin. Skin microneedling acts as a transdermal delivery system that facilitates the penetration of lightening agents to deeper layers of skin. OBJECTIVE: Clinical and dermoscopic evaluation of the efficacy and safety of topical tranexamic acid versus topical vitamin C after microneedling for melasma treatment. PATIENTS AND METHODS: Twenty patients with facial melasma were enrolled in a split-face prospective, randomized uncontrolled study. The right side of the face was treated with topical tranexamic acid after dermapen microneedling, while the left side of the face was treated with topical vitamin C after dermapen microneedling. Sessions were done every 2 weeks for 6 sessions. The Hemi-MASI score and dermoscopic examination before and after treatment were done. RESULTS: Hemi-MASI score was reduced after treatment on both sides of the face, besides improvement of the pigmented lesions showed by dermoscopy on both sides and improvement of the vascular component on the tranexamic acid treated side. CONCLUSION: Topical tranexamic acid or vitamin C application after dermapen microneedling was an effective and safe technique in melasma treatment with minimal side effects, and vascular component improvement by tranexamic acid.

Evaluation of the effect of pulsed dye laser on chronic psoriatic plaque.

BACKGROUND: Psoriasis is one of the most prevalent immune mediated skin diseases. Selective vascular destruction by pulsed dye laser is considered one of effective laser treatments. OBJECTIVE: Evaluation of the therapeutic effect of pulsed dye laser in treatment of chronic psoriatic plaque lesions and changes in human beta defensin-2(HBD-2) expression in the psoriatic patients before and after treatment, with correlation to the clinical improvement. METHODS: Twenty patients with psoriatic plaque on right side treated by laser and another plaque on left side similar in size and its severity score served as control receiving no treatment. Each patient received 3-4 sessions of pulsed dye laser 595 nm. Follow up was done for three months. RESULTS: There was statistically significant difference between the two psoriatic plaques (untreated and treated; A and B; p = .004). There was significant decrease in HBD-2 expression after treatment. No recurrence was observed during follow up period. CONCLUSION: The pulsed dye laser is safe, effective, and tolerable treatment for resistant stable localized plaque psoriasis with minimal side effects and prolonged recurrence period.