Evaluation of IL-12 serum level in patients with recalcitrant multiple common warts, treated by intralesional tuberculin antigen.

BACKGROUND: No universal consensus about optimal modality for treating the recalcitrant multiple common warts (RMCW). OBJECTIVE: To evaluate the immunological mechanisms and clinical therapeutic effect of using of intralesional purified protein derivative (PPD) in the treatment of RMCW. METHODS: The study included 40 patients with RMCW. They were randomly assigned to 2 groups: first group (20 patients) received intralesional PPD antigen, and second group (20 patients) received intralesional saline as a control group. In both groups, injections were made into single lesions, or largest wart in case of multiple lesions, at weekly intervals, until complete clearance or for a maximum of six treatments. Blood serum was taken at pre-study and at week 6 to measure IL-12 level. RESULTS: A significant difference was found between the therapeutic responses of RMCW to PPD antigen and saline control group (p < 0.001). In the PPD group, complete response was achieved in 75% after 5.8 ± 0.7 sessions' patients presenting with RMCW. There was a statistically significant increase in IL-12 of PPD group versus saline group. No recurrence was observed in the PPD group. CONCLUSION: Intralesional immunotherapy by PPD antigen is an effective and a safe treatment for RMCW in previously immunized patients.

Expression of telomerase reverse transcriptase in psoriatic lesional skin.

BACKGROUND: Little information is known about telomerase expression in the chronic benign hyperproliferative skin disease, psoriasis. Further studies are still required to investigate its usefulness as a biomarker of this skin disorder. AIM: To investigate the expression of human telomerase reverse transcriptase (hTERT) in psoriatic lesional skin and its relation to disease severity. METHODS: The levels of hTERT-mRNA were quantified using real time RT-PCR in lesional versus nonlesional skin specimens from 24 psoriatic patients. RESULTS: The expression of hTERT was detected in 16 psoriatic lesional specimens (66.7%), but in none of the normal skin. There was no relation between hTERT expression level and age of the patient or the duration of the disease. Among hTERT-positive patients, a significant positive correlation was observed between hTERT-mRNA levels and both the Psoriasis Area-and-Severity Index (PASI) and scaling scores (p = 0.012 & p = 0.006, respectively). CONCLUSION: Telomerase mRNA is detectable in lesional skin of most psoriatic patients and correlates with the severity of the disease and the rate of epidermal proliferation.