Intralesional injection of tuberculin purified protein derivative (PPD) versus measles, mumps, and rubella (MMR) vaccine in treatment of molluscum contagiosum: a comparative study.

Molluscum contagiosum (MC) is a skin and mucous membrane infection caused by the molluscum virus (MCV). To evaluate safety and efficacy of intralesional injection of tuberculin purified protein derivative (PPD) antigen injection versus MMR (mumps, measles, rubella) antigen for the treatment of molluscum contagiosum (MC). A total of thirty clinically confirmed patients of molluscum were recruited for this trial. Patients who were divided into three groups (A, B and C). Each group consisted of (30) patients. Group (A) subjects received intralesional MMR injections, group (B) subjects received intralesional PPD injection and group (C) received intralesional saline injection. The results of the present study revealed complete clearance of the injected lesions in 12 patients (80%), partial response in 3 patients (20%) of group (A). In group (B), complete clearance of the treated warts was observed in 11 patients (73.3%) and partial response in 4 (26.7%) of patients. In group (C), the majority of patients 8 (53.3%) demonstrated no response while 7 (46.7%) patients showed only partial clearance. We established a good safety and efficacy profile for tuberculin PPD and MMR antigens in treatment of molluscum contagiosum.

Evaluation of sleep quality and pruritus severity in psoriatic patients and their impact on quality of life: a cross section correlational study.

Psoriasis is a chronic inflammatory condition associated with genetic and immunological susceptibility. The objective of the study was to evaluate pruritus and sleep quality in correlation (r) to psoriasis severity and to detect their impact on quality of life. Two hundred (200) patients with psoriasis were included. Psoriasis severity was determined using the psoriasis area severity index (PASI), the quality of life (QoL) was assessed by the psoriasis disability index (PDI) questionnaire, and the sleep quality was evaluated by the Pittsburgh sleep quality index (PSQI). Finally, the severity of itching was evaluated using a 12-item pruritus severity scale (PSS). Poor sleep quality was found in 16.0% of patients in this study. Poor sleep was detected among 50.0% of cases with severe psoriasis. PASI scores correlated significantly with sleep quality, duration and sleep disturbances (p < 0.001). The global PSQI and PASI were also significantly correlated (p = 0.004). In conclusion patients complaining of psoriasis exacerbated by pruritus and sleep problems demonstrated lower quality of life in all domains. Sleep disturbances and depressive symptoms impairing quality of life should be taken into consideration when screening patients suffering from psoriasis.

Hair disorders associated with post-COVID-19 infection in females: a cross-sectional study.

BACKGROUND: Coronavirus disease (COVID-19) currently named SARS-CoV-2 is a contagious disease caused by a coronavirus. The virus may infect the hair follicles directly or indirectly through systemic changes in the immune or hormonal systems. AIMS: In the current study we aimed to determine the prevalence of hair disorders in females infected with COVID-19. METHODS: Data was collected using a questionnaire covering four main domains: personal data, past medical history, COVID-19 history and treatment, and existence of any hair problems and their management. No identifier or sensitive data were collected. Those complaining of hair loss were subjected to complete general and local hair examination using trichoscopy to confirm hair loss. RESULTS: Hair problems were reported in 307 (61.4%) of COVID-19-infected female subjects. A total of 68.1% patients reported that hair loss existed and increased after COVID-19; 29.6% reported their hair problems only post-COVID-19 while 2.3% had hair shedding issues during infection only. The main reported hair problems were telogen effluvium (60.8%), increased gray hair (13.8%), seborrheic dermatitis (5.6%) trichotillomania (3.6%), and alopecia areata (2.2%). CONCLUSION: In conclusion, we reported prevalence of post-COVID hair fall that was confirmed by trichoscopy and which affected approximately 61.4% of infected females.

Prevalence of Female Sexual Dysfunction Among Psoriatic Females: A Cross Sectional Case Controlled Study.

INTRODUCTION: Sexual relationships are an integral part of females psychological and physiological wellbeing. OBJECTIVES: The study aimed to identify prevalence and impact of Female Sexual Dysfunction (FSD) in women affected with psoriasis. METHODS: This cross-sectional study was carried out on 150 married females who were interviewed to answer Female Sexual Function Index (FSFI) questionnaire and were divided into two groups: the first group included 100 female patients complaining of psoriasis (50 suffering from moderate psoriasis and 50 with severe psoriasis). The disease severity was graded according to the Psoriasis Area and Severity Index (PASI) while the second group included 50 age matched women who served as controls. RESULTS: Female sexual dysfunction (FSD) in psoriasis female groups was higher than that in the control group (47%, 24%, P < 0.05). The mean total scores of FSFI ranged from 12.30 to 34.20 and were significantly lower in the severe PASI affected group (22.34 ± 5.35) when compared to moderate PASI group (26.24 ± 2.67) or control group (28.79 ± 2.22). In addition, total scores were significantly lower among moderate PASI affected females when compared to control group. CONCLUSIONS: Sexual dysfunction should be routinely investigated in female patients with psoriasis in the case of moderate-severe disease due to its negative impact on quality of life. Further research over the effect of certain interventional programs on FSD should be considered for patients suffering from psoriasis.

Comparative study of the efficacy and safety of topical minoxidil 2% versus topical bimatoprost 0.01% versus topical bimatoprost 0.03% in treatment of eyebrow hypotrichosis: a randomized controlled trial.

Eyebrows are an important feature of facial identity and communications in human beings as well as an important eye defense shield from dust and foreign bodies. To compare the efficacy and safety between 0.01%, 0.03% bimatoprost and minoxidil 2% in gel formulations for eyebrow enhancement. Sixty eligible subjects were female or male, aged 18 years or older with eyebrow hypotrichosis, defined as either a Grade 1 or 2 on the Global Eyebrow Assessment (GEBA) scale. Patients were randomized into 3 groups using block randomization. Group a (20 patients) applied topical 0.03% bimatoprost gel once daily onto both eyebrows, group b (20 patients) applied topical 0.01% bimatoprost gel once daily onto both eyebrows while group c (20 patients) applied topical minoxidil 2% gel once daily onto both eyebrows. A significant improvement in GEBA score was reported in all the three groups after treatment (P ≤ 0.001); however, there was no statistically significant difference between the three groups (P1 = 0.091; P2 = 0.102; P3 = 0.663). Bimatoprost is equally efficacious as minoxidil in enhancement of eyebrows with a more favorable response produced by the 0.03% concentration.

Dermoscopic Features of Psoriatic Nails and Their Correlation to Disease Severity.

Background: Nail psoriasis is a challenging chronic condition affecting patients functionally and psychologically. Nail involvement is observed in 15-80% of psoriatic patients with occasional presence of isolated nail psoriasis. Objectives: To evaluate dermoscopic features of nail psoriasis and correlate them clinically. Methods: The study included fifty subjects with nail psoriasis. Psoriasis skin and nail severity was evaluated using psoriasis area severity index (PASI) and nail psoriasis severity index (NAPSI). Dermoscopy of the nails (onychoscopy) was performed, and features were recorded and analyzed. Results: The most common clinical and dermoscopic findings were pitting (86%) and onycholysis (82%). Among all dermoscopic features of nail psoriasis, only longitudinal striations and subungual hyperkeratosis were significantly higher in patients with moderate to severe psoriasis than in patients with mild psoriasis (P=0.028; P=0.042, respectively). PASI scores correlated positively but none significantly with NAPSI scores (r = 0.132, P=0.360), and similarly, no significant correlation was observed between the duration of psoriasis and the dermoscopic NAPSI (r = 0.022, P=0.879). Conclusion: Dermoscopy can serve as a useful tool for early diagnosis of psoriatic nail changes not always visible to the naked eye and is a non-invasive easy-to-use confirmatory tool for nail changes in psoriatic disease or in isolated nail involvement.

A new extended single-switch high gain DC-DC boost converter for renewable energy applications.

High-gain DC/DC converters are considered one of the most important components of green energy systems. Large numbers of these converters are used for increasing the voltage gain by using an extreme duty cycle. However, it increases losses and the cost, degrades the system performance, and hence obtains a low efficiency. In this article, a new design of a high-gain DC/DC boost converter is proposed. This converter has the potential to be used in low input voltage applications that need a high voltage gain such as systems powered by solar photovoltaic panels and fuel cells. The new topology is characterized by its simplicity of operation, high voltage gain, better efficiency, continuity of the input current, reduced number of inductors and capacitors, and can be extended to get higher gains. The converter structure, principle of operation, and design consideration of inductors and capacitors are presented in detail. Derivation of power losses and efficiency is presented. A laboratory prototype is implemented, and various experimental tests are given. The achievement of the suggested design is confirmed and compared with other recent high-gain converters.

High gain DC/DC converter with continuous input current for renewable energy applications.

In this paper, a new design of a non-isolated high-voltage gain DC/DC converter that operates at a reasonable duty cycle, by merging the dual boost converter with the switched inductor structure, is presented as a solution for the high-conversion ratio requirement. The proposed converter operates in discontinuous-current mode (DCM) with zero current switching for all switches and diodes. Wide duty cycle range operation, high output voltage gain, low switching stress, small switching losses, and high efficiency are achieved efficiently. Operating the converter in DCM can support a wide range of the duty cycle operation, maintain lower voltage stress of all devices, ensure the same current sharing among inductors, make it easy to control, provide more stability, and require a smaller inductor which reduces size and weight of the proposed converter. Moreover, the converter operates with a continuous input current. These features make the converter a good choice for many applications such as photovoltaic, x-ray, fuel cells, etc. To prove the converter's effectiveness, theoretical analysis, project specifications, and operation principles are presented and studied. Experimental results in an open and closed-loop, and a comparison with other recent converters are also introduced to confirm the validity of the proposed converter.

Prevalence of female sexual dysfunction among diabetic females: a cross-sectional case controlled study.

BACKGROUND: Sexual relationships, sexual functions are all parts of the female sexual identity and which influence physiological, psychological, and reproductive functions of women. AIM OF THE WORK: The study aimed to identify prevalence of Female Sexual Dysfunction (FSD) in women affected by type 1 and type 2 Diabetes Mellitus (DM) and to evaluate the impact of diabetes on female sexuality. PATIENT AND METHODS: This cross-sectional study was carried out on 400 married females who were interviewed to answer Female Sexual Function Index (FSFI) questionnaire and were divided into two groups: the first group included 300 diabetes patients (134 patients with type 1 DM and 166 patients with type 2 DM), while the second included 100 women not diagnosed with diabetes who served as controls. RESULTS: Considering female sexual dysfunction (score < 26.55), there was statistically significant increase of patients with female sexual dysfunction (FSD) in Type 1 DM (50.7%) when compared to type 2 DM patients (28.9%) or control group (10.0%). CONCLUSION: FSD is a significant health problem in premenopausal women complaining of DM. Females with type 1 DM were more affected than females with type 2 DM, who in turn were more affected than healthy controls. Long duration of the disease was the main risk factor for developing FSD.

Urban-rural differences in the prevalence of female pattern hair loss among secondary school girls: A cross-sectional study.

AIM: Female pattern hair loss (FPHL) is a common condition that is influenced by many external and internal factors. We aimed to identify the prevalence of FPHL among secondary school girls and identify possible associated factors. METHODS: FPHL among 3405 adolescent females was identified using detailed history, physical examination, and dermoscopy in this cross-sectional study. RESULTS: Among the 3405 included students, 2430 (71.4%) had no FPHL and 975 (28.6%) were diagnosed with FPHL (p = 0.001). The mean age of girls with FPHL was 16.43 ± 1.10 and ranged between 15 and 18 years. Among those with FPHL, 427 (43.8%) attended urban schools while 548 (56.2%) attended rural schools. No significant differences regarding paternal and maternal education, family income, or parental degree of education were observed among those with FPHL and those without (p = 0.230; p = 0.063; p = 0.276, respectively). CONCLUSION: FPHL had an overall prevalence of 28.6% among secondary school girls with a significant predominance in rural over urban areas and with a significantly associated family history. Irregular menses, history of thyroid disease, and hirsutism were significant predictors for FPHL.

Microneedling-assisted topical tranexamic acid solution versus 4% hydroquinone for treating melasma: A split-face randomized study.

BACKGROUND: Melasma, also known as chloasma or mask of pregnancy, is a common, acquired, hyperpigmentary disorder usually affecting females. Tranexamic acid (TA), a derivative of amino acid lysine, has shown promising results over the past few years when used along with other therapies and when used as a stand-alone therapy. AIM OF THE WORK: In this study, we aimed to evaluate and compare the effectiveness of topically applied tranexamic acid after microneedling versus topically applied hydroquinone (HQ) 4% alone in patients with melasma. PATIENTS AND METHODS: Fifty selected patients were divided randomly according to the random number allocation method into two groups (25 patients each) of A (topical 4% hydroquinone, nightly application) and B (microneedling + topical 4% TA, every other week). RESULTS: After eight weeks of treatment, the mean modified MASI score of the HQ treated side changed from 6.604 ± 4.02 to 3.032 ± 1.19 with a mean decrease percentage of 54.8% ± 19.4%. This reduction in modified MASI score was found to be statistically significant, (p < 0.001). MASI score of group B (TA +microneedling) changed from 6.348 ± 3.84 to 3.712 ± 1.19 with mean decrease percentage of 57.4% ± 23.4% which was also statistically significant, (p < 0.001). CONCLUSION: We demonstrated safety and efficacy of both used modalities and with minimal side effects. Topical HQ application achieved minimal non-significant higher satisfactory results among raters and subjects.

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.

Therapeutic implications of topical cetirizine 1% in treatment of male androgenetic alopecia: A case-controlled study.

BACKGROUND: Androgenetic alopecia (AGA) is the most common form of alopecia in men. Cetirizine, a second-generation H1 blocker, is known for its anti-inflammatory properties and its ability to decrease prostaglandin D2 (PGD2) production. AIM: To evaluate the efficacy and tolerability of topical cetirizine in male patients with AGA. METHODS: Two groups of 30 patients each (healthy males aged between 22 and 55 years) with different grades of AGA classified according to the Hamilton-Norwood classification were recruited for this study. Group A subjects applied 1 mL of 1% topical cetirizine daily, while group B subjects served as controls and were instructed to apply 1 mL of a placebo solution for 6 months. RESULTS: Dermoscopic assessment revealed significantly higher hair regrowth among the cetirizine-treated group (P < .001). The patients' satisfaction was significantly higher among the cetirizine-treated group (P < .001). CONCLUSION: The current study highlights a potential role cetirizine might have in treating AGA. It should be noted that studies are lacking in this regard and more randomized and controlled trials are warranted in order to confirm or refute such early findings.

Therapeutic implications of prevalence and predictor risk factors for burn out syndrome in Egyptian dermatologists: A cross sectional study.

Burnout among physicians and dermatologists is gaining a wide attention in the recent decade. The aim of this cross sectional study was to assess the prevalence and predicting factors for burnout among Egyptian dermatologists. A cross sectional study was designed and data were collected using structured open access survey. A total of 144 dermatologists completed the full questionnaire. The majority of dermatologists completing the survey 85 (59%) were between 30 and 40 years age group while those above 50 years of age represented a minority 10 (6.9%). The Mean score of emotional exhaustion was 29.24 ± 12.73 (high) while that of personal accomplishment was 29.14 ± 9.24 (moderate) and for depersonalization was 10.07 ± 6.46 (moderate). We demonstrated high burnout prevalence among Egyptian dermatologist that needs to be further verified by other randomized studies. Being a resident dermatologist living in a rural locality and with more than 8 daily working hours were significant predictors of increased burnout rates.

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.