JAK1 rs310241 and JAK3 rs3008 Genotypes May Increase Susceptibility to Psoriasis: A Case Control Study.

BACKGROUND: Janus kinases (JAKs) are a family of non-receptor protein tyrosine kinases that are expressed in a variety of tissues. Several JAK-controlled cytokine receptor pathways are incriminated in the initiation and progression of psoriasis. Genetic polymorphisms influencing JAK expression would be anticipated to have a great impact on disease activity. OBJECTIVE: The aim of the study was to evaluate the association between JAK1 rs310241 and JAK3 rs3008 polymorphisms and the risk of developing psoriasis. METHODS: Blood samples of 150 patients and 120 controls were screened for nucleotide polymorphisms in JAK1 rs310241 and JAK3 rs3008 genes by using polymerase chain reaction (PCR)-restriction fragment length polymorphism technique. RESULTS: The GG genotype of the JAK1 rs310241 and JAK3 rs3008 genes was significantly associated with an increase in psoriasis risk (p = 0.000, OR = 7.7, 95% CI = 2.8-21.5; p = 0.003, OR = 3.3, 95% CI = 1.5-6.9, respectively). The G allele of both genes was also associated with psoriasis susceptibility (p = 0.000, OR = 2.0, 95% CI = 1.4-2.8; p = 0.002, OR = 1.7, 95% CI = 1.2-2.4, respectively). CONCLUSION: The results indicate a possible association between JAK1 rs310241 and JAK3 rs3008 gene polymorphisms and susceptibility to psoriasis. These findings validate the importance of these molecules in psoriasis and may enable the identification of the individuals most susceptible to the disease.

Egyptian dermatologists attitude toward telemedicine amidst the COVID19 pandemic: a cross-sectional study.

BACKGROUND: Telemedicine involves distant exchange of medical information between health providers and patients via a telecommunication device with/without the aid of an audiovisual interactive assistance. The current COVID 19 pandemic impact on health services mandated an utmost readiness to implement telemedicine which in part is dependent on health care providers willingness to adopt such platforms. AIM: The aim of this cross sectional study was to assess knowledge and attitude toward telemedicine Egyptian dermatologists amidst the COVID 19 pandemic. PATIENTS AND METHODS: A cross sectional study was designed and data were collected using structured self-administered online questionnaires. RESULTS: Dermatologists had a good knowledge about telemedicine (mean 4.17 ± 1.63; p < .05). Of those completing the questionnaire, 193 (68.9%) were familiar with the term 'telemedicine' and 164 (58.6%) were familiar with tools like teleconferencing. The majority of responding dermatologists 227 (81.1%) were confident that the COVID 19 pandemic is a good opportunity to start applying telemedicine protocols however the majority 234 (83.6%) preferred using it on trial basis at first before full implementation. CONCLUSION: In conclusion an overall good attitude toward telemedicine was reported with a mean of 3.39 (p < .05). Further large scale studies are required to verify such findings.

Effect of botulinum toxin type A for treating hypertrophic scars: A split-scar, double-blind randomized controlled trial.

BACKGROUND: Hypertrophic scars (HS) are a challenging disorder that mostly develops during wound-healing process following skin injuries. METHODS: A split-scar, double-blind randomized controlled trial was held to assess the safety and efficacy of botulinum toxin type A (BTA) injection in hypertrophic scars (HS). Thirty patients with old scars (range: 1-15 years) were treated, with sides randomized to receive treatment with either BTA or 0.9% normal saline once monthly for three consecutive months. Scars were assessed using the Vancouver scar scale (VSS) along with digital photograph standardization. RESULTS: Twenty-one subjects completed the study. The mean VSS score for the BTA-treated half of the scars decreased from 7.29 ± 2.327 before injection to 5.33 ± 2.41 following injection which was highly significant (P = .01). For the control half, the mean VSS decreased insignificantly from 7.29 ± 2.327 before injection to 7.10 ± 2.234 following injection (P = .104). CONCLUSION: Clinical and cosmetic improvement was demonstrated significantly among the BTA-treated group. BTA can be an additional and useful tool for improving scar outcomes.

The Effect of the Fractional Carbon Dioxide Laser on Improving Minoxidil Delivery for the Treatment of Androgenetic Alopecia.

Introduction: Recently, laser treatment for hair loss has become very popular. Laser-assisted drug delivery (LAD) is an evolving technology with potentially broad clinical applications. This work aims at inspecting the effect of the fractional carbon dioxide laser (CO2 ) on improving the delivery of minoxidil in patients with androgenetic alopecia and detecting the role of the fractional CO2 laser in its treatment. Methods: We enrolled 45 Egyptians with male androgenetic alopecia (MAGA); clinical grading was assessed based on Norwood-Hamilton classification. The patients were divided into 3 groups: the first group (combined group) received the fractional CO2 laser session followed by topical application of minoxidil and also in between sessions; the second group received fractional CO2 laser sessions only and 6 sessions with 2-week intervals were performed; the third group applied topical minoxidil only for 3 months. Global photographs and dermoscopic assessments were performed before treatment and 3 months after the treatment. Results: Several dermoscopic findings were detected, including peripilar sign, hair diversity, yellow spot, white dots, and arborizing red lines. The number of double hair units significantly increased after the treatment in the combined group. The mean number of hair after the treatment in the 3 groups significantly increased, mostly in the combined group. The hair thickness (thin & thick) significantly increased after the treatment in the combined group and the fractional group; however, in the minoxidil group, only thin hair thickness increased. In all the 3 groups, there was a significant improvement in hair count and thickness. Conclusion: The ablative fractional CO2 laser alone or combined with minoxidil may serve as an additional treatment for MAGA.

Epidemiologic study of dermatologic disorders among children in South Sinai, Egypt.

BACKGROUND: Few epidemiologic surveys have been carried out to determine the prevalence of skin diseases in the population of Egypt, particularly in the Sinai Peninsula. Thus, the necessity of such research in South Sinai is pressing. This study aimed to determine the prevalence of various skin diseases among children in South Sinai. METHODS: A community-based protocol was followed. The study included 2194 children of both genders, 18 years of age and younger, and in six different localities within South Sinai. Data were collected by taking a full history and by systemic and dermatologic clinical examination that included the site, severity, distribution, and extent of skin lesions if present. Subjects were surveyed at general morbidity consultations and campaign field visits. The study was conducted from August 2008 to August 2009. Data were tabulated and analyzed statistically using Pearson's chi-squared test. Differences were considered significant at a P-value of < 0.05. RESULTS: Findings revealed that 71.4% of the studied population had one or more skin diseases. The highest rate of prevalence applied to parasitic skin infestations (pediculosis capitis, 37.6%). Eczema or dermatitis were found in 25.8% of participants. Pityriasis alba occurred at a rate of 18.3% and seborrheic dermatitis at a rate of 6.7%. Xerosis was found in 11.8% of subjects, viral warts in 4.1%, photosensitivity in 4.1%, acne vulgaris in 2.6%, and fungal skin infections in 1.0%. Other skin diseases diagnosed in low numbers in the study children included impetigo, freckles, and scabies. Prevalences of vitiligo and psoriasis were very low (0.18% and 0.05%, respectively). CONCLUSIONS: Infective parasitic diseases are a major health problem, particularly among younger children and in subjects of low socioeconomic status.

Early prediction of preeclampsia in high-risk women.

BACKGROUND: The purpose of this study was to determine the role of the combined use of uterine artery Doppler velocimetry (UADV) and maternal serum placental growth factor (PlGF), vascular endothelial growth factor receptor-1 soluble fms-like tyrosine kinase-1 also called soluble (sVEGFR-1), and nitric oxide (NO) products concentrations for the prediction of preeclampsia in high-risk women and to compare these parameters between patients with mild and severe preeclampsia. METHODS: Patients at risk of preeclampsia (n=112) were subclassified as having either severe (n=38), mild (n=17), or no preeclampsia (n=57). Blood samples were obtained between 22 and 26 weeks of gestation. Doppler ultrasound of the uterine arteries was done at the time of blood sampling. Maternal serum PlGF and sVEGFR-1 concentrations were determined with enzyme-linked immunosorbent assay (ELISA). Nitric oxide colorimetric assay was used also to measure NO products in the maternal blood. RESULTS: Among patients with abnormal UADV, maternal serum sVEGFR-1, PlGF, and NO product concentrations contributed significantly in the identification of patients destined to develop mild and severe preeclampsia. sVEGFR-1 (pg/mL) concentration followed by NO product concentration (µmol/L) were found to be the best predictors for preeclampsia, with high sensitivity and specificity, followed by PlGF (pg/mL). CONCLUSIONS: Abnormal UADV and high concentrations of sVEGFR1 combined with low concentrations of PlGF and NO products may be used to predict the development of preeclampsia.