Introduction Acne scarring is a common complication of acne, and no appropriate and effective single treatment modality has been developed yet. A new technique of focal application of high strength trichloroacetic acid (TCA) (65-100%) has been suggested. The aim of the study was to evaluate the efficacy and safety of 50% TCA in three different types of atrophic acne scars using the chemical reconstruction of skin scars technique in three sessions, each at an interval of 1 month. Materials and methods Thirty adults with a clinical diagnosis of atrophic acne scars were selected. Results Statistically significant difference was found in the total Goodman score between the atrophic acne scars before and after treatment (P < 0.0001), especially between the icepick and boxcar scars before and after treatment (P < 0.05). In addition, statistically significant difference was observed in the percentage of improvement between the three types of atrophic acne scars (P < 0.05). The best improved were the icepick type followed by the boxcar scars and then the rolling scars. Conclusion Chemical reconstruction of skin scars technique using 50% TCA is nonsurgical and safe in the treatment of atrophic acne scars, especially the icepick type followed by the boxcar scars, with minimal side effects and a short downtime.

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Background and objectives The relationship between androgenetic alopecia (AGA) and cardiovascular diseases has been studied by some authors in the past, although the results of epidemiological studies have been variable. The objective of this study was to determine the prevalence of hypertension and aldosterone level in male patients with AGA. Patients and methods Sixty men were enrolled in this case-control study, 30 with a diagnosis of AGA and 30 control participants who consulted for other skin conditions. They were recruited from the outpatient clinic of the Dermatology and Andrology of Benha University Hospital. Data were collected included, age, AGA score with Ebling score (I-V), serum aldosterone and serum testosterone level, blood pressure or history of hypertension, smoking, family history of AGA, and treatment. Results Patients with AGA showed significantly higher aldosterone levels and blood pressure values (P < 0.05) versus controls. However, there was no statistically significant difference between patients and controls in the serum testosterone level. Conclusion Blood pressure screening of patients with AGA will enable earlier diagnosis of an unknown hypertension and initiation of appropriate treatment. Moreover, determination of aldosterone levels can enable early detection of individuals at risk and initiation of preventive treatment before cardiovascular disease becomes established.

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Background Psoriasis is a genetically determined inflammatory and proliferative disease of the skin. There is now increased evidence for the role of nitric oxide in some diseases, including psoriasis. Nitric oxide is a potent regulator of keratinocyte growth and differentiation and stimulates angiogenesis. Aim This study aimed to detect serum nitric oxide level in active psoriasis patients, to correlate these levels with severity of the disease scored with psoriasis area and severity index, and compare them with those in normal individuals. Patients and methods Twenty-five patients with active psoriasis and 25 age-matched and sex-matched controls were recruited after their written consent was obtained. Patients on local or systemic treatment or with coexisting inflammatory skin disease were excluded. Serum nitric oxide levels were assessed using the Griess method. Results The mean serum nitric oxide levels (95.96 ± 12.7 μmol/l) were significantly higher in active psoriasis patients than that in the healthy controls (27.1 ± 6.85 μmol/l). Conclusion The significantly elevated serum levels of nitric oxide and their positive correlation with the severity of psoriasis may suggest the possible role of this mediator in the etiopathogenesis of the disease, and suggest a potential future therapy for the disease.

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Background Skin manifestations in diabetes mellitus (DM) are quite common. Skin changes can manifest in the prediabetic stage, in the acute metabolic situation and in the late diabetic degenerative stage. Objective To study the prevalence and the pattern of cutaneous manifestations among diabetic patients to aid in better management of diabetic skin diseases. Patients and methods One hundred patients with DM having at least one skin manifestation were selected and subjected to a detailed dermatological and systemic examination, and the findings were recorded. Blood samples were obtained for random blood glucose level. Results The most prevalent findings were cutaneous infections (40%), followed by pruritus (11%), local reactions at the site of insulin injection (8%), vitiligo (8%), diabetic dermopathy (7%), periungual telangectasia (6%), and xanthelasma (5%). The prevalence of skin manifestations was higher as the duration of diabetes increased and was more in type II than in type I diabetic patients. Conclusion The early detection of skin manifestations in DM is of prime importance to be able to avoid and/or properly manage the complications and prevent disability.

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Background Studies suggest that reactive oxygen species (ROS) attack the integrity of DNA in the sperm nucleus by causing base modifications, DNA strand breaks, and chromatin cross-linking. Sperm DNA damage analysis may reveal hidden sperm DNA abnormalities in infertile men with normal standard semen analysis values who were diagnosed with idiopathic infertility. Aim of the work We explored the levels of ROS and their correlation with sperm DNA damage in patients with idiopathic male infertility. Patients and methods A total of 93 men were included in this study. Among them, 68 presented to our Andrology outpatient clinic with idiopathic infertility and were selected, and 25 were healthy fertile men, who were assigned to the control group. Both groups were subjected to the following laboratory investigations: semen analysis including peroxidase test, measurement of ROS levels by chemiluminescence assay, and sperm DNA damage assessment by terminal deoxyribonucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL). Results There were no significant differences in the semen parameters between idiopathic infertile men and controls. However, ROS and sperm DNA damage levels were significantly higher in idiopathic infertile men compared with controls ( P ͳ 0.001). In addition, the results showed a strong positive correlation between ROS levels and the percentage of sperm DNA damage ( P ͳ 0.001). Conclusion Traditional semen analysis does not reveal seminal defects at the molecular level that might be induced by ROS. Therefore, our results suggest that standard semen analysis should be coupled with measurement of ROS and assessment of DNA integrity in cases of idiopathic male infertility as even sperms with normal morphology and motility may harbor DNA damage.

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Background Lipid peroxidation of sperm plasma membranes has a deleterious effect on the semen quality, and measurement of malondialdehyde acid (MDA) is the most widely used method for assessing lipid peroxidation. High levels of seminal MDA represent increased lipid peroxidation rates and oxidative damage to the sperm plasma membranes, which may result in the impairment of the integrity and functioning of sperm plasma membranes and damage of both nuclear and mitochondrial DNA. Aim of the study The aim of the present study was to investigate the seminal plasma MDA concentration as a marker of lipid peroxidation and its correlation with the hypo-osmotic swelling test (HOST) scores as a predictor for the functional integrity of the sperm membrane in cases of idiopathic male infertility. Participants and methods A total of 93 men were included in this study: 68 men who had been attending to our andrology outpatient clinics with idiopathic infertility were selected as cases and 25 healthy fertile men were assigned as control group. Both groups were subjected to the following laboratory investigations: semen analysis, peroxidase test, HOST, and measurement of MDA in the seminal plasma. Results Our results showed that seminal plasma concentration of MDA was significantly higher in men with idiopathic infertility compared with the fertile control group ( P ≤ 0.001), and HOST was significantly lower in men with idiopathic infertility compared with the fertile control group ( P ≤ 0.001). In addition, the results showed a strong negative correlation between MDA concentration and HOST ( P ≤ 0.001). Conclusion Our results suggest that the evaluation of lipid peroxidation must be used in combination with the HOST as a diagnostic tool in men with idiopathic infertility in addition to standard semen analysis.

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Background Vitiligo is a specific type of idiopathic acquired or inherited leukoderma which is characterized by patterned/circumscribed hypomelanosis of the skin and hair, with complete absence of melanocytes. The aetiology of vitiligo is unknown, several hypotheses have been proposed to explain its pathogenesis and a convergence theory was proposed which assumes that all hypotheses are not mutually exclusive. In vivo, immunohistochemical studies of perilesional area of active lesions in generalized vitiligo mainly detects predominant CD8+ and to lesser extent CD4+ T cells in the infiltrate, which express activation molecules such as the skin homing receptor; CLA antigen and the IL-17. IL17 mRNA is up-regulated in the blood of vitiligo patients therefore, it has been suggested as a crucial regulator of vitiligo. Aim of work In this study, we focused primarily on the regulatory pathways and role of IL-17 in vitiligo by determination of the level of expression of IL17 mRNA by Real-time RT-PCR.

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Background Psoriasis is a chronic, relapsing, inflammatory, and hyperproliferative disease. The pathological changes affecting skin in psoriasis are mainly driven by abnormal differentiation secondary to activation of T cells. Keratinocytes may undergo apoptosis by loss of cell-cell contact after crosslinking of the FAS (CD95) molecule. The epidermal hyperplasia in psoriasis has been implicated to be a result of suppression of apoptosis. A key inhibitor of death receptor signaling is cellular FLICE inhibitory protein (c-FLIP), which interacts with FAS-associated death domain protein (FADD) and procaspase-8 preventing it from binding to caspase-8, thereby inhibiting the initiation of the apoptotic cascade. Aim of work This study was designed to investigate the expression pattern of antiapoptotic molecule c-FLIP in psoriasis vulgaris patients. Materials and methods Twenty psoriasis vulgaris patients were enrolled in this study. All patients were subjected to assessment of the degree of severity using PASI score. A 2-mm punch biopsy was taken from each patient from lesional and nonlesional areas for evaluation of c-FLIP mRNA gene expression using RT-PCR. Results We found that there was a direct significant relationship between psoriasis and c-FLIP protein levels measured. The study also showed that the discrimination of the degree of severity of psoriasis using psoriatic skin c-FLIP mRNA level can be reliable, with 100% sensitivity, 81.2% specificity, and 85% accuracy. Conclusion Increased levels of c-FLIP might induce upregulation of keratinocyte proliferation and downregulation of the apoptotic signaling pathway in psoriatic epidermis. c-FLIP might be a potential new target for preventing keratinocyte proliferation in psoriasis in the future.

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