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   2021| January-June  | Volume 41 | Issue 1  
    Online since December 23, 2020

 
 
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REVIEW ARTICLE
Major challenges in dermatophytosis treatment: current options and future visions
Falah H.O AL-Khikani, Aalae S Ayit
January-June 2021, 41(1):1-9
DOI:10.4103/ejdv.ejdv_23_20  
There is no part of the world can be cleared of the infection with dermatophytosis. Millions of persons and animals around the world are infected with specialized filamentous fungi called superficial infections of which dermatophyte are the most common agents. Dermatophyte infection incorporates a broad range of diseases involving particularly the nails, hair, and the skin. These infections were considered the most common causative agents of a patient visiting the dermatology. Dermatophytosis is mainly due to different species of dermatophytes that infect the cutaneous layer of the skin. There are many problems in the treatment of dermatophytosis that deserve to highlight because few studies have discussed this issue, especially dermatophyte management challenges became the state of anxiety in physicians and causing alarming distress to the patients recently. So the current review may serve as an impetus for researchers working in the field of medical mycology and antifungal drug design, as well as rationally reports and critically analyses the available knowledge by focusing and mentioning future steps strategies trying to find appropriate solutions regarding challenges in dermatophytosis management.
  4,582 492 3
ORIGINAL ARTICLES
Serum level of the neuropeptide substance ‘P’ in patients with acne vulgaris
Heba Nagiub, Yousef Elbayomi, Mostafa Mansour, Marwa Zohdy
January-June 2021, 41(1):10-15
DOI:10.4103/ejdv.ejdv_33_20  
Background Acne vulgaris is a very common chronic inflammatory disease of pilosebaceous units affecting up to 80% of adolescents with complex pathogenesis. Substance P (SP) is a neuropeptide that is secreted from the terminal ends of special sensory nerves, acts as a neurotransmitter, and is involved in inflammatory processes and pain. Various studies have proved that the inflammatory process within the pilosebaceous unit is modulated by neuropeptides, especially SP. Objective The aim of this study was to evaluate the correlation between SP level and severity of acne. Patients and methods SP levels were estimated in 45 patients with acne vulgaris (AV) and 35 age-matched and sex-matched controls, with exclusion of patients who were taking anxiolytics, antipsychotics, or related drugs within the last year, present or past medical history of isotretinoin or hormonal therapy within the last 3 months, patients on systemic antibiotic for at least 3 months before the study, and patients with any neurological or psychiatric diseases such as mood disorders, major depressive disorder, and anxiety disorders. SP level was detected quantitatively by enzyme-linked immunosorbent assay method. Results SP level was significantly higher in the acne group vs the control group (P<0.001). SP level was highest in the severe acne group, followed by the moderate group and lastly the mild group. SP level was higher in the smoker group vs the nonsmoker group, with a statistically significant difference (P<0.05). Conclusion There was a statistically significant relation between acne severity and the serum levels of SP.
  1,402 207 -
Role of autophagy in nonsegmental vitiligo Naguid and Rashed
Rehab M Naguib, Laila A Rashed
January-June 2021, 41(1):22-25
DOI:10.4103/ejdv.ejdv_9_20  
Background Vitiligo is a skin and less common hair disease characterized by decline in melanocyte function and depigmentation, with a prevalence of 0.5–1% in most populations. Autophagy is the degradation of components of the cytoplasm within lysosomes. This is distinct from endocytosis-mediated lysosomal degradation of extracellular and plasma membrane proteins. Aim The aim was to detect biochemical parameter light chain 3 (LC3) to monitor autophagy in vitiligo skin of patients as compared with normal control persons to evaluate the role of autophagy in the vitiligo pathogenesis. Materials and methods This case–control study included 60 patients with vitiligo and 60 age-matched and sex-matched healthy controls. Herein, 4 mm punch skin biopsy was taken from every patient (vitiligo lesion) and control and kept in lysis solution for the stability of the studied parameters and was kept frozen at −80°C till analysis of autophagy protein LC3 by qRT PCR. Results The level of LC3 in lesional skin of vitiligo was significantly lower as compared with normal control persons.
  1,211 155 1
Childhood bullous systemic lupus erythematosus: unusual prognosis
Khaled Gharib
January-June 2021, 41(1):16-21
DOI:10.4103/ejdv.ejdv_2_20  
Background Bullous systemic lupus erythematosus (BSLE) has rarely been described in pediatric lupus population, and the real prevalence of childhood-onset BSLE has not been reported. BSLE is a rare manifestation of systemic lupus erythematosus and is very rare in children. BSLE affects women more often than men, reflecting the female preponderance in systemic lupus erythematosus. It most often manifests in the second through fourth decades of life, but it has also been reported in children and older adults. Patients and methods Herein, we describe a case of a 10-year-old female patient who presented with a 1-year history of recurrent itchy urticated skin eruption, which was followed 2 months later (after the first year) by a generalized blistering eruption with photosensitivity. Results Histopathologic examination revealed a subepidermal blister and papillary-tip neutrophil microabscesses. Immunofluorescence studies showed linear immunoglobulin G (IgG) and IgC deposition along the BMZ with weaker staining of IgA and IgM. Laboratory tests revealed positive ANA, dsDNA, anti-SM antibodies, elevated erythrocyte sedimentation rate, and proteinuria. Conclusion Although the course of BSLE is often remitting, but not in our case, treatment with dapsone is successful in most cases of BSLE.
  1,197 161 -
Global inequality in the incidence and mortality rate of melanoma skin cancer according to human development index: a country-level analysis
Abolfazl Mohammadbeigi, Salman Khazaei, Yousef Veisani, Ali Delpisheh, Ensiyeh Jenabi
January-June 2021, 41(1):26-31
DOI:10.4103/ejdv.ejdv_10_20  
Objective The present study aimed to quantify existing inequalities in melanoma skin cancer (MSC) incidence and mortality between countries with different level of human development index (HDI). Methods A descriptive study was conducted based on GLOBOCAN project of the WHO for most countries in the world. Inequality in the age-specific incidence and mortality rates of MC was calculated according to the HDI by using the concentration index (CI) and decomposition of the CI was conducted. Results The CI for incidence and mortality rates of MSC was 0.44 (95% CI: 0.38, 0.54) and 0.11 (95% CI: 0.04, 0.21), respectively, which showed that MSC was more concentrated in countries with higher HDI. Expected years of schooling (0.44), mean year of schooling (0.38), and gross national income per 1000 capita (0.17) were the most important contributors of inequality in MSC incidence. Conclusion Disparity in melanoma rates was observed across diverse HDI components in different countries. The risk of MCS increased with higher life expectancy at birth, higher mean year of schooling, more expected years of schooling, and higher gross national income per 1000 capita according to the decomposing analysis.
  1,081 180 1
Serum interleukin-22 and C-reactive protein in patients with vitiligo: a case–control study on 35 Egyptian patients
Tawfik M Yasmin, Badran Y Aya, Hosni Amal, Kamel A Amira, Gomaa S Ahmed
January-June 2021, 41(1):32-37
DOI:10.4103/ejdv.ejdv_11_20  
Background Vitiligo is a chronic depigmentary skin disorder caused by destruction of epidermal melanocytes. Various cytokines play an important role in its pathogenesis. Interleukin-22 (IL-22) is one of the cytokines produced by multiple immune cells such as lymphocytes and natural killer cells. It has a role in the proinflammatory process, and also it can induce production of C-reactive protein (CRP). The role of IL-22 has been studied and evaluated in many chronic inflammatory diseases such as psoriasis, rheumatoid arthritis, and inflammatory bowel diseases. Aim This study was planned to study the effect of serum IL-22 and CRP in patients with vitiligo and to correlate their level with the severity of the disease using vitiligo area severity index, vitiligo extent score, and vitiligo disease activity score. Patients and methods A prospective case–control study was conducted on 35 patients with vitiligo and 35 age-matched and sex-matched healthy volunteers. Both disease severity and disease activity were estimated using vitiligo area severity index and vitiligo disease activity score, respectively. All participants were subjected to measurement of serum IL-22 by enzyme-linked immunosorbent assay technique and measurement of serum CRP level by rate nephelometry. Results We found that the most common type of vitiligo was the generalized type (88.6%), followed by segmental vitiligo (5.7%) and focal vitiligo (5.7%). We found that both IL-22 and CRP are significantly higher in patients with vitiligo compared with healthy participants (P=0.001), with a positive correlation with the disease activity. Conclusion Both IL-22 and CRP have a role in vitiligo pathogenesis as their presence intensifies the severity of the disease. They could be considered useful tools for evaluating the disease activity.
  972 152 1
Prevalence of cholinergic urticaria among Egyptian students and its effect on quality of life
Mahmoud A Abdallah, Amr M Swidan, Manal A Sharara
January-June 2021, 41(1):45-50
DOI:10.4103/ejdv.ejdv_16_20  
Background Cholinergic urticaria (CholU) is a type of physical urticaria characterized by pinpoint, highly pruritic heat-associated wheals. The prevalence of CholU ranges in different regions of the world between 0.2 and 11%. The prevalence in Egypt has not been studied before. Objective We aimed to study the prevalence and clinical characteristics of CholU among Egyptian students together with assessing the effect of this disease on their quality of life (QOL). Patients and methods A total of 400 Egyptian students (20–28 years of age) were surveyed to assess prevalence of CholU among them. Two questionnaires were used, one to study clinical characteristics of the disease, and the other was the dermatology life quality index to assess the effect of this disease on their QOL. Diagnosis was confirmed by exercise provocation test. Results The overall prevalence of CholU was 7.5% (30 of 400 students), with most of the affected persons being females (73.3%). In 83.3% of the patients, the disease started in their third decade. Exercise was the most exacerbating factor, with tingling/itching without wheals more commonly occurring on the back. A total of 19 (63.3%) patients reported exacerbation in winter and 20 (66.7%) reported decreased sweating. Overall, 11 (36.7%) patients had a family member with similar condition. Regarding the effect on QOL, 10 (33.3%) patients showed extreme large affection and 17 (56.7%) had large affection. Conclusion The study showed a high prevalence of CholU among Egyptian students, and it basically affected their QOL.
  862 132 -
Erectile dysfunction in Egyptian patients with chronic obstructive pulmonary disease
Emad E Kamal, Hatem M Zedan, Ahmed A Ismail, Khaled Hussein, Mohammed Zakaria, Aya Y Badran
January-June 2021, 41(1):38-44
DOI:10.4103/ejdv.ejdv_12_20  
Background Chronic obstructive pulmonary disease (COPD) is a life-long disease affecting the airways. It occurs owing to long-term exposure to hazardous smokes and particles and leads to increased inflammatory response in the airway. Multiple well-recognized comorbidities are associated with COPD presence. Sexual affection is considered one of them through incompletely understood mechanism. Studies demonstrating erectile dysfunction (ED) prevalence among Egyptian patients with COPD are limited. Aim This study aimed to assess ED prevalence in male patients with a confirmed diagnosis of COPD and also to assess their serum testosterone level. Patients and Methods One hundred male patients with COPD and 40 age-matched healthy male controls were included in the study. Each participant was subjected to detailed medical history and full clinical examination, pulmonary assessment (pulmonary function tests by spirometry and arterial blood gas analysis), and measurement of total testosterone level. Also, each participant completed the Arabic version of the IIEF-5 questionnaire for assessment of erectile function and ED severity. Results The scores of the IIEF-5 questionnaire revealed that 71% of patients had ED of varying severity: 16% mild, 4% mild to moderate, 18% moderate, and 33% severe. Conclusion The results showed that patients with COPD also have ED of variable degrees. IIEF-5 scores negatively correlated with the age of the patients and the duration of COPD.
  664 143 1
LETTERS TO THE EDITOR
Phthiriasis palpebrarum and outpatient-based education: scooping beyond treatment
Ghazal Ahmed, Soumil Khare, Neel Prabha
January-June 2021, 41(1):53-54
DOI:10.4103/ejdv.ejdv_17_20  
  542 111 -
Interrelationship between head lice infestation and nutritional status of Thai preschool nursery children in a remote community near Thailand-Cambodia international border: an observation
Beuy Joob, Viroj Wiwanitkit
January-June 2021, 41(1):51-52
DOI:10.4103/ejdv.ejdv_8_20  
  498 104 -
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