Punch grafting is more effective than follicular grafting in the treatment of stable vitiligo; however, follicular hair transplantation is cosmetically better, so we recommend it in exposed areas as face.

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Background Alopecia areata (AA) is a common inflammatory disorder targeting the hair follicles leading to non-scaring hair loss. The pathogenesis of AA is still unclear, despite the accumulating evidence of the immune-mediated nature of this disease. So, in this study, we aimed to assess the level of CD4 T cells, CD8 T cells and natural killer (NK) cells in the peripheral blood of patients with active AA and control subjects, and to evaluate the association between the level of those cells and the duration of disease in different subtypes of AA. Results Fifty female patients and 50 age- and sex-matched healthy controls were enrolled in this case control study. CBC analysis and the level of CD4, CD8 T cells and NK cells were evaluated during the active stage of the disease. We found that CD4, CD8 T cells and NK cells proportion was significantly lower (P < 0.05) in patients with active stage AA compared with healthy subjects, however, the ratio of CD4:CD8 T cells was significantly higher in patients than control subjects. The level of CD4, CD8 T cells CD56 bright CD16− % NK cells were positively correlated with the disease duration. Conclusion Active stage of AA disease is associated with a reduction of the circulating CD4, CD8 T cells and NK cells and an increase in CD4/CD8 T cells ratio, however, the level of those cells were higher with prolonged disease duration. Our findings confirm that immune mechanisms are involved in the pathogenesis of AA.

Background Psoriasis is a multisystem, immune disorder driven by inflammatory processes, characterized by skin and joint manifestations, and may be associated with hearing loss. Aim To assess the hearing function in patients with psoriasis and if psoriasis could cause sensorineural hearing loss (SNHL). Patients and methods A total of 50 patients with psoriasis and 50 apparently healthy controls matched for age and sex were included in a cross-sectional comparative study between May 2017 and April 2018. Medical history of patients was taken. Demographics, type of psoriasis, and disease severity evaluated by PASI score were assessed. All patients who were included in this study provided a complete history and audiological history. All patients underwent otoscopic examination, pure tone audiometry, speech audiometry, and immittancemetry including tympanometry and acoustic reflexes. Results There was no statistically significant difference in age or sex for patients with psoriasis and the control group. Eight patients with psoriasis showed impaired hearing function with significant longer duration with psoriasis and older age more than 20 years old in comparison with the rest of the patient. Conclusion Psoriasis is a chronic inflammatory immune-mediated skin disease with estimated prevalence in Upper Egypt at a rate of 0.19% of skin diseases. There were eight (16%) patients who had SNHL in psoriatic group in comparison with three (6%) cases in nonpsoriatic group. There was a statistically significant difference for the age and the duration of psoriasis in relation to hearing loss. SNHL increased with age in psoriatic patients much more than in healthy controls.

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