Background Alopecia areata is a common disease that affects the psychological well-being of the affected individuals. No single treatment option is proved to be effective and safe in its management. Laser-assisted drug delivery is a new method for the management of different dermatological diseases. Objective To evaluate the effectiveness of fractional carbon dioxide laser-assisted topical steroid delivery in the management of alopecia areata. Patients and methods A total of 30 patients with alopecia areata with two or more nonadjacent patches were included. Patients were randomized and given two separate treatment modalities in two different patches in the same individual. One patch was treated with fractional carbon dioxide laser followed by topical triamcinolone acetonide (group I), and the other was treated with intralesional triamcinolone acetonide (group II). Follow-ups by MacDonald Hull and Norris grading were done every 3 weeks for 3 months. Results The mean grading score in group I patches treated with ablative fractional CO2 laser followed by the topical steroid application at fourth follow-up was 3.37±0.76, and the mean grading score in group II patches treated with intralesional steroid at fourth follow-up was 3.73±0.58. There was significant improvement in the MacDonald Hull and Norris grading score every follow-up in both groups. However, group II patches showed significantly higher mean grading score as compared with group I patches. The mean pain score in group II patches was significantly higher than that in group I patches. Conclusion The use of fractional carbon dioxide laser to assist topical steroid delivery is a promising, safe, and effective method for the treatment of alopecia areata. Although intralesional steroid treatment showed more significant results, we thought that the low pain score in patients treated with laser-assisted drug delivery is more advantage, which increases their compliance to treatment.

Introduction. Lymphangiogenesis is a complex process mediated by a wide spectrum of inflammatory cells including mast cells. Lymphatic vessels play an important role in chronic inflammatory disorders including psoriasis. Objective. Assessment of interaction between lymphatic vessels and inflammatory cells, including mast cells to determine the influence of inflammatory cells on lymphangiogenesis in psoriasis. Material and methods. Fifty patients with psoriasis and 10 healthy controls were included. D2-40 immunostaining was performed for delineation of lymphatic vessels, and Giemsa stain for highlighting mast cells. Results. Psoriatic skin lesions were characterized by a higher number of mast cells and inflammatory cells as well as denser and larger lymphatic vessels than normal skin. A significant positive correlation was detected between number of lymphatic vessels and mast cells as well as other inflammatory cells in psoriatic lesions. However, none of them emerged as an independent inducer of lymphangiogenesis on multilogistic regression analysis. Simple logistic regression analysis revealed that mast cells are significant influencers. One unit change in mast cells can explain 1.369 unit changes in lymphatic vessels, while one unit change in other inflammatory cells can only explain 0.099 unit change in lymphatic vessels. Conclusions. Mast cells and other inflammatory cells significantly and synergistically act in induction of lymphangiogenesis in psoriatic lesions, with a slightly higher participation for mast cells. streszczenie Wprowadzenie. Limfangiogeneza jest złożonym procesem, w którym uczestniczy szerokie spektrum komórek zapalnych, w tym komórki tuczne. Naczynia limfatyczne odgrywają istotną rolę w przewlekłych chorobach zapalnych, m.in. w łuszczycy. Cel pracy. Ocena interakcji pomiędzy naczyniami limfatycznymi a komórkami zapalnymi, w tym komórkami tucznymi, w celu określenia wpływu komórek zapalnych na proces limfangiogenezy w łuszczycy. Materiał i metody. Badanie objęło 50 pacjentów z łuszczycą i 10 zdrowych osób, które stanowiły grupę kontrolną. Do wizualizacji naczyń limfatycznych wykorzystano barwienie immunohistochemiczne z przeciwciałem D2-40, a do oznaczenia komórek tucznych-barwienie metodą Giemsy.

Natural infected broad bean seeds were collected from Noubaria region during the season of 2012-2013. The isolated and purified fungi from these seeds were identified as: Alternaria alternata, Penicilliun citrinum and Aspergillus flavus. Occurrence frequencies of the isolated fungi were 75.76, 15.16 and 9.08%, respectively. Toxin production potentials of Alternaria alternata and P. citrinum isolates, as estimated by Plug Agar method, were 231.00 and 337.00 µ.g/g, respectively., whereas, A.flavus isolate was unable to produce aflatoxins. Sorbic and benzoic acids were proved to be more effective in reducing fungal growth of A. alternata and P. citrinum than metalaxyl and ridomyl fungicides. A. alternata was less sensitive to sorbic acid than benzoic acid. All the tested treatments, at their MICs, significantly reduced growth of A. alternata growth and alternariol (AOH) production; however, higher efficiency ratio (99.860%) was realized by benzoic acid. Similar inhibition of growth and citrinin (CTN) production was induced by P. citrinum. Metalaxyl was less efficient in inhibiting AOH and CTN than the other tested treatments. Soaking seeds in water significantly raise the efficiency of mycotoxins production in all the tested seed treatments. Moreover, efficiency of benzoic and sorbic acids in reducing AOH and CTN production was higher during soaking process. Seeds inoculated with the tested pathogens, then treated with sorbic or benzoic acid appeared healthy with normal color, texture and morphology.

Background Interleukin 15 (IL15) is a proinflammatory cytokine that is involved in the pathogenesis of several autoimmune and inflammatory diseases. The stability of vitiligo represents the periods of no activity of the disease, and it is crucial in determining the line of treatment of the patient. Objective To assess serum IL15 in patients with vitiligo and to evaluate its predictive capacity as a marker of vitiligo activity. Patients and methods A total of 40 patients with nonsegmental vitiligo were included, in addition to 30 age-matched and sex-matched healthy individuals as a control. The severity of vitiligo was assessed using vitiligo area severity index score, whereas the activity of disease in patients was assessed using vitiligo disease activity score. Serum levels of IL15 were measured using the ELISA technique. Results The mean serum level of IL15 was significantly higher in patients with vitiligo (201.14±115.41 ng/l) than in control (136.13±22.57 ng/l). Moreover, the mean serum level of IL15 was significantly higher in patients with unstable/active vitiligo (243.12±136.64 ng/l) than in patients with stable vitiligo (144.35±28.82 ng/l). Patients with serum level of less than or equal to 150.90 ng/l can be diagnosed as stable vitiligo, with 76.47% sensitivity and 73.91% specificity. Conclusion IL15 is a good and reliable marker for the detection of activity in patients with vitiligo, but further studies are needed to follow the progression of disease and to correlate this with the serum level of IL15. Targeting IL15 could be a novel treatment approach for patients with vitiligo.

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