Fractional CO laser-assisted drug delivery is an effective and safe treatment option for onychomycosis.

Onychomycosis is an important medical disorder affecting both health and quality of life of patients. This study was done to compare the efficacy of CO 2 laser in combination with topical tioconazole versus CO 2 laser only versus topical tioconazole alone in onychomycosis. A total of 120 patients with onychomycosis were randomly assigned to three groups. Group A patients were treated with fractional CO 2 laser followed by topical tioconazole 28% for five sessions with 3 weeks interval. Group B patients were treated with only fractional CO 2 laser for five sessions with 3 weeks interval. Group C patients were treated with only topical tioconazole 28% for 16 weeks. The clinical effect, KOH examination, and culture for the affected nails in the three groups were analyzed.One month after the last session, regarding clinical response, 55% showed complete clinical improvement in Group A versus 30% in Group B versus 25% in Group C with a significant difference in between. There was a significant difference between the three studied groups as regard KOH test and culture after treatment. Fractional CO 2 laser combined with topical antifungal is a safe and effective treatment for onychomycosis. K E Y W O R D Sfractional CO 2 laser, onychomycosis, tioconazole

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Introduction: Granulocyte-macrophage colony-stimulating factor (GM-CSF) is an essential factor in the growth and maturation of blood cells as well as modulation of the immune system. Few studies have investigated its involvement in the development of vitiligo, and no studies have been performed on Egyptian patients. Aim: To assess GM-CSF serum level among non-segmental Egyptian vitiligo patients and to determine its possible role in the etiopathogenesis of the disease. Methods: Forty patients with non-segmental vitiligo and 40 age-and sex-matched subjects were assessed for levels of GM-CSF in serum using the ELISA technique. Results: The patients in this study showed lower levels of GM-CSF in serum compared to controls (mean ± SD was 33.4 ± 5.7 pg/ml versus 63.4 ± 7.4 pg/ml, respectively, p = 0.0001). No appreciable relation was detected between levels of GM-CSF in serum and age, sex, family history, and stressful events or disease activity, type, and extent, p > 0.05. Conclusions: GM-CSF serum level may be one of the determinants of the autoimmune hypothesis in the etiopathogenesis of nonsegmental vitiligo.

Pityriasis versicolor (PV) is a chronic superficial fungal infection. Management using azole drugs leads to drug resistance. The present study aimed to compare the clinical outcome of 0.1% adapalene gel vs 2% ketoconazole cream and their combination in PV. This randomized double‐blinded study was conducted on 90 PV patients divided into three equal groups. GI was treated with topical ketoconazole 2% cream twice daily and placebo, GII was treated with topical 0.1% adapalene gel twice daily and placebo and GIII was treated with topical combination of 0.1% adapalene gel (at night) and ketoconazole 2% cream (in the morning). All patients received medications for 4 weeks. Evaluation was done at 2 and 4 weeks and included clinical assessment, laboratory assessment, and patient satisfaction. We found that after 4 weeks of treatment, all groups showed significant improvement. There was better response in GIII in terms of lower rate of positive potassium hydroxide staining, higher rate of significantly improved cases and higher rate of well‐satisfied patients. However, the difference fell short of statistical significance. We concluded that a combination of adapalene gel and ketoconazole cream is very effective in treatment of PV with no or mild side effects.