Background Acne vulgaris is a chronic inflammatory disorder of the pilosebaceous unit that affects predominantly adolescents and young adults. Oral isotretinoin is a highly effective treatment agent for patients with nodulocystic acne and moderate to severe acne resistant to conventional therapy, isotretinoin might have side effects of oxidative stress and lipid peroxidation. . Malondialdehyde is the end product of lipid peroxidation and is a good marker of free radical-mediated damage and oxidative stress. Objective The purpose of this study to estimate malondialdehyde level in patients on Isotretinoin treatment for moderate to severe acne and compare them with healthy control group. Patients and Methods The case-control study was conducted at Ain. Shams University Faculty of Medicine, Egypt, from October 2017 to April 2017, and comprised male or non-pregnant female patients more than 18 years of age. 88 participants were included in the study; 44 cases, categorized by the Global Evaluation Acne (GEA) into 22 patients with moderate acne vulgaris and 22 patients with severe acne in comparison to equal healthy matching group. Isotretinoin was started in a dosage of 0.5mg/kg/day, and1.0mg/kg/day in patients with moderate and severe acne vulgaris respectively. Malondialdehyde, liver function tests, lipid profile and CBC were tested at the baseline for all participants and after 3 months for the patients who started isotretnoin therapy. Results In the current study, the mean baseline level malondialdehyde among all cases was 141.39 µmo1/m1±88.90, (range: 34.5 -360) and in controls it was 40 [µmo1/m1 ±11.3, (range: 9.5-90.4) this difference was statistically highly significant (P = 0.001). There was highly significant difference in malondialdehyde serum level (p = 0.0001) among all cases after 3 months of isotretnoin therapy, also there was a significant increase in MDA serum level among moderate cases (p = 0.021) and highly significant increase of MDA in severe cases (p=.001).ALP, ALT, serum cholesterol and triglyceride significant increases were seen in all cases. Conclusion low dose isotretinoin seems to have less side effects on basic laboratory data such as CBC, liver function tests, lipid profile and Malondialdehyde serum levels than high dose.

Background Acne is a chronic inflammatory disorder of the pilosebaceous unit. Oral isotretinoin is a highly effective treatment for patients with moderate and severe, but causes significant side effects. Objective To estimate homocysteine level in acne patients after treatment with isotretinoin. Patients and Methods The prospective study was conducted at Ain Shams University Faculty of Medicine, Egypt, from June 2017 to November 2017, including male or non-pregnant female patients more than 18 years of age, categorized by the Global Evaluation Acne (GEA) into 22 patients with moderate acne vulgaris and 22 patients with severe acne. Isotretinoin was started in a dosage of 0.5 mg/kg/day, and 1.0mg/kg/day in moderate and severe acne patients respectively. Baseline homocysteine level, liver function tests, serum cholesterol and lipid profile were tested before and after 3 months. Results There was significant difference (p = 0.001) in homocysteine level among all cases Moreover, homocysteine serum level in patient's group who received high dose isotretinoin (1 mg/kg/d) showed highly significant results (p = 0.001) in contrast to patient's group who received low dose isotretinoin (0.5 mg/kg/d) = 0.003). A significant increase in lipid profile and liver function test was seen in all cases. Conclusion low dose isotretinoin seems to have less side effects on basic laboratory data such as CBC, liver function tests, lipid profile and homocysteine serum levels than high dose.

Background seborrheic keratosis is one of the most common benign epidermal tumors that affects both sexes equally, and usually arises in individuals older than 50 years. It presents as sharply demarcated, slightly raised brownish patches or plaques, usually on sun-exposed surfaces of the skin. The clinical presentation can be quite variable and includes clinical variants, such as stucco keratosis and dermatosis papulosa nigra. Aim of the Work to evaluate the efficacy and safety of topical carbon gel photo-enhancer assisted intense pulsed light versus methylene blue assisted intense pulsed light photodynamic therapy for treatment of Seborrheic Keratosis. Patients and Methods this is a comparative prospective study that included thirty patients of skin types III to V Fitzpatrick class having multiple Seborrheic Keratosis lesions with no sex or age predilection. They were randomly recruited from Dermatology out-patient clinic of Ain –Shams University Hospitals, during period from June 2017 till March 2018. The study was approved by Research Ethical Committee of Ain Shams University and fulfilled all the ethical aspects required for human research. Results this denoted that the methylene blue-mediated photodynamic therapy (MB-PDT) (liposomal-loaded methylene blue gel 10%).and topical carbon gel photo-enhancer assisted intense pulsed light). could be effective in treating patients with Sks. Our findings denote the efficacy of them in curing multiple Sk lesions. The efficacy of methylene blue-mediated photodynamic therapy (MB-PDT) (liposomal-loaded methylene blue gel 10%). Conclusion that Intense Light Pulse using liposomal-loaded MB and Topical carbon suspension-assisted IPL treatment could be a good option for patients with indistinct pigmented or thick melanogenesic lesions. Adverse reactions to this treatment were minimal and the results acceptable, though appropriate lesions need to be chosen care- fully.