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   2013| June  | Volume 33 | Issue 1  
    Online since June 23, 2014

 
 
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ORIGINAL ARTICLES
Easy phytic peel as a therapeutic agent in acne vulgaris and melasma
Sahar Al-Mokadem, Ola Al-Aasser, Amani Nassar, Eman A Al-Sharkawy
June 2013, 33(1):6-11
DOI:10.7123/01.EJDV.0000430805.40547.ba   
Background

Phytic acid (myoinositol hexaphosphate) is found in almost all grains, fibers, and plants. It is a natural plant antioxidant. Easy phytic peel is a commercial product; it has a slow release, which promotes continuous penetration of the skin, and requires no external neutralization.

Aim

The aim of this study was to evaluate the effect of chemical peeling using a solution composed of phytic acid, glycolic acid, lactic acid, and mandelic acid in the treatment of acne vulgaris and melasma.

Methods

This study was carried out on 40 patients: 20 with active lesions of acne vulgaris and 20 with melasma. Both groups were treated with the aforementioned solution every week for 6 weeks.

Results

A highly significant decrease in the Global Acne Grading System scores and the Melasma Area Severity Index scores was reported after treatment (P<0.001) in case of patients with acne and melasma, respectively. However, the results of peeling were much more promising in patients with active acne compared with in those with melasma. No side effects were observed during or after treatment.

Conclusions

Peeling with this combination can be considered an effective, safe, and well-tolerated procedure in the treatment of patients affected with active acne and melasma.

  4,147 360 -
Comparative study of the 80% trichloroacetic acid multiple puncture technique versus botulinum toxin type A in the treatment of keloid scars
Noha Ghonaim
June 2013, 33(1):22-27
DOI:10.7123/01.EJDV.0000431207.04926.59   
Background

Keloid is one of the most challenging clinical problems encountered in wound healing. Although there are numerous treatment modalities, none of them have shown excellent therapeutic results.

Aim

The aim of the study was to evaluate the efficacies of 80% trichloroacetic acid (TCA) and botulinum toxin type A in the treatment of patients with keloid scars.

Methods

Thirty keloid patients were divided into two groups (each consisting of 15 patients). In group A, keloid scars were punctured using a punch instrument previously dipped in 80% TCA, whereas in group B keloid scars were injected intralesionally with botulinum toxin type A (2.5 U/cm3;). All patients underwent three to five therapeutic sessions 1 month apart, and follow-up for 1 year. The therapeutic response was determined according to the scores on the Vancouver scar scale and a self-assessment scale for pain and pruritus.

Results

In group A, the mean scores on the Vancouver scar scale before and after treatment were 9.73±1.33 and 4.94±2.44, respectively, with a total improvement of 49%. In group B, the mean scores on the Vancouver scar scale before and after treatment were 9.05±1.34 and 4.68±2.67, respectively, with a total improvement of 48%. Comparison between mean values obtained on the Vancouver scar scale in groups A and B after treatment showed a statistically nonsignificant difference. Group B showed better improvement as per the self-assessment score. Most common side effects were reported in group A and were in the form of hyperpigmentation (33.3%), hypopigmentation (6.7%), and mixed pigmentation (6.7%). Relapses occurred in 26.7% of patients in group A, whereas no relapses occurred in group B.

Conclusions

The 80% TCA multiple puncture technique is better than botulinum toxin type A in the treatment against keloids.

  2,838 211 -
Quality of life in erectile dysfunction patients and their partners responding to tadalafil versus sildenafil citrate
Attia A Attia, Faisal A Hassan, Mohamed I Kamel, Mohammed R Ayoub
June 2013, 33(1):32-36
DOI:10.7123/01.EJDV.0000431583.00793.33   
Background

Erectile dysfunction (ED) is considered the most common sexual problem in men, with a direct impact on the life of the patient and their partners. Quality of life (QOL) has become a useful variable to assess the overall impact of diseases and medical treatments from the patient’s point of view.

Aim

The aim of this study was to estimate the QOL in ED patients responding to tadalafil versus sildenafil citrate as well as that of their partners and also to find out the type of treatment associated with the best QOL among these patients.

Methods

The present study was carried out over a period of 2 months and involved 60 diagnosed ED patients and their partners who were divided into two groups. Group A comprised 30 male patients who responded to tadalafil (20 mg) on demand therapy as well as their partners. Group B comprised 30 male patients who responded to sildenafil citrate (50 mg) on demand therapy as well as their partners. All patients included in the study were subjected to a thorough medical history taking, physical and genital examination, and QOL assessment using the WHO QOL BREF questionnaire before administration of tadalafil or sildenafil as a treatment for their condition; they were then reassessed after 2 months.

Results

The present study showed that ED has a negative impact on all domains of QOL.

Conclusions

Treatment with tadalafil or sildenafil improves QOL for both the patients and their partners in different domains of QOL.

  1,941 143 -
Study of the possible relationship between skin tags and obesity in Egypt
Khaled M El-Zawahry, Mohamed A.R. Abdallah, Heba E Elmahdy
June 2013, 33(1):18-21
DOI:10.7123/01.EJDV.0000431077.63748.d0   
Background

Skin tags have been investigated as a marker of type 2 diabetes mellitus; however, the relationship between skin tags and obesity is still a matter of controversy.

Aim

The aims of this study were to highlight the association between obesity and the presence of skin tags and to study the impact of carbohydrate intolerance on the prevalence of skin tags among patients attending the Dermatology Clinic in Cairo, Egypt.

Methods

This study included 170 patients with skin tags and 75 controls. We recorded age; sex; BMI; random blood glucose; and skin tag color, size, and number at different anatomical sites.

Results

There was no correlation between the presence of skin tags and age (P>0.05). The prevalence of skin tags was detected more often among male (68%) than among female participants (32%); this was statistically significant (P<0.05). They were detected more often among obese (87%) than among nonobese (13%) participants; this was statistically significant (P<0.05). The mean number of skin tags was significantly higher among obese (1032 skin tags, 95%) than among nonobese (52 skin tags, 5%) participants; this was statistically significant (P<0.05). Skin tags were higher among diabetic (60.5%) than among nondiabetic (39.5%) participants; this was statistically significant (P<0.005).

Conclusions

Skin tags are commonly among male patients and their expression is believed to be correlated with obesity as most patients showed an increase in BMI and have hyperglycemia.

  1,552 152 -
Role of prolactin in pemphigus vulgaris
Afaf Helmy, Mervat Azab, Mohamed Abd El-Kader, Amani Nassar, Hend Embaby
June 2013, 33(1):12-17
DOI:10.7123/01.EJDV.0000430806.59546.2f   
Background

Prolactin (PRL) has been shown to have immunomodulatory as well as lactogenic effects. Generally, it is known that PRL may also play a role in the activity of autoimmune diseases such as pemphigus, systemic lupus erythematosus, and rheumatoid arthritis.

Aim

The aim of this study was to estimate serum PRL levels in pemphigus vulgaris (PV) patients and determine the presence of any correlation between its levels and the extent of affected body surface area or type of involvement.

Methods

Forty serum samples from 20 PV patients and 20 healthy individuals as controls were collected. Serum PRL levels were measured using an electrochemiluminescence immunoassay.

Results

Hyperprolactinemia was found in 15% of PV patients and was absent in controls. However, this showed no statistically significant difference between serum PRL levels in PV patients and controls (P=0.4). Serum PRL levels were highest in patients with mucocutaneous involvement, followed by in those with mucosal involvement, and were the least in those with cutaneous involvement. However, there was no statistically significant difference between the three types of involvements and PRL levels (P=0.95). A statistically highly significant correlation between serum PRL levels and the extent of body surface area involvement was found (P<0.001).

Conclusions

PRL may serve as a useful biological marker of PV activity. Therefore, in severe refractory cases of PV, estimation of serum PRL levels should be carried out, as PRL-lowering drugs serve as useful adjuvant therapy in PV treatment.

  1,138 135 -
Evaluation of plasma-transforming growth factor-β1 in active-phase Peyronie’s disease
Mohammed I. Elzorkany, Naglaa A. Ahmed, Mohamed I. Kamel, Neama R. Hussein, Marwa M. Embarak
June 2013, 33(1):28-31
DOI:10.7123/01.EJDV.0000431535.86674.97   
Background

Peyronie’s disease (PD) is an acquired disorder of the penile tunica albuginea. PD may manifest in the form of palpable penile plaques, penile curvature, erectile dysfunction, and/or painful erections, all of which carry significant morbidity and psychological distress for both patients and partners. The underlying etiopathogenesis of PD is not well understood but is thought to be caused by injury to the penis, usually through sexual activity. The study of transforming growth factor-β (TGF-β) is of particular interest in the identification of the pathophysiological mechanisms involved in PD tunical fibroses and in the activation of inflammatory cytokines and fibrosis-associated cytokines.

Aim

The aim of the study was to determine and evaluate the plasma TGF-β1 level in patients with active-phase PD compared with control individuals and determine the association between TGF-β1 level and disease activity.

Methods

The study was carried out on 30 patients with clinically suspected and ultrasonographically confirmed PD, and the results were compared with 20 matched healthy individuals who formed the control group. All participants were subjected to full history taking, clinical examination, ultrasonographic evaluation, and measurement of plasma TGF-β1 levels.

Results

A significant increase in plasma TGF-β1 levels was found in active-phase PD patients when compared with controls, especially in patients suffering from pain and deformity and patients with associated comorbidities such as diabetes or hypertension (P<0.05).

Conclusions

Assessment of plasma TGF-β1 levels from peripheral blood samples is a simple method for detecting cavernous TGF-β1 expression without the need for penile blood samples. TGF-β1 may be a marker for PD.

  871 90 -
Vitamin D receptor and cathelicidin expressions in children with atopic dermatitis
Hanan M. Darwish, Noha M. Ghoneim, Doaa A. Hassan, Asmaa S. Farag, Laila Rashed
June 2013, 33(1):1-5
DOI:10.7123/01.EJDV.0000430804.31381.9c   
Background

Atopic dermatitis (AD) is a common chronic inflammatory type of eczema. Vitamin D may enhance the innate immune response by induction of cathelicidin (LL-37), an endogenous antimicrobial peptide. Several recent reports suggest a connection between vitamin D3 and the expression of antimicrobial peptides in keratinocytes. 1,25-dihydroxyvitamin D (1,25(OH)2D3) is the active form of vitamin D and exerts its actions through a specific intracellular vitamin D receptor (VDR).

Aim

To evaluate the expression of VDR and cathelicidin in children with AD in Egypt.

Methods

The study was carried out on 15 patients with AD and 15 healthy controls. Patients were divided into mild, moderate, and severe groups according to the SCORAD score. All individuals were subjected to skin biopsy. VDR and cathelicidin expressions were estimated using real-time PCR in patients and controls.

Results

A highly significant difference was detected between patients and controls in VDR and cathelicidin expression (P=0.001). A statistically significant correlation was observed between VDR and cathelicidin expressions.

Conclusions

Influencing cathelicidin expression by targeting the vitamin D3 pathway might present a novel therapeutic approach for the treatment of AD.

  747 125 -
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