Although the efficacy of long-pulsed alexandrite laser seems unmistakable, the short- and long-term untoward effects of such treatment have yet to be carefully delineated and the underlying mechanisms are yet to be adequately clarified.
Background: Atrophic scars cause significant patient morbidity. Fractional photothermolysis is one of the most effective treatment options used to resurface scars of different etiologies. Aims: To assess the efficacy and safety of different fractional ablative CO 2 laser parameters in treatment of linear atrophic depressed post-traumatic facial scars in adult male patients. Methods: A prospective pilot study of 20 adult male patients (skin types Π-Ⅳ, aged 18-45) with post-traumatic atrophic linear scars were divided into 2 groups each comprising 10 patients receiving different fractional CO 2 laser parameters. Both groups received 3 laser sessions, one month apart, and were followed for 2 months after the last treatment session. Clinical and histological assessments were done to all patients before treatment and 2 months after the last treatment session. Also, patient satisfaction and side effects were recorded. Results: The study showed statistically significant reduction in average scar volume in both groups (P < .01), with reduction in depth more obvious than reduction in width or length in both groups. There was a highly significant difference in overall scar improvement represented by scar volume between both groups (P < .01) with an average reduction in scar volume of 42.85% in group (a) compared with 35.29% in group (b). Also, there was a highly statistically significant increase in both epidermal and papillary and reticular dermis thickness in both groups after treatment. However, the difference between both groups was nonsignificant. Side effects were mild, well tolerated, and transient. Conclusion: Fractional CO 2 laser can be utilized as a safe and effective modality in treatment of post-traumatic linear atrophic scars of the face. Adjusting parameters toward increasing depth of penetration and decreasing thermal coagulative effect gives better results.
Background Vitiligo is a disease that causes the loss of skin color. The extent and rate of color loss from vitiligo is unpredictable. It can affect the skin on any part of your body. It may also affect hair and the inside of the mouth. Aim of the Work Aiming for treating localized stable vitiligo by a simple, old technique. This study was based on a minimal burn, insufficient to develop scar, might activate the repairing processes which would enhance in the same time the MCs proliferation. Patients and Methods The study was done on 30 patients presented with localized stable vitiligo. Superficial electrocautery was done every month for 4 months with application of daily closed wound care using combined fusidic acid and betamethasone valerate cream followed by herbal β sitosterol containing cream then occlusion with Vasline gauze for 10 days or till complete wound healing. Other patch in the same patient is treated only by the above mentioned topical treatment as a control. Results In our study of total 30 patients, 8 patients (27%) showed marked repigmentation after treatment, 16 patients (53%) showed moderate response and the remaining 6 patients (20%) showed mild or no response to treatment. Conclusion No significant side effects were noticed during the course of treatment. Just mild, transient erythema and burning sensation were detected.
Background Alopecia areata (AA) is an autoimmune disorder characterized by transient, non-scarring hair loss with preservation of the hair follicle. It affects nearly 2% of the general population at some point during their lifetime. Extent of the disease can vary widely from localized hair loss in well-defined patches to diffuse or total hair loss, which can affect all hair-bearing sites. Patchy alopecia areata affecting the scalp is the most common type. Objectives The aim of this study is to evaluate the efficacy and safety of topical diphenylcyclopropenone alone and in combination with intralesional steroids or systemic steroids for the treatment of extensive and/or refractory cases of alopecia areata. Patients and Methods The study included 21 patients suffering from alopecia areata during January 2018 till November 2018. They were recruited from the Outpatient Clinic of Dermatology, Ain Shams University Hospital and El-houd EL-marsoud Hospital. All patients gave written consent to participate in this work after explanation of the technique, expectations, possible side effects and alternative treatments. The study was approved by Research Ethical committee of Ain Shams University. Results We found that about three quarters of AA patients were males and majority were young adults aged 15 to 50 years. The duration of the disease was more than one year and mean age of first onset was 15 years. About half of the patients was of refractory type. All patients recalled previous history of AA and 90% treated by combined therapy. Scalp was affected in all patients and eyebrow in half of them while nails were affected in 10%. Mean SALT score at time of presentation was 59%. Dermoscopic examination revealed that majority of the patients (95%) had yellow dots; two third had black dots and vellous hair; while exclamation and short thin hairs were found in approximately one third of the patients. The study found that there is statistically significant difference between mean SALT scores among the three treatment modality groups at start of treatment course specifically between group II (40.6 (±20.9)) and group III (82.5 (±21.7)) (p = 0.04). Conclusion DPCP is an effective and safe treatment of extensive and refractory AA especially with intralesional steroid. Older age at onset of the disease is good indicator for a better prognosis. No statistical significant difference between treatment modalities regarding response stratified by other demographic and clinical feature of AA patients.
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