The Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling pathway has been linked to the pathogenesis of many inflammatory skin diseases; however, the role of JAKs in the pathogenesis of acne vulgaris has not been previously elucidated. We aimed to analyze the cutaneous expression of JAK1/2/3 proteins in acne vulgaris and investigate the possible role of JAK signaling in acne pathogenesis. This case‐control study was carried out on 28 patients with inflammatory acne vulgaris vs 20 age‐ and sex‐matched healthy volunteers. Acne severity was assessed using Global acne severity grading system (GAGS). Skin biopsies were collected from lesional and non‐lesional skin of patients and from control group. The expression of JAK1/2/3 proteins was examined by real‐time quantitative polymerase chain reaction. JAK1 and JAK3 were overexpressed in acne lesions, compared to non‐lesional skin and the control group. No significant difference was found in JAK2 expression between patients and controls. JAK1 and JAK3 showed no significant relation with the patients' age, sex, family history, duration of acne, or GAGS score. Our results suggest the activation of JAK pathway in acne lesions, indicating that it may play a pivotal role in the inflammatory disease process. JAK1 and JAK3 may be possible new targets for acne therapy.

BACKGROUND Melasma is an acquired challenging pigmentary skin problem, which commonly affects the face. A wide range of therapeutic modalities is available, yet none is satisfactory. OBJECTIVE To compare efficacy and safety of trichloroacetic acid (TCA) 20% peeling with either modified Jessner's solution (MJs) or with glycolic acid (GA) 70% peeling in the treatment of melasma. PATIENTS AND METHODS Thirty adult Egyptian women with melasma were recruited in the study. After cleansing the face, MJs was applied on one side of the face and GA 70% on the other side. Then, TCA 20% was applied in one uniform coat on both sides of the face. Assessment of the clinical response was guided by calculating the melasma area, severity index (MASI), modified MASI, and hemi-MASI scores before and after the end of treatment. RESULTS Both combinations showed significant reduction in MASI, modified MASI, and hemi-MASI scores (p value 5 .000, for each). Moreover, the hemi-MASI score after MJs and TCA20% showed a significant decrease compared with GA70% and TCA20% (p value 5 .013). CONCLUSION Both modalities are successful, safe options for treating melasma. Moreover, combining MJs with TCA 20% is more efficacious.

Background The Janus kinase–signal transducer and activator of transcription signaling pathway has been suggested as a promising therapeutic target in vitiligo. However, limited data is available on the cutaneous expression of JAK in vitiligo. Aim This study is designed to analyze the cutaneous expression patterns of JAK1, 2, and 3 in vitiligo and investigate their relation to the disease clinical parameters. Methods This case–control study recruited 24 patients having active vitiligo and 20 age, sex, and skin type-matched healthy volunteers. Skin biopsies were obtained from patients (lesional, perilesional and nonlesional) and controls for assessment of JAK1, 2, and 3 expression using RT-PCR. Results JAK1 and JAK3 were overexpressed in patients’ skin compared to control skin and showed a stepwise pattern of upregulation from control to nonlesional, perilesional and lesional skin. However, JAK3 showed much stronger expression. In contrast JAK2 expression showed no significant difference in any of lesional, perilesional or nonlesional skin compared to control skin. JAK1 and JAK3 expression levels showed no correlation with neither the disease activity nor severity. Conclusion JAK1 and more prominently JAK3 are upregulated in vitiliginous skin and possibly contribute to the pathogenesis of the disease. Accordingly, selective JAK3/1 inhibition may provide a favorable therapeutic opportunity for vitiligo patients. This study is registered on the ClinicalTrials.gov Identifier: NCT03185312

Introduction: Common warts are hyperkeratotic, benign cutaneous growths caused by types 1, 2, and 7 Human papilloma viruses. Different modalities are available to treat warts. Cryotherapy is one of the most common and effective treatments for common warts. Trichloroacetic acid (TCA), in high concentrations, can be used as a therapeutic modality. Objectives:The aim of this study is to compare the efficacy and safety of cryotherapy using liquid nitrogen (spray method) versus trichloroacetic acid 90% in treatment of common warts. Patients and methods:Thirty-five patients with 414 common warts, from the Dermatology outpatient clinic, Assiut University Hospital, were enrolled in this study.We used two techniques for the treatment of common warts. The lesions in each patient were divided into two groups (A and B), group A treated by cryotherapy while group B treated by trichloroacetic acid (TCA) 90%. Results:There was significant decrease in the size of the warts in both groups. There were statistically significant better results among group A than group B regarding the mean percentage of improvement (90.11 ± 27.92 vs 26.19 ± 42.93, respectively; P < 0.001) and grade of improvement, where good response was obtained in 89.2%in group A compared with 26.2% in group B (P < 0.001). Complete cure was significantly higher in group A (83.1%) than group B (21.3%; P < 0.001). However, side effects were significantly higher among group A than group B. Conclusion:Cryotherapy is more effective than TCA 90% in treatment of common wart. TCA 90% has lesser complications than cryotherapy.

This study aimed to assess the possible correlation between mammalian target of rapamycin (mTOR) gene expression and sperm DNA damage among infertile patients with and without varicocele. The study included sixty infertile males and fifty fertile males as controls. The infertile group was subdivided into the following subgroups: thirty males with varicocele and thirty males without varicocele. All subjects underwent medical history collection, clinical examination, semen analysis, sperm DNA integrity assessment, mTOR gene expression assessment and scrotal colour Doppler ultrasound. The mean mTOR gene expression in infertile patients with varicocele (23.52 ± 14.65) was significantly higher than that in infertile patients without varicocele (12.24 ± 12.44) and fertile control subjects (3.92 ± 3.26; p = 0.003 and p < 0.001 respectively). In the infertile varicocele‐positive group, mTOR gene expression showed a significant negative correlation with sperm count (p = 0.028, r = −0.400) and progressive sperm motility (p = 0.038, r = −0.381), as well as a significant positive correlation with the sperm DNA fragmentation index (DFI; p = 0.001, r = 0.578). In the infertile varicocele‐negative group, mTOR gene expression showed a significant negative correlation with progressive sperm motility (p = 0.018, r = −0.429) and a significant positive correlation with sperm DFI (p < 0.001, r = 0.673). In conclusion, according to these results, there is a significant positive correlation between mTOR gene expression and sperm DFI among infertile patients with and without varicocele.

Recalcitrant alopecia areata is not uncommon in clinical practice and some patients experienced either treatment failure or recurrence with most of the conventional therapies. Several studies have evaluated the efficacy of cryotherapy in the treatment of alopecia areata with controversial results. This study aimed to optimize the ideal timing of liquid nitrogen cryospraying to achieve the most favorable results. A total of 75 patients with recalcitrant alopecia areata were treated with superficial cryotherapy, two freeze‐thaw cycles, each consisted of 3 to 5, 8 to 10, and 13 to 15 seconds in group A, B, and C, respectively. Good to moderate improvement was achieved in 65.2%, 76%, and 76.2% in groups A, B, and C, respectively, with no statistically significant difference. However, the mean percentage of improvement was significantly higher in group B and C compared to group A (P‐value < .05 for each). Superficial liquid nitrogen cryotherapy is an effective therapeutic modality for recalcitrant alopecia areata. Moreover, using 8 to 10 seconds dual freeze‐thaw cycles is the optimum timing.

Background Therapies for postacne scarring act through modulation of elastin and collagen, and collagen III might therefore represent a biomarker of treatment effectiveness. Patients and methods Patients (n = 70) with postacne scars and individuals without scars (n = 56) were included in this case‐control study. Patients were treated with Dermaroller microneedling, trichloroacetic acid chemical reconstruction, punch excision, or scar subcision. Scar severity was graded immediately before and after treatment with a photographic quartile scale and the ECCA scale. Serum levels of collagen III were measured in control individuals and in patients, before treatment, 1 month after the first treatment session, and 4 months after the final session. Results Circulating levels of collagen III were significantly higher in patients with postacne scarring (24.1 ± 12.5) before treatment than in control individuals (2.6 ± 0.8). Circulating levels of collagen in patients were significantly lower 4 months posttreatment (14.3 ± 8.1) than at baseline. The mean percentage change in serum collagen III was positively correlated with both the mean percentage improvement by photographic evaluation (r = .530, P < .000) and the mean percentage change in the ECCA scale (r = .632, P < .000). Conclusion Circulating collagen III is a biomarker for improvement of postacne scarring following different therapies.