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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

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.

Vitiligo is an autoimmune disease characterized by patches of depigmentation. Zinc is an antiapoptotic molecule that exhibits antioxidant properties. The study aimed to investigate the serum levels of zinc in vitiligo patients compared to healthy controls and to whether exists a correlation between disease severity and serum levels of zinc. Fifty patients with vitilgo (group A) and 50 age and sex matched healthy controls (group B) were recruited and serum zinc level was measured using atomic absorption spectrophotometry and results were compared and correlated to each other and to disease severity and extension. The mean serum zinc levels in group A was 50.93 ± 11.02 in comparison to a mean of 77.09 ± 12.16 in group B (P = .049, T = −1.993). Vitiligo area severity index (VASI) scores in the vitiligo group ranged from 0.5 to 27 with a mean ± SD of (9.19 ± 4.47). A high statistically significant negative correlation was demonstrated between serum zinc levels and the extension of vitiligo (P value = .0001 and R value = − 0.835). A significant association exists between vitiligo and serum zinc levels. Serum zinc levels correlated negatively with vitiligo disease severity and extension. Zinc supplementation and use can be of potential importance in setting vitiligo treatment protocols.

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