Fractional CO2 laser is a possible safe and effective modality for the treatment of hypertrophic burn scars with improvement achieved both clinically and histopathologically.

Using different techniques in M-K susp produces comparable results. However, the distal fingers showed better results using combination of donor NCECS and recipient cryoblebs.

Diphencyprone is an effective and safe treatment of extensive AA. A long period of therapy is needed and will increase the percentage of responders especially in alopecia totalis and universalis. Maintenance therapy is recommended to reduce the risk of relapse.

NB-UVB phototherapy remains to be an effective and safe therapeutic option in vitiligo. Response to UVA1 in vitiligo seems to be dose dependent and seems to be of limited value in treatment of vitiligo as a monotherapy. Further studies combining it with other lines of therapy such as systemic steroids may prove beneficial.

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Rituximab (RTX) has been used successfully to treat refractory pemphigus. We aimed to assess the response of pemphigus vulgaris (PV) cases to RTX therapy and its effect on CD4CD25 (T regulatory) cells level. Sixteen PV patients were included in this study, each received one cycle of two RTX infusions (1000 mg on days 1 and 15). Five PV patients served as controls. All cases were on prednisolone ± adjuvant therapy. Pemphigus disease area index (PDAI), autoimmune bullous skin intensity score (ABSIS), anti-desmoglein antibodies, CD4, CD8, CD20 and CD4CD25 levels were assessed at baseline, 3, 6 and 12 months after therapy. Fourteen patients were followed up for a mean duration of 17 while two were lost to follow up 6 months after RTX therapy. A significant decrease in PDAI, ABSIS, Dsg3 (p < 0.0001) was found. The depletion of B cells lasted for 12 months in 11 (69%) patients and for 24 months in 3 (21.4%) patients. There was significant decrease in CD20 and CD4CD25 cells after 12 months of RTX, p values were 0.005 and 0.02, respectively. While no similar change in CD8 and CD4 was found (p = 0.2 for both), no significant change of CD20 and CD4CD25 cells were detected in the control group. In conclusion RTX is safe and effective as an adjuvant therapy in refractory cases of PV. In addition to B cell depletion a significant reduction of T regulatory cells occurs in treated cases which may be due to increased skin homing of these cells.

Summary Introduction Acral vitiligo is a resistant subtype of vitiligo that does not respond easily to any treatment modality. Ultraviolet A1 (UVA1) (340‐400 nm) therapy can penetrate the deep dermis of the skin and is relatively free of adverse effects associated with different phototherapeutic modalities. This study's objective was to evaluate the effect of medium‐dose long‐wavelength UVA1 (40‐70 J) in acral vitiligo treatment and compare it with topical psoralen plus ultraviolet A (topical PUVA). Methods Patients in this randomized‐controlled comparative clinical trial were divided into two groups, medium‐dose UVA1 group and topical PUVA group (10 acral vitiligo patients each). Patients received 36 sessions of phototherapy over a period of 12 weeks. Every patient was clinically evaluated monthly as regards the appearance of new lesions or increase in diameter of the current lesion according to point counting and vitiligo area severity index. Results No statistically significant clinical difference was found between patients in UVA1 and topical PUVA groups regarding response and pattern of response (P > 0.05). Conclusion Ultraviolet A1 seems to be of limited use as a monotherapy in acral vitiligo treatment. However, more studies combining it with other treatment modalities as systemic steroids and/or using higher UVA1 doses may prove beneficial.

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