Androgenetic alopecia (AGA) is a nonscarring alopecia due to hormonal and genetic influences and is characterized by the progressive miniaturization of hair follicles, with the transformation of terminal hair into vellus hair. Female pattern hair loss is a term that is used latently to describe AGA in females. 1 The frequency and severity of AGA increase with the increasing age of the patients. 2 The major pathogenic cause of AGA is a dihydrotestosterone (DHT) imbalance, which might interfere with the progressive miniaturization of scalp hair. Most of the research in this field is aimed at solving this problem by medical therapy that has been used effectively for androgenetic alopecia (AGA). FDA approved two therapies for AGA: topical minoxidil and oral finasteride. 3 Many authors investigated adding some procedures as co-adjuvant therapies for AGA as mesotherapy, platelet-rich plasma (PRP), stem cell therapies, that is, adipose-derived mesenchymal stem cells (AD-MSCs), and human follicle stem cells (HFSCs). 4,5 Platelet-rich plasma is an emerging treatment for AGA. It is an autologous solution drawn from one's blood that has been centrifuged and filtered to contain a high concentration of platelets and their bioactive growth factors. 4,6 The use of PRP is promising adjuvant therapy for AGA. Safety issues, downtime, and side effects seem to be minimal. PRP

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Background: NB-UVB phototherapy is still an effective treatment in vitiligo but requires more than 1 year for its completion. Topical 5-flurouracil could improve the proliferation and migration of melanocytes. Laser-assisted dermabrasion results in stimulation of the inactive melanocytes present at the outer root sheath of the lower portion of the hair follicle, which migrates upward until they reach the surface of the skin. Objective: To evaluate the effect of Er:YAG laser skin ablation followed by topical 5-flurouracil on the outcome of NB-UVB phototherapy as a short term technique in resistant and stable vitiligo. Methods: The current study included 40 patients suffering from bilateral stable vitiligo resistant to NB-UVB. For each patient, one side of the body subjected to 4 months NB-UVB sessions (control side). While the other side of the body subjected to one session of Er:YAG laser ablation combined with topical 5% 5-flurouracil application under occlusion followed by NB-UVB sessions for 4 months after complete re-epithelization. Outcomes were evaluated objectively based on standard digital photographs, histopathological examination, patient satisfaction, and adverse effects. Results: There was a statistically significant improvement in the repigmentation in laser side compared with control side. Histopathological examination revealed expression of prominent melanin pigmentation, with marked expression for Melan-A in laser side, whereas these findings were negative in control side. Conclusion: Er:YAG laser ablation, followed by 5FU application before NB-UVB phototherapy for vitiligo, is a safe and tolerable technique that improves the outcome of short-term NB-UVB therapy and is expected to increase patient compliance.

PurposeDermatophytes are fungi that cause infections affecting hair, nail, and skin; in nails they cause onychomycosis, while in hair they lead to tinea capitis. Detection of dermatophytes using traditional methods, including potassium hydroxide (KOH) and culture on agar-based media leads to high rates of false-negative results. Here, we investigated more accurate diagnostic techniques, including Chicago sky blue staining and Calcofluor white fluorescent staining and compared them with traditional KOH and culture methods for the diagnosis of fungi causing onychomycosis and tinea capitis.Patients and methodsThis study was conducted using samples from 50 patients with dermatophytosis of the hair or nail. Samples were subjected to all the following laboratory investigations: KOH wet mount, culture on Sabouraud’s dextrose agar, Chicago sky blue staining, and Calcofluor white staining. The results of the new diagnostic techniques were compared with those of the traditional methods.ResultsCalcofluor white stain and Chicago sky blue stain for dermatophytosis of hair and nail are more specific and sensitive as compared to traditional diagnostic methods. KOH wet mount is simple, rapid, and inexpensive test but lacks color contrast and gave more false positive (artifacts) and false-negative results as compared to these new stain methods.ConclusionChicago sky blue and Calcofluor white staining are excellent methods for diagnosis of fungal infections, including those that cannot be confirmed using conventional methods.

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Background Acne vulgaris is a multifactorial disease that mostly heals by scarring. Interleukin‐1 beta (IL‐1β) is a proinflammatory cytokine, suggested to play a key role in acne pathogenesis. Objective To study the immunohistochemical (IHC) expression of IL1β in acne vulgaris and acne scars to evaluate its possible role in their pathogenesis and to study the relation between the expression of IL1β and the clinicopathological parameters. Patients and methods This study was conducted on sixty subjects (twenty patients with acne vulgaris and twenty patients with acne scars), and twenty healthy volunteers as controls. Skin biopsies were taken from patients and controls for routine histopathological examination with hematoxylin and eosin stain and IHC staining of IL‐1β. Results There was a statistically significant increase in expression of IL‐1β in acne vulgaris compared with post‐acne scars and controls, (p < 0.001) for both. IL‐1β expression was significantly positively correlated with both clinical severity of acne vulgaris (p = 0.022) and severity of histopathological inflammation (p = 0.011). Conclusion Interleukin‐1β expression was associated with acne vulgaris and post‐acne scars with significant positive correlation to clinical and histopathological severity of acne vulgaris. Thus, IL‐1β could be a key player cytokine in acne pathogenesis, its severity and development of post‐acne scars.

Background Updates of treatment methods of stable vitiligo are needed to give better outcomes with a shorter duration of treatment. Objective To test the effect of transdermal 5‐fluorouracil (5‐FU) delivery using fractional CO2 (FrCO2) laser versus intralesional 5‐FU injection, with narrow‐band type ultraviolet B (UVB) (NB‐UVB) therapy after both, in the treatment of stable vitiligo. Patients and methods The present study comprised 40 patients with nearly symmetrical stable vitiligo lesions. The left side was treated with FrCO2 laser followed by topical 5‐FU (FrCO2 + 5‐FU), while the right side was treated with 5‐FU intradermal injection. Both procedures were done at 2‐week intervals for 3 sessions followed by 24 sessions of narrow‐band UVB for both sides. Results Repigmentation was demonstrated on the left side of 90% of patients and the right side of 85% of patients. As much as >50% improvement was demonstrated on the left side of 50% of patients, and the right side of 55% of patients. Intralesional 5‐FU showed a statistically significant difference in repigmentation compared to FrCO2 + 5‐FU. Conclusion Both 5‐FU injection and FrCO2 + 5‐FU were effective therapeutic modalities for vitiligo. Patients were more compliant with FrCO2 + 5‐FU.

The clinical presentation of severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2 COVID‐19) varies from asymptomatic infection to a life‐threatening, multiorgan disease. One of these manifestations is telogen effluvium (TE) which is characterized by diffuse hair loss occurring in patients previously infected with SARS‐CoV‐2 and lasts ~3 months, after which excessive hair loss follows. Hair follicles are known to contain a well‐characterized niche for adult stem cells which is the bulge containing epithelial and melanocytic stem cells. Stem cells in the hair bulge, a demarcated structure within the lower permanent portion of hair follicles, can generate the interfollicular epidermis, hair follicle structures, and sebaceous glands. This study aims to evaluate autologous micrografts from scalp tissues as a therapeutic modality in the management of TE caused by COVID‐19. Twenty patients of previous COVID‐19 infection suffered from TE were included in this study for human follicle stem cells micrograft scalp treatment and they were evaluated after 3 months of treatment and after 6 months. There was significant improvement of the hair thickness and density compared with the start of the treatment and 6 months of follow‐up. Autologous micrograft of the scalp showed marked improvement in the treatment of COVID‐19 TE.