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Both NB-UVB and PUVA show comparable efficacy in the treatment of chronic urticaria with minimal reversible side effects.

Plexiform schwannoma is a rare neurogenic tumor, arising from skin and subcutaneous tissue. The presence of multiple schwannomas suggests a possible association with neurofibromatosis type 2 (NF2). A 50-year old male patient presented with multiple papulo-nodular cutaneous lesions on both arms and forearms. Histopathological examination revealed a dermal multinodular pattern of well-circumscribed masses of closely packed cells, with peripheral myxoid tissue, well-encapsulated in a thin collagenous capsule. S-100 immunohistochemical staining was diffusely and strongly positive. Neuron-specific enolase was positive, confirming a neural tissue tumor. An audiogram and Magnetic Resonance Imaging (MRI) of cerebro-pontine angle showed no detected abnormality, excluding acoustic neuroma. Thus, we present a case of multiple bilateral isolated cutaneous plexiform schwannomas, not associated with NF2. Multiple plexiform schwannomas is a very rare entity, distinct from neurofibromatosis (NF), and being confined to the dermis is even more rarely reported.

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Background This study will evaluate the effect of microneedling of vitiligo lesion with and without topical 5 fluorouracil. Vitiligo is an acquired pigmentary disorder of unknown etiology, affecting approximately 1 % of the world population, without predilection for race or sex. It is characterized by white macules and patches, whose size increases over time, due to the loss of melanocytes. Vitiligo can appear at any time, and it significantly impairs the patients’ quality-of-life Objective To compare the efficacy of microneedling followed by 5-FU with microneedling alone in the treatment of stable non-segmental vitiligo. Patients and Methods This interventional study was held in Dermatology, Andrology & STDs department, Faculty of Medicine, Ain Shams University during the period from January till November 2019. Fifty patients with stable non-segmental vitiligo were included in the study. Results Regarding the efficacy of treatment with microneedling only vs microneedling with 5-FU in our study, there is statistically significant difference between the two sides according to treatment response, needling with 5-FU side showed response in 76% of cases, while needling side alone showed (0%) response. The degree of improvement among our patients in microneedling with 5-FU side, we detect different grades of repigmentation as 12 patients of the studied participants (24%) showed no repigmentation, 23 patients (46%) showed mild grade (<25% repigmentation), 15 patients (30%) showed moderate grade (25–50% repigmentation) and no one of the studied participants experienced either good grade (50–75% repigmentation) either excellent grade (more than 75% repigmentation). Our study showed no relation between repigmentation response and both demographic and clinical data of the patients as (age, gender, family history, duration of disease, VASI severity score and Fitzpatrick skin phototype). On the other hand, we found statistically significant difference with better repigmentation after microneedling with 5FU on certain sites of vitiligo. We noticed that lesions on the trunk and extremities showed better results while the acral parts showed no response. Observing side effects after treatment, we noticed that, there is statistically significant difference in side effects incidence between two sides. Side treated with microneedling and 5FU experienced more frequent side effects as compared with the side treated with microneedling only, these side effects included, slight to moderate pain and burning sensation during procedure that was tolerated and disappeared within few minutes to hours and minimal erythema in the first few days post procedure. Conclusion On the basis of the current study, we can conclude that microneedling followed by topical 5% 5-FU of vitiligo lesion is safe and tolerable method of treatment of vitiligo. It can induce repigmentation in vitiligo lesion but it could not be considered as effective method of treatment. We need to combined it with other treatment modalities to improve the outcome. However, long followup of the patients is needed.

Background Androgenetic alopecia (AGA) is a patterned hair loss with multifactorial background including genetic, hormonal as well as environmental and lifestyle-related risk factors. The impact of non-genetic risk factors on the onset and disease progression of androgenetic alopecia in Egyptian males. Objective To explore the potential role of non-genetic risk factors on the disease development and progression of androgenetic alopecia in Egyptian males. Patients and Methods The study included 2000 subjects with and without AGA, during the period from February 2019 to September 2019. The study protocol was approved by faculty of medicine, Ain Sham University, Research ethics committee (FWA 000017585). An informed written consent for participation in this study was obtained from patients and controls before enrollment. One thousand male patients with AGA were recruited in the study. The diagnosis was made via clinical diagnosis, dermatological findings, trichoscopic assessment. Results Our study showed that after skin examination 416 patients had acne and 344 patients had seborrhea, with statistically significant association to AGA cases. Conclusion From our study, it can be concluded that AGA became a major type of hair loss complaint among Egyptian males especially young males. Many potential risk factors were found to be associated with the disease as smoking, stress, obesity, family history, exercise, HTN and unbalanced diet. Avoidance of such risk factors may help improve the disease.

Background Alopecia areata is an autoimmune hair loss which frequently starts in childhood. Its presentation had an extreme variability not only in the time of initial onset but also in the duration, extent, and pattern of hair loss during any given episode of active loss. Moreover, the course of disease is unpredictable, with spontaneous regrowth of hair occurring in 80% of patients within the first year and sudden relapse at any given time. Due to the clinical variability and unpredictable nature of spontaneous regrowth, diagnosis and management may be difficult and challenging. Objective The aim of this study is to evaluate the serum levels of IL-15 in active alopecia areata and correlate them with disease severity and activity according to dermoscopic findings. Methods This case-control study were conducted in Dermatology, Venereology and Andrology department, Ain Shams University Hospitals included 30 patients with different clinical variants of AA, the diagnosis was made via clinical examination and dermoscopic findings. In addition, 30 apparently healthy individuals of matched age and sex as a control group were included in the study. Results Dermoscopic examination among cases showed that the most common dermoscopic findings in patients were vellus hair and yellow dots, while the least common finding was exclamation mark hairs. On comparing serum IL-15 in patients and control groups, it was found that serum levels of IL-15 in patients were significantly higher than those in the control group. There was no statistically significant difference in serum IL-15 levels between patients with negative and positive pull test, nail involvement, or body involvement. Similarly, no statistically significant difference in serum IL-15 levels in patients with various subjective disease activity was detected. However, there was a highly significant difference between serum IL-15 levels in different SALT score groups, with the highest levels being in the S3 group. There was a highly significant difference between IL-15 levels in patients with and without black dots. Also, there was significant difference between IL-15 in patients with and without broken hair, and exclamation mark hair. There was no significant difference in level of IL-15 among patients with and without yellow dots, and with and without vellus hair. Conclusion On the basis of the current study, we can conclude that IL-15 is significantly elevated in AA patients when compared to the control subjects. It is also a possible marker of AA severity. It is positively correlated with dermoscopic findings in AA patients, so dermoscopic findings can be useful in evaluating severity of alopecia areata.

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