Keloid scars are often considered an aesthetical problem that has physical implications and depressing outcomes. It may get itchy, painful, and may eventually result in psychological stress, clinical depression and may possibly affect joint movement. 1 Treating keloids is always challenging. Many therapeutic modalities have been proven to improve the limitations of keloid scars using

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IntroductionVitiligo is an idiopathic pigmentary disorder of the skin characterized by sharply demarcated asymptomatic depigmented macules. Its pathogenesis is still unclear. Many mechanisms and theories have been suggested including autoimmunity, auto cytotoxicity, biochemical and neuronal mechanisms. No universally effective nor curative medical or surgical treatment has been proposed till this day. First line treatments include topical treatments such as corticosteroids and calcineurin inhibitors. While surgical options such as autologous melanocytes transplantation are suggested later on. Phototherapy, including narrow band ultraviolet B (NB-UVB) and monochromatic excimer light (MEL) of wavelengths 311 nm and 308 nm respectively, is considered as a successful method of treatment among those approaches.2 The cytotoxic T-cells accountable for the destruction of melanocytes and disappearance of melanin are eliminated by phototherapy through apoptosis (diffuse repigmentation) and UVB does stimulate melanocytic proliferation and their migration to the epidermis from nearby follicular units (follicular repigmentation) and perilesional active melanocytes (marginal repigmentation).3 NB-UVB indoor cabins have been used to treat vitiligo since the early 1990s, but recently, MEL was used and adapted for the treatment of some dermatological diseases including vitiligo. 4 The 308 nm wavelength delivered by either laser/lamp has shown satisfactory superiority to broad band (BB-UVB) and NB-UVB for clinically treating vitiligo. 5Only few researchers studied histopathological changes before and after treatment with NB-UVB. 6 However, to the best of our knowledge, none compared the Recently, the monochromatic excimer light (MEL) of 308 nm wavelength has shown some advantages in comparison to narrow band ultraviolet B (NB-UVB) for the treatment of vitiligo. To histopathologically compare the early effects of NB-UVB and 308-nm MEL phototherapy on vitiliginous patches using H&E and HMB-45. Methods: Thirty subjects with non-segmental vitiligo lesions were treated twice a week for 6 weeks with 308-nm MEL, while NB-UVB was used to treat lesions contra laterally. Skin biopsies were taken from lesional areas before and after 6 weeks of treatment by either modality. It was prepared for light microscopy and immunohistochemical study . This study was performed as a clinical trial (Trial registration: http://www.pactr.org; Identifier: PACTR201705002279419) Results: All lesions before treatment had labeling index (number of pigmented cells/nonpigmented cells) of 0.0 (0%). After treatment the LI for MEL was 4.2 ± 2.6, while for NB-UVB LI it was 0.3 ± 0.7. MEL showed higher statistical significance regarding increase of basal pigmented cells, and significant decrease in vacuolated keratinocytes and basal membrane thickness than NB-UVB. Conclusion:Although NB-UVB is considered as treatment of choice for vitiligo, MEL is acknowledged as an effective treatment modality for vitiliginous lesions that induces more repigmentation than NB-UVB, and ...

Burnout among physicians and dermatologists is gaining a wide attention in the recent decade. The aim of this cross sectional study was to assess the prevalence and predicting factors for burnout among Egyptian dermatologists. A cross sectional study was designed and data were collected using structured open access survey. A total of 144 dermatologists completed the full questionnaire. The majority of dermatologists completing the survey 85 (59%) were between 30 and 40 years age group while those above 50 years of age represented a minority 10 (6.9%). The Mean score of emotional exhaustion was 29.24 ± 12.73 (high) while that of personal accomplishment was 29.14 ± 9.24 (moderate) and for depersonalization was 10.07 ± 6.46 (moderate). We demonstrated high burnout prevalence among Egyptian dermatologist that needs to be further verified by other randomized studies. Being a resident dermatologist living in a rural locality and with more than 8 daily working hours were significant predictors of increased burnout rates.

The merging of psychiatry and dermatology has resulted in a relatively newer emerging field known as psychodermatology (PD). The aim of this cross sectional study was to assess knowledge, attitudes, and practice patterns of Egyptian dermatologists towards psychodermatology. A cross sectional study was designed and data were collected using structured self-administered online questionnaires. A total of 212 dermatologists completed the full questionnaire. Those with incomplete or partially answered responses were excluded. 171 (81.1%) were females and 40 (18.9%) were males. The majority (n = 109;51.4%) of dermatologists completing the survey were between 30 and 40 years age group while those between 40 and 50 years of age accounted for 48 (22.6%). The vast majority of respondent dermatologists never referred (n = 87; 41%) or very rarely referred (n = 58; 27.5%) any psychocutaneous patients to a psychiatrist. Almost 75% of responding dermatologists were not aware of available community or educational resources for PD and 157 (74.1%) expressed interest in receiving continuing medical education (CME) programs. In conclusion, psychodermatology training among dermatologists shall enhance and improve their approach to psychocutaneous conditions.

Background Phosphodiesterase type 5 inhibitors (PDE5Is), due to their efficacy and tolerable profile for more than 2 decades,are considered a good addition to the available treatments in patients with erectile dysfunction (ED). Aim We sought to assess the possible influence of oral PDE5Is on male human reproduction. Methods A literature review was performed in several databases, including the PubMed/Medline database, Scopus, Cochrane Library, EMBASE, Academic Search Complete, and Egyptian Knowledge Bank databases. The keywords/search terms were “PDE5Is,” “sildenafil,” “vardenafil,” “tadalafil,” or “avanafil,” combining and crossing them with “male infertility,” “semen,” “reproductive hormones,” or “sperm.” Results Overall, 101 articles were selected. After removal of duplicates and animal studies, 75 articles were finally subjected to review covering the different items related to male human reproduction, including effects of PDE5Is on different parameters of semen or reproductive hormones, as uses of PDE5Is in cases related to distinctive male factor infertility, such as ED, temporary ED, or ejaculatory failure alongside assisted reproduction (AR) procedures, and ejaculatory dysfunction in spinal cord lesions. We found 26 articles that addressed the direct effects of PDE5Is on semen and reproductive hormonal profiles, 16 in vivo studies and 10 in vitro studies. Oral PDE5Is have in general a stimulatory effect on sperm motility, while other semen parameters and reproductive hormonal profiles showed varied outcomes. Such effects are more pronounced with a long-term daily regimen than with an on-demand regimen. However, it seems that the best-controlled studies suggested no change in the sperm quality of male reproductive potential. Conclusion Oral PDE5Is have in general stimulatory effects on sperm motility, while other semen parameters and hormone profiles showed varied results. In addition, oral PDE5Is have played a useful role in conditions related to distinctive male factor infertility, such as ED, temporary ED, ejaculatory failure alongside AR, and ejaculatory dysfunction in spinal cord lesions.