Acanthosis nigricans is a common pigmentary disorder characterized by hyperpigmented and hyperkeratotic velvety skin lesions that presents mainly on the flexural sites, for example, the neck, the axillae, and groin. 1 The pathogenesis is mostly attributed to increased insulin resistance and hyperinsulinemia that result in stimulation of insulin growth factor 1 (IGF-1) receptors on keratinocytes and fibroblasts, leading to cellular proliferation. The dark color of AN is mostly due to hyperkeratosis rather than an increase in melanocytes. 2 It can be simply classified into four types: benign, malignant, drug-induced, and syndromic/pseudo-acanthosis nigricans. The term pseudo-acanthosis nigricans was referred to obese individuals who have AN with no underlying endocrinopathies. In these cases, the etiology was attributed to obesity, excessive local friction, and sweat. 3 The goal of therapy in AN is to correct the underlying disorder and treatment of AN lesions through cosmetic correction of the pigmentation. 4 Several topical and systemic agents have been used in the treatment of AN, for example, tretinoin, salicylic acid,

The term dilated facial pores refers to the visible openings on the surface of the skin that correspond to the dilated openings of pilosebaceous follicles. Large facial pores represent a common aesthetic complaint in both men and women with negative psychological impact. 1 They have been discussed in literature as sequelae of chronological aging and photoaging due to the defect in the collagen and elastin dermal framework. However, an increasing number of young patients are presenting at dermatology clinics with the complaint of dilated pores without signs of skin aging. 2 Other potential causative factors include sex, ethnic, and genetic predisposition, follicular size, and seborrhea. The association between increased sebum output and wide pores has been well established, and acne patients often complain of wide facial pores. 3 The treatment of dilated pores is difficult due to the multifactorial nature of its pathogenesis, and most current treatment options intend to address the associated factors. 4 A variety of treatment modalities have been tried, for example, topical and oral retinoids, chemical peels, microbotox, and energy-based devices. 4,5 The treatment

White piedra (WP) of the scalp is a superficial mycotic infection of the hairs frequently reported in tropical humid regions as Southeast Asia, South America, and Middle East. 1 The majority of cases occur in children and young adult females. 2 It is characterized clinically by the presence of multiple whitish soft nodules along the hair shafts. The patients may also present with dry lusterless hair, hair breakage, and frayed ends. 3 Direct microscopic examination and culture of infected hair enable a definitive diagnosis to be made. 4 Treatment of scalp WP is challenging as eliminating the fungus through cutting the hair is not always acceptable by the patients. Moreover, lack of response and post-treatment relapse is frequently encountered after topical antifungal therapy. 3 Persistent infection is more common in patients with long hair and those who reutilize their infected hairbrushes. 5 It was also hypothesized that the organism may cause penetration of the hair cuticle by its keratolytic activity, which

No abstract

Background Treatment of warts in diabetic patients with ablative modalities poses a significant risk owing to increased possibility of secondary infection, slow healing, and recurrence. Intralesional immunotherapy has gained popularity in the treatment of warts due to its proven efficacy and good tolerability compared with destructive methods. Aim To evaluate the intralesional Candida antigen injection for the treatment of multiple warts in diabetic patients. Patients/Methods Fifty diabetic patients with multiple genital/nongenital warts were divided into two groups. The first group (30 patients) received intralesional Candida antigen, and the second group (20 patients) had intralesional saline as control. The treatments were injected into the largest wart every 2 weeks until complete clearance of warts or for a maximum of five sessions. Results Complete clearance of warts was observed in 80% of the diabetic patients in the Candida antigen group compared with 15% in the control group (P < .001). Side effects to Candida antigen included pain during injection in all patients, flu‐like symptoms, and localized reaction at the injection site in few patients. Conclusion Intralesional Candida antigen injection can be a promising effective and safe therapeutic option for the treatment of warts in diabetic patients.

No abstract

The energy homeostasis-associated (Enho) gene, the transcript for the Adropin peptide, is usually linked to energy homeostasis, adiposity, glycemia, and insulin resistance. Studies on Enho expression in stressful conditions are lacking. This work aimed to investigate Enho mRNA expression and energy homeostasis in acute stress (AS) versus chronic unpredictable mild stress (CUMS) rat models. A total of thirty male Wistar rats (180–220 g) were fed a balanced diet with free access to water. Rats were divided into three equal groups (n = 10): (a) the normal control (NC) group; (b) the AS group, where one episode of stress for 2 h was applied; and (c) the CUMS group, in which rats were exposed to a variable program of mild stressors for 4 weeks. Energy homeostasis was analyzed by the PhenoMaster system for the automatic measuring of food intake (FI), respiratory O2 volume (VO2), CO2 volume (VCO2), respiratory quotient (RQ), and total energy expenditure (TEE). Finally, liver, whole brain, and adipose (WAT) tissue samples were collected, total RNA was prepared, and RT-PCR analysis of the Enho gene was performed. The CUMS group showed higher VO2 consumption and VCO2 production, and a higher RQ than the AS group. Furthermore, the TEE and FI were higher in the CUMS group compared to the AS group. Enho gene expression in the liver, brain, and WAT was significantly higher in the CUMS group than in the AS and NC groups. We can conclude that in the chew-fed AS rats, hypophagia was evident, with a shift in the RQ toward fat utilization, with no changes in body weight despite the increase in Enho mRNA expression in all studied tissues. In the CUMS group, the marked rise in Enho mRNA expression may have contributed to weight loss despite increased FI and TEE.