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Several treatment modalities have been used for the treatment of keloid scarring but the optimal treatment has not yet been identified. Corticosteroids reduce excessive scarring by reducing collagen synthesis. Vitamin D can curb inflammation by inhibiting the activation and migration of leukocytes. Pentoxifylline is a methyl xanthine derivative initially developed for its vasodilatory properties. Evaluation and comparison between three modalities of treatment for keloid; intralesional vitamin D, pentoxifylline, and steroid. Forty-five patients with keloid lesions were divided into 3 groups; The first group: 15 patients were treated with intralesional triamcinolone acetonide. The second group: 15 patients treated with intralesional pentoxifylline. The third group: 15 patients treated with intralesional vitamin D. The response was evaluated clinically, Vancouver scar scale and patient satisfaction scale. At the end of the study, all groups showed highly statistically significant improvement compared to the baseline. The first group which was treated with triamcinolone acetonide showed excellent and good improvement 53% and 47% respectively. The second group which was treated with pentoxifylline showed excellent and good improvement 6.7% and 73.3% respectively. The third group which was treated with vitamin D showed excellent and good 6.7% and 86.7% respectively. Intralesional vitamin D and pentoxifylline are safe and effective therapeutic options for keloid lesions., Competing Interests: Declarations. Ethical approval: Ethical consideration: this study was obtained from the Research ethics committee of the Faculty of Medicine for Girls, Cairo, Al-Azhar University (FMG-IRB) met at the Faculty of Medicine for Girls, Nasr City with IRB 1318.The manuscript is an original unpublished work, and it is not submitted for publication elsewhere. Competing interests: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Despite the fact that anti-gliadin antibodies (AGA) play a key role in coeliac disease (CD) screening, elevated AGA levels have been reported in several immune-mediated cutaneous conditions even in the absence of gastrointestinal disease clinical manifestations. A gluten-free diet led to improvements in some of these disorders. The link between oral lichen planus (LP) and CD was revealed, but there is currently no information available regarding the association between cutaneous LP and gluten sensitivity. This study aimed to assess the AGA (IgA and IgG) serum levels in LP patients compared to controls and to determine their correlation with LP severity. The study included 20 patients with cutaneous LP and 20 age- and sex-matched controls, both free of CD manifestations. The enzyme-linked immunosorbent assay (ELISA) technique was utilized for the evaluation of AGA (IgA and IgG) serum levels. Hepatitis C virus (HCV) antibodies in LP patients were evaluated qualitatively using a chromatographic immunoassay. In LP patients, AGA (IgA and IgG) serum levels were significantly elevated compared to controls (p = 0.015 and p=0.016, respectively). A significant positive correlation between AGA (IgG) serum levels and the age of patients (p= 0.024), duration of disease (p= 0.02), and LP severity index (p< 0.0001) was found. AGA serum levels were insignificantly different between HCV-positive and HCV-negative LP patients (p= 0.054). In conclusion, the significant elevation of serum AGA levels in LP patients reflects a possible link between LP and occult CD. Serum AGA (IgG) levels can be used as a marker of LP severity.., (Copyright© by the Egyptian Association of Immunologists.)

Background: Melanocyte-keratinocyte transplant procedure (MKTP) or non-cultured epidermal cell suspension transplantation is a very popular surgical modality for treating stable vitiligo. The recipient-site preparation is one potential determinant in the repigmentation outcomes., Aim: To assess the efficacy of fractional CO 2 (FCO 2 ) laser in recipient-site preparation before MKTP and comparing it to the frequently used full surface laser ablation., Methods: This randomized comparative trial included 19 patients with 40 stable vitiligo lesions. In each patient, the treated sites were randomly categorized into two groups according to the recipient-site ablation (either fractional or full ablative CO 2 laser). Assessment of repigmentation was performed six months after the procedure., Results: Both modalities achieved successful repigmentation of a median of 80% and 77.5% for fractional and full ablation groups, respectively, with a non-statistically significant difference between them. The median of VASI change percent was -73% and -71% with fractional and full surface ablation, respectively., Conclusions: FCO 2 laser ablation is effective for recipient-site preparation before cell suspension transplantation as well as the full ablative CO 2 laser., (© 2021 Wiley Periodicals LLC.)

Background: Multiple therapeutic modalities are available for alopecia areata (AA) but still a challenging disease with variable severity, recurrence, and a major cosmetic concern., Aims: Compare the effectiveness and safety of intralesional methotrexate (MTX) versus triamcinolone acetonide (TrA) in the treatment of localized AA in adults, both clinically and trichoscopically., Patients/methods: 40 adult patients with localized AA were recruited and divided into two groups. 20 patients were treated by intralesional TrA and the other 20 patients were treated by intralesional MTX every 3 weeks, for maximum four sessions. Clinical and trichoscopic evaluation at baseline, each session and for 3 months after the last session was performed., Results: At the end of sessions (12 weeks), regrowth scale was significantly higher in TrA group compared to MTX group (p-value = 0.028). But, after 3-month follow-up, regrowth scale was higher in MTX group compared to TrA group (p-value = 0.153). A statistically significant reduction in AA specific trichoscopic signs after 12 weeks and at the 3-month follow-up in both groups. Local adverse events in both groups were transient and disappeared during the follow-up period., Conclusion: Intralesional MTX in treatment of localized AA in adults can be promising and comparable to intralesional TrA with the need for further controlled and extensive trials. Trichoscopy can reveal early clinical response through disappearance of AA-specific trichoscopic signs and also early detection of adverse effects., (© 2021 Wiley Periodicals LLC.)

Background: Atrophic acne scarring is a common cosmetic problem that may affect 95% of patients with acne., Aims: The objective is to evaluate the efficacy of the fractional CO 2 laser combined with intradermal injection of PRP versus intradermal injection of noncross-linked hyaluronic acid in the treatment of different types of atrophic postacne scars., Methods: The study included 30 patients with postacne scars. All the patients received 3 treatments of fractional CO 2 laser combined with intradermal injection of PRP at one side of the face compared with intradermal injection of noncross-linked hyaluronic acid at the other side of the face. Efficacy of the treatment was assessed by the physician's clinical assessment using Goodman and Baron's qualitative and quantitative grading systems and histopathological evaluation from six participants., Results: The study included 30 patients ages ranging from 25 to 44 years old. There was a statistically significant reduction in the severity of acne scars on both sides after treatment using qualitative and quantitative Goodman and Baron. Histopathological evaluation showed an increase in the collagen and elastic fiber content in both modalities with a more favorable outcome in the PRP-treated side., Conclusion: Both treatment modalities resulted in a significant clinical and histopathological improvement in atrophic postacne scar with insignificant difference between them., (© 2020 Wiley Periodicals, Inc.)

Alopecia areata incognita (AAI) is a type of diffuse hair fall with no confirmatory diagnostic test. The UL16 binding protein-3 (ULBP3) is ligands for natural-killer group 2, member D (NKG2D) receptor. It is a key regulator of both innate and adaptive immune responses. In the normal hair follicle, ULBP3 is turned off. However, different studies reported its high level in alopecia areata (AA). Therefore, this study was done to evaluate ULBP3 in AAI in comparison with telogen effluvium (TE), female pattern hair loss (FPHL), and normal hair. Biopsy specimens from 36 females suffering from AAI, 15 with FPHL, nine with TE, and ten healthy female controls were subjected to the immunogenetic detection of ULBP3 levels by real-time polymerase chain reaction (PCR). A high statistically significant increase in ULBP3 level in AAI patient group compared with FPHL, TE, and normal hair was detected. ULBP3 levels were positively correlated with the age and duration of the disease. Accordingly, ULBP3 may act as a confirmatory test for AAI. ULBP3 may be implicated in the disease pathogenesis, progression, and chronicity, and AAI may be a subtype of AA.

Background: It is widely believed that an imbalance between activated CD8(+) T cells and regulatory T cells (Tregs) exists in patients with vitiligo. Although there is evidence that narrow band ultraviolet (NB-UVB) irradiation can induce Tregs' number and activity, but up to our knowledge, none of the published studies involved the possible effect of NB-UVB on Tregs in vitiligo., Objective: To evaluate the effect of NB-UVB on circulating CD4(+) CD25(high) FoxP3(+) regulatory T cells (FoxP3(+) Tregs) in vitiligo., Methods: This prospective analytic study included 20 patients with active non-segmental vitiligo and 20 healthy controls. The patients were exposed to NB-UVB therapy three times per week for 30 sessions. Blood sampling before and after NB-UVB phototherapy was done to evaluate circulating CD4(+) CD25(high) Tregs and Foxp3(+) Tregs., Results: The CD4(+) CD25(high) Tregs% and FoxP3(+) Tregs% were significantly higher in vitiligo patients compared with controls. NB-UVB therapy decreased both of them in patients, but they did not reach those of controls. Each of circulating CD4(+) CD25(high) Tregs% and FoxP3(+) Tregs% didn't correlate with either extent or activity of vitiligo before or after NB-UVB., Conclusion: Tregs functional defect is probably having an impact on NSV. NB-UVB may improve the function of Tregs. Understanding the mechanisms through which NB-UVB exert its effect on reducing the number of circulating Tregs would help open up the paths for future therapeutic options., (© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

A spectrofluorimetric method was described for the determination of drugs containing active methylene groups adjacent to carbonyl groups. The method was applied successfully to the determination of three life saving cardiovascular drugs, with narrow therapeutic indices: pentoxifylline (I), propafenone hydrochloride (II) and acebutolol hydrochloride (III), in laboratory-prepared mixtures, in commercial tablets and in plasma samples. The method involved the reaction of each of the tested drugs with N1-methyl nicotinamide chloride (NMNCl) in the presence of alkali, followed by addition of formic acid, where highly fluorescent reaction products were produced. The produced fluorescence were measured quantitatively at 472 nm (lambdaex 352 nm), 409 nm (lambdaex 310 nm) and 451 nm (lambdaex 266 nm) for (I), (II), and (III) respectively. The method was linear over concentration ranges of 10-1000 microg/ml , 0.2-12 microg/ml and 0.08-10 microg/ml in standard solutions for (I), (II), and (III) respectively. In spiked human plasma samples, calibration graphs were linear over concentration ranges of 20-1000 microg/ml, 0.2-15 microg/ml and 0.08-10 microg/ml for (I), (II), and (III) respectively. The method showed good accuracy, specificity and precision in both laboratory-prepared mixtures and spiked human plasma samples. The proposed method is simple, with low instrumentation requirements, suitable for quality control application, bioavailability and bioequivalency studies.

A spectrofluorimetric method is described for the determination of drugs containing active methylene groups adjacent to carbonyl groups. The method was applied successfully to the determination of warfarin sodium in laboratory-prepared mixtures, in commercial tablets, and in spiked human plasma samples. Finally, the method was applied to the determination of the steady-state concentration of warfarin sodium in the blood of a hospitalized patient. The method involves the reaction of warfarin sodium with 0.2 ml (0.4 x 10(-3)M) N1-methylnicotinamide chloride reagent in the presence of 3 mL 1.0N NaOH and cooling in ice for 8 min, followed by adjustment of the pH to 2.0, using formic acid and heating for 4 min, whereby a highly fluorescent reaction product is produced. The optimal wavelengths of excitation and emission were determined by using a synchronous wavelength search and found to be 284 and 354 nm, respectively. The standard curves were linear over a concentration range of 50-1500 ng/mL in both aqueous solutions and spiked human plasma samples. The mean recoveries (+/- standard deviation) were 101.157 (+/-1.33) and 95.73 (+/-1.88%) for aqueous solutions and spiked human plasma samples, respectively. The method showed good specificity and precision. The proposed method is simple and economical because of its minimal instrumentation and chemicals requirements. Nevertheless, it is highly sensitive, specific, and reproducible. Accordingly, it is suitable for quality-control applications, drug monitoring, and bioavailability and bioequivalency studies.