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Plants are considered as a source of medicine to treat skin-related disorders since decades. Seeds of Psoralea corylifolia were used thousands of years ago for re-pigmentation in vitiligo patients especially in South Asia. It is a well-known fact that melanocytes, which are the specialized cells in the skin causes vitiligo through a series of chemical and enzymatic reactions, mainly due to the copper containing enzyme tyrosinase. Conditions associated with overproduction of melanin are termed hyperpigmentation. The treatment options are generally limited due to the complicated and slow pathogenesis of the disease. Therefore, therapeutic repigmentation modalities for the treatment of vitiligo are highly desirable. The aim of this study was to investigate the effects of various doses of ethanol and water extracts of P. corylifolia seeds on proliferation of normal human cultured melanocytes and its gas chromatography–mass spectrometry profiling.

Sahar Hasan Alsharif,1 Khalid M AlGhamdi1,2 1Department of Dermatology, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 2Vitiligo Research Chair, College of Medicine, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Khalid M AlGhamdi, Department of Dermatology, Vitiligo Research Chair, College of Medicine, King Saud University, P.O. Box 240997, Riyadh, 11322, Saudi Arabia, Email kmgderm@gmail.comBackground: Knowing normal values of scalp hair thickness and density is beneficial for diagnosing hair disorders, monitoring responses to therapy, performing hair transplants, and conducting relevant research. Such normal values have not yet been studied for Arabs.Objective: To assess the hair density and diameter of the Arab population at different scalp sites using phototrichogram.Methods: A cross-sectional descriptive study was performed at King Saud University Medical City from December 2021 to August 2022. The study was conducted on Arab adults who were not suffering from any hair disorder. The study was conducted using a questionnaire and clinical examination by phototrichogram.Results: A total of 120 participants were enrolled in this study. The mean hair density was 147.1± 7.8 hairs/cm2, and the mean hair diameter was 87± 4.9 μm. There were significant differences between hair density (P=0.0001) and diameter (P=0.0001) in different regions of the scalp. Females had higher hair density than males at occiput (P=0.038).Conclusion: Arab hair has a higher thickness and lower density than hair of other ethnicities. This needs to be considered when diagnosing and/or treating hair problems in Arabs.Keywords: hair density, hair diameter, Arab population, phototrichogram

Mosquitoes transmit many diseases to humans and animals e.g., malaria, yellow fever, dengue, filariasis and encephalitis. The fundamental target of this search was to study the effect of three different blood meal sources (human; rabbit and pigeon) on some biological and behavioral properties of

The present study aimed to evaluate the toxic and biological effects of some extracts of seagrasses (Cymodocea rotundata; Halophila ovataThalassia hemprichii

A coprecipitation process was utilized for the preparation of terbium fluoride nanocrystals by cerium fluoride. Silica was used to modify the surface of these core/shell nanocrystals. The synthesized CeF3:Tb@LaF3 and CeF3:Tb@LaF3@SiO2 nanoparticles (NPs) were characterized by X-ray diffraction (XRD), transmission electron microscopy (TEM), UV/vis spectrophotometry, and photoluminescence spectrophotometry. XRD patterns showed resolved reflection planes with broad widths, confirming the nanocrystalline nature of the CeF3:Tb@LaF3@SiO2 NPs. Fourier transform infrared spectra clearly revealed a uniform, smooth silica layer encapsulating the luminescent seed core and confirmed the polycrystalline nature of the CeF3:Tb@LaF3@SiO2 NPs. The TEM result showed an average crystalline size of 18 nm, which illustrated good agreement with the XRD results. The results of photoluminescence spectrophotometry confirmed the doping of terbium ions in the CeF3 crystal lattice. The cytotoxicity results of the MTT assay showed that CeF3:Tb@LaF3@SiO2 NPs have minimum toxicity with respect to CeF3:Tb@LaF3 NPs and the control drug dasatinib on HT-29 and HepG2 cell lines. Moreover, results of inverted microscopy confirmed the nontoxic and biocompatible nature of CeF3:Tb@LaF3@SiO2 NPs. These findings show that CeF3:Tb@LaF3@SiO2 NPs are promising candidates for applications in biomedical science in the future, such as bioimaging, biolabeling, biodetection or bio-probing, labeling of cells and tissue, drug delivery, cancer therapy, and multiplexed analysis.

The productivity of plants is a direct variant of the countless biotic and abiotic stresses to which a plant is exposed in an environment. This study aimed to investigate the capabilities of leguminous plant garden pea (Pisum sativum L.) to resist water deficit conditions in arid and semi-arid areas when applied with varied doses of sludge for growth response. The effect of sludge doses was evaluated on crop yield, antioxidant enzymes, viz., ascorbate peroxidase (APX), dehydroascorbate reductase (DHAR), superoxide dismutase (SOD), and glutathione reductase (GR), and metabolites (ascorbic acid, glutathione, and total protein content). The effective sludge concentrations with respect to seed weight and crop yield were found to be in the following trend: D

Introduction: Colorectal cancer (CRC) constitutes one of the most aggressive malignancies worldwide and in Malaysia. Due to high recurrence rate and toxic side effects associated with radiation and chemotherapies, new agents are urgently needed. CARP-1 is a peri-nuclear phospho-protein which plays a dynamic role in regulating cell growth and apoptosis. CARP-1 functional mimetics (CFMs) are a class of compounds that stimulate CARP-1. CFM-4, a lead compound, was shown to suppress growth and metastasis of various cancers, other than CRC. We hypothesized that CFM-4 inhibits proliferation and metastasis in CRC. Materials and method: CFM-4 anti-cancer effects of on CRC cells were investigated using MTT assay, Annexin V/Propidium iodide (PI) apoptosis assay, cell cycle analysis, quantitative real-time PCR (qRT-PCR) and Western blotting. Antimetastatic activities were assessed by migration, colony formation and invasion assays. Results: CFM-4 inhibited CRC cell proliferation and was much more potent than the classical anti-CRC 5-fluorouracil. These effects were shown to be mediated at least in part by stimulating apoptosis, as indicated in our Annexin V/PI assay results. Cell cycle analysis showed that CFM-4 induced G2/M phase arrest. Molecularly, qRT-PCR results revealed that CFM-4 promoted intrinsic apoptosis by upregulating expression of caspase-8 and -9 , p53, PUMA and Noxa, and stimulated extrinsic apoptosis by enhancing expression of death receptors (DR4 and DR5). CFM-4 upregulated NF- k B signaling inhibitor A20-binding inhibitor protein and the PI3K negative regulator PTEN. Western blot analysis results revealed that CFM-4 enhanced expression of CARP1, caspase-8 and executioner caspase-3. Metastatic properties of the CRC cells were reduced by CFM-4 through blocking their capabilities to form colonies, migrate and invade through the matrix-coated membranes. Conclusion: The potent antitumor and anti-metastatic properties of CFM-4 against CRC are due to collective pro-apoptotic, anti-proliferative and anti-metastatic activities. Together our data warrants further investigations of CFM-4 as potential anti-tumor agent for CRC malignancy and metastasis.

Normal human cultured melanocytes were exposed to various glutathione concentrations (0.1, 0.5, 1.0, 5.0, and 10.0 mg/mL) for 72 hours. At the end of the experiment, proliferation, viability, migration, and ultrastructural changes were monitored. Glutathione at the doses of 0.5 to 10.0 mg/mL reduced the viability of melanocytes significantly as compared to the control (P < .05). Glutathione significantly reduced the proliferation of melanocytes at the doses of 0.5 to 10.0 mg/mL as compared to the control (P < .001). Glutathione at 0.5 to 10.0 mg/mL significantly reduced the migration of melanocytes as compared to the control (P < .001). The percentage of mature melanosomes was 53.43% in control and 50.58%, 41.83%, 33.4%, and 8.95% in 0.1, 0.5, 1.0, and 5.0 mg/mL glutathione exposed cells, respectively. This reduction in the number of mature melanosomes was statistically significant as compared to the control. However, no cytotoxic effects were recognized by electron micrographs. These results encourage the potential implementation of glutathione as a skin-lightening agent. However, this study is limited by cell culture and ultrastructural. It should therefore be expanded in the future to include patients with pigmentary disorders.

Vitiligo is a skin disease characterized by depigmentation disorders due to lack of melanin production. Piperine, an alkaloid extracted from black piper, is active in melanocytes proliferation. To achieve this, the drug has to reach the melanocytes which exist in the deep layer of the epidermis. Higher drug concentration can be obtained after application of optimized formulation to skin. Accordingly, the aim of this work is to investigate the effect of vehicles on skin penetration of piperine as the first step in development of optimized formulation. The tested vehicles include ethanol (Eth), propylene glycol (PG), polyethylene glycol 400 (PEG), and oleic acid (OA) and their combinations. Water was used as the control and skin permeation was monitored using rabbit ear model skin. The highest piperine solubility (48.6 mg/ml) and flux (40.8 μg/cm 2 h) was achieved by Eth and the lowest piperine flux (1.17 μg/cm 2 h) was reported for PEG. PG and OA showed piperine flux values comparable to that of the control. Among different combination systems, Eth-OA (75:25) binary system had the highest piperine flux (59.3 μg/cm 2 h) followed by Eth-OA (50:50) (32.3 μg/cm 2 h) and PG-OA (90:10) (22.7 μg/cm 2 h). The study thus introduced a vehicle system as the first step in the development of topical formulation of piperine.

Hyperpigmentation was induced in the skin of experimental animals using UVB at 6 J/cm2 three times a week for three consecutive weeks. Subsequently, glutathione was injected intraperitoneally in the experimental animals at doses of 10, 20, and 40 mg/kg body weight three times a week for three consecutive weeks. At the end of the experiment, blood samples and lung, kidney, liver, and skin tissue specimens were collected from animals for hematological, biochemical, histological, and electron microscopy examination. Glutathione at 40 mg/kg body weight/day reduced skin hyperpigmentation significantly, except at low doses. The skin lightening effect assessed by a chromameter was dose-dependent. There were no statistically significant differences among the mean values of AST, ALT, creatinine, BUN, and CBC counts across the four groups. Lung, kidney, and liver tissue specimens did not show any histological toxic changes. The number of melanin granules was significantly lower in the group treated with the highest dose of glutathione compared to that in the control. Electron microscopy proved that glutathione at 20 and 40 mg/kg body weight/day was able to reduce the number of melanized cells significantly compared to that in the control. Parenteral glutathione was effective as a skin lightening agent and did not provoke any toxic effects in the employed animal model. The limitation of the study was conducted in guinea pigs and was of short-term duration.

Nano-erythrocyte coating has been developed as an interesting biomimetic platform to provide hybrid nano-carriers with innate functions to target liver cancer. This goal was achieved by coating nano-erythrocyte membranes (NEMs) onto 5-fluorouracil (5-FU)-loaded liposomes (LPs) to produce NEM-5-FU-LPs. This framework is used to promote the escape of 5-FU-LPs from degradation during systemic circulation. NEMs were obtained by hypotonic lysis of erythrocytes to produce ghost erythrocytes (GEs) followed by extrusion through polycarbonate membranes. Chimeric NEM-5-FU-LPs were fabricated via the fusion of NEMs and artificial LPs. The resultant chaperoned LPs were characterized based on particle size, morphology, entrapment efficiency (EE %), stability, protein content and phosphatidylserine exposure and their in vitro release profiles and cytotoxic efficacy were also determined. The present results revealed that 5-FU-LPs, NEM-5-FU and NEM-5-FU-LPs exhibited nanosize, spherical shapes and unimodal size distributions0.3. In addition, the vesicles presented a zeta potential with EE% of 24.6-30.7% and an appropriate stability for 3 weeks. NEM-5-FU-LPs retained the erythrocyte membrane proteins as confirmed by PAGE and displayed a sustained release profile up to 48 h when compared to NEM-5-FU and the 5-FU solution. Moreover, hybrid NEM-5-FU-LPs induced a late cytotoxic effect after 48 h compared to the other formulations. Thus, mantling of 5-FU-LPs by NEMs could enhance vesicle controllability and their targetability to liver cancer cells.

Organic fractions and extracts of willow (Salix safsaf) leaves, produced by sequential solvent extraction as well as infusion and decoction, exhibited anticancer potencies in four cancerous cell lines, including breast (MCF-7), colorectal (HCT-116), cervical (HeLa) and liver (HepG2). Results of the MTT assay revealed that chloroform (CHCl3) and ethyl acetate (EtOAc)-soluble fractions exhibited specific anticancer activities as marginal toxicities were observed against two non-cancerous control cell lines (BJ-1 and MCF-12). Ultra-high-resolution mass spectrometry Q-Exactive&trade, HF Hybrid Quadrupole-Orbitrap&trade, coupled with liquid chromatography (UHPLC) indicated that both extracts are enriched in features belonging to major phenolic and purine derivatives. Fluorescence-activated cell sorter analysis (FACS), employing annexin V-FITC/PI double staining indicated that the observed cytotoxic potency was mediated via apoptosis. FACS analysis, monitoring the increase in fluorescence signal, associated with oxidation of DCFH to DCF, indicated that the mechanism of apoptosis is independent of reactive oxygen species (ROS). Results of immunoblotting and RT-qPCR assays showed that treatment with organic fractions under investigation resulted in significant up-regulation of pro-apoptotic protein and mRNA markers for Caspase-3, p53 and Bax, whereas it resulted in a significant reduction in amounts of both protein and mRNA of the anti-apoptotic marker Bcl-2. FACS analysis also indicated that pre-treatment and co-treatment of human amniotic epithelial (WISH) cells exposed to the ROS H2O2 with EtOAc fraction provide a cytoprotective and antioxidant capacity against generated oxidative stress. In conclusion, our findings highlight the importance of natural phenolic and flavonoid compounds with unparalleled and unique antioxidant and anticancer properties.

A conventional skin punch biopsy instrument has a circular hollow blade, which can be used to make a full circular incision to evacuate subcutaneous abnormalities such as lipomas. Here, we present a modified punch instrument, in which the cutting element has a C-shape to form a pivotal skin fragment (miniflap) to access subcutaneous tissues. The "C" part comprises almost half of a circle. The C-punch incision gives access to subcutaneous abnormalities, while keeping a connecting neck to the surrounding skin, which allows for efficient resealing of the skin surface. Therefore, there is less potential for subsequent scarring.

Background: The onset of vitiligo during childhood is common. Limited data exist that compare the clinical associations of prepubertal and postpubertal vitiligo in Arabs. Objective: To compare the clinical profile of pre and postpubertal onset vitiligo. Methods: A cross-sectional observational study was conducted. The Vitiligo European Task Force questionnaire was completed for each patient. Results: A total of 375 patients were included; 199 had postpubertal vitiligo (>12 years), and 176 had prepubertal onset vitiligo (

Chronic idiopathic urticaria (CIU) is one of the mysteries of dermatology. An association between spontaneous CIU and contact allergy sensitization is possible. In this study, we aimed to test the hypothesis that contact allergy might play a role in disease in CIU patients. Furthermore, we examined if patch testing should be routinely performed in patients with chronic urticaria (CU). Ultimately, we concluded that patch testing should be included among the diagnostic procedures for CU.

Ingrown toenail (IGTN) is a common problem that can affect walking and can preclude daily activities.To compare the safety and efficacy of lateral nail avulsion with phenolization (LNAP) versus sleeve (nail tube splinting) surgical techniques in the treatment of IGTN.Patients older than 15 years with IGTN were included. Patients were evaluated for the duration and severity of pain, drainage, complete healing periods, recurrence rate, and overall success rate. Assessment was performed at baseline and at 1, 3, and 6 months. Complications were noted.A total of 53 patients, including 46 males (87.8%), were treated. The mean age was 27.7 ± 1.3 years. Thirty patients underwent LNAP, and 23 underwent sleeve methods. The surgical success rate, defined as90% improvement, was found to be 80% to 82% for both groups. Recurrence was observed in only 1 patient of each group. None of the observed differences in healing, discharge, and recovery were statistically significant except in reporting shoe-wear discomfort, which was shorter in the sleeve group (p.05). Postoperative pain experience was also noted to be less in the sleeve group (p = .057).Both methods, LNAP and sleeve, seem to be equally effective for the treatment of IGTNs. Postoperative shoe-wearing discomfort and pain are shorter when the sleeve method was used.

Background: A permanent, unpleasant atrophic leishmaniasis scar is a potentially disfiguring condition that causes social stigma with limited treatment choices. Fractionated carbon dioxide (CO2) laser resurfacing is expected to be a safe and effective treatment for leishmaniasis scars. Objective: To assess the safety and efficacy of ablative fractional resurfacing (AFR) with a CO2 laser for facial leishmaniasis atrophic scars. Methods: Eleven patients (five males, age 18–47 years) underwent the fractional CO2 laser procedure. The mean duration for scars was 18.3 years. Three to five treatment sessions with the fractional laser eCO2 (10,600 nm, Lutronic Corporation, Gyeonggi-do, Korea) were performed for each patient, at 2-month intervals, under topical anesthesia. Two passes (with tip type 120, density 150 spots/cm2 in static mode, and peak power of 30 watts) were performed on each leishmaniasis scar. Pulse energies ranged between 100 and 140 mJ. Posttreatment improvements in texture, atrophy, and overall satisfaction with appearance were graded on a quartile scale 1 month after the second session and 3 months after the final session. Scar improvement was graded using a 4-point score with a maximum score of 20. Results: At the 3-month posttreatment follow-up, all subjects were rated as having at least 50% improvement in texture, atrophy, borders, and overall appearance of scars. The median score of improvement was 18 of 20 (range 11–19). Mild postinflammatory hyperpigmentation was the only adverse effect, observed in 18% (2 of 11) of subjects. After the procedure, moderate to severe erythema and edema typically resolved within 24 to 48 hours. No additional adverse effects were observed. Conclusion: Fractional CO2 resurfacing represents a safe, effective, and well-tolerated potential treatment for atrophic facial leishmaniasis scars in ethnic skin.

Primary prevention, specifically skin care, is an important principle in Islamic theology just as it is emphasized in contemporary medicine. Many skin diseases can be prevented by a proactive approach to skin care, such as proper hygiene and routine inspections, principles that are constantly highlighted in the Islamic literature. Islam promotes primary prevention of disease, including recommendations for skin care practices.The recommendations for skin care practices in Islamic teachings are analogous to current medical guidelines. Sun avoidance, which is recommended by Islam, is mandatory for diseases such as systemic lupus erythematosus, melasma and skin cancers. Skin care and hygiene practices are recommended in Islam and it is considered an important mechanism for reducing the transmission of infections in modern medicine. The body creases and hair are ideal sites for malicious infestations to grow. The practice of “Wudu” includes washing the hands, feet, and hair with clean water. It is an indispensible part of daily prayers which is mandatory for every Muslim. Oral hygiene is also an integral part of both preventive medicine and Islamic teachings. Genital hygiene, particularly after urination and defecation, is recommended in Islamic teachings and is known to prevent urinary and vaginal infections in contemporary medicine. Male circumcision is an Islamic practice. Recently, it was proven that circumcised men are less likely to have sexually transmitted diseases, including HIV.This paper reviews skin care from an Islamic perspective and its relevance to contemporary medicine by translating the simple self care principles into practical guidelines in everyday use.

We aimed to explore perceptions, attitudes and practices toward research among medical students. A self-administered questionnaire was distributed among senior medical students at the King Saud University, Riyadh, Saudi Arabia. Hundred and seventy two students participated in the study, with 97 males (65.5%). The majority of the students agreed that research is important in the medical field (97.1%, 167/172). A total of 67.4% (116/172) believed that conducting research should be mandatory for all medical students. During medical school, 55.3% (88/159) participated in research. The obstacles that prevented the students from conducting research included lack of professional supervisors (84.7%, 143/169), lack of training courses (88.8%, 151/170), lack of time (72.3%, 123/172) and lack of funding (54.1%, 92/170). Although the majority of students believe that research is important in the medical field, only around half of the students participated in research during medical school.

Background Varicose and ectatic cutaneous vessels are common chronic conditions that might need surgical treatment. There are several treatment modalities, but all can cause complications and have significant recurrence rates. A new effective and safe treatment with low or no recurrence is needed. Phenol seems to be a potential therapeutic agent. Objective To assess the efficacy and safety of phenol as a sclerosing agent in the treatment of varicose veins and other vascular ectatic conditions. Methods The dorsal ear veins of white New Zealand rabbits were injected with 0.1 ml of a sclerosing agent. Four experimental groups were used to test the sclerosant efficacy of different concentrations of phenol (1%, 5%, 20% and 50%). Sodium tetradecyl sulphate (STS), a commonly used sclerosing agent, was used as a positive control, while normal saline was used as a negative control. The blood vessels of the treated ears were photographed before and 1 h, 2 days, 8 days and 45 days after treatment. Biopsies from the treated areas were obtained for histologic examinations. Results A concentration of 1% phenol was too low to cause significant vascular changes, whereas a concentration of 5% phenol caused 90% lumen narrowing. Interestingly, 1% STS only caused 25% lumen narrowing. Concentrations of 20 and 50% phenol caused 100% lumen narrowing but caused haemorrhage and necrosis. Toxicity monitoring showed no apparent haematologic, cardiac, pulmonary, hepatic or renal toxicity associated with the concentrations of phenol used in this study. Conclusion A concentration of 5% phenol appears to be a potent and safe sclerosing agent for ectatic small vessels. This provides a significant new therapeutic option, which may eventually advance to the clinic and have an impact on the treatment of patients suffering from varicose veins and other vascular ectatic conditions.

Background / aim: Although complementary and alternative medicine (CAM) use is highly prevalent, there is very limited information on dermatologists’ attitudes and knowledge about CAM. In this survey, we aimed to study the knowledge and attitude of dermatologists in Saudi Arabia towards CAM. Furthermore, we assessed dermatologists' intention to receive CAM education and training. Methods and design: We collected data through an online cross-sectional survey sent to email addresses of dermatologists in Saudi Arabia. Questions included socio-demographic data, knowledge and attitudes towards CAM practice. Results: A total of 93 questionnaires were returned from dermatologists in various regions of Saudi Arabia. The mean age was 41.7 ± 10.3 (range, 25–63) years. A total of 67% of dermatologists had welcoming attitudes towards CAM. We did not find any significant relationship between age, gender, experience or any other factor and positive attitudes towards CAM. More than 70% of participants reported an interest in learning about CAM. However, only 9 (9.7%) dermatologists had attended CAM courses. Sixty-one participants (65.6%) were eager to receive CAM-specific education, and 66% of dermatologists acknowledged having previously discussed CAM with their patients. The most important reason that dermatologists did not discuss CAM with their patients was a lack of studies supporting CAM (66.7%) and the belief that doctors’ knowledge on CAM is insufficient (58.1%). Conclusion: A greater number of dermatologists have an affirmative attitude towards CAM. The willingness to improve knowledge and training indicates that the CAM field could potentially grow in dermatology.

BACKGROUND:: Varicose veins and the complications of venous disease are common disorders in humans. OBJECTIVE:: To study the effects of bleomycin as a potential new sclerosing agent and its adverse events in treating varicose veins. METHODS:: Bleomycin-loaded liposomes 0.1ml was injected in the dorsal ear veins of white New Zealand rabbits. Sodium tetradecyl sulfate was used as a positive control. Normal saline was used as negative control. The blood vessels of the treated ears were photographed before and at one hour and two, eight and 45 days after treatment. Biopsies from the treated areas were obtained for histological examination. Blood samples were collected to determine any possible toxicity. RESULTS:: Bleomycin by itself was ineffective; therefore, liposomes were used as a vector to deliver bleomycin to the vein lumen. Subsequently, bleomycin started showing its sclerosing effects. Toxicity monitoring showed no apparent hematologic, pulmonary, hepatic or renal toxicities. This study revealed that bleomycin induced vasculitis, which led to vascular occlusion, which was observed on day 1 and day 8. No bleomycin-related injury was noted by histopathological examination of lung sections. The calculation of the lung/body weight coefficient indicated that edema was present in the experimental groups compared with the negative and positive controls. STUDY LIMITATIONS:: Relatively small number of experimental animals used. CONCLUSIONS:: This study showed that bleomycin-loaded liposomes were able to induce vasculitis and vascular occlusion without any toxicity or complications. It might be useful, hence, to treat patients suffering from Varicose veins and other ectatic vascular diseases with this agent.

Background: Previous studies have discussed attitudes of vitiligo patients toward their disease. However, no studies have addressed this issue from the public's point of view. Objective: To explore the perceptions, attitudes, and misconceptions of the public toward vitiligo. Methods: A self-administered questionnaire was distributed to attendees of primary health care centers in Riyadh, Saudi Arabia, between January and August 2010. Results: Overall, 924 of the 1,000 distributed questionnaires were returned, and 429 were males (46.8%). Moreover, 33.1% (303 of 916) believed that vitiligo is contagious or did not know that it is not. The cause of vitiligo was thought to be infectious by 20.4% of respondents (182 of 894), inherited by 40.5% (365 of 902), autoimmune by 41.2% (370 of 899), and due to a lack of hygiene by 22.5% (199 of 883). Unmarried individuals and those with less education were more likely to state that vitiligo is caused by an infection ( p = .02, p = .03, respectively). Younger individuals and those with less education were more likely to think that vitiligo is caused by a lack of hygiene ( p = .01, p = .001, respectively). More than half of the participants (56.1%, 504 of 898) would be unwilling to marry a vitiligo patient. Younger individuals and males were less likely to marry a vitiligo patient ( p = .01, p = .05, respectively), whereas those of lower income were more likely to accept it ( p = .002). Conclusions: Various misconceptions and negative attitudes about vitiligo among the public are prevalent. Educating the public about vitiligo could ultimately lead to better psychosocial well-being of vitiligo patients. Contexte: Des études ont déjà porté sur la perception des personnes atteintes de vitiligo à l'égard de leur propre maladie, mais aucune étude n'a porté sur la perception du public à l'égard de cette maladie. Objectif: L'étude visait à analyser les perceptions, les attitudes, et les idées fausses du public à l'égard du vitiligo. Méthodes: Un questionnaire autoadministré a été remis à des personnes présentes dans des centres de soins primaires à Riyad, en Arabie saoudite, entre janvier et août 2010. Résultats: En tout, 924 questionnaires sur 1,000 ont été remis. Sur ce nombre, 429 avaient été remplis par des hommes (46.8%). De plus, 33.1% (303 sur 916) des répondants croyaient que le vitiligo était contagieux ou ne savaient pas qu'il ne l'était pas. Quant à la cause du vitiligo, 20.4% des participants (182 sur 894) croyaient que c'était une maladie contagieuse; 40.5% (365 sur 902), que c'était une maladie héréditaire; 41.2% (370 sur 899), que c'était une maladie auto-immune; et 22.5% (199 sur 883), que c'était une maladie due à un manque d'hygiène. Les personnes célibataires et celles moins instruites étaient plus portées à croire que le vitiligo était causé par une infection ( p = .02 et p = .03, respectivement). Les jeunes et les personnes moins instruites étaient plus susceptibles de croire que le vitiligo était causé par un manque d'hygiène ( p = .01 et p = .001, respectivement). Plus de la moitié des participants (56.1%, 504 sur 898) ne voulaient pas se marier avec une personne atteinte de vitiligo. Les jeunes et les hommes étaient moins disposés à se marier avec une personne atteinte de vitiligo ( p = .01 et p = .05, respectivement), tandis que ceux à faible revenu étaient plus susceptibles d'accepter le fait ( p = .002). Conclusions: Il existe plusieurs idées fausses sur le vitiligo au sein de la population, et la maladie suscite des réactions négatives. L'éducation du public sur le vitiligo pourrait peut-être améliorer le bien-être psychosocial des personnes atteintes de vitiligo.

Background: Plantar warts are common and often painful. Treatment of plantar warts is difficult and requires multiple treatments. Several clinical trials have proven the efficacy of bleomycin, but relatively high concentrations have been required and considerable side effects have been experienced. Objective: To evaluate the efficacy and safety of low-concentration (0.1 U/mL) bleomycin using a translesional injection technique for the treatment of plantar warts. Methods: The study included 23 patients with single or multiple plantar warts. Very low-concentration bleomycin was injected into a single wart or the largest plantar wart in the case of multiple lesions. Injections were performed at 4-week intervals until resolution of the warts or development of side effects. The translesional multipuncture technique was used. Results: Thirteen patients were male (56.5%), and the mean age was 27.7 years. The results revealed complete clearance of warts in 17 of 23 (74%) patients, partial response in 1 (4.3%) patient, and no response in 3 (13%) patients. Recurrence was observed in 2 patients at 3 months of follow-up. Among those two, one patient showed complete clearance after the second injection at 6 months of follow-up. All patients were followed for 6 months after the initial treatment. No significant long-term adverse effects were noted. Only three patients (13%) had localized moderate pain for 2 to 3 days after the injection. Conclusion: Translesional injection by very low-concentration (0.1 U/mL) bleomycin appears to be a simple, effective, and safe treatment modality for plantar warts.

Summary Background Until now, segmental vitiligo has been considered as a stable entity and mixed vitiligo, the association of segmental and nonsegmental vitiligo, has been reported rarely. Objectives The aim of this study was to search for factors associated with the generalization of vitiligo in patients with segmental vitiligo. Patients and methods This was a prospective observational study conducted in the vitiligo clinic of the Department of Dermatology of Bordeaux, France. The Vitiligo European Task Force questionnaire was completed for each patient attending the clinic with a confirmed diagnosis of segmental vitiligo after exclusion of other forms of vitiligo (focal, mucosal, not classifiable.) Thyroid function and antithyroid antibodies were screened if not obtained in the previous year. Results One hundred and twenty-seven patients were recruited: 101 had segmental vitiligo and 26 had segmental vitiligo that evolved into mixed vitiligo; 56 were male and 71 were female. Most patients had onset of segmental vitiligo before the age of 18. When conducting multivariate analysis, we found the following to be independent factors associated with the evolution of patients’ disease from segmental vitiligo to mixed vitiligo: initial percentage of body surface involvement of the segment > 1% [odds ratio (OR) 15·14, P = 0·002], the presence of halo naevi (OR 24·82, P = 0·0001) and leukotrichia (OR 25·73, P = 0·0009). Conclusions Halo naevi association and leukotrichia at first consultation in segmental vitiligo are risk factors for the progression of segmental vitiligo to mixed vitiligo. In addition, this progression of segmental vitiligo to mixed vitiligo carries a stronger link if initial segmental involvement is situated on the trunk.

Background: The details of phototherapy practices for vitiligo have been rarely studied. Objective: To explore the details of phototherapy practices for vitiligo among dermatologists. Methods: A self-administered questionnaire about the details of phototherapy practices for vitiligo was distributed to all dermatologists attending a national general dermatology conference in Riyadh, Saudi Arabia, in 2008. Results: Questionnaires were returned by 121 of 140 participants (response rate = 86.4%). The mean age of the respondents was 39.34 ΁ 9.7 years, and 65% were males. One hundred eight of 110 (98.2%) respondents provided phototherapy to their vitiligo patients. The mean number of vitiligo patients who underwent phototherapy each week per dermatologist's office was 18 ΁ 2.26. Narrowband ultraviolet B (NB-UVB) was the most common modality chosen to treat generalized vitiligo (84%). Excimer laser was the most common modality used to treat focal and segmental vitiligo (53% and 39%, respectively). Sixty-eight percent of dermatologists administered a fixed starting dose of NB-UVB to all patients, whereas 31% used the minimal erythema dose as a guide. Fifty percent reported that NB-UVB resulted in better color matching with the surrounding skin. Thirty-seven percent favored NB-UVB over psoralen + ultraviolet A for a faster response, and 31% preferred NB-UVB for a pigmentation that is more durable. Forty-seven percent (50/106) of the respondents limited the number of phototherapy sessions to reduce the risks of skin cancer. However, no respondent reported any skin cancer incidence in phototherapy-treated vitiligo patients. Conclusion: There is a need for phototherapy guidelines for the treatment of vitiligo in patients with skin of color.

Background Potent teratogenicity limits the use of isotretinoin among females of childbearing potential (FCBP). Objective To explore the current practice of dermatologists for pregnancy prevention when prescribing isotretinoin for FCBP. Materials and methods A self-administered questionnaire was distributed to 160 dermatologists attending a national conference in Riyadh, Saudi Arabia, in 2008. The survey was designed to capture the details of precautions taken by dermatologists to prevent pregnancy among isotretinoin users. Results Ultimately, 134 dermatologists completed the questionnaire (84% response rate). Their mean age was 39 ± 9.5 years. A total of 82 were female (65%). The median number of FCBP for whom isotretinoin was prescribed by each dermatologist during the previous 12 months was two (range from 0 to 30). Of the 792 total FCBP, seven were reported to have become pregnant (incidence rate of 8.8/1000) while on isotretinoin. Out of those seven, three women terminated the pregnancy (elective abortions: 42.7%). The majority of the dermatologists (79%) always obtained written consent and discussed teratogenic risks (98%); 44% provided written information about potential isotretinoin teratogenicity, and 30% offered printed information on contraception. Survey results also revealed that 62% recommended double contraception for FCBP, 60% always recommended pregnancy testing prior to therapy, but only 16% requested monthly pregnancy tests. In general, 62.4% avoided isotretinoin prescription to FCBP, which was independent of dermatologists’ gender, years of experience, or having a previous incident of isotretinoin-exposed pregnancy. Conclusion Some dermatologists still do not follow the recommendations for isotretinoin prescription to FCBP. This needs to be corrected, especially in countries with restrictions on abortion.

Summary Background Eyebrow bleaching is a common practice among women with dark hair that allows for alterations in the eyebrows’ shape without the use of hair removal. A literature search on this topic failed to reveal any extant studies. Objective To explore the prevalence, associated motives, and side effects of eyebrow bleaching among women. Methods A questionnaire about eyebrow bleaching was distributed randomly to female patients attending the outpatient clinics at a university hospital between June and August 2008. Results The response rate was 87.2%; with 567 of the 650 distributed questionnaires returned. The mean age was 32.01 ± 10.17 years. 48.4% (253/522) of the participants reported having bleached their eyebrows. Of these individuals, 55.8% (101/181) experienced side effects related to eyebrow bleaching. These side effects included increased or decreased density of the eyebrow hair, and redness, itching, and scaling of the eyebrow skin. The motives behind eyebrow bleaching varied widely, but were primarily esthetic in nature. Younger women, students, and participants with higher monthly incomes reported bleaching their eyebrows a greater number of times than others (P

BACKGROUND The treatment of periungual warts is a therapeutic challenge. Various treatment modalities can be ineffective and may cause scarring and permanent nail changes. OBJECTIVES A prospective pilot study to investigate the efficacy and safety of a low concentration (0.1 U/mL) of bleomycin in the treatment of periungual warts. METHODS Periungual warts were injected with bleomycin (0.1 U/mL) every 4 weeks until elimination of the lesions or until the injections were discontinued because of adverse effects. Bleomycin was administered using the translesional multipuncture technique. RESULTS We recruited 15 patients with periungual warts from March 2007 to March 2008. Thirteen patients were male (86.6%); median age was 30. Seven patients (46.6%) demonstrated complete clearance 1 month after the first injection; two required two treatment sessions. Thirteen (86.6%) patients had complete clearance of the treated wart at the 6-month follow-up with only one injection. Wart recurrence was observed in two patients. All patients were followed for 6 months after the initial treatment. No significant long-term adverse effects were noted. Only one patient demonstrated mild postinflammatory hyperpigmentation, which resolved after 1 month, and nine (60%) had localized moderate pain for 2 to 3 days after the injection. CONCLUSION Translesional multipuncture treatment with a low concentration (0.1 U/mL) of bleomycin is an effective modality for periungual warts that results in minimal side effects. Larger controlled studies are needed.

Background As the use of the Internet increases, it is important to gain insight into how it is used by patients to obtain health-related information. Objectives We aimed to explore the attitudes and practices of dermatology outpatients regarding their use of the Internet to find health information. We also aimed to investigate the consequences of this Internet use on the patient‐doctor relationship. Methods A self-administered questionnaire on Internet use was given to adult dermatology outpatients attending the Dermatology Department at King Saud University, Riyadh, Saudi Arabia, from January to June 2008. Results A total of 86% (432/500) of distributed questionnaires were returned. The mean age of respondents was 29.7 ± 10.0 years. Of the respondents who answered the relevant items, 42% (185/431) were females, 87% (376/432) were Internet users, and 47% (190/ 404) stated that they had accessed the Internet to obtain general medical information. Younger women educated to college level and with higher incomes tended to search for online health-related information more often than other groups. More than 93% (343/367) of respondents reported that they relied on their doctors as their primary source of information, but 69% (277/401) indicated that online medical information was beneficial, and almost 8% (30/399) stated that they would always trust data obtained from the Internet. Conclusions A significant proportion of patients use the Internet to search for medical information. This has a positive effect on the patients’ skin diseases and on their relationships with their doctors. Therefore, doctors should be more aware of the health-related information available online and should guide patients to reliable websites.

The aim of this work is to review the available literature on the details of low-level laser therapy (LLLT) use for the enhancement of the proliferation of various cultured cell lines including stem cells. A cell culture is one of the most useful techniques in science, particularly in the production of viral vaccines and hybrid cell lines. However, the growth rate of some of the much-needed mammalian cells is slow. LLLT can enhance the proliferation rate of various cell lines. Literature review from 1923 to 2010. By investigating the outcome of LLLT on cell cultures, many articles report that it produces higher rates of ATP, RNA, and DNA synthesis in stem cells and other cell lines. Thus, LLLT improves the proliferation of the cells without causing any cytotoxic effects. Mainly, helium neon and gallium-aluminum-arsenide (Ga-Al-As) lasers are used for LLLT on cultured cells. The results of LLLT also vary according to the applied energy density and wavelengths to which the target cells are subjected. This review suggests that an energy density value of 0.5 to 4.0 J/cm(2) and a visible spectrum ranging from 600 to 700 nm of LLLT are very helpful in enhancing the proliferation rate of various cell lines. With the appropriate use of LLLT, the proliferation rate of cultured cells, including stem cells, can be increased, which would be very useful in tissue engineering and regenerative medicine.

Background Patients’ beliefs about their illness can result in positive and/or negative implications for the management of their disease. To examine the beliefs held by vitiligo patients about their condition and to explore the potential factors that might influence such beliefs. Methods The illness perception questionnaire (IPQ) was translated into the particular regional language (Arabic) and administered to adult vitiligo patients visiting our Dermatology Department, from 2006 to 2008. Demographic and illness details were obtained. Results We recruited 164 vitiligo patients (91 male subjects). The mean age was 27 years (SD = 13, range 15–57 years). It was believed that stress, altered immunity, and heredity were the cause of vitiligo by 33%, 26%, and 24% of the respondents respectively. Eighty-four percent and 28% believed in fate and evil eye as a cause of their illness respectively. Fortytwo percent believed that their illness had a major effect on their lives and 44% believed that vitiligo had strongly affected the way others see them. For both beliefs, this was independent of the gender. Thirty-seven percent reported that they do not understand their illness. Six percent believed that their disease was contagious while 12% were not sure. Fifty-four and 57% reported feeling depressed and anxious respectively, because of their disease. This was more common in female patients (P = 0.019 and 0.031 respectively). Conclusion Misconceptions and negative attitudes are widespread among vitiligo patients. The lack of disease-related understanding and the existence of anxiety and depression require targeted health education and psychosocial support.

Background Although the practice of bleaching is common worldwide, there are few studies that discuss knowledge, attitudes and practices towards bleaching. Objective The aim of this study was to explore the knowledge, attitudes and practices towards the usage of topical bleaching agents among women. Methods A self-administered questionnaire on the use of bleaching creams was distributed randomly to women attending the outpatient clinics at a university hospital in Saudi Arabia during 2008. Results Five hundred and nine of 620 women responded (82% response rate). All the participants had dark skin (skin type 4–5). The mean age was 29.22 ± 9 years. Of the participants, 38.9% (197 ⁄506) were current users of bleaching agents. Only 26.7% (106 ⁄397) of the respondents used bleaching agents for medical purposes to treat localized abnormal skin hyper-pigmentation; 20.8% (101 ⁄485) were ready to use any bleaching cream that gives fast results, even if the components were unknown. Of the respondents, 30% (152 ⁄509) used more than 100 g of bleaching creams monthly. These products were applied to the whole body in 7.3% of the cases. While 10.3% (28 ⁄271) continued applying the bleaching products during pregnancy, 20.8% (54 ⁄260) did so during lactation. No associations could be found between the various sociodemographic variables and differences in the attitude towards and practice of using bleaching creams. Conclusion A major proportion of our sample respondents have overused and ⁄or misused bleaching agents. This was regardless of age, income, education or marital status. There is a need to educate women about the possible risks.