The effect of long-pulsed 1064 nm Nd:YAG laser-assisted hair removal on some skin flora and pathogens: an in vivo study.

Background The effect of NDYag on normal skin flora and pathogenic microbes has not been studied. Objectives Evaluation of immediate (before versus after each session) and delayed (pre-first session versus pre-fourth session) antimicrobial effect of Nd:YAG laser-assisted hair removal. Methods Thirty females scheduled for axillary Nd:YAG laser hair removal were included. Skin swabs were collected from the vault of the dominant axilla before and after each of the four sessions. Bacteriological cultures were performed to record the counts of total aerobes, total anaerobes, lipophilic bacteria, total staphylococci, Staphylococcus epidermidis (S. epidermidis), S. saprophyticus, S. hominis, and S. aureus. Reported changes in sweat odour and folliculitis (if present) were recorded. Results S.hominis was the predominant species in all subjects before and after all sessions. Counts of total aerobes, total anaerobes, lipophilic bacteria, total staphylococci, and S.hominis significantly decreased after all 4 sessions. A significant reduction was noted in the median colony counts before the fourth session as compared to the baseline count before the first session in total aerobes (278.9 versus 126.3 × 105 CFU/cm2, p = 0.003), total anaerobes (338.7 versus 103.7 × 105 CFU/cm2, p = 0.002) and total staphylococci (248.5 versus 105.0 × 105 CFU/cm2, p = 0.004). Most subjects reported worsened or unchanged axillary sweat odour. There was a statistically significant positive correlation between sweat odour and the counts of total aerobes (r = 0.433, p = 0.017), total anaerobes (r = 0.377, p = 0.040), total staphylococci (r = 0.383, p = 0.036) and S.hominis (r = 0.497, p = 0.005) ; lower counts were associated with a worsened odour. Limitations Small sample size; few laser sessions; short follow-up; subjective assessment of sweat odor and quantity. Conclusions Laser caused an immediate and delayed reduction in axillary aerobes, anaerobes, lipophilic bacteria, and staphylococci. This form of dysbiosis might lead to sweat odour changes.

Transepidermal Delivery of Triamcinolone Acetonide or Platelet Rich Plasma Using Either Fractional Carbon Dioxide Laser or Micro-needling in Treatment of Alopecia Areata.

Introduction: Trans-epidermal drug delivery, using "laser-assisted drug delivery", or micro-needling, are new treatment modalities, that can improve drug penetration into skin in treatment of alopecia areata patients. Objectives: To evaluate the use of fractional carbon dioxide laser versus micro-needling in trans-epidermal delivery of triamcinolone acetonide and platelet rich plasma in alopecia areata treatment. Methods: Interventional comparative study carried out on 60 patients, randomly divided into four equal groups. Group I: Fractional Carbon dioxide laser and triamcinolone acetonide. Group II: micro-needling with Dermapen and triamcinolone acetonide. Group III: fractional carbon dioxide laser and platelet-rich plasma. Group IV: micro-needling with Dermapen and platelet-rich plasma. Patients were evaluated clinically, using Severity of Alopecia Tool score and hair regrowth scale, and dermoscopically. Results: In all treatment groups, there was improvement in the Regrowth scale, with statistical significance between the different groups at fourth (P = 0.001) and last (P = 0.008) visits, with highest, most significant changes in Pen-Steroid group. Comparing Regrowth scale at last visit, results were in favor of Dermapen, compared to Carbon dioxide laser for trans-epidermal drug delivery (P = 0.023); and in favor of triamcinolone acetonide, compared to platelet-rich plasma as topical medication (P = 0.015). Dermoscopic signs of improvement included decrease in black dots, and appearance of Upright regrowing hairs (P < 0.001). Conclusions: Micro-needling and fractional carbon dioxide laser are effective tools for trans-epidermal drug delivery for Alopecia areata treatment. Micro-needling for delivery of Triamcinolone acetonide showed best treatment outcomes. Dermoscopy is highly beneficial in evaluating treatment response in alopecia areata.

Extension of separation along the follicular epithelium and follicular basement membrane in pemphigus and bullous pemphigoid.

BACKGROUND: The outer root sheath of hair follicle and the interfollicular epidermis are continuous and basically similar in many aspects. The expression of various basement membrane (BM) components in the upper portion of the hair follicle is similar to that of the interfollicular BM. The extension of acantholysis into the adnexal structures was highlighted in the pemphigus group of diseases. On the other hand, extension of separation down the hair follicle BM has not been studied in subepidermal autoimmune bullous dermatoses. The aim of the present work was to study the extension of separation along follicular epithelium and follicular BM in pemphigus and bullous pemphigoid. METHODS: This retrospective study was conducted on pemphigus and bullous pemphigoid cases. For each case, 4-µm-thick sections stained with hematoxylin and eosin were examined for the presence of hair follicles and the extension of separation down follicular epithelium and follicular BM. RESULTS: Positive extension of acantholysis down the follicular epithelium was seen in 23/27 (85.2%) of pemphigus vulgaris (PV) and 7/9 (77.8%) of pemphigus foliaceus (PF) cases with hair follicles. Follicular extension was limited to the infundibulum in PF but down the entire follicular length in PV. As for bullous pemphigoid (BP) cases, 20/26 cases (76.9%) that had hair follicles showed positive extension of the separation down the follicular BM. The cellular infiltrate detected was identical in its nature and density to that of subepidermal blister in all cases. CONCLUSIONS: Extension of the separation along follicular epithelium and follicular basement membrane was observed in PV, PF, and BP without significant difference.

Serum lipocalin-2 and carotid artery intima-media thickness in relation to obesity in eugonadal males over forty with venogenic erectile dysfunction.

Obesity is a risk factor for erectile dysfunction and atherosclerosis. Lipocalin-2 is an adipocytokine with proinflammatory properties involved in several disorders with metabolic alterations. Our aim was to study the relation of serum lipocalin-2 and carotid artery intima-media thickness (CIMT) to obesity in erectile dysfunction. Serum lipocalin-2 and CIMT were measured in 25 obese and 25 nonobese eugonadal patients over forty with venogenic erectile dysfunction and 25 healthy controls. Their relation to different patient- and disease-related parameters was studied. Results revealed lipocalin-2 to be significantly higher in obese compared with nonobese patients and with controls, and in nonobese patients compared with controls. CIMT was lower in controls compared with both obese and nonobese patients. In obese and nonobese patients, lipocalin-2 was positively correlated with disease duration, body mass index, waist circumference and end-diastolic velocity. Lipocalin-2 was negatively correlated with the short form of the international index of erectile function scores in both groups. In conclusion, the elevated lipocalin-2 in obese and to a lesser extent in nonobese patients and its association with disease severity points to its potential value as a diagnostic marker and a possible therapeutic target that could ameliorate the metabolic derangement associated with erectile dysfunction.

The Therapeutic Potential of Amniotic Fluid-Derived Stem Cells on Busulfan-Induced Azoospermia in Adult Rats.

BACKGROUND: Busulfan is an alkylating chemotherapeutic agent that is routinely prescribed for leukemic patients to induce myelo-ablation. However, it also results in azoospermia and infertility in cancer survivors. This research was constructed to explore the possible therapeutic role of amniotic fluid-derived stem cells (AFSCs) in improving busulfan-induced azoospermia in adult rats. METHODS: Forty two adult male albino rats were randomized into: (1) control group, (2) azoospermia group, (3) spontaneous recovery group, and (4) AFSCs-treated group, in which AFSCs were transplanted through their injection into the testicular efferent ducts. The assessment included a histo-pathological examination of the seminiferous tubules by the light and transmission electron microscopes. Additionally, the confocal laser scanning microscope was used for confirmation of homing of the implanted cells. Moreover, we conducted an immuno-fluorescence study for detection of the proliferating cell nuclear antigen (PCNA) in the spermatogenic cells, epididymal sperm count, and a histo-morphometric study. RESULTS: AFSCs successfully homed over the basement membrane of the injured seminiferous tubules. They greatly attenuated busulfan-induced degenerative and oxidative changes. They also caused a re-expression of PCNA in the germ cells, leading to resumption of spermatogenesis and re-appearance of spermatozoa. CONCLUSION: AFSCs could be a promising treatment modality for male infertility induced by chemotherapy, as they possess prominent regenerative, anti-apoptotic, and anti-inflammatory potentials.

Light and electron microscopic study of the toxic effect of prolonged lead exposure on the seminiferous tubules of albino rats and the possible protective effect of ascorbic acid.

BACKGROUND: Lead has been long recognized as an occupational toxicant. Now, lead is considered to be one of the major environmental pollutants which have serious potential threat to human health. Reports of declining male fertility have renewed interest in the role of environmental and occupational exposures in the etiology of human infertility. OBJECTIVES: The aim of the present work was to investigate the toxic effect of prolonged exposure to lead on albino rat's seminiferous tubules and the possible protective effect of ascorbic acid (vitamin C) on lead toxicity. METHODS: The study was carried out on 40 adult male albino rats divided into three groups: a control group which comprised three subgroups; negative control which received no treatment and two positive controls receiving an oral daily dose of distilled water or ascorbic acid, respectively. Lead acetate--intoxicated group received lead acetate orally in a dose of 25 mg/kg b.w dissolved in distilled water for 3 months. While the protected group received ascorbic acid orally in a dose of 100 mg/kg b.w daily for 3 months, simultaneously with lead acetate in a similar dose to that of the intoxicated group. By the end of the experimental period, blood samples were collected for estimation of blood lead level. Fresh specimens were taken from the testis and processed for light and electron microscopic examination. RESULTS: Biochemical analysis demonstrated significant increase in the blood lead level in lead intoxicated group compared to the control group, while ascorbic acid--protected group revealed significant decrease in the blood lead level. Light microscopic examination of lead treated group revealed loss of normal architecture of the testicular tissue in the form of thin walled seminiferous tubules with wide lumen and vacuolations in the spermatogenic epithelium mostly separating primary spermatocytes from spermatogonia and surrounding nuclei of Sertoli cells. Apoptotic bodies were found among the basal part of the spermatogenic epithelium. Ultrastructural examination of the same group revealed degenerating cells with cytoplasmic vacuolations, apoptotic cells with heterochromatic nuclei and dense cytoplasm, irregularities in the basal lamina with increased collagen deposition and shrunken myoid cells. Late differentiating spermatids showed deformed head with widening of the subacrosomal space and redundant acrosome, in addition to the abnormalities in the tail of developing sperms. On the other hand, ascorbic acid--protected group showed amelioration of most of the degenerative changes depicted in the lead intoxicated group. CONCLUSION: Lead had an injurious effect on the testis of the exposed animals. Simultaneous administration of ascorbic acid was efficient in preventing most of such toxic effect and decreasing the blood lead level. Therefore, ascorbic acid can be recommended for protection against lead intoxication.