Granzyme B Gene Polymorphisms Are Associated With Severe Non-segmental Vitiligo.

Background: Granzyme B (GZMB) gene is related to human immunity and is considered as one of the genes indulged in vitiligo. Objective: To evaluate the association between GZMB (R55Q) and (P94Q) gene polymorphisms with vitiligo development in a sample of vitiligo Egyptian patients. Methods: This study was a case-control study which included 100 non-segmental vitiligo patients as well as a control group consisted of 100 healthy, sex and age matched vitiligo free individuals. The polymorphism of GZMB gene at (R55Q) and (P94A) were analyzed by polymerase chain reaction. Results: P94Q and R55Q gene polymorphisms were significantly associated with higher VASI scores. Conclusion: GZMB (Q55R) and P94A) gene polymorphisms are associated with the susceptibility to develop vitiligo in the Egyptian population and could help predicting more extensive forms of the disease.

Assessment of seminal cystatin C levels in infertile men with varicocele: A preliminary study.

Varicocele has been raised as a contributor to male infertility supported by the improvement of sperm parameters after varicocelectomy. Cystatin C (Cys C) has been linked to several cellular changes that are common in male infertility cases associated with varicocele such as apoptosis and autophagy. This preliminary study aimed to assess the seminal levels of Cys C in infertile oligoasthenoteratozoospermic (OAT) men associated with varicocele that have been shown to have spermatic vein vasodilation and active death pathway. Overall, 60 men were investigated being divided into two equivalent groups-infertile OAT men with varicocele who underwent varicocelectomy and healthy fertile men as a control group. These men were subjected to history taking, clinical examination, semen analysis and assessment of seminal Cys C pre and 6 months post-varicocelectomy. The results showed a significant increase of seminal Cys C in infertile OAT men with varicocele than the fertile control (55.57 ± 25.6 ng/ml versus 10.78 ± 1.88 ng/ml, p = .001). Seminal Cys C was a significantly decreased post-operative than its pre-operative level (34.69 ± 14.02 versus 55.57 ± 25.6 ng/ml, p = .01). These results show a potential role of Cys C in varicocele-induced infertility.

Topical ß-blockers for pyogenic granulomas: A promising option for younger patients.

BACKGROUND: Topical ß-blockers, propranolol, and timolol were used for pyogenic granuloma (PG) treatment; however, their efficacies and safety profiles were not compared. AIMS: The aim was to evaluate the safety and efficacy of propranolol 1% and timolol 0.5% creams in the treatment of pyogenic granulomas. PATIENTS: The study included 30 PG patients. They were divided into three groups (10 patients each). Group I patients received propranolol 1% cream. Group II patients used timolol 0.5% l cream. Group III patients used placebo cream. Creams were applied twice daily for 2 months. Patients were followed up for 3 months to detect any recurrence. RESULTS: Complete resolution was reported in 6 patients of groups I and II, while none of the control patients reported complete resolution. Despite the absent change in lesions' size in 40% of ß-blockers treated groups, they all reported decreased bleeding tendency. There was insignificant difference between the clinical responses between ß-blockers groups. No recurrence was reported in any of the patients who achieved complete resolution after 3 months of follow-up. Younger patients respond better to ß-blockers. Three patients were deteriorated on beta-blockers treatment. CONCLUSION: ß-blockers are a promising PG treatment option in cases where invasive modalities are not desirable especially in younger patients.

Serum TWEAK: A cutoff between segmental and nonsegmental vitiligo.

BACKGROUND: TWEAK/Fn14 is expressed in many tissues including the skin, playing an important role in many inflammatory, autoimmune, and neoplastic cutaneous disorders. AIMS: To assess the serum levels of tumor necrosis factor-like weak inducer of apoptosis (TWEAK) in vitiligo patients. METHODS: This case-control study included 100 subjects (50 vitiligo patients and 50 control subjects) recruited from Dermatology Outpatient Clinic, Benha University. All patients were subjected to complete cutaneous examination, to evaluate the clinical type, distribution and severity of vitiligo using the Vitiligo Area Scoring Index (VASI). RESULTS: TWEAK serum levels were significantly higher in patients than in the control subjects (644.76 ± 688.93 vs 282.75 ± 125.67, respectively). Serum levels were significantly elevated in segmental versus nonsegmental vitiligo. Receiver operating characteristic (ROC) analysis revealed that TWEAK shows 80% sensitivity and 56.67% specificity in diagnosing vitiligo and 100% sensitivity and 80.09% specificity in differentiating segmental from nonsegmental vitiligo. CONCLUSION: TWEAK may play a role in vitiligo pathogenesis. It may be used in the differentiation between segmental and nonsegmental vitiligo and represent a promising therapeutic target in vitiligo.

Serum TWEAK in acne vulgaris: An unknown soldier.

BACKGROUND: TWEAK is an inflammatory cytokine which is involved in the development of many inflammatory disorders. AIMS: This study aimed to evaluate serum levels of TWEAK in patients with acne vulgaris. SUBJECTS AND METHODS: This case-controlled study included 100 acne vulgaris patients divided into two groups. Group 1 included 25 patients with moderate acne and 25 patients with severe acne. Group 2 consisted of 50 acne-free control subjects. Acne was graded by the Global Acne Grading System (GAGS). Serum TWEAK was measured by ELISA kits. RESULTS: Acne patients had significant elevation in TWEAK serum levels when compared to the control subjects (P < 0.001). TWEAK serum levels did not show significant difference regarding disease grade, postacne scar, and hyperpigmentation (P value = 0.43, 0.37, 0.80, 0.67, respectively). TWEAK levels were not affected by any of the studied variables except for the significant negative correlation between its levels and the disease duration in severe acne group only (r = -0.42, P = 0.03). CONCLUSION: TWEAK may be involved in acne vulgaris development, but more studies are needed to clarify its role.

Cigarette smoking reduces the efficacy of intralesional vitamin D in the treatment of warts.

Cigarette smoking may decrease serum levels of vitamin D and reduce its efficacy. We aimed to evaluate the safety and efficacy of intralesional vitamin D in the treatment of warts and to investigate the effect of smoking on its efficacy in these cases. The study included 20 patients with verruca vulgaris and deep palmoplantar warts. The wart to be injected was cleaned by alcohol and then injected with 0.1 mL of prilocaine (20 mg/mL). 0.2 mL of vitamin D3 (7.5 mg/mL) solution was slowly injected into the base of each wart. The maximum total amount of vitamin D3 injected into a patient in one session was 7.5 mg. The injection was done at 4 weeks interval until clearance or for a maximum of two sessions. Clinical and dermoscopic follow-up of the treated and distant warts was carried out. Forty percent of the treated lesions showed complete clearance and the rate of distant wart response was 17.65%. Among different demographic and clinical variables in the studied patients, smoking and older age seemed to decrease the therapeutic response Intralesional vitamin D is effective in the treatment of warts, however, smoking and aging may reduce its efficacy.