Topical niacinamide (Nicotinamide) treatment for discoid lupus erythematosus (DLE): A prospective pilot study.

BACKGROUND: Cutaneous lupus erythematosus is an umbrella term for a group of autoimmune connective tissue disorders affecting the skin. Discoid lupus erythematosus (DLE) is the chronic condition and most common form of cutaneous lupus erythematosus. AIMS: Current therapies of DLE are challenging and not completely satisfactory, highly expensive, off-label, or poorly available (like antimalarials due to COVID-19 outbreaks). Nicotinamide, also called niacinamide, is a water-soluble form of vitamin B3 (niacin). Its multiple effects let us think that nicotinamide could be a therapy for lupus-associated skin lesions. METHODS: We performed a prospective randomized double-blind clinical trial on 60 subjects diagnosed with Discoid lupus erythematosus using topical Nicotinamide 2% and 4% preparations in form of cream and gel on skin and scalp lesions. Control group was included using only cream/gel base as placebo control. RESULTS: Obtained data showed that topical Nicotinamide can be used for the treatment of DLE as adjuvant to other treatment regimens with good cosmetic results and minimal side effects. Topical 4% Nicotinamide is superior to 2% preparation in response but associated with a higher incidence of irritation. CONCLUSION: Topical Nicotinamide can be used for the treatment of DLE as an adjuvant to other treatment regimens with good cosmetic results and minimal side effects. Further trials with long-term therapy, follow-up period, and bigger sample sizes are required.

Dermoscopic evaluation of the efficacy of combination of topical spironolactone 5% and minoxidil 5% solutions in the treatment of androgenetic alopecia: A cross sectional-comparative study.

BACKGROUND: Androgenetic alopecia (AGA) is a common chronic dermatological illness that affects both men and women. AIM: To assess and compare dermoscopically the impact of a combination of topical minoxidil solution (5%) and topical spironolactone solution (5%) in treating AGA in both sexes. PATIENTS AND METHODS: One hundred and twenty patients diagnosed with AGA were divided into three groups; each group is composed of 40 patients. Group A (n = 40) were treated with a 5% topical minoxidil solution, group B (n = 40) were treated with a 5% topical spironolactone solution, and group C (n = 40) were treated with a 5% topical minoxidil and spironolactone combination. RESULTS: Following the initiation of treatment and at 6 weeks (midterm), reduction in all dermoscopic features was observed in all groups; however, it was not statistically significant except for vellus hair reduction (p = 0.033). On the contrary, upright regrowing hairs were insignificantly increased in all groups (p = 1.088). The pattern of dermoscopic features remained to insignificantly decrease toward the end of 12 weeks treatment (full term) in all studied groups except for vellus hair that showed further significant reduction toward the end of the study (p = 0.011). CONCLUSION: Both spironolactone as a 5% topical solution and minoxidil as a 5% topical solution might be used safely in a twice-daily dosage to treat AGA in both genders. Furthermore, combining them in a single topical dose form can boost efficacy and yield greater advantages.

Cross sectional quality of life assessment in patients with androgenetic alopecia.

Assessment of quality of life (QOL) of patients with androgenetic alopecia (AGA) has become increasingly important, both in order to evaluate the influence of the disease on patients and the therapy they require. We aimed to assess QOL in subjects complaining from AGA and evaluated the effects of various sociodemographic factors affecting their QOL. QOL was assessed in 400 patients with AGA and 100 controls using the World Health Organization Quality of life (WHOQOL-BREF) questionnaire. Four domains (physical, psychological, social, and environmental) and two items (overall perception of QOL and health) of the WHOQOL-BREF were the primary end points of this study. Patients had a lower QoL and less general satisfaction in all four domains of assessment than controls. The social impact was significantly higher in patients < 30 years of age (P = .003). Patients with severer form of AGA significantly had higher scores in all domains compared to those with less severe forms. Disease severity negatively impacted all the four domains significantly (P = .021). AGA harmfully affected the patient's QOL which warns the physicians to pay more attention to QOL impairment in patients of AGA for the better understanding of the disease burden on individual patients.

Therapeutic implications of immunohistochemical expression pattern of the cancer stem cell marker (nestin) in basal and squamous cell carcinomas.

Cancer stem cells (CSC) are populations of cells responsible for tumor initiation, progression and therapeutic resistance in many cancers. In the present study, we aimed to investigate the expression pattern and clinical significance of the stem cell marker nestin, in Squaous cell carcinoma (SCC) and basal cell carcinoma (BCC). The samples (23 cases of BCC and 22 cases of SCC) were immunohistochemically examined for the expression of nestin and its correlation with the corresponding clinical and pathological parameters. Nestin was expressed in four out of the 23 cases of BCC (17.4%) and was expressed in 10 out of the 22 cases of SCC (45.5%). Nestin expression between the two tumors was statistically significant (P = .042). Although a direct relationship was found between the tumor grade and nestin expression, the results were statistically insignificant (P = .495). The results of this study suggest that BCC and SCC may share some cellular origin but with different biologic behavior. The relation of nestin expression to the grade of SCC, although statistically insignificant, may suggest its role in predicting the biologic behavior of this tumor.

Impact of Uraemic Pruritus on Quality of Life among End Stage Renal Disease Patients on Dialysis.

INTRODUCTION: Uraemic pruritus is significant complication in (ESRD) patients and substantially impairs their quality of life (QOL). ESRD is a bothersome problem with attempts being made to increase the survival of patients on dialysis. AIM: An attempt was made to compare the QOL of haemodialysis patients and suffering from uraemic pruritus with the QOL of those on haemodialysis but with no presenting uraemic pruritus. MATERIALS AND METHODS: A cross-sectional study was conducted to evaluate the QOL of haemodialysis patients suffering from uraemic pruritus. The WHOQOL-BREF questionnaire was used to assess the QOL. Haemodialysis patients with pruritus who had completed three months of maintenance haemodialysis (n=100) were enrolled into the study and 100 controls (n=100) on haemodialysis but with no pruritus were further enrolled. RESULTS: The QOL of haemodialysis patients with pruritus was found to be significantly impaired (p < 0.05) in comparison to those on haemodialysis with no prutitis, particularly with respect to all the four WHOQOL-BREF domains. CONCLUSION: Quality of life of ESRD patients on dialsysis was siginificantly affected by pruritis.