Combined therapy of plantar warts with topical bleomycin and microneedling: a comparative controlled study .

Background: The aim of this study was to assess the efficacy of combination between microneedling with dermapen and topical bleomycin in the treatment of plantar warts in comparison with intralesional bleomycin and intralesional saline (placebo).Methods: Fifty-four patients were assigned into three groups, each containing 18 patients. The first group treated by micro-needling phenotype with topical bleomycin at 2 weeks interval, the second group received intralesional bleomycin at 3 weeks interval and the control group was intralesional saline for a maximum of four weeks.Results: Complete clearance of warts in 16 patients in the micro-needling group (88.9%) versus 15 patients (83.3%) in the intralesional bleomycin group versus one patient (5.6%) in the control group .Conclusions: Microneedling assisted topical bleomycin spraying seems to be a promising effective and noninvasive therapeutic modality for recalcitrant plantar warts that facilitates delivery and absorption of bleomycin into the lesion .

Comparison of intralesional triamcinolone acetonide, botulinum toxin type A, and their combination for the treatment of keloid lesions.

Objective: Despite the myriad options available, there is no universally the accepted treatment for keloids. Our objective was to compare three regiments and establish superiority in terms of objective and subjective outcomes.Approach: In this intervention study, 50 patients were enrolled. The Group I: included 26 patients with at least two keloid lesions subjected to intralesional triamcinolone acetonide in left-sided lesions and intralesional botulinum toxin type A in right-sided lesions. While group II included 24 patients subjected to a combination of both intralesional TAC and BTX-A. Injections were done for a total of three sessions 4 weeks apart. Color Doppler ultrasound (CDU) was done before and one month after treatment.Results: In terms of thickness and surface area the keloids responded significantly better to combined TCA and BTX versus TCA alone or BTX alone (p .0001). Also improvement in transverse and longitudinal axis was significantly higher in combined therapy (p < .0001 and .004, respectively). Conclusion: Combined injection of intralesional steroids with BTX-A appears to be superior to either therapy alone and offer the best benefit of safer and more efficacious response with lesser side effects.

Successful treatment of acne keloidalis nuchae with erbium:YAG laser: a comparative study.

Background: Acne keloidalis nuchae (AKN) is a chronic inflammatory disease involving hair follicles of the neck. It is a form of keloidal scarring alopecia that is often refractory to medical or surgical management. Objective: To evaluate the efficacy of Er:YAG laser in the treatment of AKN as compared to long pulsed Nd:YAG laser. Patients and Methods: This study was conducted on 30 male patients with AKN. Their ages ranged from 19 to 47 years with a mean age of 36.87 ± 7.8 years. Patients were divided randomly into two groups of 15 patients, each receiving six sessions of either Er:YAG or long-pulsed Nd:YAG laser therapy. Results: A statistically significant decrease in the number of papules was detected at the end of therapy in both groups, with a mean of 91.8% improvement in the Er:YAG group versus 88% in the Nd:YAG group. A significant decrease in plaques count was detected only in the Er: YAG group while a significant decrease in plaques size and consistency was recorded in both groups. Conclusion: The Er: YAG laser proved to be a potentially effective and safe modality both in the early and late AKN lesions.

Platelet-Rich Plasma Versus Tretinoin in Treatment of Striae Distensae: A Comparative Study.

BACKGROUND: Striae distensae (SD) are dermal scars associated with atrophy of the epidermis. OBJECTIVE: To evaluate the effect and safety of intralesional injection of platelet-rich plasma (PRP) versus topical tretinoin 0.05% in treatment of SD. METHODS: Thirty patients (27 females and 3 males) had bilateral striae distensae were enrolled in this study. In every patient, half of the selected striae were treated with PRP intralesional injection. The other half was treated by topical tretinoin. Skin biopsies were taken from both sides before and after the treatment. Digital photographs were taken at the baseline and at the end of follow-up period. Clinical improvement was evaluated by 2 blind dermatologists in addition to the patient's satisfaction rating. RESULTS: There was statistically significant improvement in the SD treated with PRP and topical tretinoin cream. The improvement was more in the SD treated with PRP injections (p = .015). Patient's satisfaction showed that the improvement was more in the PRP-treated side (p = .003). Collagen and elastic fibers in the dermis were increased in all biopsies after treatment. CONCLUSION: PRP injection and topical tretinoin are safe for the treatment of SD, but PRP is more effective and it gives better therapeutic response than tretinoin.