Cascaded Hough Transform-Based Hair Mask Generation and Harmonic Inpainting for Automated Hair Removal from Dermoscopy Images.

Restoring information obstructed by hair is one of the main issues for the accurate analysis and segmentation of skin images. For retrieving pixels obstructed by hair, the proposed system converts dermoscopy images into the L*a*b* color space, then principal component analysis (PCA) is applied to produce grayscale images. Afterward, the contrast-limited adaptive histogram equalization (CLAHE) and the average filter are implemented to enhance the grayscale image. Subsequently, the binary image is generated using the iterative thresholding method. After that, the Hough transform (HT) is applied to each image block to generate the hair mask. Finally, the hair pixels are removed by harmonic inpainting. The performance of the proposed automated hair removal was evaluated by applying the proposed system to the International Skin Imaging Collaboration (ISIC) dermoscopy dataset as well as to clinical images. Six performance evaluation metrics were measured, namely the mean squared error (MSE), the peak signal-to-noise ratio (PSNR), the signal-to-noise ratio (SNR), the structural similarity index (SSIM), the universal quality image index (UQI), and the correlation (C). Using the clinical dataset, the system achieved MSE, PSNR, SNR, SSIM, UQI, and C values of 34.7957, 66.98, 42.39, 0.9813, 0.9801, and 0.9985, respectively. The results demonstrated that the proposed system could satisfy the medical diagnostic requirements and achieve the best performance compared to the state-of-art.

Facial rejuvenation by microneedling with irradiated amniotic collagen matrix compared to platelet rich plasma.

Many modalities are used for treatment of facial wrinkles, such as microneedling that enhances collagen production, and platelet-rich plasma (PRP) which contains concentrated levels of growth factors. The human amniotic membrane isolated from the placentae of donors (during elective cesarean sections) has high levels of growth factors that help in rejuvenation by improving the migration and proliferation of keratinocytes, fibroblasts and increased collagen synthesis. Was to confirm the efficacy of irradiated amniotic collagen matrix (IACM) versus platelet rich plasma (PRP) delivered via microneedling in facial rejuvenation. The present study included 20 patients with facial wrinkles divided into two groups using split face technique: Group A subjected to microneedling with topical IACM on the right side of the face. Group B subjected to microneedling with topical PRP on the left side of the face. Patients received six sessions 2 weeks apart. Photos by Antera camera and skin biopsies were taken to assess the clinical results. There were a statistically significant improvement in both sides after than before treatment; with better improvement in patients treated with IACM more than patients treated with PRP using microneedling in both sides as proved clinically (assessed by WSRS and GAIS scale), pathologically (Orcein and Masson trichrome stain) and by Antera camera (texture and pigmentation). Microneedling using IACM is a new, safe and effective method for facial rejuvenation, more effective when compared to microneedling using PRP; in need for further studies to evaluate the correct dose and number of sessions to get the best outcome.

Treatment with oral vitamin D alone, topical minoxidil, or combination of both in patients with female pattern hair loss: A comparative clinical and dermoscopic study.

BACKGROUND: One of the most common dermatological complaints among female is female pattern hair loss (FPHL). Serum vitamin D is a factor lately taken into consideration in approaching patients complaining of hair loss. AIM: To evaluate the serum level of 25-hydroxy vitamin D in patients with FPHL and to evaluate the efficacy of vitamin D therapy alone or combined with minoxidil in the treatment of this disease. METHODS: 45 patients with FPHL and 15 controls to measure serum level of vitamin D were enrolled in the study. Patients then were subdivided into 3 groups: group I received topical minoxidil and oral vitamin D, group II received topical minoxidil, and group III received oral vitamin D for 6 months. Clinical and dermoscopic evaluation was done for the three groups before and after treatment. RESULTS: Vitamin D level was significantly decreased in patients compared to controls. After treatment, as regard Ludwig scale, there was statistically significant improvement in group I than II while no significant improvement was found in group III. Dermoscopy revealed that thin hair and single-hair unit were significantly improved in groups I and II, while it was not significantly improved in group III. CONCLUSION: Oral vitamin D combination to topical minoxidil is recommended to treat patients with FPHL; they had better results than vitamin D or topical minoxidil alone.

Platelet rich plasma injection versus topical erythromycin 2% in treatment of acne vulgaris.

BACKGROUND: Acne vulgaris is a common inflammatory skin disease that affects the pilosebaceous glands. There are different modalities of treatment of acne but there is no standard treatment free of side effects. Platelet rich plasma (PRP) is an autologous concentration of platelets in a small volume of plasma. When platelets are activated, multiple growth factors are released. They play an important role in angiogenesis, inflammatory process and wound healing. AIM: was to evaluate and compare the therapeutic efficacy of platelet rich plasma versus topical erythromycin 2% in treatment of acne vulgaris. METHODS: 40 patients with inflammatory acne lesions were included. All patients received PRP injection sessions in one side of the face (group A) every 2 weeks for 6 sessions and topical erythromycin 2% in the other side (group B). RESULTS: There was significant difference between both groups in which better improvement was reported in group A (55% of patients showed good to excellent improvement and 35% showed moderate improvement, especially the inflammatory lesions). Group A showed better patients' satisfaction and lower rate of recurrence than group B. CONCLUSION: PRP is effective and safe treatment option for inflammatory acne and alternative to other systemic modalities especially if they are contraindicated.

Safety and efficacy of platelet-rich plasma vs carboxytherapy in the treatment of atrophic scars: A comparative clinical and histopathological study.

Atrophic scars that occur after surgical procedure or trauma are considered as a cosmetic problem for patients. Atrophic scarring results usually during wound healing with inadequate production of collagen and connective tissue. Factors that precipitate to the formation of depressed scars include: individual variations in wound healing, wound tension, tissue apposition, and scar contraction. To evaluate the safety and efficacy of PRP vs carboxytherapy in treatment of atrophic scars. This study included 40 patients with atrophic scars divided into two groups; group A including 20 patients received PRP injection, group B including 20 patients received CO2 injection. They received the treatment every 4 weeks for four sessions and had follow up for 6 months after the end of treatment. Skin biopsies were taken before and after treatment to evaluate clinical results. There was statistically significant difference between both groups in treating atrophic scars, regarding clinical improvement and patients' satisfaction with better results in group B. Histopathological examination showed significant expression of MMP-1 in group B more than group A. Both methods were safe and effective with minimal side effects with better improvement in patients treated with carboxytherapy than those treated with PRP.

Comparative clinical study of the efficacy of intralesional MMR vaccine vs intralesional vitamin D injection in treatment of warts.

BACKGROUND: Many therapeutic modalities were reported for the treatment of warts; however, no single treatment is completely effective. OBJECTIVE: To evaluate the efficacy of intralesional injection of MMR vaccine vs vitamin D in treatment of warts. PATIENTS AND METHODS: A total of 60 patients were included in the study divided into two groups. Group A received intralesional MMR vaccine into largest wart, and group B received intralesional vitamin D3 into each lesion with maximum of five warts treated in one session. A maximum of six sessions was done every 3 weeks in both groups. Follow-up was done for 6 months for any recurrence. RESULTS: In group A: complete response in 80%, partial response in 6.67%, minimal response in 6.67%, and no response in 6.67% of patients. About 60% of patients with multiple warts showed complete clearance of distant untreated warts. In group B: complete response in 66.7%, partial response in 6.67%, minimal response in 20%, and no response in 6.67% of patients. There was no significant difference between both groups. No recurrence was observed in both groups in the follow-up period. CONCLUSIONS: Immunotherapy by both intralesional MMR vaccine and vitamin D3 is simple, well-tolerated, effective, and cost-benefit modalities for the treatment of warts.

Evaluation of the efficacy of transdermal drug delivery of calcipotriol plus betamethasone versus tacrolimus in the treatment of vitiligo.

BACKGROUND: Vitiligo is a common pigmentary disorder affecting about 1% of the general population. There are numerous medical and surgical treatments. Microneedling is an evolving treatment technique for an expanding number of dermatologic conditions. It is used also to augment transdermal drug delivery through pores created in the stratum corneum. AIM: To evaluate the efficacy of microneedling with tacrolimus versus its efficacy with calcipotriol plus betamethasone in vitiligo treatment. METHODS: Twenty-five patients having vitiligo were selected and their symmetrical patches were divided into side A (right side) which received microneedling with dermapen and topical calcipotriol plus betamethasone and side B (left side) which received microneedling and topical tacrolimus. Every patient received a session every 2 weeks for a maximum 6 months (12 sessions) and follow-up for 3 months. Skin biopsies were taken before and after the treatment to evaluate the clinical results. RESULTS: On side A, 60% of the patients showed excellent improvement while 32% showed excellent response on side B. The mean percentage of improvement was significantly higher on side A than side B (P = 0.017* ). It was effective in the most resistant sites of vitiligo such as: elbows, knees, extremities, and acral area. Histopathological examination showed a significant expression of HMB45 on side A more than side B (P = 0.005* ). CONCLUSION: The combination of microneedling with calcipotriol plus betamethasone is more effective than its combination with tacrolimus. They are both effective in resistant sites. Both methods are safe, cheap, and good tolerated office techniques with minimal side effects.

Clinical and immunohistochemical comparative study of the efficacy of carboxytherapy vs platelet-rich plasma in treatment of stretch marks.

BACKGROUND: Striae distensae are dermal scars with a linear atrophic depression. The exact origin of striae distensae remains unrevealed, but low expression of collagen and fibronectin genes in the affected tissue was found. Several treatment modalities have been proposed, yet no consistent modality is available. AIM OF THE WORK: To evaluate and compare the efficacy and safety of carboxytherapy vs platelet-rich plasma (PRP) in treatment of stretch marks. PATIENTS AND METHODS: This study included 20 patients with striae alba. Every patient received treatment in the form of PRP injection in their right side (group A) and carboxytherapy session in their left side (group B) every 3-4 weeks for 4 sessions. Skin biopsies were taken before and after treatment, and they were subjected to fibronectin immunohistochemical stain. RESULTS: There was a significant improvement in striae alba in both groups after than before treatment. There was no significant difference between both groups as regards either percentage of improvement, response (grading scale), or patient satisfaction. The fibronectin-stained area was significantly higher in both groups after than before treatment, and it was significantly higher after treatment in group (B) than group (A). CONCLUSIONS: Both methods were safe and effective with minimal side effects. There was no significant difference between both methods of treatments. This was confirmed histopathologically by fibronectin expression which is found to be low in striae and increased significantly after treatment. But fibronectin expression was higher in group (B) than (A).