Fractional Erbium-Doped Yttrium Aluminum Garnet Laser in the Treatment of Primary Cutaneous Amyloidosis.

BACKGROUND: Although various treatments are currently available for primary cutaneous amyloidosis (PCA), there is no entirely satisfactory treatment. Recently, fractional ablative lasers are claimed to have therapeutic effects for PCA. OBJECTIVE: To evaluate the efficacy and safety of fractional Er:YAG laser for the treatment of PCA. METHODS AND MATERIALS: Ten patients with macular and lichen amyloidosis received 4 treatment sessions with 4-week intervals. The outcome was assessed clinically (degree of pigmentation, rippling, lichenification, and itching) through photographs and histologically (amount of amyloid, melanin, epidermal thickness, and depth of rete ridges) through biopsy specimens stained with hematoxylin-eosin, Congo red, and Fontana-Masson stain. Patients were followed up for 3 months after the final treatment. RESULTS: At 3-month follow-up, fractional Er:YAG laser exhibited a significant clinical and histological improvement. Patient satisfaction concurred with physicians' evaluations. Recurrence was detected in 1 patient. CONCLUSION: In light of the authors' findings, fractional Er:YAG laser offered a great clinical and histological efficacy with excellent safety profile. Careful laser selection based on making a compromise between efficacies and safeties may improve outcome.

Combined Low-Dose Isotretinoin and Pulsed Dye Laser Versus standard-Dose Isotretinoin in the Treatment of Inflammatory Acne.

BACKGROUND AND OBJECTIVES: Acne is a widespread disorder of the pilosebaceous unit. Isotretinoin is the background treatment of cases of severe acne. Side effects associated with the standard 0.5-1 mg/kg/day dose decrease patient compliance. Pulsed dye laser (PDL) was proved effective in the management of inflammatory acne. The focus was to evaluate the efficacy of combining low-dose isotretinoin (0.25 mg/kg/day) with PDL in comparison with the standard higher-dose isotretinoin (0.5 mg/kg/day) as monotherapy for the management of acne vulgaris. STUDY DESIGN/MATERIALS AND METHODS: The current prospective randomized comparative study included 46 acne patients, who were randomly divided into two groups. The first (ISO/PDL group) was treated with oral isotretinoin (0.25 mg/kg/day) and five sessions of PDL. The second (ISO group) was treated with oral isotretinoin (0.5 mg/kg/day). The physician's clinical assessment was done by three blinded dermatologists using quartile scale score and erythema score at baseline, 3 months, and 6 months and global acne grading system (GAGS) at baseline and 6 months. Patient satisfaction was assessed using the Cardiff Acne Disability Index (CADI). RESULTS: Both groups showed a significant improvement in all assessed parameters compared with baseline at 3 and 6 months. Comparing both groups together, the ISO/PDL group showed a statistically significantly greater improvement regarding all parameters at both assessment times. Regarding adverse events, six patients (26%) suffered from flare in the ISO group versus none in the combined group. Dryness was encountered in 20 patients (86%) in the ISO group versus five patients (21%) in the other group. The ISO/PDL group received significantly less cumulative isotretinoin dosage (48.7 ± 5.7 mg/kg) in comparison to the ISO group (100.4 ± 3.1 mg/kg) (P < 0.05). CONCLUSION: The current study offers a new collaboration between two well-studied and established treatment modalities leading to a harmony of therapeutic synergism while minimizing the risk of side effects. Longer periods of follow-up are recommended to diagnose any relapses and modify the proposed protocol. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.

Serum Vitamin D and Vitamin D Receptor Gene Polymorphism in Mycosis Fungoides Patients: A Case Control Study.

BACKGROUND: Vitamin D has been considered a key player in various malignancies including cutaneous cancers. To date, mycosis fungoides (MF) has been the least studied in relation to vitamin D. Furthermore, the vitamin D receptor (VDR) single nucleotide polymorphisms (SNPs) have not been tackled before in the context of MF, despite their incrimination in numerous diseases. AIM OF STUDY: To assess the role of vitamin D in MF by measuring its serum level, and studying VDR SNPs (TaqI, BsmI, FokI) in different stages of MF. PATIENTS AND METHODS: 48 patients with various stages of MF, and 45 healthy controls were included. Complete history, full clinical examination and a five mm punch skin biopsy were performed to all recruited patients. Venous blood samples were withdrawn from both patients and controls to determine the serum vitamin D level and VDR gene polymorphisms. RESULTS: Serum vitamin D level was significantly lower in patients (5.3-33.7 nmol/L)] compared to controls (8.3-90.1 nmol/L)] (P<0.001). A significant difference was observed between patients and controls regarding the FokI polymorphism only, being higher in patients (P = 0.039). Also Vitamin D serum levels differed significantly in patients with FokI genotypes (P = 0.014). No significant correlations were detected between any of the studied parameters and the demographic and clinical data of the included subjects. CONCLUSION: Depressed vitamin D and FokI polymorphism are potentially involved in the context of MF. VDR gene polymorphisms warrant further larger scale investigations to detect the exact genes involved in the pathogenesis of such an enigmatic disease.

Investigation of long noncoding RNAs expression profile as potential serum biomarkers in patients with hepatocellular carcinoma.

There is an increasing interest in using long noncoding RNAs (lncRNAs) as biomarkers in cancer. Predictive biomarkers in hepatocellular carcinoma (HCC) have great benefit in the choice of therapeutic modality for HCC. The aim of this study is to assess lncRNA-urothelial carcinoma associated-1 (lncRNA-UCA1) and WD repeat containing, antisense to TP53 (WRAP53) expression as novel noninvasive biomarkers for diagnosis of HCC in sera of HCC patients compared with chronic hepatitis C virus (HCV) patients and healthy volunteers and to analyze their relationship with respect to the clinicopathologic features. We retrieved HCC characteristic lncRNAs, lncRNA-UCA1 and lncRNA-WRAP53, based on the microarray signature profiling (released by LncRNADisease database). Quantitative reverse-transcriptase polymerase chain reaction assay (RT-qPCR) was then used to evaluate the expression of selected lncRNAs in the serum of 160 participants. Furthermore, in 20 of 82 HCC cases involved in the study, we examined the expression of lncRNA-UCA1 and lncRNA-WRAP53 in 20 HCC tissues and adjacent nontumor tissues and analyzed its correlation with the serum level of these lncRNAs. The prognostic significance of the investigated parameters in HCC patients was explored. We found that lncRNA-UCA1 and lncRNA-WRAP53 were significantly higher in sera of HCC than those with chronic HCV infection or healthy volunteers. Our data suggested that the increased expression of UCA1 and WRAP53 was associated with advanced clinical parameters in HCC. Of note, tissue levels of the chosen lncRNAs strongly correlate with their sera level. The combination of both lncRNAs with serum alpha fetoprotein resulted in improved sensitivity to 100%. The median follow-up period was 21.5 months. LncRNA-WRAP53 was significant independent prognostic markers in relapse-free survival. LncRNA-UCA1 and lncRNA-WRAP53 upregulation may serve as novel serum biomarkers for HCC diagnosis and prognosis.