A Novel Treatment of Acne Keloidalis Nuchae by Long-Pulsed Alexandrite Laser.

BACKGROUND: Acne keloidalis nuchae (AKN) is a dermatological condition characterized by follicular-based papules and pustules that later form hypertrophic or keloid-like scars. Laser-assisted hair reduction such as 810-nm diode laser and 1,064-nm Nd:YAG laser have been used for treating AKN with promising results. OBJECTIVE: To evaluate the therapeutic effect and safety of alexandrite laser in the treatment of different lesions of AKN. METHODS: Seventeen male patients with AKN received 6 sessions of 755-nm alexandrite laser. Papule and pustule count, keloidal plaque size, pliability, tenderness, and itching were assessed at the fourth session and 4 weeks after the sixth session. Patient satisfaction and Dermatology Life Quality Index (DLQI) questionnaire were performed at the end of treatment. Patients were followed up for 3 months after the final treatment. RESULTS: There was a significant decrease in the mean papule, pustule count, keloidal plaque size, and pliability at the fourth and sixth laser sessions when compared with baseline. Reduction of the hair density in the treated area is the only complication observed, which was accepted by the patients because of its reversible course. There was a statistically significantly higher percentage of improvement in the early lesions (papulopustular) compared with late (keloidal plaque) lesions. By the end of laser sessions, DLQI scores were significantly reduced. Temporary hair loss was noted in 4 patients in the treated sites. No lesional recurrence was detected in the follow-up period. CONCLUSION: Using 755-nm alexandrite laser for treatment of AKN is a safe and effective procedure with low recurrence rates. Alexandrite laser can significantly improve the quality of life of those patients suffering from this disfiguring chronic disorder.

Production of proinflammatory cytokines: granulocyte-macrophage colony stimulating factor, interleukin-8 and interleukin-6 by peripheral blood mononuclear cells of protein energy malnourished children.

Protein-energy malnutrition (PEM) is a serious disease responsible for the high morbidity and mortality rates among children in developing countries. The damaging effects of PEM on their immune system may persist for long throughout their lives. In this study, the levels of the proinflammatory cytokines; Granulocyte-Macrophage colony stimulating factor (GM-CSF), interleukin-8 (IL-8) and interleukin-6 (IL-6) were measured in culture supernates of peripheral blood mononuclear cells (PBMCs) isolated from 46 PEM children before and after stimulation with lipopolysaccharide (LPS). The PEM children were classified into four groups; under weight (u.wt= 15), marasmus (M= 11), marasmic kwashiorkor (MK=10), and kwashiorkor (K=10). Results were compared with those of a control group composed of ten healthy well-nourished age-matching children (C=10). Before LPS stimulation, GM-CSF levels of M, MK and K groups were lower than those of the control group, while IL-8 and IL-6 levels were higher in all PEM groups than in the controls. After LPS stimulation, GM-CSF, IL-8 and IL-6 levels were lower in all PEM groups than controls. The three cytokines' levels were elevated in control and PEM groups after LPS stimulation than before. Before and after LPS stimulation, the highest level of the GM-CSF, IL-8 and IL-6 within PEM children were detected in the u.wt group followed by M, MK and K groups respectively. The disturbance in the production of GM-CSF, IL-8 and IL-6 by PBMCs of PEM children under study and the decreased stimulatory responses of these cells denoted to severely impaired inflammatory response associated with PEM status in addition to several immunological processes in which these cytokines are involved.