Efficacy of Polycaprolactone Threads in Treating Atrophic Acne Scars: A Split-face Comparative Study.

Background: Polycaprolactone (PCL) threads are a novel treatment option for promoting collagen production and smoothing the skin. Objective: This study aimed to compare the efficacy and safety of threads versus microneedling with autologous platelet-rich plasma (PRP) in the treatment of atrophic acne scars. Methods: The study included 24 patients (12 females, 12 males) aged 20 to 37 years with atrophic acne scars. Each patient was treated in a split-face manner; a microneedling pen device was used to treat the right side with microneedling and PRP, whereas the left side was treated with threads. Four microneedling plus PRP sessions were used to treat the right side and a single session of threads was used on the left side. For scoring, a global scarring grading system was utilized. Patients were evaluated every three months following the conclusion of treatment. A six-month follow-up was conducted. Results: Significant clinical improvement was observed in 95.8 percent of the patients on the threads-treated side of the face and in 83.3 percent of the patients on the microneedling plus PRP side. Patient satisfaction was significantly greater in the threads group than in the microneedling+PRP group (p<0.0001). The side effects were tolerable and transient. Conclusion: Based on our results, we conclude that both threads insertion and microneedling with autologous PRP can yield satisfactory results with minor side effects (fine edema and erythema) that resolve rapidly.

Estimation of neutrophil activation marker in lichen planus patients.

BACKGROUND: Lichen planus disease is a chronic inflammatory disorder of mucosal and cutaneous tissues, and its etiology and pathogenesis are unclear. Cytokines have a significant role in the beginning, the maintenance of inflammatory and intercellular crosstalk. AIM: We assessed serum levels of neutrophil activation marker (calprotectin) in patients with cutaneous lichen planus with different subtypes and made a comparison with healthy individuals. MATERIALS AND METHOD: Peripheral blood samples of 30 cases with lichen planus were compared with 30 healthy individuals. Serum samples were prepared from LP patients, using a commercial ELISA kit, and calprotectin level was measured in each serum sample. RESULTS: The serum level of calprotectin was significantly raised in LP cases compared with control (141.34 ± 17.47 ng/ml versus 40.03 ± 1.54 ng/ml respectively; p < 0.001). No correlation was recorded among of serum of calprotectin and patients' ages, sex, disease period, and the existence or strength of pruritus. But a strong positive correlation was present between the coexistence of oral lesions and the number of locations. CONCLUSION: Calprotectin can be used as a marker of Lichen planus severity and progression. Calprotectin may play a role in the pathogenesis of LP.

Botulinum toxin type-A versus 5-fluorouracil in the treatment of plaque psoriasis: Comparative study.

BACKGROUND: Long-term remission and total clearance in Psoriasis can only be achieved in a few patients. AIM: To compare the efficacy and safety of intradermal Botulinum toxin (BTX) in the treatment of plaque psoriasis. SUBJECTS AND METHODS: A comparative study conducted in thirty-five patients with chronic plaque psoriasis was treated by split-body therapy. The patients were either treated with intradermal BTX or with intralesional 5-fluorouracil (5-FU) to each of 2 bilaterally symmetrical psoriatic plaque lesions. The outcomes were assessed using the following criteria: the sum of erythema, scaling, and induration scores and the clearing percentage of the target plaque lesion assessed by 2 blinded observers. RESULTS: At the end of the study, the response rate was 85% on the BTX treatment side and 90% on the 5-FU side. There was no significant difference between both sides regarding a clinical response or side effects. The recurrence rate was 15% on both sides. CONCLUSIONS: Botulinum toxin was a novel, safe, single injection, and effective therapy for plaque-type psoriasis. More studies are required to further prove the efficacy of BTX in the treatment of plaque psoriasis.

Assessment of neopterin level and severity in lichen planus patients treated with narrow-band ultraviolet B.

BACKGROUND: Neopterin is a cellular immunity biochemical marker. Serum and saliva neopterin levels have been reported to increase in lichen Planus. Nonetheless, analysis has not yet been made for the direct link between narrow band ultraviolet B and severity of Lichen planus. AIM: We aimed to assess serum neopterin levels in patients who receive narrow band ultraviolet B therapy treatment with lichen planus, paired with the severity of the disease. PATIENTS AND METHODS: The study consisted of 35 lichen planus patients and 30 healthy individuals. A 35 patient group received narrow band ultraviolet B therapy. An enzyme-related immunosorbent assay procedure was used in serum neopterin analysis before and post-therapy. RESULTS: The correlation between the level and severity of the patient group was statistically significant (P = .001). In patients with severe disease, serum neopterin levels were significantly increased. Also, in the severe lichen planus group, the serum neopterin level was statistically higher than that of the mild or moderate groups (P = .001).Also, a significant decrease was seen following therapy according to serum neopterin level. CONCLUSION: Serum neopterin levels are a useful marker for the assessment of the severity and effectiveness of narrow band ultraviolet therapy. Thus, our findings may provide a new approach with the management of disease and follow-up strategies in patients with lichen planus.

Correlation between serum IL 37 levels with keloid severity.

BACKGROUND: Keloids are dermal fibroproliferative disorders that characterized by over deposition of components of the extracellular matrix. Interleukin 37 (IL-37) is known by its ability to inhibit the proliferation of keloid fibroblasts by inhibiting extracellular matrix production induced by transforming growth factor ß (TGF-ß). Thus, Il-37 is suggested to be used as an early preventive treatment for keloids. AIMS: This study aimed to evaluate the correlation between serum levels of IL37 level and the keloid severity. PATIENTS/METHODS: This is a cross-sectional analytic study involving thirty-two patients diagnosed clinically as having Keloid. An assessment of keloid severity was conducted by using Vancouver Scar Scale (VSS). Blood samples were collected from every patient to measure and assess the serum levels of IL37. RESULTS: A negative correlation was found between IL37 level and the keloid severity (P = .0001; r = -.737). Also, there was a nonsignificant correlation between IL37 levels in patient with keloid and age, gender, duration of lesions, and family history. CONCLUSION: Lower level of plasma IL 37 could be an indicator of the severity of Keloids.

Measurement of squamous cell carcinoma antigen 2 in lichen planus patients.

BACKGROUND: Lichen planus (LP) is an autoinflammatory mucocutaneous skin disorder with a multifactorial pathogenesis. Squamous cell carcinoma antigen (SCCA) is a tumor marker recognized as a part of the ovalbumin-serpin family. In patients' serum and skin, SCCA expression is increased with inflammatory skin diseases as psoriasis. AIM: This study aimed to estimate serum SCCA2 levels in patients with LP and to assess its relationship with disease severity and types. PATIENTS AND METHODS: We included 34 adult patients with LP and 20 healthy adults as control. The total score of LP activity, area, and severity index was calculated for all patients, whereas serum SCCA2 levels were measured in all participants using enzyme-linked immunosorbent assay. RESULTS: The mean serum SCCA2 levels were significantly higher in patients than their healthy controls (P < .001) and in female patients than male patients (P < .01). The mean serum SCCA2 levels in patients with eruptive LP were significantly higher compared to those with localized (P < .05) and hypertrophic (P < .01) forms. In ROC analysis, when LPAASI = 5 was taken as the limit, an ideal SCCA2 endpoint was discovered at 0.45 ng/mL with the upper Youden index. CONCLUSION: Serum SCCA2 might be a potential biomarker for LP as it was elevated in patients with LP and was associated with disease severity. Further studies are needed to assess the therapeutic effect of its blockade, which could be a way to improve outcome in LP patients.