Novel mint-stalks derived biochar for the adsorption of methylene blue dye: Effect of operating parameters, adsorption mechanism, kinetics, isotherms, and thermodynamics.

The pyrolysis of mint stalks and lemon peels was performed to synthesize mint-stalks (MBC) and lemon-peels (LBC) derived biochars for adsorbing methylene blue (MB). The preparation, characterization, and application of MBC in adsorption have not been reported in the literature. MBC showed higher surface area and carbon content than that of LBC. The removal ratios of MB were 87.5% and 60% within 90 min for MBC and LBC, respectively at pH 7, temperature of 30oC, adsorbent dose of 0.5 g/L, and MB concentration of 5 mg/L. The optimal MBC dose was 1 g/L achieving a removal efficiency of 93.6% at pH 7, temperature of 30oC, contact time of 90 min, and initial dye concentration of 5.0 mg/L. The adsorption efficiency decreased from 98.6% to 31.33% by raising the dye concentration from 3.0 mg/L to 30 mg/L. Further, the increase of adsorbent dose to 10 g/L could achieve 94.2%, 90.3%, 87.6%, and 84.1% removal efficiencies of MB in the case of initial concentrations of 200 mg/L, 300 mg/L, 400 mg/L, and 500 mg/L, respectively. MBC showed high stability in adsorbing MB under five cycles, and the performed analyses after adsorption reaffirmed the stability of MBC. The adsorption mechanism indicated that the adsorption of MB molecules on the biochar's surface was mainly because of the electrostatic interaction, hydrogen bonding, and π-π stacking. Pseudo-second-order and Langmuir models could efficiently describe the adsorption of MB on the prepared biochar. The adsorption process is endothermic and spontaneous based on the adsorption thermodynamics. The proposed adsorption system is promising and can be implemented on a bigger scale. Moreover, the prepared biochar can be implemented in other applications such as photocatalysis, periodate, and persulfate activation-based advanced oxidation processes.

Comparative study of fractional Erbium: YAG laser vs combined therapy with topical steroid as an adjuvant treatment in melasma.

BACKGROUND: Melasma is an acquired disorder of symmetrical hyperpigmentation. Several treatment methods are available for patients with melasma, including topical compounds, broad-spectrum photoprotection, camouflage, chemical peels, and laser and light therapies which represent potentially promising options for patients who are refractory to other modalities. OBJECTIVE: To evaluate and compare the clinical, histopathological, and immunohistochemical changes in melasma after fractional Er:YAG laser versus fractional Er:YAG laser and topical steroids. METHODS: Twenty-two patients were treated with fractional Er:YAG laser on both sides of the face with the use of topical steroid only on the left side to make left-to-right-side comparison. Clinical evaluation, histopathological, and immunohistochemical assessment for skin specimens were performed before treatment and 3 months after the end of sessions. RESULTS: Treatment by fractional Er:YAG laser on the right side showed significant decrease in MASI score with clinical outcome which considered as excellent in three patients (13.6%), very good in six (27.2%), good in eight (36.3%), and fair in five (22.7%) with significant decrease in basal pigmentation and reorganization of dermal collagen and decreased number of MART1-positive cells. After combined therapy, the decrease in MASI score was highly significant with the clinical outcome which considered as excellent in six patients (27.2%), very good in 10 (45.4%), good in three (13.6%), and fair in three (13.6%). The histological changes were highly evident and more significant. CONCLUSION: Clinical, histopathological, and immunohistochemical improvement was evident on both sides, with more significant better outcome with the use of combined therapy on the left side. However, combined therapy was more beneficial for Fitzpatrick skin type III rather than type IV.

Q-switched Nd: YAG laser alone or with modified Jessner chemical peeling for treatment of mixed melasma in dark skin types: A comparative clinical, histopathological, and immunohistochemical study.

BACKGROUNDS: Treatment of mixed melasma remains challenging. Promising results have been achieved with low-fluence 1064-nm Q-switched Nd-YAG laser; however, multiple sessions are necessary with occurrence of complications especially in dark skin types. So, combination methods may be recommended. AIMS: To compare efficacy of Q-switched Nd-YAG laser alone or with modified Jessner's peel in mixed melasma in dark skin. PATIENTS/METHODS: Nineteen patients with mixed melasma received 6 sessions of laser on left side of face and alternating laser and modified Jessner on right side. Evaluation was carried out clinically through modified melasma area and severity index at 1 month after last session. Using histopathological, immunohistochemical, and computerized morphometric analysis, objective evaluation of melanin particle surface area and MART-1-positive cells was performed for pre- and post-treated skin biopsies. RESULTS: There was significant clinical improvement on both sides of face (P < .001), without significant difference (P > .05). At the sixth laser session on left side of face, ill-defined mottled hypopigmentation was observed in 21.05% of patients. Histopathologically, melanin particle surface area and number of MART-1-positive cells (total, epidermal, and dermal) were significantly decreased after two treatment modalities (P < .001), without significant difference in their reduction percentage between both sides of face (P > .05). CONCLUSION: Low-fluence Q-switched Nd-YAG laser alone and with modified Jessner's peel are equally effective regimens for mixed melasma clinically, histopathologically, and immunohistochemically. However, combined method is preferred, especially in dark skin, for obtaining better cosmetic result with fewer side effects of multiple laser sessions and decreasing cost rate of laser.

Microdermabrasion: a clinical, histometric, and histopathologic study.

BACKGROUND: Microdermabrasion is a nonchemical superficial resurfacing procedure that removes the stratum corneum. Because it is a somewhat subtle procedure, it may be difficult to demonstrate its cosmetic benefit. OBJECTIVES: To assess the efficacy of microdermabrasion in treatment of melasma, postacne scarring, striae distensae, and photoaging by a series of microdermabrasion sittings through clinical, histometric, and histopathologic analysis. PATIENTS AND METHODS: The study was conducted on 38 patients constituting four groups (melasma, acne scars, striae destinsae, and photoaging), each patient was subjected to a series of 8 microdermabrasion treatments performed at 1-week interval. Punch biopsies, at base line, 1 week after the 4th and the 8th session, were obtained from each subject for histometric and histopathologic analysis. RESULTS: Clinically, the improvement in melasma, acne scars, and striae distensae groups was mainly mild to moderate, while in photoaging group was mainly mild. Histometric analysis of epidermal thickness showed insignificant changes in all groups. Histopathologically, decreased melanization and regular distribution of melanosomes in the epidermis were noted in melasma group while increased density of collagen fibers with more regular arrangement in collagen bundles was detected in all candidates of acne scars, striae distensae, and photoaging groups. Meanwhile, Orcein stain did not show any significant changes in elastic fibers. CONCLUSIONS: Microdermabrasion is an easy and safe technique. In this study, most cases showed mild to moderate improvement. Decreased melanization with regular distribution of melanosomes and increased collagen density with regular arrangement of collagen bundles were the most common observed histologic changes.

Clinical efficacy and safety of topical versus oral ivermectin in treatment of uncomplicated scabies.

Many medications are available for scabies treatment including oral and topical ivermectin. However, studies comparing these two forms as a scabies treatment are few. This study compares efficacy and safety of topical versus oral ivermectin as scabies treatment. The study included 62 confirmed uncomplicated scabies patients, divided into: Group I (32 patients, received topical ivermectin) and Group II (30 patients, received oral ivermectin). Patients were assessed, clinically and by KOH smear at 1, 2 and 4 weeks. Treatment was repeated after one week in patients with persistent infection. Adverse events were recorded. Most patients (87.5% and 73.5% in group I and group II respectively) were symptom free after a single treatment. A second treatment was required in 4 patients of group I and 8 patients of group II. However, 2 weeks after treatment symptoms and signs completely resolved in all cases with no recurrence at 4 weeks. This study suggests that both topical and oral ivermectin are safe and equally effective in treatment of uncomplicated scabies. Single treatment, whether topical or oral, is associated with high cure rate in a week post treatment. However, repeating treatment after one week may be required to achieve 100% cure.

Nail changes and disorders in elderly Egyptians.

BACKGROUND: The nail unit is an important part of cosmetic appearance of an individual. Older people are at an increased risk of nail alterations, including normal age-related changes and disorders that more commonly affect this specific population. OBJECTIVES: To identify and evaluate the age-related nail changes and disorders in Egyptian elderly people both clinically and histopathologically. PATIENTS/METHODS: A total of 400 adult subjects, not complaining from any dermatological disease, were included in the present study; half of them were elderly of 60 years and above (elderly group). Meanwhile, the other half served as a control group with younger ages. Full history taking, general and local examinations as well as nail biopsies were performed from selected cases with age-related nail changes and disorders. RESULTS: Nail changes were significantly (P < 0.05) more common in old age group (88%) compared to control subjects (39%). The commonest age-related nail changes noticed were pale, dull, opaque, and lusterless nails (73%); brittle nails (67.5%); decreased lunula visibility (49%); and onychorrhexis (45.5%). They showed highly significant increase (P < 0.001) when compared with control group. CONCLUSIONS: The prevalence of nail changes and disorders has increased among elderly patients although they are frequently overlooked by health care providers. Dermatologist should be aware about various nail changes related to aging and those associated with other dermatoses or systemic diseases. Histopathologic picture can enhance the accuracy of clinical diagnosis of various nail changes and disorders.

Assessment of topical versus oral ivermectin as a treatment for head lice.

Many medications are available for treatment of pediculosis capitis including ivermectin. Our aim is to compare the efficacy and safety of topical versus oral ivermectin in treatment of pediculosis capitis. Sixty-two patients with proved head lice infestation were included and divided into group I (31 patients; received single topical application of 1% ivermectin) and group II (31 patients; received single dose of oral ivermectin). Treatment was repeated after 1 week for nonresponders. At 1 week after treatment, the eradication rates and improvement of pruritus were significantly higher among patients who received topical than oral ivermectin. When a second treatment, topical or oral, was given to nonresponders, the cure rates of infestation and pruritus was 100% and 97% among patients treated with topical and oral ivermectin, respectively with no significant difference between the two groups. This study suggests that both topical and oral ivermectin demonstrate high efficacy and tolerability in treatment of pediculosis capitis. However, a single treatment with topical ivermectin provides significantly higher cure of infestation and faster relief of pruritus than oral ivermectin. In addition, whether topical or oral ivermectin is used to treat head lice, a second dose is required in some cases to ensure complete eradication.

Expression of IFN-γ, IL-4, and IL-17 in cutaneous schistosomal granuloma.

OBJECTIVES: Cutaneous schistosomal granuloma (CSG) is a rare dermatological disease, the clinical and histopathological features of which are well defined. Although a panoramic picture of its immunopathogenesis in humans is not yet available, it is believed to be induced by T helper 1 (Th1), Th2, or Th17 cytokines in animals. This study evaluated the expression of different types of Th cytokines, including Th1 cytokine interferon-γ (IFN-γ), Th2 cytokine interleukin-4 (IL-4), and Th17 cytokine IL-17, in human CSG. METHODS: This study included nine patients with CSG. Dermatological examinations were conducted in all subjects. Skin biopsy specimens were stained with hematoxylin and eosin (H&E). Immunohistochemical examination was performed using three monoclonal anti-human antibodies against IFN-γ, IL-4, and IL-17 to evaluate Th1, Th2, and Th17 cytokines, respectively. RESULTS: The most common site of CSG manifestation was the paraumbilical area, which was affected in 66.7% of patients. All lesional skin biopsy specimens revealed multiple dermal granulomas surrounding schistosomal eggs. Positive immunoreactivity for IFN-γ, IL-4, and IL-17 was present in dermal inflammatory infiltrate in 88.9, 11.1, and 88.9% of subjects, respectively. There were statistically significant negative correlations between the duration of disease and both IFN-γ and IL-17 (P ≤ 0.05), and a statistically significant positive correlation between IFN-γ and IL-17 (P ≤ 0.05). CONCLUSIONS: This study suggests that CSG is formed by the action of both Th1 (IFN-γ) and Th17 (IL-17) cytokines, which have been shown to be directed against the schistosomal egg to induce a cell-mediated immune response.