The role of interleukin-22 in pityriasis rosea.

BACKGROUND: Pityriasis rosea (PR) is an exanthematous disease related to reactivation of human herpes virus (HHV) types 6 and 7. The pathogenesis and cytokine profile of PR are still poorly understood.There is a large amount of evidence indicating a viral aetiology for PR. AIM: To measure the serum level of interleukin (IL)-22, a cytokine expressed by T helper (Th)17 cells in patients with PR to explore the possible association of IL-22 with the pathogenesis of the disease. METHODS: This case-control study enrolled 25 patients with PR (mean ± SD age 20 ± 12 years) and a control group of 25 apparently healthy individuals (mean age 18 ± 12.1 years). Blood samples were collected from both patients and controls to measure serum IL-22. Scoring of PR was performed using the Pityriasis Rosea Severity Score (PRSS). RESULTS: There was a statistically significant difference in IL-22 serum level between the patient and control groups. The IL-22 serum level increased with increase in disease severity (PRSS), extent and duration. CONCLUSION: Through its proinflammatory cytokines, IL-22 plays a role in the inflammatory process of PR.

Comparative study of some treatment modalities of rosacea.

BACKGROUND: Rosacea is a disease of complex pathogenesis and variable response to various therapeutic methods. Aim of the work To evaluate and compare the efficacy, safety and side effects of some topical lines of treatment of rosacea. PATIENTS AND METHODS: The study included 24 patients (23 females and 1 male) with rosacea on the face. They were classified into three groups--each including eight patients (16 face sides)--and treated with one of three topical agents (azelaic acid 20% cream, metronidazole 0.75% cream or permethrin 5% cream) on one side of the face and another one on the other side twice daily for 15 weeks. RESULTS: There was a significant improvement of lesions after 15 weeks of topical treatment with the three agents. Azelaic acid cream was significantly more effective on inflammatory lesions but not erythema than the other two creams. Side effects--mostly transient--were observed with topical creams with no significant difference. They included itching, burning sensation, oedema and scales. Patients who used azelaic acid 20% cream were more satisfied than with other modalities. CONCLUSION: Azelaic acid 20% cream provides an effective and safe alternative to metronidazole 0.75% cream or permethrin 5% cream with the added benefit of increased patient satisfaction.

Nail changes in chronic renal failure patients under haemodialysis.

BACKGROUND: Chronic renal failure is known to cause various nail pathologies. They may be directly related to the renal condition itself or its complications or to the therapy. OBJECTIVE: To compare nail changes in end-stage renal failure patients under haemodialysis with healthy persons and to study the potential relationship with various parameters in the patients. PATIENTS AND METHODS: The study comprised 100 patients with chronic renal failure under regular haemodialysis as well as 100 healthy control subjects of matched age and sex. Both groups were subjected to full history taking and thorough general and nail examination. Complete blood picture, liver and kidney function tests and fasting blood glucose level were investigated. RESULTS: Nail disorders were more prevalent in patients (76%) than in control group (30%). The half and half nail was the most common finding (20%) followed by - in descending manner - absent lunula, onycholysis, brittle nail, Beau's lines, clubbing, longitudinal ridging, onychomycosis, subungual hyperkeratosis, koilonychias, total leukonychia, splinter hemorrhage, pitting and pincer nail deformity. There was non-significant correlation between nail changes and age of the patients or duration of haemodialysis. In addition, no evidence of significant relation was found between nail changes and both haemoglobin and albumin levels. CONCLUSION: Frequent nail changes are observed on systematic nail examination of uraemic patients undergoing haemodialysis; however, the cause of them remains obscure and could not be traced to a particular abnormality in the renal condition, medication or the procedure itself and it needs further investigations.