Misbalanced CXCL12 and CCL5 Chemotactic Signals in Vitiligo Onset and Progression.

Generalized nonsegmental vitiligo is often associated with the activation of melanocyte-specific autoimmunity. Because chemokines play an important role in the maintenance of immune responses, we examined chemotactic signatures in cultured vitiligo melanocytes and skin samples of early (≤2 months) and advanced (≥6 months) vitiligo. Analysis showed that melanocytes in early lesions have altered expression of several chemotaxis-associated molecules, including elevated secretion of CXCL12 and CCL5. Higher levels of these chemokines coincided with prominent infiltration of the skin with antigen presenting cells (APCs) and T cells. Most of the intralesional APCs expressed the CD86 maturation marker and co-localized with T cells, particularly in early vitiligo lesions. These observations were confirmed by in vivo animal studies showing preferential recruitment of APCs and T cells to CXCL12- and CCL5-expressing transplanted melanocytes, immunotargeting of the chemokine-positive cells, continuous loss of the pigment-producing cells from the epidermis, and development of vitiligo-like lesions. Taken together, our studies show that melanocyte-derived CXCL12 and CCL5 support APC and T-cell recruitment, antigen acquisition, and T-cell activation in early vitiligo and reinforce the role of melanocyte-derived CXCL12 and CCL5 in activation of melanocyte-specific immunity and suggest inhibition of these chemotactic axes as a strategy for vitiligo stabilization.

Expression of apoptosis regulatory markers in the skin of advanced hepatitis-C virus liver patients.

BACKGROUND: Hepatitis-C virus (HCV) infection is considered a major worldwide public health problem with a global prevalence. Maintenance of skin homeostasis requires a delicate balance between proliferation, differentiation, and apoptosis. Meanwhile, it is unclear if there is an altered keratinocyte proliferation/apoptosis balance in advanced liver disease with HCV infection. AIM: This work aimed to evaluate the epidermal thickness and changes in the expression of apoptosis regulatory markers as well as apoptotic index in skin samples of advanced HCV liver patients compared to normal controls. MATERIALS AND METHODS: Twenty biopsies were taken from apparently normal skin of advanced HCV liver disease patients, as well as five healthy control subjects. These specimens were used for histometric epidermal measurement, immunohistochemical staining of apoptosis regulatory proteins (Bax, Fas, p53, Caspase-3, Bcl-2, Bcl-xL) as well as the TUNEL technique for detection of apoptotic cells. RESULTS: The mean epidermal thickness was significantly lower than the control group (P=0.000). There were significant overexpression of pro-apoptotic markers (Bax, Fas, P53, and Caspase-3) in patients (P=0.03, 0.03, 0.003, 0.003 respectively), with increased apoptotic index in HCV liver patients (P=0.002) when compared to normal controls. On the other hand, no statistically significant difference were encountered in the expression of antiapoptotic markers (Bcl-2, Bcl-xL) in HCV patients when compared to normal controls (P=0.5, 0.9, respectively). CONCLUSION: These findings suggest that an alteration in the proliferation/apoptosis balance is present in the skin of HCV liver patients.

Loose anagen hair syndrome in children of Upper Egypt.

BACKGROUND: Loose anagen hair (LAH) syndrome is a phenomenon in early childhood characterized by the presence of easily pluckable hair, where hair tufts can be pulled out easily and painlessly. AIMS: All reports in the English literature described mainly white patients with blond hair. We present the first report of LAH syndrome in dark-skinned children of Upper Egypt. PATIENTS AND METHODS: Twenty-eight children with LAH were diagnosed and examined from 1996 to 2007. The main complaints were patchy or diffuse alopecia and/or slow growth of hair. Clinical examination, hair pull test, trichogram, and scanning electron microscopy (SEM) were performed. RESULTS: Children with LAH included 21 girls (75%) and seven boys (25%). Light microscopy of hair pull tests and trichograms disclosed a striking predominance of anagen hairs (90-100%) with misshapen hair bulbs and absent inner and outer root sheaths. SEM confirmed the misshapen anagen bulbs with ruffled appearance of cuticle and the longitudinal groove parallel to the long axis of the hair shaft. Most children improved spontaneously within few years, however, hair shed continued. CONCLUSION: LAH syndrome occurs in dark-skinned children and could be under-diagnosed. The condition is of cosmetic concern and does not affect the general health.

Continuous-wave Nd:Yag laser hyperthermia: a successful modality in treatment of basal cell carcinoma.

It was observed that malignant tumor cells are more sensitive than normal cells to heat. Hyperthermia is known to be cytotoxic at temperatures above 41 degrees C and selectively lethal to cancer cells. The aim of the present study was to evaluate the therapeutic efficacy of continuous wave Nd:Yag laser-induced hyperthermia in treatment of basal cell carcinoma (BCC). The study was performed between April 1995 and August 2000 on 37 patients with BCC selected from of the outpatients of the dermatology clinic of al-Minya University Hospital. Patients were treated with continuous-wave Nd:Yag laser hyperthermia at 6-week intervals (laser output power was 10 W, spot size 8 mm, and irradiation time up to 1 minute). Following this treatment, 36 patients (97.3 %) were completely cured. Within a follow-up period of 3-5 years only one recurrence was encountered (2.7 %). Continuous wave Nd:Yag laser-induced hyperthermia should be considered as an alternative treatment for BCC. This simple, bloodless, outpatient procedure showed excellent efficacy and cosmetic result with minimal complication.