Intralesional acyclovir versus intralesional Hepatitis-B vaccine in treatment of resistant plantar warts: a randomized controlled trial.

Treating plantar warts is still a challenging problem with a long list of diverse treatment options that none of them seems to be definitive. To evaluate the effectiveness of intralesional acyclovir versus intralesional Hepatitis-B vaccine (HBV) in treatment of multiple resistant plantar warts. Forty-eight patients with resistant plantar warts completed the study with no dropouts. They were randomized into 3 groups; group(A) receiving intralesional HBV, group (B) receiving intralesional acyclovir and group (C) receiving intralesional saline as a control group over 5 biweekly sessions or until wart clearance. Clinical outcome was assessed through sequential digital lesion photographing upon each visit. Treatment related adverse reactions were recorded. 43.8%, 37.5% & 18.7% of Groups A, B &C respectively showed a complete response. pain was obvious in 100% and 56.3% of cases receiving intralesional acyclovir and HBV respectively. Up to the 6 month follow up period, none of the complete responders in all groups returned with a recurrence. Both acyclovir and HBV showed comparable efficacy and seem to be promising options for treating plantar warts being safe, affordable, and theoretically safe in immunocompromised cases.

Combination chemical peels are more effective than single chemical peel in treatment of mild-to-moderate acne vulgaris: A split face comparative clinical trial.

BACKGROUND: Successful management of acne involves choosing proper medication. Chemical peeling is a well-known option in treatment of acne vulgaris. OBJECTIVE: To evaluate and compare the clinical efficacy and safety of combination chemical peels vs single peel in treatment of mild-to-moderate acne. METHODS: The study included 45 patients with mild-to-moderate acne divided into three equal groups. Group A underwent combination sequential peels with modified Jessner's solution (MJ) followed by trichloro acetic acid (TCA20%) on the right (Rt) side of the face vs TCA 30% on the left (Lt) side. Group B was treated by combination peels of salicylic (20%) mandelic (10%) (SM) mixture on the Rt half vs salicylic acid 30% on the Lt half. Group C underwent combination sequential peeling of MJ and TCA on the Rt side vs SM combination peels on the Lt side. All patients received six sessions with 2-week intervals and followed up for 3 months after the last session. Side effects were reported. RESULTS: Both sides of the face showed significant improvement of acne lesions but improvement was significantly higher and earlier in sides treated by combination peels. Side effects were minimal. CONCLUSION: In conclusion, combination peels achieved a higher and earlier therapeutic response with a reasonable cost that is maintained for a relatively long periods than single peel. Combination sequential peels gave the best results.

Helicobacter pylori Infection as a Risk Factor in Patients Suffering from Food Allergy and Urticaria.

H. pylori infection is common worldwide. Many intestinal and extra intestinal manifestations have been associated with H. pylori infection. H. pylori destruct the gastric lining which allows food allergens to get access to blood, predisposing to Food allergy. Previous works considered chronic urticaria as a known symptom for food allergy and a skin manifestation for H. pylori infection. The aim of this work is to provide evidence based recommendation for detecting H. pylori antigen in stool in patient suffering from both food allergy and chronic urticaria. We determined the frequency of H. pylori Ag in stool in a group of patients complaining from both disorders and compared it with a group of apparently healthy control subjects with no history of either urticaria or food allergy. Our results showed that the frequency of H. pylori Ag in stool in control group was 62.5 %, while, it was 97 % in patient group. When we calculated the risk of H. pylori infection in predisposing to both disorders, odds ratio was 18.6. According to these results we concluded that H. pylori is a risk factor for developing chronic urticaria and food allergy and we recommend testing for H. pylori Ag in stool in patients complaining from these disorders.