Transverse Needling After Autologous Mini-Punch Grafts Improves Repigmentation in Stable Non-Segmental Vitiligo.

BACKGROUND: Repigmentation remains the primary target in vitiligo treatment. Melanocyte transfer procedures are often required for repigmenting stable, resistant vitiligo lesions necessitating procedural optimization and comparative evaluation. In the current study, we aimed to assess the additive value of weekly transverse needling sessions after mini-punch grafting for repigmenting stable non-segmental vitiligo lesions versus either procedure alone. METHODS: Eighty lesions, included in 20 stable non-segmental vitiligo patients, were randomly allocated to each of the three treatment groups (line-1, mini-punch grafting; line-2, needling; and line-3, combined grafting and needling) and to a fourth control group receiving non-procedural treatment (line-4). Oral mini-pulse steroids and narrow-band ultraviolet-B sessions were administered to all patients for 3 months before and 6 months after the interventions. The extent of repigmentation was assessed using planimetry. Secondary outcomes were the time to first repigmentation response, cosmetic matching, and patient satisfaction. Blinding and allocation concealment were not feasible owing to the intervention nature and within subject design. RESULTS: Mini-punch grafting followed by weekly needling for 6 months achieved the fastest response and highest extent of repigmentation. Mini-punch grafts and transverse needling alone provided better results than the control group. No steroid-associated side effects were reported. CONCLUSION: Weekly needling sessions after mini-punch grafting hastened and improved the repigmentation extent of stable, resistant, non-segmental vitiligo lesions and should be considered during treatment planning.

Serum level of interleukin-15 in active alopecia areata patients and its relation to age, sex, and disease severity.

INTRODUCTION: Autoimmune mechanisms with evident genetic background are the main components of alopecia areata (AA) pathogenesis. Interleukin 15 (IL-15) is considered as an important signalling cytokine. Its disordered expression has been linked to inflammatory autoimmune disorders. AIM: The present study aimed to evaluate serum IL-15 in active AA patients and to assess its association with patients' sex, age, and disease severity. MATERIAL AND METHODS: IL-15 serum level was measured in 40 patients with active alopecia areata and 20 healthy controls using the ELISA technique. The severity of hair loss was assessed in accordance with the Severity of Alopecia Tool (SALT). RESULTS: A significantly higher serum level of IL-15 in AA patients than in controls was detected (p < 0.001). A significant positive correlation was detected between the SALT score and IL-15 serum level (rs = 0.433, p = 0.005). No significant correlation between age of the patients and the serum level of IL-15 was observed (rs = 0.224, p = 0.164). No significant difference in IL-15 serum level regarding patients' sex, history of disease recurrence, or family history of AA was noted. CONCLUSIONS: The elevated serum level of IL-15 in active AA patients might reflect its role in disease pathogenesis as a key signalling cytokine. Its level is correlated with disease severity. However, IL-15 is not influenced by patients' gender or age.

The effect of continuous high versus low dose oral isotretinoin regimens on dermcidin expression in patients with moderate to severe acne vulgaris.

The continuous low dose (LD) isotretinoin is frequently used in the treatment regimen for acne vulgaris. However, data about its antimicrobial are lacking. The present study aimed to investigate dermcidin expression and the effects of low and conventional dose isotretinoin on its expression in acne vulgaris patients. Skin dermcidin expression was investigated in 30 patients with moderate-severe acne vulgaris and 15 healthy control subjects using ELISA. 15 patients were given continuous low-dose isotretinoin (20 mg/day) and the other 15 given the conventional high dose (0.5 mg/kg/day). Skin biopsies were taken at the start of the study and 6 months later. Dermcidin was significantly lower in acne vulgaris patients (p < .001). Both isotretinoin regimens significantly raised dermcidin levels compared to pre-treatment values (p < .001). Relapse after 12 months was not statistically different among the two isotretinoin regimens (p = .464). Pretreatment global acne grading system score of 28.6 ± 6.4 was reduced to 6 ± 6.1 following isotretinoin treatment (p < .001). Relapse was significantly related to posttreatment dermcidin levels (p = .017). Dermcidin expression is reduced in acne vulgaris. Conventional and LD isotretinoin regimens are associated with increased dermcidin expression.