RESUMEN
BACKGROUND: Alopecia areata (AA) is a multifactorial disease in which tumor necrosis factor alpha (TNF-α) plays an important role. OBJECTIVE: To study the effect of oral pulse steroids on both serum and tissue levels of TNF-α in AA patients. METHODS: Skin biopsies and serum samples were collected from 20 patients with patchy AA before and after treatment (oral prednisolone for two consecutive days every week for 3 months) for determination of the levels of TNF-α levels using ELISA technique. RESULTS: Both serum and tissue levels of TNF-α in AA patients were significantly higher than in controls before (P < 0.001) as well as after treatment (P = 0.0169 and P = 0.3051), respectively. The duration of disease negatively correlated with tissue TNF-α before treatment (P < 0.0001). Serum and tissue levels of TNF-α dropped significantly after treatment (P < 0.0001). The percentage of reduction of both tissue and serum TNF-α levels correlated positively with the percentage of clinical improvement (r = 0.682, P = 0.0009; r = 0.567, P = 0.009, respectively). CONCLUSION: TNF-α plays an important role in the evolution of AA lesions, and alteration in both serum and tissue levels of TNF-α could be considered one of the important mechanisms of action of systemic oral pulse steroids in the treatment of AA.
Asunto(s)
Alopecia Areata/tratamiento farmacológico , Glucocorticoides/farmacología , Piel/patología , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores , Administración Oral , Adolescente , Adulto , Alopecia Areata/sangre , Alopecia Areata/patología , Biopsia , Estudios de Casos y Controles , Femenino , Glucocorticoides/uso terapéutico , Humanos , Masculino , Prednisolona/farmacología , Prednisolona/uso terapéutico , Quimioterapia por Pulso , Piel/efectos de los fármacos , Resultado del Tratamiento , Factor de Necrosis Tumoral alfa/análisis , Adulto JovenRESUMEN
BACKGROUND: Laser-assisted hair removal causes miniaturization of hair shafts which are the principal contributors to inflammation in acne keloidalis nuchae (AKN). OBJECTIVE: To assess the efficacy of hair reduction by long pulsed Nd-YAG laser as a therapeutic modality for AKN. METHODS: This interventional pilot trial included 16 patients with AKN who received 5 sessions of long pulsed Nd-YAG laser. Lesions were objectively and subjectively assessed at the third and fifth laser sessions, and 1 year after. Global response to treatment was rated using a quartile grading scale regarding the percentage improvement in the count of papules and the size of the plaques. Biopsies were taken before and 2 weeks after the fifth session to evaluate the pathological changes associated with improvement of the treated lesions. RESULTS: All patients showed a significant improvement. The percentage of improvement in the early caseswas significantly higher when compared to late cases.Two weeks after the fifth session, all biopsies showed a significant decrease in the inflammatory infiltrate except one case. Sclerosis was markedly decreased. Complete absence of hair follicles and adenexawas observed, apart from in 2 cases. CONCLUSION: Laser hair depilation can significantly improve this disfiguring chronic disorder. Starting treatment as early as possible achieves the best results and can stop the disease process if followed by maintenance sessions.
Asunto(s)
Acné Queloide/patología , Acné Queloide/cirugía , Remoción del Cabello , Láseres de Estado Sólido/uso terapéutico , Piel/patología , Acné Queloide/complicaciones , Adulto , Biopsia , Eritema/complicaciones , Estudios de Seguimiento , Remoción del Cabello/efectos adversos , Humanos , Láseres de Estado Sólido/efectos adversos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Índice de Severidad de la Enfermedad , Estadísticas no Paramétricas , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: Skin tags (STs), are papillomas commonly found in the neck and in the axillae of middle-aged and elderly people. Metabolic syndrome (MS) is a complex of interrelated risk factors for cardiovascular disease and diabetes. Epidemiologic studies of different ethnic populations have indicated that hyperleptinaemia and leptin resistance are strongly associated with MS. AIM: To study the possible relation of skin tags and leptin levels to MS guided by the International Diabetes Federation (IDF) diagnostic criteria. METHODS: This study included 80 participants, 40 ST patients and 40 apparently healthy controls. Age, sex, waist circumference (WC), body mass index (BMI), smoking status, fasting glucose level, insulin level and insulin resistance were estimated as well as cholesterol, triglycerides, HDL, criteria of MS, and leptin levels. RESULTS: The univariate analysis showed that WC, BMI, fasting glucose, insulin levels, insulin resistance, cholesterol, triglycerides, HDL, and leptin levels were significantly higher in ST patients compared to controls (P<0.001). The multivariate analysis between MS components and ST showed that only high triglyceride levels (OR 1.205/95% CI 1.044-1.391/P=0.011) and low HDL levels (OR 0.554/95% CI 0.384-0.800/P=0.002) were significantly associated with ST. Multivariate linear regression analysis of the predictors of high plasma leptin levels, showed that high triglyceride levels (OR 0.287/95% CI 0.410-3.56/P=0.014), and low HDL levels (OR -0.404/95% CI -8.7 to -2.08/P=0.002) were significant predictors. CONCLUSION: The results of this study suggested that the presence of both ST and hyperleptinaemia in patients with STs may be associated with high levels of triglycerides and low levels of HDL and this could suggest that changing the life style of patients with ST may have a beneficial role.