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INTRODUCTION: Despite the promising results of intralesional vitamin D in verruca treatment; its precise mechanism of action is not fully understood. AIM OF THE WORK: To investigate immunohistochemical expression of cathelicidin (LL 37) before and after injection of vitamin D in verruca vulgaris and to clarify its possible role in pathogenesis of verruca. PATIENTS AND METHODS: This study included 20 patients with multiple verrucae vulgaris. Vitamin D was intralesionally injected every 2 weeks for a maximum of 4 sessions or clearance of verrucae. Skin biopsies were taken from the patients before and at the end of the study and compared to skin samples from ten apparently healthy, age and sex matched individuals for histopathological and immunohistochemical assessment of LL37 expression. RESULTS: Eight (40%) verrucae showed complete response, seven (35%) showed partial response and five (25%) showed no response. Decreased epidermal thickness and reduced density of inflammatory cells in dermis were observed after injection. Significant increase in LL37 intensity of expression was observed after intralesional injection of vitamin D3 (p = .003) and in verrucae showing complete clinical response (p = .022). CONCLUSIONS: Intralesional injection of vitamin D is effective and safe treatment for verruca vulgaris and causes increase in LL37 expression.

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INTRODUCTION: Several modalities are used in the treatment of verrucae vulgaris; however, their side effects are common. Vitamin D3 has been recently used as a treatment in verruca vulgaris. AIM OF THE WORK: We aimed to assess the expression of involucrin in verrucae before and after intralesional injection of vitamin D3 and its correlation with clinical response. SUBJECTS AND METHODS: This study included 60 patients with verrucae vulgaris. These patients were subjected to intralesional injection of vitamin D3 at 3-week intervals for a maximum of five sessions. The pathological assessment was done by skin biopsies obtained from thirty patients before the first session and after the last session of injection and compared to skin biopsies from 30 healthy individuals. RESULTS: The injected verrucae showed complete response in 39 patients (65%), partial response in 15 patients (25%), and no response in 6 patients (10%). Nonsmoker patients had a better response than smokers. Vitamin D3 injections also resulted in increasing involucrin expression and changing its pattern of expression. CONCLUSIONS: Intralesional vitamin D3 is an effective treatment for verrucae vulgaris. Involucrin expression is modified in verrucae.

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Varicocele is the most common cause of male infertility. Several theories have been proposed to explain how varicocele induces infertility. The role of epididymis in male infertility is not fully well established. Fibrinogen-like protein 2 is one of serine proteases and is a potent coagulant in membranous form and immune-modulator in soluble form (sFGL-2) and expressed in the epididymis. There are no previous reports about its possible role in varicocele. This case-controlled study aimed to evaluate the seminal level of sFGL-2 in infertile men with varicocele and in men with idiopathic infertility. This study included 85 participants divided into three groups; 25 normal fertile men, 30 infertile men with varicocele and 30 infertile men of idiopathic cause. Clinical examination, Doppler ultrasound, semen analysis and measurement of seminal level of sFGL-2 were done to all participants. Seminal level of sFGL-2 was significantly elevated in infertile than normal fertile men. Seminal level of sFGL-2 showed negative correlations with sperm concentration, motility and normal morphology. Seminal level of sFGL-2 had a positive correlation with seminal liquefaction time. This study concluded that seminal level of sFGL-2 is increased in infertile men with idiopathic cause and with varicocele induced infertility and affects seminal liquefaction.

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BACKGROUND: Pruritus is a common symptom in end-stage renal failure. Many patients suffer from this severe distressing symptom. Although several factors have been postulated to explain uremic pruritus, there is not any conclusive evidence for one of these factors. OBJECTIVES: We aimed to evaluate serum levels of brain-derived nerve growth factor (BDNF), neurotrophin-4 (NT-4), serum calcium, phosphors and parathyroid hormone in uremic patients with pruritus and without pruritus compared to control subjects. METHODS: One hundred twenty patients suffering from renal failure and 60 healthy subjects were included in the study. Serum BDNF and NT4 levels were determined by ELISA. The serum calcium, phosphorus, parathyroid hormone and hemoglobin were also evaluated. RESULTS: Serum BDNF was significantly higher in uremic patients with pruritus (P=0.0026) and uremic patients without pruritus (P=0.0294) than control subjects. In addition, NT-4 levels were significantly elevated in uremic patients with pruritus (P<0.0001) and uremic patients without pruritus than control subjects (P=0.0016). There was no significant difference of serum level of BDNF between uremic patients with pruritus and uremic patients without pruritus (P=0.1215). However, serum NT-4 was higher in uremic patients with pruritus vs nonpruritic uremic patients with a significant difference (P=0.0026). There was a positive significant correlation between serum level of NT-4 and severity of pruritus (P=0.024). CONCLUSION: The present study shows that NT-4 level is increased in the serum of uremic patients with pruritus and there was a significant correlation between NT-4 and severity of pruritus suggesting that NT-4 may have a role in uremic pruritus.