The effect of low level laser therapy on Pemphigus vulgaris lesions: A Pilot Study

Background: Pemphigus vulgaris is a chronic blistering skin disease. Management of recalcitrant pemphigus ulcers is a great problem. Low Level Laser Therapy (LLLT) is known to supply direct biostimulative light energy to body cells. Objective: This study evaluates the efficacy of low power laser in the healing of pemphigus lesions.Methods: Ten patients with pemphigus vulgaris were enrolled in the trial. The LED-LLLT system used was the Thor LED clusters (109, 69 or 19 diode) (ENGLAND) with 660 nm wave length in continuous wave (CW) and 30 MW energy. Both sides of the patients’ lesion were photographed prior to the study and in each laser therapy sessions.Results: The pattern of changes in QWS patterns differed significantly over time between the two therapies (treatment × time interactions, p<.0001). When compared to the routine therapy, the laser therapy showed more decreases in mean QWS in all sessions in comparison with baseline.Limitations: This is a pilot study.Conclusion: Application of Low Level Laser simultaneously with conventional therapy could result in sensational healing of ulcers especially in patients who do not respond to conventional treatment or suffering from recalcitrant lesions

Gene-Targeted Next Generation Sequencing Identifies PNPLA1 Mutations in Patients with a Phenotypic Spectrum of Autosomal Recessive Congenital Ichthyosis: The Impact of Consanguinity

Heritable forms of ichthyoses, also referred to as generalized Mendelian disorders of cornification, are phenotypically a highly heterogeneous group of conditions caused by mutations in a number of genes playing a role in keratinocyte differentiation and epidermal barrier function (Baden and Digiovanna, 2013; Schmuth et al., 2013). These diseases are characterized by scaling and hyperkeratosis with associated cutaneous and extracutaneous features. This group of disorders is also genetically heterogeneous, with autosomal dominant, autosomal recessive, and X-linked inheritance being described. A specific subgroup of inherited ichthyoses is the autosomal recessive congenital ichthyosis (ARCI), with many newborns presenting as collodion babies, but the subsequent clinical presentation and the spectrum of severity can be highly variable (Richard and Bale, 2014). In the most severe forms, such as harlequin ichthyosis, the disease is often fatal during the early postnatal period, whereas at the other end of the continuum of the spectrum, the disease may present with a relatively mild scaling and variable degree of palmoplantar keratoderma. There is considerable genetic heterogeneity in ARCI, and as many as nine different genes are known to harbor biallelic mutations; these include TGM1, ALOXE3, ALOX12B, NIPAL4, ABCA12, CYP4F22, PNPLA1, LIPN, and CERS3. Previous reports have suggested that mutations in TGM1 account for 30e65% of patients with ARCI, whereas mutations in LIPN, PNPLA1, and CERS3 have been reported only in a few consanguineous families (Richard and Bale, 2014). With the advent of next generation sequencing (NGS), there has been tremendous progress in facilitating the mutation detection in various heritable skin disorders, including ichthyosis (South et al., 2015; Takeichi et al., 2013). In fact, at least 38 different genes have now been suggested to be associated with the ichthyotic phenotypes, either as the primary mutated genes or modifying the phenotypic presentation. To elucidate the genetic basis of ichthyosis in Iran, a country of approximately 80 million people with high prevalence of customary consanguineous marriages, we developed a gene-targeted NGS array consisting of 38 genes reported in association with ichthyosis phenotypes. Identification of specific mutations in a large number of families has allowed us to examine phenotype/genotype correlations with respect to both intra- and interfamilial heterogeneity, in part because of extensive consanguinity in these families. In this study, we identified six distinct and, to our knowledge, previously unreported mutations in the PNPLA1 gene in nine families

The Immediate Pain-Relieving Effects of Non-Thermal CO2 Laser Therapy on Genital Ulcers of Behcet’s Disease: A Case Report

Behçet’s disease (BD) is a chronic, relapsing, systemic vasculitis of unknown etiology. Oral and genital aphthous ulcers are considered as the hallmarks of BD. The genital ulcers of BD may be extremely painful and often refractory to multiple treatments. In addition, they exert a negative impact on the patient’s quality of life. Some investigations have demonstrated the significant and immediate pain-relieving effects of NTCLT (non-thermal CO2 laser therapy) on some oral lesions with no visible adverse effects. In this paper, we report a case of BD whose painful genital ulcers were irradiated with NTCLT and the patient’s pain caused by the ulcers relieved immediately and significantly with no visible complications

Relieving Pain in Oral Lesions of Pemphigus Vulgaris Using the Non-ablative, Non-thermal, CO2 Laser Therapy (NTCLT): Preliminary Results of a Novel Approach

Introduction: Pemphigus vulgaris (PV) is a chronic, serious autoimmune mucocutaneous bullous disease. Oral lesions in PV may be extremely painful. This pain may adversely affect the patients’ oral intake and quality of life. This before-after clinical trial was designed to assess the pain relieving effects of single session of non-ablative, non-thermal CO2 laser therapy (NTCLT) in oral lesions of PV.Methods: Fifty painful oral lesions of fourteen patients with PV were illuminated by CO2 laser (power: 1 W, scanning the lesions with rapid circular motion of the handpiece) passing through a thick layer of transparent gel with high water content. The pain severity of the oral lesions was reported by the patients up to the fourth postoperative day. They were also asked to continue their existing systemic treatment during the course of this study as a precondition for the participation.Results: The severity of contact and non-stimulate (non-contact) pain declined immediately and significantly after NTCLT (P < 0.001). The pain relieving effect was sustained during the four successive days of follow-up. The procedure was pain free and no kind of analgesics was required. Following NTCLT, there were no visible thermal complications such as destruction, ablation or irritation of the oral lesions.Conclusion: The results of the trial proposed that single session of NTCLT could immediately and significantly relieve pain in oral lesions of PV, without any visible thermal complications

The effect of hydroalcoholic extracts of Zizipus vulgaris L. on burn healing

زمینه و هدف: از قدیم میوه عناب جهت ترمیم زخم سوختگی مورد استفاده قرار می گرفته است ولی این امر از نظر علمی مورد بررسی قرار نگرفته است. این مطالعه به منظور بررسی اثرات عصاره ی میوه ی عناب بر فرآیند التیام زخم سوختگی در موش Balb/c انجام شده است. روش بررسی: این مطالعه تجربی بر روی 40 سر موش Balb/c به وزن تقریبی 3±30 گرم انجام شد. پس از ایجاد زخم های سوختگی به مساحت 5/1سانتیمتر مربع و تایید سوختگی درجه دو موش ها در چهار گروه کنترل، تحت درمان با وازلین و تحت درمان با عصاره های 1 و 10 عناب تقسیم شدند. در گروه های تحت درمان، 1 گرم پماد روزی 2 بار، تا التیام کامل استعمال شد. سپس چهار گروه از نظر مساحت زخم و وضعیت هیستوپاتولوژی مقایسه شدند. یافته ها: بر اساس آزمون کروسکال والیس تفاوت معنی داری بین درصد بهبودی زخم در 4 گروه وجود داشت (001/0

BCL11B Is Involved in Stress-Induced Differentiation of Keratinocytes and Has A Potential Role in Psoriasis Pathogenesis

Objective: Psoriasis is a common, auto-immune skin disease characterized by abnormal proliferation and differentiationof keratinocytes. Studies revealed the role of stress stimulators in the pathogenesis of psoriasis. Oxidative stressand heat shock are two important stress factors tuning differentiation and proliferation of keratinocytes, regardingto psoriasis disease. BCL11B is a transcription factor with critical role in embryonic keratinocyte differentiation andproliferation. Given this, in keratinocytes we have investigated potential role of BCL11B in stress-induced differentiation.Furthermore, we searched for a potential intercommunication between BCL11B expression and psoriasis-relatedkeratinocyte stress factors.Materials and Methods: In this experimental study, data sets of psoriatic and healthy skin samples were downloadedin silico and BCL11B was chosen as a potential transcription factor to analyze. Next, a synchronized in vitro model wasdesigned for keratinocyte proliferation and differentiation. Oxidative stress and heat shock treatments were employed onHaCaT keratinocytes in culture, and BCL11B expression level was measured. Cell proliferation rate and differentiationwere analyzed by synchronized procedure test. Flow cytometry was done to analyze cell cycle alterations due to theoxidative stress.Results: Quantitative reverse transcription polymerase chain reaction (qRT-PCR) data revealed a significantupregulation of BCL11B expression in keratinocytes, by 24 hours after initiating differentiation. However, it was followedby a significant down-regulation in almost all the experiments, including the synchronized model. Flow cytometer datademonstrated a G1 cell cycle arrest in the treated cells.Conclusion: Results indicated a remarkable role of BCL11B in differentiation and proliferation of HaCaT keratinocytes.This data along with the results of flow cytometer suggested a probable role for BCL11B in stress-induced differentiation,which is similar to what is happening during initiation and progression of normal differentiation

In vivo Skin Penetration, Radical Protection, and Structural Changes after Topical Application of a Herbal Oil Cream Compared to Topical Calcipotriol in Mild to Moderate Psoriasis

Background: The chronicity of psoriasis often requires continuous topical treatment. Materials and Methods: Here, the radical protection of a cream containing various herbal oils was evaluated in vivo by electron paramagnetic resonance (EPR) spectroscopy and its skin penetration by Raman microscopy in intact and barrier-disturbed skin. Changes in skin barrier properties were evaluated after 4 weeks of daily topical application using in vivo laser scanning microscopy (LSM) and transepidermal water loss in 26 healthy volunteers. A randomized, controlled, double-blind, three-arm parallel clinical study evaluated the efficacy of the herbal oil cream compared to a 0.05% calcipotriol-containing cream and to a vehicle cream, in 135 patients with mild to moderate plaque psoriasis with the change in Psoriasis Area and Severity Index (PASI) from baseline to week 12 as the primary endpoint. Results: EPR spectroscopy disclosed a significantly higher radical formation in untreated than skin treated with the herbal oil cream (p ≤ 0.05). LSM measurements indicated a protective skin barrier effect in treated compared to untreated skin. In the clinical trial, the topical application of herbal oils showed a significant reduction of the PASI score compared to topical calcipotriol at week 12 (p = 0.016). The mean reduction in PASI was 49% for the herbal oil cream, 38% for calcipotriol, and 55% for the vehicle cream. The percentage of patients, who reached PASI 50 and 75 at any time point, was 55.9% and 29.4% for the herbal oil cream, 47.4% and 15.8% for calcipotriol, and 23 (60.5%) and 13 (34.2%) for the vehicle, respectively (p > 0.05). The vehicle, originally designed as a placebo, contained a main ingredient of the herbal oil cream and therefore showed corresponding results. Conclusion: The herbal oil cream demonstrated effectiveness in the treatment of mild to moderate plaque psoriasis

Whole Transcriptome-Based Skin Virome Profiling in Typical Epidermodysplasia Verruciformis Reveals α-, β-, and γ-HPV Infections

HPVs are DNA viruses include approximately 450 types that are classified into 5 genera (α-, β-, γ-, μ-, and ν-HPV). The γ- and β-HPVs are present in low copy numbers in healthy individuals; however, in patients with an inborn error of immunity, certain species of β-HPVs can cause epidermodysplasia verruciformis (EV), manifesting as recalcitrant cutaneous warts and skin cancer. EV presents as either typical or atypical. Manifestations of typical EV are limited to the skin and are caused by abnormal keratinocyte-intrinsic immunity to β-HPVs due to pathogenic sequence variants in TMC6, TMC8, or CIB1. We applied a transcriptome-based computational pipeline, VirPy, to RNA extracted from normal-appearing skin and wart samples of patients with typical EV to explore the viral and human genetic determinants. In 26 patients, 9 distinct biallelic mutations were detected in TMC6, TMC8, and CIB1, 7 of which are previously unreported to our knowledge. Additionally, 20 different HPV species, including 3 α-HPVs, 16 β-HPVs, and 1 γ-HPV, were detected, 8 of which are reported here for the first time to our knowledge in patients with EV (β-HPV-37, -47, -80, -151, and -159; α-HPV-2 and -57; and γ-HPV-128). This study expands the TMC6, TMC8, and CIB1 sequence variant spectrum and implicates new HPV subtypes in the pathogenesis of typical EV