Efficacy and safety of 308-nm Excimer lamp combined with Tacrolimus 0.1% ointment vs Tacrolimus 0.1% ointment as monotherapy in treating children with limited vitiligo: a randomized controlled trial

OBJECTIVE

This study aims to assess the efficacy and safety of combining the 308-nm Excimer lamp with Tacrolimus 0.1% ointment, compared to Tacrolimus 0.1% ointment monotherapy, for treating pediatric vitiligo involving less than 10% of the body surface area.

METHODS

Fifty pediatric patients with vitiligo were randomly assigned to two groups. Group A received Tacrolimus 0.1% ointment twice daily and Excimer light at 308-nm twice weekly, while Group B received Tacrolimus 0.1% ointment alone, administered twice daily. Repigmentation percentages were evaluated after 30, 90, and 180 days using the rule of nine.

RESULTS

Group A exhibited a significant improvement in repigmentation, increasing from 10% after one month to 65% after six months. In contrast, Group B observed an increase from 10% to 30% over the same timeframe. The efficacy of the treatment was significantly higher in Group A at both the 3-month and 6-month follow-up points (p-value < .001). Moreover, Group A achieved notably higher repigmentation rates in the face, trunk, and lower limbs.

CONCLUSION

The combination of Tacrolimus and the 308-nm excimer lamp yielded superior repigmentation results compared to Tacrolimus monotherapy in pediatric vitiligo patients. This combined approach may offer an effective new treatment protocol for pediatric vitiligo.

The Effect of Whey Protein Supplements on Acne Vulgaris among Male Adolescents and Young Adults: A Case-Control Study from North of Jordan

Background

Young people and athletes willing to gain muscle mass and strength are likely to consume whey protein supplements. The effect of milk as a dietary source of whey protein on acne is still controversial. At the same time, a few studies have suggested an acnegenic impact of whey protein supplements.

Objectives

To examine the association of whey protein supplements on acne risk among male adolescents and young adults.

Materials and Methods

201 male teenagers and young adults attending fitness centers in Irbid/Jordan were involved in an observational case-control research; those with acne were deemed cases, and those without acne were considered controls. The primary outcome was a comparison of the proportion of participants in each group who consumed whey protein supplements within the previous three months.

Results

100 acne-afflicted participants were compared to 101 healthy controls with similar demographics, including age, body mass index, educational level, and smoking habits, as well as intake of vitamin B12, corticosteroids, and anabolic steroids. However, considerably more participants in the acne group (47%) were taking whey protein supplements than in the control group (27.7%) (p=0.0047). The significance of this difference was maintained after multivariate analysis.

Conclusion

This case-control study provides evidence of a positive association between whey protein consumption and acne risk.

Comparison of the efficacy of tacrolimus 0.1% ointment vs calcipotriol/betamethasone in combination with NBUVB in treatment of vitiligo

Purpose: Vitiligo is an idiopathic depigmenting skin disorder. The study compares the efficacy of topical tacrolimus 0.1% with calcipotriol/betamethasone dipropionate in vitiligo patients receiving NB-UVB treatment.Materials and methods: Forty-one adult patients with generalized type vitiligo were recruited. Patients were assigned to phototherapy and then classified into either group one (20 patients), receiving calcipotriol/betamethasone dipropionate cream (D group), or group two (21 patients), receiving tacrolimus 0.1% ointment (T group). They were followed-up at 3 and 6 months.Results: The D group witnessed an increase in the repigmentation area from 35.4% in the third month to 54.7% in the sixth month (p = 0.001) and the T group from 32.2% to 45.6% (p = 0.011). However, the differences between the treatment groups were not statistically significant. Body sites demonstrated different levels of improvement ranging from the highest in the face to the lowest in the Hand & Feet with the other body sites in between. A negative correlation was identified between the duration since diagnosis and the response to D treatment (3 months: r = -0.612, p = 0.007; 6 months: r = -0.755, p = 0.001).Conclusions: Although both combinations are efficacious, they did not significantly differ in efficacy at three and six months follow-up points.Clinical trial registration: The study was registered at clinicaltrials.gov (NCT04440371).

Compensatory Hyperhidrosis After Non-Surgical Treatment of Primary Focal Hyperhidrosis: Two-Year Single-Centered Prospective Study From Jordan

BACKGROUND

Primary focal hyperhidrosis (PH) can be managed by a wide range of medical and surgical modalities. Compensatory hyperhidrosis (CH) is a well-documented complication of surgical treatment. We aimed to investigate the occurrence of compensatory hyperhidrosis (CH) in PH patients after nonsurgical treatment with botulinum toxin A (BTX- A) or iontophoresis.

METHODOLOGY

We carried out a unicentric prospective study on PH patients from King Abdullah University Hospital (KAUH) in Jordan. PH patients were evaluated after 1-month of nonsurgical treatment. Patients who developed CH were re-assessed after 3-6 months through a telephone-based interview.

RESULTS

A total of 86 patients with PH who underwent nonsurgical treatment with iontophoresis or botulinum toxin were recruited. Twenty-four (27.9%) patients developed subjective CH. It was mild in (75%), moderate in (21%), and severe in (4%) of patients affected, it was self-limiting within a few months in all patients. Patients with CH did not differ significantly in demographic or clinical variables from patients who did not develop CH except at the site of PH (p value = .05).

CONCLUSION

The findings of this study indicate that more than quarter (27.9%) of patients with PH may develop minor compensatory sweating, however this didn't affect satisfaction with treatment.

Predicting COVID-19 future trends for different European countries using Pearson correlation

The ability to accurately forecast the number of COVID-19 cases and future case trends would certainly assist governments and various organisations in strategising and preparing for the newly infected cases well in advance. Many predictions have failed to foresee future COVID-19 cases due to the lack of reliable data; however, such data are now widely available for predicting future trends in COVID-19 after more than one and a half years of the pandemic. Also, various countries are closely monitoring other countries that are experiencing a surge in COVID-19 cases in the expectation of similar scenarios, but this does not always produce correct results, as no research has identified specific correlations between different countries in terms of COVID-19 cases. During the past 18 months, many nations have watched countries whose COVID-19 cases have risen sharply, in anticipation of handling the situation themselves. However, this did not provide accurate results, as no research was conducted that compared countries to determine if their COVID-19 case trends were correlated. As official data on COVID-19 cases has become increasingly available, using the Pearson correlation technique to pinpoint the countries that should be closely monitored will help governments plan and prepare for the number of infections that are expected in the future at an early stage. In this study, a simple and real-time prediction of COVID-19 cases incorporating existing variables of coronavirus variants was used to explore the correlation among different European countries in terms of the number of COVID-19 cases officially recorded on a daily basis. Data from selected countries over the past 76 weeks were analysed using a Pearson correlation technique to determine if there were correlations between case trends and geographical position. The correlation coefficient (r) was employed for identifying whether the different countries in Europe were interrelated, with r > 0.85 indicating they were very strongly correlated, 0.85 > r > 0.8 indicating that they were strongly correlated, 0.8 > r > 0.7 indicating that they were moderately correlated, and r < 0.7 indicating that the examined countries were either weakly correlated or that a correlation did not exist. The results showed that although some neighbouring countries are strongly correlated, other countries that are not geographically close are also correlated. In addition, some countries on opposite sides of Europe (Belgium and Armenia) are also correlated. Other countries (France, Iceland, Israel, Kosovo, San Marino, Spain, Sweden and Turkey) were either weakly correlated or had no relationship at all.

Post-acne hyperpigmentation: Evaluation of risk factors and the use of artificial neural network as a predictive classifier

Acne is common among young individuals. People with dark skin have a higher risk for developing pigmentary complications. Inflammation is an important factor in post-acne hyperpigmentation however other factors are also involved in developing this complication however these factors are not well studied. The aim of this study is to identify risk factors involved in post-acne hyperpigmentation. Clinical data related to acne, acne- related hyperpigmentation were collected. Data was analyzed for risk factors associated with acne pigmentation. Artificial neural network was used as predictive disease classifier for the outcome of pigmentation. Majority of patients in this study (339 patients) had dark skin phototypes (3 and 4). Post- acne hyperpigmentation was seen in more than 80% of patients. Females, darker skin color, severe acne, facial sites, and excessive sunlight exposure, squeezing or scratching lesions are important risk factors for post-acne hyperpigmentation. Post-acne hyperpigmentation is multifactorial. Several factors implicated in PAH are modifiable by adequate patient education (lesion trauma, excessive sunlight exposure). The use of ANN was helpful in predicting appearance of post-acne hyperpigmentation based on identified risk factors.

Unilateral Linear Induration of the Skin: A Case Report of an Unusual Presentation of Scleredema

Scleredema is an idiopathic condition with specific clincopathological findings, including symmetrical and diffuse nonpitting induration of the upper body and thickened dermis due to deposition of acid mucopolysaccharides. Here, we report a case of linear scleredema in a healthy female patient, who presented with firm induration of the skin over her right shoulder and arm in a Blaschkolinear distribution. The onset was insidious in childhood and stable over several years. While the clinical picture has closely mimicked linear morphea, the diagnosis of scleredema was confirmed by the typical histopathological findings. To the best of our knowledge, linear scleredema is a unique presentation that has not been previously reported.

Awareness about proper use of sunscreen in people of color: A Jordanian-based survey

INTRODUCTION

The use of sunscreen is an important preventive measure against skin cancer and treatment for other skin conditions. There is evidence pointing to lack awareness and misconceptions regarding use of Sunscreen. This is especially evident in populations with skin of color (POC).

METHODS

This is a cross-sectional study of 2000 individuals. A structured questionnaire was designed to collect data on general knowledge and use of sunscreen as well as reasons for stopping use of sunscreen.

RESULTS

The results of this study indicate a clear deficiency in the use and knowledge about sunscreen among Jordanians. Females are using sunscreen more than males. However, the use of sunscreen is inadequate in many aspects including timing of application, frequency of use, and amount used among other things. There is an obvious lack of knowledge about sunscreen as shown by lack of awareness about benefits of use in various times of the year, use in children, use for all skin types, and several misconceptions among other knowledge gaps. Main reasons for stopping sunscreen include side effects, cost, and being not suitable for skin. Awareness about sunscreen can be improved by proper counseling by healthcare professionals and utilization of various media platforms.

CONCLUSIONS

The use of sunscreen is inadequate in this population of color (POC). Lack of proper counseling, failure to read use instructions can contibute to inadequate use of sunscreen. Risks and benefits of sunscreen should be explained by medical professionals. The media should be more utilized to disseminate such knowledge.