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Background: Targeted ultraviolet B (T-UVB) phototherapy in vitiligo is usually administered twice or thrice a week on non-consecutive days. It is difficult for many patients to adhere to this regimen, forcing them to discontinue treatment. Aim: The study aimed to compare the efficacy of twice-weekly and once-weekly targeted ultraviolet B phototherapy regimens in vitiligo. Methods: Sixty patients with non-segmental vitiligo on the face, neck or trunk were divided into two groups of 30 patients each. The patients in group A received targeted ultraviolet B twice weekly, while those in group B received targeted ultraviolet B once weekly. Repigmentation was monitored and graded as excellent (≥75% repigmentation), good (50−74% repigmentation) and poor (<50% repigmentation). The extent of repigmentation at each body site (primary outcome measure), the number of doses required for initiation of pigmentation, and the cumulative dose of targeted ultraviolet B administered was calculated and compared between both groups. Results: A total of 90 lesions (48 in the twice weeklygroup and 42 in the once weekly group) were treated on the face, neck and trunk. Excellent results were obtained in 62.5% (30/48) of lesions treated twice weekly, and 64.3% (27/42) in lesions treated once weekly. The mean number of doses required for initiation of pigmentation was 4.69 in the twice weekly group, and 4.35 in the once weekly group. The patients in the twice weekly group received a mean cumulative dose of 8.26 J/cm ², while the once weekly group received 7.69 J/cm ². No statistically significant differences were observed between the two groups with respect to the outcome, with respect to the total repigmentation, the number of doses till onset of pigmentation, as well as the cumulative dose of targeted UVB. Conclusion: Once-weekly targeted ultraviolet B phototherapy appears to be as efficacious as the twice-weekly regimen in vitiligo.

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Background: Narrow band ultraviolet-B (NB-UVB) is now one of the most widely used modalities in the treatment of psoriasis. However, despite its high efficacy, conventional Goeckerman treatment has fallen out of favor in recent years and some institutions are now using NBUVB with coal tar as their regimen. Objective: To evaluate the efficacy of NB-UVB, Goeckerman therapy and the effect of addition of retinoid to the treatment regimen in the treatment of psoriasis,. Patients and Methods: A retrospective analysis of 65 patients who underwent 81 courses of treatment in our department was undertaken. The efficacy of NB-UVB and Goeckerman therapy individually, and in combination with acitretin was assessed. Data were analysed to evaluate the contribution of acitretin to these modalities. Results: PASI-75 responses in the NB-UVB, retinoid + NB-UVB (re-NB), Goeckerman and retinoid + Goeckerman (re-Goeckerman) groups were achieved for 12 of 31 patients (39%), 13 of 21 patients (62%), 15 of 17 patients (88%) and 10 of 12 patients, respectively. The addition of acitretin to both modalities reduced both the number of sessions and the cumulative ultraviolet-B dose delivered. Limitations: This is a retrospective study, the patients were not randomized and the number of patients in the treatment groups were dissimilar. Conclusion: Goeckerman therapy is more effective than NB-UVB phototherapy. Although the addition of acitretin to both NB-UVB and Goeckerman therapy did not contribute to treatment outcomes in terms of PASI-75 responses, it enabled a reduction in UV exposures and enhanced efficacy.

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Background: An increase in number of melanocytes in the basal cell layer of the epidermis is an important feature in many disorders of hyperpigmentation. In this study, we attempted an objective evaluation of the linear density of melanocytes and keratinocytes, along with other epidermal characteristics, in periorbital hyperpigmentation using immunohistochemistry and morphometric techniques. Methods: Melanocytes and epidermal parameters were assessed by digital morphometry in 30 newly diagnosed cases of periorbital hyperpigmentation and 14 controls from the post-auricular region. Melanocytes were labelled with the immunohistochemical stains, Melan-A and tyrosinase. We studied the linear keratinocyte density, mean linear melanocyte density, ratio of melanocytes to keratinocytes, the ratio between inner and outer epidermal length, maximum epidermal thickness and minimum epidermal thickness. Results: Melan-A expression of melanocytes showed strong positive correlation (r = 0.883) with the tyrosinase expression. Mean linear melanocyte density was 24/mm (range: 13–30/mm) in cases and 17/mm (13–21/mm) in controls and this difference was statistically significant (P < 0.001). The mean ratio of melanocyte to keratinocyte was 0.22 (0.12–0.29) in cases and 0.16 (0.12–0.21) in controls; again, this difference was statistically significant (P < 0.001). There was a mild negative correlation with linear keratinocyte density (r = −0.302) and the ratio between inner and outer epidermal length (r = −0.456). However, there were no differences in epidermal thicknesses. Limitations: There were fewer control biopsies than optimal, and they were not taken from the uninvolved periorbital region. Conclusion: Mean linear melanocyte density and the ratio of melanocytes to keratinocytes is increased in cases with periorbital hyperpigmentation. It is, therefore, likely that increased melanocyte density may be the key factor in the pathogenesis of periorbital hyperpigmentation.

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Background: Leprosy is a chronic granulomatous infection caused by Mycobacterium leprae, an intracellular parasite that resides within macrophages and cannot be eliminated effectively. Solute carrier family 11a member 1 (Slc11a1) and inducible nitric oxide synthase (iNOS), both expressed in macrophages, play major roles in host defense against several intracellular pathogens. However, the roles of these molecules in natural infection with M. leprae remain unknown. Objective: We aimed to investigate the expression of Slc11a1 and iNOS in macrophages (CD68+ cells) infiltrating skin lesions in leprosy. Methods: Skin biopsies from 48 Mexican patients of leprosy [(33 lepromatous (LL), 15 tuberculoid (TT)] and from 10 healthy controls, were subjected to immunohistochemistry to determine expression of CD68, Slc11a1 and iNOS. Results: We found a high expression of Slc11a1 and iNOS in most lepromatous leprosy samples. In tuberculoid leprosy samples, Slc11a1 expression was moderate or low, and that of iNOS was almost always low. In addition, Slc11a1 and iNOS expression levels were positively associated with bacillary loads in lepromatous leprosy lesions (P = 0.05). Conclusions: These observations suggest that M. leprae infection promotes the expression of Slc11a1 and iNOS in macrophages and that lepromatous leprosy can occur despite this response.

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Compared to the general population, the risk of developing non-melanoma skin cancer is considerably higher among individuals with a previous history of this condition. Protection from ultraviolet (UV) radiation is the primary evidence-based approach for minimizing this risk. This review was aimed to assess the prevalence of sun-safe behaviors in non-melanoma skin cancer survivors. Searches were conducted in six electronic databases including PubMed, Psyclnfo, CINAHL, EMBASE, ERIC and Science Direct. A narrative approach was adopted to synthesize the data. The findings demonstrated that respondents do not protect themselves optimally from UV radiation exposure. Low levels of perceived skin cancer risk, a lack of knowledge about effective sun protection strategies and the inconvenience associated with sun-safe behaviors appear to explain this finding. A note of caution is required here, as there is a potential for publication bias. Moreover, the results of this study cannot be generalized to all non-melanoma skin cancer patients. Skin cancer survivors must be educated about their increased risk of future skin cancers. Behavioral interventions must be developed to increase the adoption of skin protective behaviors in this high-risk population group.

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Background: The aim of these guidelines is to encourage dermatologists to use bath psoralen plus ultraviolet A (PUVA), bathing suit PUVA and soak PUVA in the treatment of psoriasis vulgaris and other conditions. Methods: Evidence was collected using searches of the PubMed, MEDLINE and COCHRANE databases using the keywords “bath PUVA,” “soak PUVA,” “bathing suit PUVA” and “turban PUVA.” Only publications in English were reviewed. Results: One hundred and thirty-eight studies were evaluated, 57 of which fulfilled the criteria for inclusion. Conclusions: Both bath PUVA and bathing suit PUVA are very effective and safe treatments for generalized stable plaque psoriasis (strength of recommendation, A). Soak PUVA is very effective in the treatment of both palmoplantar psoriasis and chronic palmoplantar eczema (strength of recommendation, A).

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