Abstract

Background: Cutaneous Leishmaniasis (CL) is a disease transmitted by infected sandflies in tropical and subtropical areas of the world. Over 12 million people are infected with CL, with 90% of cases occurring in Afghanistan, Iran, Algeria, Brazil, Peru, Saudi Arabia, Syria, and Libya. CL causes localized skin lesions that may disappear without treatment or persist, causing severe tissue damage, permanent disfigurement, and serious disability. Physical methods such as cryotherapy, heat therapy, photodynamic therapy, laser, and radiofrequency have shown promising results in treating CL. However, none of the suggested treatments are universally effective, and many of them are associated with serious local and systemic side effects. Early diagnosis and treatment can cure the disease, prevent psychological impact, and help in the prevention of transmission. Different therapeutic modalities (monotherapy or combined therapy) were used in patient treatment, with different approaches planned according to the severity and duration of the condition.

Patients and methods: The study was conducted on 60 Patients who were divided into three groups: 20 patients treated with dapsone tab 100mg once daily for one month and 20 with radiofrequency, the third group, 20 Patients were treated with a combination of dapsone tab 100mg and radiofrequency. Treatment sessions were scheduled 1 session every 2 weeks. Statistical analysis was carried out using SPSS software version 18 (USA).

Results and Discussion: Patients underwent weekly physical exams to evaluate clinical response and adverse effects. Clinical response was classified as complete, good, or poor. Data were analyzed using one-way NOVA, Turkey's test, chisquare test, ANOVA, and Fischer's exact test. There was no significant difference among studied groups regarding demographic data. Patients treated with dapsone and radiofrequency were significantly more cleared in 1-2 months than those treated with radiofrequency alone. Conclusion: Patients had weekly physical exams to evaluate the clinical response and adverse effects. Clinical response was classified as complete, good, or poor. Data was analyzed using various tests. Dapsone and radiofrequency-treated patients cleared more in 1-2 months.

Keywords: Cutaneous leishmaniasis; Dapsone; Radiofrequency; Aalgabal algarby; Libya

Abstract

Background: Cutaneous leishmaniasis (CL) is endemic in many regions of the world, and has a significant economic and health impacts. Despite the numerous proposed therapies for this zoonotic parasitic disease. Currently, there is no definitive cure for CL. Meglumine antimony compounds are regarded as the typical treatment for leishmaniasis. However, they have a rather high incidence of adversative effects, that always, are not successful. Alternatively, Paromomycin and dapsone were used in various studies, though, with conflict results. Aim of study: This study aims to evaluate the clinical efficacy and safety of using of paromomycin cream, oral dapson and their combination in treatment of CL. Patients and Methods: This study is a prospective randomized clinical trial was carried out at the private outpatient Al- Ahlam Center of Dermatology and Cosmetology in city of Gharyan, Libya. That started from 1st of January 2020 to end of Dec 2021. 42 patients were joining this study, and randomly were divided into three groups according to protocol of treatment to assess the clinical response of the treatment methods. Results Regarding the outcome of the three different treatment regimen and after exclusion of the patients stop their follow-up; we found that 50% of dapsone treated group cleared the lesions in 1-2 months versus only 40% in paromomycin & Dapsone treated group and 0% for the paromomycin group, only 8 patients had no improvement with received treatment; 4 (33.3%) from dapsone group, 2 (20%) from each other group (P=0.036) Conclusion: Using of paromomycin & dapson combination in treatment of cutaneous leishmaniasis shows better result and early clearance LC lesions, whereas, using of topical paromomycin cream or oral dapsone alone were effective. Also, our results showed that, paromomycin is effective, safe and well tolerated in children. Keywords: Cutaneous leishmaniasis, Paromomycin, Dapson, Gharyan, Libya

Abstract

Dear colleagues, Asalamu Alykum

Welcome to the group of dermatologists in Libya, which hosts specialists and dermatologists and those who are involved in the training program for specialization, through which subjects related to the specialization are posted in the form of different formulas and scenarios, for example clinical patient photos or theoretical topics for discussion or the introduction of

topics of medical literature for enrichment Discussion, sharing and

exchange of experiences among fellows in the CME course

In view of the privacy of the group in terms of which medical cases are reviewed with pictures of patients, it is necessary to join those with the

real name of the doctor and do not accept the aliases and only admission to

doctors and their names the truth and we hope from the colleagues

appreciate this point. In order to protect us from individual ownership, it is

not permissible to present pictures of patients' cases except by the doctor

concerned. It should be noted that there is no room in this group for

advertising propaganda and promotional all types and keep them as a

scientific group and even the names of drugs must be mentioned scientific

names. I also hope that all members will participate actively and enrich the

discussion so that the benefit will prevail. May Allah guide us all to what

is good and God is behind the intention.

Abstract

Background: Warts are a common skin condition that affects people all over the world. This ailment affects 2–20% of students in primary school. A well-known keratolytic agent, potassium hydroxide (KOH), has many dermatological uses. Vitamin D is important in the proliferation and differentiation of keratinocytes.

Objective: The aim of the current work was to compare the efficacy and safety of intralesional vitamin D3 injections and 5% KOH cream separately and in combination with each other in the treatment of warts.

Patients and Methods: This study was carried out at the private outpatient Al- Ahlam Center of Dermatology and Cosmetology in Gharyan, Libya from 1^st of Sep to last of Dec 2021. 45 patients with warts were included in the study. They were classified into 3 groups according to method of treatment into Vitamin D3 group, 5% KOH cream group, and combination group.

Results: The mean age of patients was 27.04 ± 11.7 years. 31 patients completed the study. Complete response was seen in 12 patients with vitamin D injection after period of 4 months, 9 patients with 5% KOH cream after period 2-3 months, and 10 patients with combination both treatment after a period of 1 month.

Conclusions: It could be concluded that intralesional vitamin D with 5% KOH cream is safe, effective, and inexpensive treatment option for recalcitrant palmoplantar and periungual warts.

 KeywordsVitamin D3; Palmoplanter; Periungual; KOH; Warts

Abstract

Background:Acne vulgaris is the most common skin condition affecting the pilosebaceoussystemin adolescents and young age and characterized bydifferentskinlesionsand might result in permanent scars. Chemical peeling is an effective option in the management of active acne. The mechanism of action lies in causing desquamation by targeting the corneosomes and keratinocytes, enhancing breakdown and decreasing cohesiveness. It also increases epidermal activity of enzymes, leading to epidermolysis and exfoliation and induces improvement of skin texture , pore size and reduces sebum production. Proper and successful treatment of acne involves choosing the right medication. Objectives:This study aims to evaluate the clinical efficacy and safety of using topical 25% Salicylic acid alone, in comparison with a combination of systemic Azithromycin and topical 25% salicylic acid, Zinc sulphate, and Benzoyl peroxide gel, in treatment of mild to moderate acne lesions. Subjects and methods:This study is a prospective, randomized clinical trial included a hundred patients diagnosed with mild-to-moderate facial acne vulgaris and randomly divided into two equal groups Group A, treated by25% Salicylic Acid peeling in combination with systemic Azithromycin in addition to Zinc sulphate and topical Benzoyl peroxide gel. Group B, treated by 25% salicylic peeling only.All patients received at least 6 peeling sessions performed 2 weeks apart in 12-weeks duration. Results:Number of peeling sessions was significantly lower in group A than group Bp= 0.03. Improvement rate (92%) 46 cases in group A vs. (20%) 10 cases in group B.Improvement score after 6th session was 4.71 in group A vs 2.67in group Bp<0.001.Also, there was a highly significant improvement after each session in group A as 15 cases (30%) needed only 4 sessions for complete improvement. group B showed only significant improvement after 2nd,3rd, and 4th sessions, while there was no improvement in score after 5th and 6thsessions.There were no statistically significant differences regarding risk factors of acne such as; psychological distress, family history, dairy product consumption, fast food, cosmetics, regular exercise and special diet habits p>0.05. Disease duration were matched in both groups as mean duration in group A was 26.8 versus 27.5 months in group B. Back & shoulder lesion were found in 34 cases in group A while they present in 31 cases in group B. There were no differences regarding lesions characteristics between both studied groups except for pustules that were predominant in group A in 34/50 cases (68%) whereas, they found in 24/50 cases (48%) in group Bp=0.04. Conclusion:Topical 25 % of salicylic acid is more efficient to treat mild to moderate acne vulgaris andincombinationwith systemic Azithromycin in addition to Zinc sulphate and topical Benzoyl peroxide gel is significant than alone and both protocols equal in safety and tolerability. Keywords:Acne Vulgaris, Salicylic Acid,Chemical Peeling, Benzoyl Peroxide.