OBJECTIVES To evaluate the efficacy and tolerability of needling/microneedling as an adjunct to N... more OBJECTIVES To evaluate the efficacy and tolerability of needling/microneedling as an adjunct to NB-UVB phototherapy in the treatment of stable refractory patches of acral vitiligo, based upon clinical and immunohistochemical assessment of melanocyte count and distribution in response to needling/microneedling. MATERIALS AND METHODS Twenty patients with stable acral vitiligo (≥ 2 patches) were enrolled. One of the two index patches was randomized to receive needling or microneedling in conjunction with NB-UVB. Patients received phototherapy sessions 3 times weekly, while needling was carried out on biweekly basis for 6 months. Assessment was done clinically using point counting method, VESTA, and global patients' satisfaction, and immunohistochemically by quantitative assessment of melanocyte count by Melan-A. RESULTS No statistically significant difference was observed between NB-UVB monotherapy and either of the combined therapy regimens as regards the mean percentage change in vitiligo surface area (p = 0.451), mean change in absolute melanocyte count from baseline (p = 0.589), and mean VESTA (p = 0.916). Patches subjected to adjuvant microneedling/needling were afflicted by koebnerization in 50% and 20% of cases, respectively. CONCLUSION Neither microneedling nor needling appear to confer an added therapeutic value to NB-UVB phototherapy in the treatment of stable acral vitiligo. Moreover, both carry the risk of koebnerization.
Background: Emerging evidence is implicating stem cells in the pathogenesis of different cutaneou... more Background: Emerging evidence is implicating stem cells in the pathogenesis of different cutaneous neoplasms. The immunohistochemical use of stem cell markers has facilitated stem cell identification. Aim: This study was designed to determine the expression of stem cell markers ck19 and p63 in BCC and their link to proliferation marker ki67. Subjects: Thirty patients with BCC were the subjects of this study. They were classified according to the hitopathological types into 12 patients solid circumscribed type, 3 patients solid infiltrative type, 8 patients mixed type, 3 patients superficial type, 2 patients adenoid type, one patient morpheaform type and one patient basosquamous type. Methods: The thirty paraffin-embedded BCC skin lesions were examined histopathologically to confirm the diagnosis and to determine histological type of the tumour and also, were examined immunohistchemically for CK19, p63 and Ki-67. Results: Cytokeratin 19 immunoreactivity was observed in 30% (9 of 30) ...
Background: The exact pathogenesis of psoriasis remains unclear. Signal transducer and activator ... more Background: The exact pathogenesis of psoriasis remains unclear. Signal transducer and activator of transcription-3 (STAT3) is a possible important link between keratinocytes and immunocytes during psoriasis evolution. Aims: To detect the state of STAT3 activation in both lesional and non-lesional skin of patients with psoriasis and to correlate the degree of STAT3 activation with the severity of psoriasis. Methods: The study included (30) psoriasis patients and (30) age and sex matched healthy control subjects. Skin biopsy was taken from a lesional and a non-lesional site for every patient. A single biopsy site was done for every control subject. Immunohistochemical staining using anti-STAT3 antibodies was done. Statistical analysis was performed to detect the relation between the strength of STAT3 staining reaction and PASI (psoriasis area severity index) score. Results: The strength of immune-staining reaction for STAT3 is statistically higher in lesional sites than the non-lesio...
The distinction of trichoepithelioma from basal cell carcinoma in small superficial biopsies is i... more The distinction of trichoepithelioma from basal cell carcinoma in small superficial biopsies is important but often challenging. This has inspired many scientists to test the validity of immunohistochemical markers in the differential diagnosis. To develop an immunohistochemical protocol that helps in differentiation between both trichoepithelioma (TE) and basal cell carcinoma (BCC) with higher sensitivity and specificity. Using standard immunohistochemical techniques, we examined 10 TEs and 19 BCCs for the expression of CK19, Ki-67, androgen receptors (AR), CD10, and PHLDA1. Immunoreactivity of AR, Ki-67, and CD10 in tumor cells was significantly higher in BCC than TE with a diagnostic accuracy in BCC of 75.5%, 75.8%, and 79.3% respectively, whereas immunoreactivity of PHLDA1 in tumor cells and stromal CD10 was significantly higher in TE than BCC with a diagnostic accuracy in TE of 100% and 82.8%, respectively. In contrast, immunoreactivity for CK19 showed no statistically signific...
Asian Pacific journal of cancer prevention : APJCP, Jan 24, 2018
Background: Endometrial carcinomas are common gynecologic malignancies worldwide. In Egypt they r... more Background: Endometrial carcinomas are common gynecologic malignancies worldwide. In Egypt they represent 2.6 %. We evaluated the role of morphometry and MMP-9 immunohistochemical expression to differentiate atypical endometrial hyperplasia from low grade endometrial adenocarcinoma. Methods: 60 cases of endometrial lesions that included 25 cases of complex endometrial hyperplasia with atypia, 25 cases of low grade endometrioid adenocarcinoma, in addition to 10 cases of proliferative endometrium as a control group. Morphometric measurements and D-score were evaluated. MMP9 was performed using streptavidin –biotin immunoperoxidase system. Results: D score was more than 1 in 100% of cases of proliferative endometrium. In atypical hyperplasia 28 % of cases had a D-score more than 1, 44% less than 0 and 28% of cases had a D score between 0 and 1 with uncertain prognosis. All carcinoma cases had D-score less than 0. MMP9 was positive in all cases of the study but differ in its degree of e...
BackgroundMelasma is a common pigmentary disorder that remains resistant to available therapies.O... more BackgroundMelasma is a common pigmentary disorder that remains resistant to available therapies.ObjectivesThe aim of the present study was to evaluate the efficacy of erbium:YAG lasers in the treatment of refractory melasma and investigate the histopathological and ultrastructural changes between melasma skin and adjacent control skin before and after surgery.MethodsFifteen Egyptian female patients with melasma unresponsive to previous therapy of bleaching creams and chemical peels were included in this study. Full‐face skin resurfacing using an erbium:YAG laser was performed. Clinical parameters included physician and patient assessment, and melasma area and severity index score were done. Adverse effects after laser resurfacing were recorded. Biopsies of lesions and adjacent healthy skin were stained using hematoxylin–eosin, immunohistochemically marked for Melan‐A, and evaluated by electron microscopy.ResultsThe amount of melanin, staining intensity, and number of epidermal melan...
BackgroundGeneralized eruptive keratoacanthoma (GEKA) is an extremely rare variant of keratoacant... more BackgroundGeneralized eruptive keratoacanthoma (GEKA) is an extremely rare variant of keratoacanthoma that poses significant diagnostic and therapeutic challenges.PatientsThe study included three patients presenting with highly pruritic, generalized eruption of numerous small skin and flesh‐colored follicular papules. They were mainly distributed on the face, neck, and trunk. Few larger nodules were also present. Mask‐like facies, mucosal involvement, and ectropion were evident in two patients. Family history was irrelevant, and general examination was unremarkable.ResultsHistopathological examination revealed typical features of keratoacanthoma, particularly in the larger lesions. Routine laboratory tests were normal, and ultrasonography and computed tomography revealed no evidence of malignancy. Based on the clinicopathological correlation, the diagnosis of our cases was GEKA of Grzybowski. Acitretin 1 mg/kg per day and methotrexate 15 mg/week for three months were associated with...
Background: Emerging evidence is implicating stem cells in the pathogenesis of different cutaneou... more Background: Emerging evidence is implicating stem cells in the pathogenesis of different cutaneous neoplasms. The immunohistochemical use of stem cell markers has facilitated stem cell identification. Aim: This study was designed to determine the expression of stem cell markers ck19 and p63 in BCC and their link to proliferation marker ki67. Subjects: Thirty patients with BCC were the subjects of this study. They were classified according to the hitopathological types into 12 patients solid circumscribed type, 3 patients solid infiltrative type, 8 patients mixed type, 3 patients superficial type, 2 patients adenoid type, one patient morpheaform type and one patient basosquamous type. Methods: The thirty paraffin-embedded BCC skin lesions were examined histopathologically to confirm the diagnosis and to determine histological type of the tumour and also, were examined immunohistchemically for CK19, p63 and Ki-67. Results: Cytokeratin 19 immunoreactivity was observed in 30% (9 of 30) ...
OBJECTIVES To evaluate the efficacy and tolerability of needling/microneedling as an adjunct to N... more OBJECTIVES To evaluate the efficacy and tolerability of needling/microneedling as an adjunct to NB-UVB phototherapy in the treatment of stable refractory patches of acral vitiligo, based upon clinical and immunohistochemical assessment of melanocyte count and distribution in response to needling/microneedling. MATERIALS AND METHODS Twenty patients with stable acral vitiligo (≥ 2 patches) were enrolled. One of the two index patches was randomized to receive needling or microneedling in conjunction with NB-UVB. Patients received phototherapy sessions 3 times weekly, while needling was carried out on biweekly basis for 6 months. Assessment was done clinically using point counting method, VESTA, and global patients' satisfaction, and immunohistochemically by quantitative assessment of melanocyte count by Melan-A. RESULTS No statistically significant difference was observed between NB-UVB monotherapy and either of the combined therapy regimens as regards the mean percentage change in vitiligo surface area (p = 0.451), mean change in absolute melanocyte count from baseline (p = 0.589), and mean VESTA (p = 0.916). Patches subjected to adjuvant microneedling/needling were afflicted by koebnerization in 50% and 20% of cases, respectively. CONCLUSION Neither microneedling nor needling appear to confer an added therapeutic value to NB-UVB phototherapy in the treatment of stable acral vitiligo. Moreover, both carry the risk of koebnerization.
Background: Emerging evidence is implicating stem cells in the pathogenesis of different cutaneou... more Background: Emerging evidence is implicating stem cells in the pathogenesis of different cutaneous neoplasms. The immunohistochemical use of stem cell markers has facilitated stem cell identification. Aim: This study was designed to determine the expression of stem cell markers ck19 and p63 in BCC and their link to proliferation marker ki67. Subjects: Thirty patients with BCC were the subjects of this study. They were classified according to the hitopathological types into 12 patients solid circumscribed type, 3 patients solid infiltrative type, 8 patients mixed type, 3 patients superficial type, 2 patients adenoid type, one patient morpheaform type and one patient basosquamous type. Methods: The thirty paraffin-embedded BCC skin lesions were examined histopathologically to confirm the diagnosis and to determine histological type of the tumour and also, were examined immunohistchemically for CK19, p63 and Ki-67. Results: Cytokeratin 19 immunoreactivity was observed in 30% (9 of 30) ...
Background: The exact pathogenesis of psoriasis remains unclear. Signal transducer and activator ... more Background: The exact pathogenesis of psoriasis remains unclear. Signal transducer and activator of transcription-3 (STAT3) is a possible important link between keratinocytes and immunocytes during psoriasis evolution. Aims: To detect the state of STAT3 activation in both lesional and non-lesional skin of patients with psoriasis and to correlate the degree of STAT3 activation with the severity of psoriasis. Methods: The study included (30) psoriasis patients and (30) age and sex matched healthy control subjects. Skin biopsy was taken from a lesional and a non-lesional site for every patient. A single biopsy site was done for every control subject. Immunohistochemical staining using anti-STAT3 antibodies was done. Statistical analysis was performed to detect the relation between the strength of STAT3 staining reaction and PASI (psoriasis area severity index) score. Results: The strength of immune-staining reaction for STAT3 is statistically higher in lesional sites than the non-lesio...
The distinction of trichoepithelioma from basal cell carcinoma in small superficial biopsies is i... more The distinction of trichoepithelioma from basal cell carcinoma in small superficial biopsies is important but often challenging. This has inspired many scientists to test the validity of immunohistochemical markers in the differential diagnosis. To develop an immunohistochemical protocol that helps in differentiation between both trichoepithelioma (TE) and basal cell carcinoma (BCC) with higher sensitivity and specificity. Using standard immunohistochemical techniques, we examined 10 TEs and 19 BCCs for the expression of CK19, Ki-67, androgen receptors (AR), CD10, and PHLDA1. Immunoreactivity of AR, Ki-67, and CD10 in tumor cells was significantly higher in BCC than TE with a diagnostic accuracy in BCC of 75.5%, 75.8%, and 79.3% respectively, whereas immunoreactivity of PHLDA1 in tumor cells and stromal CD10 was significantly higher in TE than BCC with a diagnostic accuracy in TE of 100% and 82.8%, respectively. In contrast, immunoreactivity for CK19 showed no statistically signific...
Asian Pacific journal of cancer prevention : APJCP, Jan 24, 2018
Background: Endometrial carcinomas are common gynecologic malignancies worldwide. In Egypt they r... more Background: Endometrial carcinomas are common gynecologic malignancies worldwide. In Egypt they represent 2.6 %. We evaluated the role of morphometry and MMP-9 immunohistochemical expression to differentiate atypical endometrial hyperplasia from low grade endometrial adenocarcinoma. Methods: 60 cases of endometrial lesions that included 25 cases of complex endometrial hyperplasia with atypia, 25 cases of low grade endometrioid adenocarcinoma, in addition to 10 cases of proliferative endometrium as a control group. Morphometric measurements and D-score were evaluated. MMP9 was performed using streptavidin –biotin immunoperoxidase system. Results: D score was more than 1 in 100% of cases of proliferative endometrium. In atypical hyperplasia 28 % of cases had a D-score more than 1, 44% less than 0 and 28% of cases had a D score between 0 and 1 with uncertain prognosis. All carcinoma cases had D-score less than 0. MMP9 was positive in all cases of the study but differ in its degree of e...
BackgroundMelasma is a common pigmentary disorder that remains resistant to available therapies.O... more BackgroundMelasma is a common pigmentary disorder that remains resistant to available therapies.ObjectivesThe aim of the present study was to evaluate the efficacy of erbium:YAG lasers in the treatment of refractory melasma and investigate the histopathological and ultrastructural changes between melasma skin and adjacent control skin before and after surgery.MethodsFifteen Egyptian female patients with melasma unresponsive to previous therapy of bleaching creams and chemical peels were included in this study. Full‐face skin resurfacing using an erbium:YAG laser was performed. Clinical parameters included physician and patient assessment, and melasma area and severity index score were done. Adverse effects after laser resurfacing were recorded. Biopsies of lesions and adjacent healthy skin were stained using hematoxylin–eosin, immunohistochemically marked for Melan‐A, and evaluated by electron microscopy.ResultsThe amount of melanin, staining intensity, and number of epidermal melan...
BackgroundGeneralized eruptive keratoacanthoma (GEKA) is an extremely rare variant of keratoacant... more BackgroundGeneralized eruptive keratoacanthoma (GEKA) is an extremely rare variant of keratoacanthoma that poses significant diagnostic and therapeutic challenges.PatientsThe study included three patients presenting with highly pruritic, generalized eruption of numerous small skin and flesh‐colored follicular papules. They were mainly distributed on the face, neck, and trunk. Few larger nodules were also present. Mask‐like facies, mucosal involvement, and ectropion were evident in two patients. Family history was irrelevant, and general examination was unremarkable.ResultsHistopathological examination revealed typical features of keratoacanthoma, particularly in the larger lesions. Routine laboratory tests were normal, and ultrasonography and computed tomography revealed no evidence of malignancy. Based on the clinicopathological correlation, the diagnosis of our cases was GEKA of Grzybowski. Acitretin 1 mg/kg per day and methotrexate 15 mg/week for three months were associated with...
Background: Emerging evidence is implicating stem cells in the pathogenesis of different cutaneou... more Background: Emerging evidence is implicating stem cells in the pathogenesis of different cutaneous neoplasms. The immunohistochemical use of stem cell markers has facilitated stem cell identification. Aim: This study was designed to determine the expression of stem cell markers ck19 and p63 in BCC and their link to proliferation marker ki67. Subjects: Thirty patients with BCC were the subjects of this study. They were classified according to the hitopathological types into 12 patients solid circumscribed type, 3 patients solid infiltrative type, 8 patients mixed type, 3 patients superficial type, 2 patients adenoid type, one patient morpheaform type and one patient basosquamous type. Methods: The thirty paraffin-embedded BCC skin lesions were examined histopathologically to confirm the diagnosis and to determine histological type of the tumour and also, were examined immunohistchemically for CK19, p63 and Ki-67. Results: Cytokeratin 19 immunoreactivity was observed in 30% (9 of 30) ...
Uploads
Papers by Magda Assaf