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Hafez VG, Bosseila M, Abdel Halim MR, Shaker OG, Kamal M, Kareem HS. Clinical effects of “pioglitazone”, an insulin sensitizing drug, on psoriasis vulgaris and its co-morbidities, a double blinded randomized controlled trialx1. Journal of Dermatological Treatment. 2014:1-7. AbstractWebsite

OBJECTIVES:
To evaluate the therapeutic efficacy of pioglitazone on psoriasis vulgaris and its comorbidities.
MATERIALS AND METHODS:
Forty-eight patients with moderate-to-severe psoriasis vulgaris were enrolled in this randomized double blinded placebo-controlled trial. Active treatment included: oral pioglitazone 30 mg daily for 10 weeks. Primary outcome (treatment success) was PASI-75. Secondary outcomes included changes in metabolic syndrome, insulin resistance and cardiovascular risk.
RESULTS:
Treatment success was achieved in 5/24 (21%) in the pioglitazone group compared to 1/24 (4%) in the placebo group; however, this difference was not significant (p = 0.081). Compared to placebo, no significant difference existed as regards high-sensitive C reactive protein. Metabolic syndrome and insulin resistance were not affected.
CONCLUSIONS:
This short term (10 weeks duration) study revealed no effect of pioglitazone 30 mg daily neither on the clinical response of moderate-to-severe psoriasis nor on metabolic syndrome and insulin resistance. Cardio-protective role appears to be more related to improvement of psoriasis.
LIMITATION:
Short duration of treatment and small number of subgroups.

Hoshy KE, Bosseila M, Sharkawy DE, Sobhi R. Can Basal Cell Carcinoma Lateral Border be Determined by Fluorescence Diagnosis? Photodiagnosis and Photodynamic Therapy. 2016. AbstractWebsite

Background
The preferential accumulation of 5-aminolaevulinic acid (ALA)- induced protoporphyrin IX (PpIX) in neoplastic cells supports its potential use in the photodetection of epithelial tumours through porphyrin fluorescence.

Objective
To assess the validity of fluorescence diagnosis (FD) as an efficient pre-surgical in vivo imaging tool for defining the lateral boundaries of various types of basal cell carcinomas (BCCs).

Methods
The BCC tumour area was determined for 27 patients using FD digitalized imaging system, where the accumulation of PpIX in tumour tissue in relation to normal tissue was measured. Subsequently, BCCs were excised according to the complete area defined by FD using Mohs micrographic surgery (MMS).

Results
Of the 27 BCCs, the FD margin of the lesion coincided with the histopathological picture in 12 BCCs (44.44%). The mean value of accumulation factor (AF) was 2.7. Although 17 pigmented BCCs showed attenuated or absent fluorescence in the center, fluorescence at their periphery was used as a guide for excision, and statistically, the pigmentation of the BCCs showed no effect on the results of the FD efficacy (p = 1.0).

Conclusion
Fluorescence diagnosis of BCC may be beneficial as a guide to the safety margin needed before MMS. The safety margin is decided according to the FD tumour diameter in relation to the clinical tumour diameter.