Elbendary, A., R. Youssef, M. R. E. Abdel-Halim, D. abd el halim, D. A. El Sharkawy, M. Alfishawy, M. A. Gad, A. A. Gad, and M. F. Elmasry, "Role of streptococcal infection in the etiopathogenesis of pityriasis lichenoides chronica and the therapeutic efficacy of azithromycin: a randomized controlled trial.", Archives of dermatological research, 2022. Abstract

The exact aetiology of pityriasis lichenoides chronica (PLC) remains unknown. While phototherapy is the most investigated therapeutic modality, azithromycin has been used scarcely. The aim of this study is to evaluate the therapeutic efficacy of azithromycin in the treatment of PLC compared to NB-UVB and evaluating the presence of streptococcal infection as a possible etiological factor in PLC patients. The study was designed as a randomised controlled trial. Twenty-four patients with PLC were randomly allocated into either azithromycin (n = 13, standard dose every 10 days) or NB-UVB (n = 11, thrice weekly) groups. End of study (EOS) was either complete clearance of lesions or a maximum of 8 weeks. Therapeutic efficacy was defined as percent reduction in lesions and was calculated for the rash as a whole, erythematous papules alone, and hypopigmented lesions alone and graded into complete, very-good, good, poor or no response. Anti-streptolysin O titre (ASOT), anti-deoxyribonuclease B titre (anti-DNaseB) and throat culture were evaluated at day 0. No significant difference existed between both groups as regards therapeutic efficacy. At EOS, NB-UVB achieved significantly more percent reduction in the extent of hypopigmented lesions and consequently in the rash as a whole (p = 0.001, p = 0.034, respectively). The extent of the rash as a whole was significantly less in the NB-UVB at EOS (p = 0.029, respectively). The effect of NB-UVB on hypopigmented lesions appeared early at week 4 of treatment. Only two patients, one from each group, relapsed during the 3 month follow-up. Evidence of recent streptococcal infection was present in 79% of the cases, mainly in the form of elevated ASOT (94.7%). It was significantly more encountered in young children (< 13 years) (p = 0.03) and was associated with more extent of erythematous papules and consequently with more extent of the rash as a whole (p = 0.05 and p = 0.01, respectively). It did not affect outcome of therapy at EOS. Azithromycin did not show more favorable response in patients with recent streptococcal infection. Therapeutic efficacy of azithromycin is comparable to NB-UVB in treatment of PLC; however, NB-UVB is superior in management of hypopigmented lesions. It is highly suggested that PLC could be a post streptococcal immune mediated disorder.Registration number: ClinicalTrials.gov, NCT03831269.

Abdelkader, H. A., M. M. Fawzy, N. Nour, and M. R. E. Abdel-Halim, "Eczematous mucinous eccrine nevus: a novel presentation with Meyerson phenomenon.", International journal of dermatology, 2022.
El-Komy, M. H. M., N. Shawky, A. Mourad, and M. R. Abdel-Halim, "Erythema gyratum repens-like psoriasis: a case report and review of literature.", International journal of dermatology, 2022.
Abdel-Halim, M. R. E., A. Mahmoud, and G. Ragab, "Cutaneous manifestations of ANCA associated vasculitis", Vessel Plus, vol. 6, 2022.
El-Komy, M. H. M., Y. Azzazi, R. El Naggar, and M. R. E. Abdel-Halim, "Chronic Atrophic Scar-like Plaque: Challenge.", The American Journal of dermatopathology, vol. 44, issue 1, pp. e6-e7, 2022.
Shahin, A., R. Yousef, S. Hussein, M. Niazy, D. Attia, M. AlMasry, S. Shalaby, H. A. El-Kader, M. Bahgat, D. Teleb, et al., "Widespread Necrotizing Purpura and Lucio Phenomenon as the First Diagnostic Presentation of Diffuse Nonnodular Lepromatous Leprosy", CUTIS, vol. 108, pp. E4-E8, 2021.
Komy, M. E. L., E. El-Nabarawy, H. Abdelkader, M. R. E. Abdel-Halim, and R. AlAguizy, "Pigmentary mosaicism and extracutaneous defects: a case report of a rare form of twin spotting", Pigment International, vol. 8, pp. 176-8, 2021.
Elbendary, A., M. R. E. Abdel-Halim, R. Youssef, D. abd el halim, M. F. Elmasry, A. A. Gad, and D. A. El Sharkawy, "Hypopigmented lesions in pityriasis lichenoides chronica patients: Are they only post-inflammatory hypopigmentation?", The Australasian journal of dermatology, 2021. Abstract

BACKGROUND/OBJECTIVES: Pityriasis lichenoides chronica (PLC) lesions are reported to subside with post-inflammatory hypopigmentation (PIH); hence, the most widely perceived nature of hypopigmented macules in PLC is PIH. However, to the best of our knowledge, no studies describing histopathological findings in these lesions are reported in literature. The aim of this study is to evaluate the hypopigmented lesions encountered in PLC patients and to shed light on their histopathological features.

METHODS: A cross-sectional observational study included twenty-one patients with PLC recruited in a period of twelve months. Clinical characteristics of each patient were collected. A skin biopsy from hypopigmented lesions whenever present was taken and assessed with routine haematoxylin and eosin stain.

RESULTS: Seventeen patients (81%) were less than 13 years old. Most patients (85.7%) demonstrated diffuse distribution of lesions. Hypopigmented lesions were present on the face in 12 (57.14%) patients. Histopathologically, hypopigmented lesions showed features of post-inflammatory hypopigmentation in 19% of patients, residual PLC in 52.4% and active PLC 28.6% of patients.

CONCLUSION: Hypopigmented lesions in PLC were noted mainly in younger ages, histopathologically they may show features of active or residual disease, beyond post-inflammatory hypopigmentation. Consequently active treatment for patients presenting predominantly with hypopigmented lesions could be required to control the disease.

Elbendary, A., M. R. E. Abdel-Halim, and G. Ragab, "Updates in cutaneous manifestations of systemic vasculitis.", Current opinion in rheumatology, vol. 34, issue 1, pp. 25-32, 2022. Abstract

PURPOSE OF REVIEW: The main purpose of this review is to present newly reported cutaneous manifestations of systemic vasculitis, updates in investigations to verify systemic involvement in cases with cutaneous vasculitis and new therapeutic guidelines. The spectrum of COVID-19-related vasculitis is also covered.

RECENT FINDINGS: Only a few reports highlighted new cutaneous presentations or associations with some systemic vasculitic entities. For example, the association of inflammatory disorders with Takayasu arteritis, the importance of considering Kawasaki disease in febrile children with erythema nodosum, the development of necrotic ulcers on fingers and toes in Behçet's disease and the possible presence of polyarteritis nodosa-like pathological features in vulvar ulcers of Behçet's disease. New attempts to classify cutaneous manifestations of giant cell arteritis (GCA) and antineutrophil cytoplasmic antibody-associated vasculitis (AAV) and the diagnostic investigations for cutaneous vasculitis cases to verify systemic involvement are discussed. Treatment of systemic vasculitis with cutaneous vasculitis should be tailored according to disease status. A plethora of reports in the past 2 years focused on the broad spectrum of COVID-19 vasculitic manifestations.

SUMMARY: Although newly reported cutaneous manifestations of systemic vasculitis are relatively uncommon, the plethora of reports in the past 2 years on COVID-19 vasculitis necessitates the expansion of the classification of vasculitis associated with probable cause to include severe acute respiratory syndrome coronavirus-2 (SARS-Cov-2) vasculitis.

Komy, M. E. L., B. Gaballa, and M. R. E. Abdel-Halim, "Longitudinal erythro-leukoxanthonychia developing after PUVA therapy", Skin Appendage Disorders, 2021.