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Background Follicular unit extraction (FUE) grafting is a surgical procedure which provides the vitiliginous patches with undifferentiated stem cells of the hair follicles. It has been postulated that adjuvant therapy enhances the results. This is the first study to assess two different adjuvant therapies vs FUE alone. Aims To study the efficiency of FUE alone or combined with either topical calcipotriol betamethasone dipropionate (CBD) or NB‐UVB phototherapy in cases of nonsegmental stable vitiligo. To assess the role of dermoscopy in monitoring the pattern and degree of repigmentation. Patients/ Methods 53 patients with 94 lesions with stable nonsegmental vitiligo were divided into three groups. Group 1 (n = 16) with 30 lesions received FUE alone. Group 2 (n = 18) with 32 lesions received FUE plus topical CBD. Group 3 (n = 19) with 32 lesions received FUE plus NB‐UVB phototherapy. Assessment was done by grades of repigmentation, color match, percent of size reduction, and immunohistochemical evaluation of perilesional CD8+T lymphocytes. Results The fastest onset of repigmentation was observed in both groups 2 and 3 in the second week (16.7%, 10.5%, respectively).Group 2 achieved the best response by all methods of assessment. Perifollicular diffuse repigmentation was the commonest dermoscopic pattern in 60 lesions (63.8%). There was a statistically significant decrease in perilesional CD8+T lymphocytes after 4 months. Conclusion FUE is an effective method of surgical treatment of stable vitiligo, and topical CBD as a new adjuvant therapy is successful in targeting the immunological background of vitiligo. Dermoscopy has an essential role in monitoring the repigmentation response.

Background Follicular unit extraction (FUE) grafting is a surgical procedure which provides the vitiliginous patches with undifferentiated stem cells of the hair follicles. It has been postulated that adjuvant therapy enhances the results. This is the first study to assess two different adjuvant therapies vs FUE alone. Aims To study the efficiency of FUE alone or combined with either topical calcipotriol betamethasone dipropionate (CBD) or NB‐UVB phototherapy in cases of nonsegmental stable vitiligo. To assess the role of dermoscopy in monitoring the pattern and degree of repigmentation. Patients/ Methods 53 patients with 94 lesions with stable nonsegmental vitiligo were divided into three groups. Group 1 (n = 16) with 30 lesions received FUE alone. Group 2 (n = 18) with 32 lesions received FUE plus topical CBD. Group 3 (n = 19) with 32 lesions received FUE plus NB‐UVB phototherapy. Assessment was done by grades of repigmentation, color match, percent of size reduction, and immunohistochemical evaluation of perilesional CD8+T lymphocytes. Results The fastest onset of repigmentation was observed in both groups 2 and 3 in the second week (16.7%, 10.5%, respectively).Group 2 achieved the best response by all methods of assessment. Perifollicular diffuse repigmentation was the commonest dermoscopic pattern in 60 lesions (63.8%). There was a statistically significant decrease in perilesional CD8+T lymphocytes after 4 months. Conclusion FUE is an effective method of surgical treatment of stable vitiligo, and topical CBD as a new adjuvant therapy is successful in targeting the immunological background of vitiligo. Dermoscopy has an essential role in monitoring the repigmentation response.

Background Follicular unit extraction (FUE) grafting is a surgical procedure which provides the vitiliginous patches with undifferentiated stem cells of the hair follicles. It has been postulated that adjuvant therapy enhances the results. This is the first study to assess two different adjuvant therapies vs FUE alone. Aims To study the efficiency of FUE alone or combined with either topical calcipotriol betamethasone dipropionate (CBD) or NB‐UVB phototherapy in cases of nonsegmental stable vitiligo. To assess the role of dermoscopy in monitoring the pattern and degree of repigmentation. Patients/ Methods 53 patients with 94 lesions with stable nonsegmental vitiligo were divided into three groups. Group 1 (n = 16) with 30 lesions received FUE alone. Group 2 (n = 18) with 32 lesions received FUE plus topical CBD. Group 3 (n = 19) with 32 lesions received FUE plus NB‐UVB phototherapy. Assessment was done by grades of repigmentation, color match, percent of size reduction, and immunohistochemical evaluation of perilesional CD8+T lymphocytes. Results The fastest onset of repigmentation was observed in both groups 2 and 3 in the second week (16.7%, 10.5%, respectively).Group 2 achieved the best response by all methods of assessment. Perifollicular diffuse repigmentation was the commonest dermoscopic pattern in 60 lesions (63.8%). There was a statistically significant decrease in perilesional CD8+T lymphocytes after 4 months. Conclusion FUE is an effective method of surgical treatment of stable vitiligo, and topical CBD as a new adjuvant therapy is successful in targeting the immunological background of vitiligo. Dermoscopy has an essential role in monitoring the repigmentation response.

Background Follicular unit extraction (FUE) grafting is a surgical procedure which provides the vitiliginous patches with undifferentiated stem cells of the hair follicles. It has been postulated that adjuvant therapy enhances the results. This is the first study to assess two different adjuvant therapies vs FUE alone. Aims To study the efficiency of FUE alone or combined with either topical calcipotriol betamethasone dipropionate (CBD) or NB‐UVB phototherapy in cases of nonsegmental stable vitiligo. To assess the role of dermoscopy in monitoring the pattern and degree of repigmentation. Patients/ Methods 53 patients with 94 lesions with stable nonsegmental vitiligo were divided into three groups. Group 1 (n = 16) with 30 lesions received FUE alone. Group 2 (n = 18) with 32 lesions received FUE plus topical CBD. Group 3 (n = 19) with 32 lesions received FUE plus NB‐UVB phototherapy. Assessment was done by grades of repigmentation, color match, percent of size reduction, and immunohistochemical evaluation of perilesional CD8+T lymphocytes. Results The fastest onset of repigmentation was observed in both groups 2 and 3 in the second week (16.7%, 10.5%, respectively).Group 2 achieved the best response by all methods of assessment. Perifollicular diffuse repigmentation was the commonest dermoscopic pattern in 60 lesions (63.8%). There was a statistically significant decrease in perilesional CD8+T lymphocytes after 4 months. Conclusion FUE is an effective method of surgical treatment of stable vitiligo, and topical CBD as a new adjuvant therapy is successful in targeting the immunological background of vitiligo. Dermoscopy has an essential role in monitoring the repigmentation response.

Background Follicular unit extraction (FUE) grafting is a surgical procedure which provides the vitiliginous patches with undifferentiated stem cells of the hair follicles. It has been postulated that adjuvant therapy enhances the results. This is the first study to assess two different adjuvant therapies vs FUE alone. Aims To study the efficiency of FUE alone or combined with either topical calcipotriol betamethasone dipropionate (CBD) or NB‐UVB phototherapy in cases of nonsegmental stable vitiligo. To assess the role of dermoscopy in monitoring the pattern and degree of repigmentation. Patients/ Methods 53 patients with 94 lesions with stable nonsegmental vitiligo were divided into three groups. Group 1 (n = 16) with 30 lesions received FUE alone. Group 2 (n = 18) with 32 lesions received FUE plus topical CBD. Group 3 (n = 19) with 32 lesions received FUE plus NB‐UVB phototherapy. Assessment was done by grades of repigmentation, color match, percent of size reduction, and immunohistochemical evaluation of perilesional CD8+T lymphocytes. Results The fastest onset of repigmentation was observed in both groups 2 and 3 in the second week (16.7%, 10.5%, respectively).Group 2 achieved the best response by all methods of assessment. Perifollicular diffuse repigmentation was the commonest dermoscopic pattern in 60 lesions (63.8%). There was a statistically significant decrease in perilesional CD8+T lymphocytes after 4 months. Conclusion FUE is an effective method of surgical treatment of stable vitiligo, and topical CBD as a new adjuvant therapy is successful in targeting the immunological background of vitiligo. Dermoscopy has an essential role in monitoring the repigmentation response.

Background Tramadol is a synthetic opioid analgesic that acts mainly on the µ-opioid receptors with less activity on norepinephrine and serotonin by reuptake inhibition. In the last decade, tramadol addiction presents an increasing medical and legal crisis in Egypt. Objective Few works in the literature studied the cognitive profile in tramadol-dependent patients without focusing on prolonged duration of dependence or on its use in high doses. Patients and methods The present work studied the cognitive functions in 30 tramadol-dependent patients in comparison to 30 healthy cross-matching controls regarding short-term and long-term memory, visuospatial function, executive functions, and reaction time. The cognitive battery used in this study included mini-mental state examination, montreal cognitive assessment scale, brief visuospatial memory test-revised, and P300-evoked potential measuring. Results The results have shown that tramadol-dependent patients have affection in memory, visuospatial, and executive functions and in reaction time compared with healthy individuals as evidenced by mini-mental state examination (P=0.003), montreal cognitive assessment scale (P0.001), brief visuospatial memory test-revised (P=0.016), and P300 latency (P0.001).

Background Tramadol is a synthetic opioid analgesic that acts mainly on the µ-opioid receptors with less activity on norepinephrine and serotonin by reuptake inhibition. In the last decade, tramadol addiction presents an increasing medical and legal crisis in Egypt. Objective Few works in the literature studied the cognitive profile in tramadol-dependent patients without focusing on prolonged duration of dependence or on its use in high doses. Patients and methods The present work studied the cognitive functions in 30 tramadol-dependent patients in comparison to 30 healthy cross-matching controls regarding short-term and long-term memory, visuospatial function, executive functions, and reaction time. The cognitive battery used in this study included mini-mental state examination, montreal cognitive assessment scale, brief visuospatial memory test-revised, and P300-evoked potential measuring. Results The results have shown that tramadol-dependent patients have affection in memory, visuospatial, and executive functions and in reaction time compared with healthy individuals as evidenced by mini-mental state examination (P=0.003), montreal cognitive assessment scale (P0.001), brief visuospatial memory test-revised (P=0.016), and P300 latency (P0.001).

Background Tramadol is a synthetic opioid analgesic that acts mainly on the µ-opioid receptors with less activity on norepinephrine and serotonin by reuptake inhibition. In the last decade, tramadol addiction presents an increasing medical and legal crisis in Egypt. Objective Few works in the literature studied the cognitive profile in tramadol-dependent patients without focusing on prolonged duration of dependence or on its use in high doses. Patients and methods The present work studied the cognitive functions in 30 tramadol-dependent patients in comparison to 30 healthy cross-matching controls regarding short-term and long-term memory, visuospatial function, executive functions, and reaction time. The cognitive battery used in this study included mini-mental state examination, montreal cognitive assessment scale, brief visuospatial memory test-revised, and P300-evoked potential measuring. Results The results have shown that tramadol-dependent patients have affection in memory, visuospatial, and executive functions and in reaction time compared with healthy individuals as evidenced by mini-mental state examination (P=0.003), montreal cognitive assessment scale (P0.001), brief visuospatial memory test-revised (P=0.016), and P300 latency (P0.001).