The aim of this work is to study the preoperative selection of cases of acute type A aortic dissection and the different surgical modalities for management of these cases and the outcome of these surgical techniques.Alpha-hydroxy acids (AHAs) cause a superficial exfoliation by keratinocyte dyscohesion of pathologically sticky cells at the level of stratum granulosum in the epidermis .This allows the pathologic cells to become loose and shed and therefore helps to correct an abnormally thickened stratum corneumIn addition, AHAs applications on the skin increase the epidermal thickness, the hyaluronic acid, collagen I, procollagen I and mucopolysaccharides; and reduce the fragmentation of elastic fibersGlycolic acid (G A) has effect on the induction of cell cycle arrest and induction of apoptosis in human keratinocytesTopical lactic acid (L A) increases the number of apoptotic cells and increase secretion of vascular endothelial growth factor in human reconstructed epidermisApoptosis is a controlled form of cell death through the interaction of many proteins including Bcl-2. Bcl-2 gene is an antiapoptotic membrane associated molecule that resides in the nuclear envelope and mitochondria. The expression of Bcl-2 prevents apoptotic cell deathThe Bcl-2 protein has been shown to suppress cell death and protects cell against apoptosis induced by different death-inducing signals. The expression of Bcl-2 protein is high in malignant tumors of the skin such as basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), as well as in the precancerous lesion as actinic keratosis (AK) and in benign tumor such as seborrheic Keratosis (SK,.