Search

Dermoscopy has frequently been used for hair and scalp disorders. Dermoscopic examinations of psoriasis and seborrheic dermatitis lesions yielded different morphologies. This study aimed to investigate the usefulness of dermoscopy in the clinical differentiation of psoriasis and seborrheic dermatitis on the scalp and additionally to evaluate its capacity in determining disease severity. The study included 46 psoriasis and 50 seborrheic dermatitis patients who were clinically diagnosed and had scalp lesions. Dermoscopic images taken from lesional scalp were then reviewed for microvascular patterns. In addition, we assessed the severity of scalp disease and looked for a correlation with these patterns. The frequency of twisted loops, glomerular vessels, red dots/globules, and polymorphous beaded lines/circles were statistically higher in the psoriasis group, whereas the frequencies of simple loops and arborizing vessels were statistically higher in the seborrheic dermatitis group (p [Med-Science 2018; 7(1.000): 118-121]

Introduction and objectives. In this study we analyzed the susceptibility to atherosclerosis of patients with psoriasis and psoriatic arthritis (PsA) by determining the femoral-carotid pulse wave velocity (PWV), which is a measure of the viscoelastic properties of blood vessels. Methods. The study included 25 patients with psoriasis (age 18-63 years, 13 male), of whom 9 had arthritis, as well as 39 sex- and age-matched healthy control subjects (age 24-70 years, 25 male). The systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate, body mass index (BMI), and waist-to-hip ratio (WHR) of all participants were recorded and, in patients, skin lesions were assessed using the psoriasis area and severity index (PASI). Arterial distensibility was determined by automatic carotid–femoral PWV measurement using the Complior Colson device. Results. Mean PWV, SBP and DBP were significantly higher in psoriatic patients than in control subjects (P=.036, P

Skin metastasis from nasopharyngeal carcinoma is a rare clinical finding. The most common form of appearance is a few solitary skin nodules. However, massive and extensive nodular dissemination or diffuse dermal lymphatic infiltration is extremely rare. We here present a case of a 40-year-old man with widespread nodular skin metastases from undifferentiated nasopharyngeal carcinoma.

Benzoyl peroxide and adapalene are among the most effective topical agents used in the treatment of acne. We planned an open-labeled, prospective study to compare the effects and side effects of these two drugs alone and in combination in the treatment of acne vulgaris. One hundred and five consecutive patients (30 men and 75 women) with acne vulgaris were included in this study. The patients were randomly divided into three groups with 35 patients in each. The groups were randomly assigned to 0.1% adapalene gel, 5% benzoyl peroxide lotion, or combination of 0.1% adapalene gel +5% benzoyl peroxide treatment. Acne lesions were classified as noninflammatory (open and closed comedones) and inflammatory (papule, pustule, nodule, cyst), and the lesions on the face were counted before the therapy, during the control visits, and after the treatment. Erythema, dryness, burning, and other side effects were recorded during the treatment. The mean age of the patients was 18.44 +/- 3.75 years. Eight patients were excluded because of noncompliance with the treatment regimen or the follow-up schedule, and four patients were excluded due to allergic contact dermatitis. The study revealed that all three therapy protocols were effective in treating noninflammatory and inflammatory lesions in acne vulgaris (p0.05) and that there was no significant difference between the groups in efficacy or side effects (p0.05). Adapalene and benzoyl peroxide are effective and well tolerated agents for acne vulgaris; combination therapy has no superiority over adapalene or benzoyl peroxide alone.

Androgen hormones play an important role in the pathogenesis of acne. Despite the demonstrated effects, spironolactone, an androgen receptor blocker, is not commonly used to treat acne. We planned an open-labelled, prospective study to evaluate the effects and side-effects of spironolactone therapy in women with acne.Thirty-five consecutive patients with acne were treated with spironolactone 100 mg/day, 16 days each month for 3 months. The patients were divided according to the clinical severity of the lesions as having mild, moderate and severe acne. Serum total testosterone and dehydroepiandrosterone sulfate (DHEAS) levels were measured before and after treatment. Lesion numbers and hormone levels before and after treatment were compared with one-sampled t-test.The mean age of the patients was 21.4 +/- 3.5 years. Two patients discontinued the study due to side-effects. Five patients were lost in the follow-up. Clinically significant improvement was noted in 24 patients (85.71%). No response was seen in four patients. All of the nonresponding patients had received previous unsuccessful therapies. Mean number of lesions and mean DHEAS levels of the 24 patients with clinical improvement decreased significantly after treatment (P0.01 and P0.05, respectively). There was no change in the mean total testosterone levels before and after treatment (P0.05).Spironolactone is a safe and effective medication for women with acne vulgaris. Although its side-effects seem to be high, they are in the majority of cases not a reason to stop treatment.

Treatment of warts can involve medical and surgical methods. Infrared coagulation is a surgical method very rarely used in the treatment of warts. We planned an open-labeled prospective study to research the effect of infrared coagulation in the treatment of common warts, comparing it with electrocoagulation, and discussing its applicability as an alternative therapy regimen. Eighteen patients with common warts were included in this study. There were 49 warts of various sizes (1 mm to 1 cm) in these 18 patients. Twenty-seven warts were treated with infrared coagulation, and 22 warts were treated with electrocoagulation. Sixteen patients were treated with both infrared coagulation and electrocoagulation; two patients were treated with only infrared coagulation. The patients were followed-up for six months after treatment. Changes in sizes of warts, healing times, and cure rates were compared by Mann-Whitney U test. The mean healing time was 35.5 +/- 5.7 days with infrared coagulation and 32.9 +/- 4.0 days with electrocoagulation. There was not any significant difference between healing times (p0.05). Bacterial infection was seen on seven (31.8%) warts treated with electrocoagulation, but no side effects were seen with infrared coagulation. There was a significant difference between side effect rates in two groups (p0.01). Nine (33.3%) of the warts treated with infrared coagulation and seven (31.8%) of the warts treated with electrocoagulation recurred in the six-month follow-up period. The overall cure rates at the end of the follow-up period were 66.7% and 68.2% respectively. There was not any significant difference between the cure rates in the two groups (P0.05). We conclude that infrared coagulation is a safe and cheap method and should be kept in mind as an alternative modality for the treatment of common warts.

2074 ondrodermatitis nodularis helisis kronika (NHK), nispeten sik gorulen, genellikle kulak kepcesi heliksinde ya da bazen antiheliksinde yerlesen agrili papul veya noduller ile seyreden, iyi seyirli inflamatuar bir hastaliktir.1-5 Ilk olarak 1915 yilinda Winkler tarafindan tanimlandigindan “Winkler hastaligi” adiyla da bilinir.2,4,5 Ayrica 1941’de ‘‘clavis helisis’’ adiyla Carol ve Van Haren tarafindan, 1944’te de ‘‘hemangi-acanto-keratoma’’ adiyla Mangabeira-Albenez ve Monteiro-Sales tarafindan tanimlanmistir.4 Lezyonlar cogunlukla sag kulakta yerlesir ancak olgumuzda oldugu gibi bilateral vakalar da bildirilmistir.3-5 Beyaz irkta ve 40 yas uzerindeki erkeklerde daha sik rastlanir, kadinlarda daha nadir gorulur. Erkek/kadin orani 10/1’dir.1,4

Sjogren's syndrome (SS) is an autoimmune disease that is characterized by exocrine gland involvement. It is reported that the skin is affected in nearly half of SS patients. Cutaneous manifestations consist of xerosis, angular cheilitis, eyelid dermatitis, pruritus, cutaneous vasculitis (frequently manifesting as palpable purpura), and erythema annulare. Most of them are nonspecific and less severe than the oral, ocular, or musculoskeletal symptoms. We present two patients with primary SS who have many cutaneous manifestations including erythema annulare and pernio-like lesions and review the literature about this topic.

Human infections caused by Alternaria alternata are more frequently reported in immunosupressive hosts. In this report, a rarely seen cutaneous infection, caused by A. alternata in an immunocompetent patient was presented. The patient (71-years-old, male) was admitted to the dermatology unit with complaints of an erythematous and squamatous lesion of 5 cm diameter on left malleolar region. The case was evaluated as immunocompetent based on the normal serum total immunoglobulin and complement levels, anti-HIV negativity, and no known underlying disease. A number of Alternaria spp. conidia and hypha were seen in the microscopical examination of KOH treated cutaneous scrapings of the lesion obtained in two different days. Fungal cultures of the skin scrapings yielded the growth of a fungus identified as A. alternata. Although fungal elements were not detected in haematoxylene-eosin stained smears of the skin biopsy, A. alternata was again isolated in the culture of the biopsy specimen. The identification of the fungus was confirmed by a reference center (Mycology Section of Scientific Institute of Public Health, Belgium) and it was integrated to BCCM/IHEM collection under accession number IHEM 22598. Antifungal susceptibility test efforts failed due to a problem in the preparation of fungal suspension. Oral itraconazole (200 mg/day) and bifonazole cream was used for the treatment and the lesion regressed after the 19th day of the therapy. The treatment was continued with oral and local terbinafine for two weeks and the patient fully recovered. Since A. alternata was demonstrated both in the skin scrapings and tissue biopsy through microscopic examination and culture, it was evaluated as the causative agent of skin infection rather than colonization. This was the first A. alternata infection in an immunocompetent patient in the light of the current literature.

Psoriatic arthritis is an autoimmune, chronic, systemic inflammatory disorder characterized by the association of arthritis with psoriasis. In this paper, we explore the characteristics of joint and nail involvement in Turkish patients with psoriatic arthritis. Forty patients with psoriasis (M/F, 18/22) and 49 (M/F, 25/24) subjects with psoriatic arthritis were included in the study. Clinical characteristics of the patients were recorded. The distribution of the subjects with arthritis: (according to the clinical and radiological findings): polyarticular, 65%; oligoarticular, 23%; isolated axial involvement, 7.7%; arthritis mutilans, 3.8%; sacroiliitis, 19%. Nail involvement was significantly higher among patients with arthritis; i.e., 91 versus 32%; (P0.05). There were no correlation between the skin involvement pattern and the arthritis type (P0.05). Nevertheless, no relation was observed between the psoriasis duration and arthritis (P0.05). Nail involvement is a frequent feature of the psoriatic arthritis which may be a useful finding for differential diagnosis of psoriatic arthritis from other inflammatory arthropathies.

A predisposition to occlusive vascular diseases has been reported in patients with psoriasis and it has been suggested that some of these patients have some disorders of lipid metabolism. In this study, serum lipid levels were investigated in psoriatic patients to explore to the knowledge of this relationship. One hundred psoriatic patients and 100 non- psoriatic controls were included in the study. Total cholesterol, triglyceride, high-density lipoprotein-cholesterol (HDL-cholesterol), low-density lipoprotein-cholesterol (LDL-cholesterol), and very low-density lipoprotein-cholesterol (VLDL-cholesterol) levels were measured. In patients with psoriasis, total cholesterol and LDL-cholesterol levels were found to be significantly higher than those of controls. No significant differences were found in the other parameters. We concluded that psoriatic patients should be evaluated and followed up for the risk of hyperlipidemia and obstructive vascular diseases.

Background The exact aetiology of recurrent aphthous stomatitis (RAS) is still unknown, but different predisposing factors, including iron, vitamin B12 and folic acid deficiencies, have been proposed. Material and methods Serum iron, ferritin, folic acid and vitamin B12 levels were investigated in 35 patients with RAS and in 26 healthy controls. Results Vitamin B12 levels were found significantly lower in subjects with RAS than in controls. No significant differences were found in other parameters. Conclusion We concluded that vitamin B12 deficiency may be an aetiological factor in recurrent aphthous stomatitis.

Darier's disease and acrokeratosis verruciformis are inherited with the same pattern and they share similar clinical properties. We present a patient with both Darier's disease and acrokeratosis verruciformis. The patient had had brownish and skin-colored papules, initially on her face and neck, since the age of 25. Similar lesions had gradually spread to various parts of her body and lastly the dorsal aspect of her feet. On dermatological examination, brownish and skin-colored, 2 to 5 mm, keratotic papules were observed on her face, neck, both axillae, inframammary regions, and dorsa of the hands and feet. The nail examination revealed "V" shaped notches and longitudinal ridges on the fingers of both hands. The biopsy taken from the neck showed typical findings for Darier's disease. The biopsy from the dorsa of the left foot revealed the distinctive structures of acrokeratosis verruciformis. In this article the clinical and histopathological findings of these diseases are reviewed based on our patient.