A Case of Familial Lichen Amyloidosis

Familial lichen amyloidosis which is also referred to familial primary cutaneous amyloidosis is a rare clinical variant of cutaneous amyloidosis. Lichen amyloidosis is characterized by persistent, pruritic, small brown papules often located on anterior surfaces of legs which show tendency to form plaques. Amyloid deposits would be identified in papillary dermis in histopathological examination. In our clinic, a 42 year old woman with a widespread involvement describing that similar skin findings were present in her both daughters, elder brother and her nephew was evaluated with suspicion of lichen amyloidosis. In histopathological examination of the involved skin, because of determining amyloid deposits in papillary dermis the case was cited as lichen amyloidosis. Our case was searched for the accompanying diseases such as atopic dermatitis, chronic urticaria, lichen planus, multiple endocrine neoplasia and Kimura disease. The family history of our patient was consistent with autosomal dominant inheritance. Familial lichen amyloidosis has been reported as cases with autosomal dominant inheritance from Russia, Germany, United Kingdom and South America. The genetic researches over familial lichen amylodiosis are limited to the cases with multiple endocrine neoplasia. In this rarely reported cases, further genetical researches are necessary in order to determine the responsible gen locus. (Turkderm 2008; 42: 137-9

Tear film and ocular surface changes in patients receiving systemic isotretinoin

Purpose: Our aim in this study was to assess the ocular surface and tear film changes in acne vulgaris patients receiving systemic isotretinoin. Material and Method: Twenty-two eyes of 22 patients who received oral isotretinoin (roaccutane®, 0.7 mg/kg/day) for nodular acne vulgaris were enrolled in this prospective study. Tear film break-up time (BUT), Schirmer 1 test scores with anesthesia, ocular surface disease index (OSDI) scores and conjunctival impression cytology scores were recorded before treatment and at 3- and 6-month visits following the beginning of treatment. Results: BUT values decreased and OSDI scores significantly increased at 3 months after treatment (p=0.007 and p=0.018, paired samples test). Schirmer scores did not significantly change by isotretinoin treatment. Of 9 eyes with impression cytology specimens, 4 revealed normal conjunctival findings before treatment. At the 3rd month, there was an increase in the scores characterized by decrease of Goblet cells, and at 6 months of treatment, normal conjunctival findings did not exist in any of the patients (p=0.004, Friedman test). Discussion: Systemic isotretinoin treatment can cause alterations in the tear film and cause dry eye symptoms

Psychiatric disorders in patients attending a dermatology outpatient clinic

Background: Psychiatric comorbidity in patients with skin disorders has been reported. Objective: To find out the prevalence of psychiatric disorders in dermatology outpatients and to investigate the factors that affect the psychiatric symptoms. Methods: 256 patients attending our dermatology outpatient clinic completed a 12-item General Health Questionnaire (GHQ) following their dermatologic examination. A standardized personal interview was performed to establish a psychiatric diagnosis in patients sampled by using a stratified random sampling method. Results: The prevalence of psychiatric disorders was found to be 33.4% in the study group. The mean of the total GHQ scores of the sample group (n = 256 patients) was 3.656. The duration of the dermatologic complaints, sex of the subjects, localization of the lesions, and dermatologic diagnosis did not affect the total GHQ scores of the patients. Conclusion: Psychiatric comorbidity in 33.4% of the dermatology outpatients indicates the need for considering emotional factors for an effective management of the cutaneous disorders

Histologic grading for psoriasis and psoriasiform tissue reactions

Among the dermatoses which show psoriasiform tissue reactions, psoriasis has characteristic histological features where others mimic these features. Atypical lesions of psoriasis or the ones under therapy can not be easily differentiated from other forms of psoriasiform dermatitis. The role of histological parameters in the differential diagnosis of these entities were investigated in our study. Two groups were constituted, one with 20 subjects with the histological diagnosis of psoriasis and the other with 15 subjects with the histological diagnosis of psoriasiform dermatitis. The extents of acanthosis, basal membrane disruption, and thinning of suprapapillary epidermal plates in psoriasis group were found to be significantly greater than that in psoriasiform dermatitis group. As a conclusion, grading the histopathological parameters may indicate some clues which may help in the histological diagnosis of atypical forms of psoriasis

Influence of narrowband UVB irradiation of serum on autologous serum skin test results

Background Autologous serum skin test (ASST) is an in vivo test to demonstrate circulating endogenous proinflammatory or wheal-inducing factors in urticaria patients. While ASST was negative in a patient with solar urticaria and in a patient with localized heat urticaria, test results turned to positive when performed with visible light-irradiated and heated serums, respectively. These data suggest that some factors and/or antibodies in serum may be activated or inhibited with different factors. We aimed to investigate whether or not ASST results change when performed with narrowband ultraviolet B (UVB)-irradiated serum. Materials and methods Seventy-seven patients with chronic idiopathic urticaria underwent ASST twice in consecutive days. The second ASST was performed with narrowband UVB-irradiated serum. The results of the first and second ASSTs were compared. Results The first ASST results were positive in 46 (59.7%) patients. ASST results reversed oppositely in 36 (46.8%) patients, turned from negative to positive in 19 patients, and turned from positive to negative in 17 patients when performed with narrowband UVB-irradiated serum. Conclusion Our results suggest that narrowband UVB may have modifying effects on some wheal-inducing factors and/or antibodies. On which factors in serum narrowband UVB has effects may be investigated. © 2013 The International Society of Dermatology

The cases with paederus dermatitis from Denizli region

Background and Objective: Paederus dermatitis is a self-limited skin disorder characterized with lineer and vesicular, bullous and/or pustular lesions on erythematous bases caused by Paederus species belonging to Staphlinidae (Coleoptera) family. The lesions which are seen in warm and moist climates especially in summer months occur within 24 hours after the crushing of the beetle over the skin and heal with slight hyperpigmentation within 7-8 days. In our study we aimed to evaluate the history and clinical features of cases with Paederus dermatitis. Materials and Methods: Sixteen patients (9 female, 7 male, mean age: 31.75 ± 15.72) were diagnosed as Paederus dermatitis on history and clinical findings. Detailed history and clinical features of the patients were recorded. Results: Most of the patients live in central part of Denizli and have a history of spending time in a garden or on a balcony. Mostly painfull lesions were commonly located on the neck and V region of the neck, upper arm, shoulder and scapular regions with lineer or nummular pattern. Conclusion: The cases from Çukurova and Aydin region have been reported previously. In this report, we stress that Paederus dermatitis may be a common dermatosis in other regions with similar climates in Turkey and should be considered in differential diagnosis of phytophotodermatitis, impetigo, herpes zoster, etc

High-frequency hearing and reflex latency in patients with pigment disorder

Purpose: To investigate the activities of inner ear melanin in patients with pigment variations and disorders. Our purpose was to find evidence on the effects of melanin-containing cells by measuring the high-frequency threshold and the latency of stapes reflex in patients with vitiligo.Patients and Methods: Twenty-nine patients with active vitiligo and 41 healthy subjects were included in this study. Pure tone thresholds were determined at frequencies between 250 and 16,000 Hz. Ipsilateral and contralateral stapes reflexes were measured at 1,000, 2,000, and 4,000 Hz. After we compared the results in the control and vitiligo groups by using the Mann-Whitney U test for each frequency, we compared women and men separately to eliminate gender differences.Results: Pure tone thresholds of the vitiligo group were significantly lower than the control group at 4,000, 6,000, 8,000 and 10,000 Hz (P <.05). The statistically different thresholds were 8,000 and 10,000 Hz in women, compared with 4,000, 6,000, 8,000, 10,000, 12,500, and 16,000 Hz in men (P< 0.05). Reflex latencies for the two groups were not statistically different.Conclusion: Vitiligo, which is a type of pigment disorder, seems to be an effective factor in hearing loss, and men are more susceptible to it than women. The mechanism for this condition might be the absence of the preventive function of melanin-containing cells in the inner ear.Copyright (C) 1998 by W.B. Saunders Company

The role of essential and non-essential elements in mal de meleda

Mal de Meleda (MDM) is a rare autosomal recessively inherited palmoplantar keratoderma. In 1826 Stulli described the disease on the Dalmatian island of Meleda. Hyperkeratosis involves other parts of the body such as elbows and knees, in addition to the palms and soles. Zinc deficiency is known to cause hyperkeratozis in addition to other skin changes. We studied the levels of essential and nonessential elements in blood and tissues /nail, hair, skin/ in MDM patients and healthy controls living in Köprüçay area, Turkey. The results show no significant difference in blood zinc, iron, copper, cadmium, and lead levels between MDM patients and healthy controls. The zinc and copper levels of nail and hair in MDM patients did not differ from those of healthy controls. © 2007, by Walter de Gruyter GmbH & Co. All rights reserved