A Case of Multiple Myeloma Diagnosed by Skin Lesions

Multiple myeloma, being a malignant proliferation of plasma cells in the bone marrow, has clinical spectrum varying from monoclonal gammopathy with unknown significance to plasma cell leukemia. The presenting symptoms have usually been bone pain, pathologic fractures or repeating infections. In patients with multiple myeloma, amyloid depositions may be seen in the skin. This form, defined as primary systemic amyloidosis, is characterized by light-chain amyloid fibril depositions. Our case applied with multiple, asymptomatic, yellowish papules localized on the face, trunk, oral and genital mucosa, gradually increasing during the last two years. He had no complaints, except for slight weight loss. In routine tests, the patient had no pathological laboratory findings, except high C-reactive protein levels. Further research revealed histopathologic and immunohistochemical findings consistent with amyloidosis. Upon these results, immunoglobulin G levels were measured and found high, and in protein electrophoresis, IgG monoclonal gammopathy was determined. The diagnosis of multiple myeloma is made by bone marrow biopsy. This patient is presented for being an asymptomatic case diagnosed by skin findings of amyloidosis

Evaluation of the clinical effects of isotretinoin on chronic rhinosinusitis

Objectives: This study aims to evaluate the clinical effects of isotretinoin (13-cis-retinoic acid), a derivative of retinoic acid, on the clinical features of chronic rhinosinusitis. Patients and Methods: The study group included 25 chronic rhinosinusitis patients (16 females, 9 males; mean age 25.2±6.8 years; range 15 to 25 years) who were on isotretinoin for acne treatment, while the control group consisted of 25 chronic rhinosinusitis patients (15 females, 10 males; mean age 25.2±6.8 years; range 15 to 25 years) who were not on isotretinoin treatment. The patients’ symptom scores in visual analog scale (VAS), Lanza and Kennedy nasal endoscopic scores and Newman computed tomography (CT) scores were obtained in order to evaluate the their symptom, examination and radiological findings. These patients’ symptom and examination results were evaluated first day, week two and at months 3-5 and 6-10. Paranasal sinus CT results were studied first day and at months 6-10. Results: In the group of patients being administered isotretinoin, no significant change in the mean symptom and examination scores was detected during the acute phase (week 2), while there was a significant regression in the longterm (months 3-5 and 6-10). There was a significant regression in the mean CT score after isotretinoin therapy. In the control group no significant change was seen in any of the scores. The number of acute sinusitis attacks were significantly lower in the isotretinoin group than in the control group. No significant difference was found between the two groups in terms of the duration of the healing period of acute sinusitis attacks. Conclusion: We conclude that the long-term administration of isotretinoin has positive effects on the clinical results of chronic rhinosinusitis

A rare case of juvenile-onset Behcet's disease: Fournier's gangrene followed by intestinal involvement

Behcet's disease (BD) is a multisystemic, inflammatory disease with still unknown etiology and rarely seen in childhood. BD has worse prognosis in young, male patients. BD exacerbations may be triggered by viral, bacterial, and other undefined antigenic stimuli in genetically predisposed individuals. Fournier's gangrene (FG) is a rapidly progressive, necrotizing fasciitis of the genital and perineal regions with high morbidity and mortality. FG is usually seen in immunocompromised patients and may be triggered by local factors such as trauma, trombosis, and vasculitis. Here, we present a adolescent, male patient with juvenile-onset BD who developed FG and afterwards entero-Behcet. This unique assocation without any other underlying immunocompromised condition is discussed. (C) 2017 Annals of Pediatric Surgery

A rare case of juvenile-onset Behçet's disease: Fournier’s gangrene followed by intestinal involvement

Behçet's disease (BD) is a multisystemic, inflammatory disease with still unknown etiology and rarely seen in childhood. BD has worse prognosis in young, male patients. BD exacerbations may be triggered by viral, bacterial, and other undefined antigenic stimuli in genetically predisposed individuals. Fournier’s gangrene (FG) is a rapidly progressive, necrotizing fasciitis of the genital and perineal regions with high morbidity and mortality. FG is usually seen in immunocompromised patients and may be triggered by local factors such as trauma, trombosis, and vasculitis. Here, we present a adolescent, male patient with juvenile-onset BD who developed FG and afterwards entero-Behçet. This unique assocation without any other underlying immunocompromised condition is discussed.Keywords: Behçet's disease, colitis, Fournier’s gangrene, juvenile onse

Behçet ve rekürren aftöz stomatit hastalarında yaşam kalitesi

Background and Design: Behçet’s disease (BD) is an important cause of morbidity and mortality. Recurrent aphthous stomatitis (RAS) is a condition affecting oral health-related quality of life (QoL). In this study, we aimed to evaluate QoL of BD patients by using the Behçet’s disease quality of life instrument (BDQLI) and to compare the QoL of patients with BD with that of patients with RAS and healthy controls. Materials and Methods: Forty patients with BD and 40 patients with RAS and 40 healthy subjects with similar sociodemographic characteristics were included in the study. We used the BDQLI to evaluate QoL of patients with BD and the Dermatology-specific quality of life instrument for comparison of QqL between patients with BD and RAS. 36-Item Short Form Health Survey and clinical data form were applied in all participants. The results were analyzed statistically. The power of the study was 99%. Results: QoL of patients with BD were lower than that of healthy controls. It was observed that patients with BD had decreased physical functions, impaired perception of pain and poor general health (p<0.001, p=0.001, p=0.016, <0.001). Physical functions were decreased and perception of general heath was worse in patients with RAS compared to healthy controls (p=0.018, p=0.021). There was no difference in QoL between patients with BD and RAS (p>0.05). Female gender, relapse periods and mucocutaneous symptoms negatively affected QoL of patients with BD. Female gender and duration of the disease were found to be the main factors affecting QoL of patients with RAS. Conclusion: Unlike the results obtained with other instruments, with BDQLI, QoL, particularly in patients with active period and female gender was found to be decreased. In this study, there was a dominance of active mucocutaneous symptoms. This may explain the effect of mucocutaneous symptoms on QoL and the fact that there was no difference in QoL between BD and RAS patients. Further studies comparing QoL of patients with BD in whom visceral involvement is also observed with those with other diseases. QoL of BD patients may be improved by paying attention on symptoms that patients have trouble and by evaluating QoL with multidisciplinary approach during routine follow up

Evaluation of ocular psoriasis with meibography

Background Previous studies has shown that dry eye test abnormalities, meibomian gland dysfunction (MGD), may occur in psoriasis. Objectives The authors aimed to evaluate the dry eye disease (DED), MGD, in psoriasis patients with meibography which is a current, objective, noninvasive method for patients with meibomian gland diseases, to investigate the relationship between disease severity and ocular involvement. Methods This study included 50 participants with psoriasis and 50 healthy individuals. All subjects were examined by the same dermatologist and referred for ophthalmological examination including meibomian gland obstruction, lid margin alterations assessment, ocular surface disease index assessment, tear film break-up time test, Schirmer test, corneal conjunctival fluorescein staining assessment. Additionally, upper and lower lids were evaluated for meibomian gland loss with meibography