Occupational Acne

Occupational and environmental acne is a dermatological disorder associated with industrial exposure. Polyhalogenated hydrocarbons, coal tar and products, petrol, and other physical, chemical, and environmental agents are suggested to play a role in the etiology of occupational acne. The people working in the field of machine, chemistry, and electrical industry are at high risk. The various occupational acne includes chloracne, coal tar, and oil acne. The most common type in clinic is the comedones, and it is also seen as papule, pustule, and cystic lesions. Histopathological examination shows epidermal hyperplasia, while follicular and sebaceous glands are replaced by keratinized epidermal cells. Topical or oral retinoic acids and oral antibiotics could be used in treatment. The improvement in working conditions, taking preventive measures, and education of the workers could eliminate occupational acne as a problem

A case of vitiligo developed after isotretinoin therapy

Oral isotretinoin, a 13-cis retinoic acid and a derivative of the retinoids, is very effective for severe nodulocystic acne and papulopustular acne, which at times turns scar-forming and resistant. Common mucocutaneous and ocular dryness are the side effects. Also, musculoskeletal symptoms such as back pain, arthralgia, and myalgia may be seen in about 16% of adults post-isotretinoin therapy, usually resolving after treatment discontinuation. Depressive side effects and suicidal thoughts are concerns voiced against its use. Vitiligo is an autoimmune disorder characterized by the selective loss of melanocytes and depigmented patches on the skin. Recently, it has been classified to include metabolic, oxidative stress, genetic, and environmental factors. We present a very rare case of vitiligo developing after systemic isotretinoin therapy in a 24-year-old female patient with severe nodulocystic acne. The patient responded well to topical treatment, and her lesions improved significantly during the five months of follow-up. This case points out that, when prescribing isotretinoin, dermatologists should consider all possible dermatological adverse effects, including vitiligo, and conduct timely intervention and monitoring

Leprosy Reactions

Sudden changes in immune-mediated response to Mycobacterium leprae antigen are referred to as leprosy reactions. The reactions manifest as acute inflammatory episodes rather than chronic infectious course. There are mainly two types of leprosy reactions. Type 1 reaction is associated with cellular immunity and particularly with the reaction of T helper 1 (Th1) cells to mycobacterial antigens. This reaction involves exacerbation of old lesions leading to the erythematous appearance. Type 2 reaction or erythema nodosum leprosum (ENL) is associated with humoral immunity. It is characterized by systemic symptoms along with new erythematous subcutaneous nodules

Activity Criteria in Behçet’s Disease

Behçet’s disease is a complex disease characterized by remission and activation periods of unknown duration. It has an unpredictable course. Behçet’s disease shows a heterogeneous pattern of organ involvement that occurs in recurrent episodes of acute inflammation throughout the course of the disease. Disease activity in Behçet’s disease is difficult to define because of its fluctuating course, lack of laboratory tests reflecting overall disease activity, absence of a standardized form to report the severity of Behcet’s disease manifestations and also trying to develop new diagnostic criteria. This led to the development of standardized disease activity index. To be useful, a measurement of disease activity must be valid, reliable, and simple enough to use in routine clinical practice. We will try to explain what the situation is in terms of Behçet’s disease activity index

The Protective Effects of a Combination of an Arginine Silicate Complex and Magnesium Biotinate Against UV-Induced Skin Damage in Rats

The purpose of this study was to observe the effects of a novel combination of inositol-stabilized arginine silicate complex (ASI) and magnesium biotinate (MgB) on the prevention of skin damage after UVB exposure in rats. Forty-nine Sprague-Dawley rats were randomized into one of the following groups: (1) NC, normal control, (2) SC, shaved control, (3) UVB (exposed to UVB radiation), (4) ASI+MgB-L (Low Dose), (5) ASI+MgB-H (High Dose), (6) ASI+MgB-L+MgB cream, (7) ASI+MgB-H+MgB cream. The results showed that ASI+MgB treatment alleviated the macroscopic and histopathological damages in the skin of rats caused by UVB exposure. Skin elasticity evaluation showed a similar trend. ASI+MgB increased serum Mg, Fe, Zn, Cu, Si, biotin, and arginine concentrations and skin hydroxyproline and biotinidase levels while decreasing skin elastase activity (p < 0.05) and malondialdehyde (MDA) concentration (p < 0.001). Moreover, ASI+MgB treatment increased skin levels of biotin-dependent carboxylases (ACC1, ACC2, PC, PCC, MCC) and decreased mammalian target of rapamycin (mTOR) pathways and matrix metalloproteinase protein levels by the regulation of the activator protein 1 (AP-1), and mitogen activated protein kinases (MAPKs) signaling pathways. In addition, ASI+MgB caused lower levels of inflammatory factors, including TNF-α, NFκB, IL-6, IL-8, and COX-2 in the skin samples (p < 0.05). The levels of Bax and caspase-3 were increased, while anti-apoptotic protein Bcl-2 was decreased by UVB exposure, which was reversed by ASI+MgB treatment. These results show that treatment with ASI and MgB protects against skin damage by improving skin appearance, elasticity, inflammation, apoptosis, and overall health

A CASE WITH POSTCHEMOTHERAPY ERUPTIVE COMPOUND NEVUS

An 8-year-old male patient who had been diagnosed as acute lymphoblastic leukemia (ALL) 4 years ago and received 120 cures of chemotherapy presented at our clinic complaining of spots on his body 3 months after the end of chemotherapy. Anamnesis of the patient revealed that the lesions started 3 months after the last cure of chemotherapy on the abdomen and spread throughout the body. It was learnt that the number of spots increased very rapidly in a period of 2 months, and exceeded 100. A dermatological examination of the patient showed 142 hyperpigmented macules, the largest of which was 1 cm × 1 cm and the smallest was 0.2 cm × 0.2 cm in size, diffusely scattered to the skin and oral mucosa. When the biopsy material taken from the lesions was histopathologically examined, nest structures composed of nevus cells with oval nuclei and eosinophilic cytoplasm starting from the dermoepidermal junction and extending toward the lower epidermis were observed and found to be consistent with the compound nevus. We present this rare case who was diagnosed as “eruptive compound nevus” on the basis of clinical signs, ALL diagnosis, chemotherapy history and histopathologic evaluation

Localized Palmar-Plantar Epidermal Hyperplasia Associated with Use of Sorafenib

A 45-year-old man receiving oral sorafenib 400 mg twice daily for metastatic renal cell carcinoma developed pain and rash on his hands and feet 3 weeks after commencement of treatment. Dermatological examination revealed hyperkeratotic plaques surrounded by erythema and with a callus-like brownish-yellow appearance centrally, together with bullae with purulent content under the plaques. Histopathological examination revealed intense hyperkeratosis in the upper part of the epidermis and parakeratosis beneath the epidermis. The integrity of the epidermis was therefore compromised and intense neutrophilic infiltration was seen. The patient was diagnosed on clinical and histopathological grounds as having localized palmar-plantar hyperplasia associated with use of sorafenib, representing the second case reported in the literature. The patient's skin lesions improved markedly after the sorafenib dose was decreased to 200 mg twice daily, a regimen that he continues to take. In the authors' opinion, use of the term localized palmar-plantar hyperplasia, as diagnosed in this patient, is more appropriate in this clinical setting than related terms such as palmoplantar erythrodysaesthesia or hand-foot syndrome

Four-site skinfolds and body fat percentage references in 6-to-17-year old Turkish children and adolescents

Objective: As skinfolds from four-sites (triceps, biceps, subscapular, suprailiac) and body fat percentage in 6-17 years is lacking in Turkey. This study was undertaken to produce references for four-site skinfolds and body fat percentage in children and adolescents