Dermoscopic diagnosis of subungual hematoma: New observations

Introduction: There are very few studies focusing on the dermoscopic features of subungual hematoma which is one of the major imitators of subungual melanoma. Aim: To identify the dermoscopic findings of subungual hematoma, which will facilitate the diagnostic process by reducing the use of more invasive diagnostic methods like nail avulsion or biopsy. Material and methods: In this study, clinical and dermoscopic findings of the cases were reviewed. The diagnosis of subungual hematoma was confirmed by observing progression of the colour change to the distal edge of the nail plate in all the cases. Results: A total of 47 subungual hematomas were enrolled in the study. The most common colour was purple-black (53%). Blue-white colour was observed in 12 (26%) lesions. 9 (19%) lesions showed granular leukonychia. All of the lesions had a homogenous pattern. In 25 (53%) lesions, a globular pattern was observed. 14 (30%) lesions showed a streaks pattern. Peripheral fading and periungual haemorrhage were present in 14 (30%) and 9 (9%) lesions, respectively. Conclusions: We detected two new findings which have not been described previously for subungual hematoma: the first one is "blue-white colour" which is known as an important clue to melanoma. The second one is granular leukonychia localized on the hematoma. We suggest that in any case of the nail discoloration, a thorough dermoscopic examination should be performed. Moreover, progression of the colour change to the distal edge should be observed to ensure that a possible melanoma is not overlooked. © 2020 Termedia Publishing House Ltd.. All rights reserved

The potential role of human HIV-1 TAT-Interactive Protein 2 levels in the pathogenesis of contact dermatitis

Background/aim: Human HIV-1 TAT interactive protein 2 (HTATIP2/TIP30) is a gene that is extensively expressed in human tissues as well as in tumor tissues. This study aimed to explore the potential role of HTATIP2/TIP30 in contact dermatitis (CD), which is one of the most common inflammatory cutaneous conditions. Materials and methods: This cross-sectional study involved adult patients with acute contact dermatitis who were admitted to the outpatient dermatology clinic of a tertiary hospital and healthy adult volunteers without any cutaneous or systemic diseases. The blood concentration of HTATIP2/TIP30 was measured using ELISA kits. Results: The research sample consisted of 31 patients with CD (18 males, 13 females) and 20 healthy control subjects (14 males, 6 females). The mean ages of the patients with CD and healthy volunteers were 37 and 30 years, respectively (p > 0.05). The mean value of serum HTATIP2/TIP30 levels in patients with CD was 1.65 ng ml–1, which is 0.60 ng ml–1 in the control group (p = 0.02) Conclusion: In this study, serum levels of HTATIP2/TIP30 were statistically significantly higher in patients with CD when compared to healthy controls. This outcome may indicate possible role of HTATIP2/TIP30 in the pathogenesis of CD. © TÜBİTAK

Vitamin B12: An underestimated cause of acneiform drug eruption

Dear Editor,Acneiform drug eruption is a type of adverse drug reaction character-ized by monomorphic papulopustular lesions. There are a limited num-ber of studies focusing on vitamin B12-induced acneiform eruption(BIAE) in the relevant literature.1,2In this study, we retrospectivelyanalyzed the clinical characteristics of BIAE in a consecutive series of32 patients who were admitted to the dermatology departments ofAhi Evran University and Kozan State Hospital over the last 3 years.Collected demographic and clinical data for each patient included age,sex, history of medication, previous experience with vitamin B12,symptoms, morphology, distribution and duration of the eruption, andthe treatment used. Causality assessment between vitamin B12intakeand BIAE was mainly based on the diagnostic criteria for drug reac-tions that have been originally proposed by Naranjo et al3For theselection of the 32 patients, the inclusion criteria were as follows..

Clinical, Demographic and Treatment Characteristics of Pediatric Psoriasis: A Multicenter Study of 150 Patients

BACKGROUND/AIMS: Many studies have focused on the epidemiological features of adult and childhood psoriasis. However, only a few studies have been conducted to demonstrate the clinical and demographic characteristics of pediatric psoriasis in Turkey. This study aimed to determine clinical, demographic, and treatment characteristics of childhood psoriasis in a multicenter series.MATERIALS and METHODS: This study was conducted in four different centers that are located in four cities of Turkey between June 2016 and June 2020. The demographic parameters, possible triggering factors (emotional stress, physical trauma, infection, and medication), and clinical characteristics (psoriasis type, psoriasis area severity index, involved areas, nail involvement, joint involvement, subjective symptoms, disease duration, last treatments and duration of use, and history of accompanying diseases) of pediatric patients with psoriasis were retrospectively analyzed.RESULTS: A total of 150 patients from four different centers were enrolled in the study, of whom 71 (47.30%) were males and 79 (52.70%) were females, with a mean age of 13.71 +/- 42 years (age range: 1-18 years). A family history of psoriasis was determined in 20 (13.33%) patients. Possible triggering factors included emotional stress (n=90, 60%), physical trauma (n=21, 14%), infection (n=14, 9.33%), and medication (n=1, 1.67%). The most common area of involvement was the trunk (n=69, 46%) followed by the scalp (n=42, 28%), hand (n=20, 13.33%), and face (n=19, 12.67%). The prevalence of clinical types was as follows: plaque (n=125,83.33%), guttate (n=10, 6.67%), palmoplantar (n=7, 4.67%), inverse (n=6, 4%), and pustular (n=2, 1.33%) psoriasis. Nail and joint involvement were observed in 30 (20%) and 15 (10%) patients, respectively. The last treatments received included topical treatment (n=101, 67.33%), phototherapy (n=23, 15.33%), acitretin (n=16,10.67%), methotrexate (n=9, 6%), and cyclosporine (n=1, 0.67%).CONCLUSION: In our cohort, the clinical types and treatments used for childhood psoriasis were similar to those of other studies, but the rate of family history was lower, whereas the incidence of emotional stress was higher. Addressing the psychological impacts of psoriasis along with its physical aspects may provide better treatment outcomes

Dermoscopic profile of pigmented purpuric dermatosis: New observations

Introduction: Pigmented purpuric dermatosis (PPD) describes a cutaneous eruption that presents with asymptomatic or pruritic macules, and petechiae with red and brown pigmentation. Dermoscopy is a non-invasive diagnostic method making a more detailed examination possible and provides important clues to many dermatologic conditions. There are few original studies focusing on the dermoscopic aspect of PPD apart from case reports. Aim: To identify dermoscopic findings of pigmented purpuric dermatosis, which will facilitate diagnosis by reducing the use of invasive procedures. Material and methods: The study included the patients with histopathologically confirmed pigmented purpuric dermatosis. Demographic, clinical and dermoscopic features of all the cases were retrospectively reviewed. Results: The study enrolled 15 (60%) men and 10 (40%) women. The mean age of the patients was 42 (age range: 28–72). The most common dermoscopic findings were red globules and red dots which were observed in all the cases (100%), followed by coppery brown background (72%), brown lines reticular (40%) and subtle brown dots (40%). The other findings were brown circles (32%), red circles (32%), grey dots (32%), red background (8%), serpentine vessels (8%), rosette structures (8%), thick brown lines (4%), and thick linear vessels (4%). Conclusions: The characteristic dermoscopic findings of PPD have been defined in the relevant literature. Here we have identified some dermoscopic findings which have not been described previously: red circles, brown circles, rosette structures, light brown background and red background. Dermoscopic examination may facilitate the diagnostic process by reducing the use of invasive methods. © 2019 Termedia Publishing House Ltd.. All rights reserve

Investigation of oxidant and antioxidant levels in patients with psoriasis

WOS: 000480360000017PubMed ID: 31269785Background/aim: Psoriasis is an immune-mediated chronic inflammatory skin disease that is seen in 1%-3% of the population. It is characterized by symmetrical papulosquamous lesions on the scalp, knees, elbows, sacral region, and extensor surfaces of the extremities. Psoriasis affects both sexes equally. It is thought that reactive oxygen species have an important role in inflammatory skin diseases, especially in psoriasis. There are few studies investigating serum oxidant-antioxidant levels in psoriasis. In this study, we aimed to investigate serum oxidant and antioxidant levels in psoriasis and their effects on its pathogenesis. Materials and methods: Included in this study were 50 patients with psoriasis who had not been treated with any systemic medication and 45 healthy volunteers (control group). The total oxidant status (TOS), total antioxidant status (TAS), malondialdehyde (MDA), and 8-hydroxy 2'-deoxyguanosine (8H2D) were studied via venous blood sampling. The parameters were measured spectrophotometrically. The study was approved by the Local Ethics Committee of the Ataturk University Faculty of Medicine. Results: The mean ages of the patients and control group were 32.48 (+/- 14.45) and 35.64 (+/- 17.40) years, respectively. Of the patients, 23 were male and 27 were female. Of the healthy volunteers, 20 were male and 25 were female. The mean disease duration was 8.77 (+/- 6.90) years. The mean Psoriasis Area and Severity Index (PASI) score was 11.41 (+/- 9.62). The mean TOS levels of the patient and control groups were 63.12 (+/- 33.23) and 4.50 (+/- 9.74), respectively. This difference was statistically significant (P = 0.00). The mean TAS levels of the patient and control groups were 3.15 (+/- 0.70) and 3.16 (+/- 0.44), respectively, without any statistically significant difference. The mean MDA levels in the patient and control groups were 14.84 (+/- 6.66) and 12.77 (+/- 4.87), respectively, without any statistically significant difference. The mean 8H2D levels of the patient and control groups were 16,781.2 (+/- 5918.95) and 15,276.13 (+/- 6084.95), respectively. This difference was also not statistically significant. There was no correlation between PASI scores and the above-mentioned parameters. Conclusion: In the present study, the TOS levels showed a significant statistical difference between the psoriasis and control groups. This finding supports the effect of the oxidant system in the pathogenesis of psoriasis. This was the first study to investigate MDA, TOS, TAS, and 8H2D levels together in patients with psoriasis. More studies are needed to clearly understand the relationship between psoriasis and the oxidant-antioxidant system

Demodex prevalence in mine, textile and food factory workers with dermatosis: a cross-sectional, multicenter study

Demodex, a type of mite, lives in human hair follicles. They can multiply very quickly in some conditions and then start to irritate the skin by causing skin disorders. This study aims to investigate if working environment conditions affect the prevalence of Demodex. A cross-sectional, multicenter study was conducted with three different occupational groups: mine, textile and food factory workers (n = 102). Determined industry workers who applied to our outpatient dermatology clinics with the complaint of dermatosis in three different cities were included in the study. Demodex positivity was checked by dermoscopy. Differences between categorical variables examined with Chi-square analysis and T test was used to compare continuous variables between groups. 50% Demodex positivity was found in mine workers, 45.3% in food factory workers and 66.7% in textile manufacturing workers. A high rate of Demodex positivity was observed in all three occupational groups. Although the highest positivity rate was observed in textile manufacturing workers, no significant difference was found between the groups (p = 0.320). The overall prevalence of Demodex in female workers was statistically significantly higher than in male workers (p = 0.029). Exposure of workers to a wide variety of factors in work environments such as textile factories and the fact that women are more sensitive to external factors may have caused the prevalence of Demodex to be higher in these groups. So, a change in the work environment or the use of suitable protective equipment may benefit the treatment of diseases caused by Demodex. But, further studies are needed with larger and various industry groups to make more certain views