Successful treatment of generalised discoid lupus erythematosus with imiquimod cream 5%: A case report and review of the literature

Discoid lupus erythematosus (DLE) is the most common form of chronic cutaneous lupus erythematosus and tends to heal with scarring, hair loss and pigmentary changes if treatment is not initiated in the early phase of the disease. Classic DLE lesions are initially red-purple macules, papules or small plaques that rapidly acquire a hyperkeratotic appearance. Only a minority of the patients with DLE progress to develop systemic lupus erythematosus (SLE). A small percentage of patients with SLE have concomitant DLE. However, generalised DLE is more frequently associated with systemic involvement than classic DLE. The diagnosis of DLE is usually based on clinical features, although in some cases histopathologic examination may be required to confirm the diagnosis. Standard therapy for cutaneous lupus includes broad-spectrum sunscreens, topical and intralesional glucocorticoids and antimalarial agents. A 63-year-old man presented with erythematous scaly patches that he had had on his face for approximately eight months. Although it was mainly his face that was affected, lesions were also noted on his scalp, neck, chest, shoulder, upper arms and trunk. Histopathologic examination verified the diagnosis of DLE. No systemic involvement was detected through laboratory examinations or consultations with the other departments. Imiquimod cream 5% was applied three times a week, every other week. After 24 applications over a period of two months an almost complete improvement was achieved. Topical imiquimod may, then, be an alternative treatment for generalised DLE

Nicolau syndrome following intramuscular injection of oxytocin in pregnant women: report of two cases

Nicolau syndrome, also known as embolia cutis medicamentosa, is a well known but very rare complication occuring after intramuscular drug injections and presenting with local intense pain. Immediately after injection the skin blanches and within minutes to hours an erythematous macule develops, which evolves into a livedoid violaceous patch with dendrites. This condition is initially hemorrhagic, then it ulcerates, and eventually heals with an atrophic scar. Many different drugs have been reported to cause Nicolau syndrome . To date there have been no reports of Nicolau syndrome caused by intramuscular oxytocin injection. We would like to report two cases that occured after intramuscular injection of oxytocin

Vestibular papillomatosis: An important differential diagnosis of vulvar papillomas

Most authors believe that vestibular papillomatosis (VP) is an anatomical variant of the vestibular mucosa. But VP is sometimes misdiagnosed as genital warts and this can lead to aggressive investigations, therapy, and anxiety in patients. We present a patient with VP. Dermoscopy and reflectance confocal microscopy (RCM) were performed to differentiate VP from other papilomatous diseases of the vulva

Vestibular papillomatosis: An important differential diagnosis of vulvar papillomas

Most authors believe that vestibular papillomatosis (VP) is an anatomical variant of the vestibular mucosa. But VP is sometimes misdiagnosed as genital warts and this can lead to aggressive investigations, therapy, and anxiety in patients. We present a patient with VP. Dermoscopy and reflectance confocal microscopy (RCM) were performed to differentiate VP from other papilomatous diseases of the vulva

Evaluation of neutrophil-lymphocyte ratio in patients with early-stage mycosis fungoides

Neutrophil-lymphocyte ratio (NLR), an indicator of inflammation, has been lately demonstrated as a prognostic factor and an indicator of disease activity in various diseases. However, the effects of NLR have not been investigated in mycosis fungoides (MF) patients yet. The aim of this study is to investigate the relationship between the NLR and treatment demand (systemic PUVA and/or chemotherapy), time to treatment, progression in stage, and time to progression in stage in MF patients. The data of 117 patients, who were followed with the diagnosis of MF at the Department of Dermatology in Istanbul Training and Research Hospital between April 2006 and January 2016, were analyzed retrospectively. The cutoff score for NLR was determined as 2 according to the median NLR level which was 1.96. At the time of diagnosis, the median age of patients was 54 years (range, 21-90) with 62 (53 %) female and 55 (47 %) male. Seventy-seven (65.8 %) patients required treatment during follow-up. Sixty-three (53.8 %) patients showed progression in disease stage. There was no significant difference in treatment demand, time to treatment, progression in stage, and time to progression in stage in patients with a NLR >= 2 and NLR< 2 (p = 0.331, 0.987, 0.065, and 0.119, respectively). It seems that there is no association between the NLR and treatment demand, time to treatment, progression in stage, and time to progression in stage in MF patients

In vivo reflectance confocal microscopy terminology in the Turkish language

In vivo reflectance confocal microscopy (RCM) is a diagnostic method to examine a skin lesion at the cellular level in vivo without biopsy. It provides non-invasive, high resolution imaging for diagnosis and follow-up of malignant, benign skin tumors and inflammatory dermatologic diseases, and its use is spreading worldwide. Standard terminology which has been used in RCM was described earlier in the English language. This study aimed to propose a Turkish terminology for RCM to allow Turkish-speaking dermatologists to communicate in a homogeneous language and familiarize themselves with the terminology of this new diagnostic technic. Six Turkish-speaking dermatologists with RCM experience participated in the study. RCM terminology used in English was determined and translated into Turkish. Turkish terms and their definitions were reviewed by each participant and the consensus was provided in the group. Finally, philology department examined the last version of the terms and the study was finalized. The terms, definitions and the translations of the terms have been identified, and the Turkish RCM terminology has been created and shown. Turkish RCM terminology will provide Turkish-speaking dermatologists to describe their findings in a homogenous language