Is There Any Association between Hepatitis G Virus (HGV), Other Hepatitis Viruses (HBV, HCV) and Behçet's Disease?

Infectious agents, especially viruses, have been implicated in the pathogenesis of Behçet's disease (BD). The aim of this study was to determine whether BD is associated with hepatitis viruses. In this study, the serological markers of hepatitis (HBsAg, anti-HBs, anti-HBc and anti-HCV) and viral nucleic acid (HGV-RNA) were studied in the sera of 35 patients, all of whom fulfilled the diagnostic criteria of the International Study Group for BD, and the results were compared with those of 36 healthy controls. The prevalences of HBsAg, anti-HBs, anti-HBc in BD patients were 2.9%, 45.7%, and 31.4%, respectively, which were not significantly different from those in healthy controls. None of the subjects in either group were found to be positive for anti-HCV. HGV-RNA was detected in two patients with BD and in none of the healthy controls. In conclusion, BD does not seem to be associated with hepatitis viral infections including hepatitis B, C, or G.

Effects of Calcipotriol Cream and Ointment, Clobetasol Cream and Ointment and Tretinoin Cream on the Erythemogenicity of UVB

Various studies have shown the blocking effects of topical agents on UVB penetration, which can be used in combination with phototherapy. In this study, the photoprotective effects of 0.005% calcipotriol, 0.05% clobetasol-17-propionate, and 0.1% tretinoin, which can be used in combination with broad-band UVB, were investigated in an in vivo test. In a study group of 20 patients, phototests were performed to determine minimal erythema doses (MED) and the tests were repeated with thin (0.1 cc/25 cm2) and thick (0.3 cc/25 cm2) calcipotriol, clobetasol-17-propionate, and tretinoin in cream forms and sunscreen. After determining the MED, the test was repeated in another 20 patients with thin and thick calcipotriol and clobetasol-17-propionate in both cream and ointment forms and sunscreen. MED was increased with thin and thick applications of all agents. Moreover, the photoprotective effects of each agent increased with their thick applications compared with thin ones. The application of calcipotriol cream and ointment, clobetasol cream and ointment, and tretinoin cream, all of which can block UVB, is not recommended just before phototherapy.

Erythema multiforme-like eruption localized to a sun-exposed area

We report on a 35-year-old woman with cutaneous lesions characterized by an erythema multiforme-like appearance localized in the photo-distributed pattern. She had no history of systemic drug ingestion, herpes simplex virus or any other infection, possible causes of erythema multiforme, before the sun exposure. She had normal tolerance to a phototest, but photoprovocation tests could not be performed because she did not agree to them. This case was diagnosed to be an erythema multiforme-like variant of a polymorphous light eruption; the differential diagnosis of target-like lesions in a photo-distributed pattern is discussed.

Papular acantholytic dyskeratosis of the anogenital area with positive direct immunofluorescence results

Acantholytic dyskeratosis is a distinct histological pattern characterized by hyperkeratotic and parakeratotic epidermis with intraepidermal clefts harbouring acantholytic and dyskeratotic keratinocytes. This histopathological pattern is uncommon in dermatoses of the anogenital region. We report a 30-year-old woman who had numerous smooth whitish papules on the labia majora, perineum and perianal region, which coalesced into plaques in some areas. Microscopically, the lesions showed prominent suprabasal and intraspinous acantholysis with dyskeratotic keratinocytes. Direct immunofluorescence examination revealed intercellular Ig G and C(3) within the epidermis. We were unable to find a similar case of papular acantholytic dyskeratosis of the anogenital area with positive direct immunofluorescence findings reported in the literature, thus in this report, the clinicopathological features of a unique case are presented.

Naproxen-induced lichen planus: report of 55 cases

BACKGROUND

Clinical and histopathological differential diagnosis is usually impossible in drug-induced lichen planus (LP) and idiopathic LP. Naproxen is a nonsteroidal anti-inflammatory drug, which is widely used for its analgesic, antipyretic and anti-inflammatory effects. To the best of our knowledge, two case reports on naproxen-induced LP have been reported.

METHODS

Fifty-five patients with LP, and a history of naproxen intake before their eruption, were investigated.

RESULTS

Twenty-five patients (45.5%) had a history of naproxen intake prior to their eruption without any other medication. Twelve patients (21.8%) had a history of simultaneous use of naproxen with other drugs that were reported as inducers of LP. Eighteen patients (32.7%) had given a history of using naproxen together with drugs that had not been previously reported as inducers of LP. Moreover, in 42 patients, eruptive-type LP development after naproxen intake, is an interesting observation. New lesions were not observed after the cessation of naproxen intake in any of the patients.

CONCLUSION

Naproxen might be accepted as an important inducer for LP, especially for the eruptive form.

Effects of some emollients on the transmission of ultraviolet

BACKGROUND/PURPOSE

Various topical agents which can be used in combination with phototherapy may have blocking or enhancing effects. In this in vivo study, the effects of topical petrolatum, basis cream, glycerine and olive oil on the transmission of ultraviolet B (UVB) were investigated.

METHODS

A phototest was performed to determine the minimal erythema dose (MED) on 32 volunteers and the test was repeated with white petrolatum, basis cream, glycerine, olive oil and sunscreen (0.3 cm3/25 cm2). The effects of each agent on MED was determined after 24 h.

RESULTS

MEDs were increased with the application of white petrolatum and basis cream. However, MEDs were not changed with the application of glycerine and olive oil.

CONCLUSION

The application of white petrolatum and basis cream, which have blocking effects, immediately before UVB therapy is not recommended. However, glycerine and olive oil, which does not have any effect, can be used before phototherapy.

Peeling skin syndrome

Peeling skin syndrome is a rare disease characterized by widespread painless peeling of the skin. To date, several cases have been described with different clinical features called peeling skin syndrome. Previous reports describe two types (type A and type B) of peeling skin syndrome, both of which show generalized desquamation, sparing palms and soles. We report a 23-year old man who has been classified as neither type A nor type B, and whose history, clinical features and histopathological findings led to a diagnosis of peeling skin syndrome. In addition, the desquamation pattern in our patient was different from that of both types because our case's palms and soles were involved too.

Angioma serpiginosum: Dermoscopy for diagnosis, pulsed dye laser for treatment

Angioma serpiginosum is a rare benign vascular disorder, characterized clinically by multiple minute, red to purple, grouped macules in serpiginous and gyrate patterns and histopathologically by ectatic dilatation of capillaries. Patients can undergo unnecessary hematological tests, because the condition can be confused with chronic purpuric dermatoses. An 18-year-old man with angioma serpiginosum of his left arm was evaluated by dermoscopy and treated with pulsed dye laser. Numerous small, relatively well-demarcated, round to oval red lagoons were determined with dermoscopy, and approximately 75% of the area of his lesion disappeared after four sessions of pulsed dye laser. Our case supports the hypothesis that dermoscopy is beneficial in the diagnosis of angioma serpiginosum and that pulsed dye laser is effective in the treatment of this disorder.

Effects of topical petrolatum and salicylic acid upon skin photoreaction to UVA

Various agents which can be used in combination can also interfere with phototherapy. In this study, the effects of topical petrolatum and 20% salicylic acid in petrolatum upon skin photoreaction to UVA were investigated, in an in vivo test. Minimal phototoxic dose (MPD) test was performed on 31 volunteers and the test was repeated with thin (0.1 cc/25 cm(2)) petrolatum, thick (0.3 cc/25 cm(2)) petrolatum, thin 20% salicylic acid in petrolatum, thick 20% salicylic acid in petrolatum and sunscreen. The effect of each agent on MPD was investigated. MPD was increased with thin and thick applications of all agents. Also, MPD was increased with 20% salicylic acid in petrolatum when compared with pure petrolatum, in the same thickness. The application of petrolatum and salicylic acid in petrolatum just before PUVA therapy is not recommended because of their blocking effects.

A comparison of dermoscopic features among lentigo senilis/initial seborrheic keratosis, seborrheic keratosis, lentigo maligna and lentigo maligna melanoma on the face

Clinical differentiation of facial lentigo senilis/initial seborrheic keratosis (LS/ISK), seborrheic keratosis (SK), lentigo maligna (LM), and lentigo maligna melanoma (LMM) can be difficult. Dermoscopy improves the diagnoses in pigmented skin lesions (PSLs), but it is not helpful for the sun-exposed face because of the flat rete ridges without network-derived features. Therefore, development of new diagnostic criteria for this particular localization is a current issue of dermatology. In this retrospective study, dermoscopic slides of facial pigmented skin lesions of 66 patients referred to two clinics in Turkey were evaluated. Our aim was to determine the reliability of dermoscopy in the differentiation of these entities. The facial PSLs of 66 patients (34 males and 32 females) (median age: 58.2) were photographed with a Dermaphot (Heine, Hersching, Germany) over a five year period from November of 1995 to May of 2000. All of the dermoscopic slides were analysed according to 27 dermoscopic criteria developed by Schiffner et al. This data set contained 22 histologically proven malignant (14 LM, 8 early LMM) and 44 benign (18 SK, 26 LS/ISK) PSLs. In general, asymmetric pigmented follicular openings, dark streaks, slate-gray streaks, dark globules, slate-gray globules, dark dots, dark rhomboidal structures, light brown rhomboidal structures, dark homogeneous areas and dark pseudonetworks were statistically significant for malignant growth. On the other hand, milia-like cysts, pseudofollicular openings, cerebriform structures, light brown globules, light brown dots, light brown homogeneous areas, yellow opaque homogeneous areas, and light brown pseudonetworks were statistically significant for benign growth. This research emphasizes that dermoscopic features on the face differ from criteria used in other locations of the body. Analysis of the data suggests that dermoscopy can be used in the differentiation of LS/ISK, SK, LM and LMM from each other.

Bullous appearance of pilomatricoma

BACKGROUND

Pilomatricomas, which are usually solitary, firm to hard tumors that are covered by normal skin, rarely show a bullous appearance.

OBJECTIVE

To discuss, through a case report, the clinical and histopathologic characteristics of bullous pilomatricomas.

METHODS

A 15-year-old boy presented with a firm, well-defined tumor on his right arm that showed dark-blue discoloration and bullous formation over it.

RESULTS

Excisional biopsy was performed, and histopathologic examination confirmed the diagnosis of bullous pilomatricoma.

CONCLUSION

The presence of dilated lymphatics, also seen in our patient, is a common feature of bullous pilomatricomas.

Effects of topical petrolatum and salicylic acid on the erythemogenicity of UVB

Various topical agents used in combination with phototherapy have blocking effects, however in contrast to in vitro studies there were not enough in vivo studies about this subject. Our purpose was to examine the photoprotective effects of white petrolatum and salicylic acid which can be used before UVB therapy in psoriasis patients. In 35 volunteers, a phototest was performed to determine the minimal erythema dose (MED) and the test was repeated with thin (0.1 cc/25 cm2) and thick (0.3 cc/25 cm2) petrolatum, thin and thick salicylic acid (20%) in petrolatum and sunscreen. After 24 hrs, the effects of each agent on MED was investigated. MED values detected after pure UVB and after application of topical agents were compared one by one, and the differences between all of them have been found statistically significant. These showed that MED values were increased by thin or thick petrolatum and also by thin and thick salicylic acid (20%) in petrolatum. The highest MED values were detected with thick salicylic acid in petrolatum followed by thin salicylic acid in petrolatum, thick petrolatum and thin petrolatum. The application of petrolatum and salicylic acid, which can block UVB, before phototherapy is not recommended.

Lack of TP53 mutations in a case of porokeratosis palmaris, plantaris et disseminata

A 73-year-old man with porokeratosis palmaris, plantaris et disseminata is presented. He had punctate, guttate and annular hyperkeratotic papular lesions widespread on his body with thorn-like hyperkeratosis on the palms and soles. Lesional skin did not show mutations of TP53 exons 5-6, 7, 8.

Anetoderma secondary to generalized granuloma annulare

Anetoderma is a rare disorder of cutaneous atrophy with loss of dermal elastic tissue. Secondary anetoderma is seen after a variety of dermatoses. We describe a 33-year-old woman with secondary anetoderma after generalized granuloma annulare lesions that were most pronounced on sun-exposed areas.

Helicobacter pylori and Behçet's disease

BACKGROUND

Recent investigation of the etiology of Behçet's disease (BD) has focused on heat shock proteins (HSP) which belong to the HSP 60 family. Both the gastric pathogen Helicobacter pylori (HP) and BD may cause ulcers in the gastrointestinal tract and, HP expresses HSP 60.

OBJECTIVE

Whether HP is linked to the pathogenesis of BD or not, and to investigate the influence of HP eradication on clinical parameters of BD.

METHODS

Patients with BD were divided into two groups. Group I comprised 49 patients and was investigated for HP seroprevalence and compared with age- and sex-matched controls. Group II comprised 20 patients with BD and HP infection diagnosed by serological and endoscopic examinations as well as the rapid urease test (RUT). A 1-week eradication therapy was administered for HP infection. Patients were examined for the course of BD at monthly intervals. Two months after the eradication therapy, patients underwent an endoscopic examination and RUT for eradication control. Seven patients were excluded because of eradication failure. Thirteen patients were evaluated for the influence of HP eradication on clinical manifestations of BD. The number and size of oral and genital ulcers before the eradication and at the end of the follow-up period were compared statistically.

RESULTS

HP seroprevalence between patients with BD and controls did not show significant difference. In 13 patients with BD, the number and size of oral and genital ulcers diminished significantly and various clinical manifestations regressed after the eradication of HP.

CONCLUSION

HP may be involved in the pathogenesis of BD.

A case of Hutchinson-Gilford progeria syndrome mimicking scleredema in early infancy

We report a case of Hutchinson-Gilford progeria syndrome (HGPS). The patient showed the characteristics of scleredema at the age of 2.5 months but developed all the manifestations of HGPS gradually until 10 months old. The possibility of development of HGPS should by considered in any case of scleredema at birth or in early infancy.