A. Tülin Güleç

Treatment of keloids and hypertrophic scars with dermojet injections of bleomycin: a preliminary study

Background  Numerous treatment modalities have been used to treat keloids and hypertrophic scars, but the optimal treatment has not been established.

Superficial fungal infections in 102 renal transplant recipients: a case-control study

BACKGROUND Renal transplant recipients are predisposed to superficial fungal infections caused by graft-preserving immunosuppressive therapy. Reports have documented a wide range of prevalence rates for superficial fungal infections in this patient group. OBJECTIVE The aim of this study was to determine the prevalence and clinical and mycological features of superficial fungal infections in renal transplant recipients at our center. METHODS One hundred two consecutively registered renal transplant recipients (34 women, 68 men) and 88 healthy age- and sex-matched persons acting as controls (30 women, 58 men) underwent screening for the presence of superficial fungal infection. Skin scrapings and swabs were obtained from the dorsum of the tongue, upper part of the back, toe webs, and any suspicious lesions. Nail clippings were also collected. All samples were examined by direct microscopy and were stained with calcofluor white. The samples were cultured in Sabouraud dextrose agar, mycobiotic agar, and dermatophyte test medium. Candida species were identified on the basis of germ-tube production, spore formation in cornmeal agar, and results of biochemical testing. Dermatophytes were identified on the basis of colonial and microscopic morphologic features in conjunction with results of physiologic evaluation (in vitro hair perforation test, urease activity, temperature tolerance test, and nutritional test). RESULTS Sixty-five (63.7%) of the 102 renal transplant recipients had cutaneous-oral candidiasis, dermatophytosis, or pityriasis versicolor, whereas only 27 (30.7%) of controls had fungal infection. Pityriasis versicolor was the most common fungal infection in the patient group (36.3%), followed by cutaneous-oral candidiasis (25.5%), onychomycosis (12.7%), and fungal toe-web infection (11.8%). Pityriasis versicolor and oral candidiasis were significantly more common among the renal transplant recipients, whereas the frequency of dermatophytosis in patients and controls was similar. Candida albicans was the main agent responsible for oral candidiasis, and Trichophyton rubrum was the most common dermatophyte isolated. Analysis showed that age, sex, and duration of immunosuppression did not significantly affect the prevalence of superficial fungal infection. Cyclosporine treatment and azathioprine therapy were identified as independent risk factors for superficial fungal disease. CONCLUSIONS The prevalence of opportunistic infections with Pityrosporum ovale and C albicans is increased among renal transplant recipients, probably owing to the immunosuppressed state of this patient population. However, renal transplant recipients are not at increased risk of dermatophytosis.

The role of psychological factors in alopecia areata and the impact of the disease on the quality of life

Background  The role of psychological factors in the pathogenesis of alopecia areata (AA) has long been the subject of debate. Numerous studies have provided controversial results.

Treatment of cellulite with LPG endermologie

BACKGROUND LPG endermologie is a FDA-approved massage system in use worldwide for cellulite treatment that lacks clinical study. OBJECTIVE To determine the efficacy and safety of LPG endermologie in treating cellulite. METHODS Thirty-three healthy women (cellulite grades, 1-3 based on the 4-stage Nurnberger-Muller scale) had LPG treatments twice weekly for a total of 15 sessions. Clinical evaluation was performed by digital photography for cellulite grade assessment, and perimetric measurements of eight body sites for the evaluation of body contours. RESULTS Significant differences were found regarding mean cellulite grades before and after treatment. However, improved cellulite appearance occurred in only 5 women (15%). All patients showed a significant circumference loss at every measured body site. Weight losers had significantly greater loss of total and average body circumference than weight gainers. Limitations Relatively small sample size and lack of more-objective methods for assessing treatment success. CONCLUSION LPG endermologie is a well-tolerated and effective method for reducing the diameter of body circumference, however, it is mildly effective in reducing the cellulite grade and so, improving its orange-peel appearance.

Clinical evaluation of alopecias using a handheld dermatoscope

BACKGROUND There are numerous reports of the value of videodermatoscopy in the clinical evaluation of alopecia. Studies performed with a handheld dermatoscope are scarce and limited to a few disease entities. OBJECTIVE The aim of this study was to evaluate the potential benefit of a handheld dermatoscope in the clinical diagnosis of alopecia. METHODS In all, 144 patients with alopecia and 144 age- and sex-matched control subjects were enrolled in the study. Diagnoses were established clinically, and confirmed by scalp biopsy in doubtful cases. Dermatoscopic examination was performed by a polarized-light handheld dermatoscope with a 10-fold magnification. The images were obtained by a digital camera with a 3-fold optical zoom. RESULTS The dermatoscopic patterns of circular hairs, dirty dots, epidermal scale, and pustules showed no statistically significant difference between patients and control subjects. The following features were significantly more common, or observed solely, in particular types of alopecia: hair diameter diversity, peripilar sign, and empty follicles in androgenetic alopecia; yellow dots, black dots, tapering hairs, and broken hairs in alopecia areata; absence of follicular openings, tufted hairs, white dots, follicular hyperkeratosis, pili torti, red dots, honeycomb pigment pattern, pink-white appearance, crusts, and pustules in primary cicatricial alopecias. LIMITATIONS Evaluation of all primary cicatricial alopecias in the same cluster. CONCLUSIONS We suggest that a polarized-light handheld dermatoscope attached to a digital camera provides a practical and useful aid for the clinical diagnosis of alopecias.

Lip and oral mucosal lesions in 100 renal transplant recipients.

BACKGROUND Renal transplant recipients (RTRs) appear to be more susceptible to the development of oral mucosal disease and lip cancer as a result of graft-preserving immunosuppressive therapy. However, reports regarding these pathologies other than lip cancer are scarce and not studied in a detailed manner in this patient population. OBJECTIVE The aim of this study was to determine the prevalence rates and clinical features of lip lesions and oral mucosal lesions (OMLs) in RTRs. METHODS In all, 100 consecutive RTRs (21 female and 79 male) and 79 healthy age- and sex-matched control subjects (23 female and 56 male) were screened for all pathologic and pseudopathologic lip lesions and OMLs, with special interest on precancerous and cancerous lesions. Information about possible associated risk factors such as smoking and alcohol consumption was also obtained. Dermatologic investigation included clinical observation and direct microscopic examination, culture, and histopathological evaluation when indicated. RESULTS One or more lip lesions, OMLs, or both were noted in every participant of both groups. Fordyce spots on the lips was the most common lesion in the patient group (73%), followed by diffuse gingival enlargement (39%), fissured tongue (35%), and oral candidiasis (26%). The last 3 disorders were significantly more common in RTRs, whereas the frequency of Fordyce spots in patients and control subjects was similar. No actinic cheilitis, lip cancer, or oral malignancy was observed. LIMITATIONS This was a relatively small sample size for evaluating precancerous and cancerous lip lesions and OMLs, as they are less frequently observed than benign lesions. CONCLUSIONS Some of the benign OMLs (oral candidiasis and diffuse gingival enlargement) are increased in RTRs mainly as a result of the immunosuppressive therapy or drug side effects. Precancerous or cancerous lesions were not observed on the lips or the oral mucosa of our RTRs. This finding is in direct contrast with those of previous studies, yet this can be related to the limited sample size of this study regarding these lesions.

CD8+ poikilodermatous mycosis fungoides with a nonaggressive clinical behaviour and a good response to psoralen plus ultraviolet A treatment

with a looped cord, amniotic band syndrome, linear and whorled hypomelanosis, linear epidermal naevus and incontinentia pigmenti. Histopathological features have varied, although only three cases have been biopsied. One case revealed postinflammatory hyperpigmentation, while two cases revealed lentiginous melanocytic hyperplasia and basal layer hyperpigmentation, without pigment incontinence. In our original case series describing sock-line hyperpigmentation, we carefully distinguished our five cases from 10 cases in the literature of a similar entity termed ‘acquired raised bands of infancy’. Whereas acquired raised bands of infancy is characterized by skin-coloured, linear, often diagonal plaques involving the arms, trunk, and ⁄or legs (thighs in addition to calves), sock-line hyperpigmentation is characterized by hyperpigmented, horizontal lesions limited to the ankle or calf. In contrast to sock-line hyperpigmentation, acquired raised bands of infancy has been associated with amniotic bands in utero, limb constrictions and limb defects including foreshortened toes and clubfoot, and pregnancy complications such as pre-eclampsia, prematurity and placental abruption. Recently, Marque et al. reported three new patients they diagnosed with acquired raised bands of infancy, who had lesions similar to the lesions of sock-line hyperpigmentation. The authors proposed an acquired posttraumatic pathogenesis based on a close temporal association with wearing socks in two cases, a clinical appearance resembling sock lines in two cases, and dermal infiltrates of adipocytes along vessels and ⁄or eccrine ducts in the two cases that were biopsied (findings similar to those in post-traumatic piezogenic papules of the feet). Although Marque et al. classified these three patients as having raised limb bands, we believe that several of their patients may be better classified as having sock-line hyperpigmentation based on the presence of multiple features not typically found in acquired raised bands of infancy, including horizontal directionality, erythema preceding the appearance of limb bands, hyperpigmentation and the association with socks. Sock-line lesions appear to have a benign course. However, ongoing collection of cases and further follow-up is needed to better characterize the natural history of lesions.

Clinical evaluation of postoperative pressure-induced alopecia using a hand-held dermatoscope.

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Solitary reticulohistiocytoma with arborizing vessels: A new mimicker of basal cell carcinoma

the Department of Dermatology, Baskent University Faculty Medicine. ing sources: None. licts of interest: None declared. int requests: A. T€ ulin G€ uleç, MD, Department of Dermatology, skent University Faculty of Medicine, 5 Sokak, No. 48, Bahçelievler, Ankara 06490, Turkey. E-mail: tulinogulec@ hotmail.com. J Am Acad Dermatol 2016;74:e5-6. 0190-9622/

Acute infantile haemorrhagic oedema: measles vaccination as possible triggering factor.

36.00 a 2015 by the American Academy of Dermatology, Inc. http://dx.doi.org/10.1016/j.jaad.2015.09.018