Canan Gorpelioglu

Serum leptin, atherogenic lipids and glucose levels in patients with skin tags

Aim: To investigate the relationship between serum leptin, atherogenic lipid and glucose levels in patients with skin tags and healthy controls. Materials and Methods: A total of 58 patients, with at least three skin tags, aged 24 to 85 years, and 31 healthy controls aged 30 to 70 years, were examined in the present study. The subjects in all the groups were selected with statistically similar Body Mass Index (BMI). Fasting concentrations of plasma glucose, serum lipids including triglyceride, total cholesterol, and high-density lipoprotein cholesterol (HDL) and low-density lipoprotein cholesterol (LDL), HbA1c, and leptin were measured by enzyme-linked immunosorbent assay (ELISA). In addition, serum LDL level was calculated using Friedewalds formula. Results: There was no significant difference in age, sex, BMI, HbA1c, triglyceride, HDL and leptin levels between the groups. Skin tags group showed significantly higher levels of total cholesterol and LDL, when compared with the healthy controls groups (P < 0.01). In addition, regression analysis showed that leptin level was positively correlated to serum triglyceride level (r = 0.265, P = 0.044). Conclusion: Total cholesterol and LDL serum levels should be controlled in patients with skin tags. On the other hand, glucose, leptin and HbA1c serum levels may not be as important as is being considered in recent times.

A case of follicular mucinosis treated successfully with pimecrolimus

1 Kossard S, Rosen R. Cutaneous Bowen s disease. An analysis of 1001 cases according to age, sex and site. J Am Acad Dermatol 1992; 27: 406–10. 2 Cox NH. Body site distribution of Bowen s disease. B J Dermatol 1994; 130: 714–6. 3 Cox NH, Eedy DJ, Morton CA. Guidelines for management of Bowen s disease: 2006 update. Br J Dermatol 2007; 156: 11–21. 4 Dave R, Monk B, Mahaffey P. Treatment of Bowen s disease with carbon dioxide laser. Lasers Surg Med 2003; 32: 335. 5 Dupree MT, Kiteley RA, Weismantle K et al. Radiation therapy for Bowen s disease: lessons for lesions of the lower extremity. J Am Acad Dermatol 2001; 45: 401–4.

Nail alterations in 250 infant patients: a clinical study.

Aims  To investigate the frequency and the nature of nail alterations in infants.

Faun tail with aplasia cutis congenita and diastematomyelia.

Spinal dysraphism, including dermal sinuses, dermoid cysts, diastematomyelia, fibrous bands, filum terminale, intraspinal lipomas, lipomyelomeningoceles and myelomeningoceles, is a term used to denote various malformations of the midline structures of the back and spine. Among them, diastematomyelia presents an embryological defect that is characterized by the division of the spinal cord or cauda equina into two separate portions [1–3]. Fig. 1. Lumbosacral hypertrichosis, i.e. Faun tail.

Isotretinoin: is there any arrhythmic effect?

Background  Oral isotretinoin is currently the most effective therapy for acne, but is associated with numerous adverse effects. To investigate the cardiac effects of isotretinoin, acne patients receiving isotretinoin for 6 months were studied.

Influence of isotretinoin on nasal mucociliary clearance and lung function in patients with acne vulgaris

Retinoids are widely used to treat acne in patients with underlying systemic diseases. We evaluated the effect of 13‐cis‐retinoic acid (isotretinoin) on nasal mucociliary clearance and pulmonary function tests (PFTs) in patients with severe acne vulgaris. Each side effect was scored using a 4‐point scale. Mucociliary clearance was evaluated by the saccharin test (ST). ST and PFTs were performed on all patients before and during the third month of treatment. A total of 40 acne patients (88% female, mean age 25 ± 7 years) were included. The most common side effects were dryness, chapped lips, and xerosis. Mild epistaxis occurred in 13 patients; only two patients reported bleeding more than 10cc. There was no difference before and during the third month of treatment in forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC ratio, forced expiratory flow rate between 25% and 75% of FVC (FEF25–75), and their predicted percentage ratios. Mean nasal mucociliary clearance time was 12.6 ± 4.1 min before and 15.9 ± 5.7 after treatment (P < 0.001). We found that nasal clearance was significantly prolonged with treatment, and there was significant correlation between drug dose and mucociliary clearance time. Isotretinoin caused signs and symptoms of dry nose and disturbed mucociliary clearance without affecting PFTs. Nasal complications generally are not serious, especially when isotretinoin is taken in low doses.

Determination of the sildenafil effect on alopecia areata in childhood: An open‐pilot comparison study

Background: Alopecia areata is an immunologically mediated cessation of hair growth primarily involving, but not limited to, the scalp. The treatment of alopecia areata involves promotion of hair growth (for instance with topical minoxidil application), immunosuppression (intralesional or systemic steroid therapy, phototherapy) or immunomodulation (anthralin, dinitrochlorobenzene, diphenylcyclopropenone, squaric acid dibutylester). All these medications have some disadvantages and difficulties for the treatment of children with alopecia areata. Objective: To use an open‐pilot study to assess the efficacy of topical 1% sildenafil in children diagnosed with alopecia areata. Methods: Eight patients with (⩽25% of scalp surface area involvement) alopecia areata who were refractory to previous topical treatments applied 1% sildenafil twice daily for 3 months. All the patients completed the study. Results: Two patients experienced vellus‐type hair growth and one patient had terminal hair growth. However, these outcomes were accepted as the spontaneous regression of the disease. Conclusion: We cannot recommend the use of topical 1% sildenafil for the treatment of alopecia areata without further evidence of its therapeutic benefit.

Isotretinoin associated anal fissure and rectal bleeding: a rare complication

References 1 Sugathan P, Zacharaiah J, Joy MI. Follicuilitis cruris pustulosa et atrophicans. Ind J Dermatol Venereol Leprol 1973; 39: 35–40. 2 Kaimal S, D’Souza M, Kumari R, et al. Dermatitis cruris pustulosa et atrophicans:our experience with 37 patients in south India. Int J Dermatol 2009; 48: 1082–1090. 3 Ramachandran K, Joy MI, Sugathan P. Serum proteins in foliiculitis et atrophicans. Ind J Dermatol Venereol Leprol 1973; 39: 238–239. 4 Harman RRM. Dermatitis cruris pustulosa et atrophicans. In: Marshall J, ed. Essays in Tropical Dermatology. Vol 2. Amsterdam: Excerpta Medica, 1972; 89–193.

A case of progressive macular hypomelanosis treated with 1% topical clindamycin lotion and narrow‐band ultraviolet B

To the Editor, Progressive macular hypomelanosis (PMH) is a common skin disorder that is often misdiagnosed. It is characterized by symmetrically distributed, ill-defined nummular non-scaly macules mainly on the trunk, sometimes extending to the neck and face, the buttocks and the upper half of the extremities (1, 2). We report a 21-year-old woman with hypopigmented macules coalescing into patches on her trunk, of 10 years duration. A 21-year-old woman with phototype III presented with multiple, hypopigmented patches and macules on her trunk, with no other symptoms, for 10 years (Fig. 1). She was diagnosed previously with tinea versicolor and treated with an antifungal cream and a zinc pyrithione shampoo without improvement. On examination, the patient had multiple discrete and confluent smooth hypopigmented macules coalescing into patches, greatest in the bra area and central back. No scaling was seen in any of the lesions. A punch biopsy specimen taken from a lesion demonstrated superficial perivascular lymphocytic infiltrate and decreased epidermal melanin. No evidence of tinea versicolor, parapsoriasis, and pityriasis lichenoides was found on histopathology. The patient was treated with narrow-band UVB (three times per week, starting with a dose of 0.018 J/cm) and with 1% topical clindamycin phosphate lotion (twice a day). Narrowband UVB treatment was completed in 34 sessions with a maximum dose of 0.130 J/cm. Three months after the therapy, we observed considerable improvements in the lesions and the treatment was stopped by the patient herself (cumulative dose: 2.985 J/cm) (Fig. 2).

Puffy Feet in an 11-month-old Infant: A Quiz

An 11-month-old boy with puffy feet had first presented at birth after a normal pregnancy. The boy’s father and 8-year-old sister had the same oedema of the foot unilaterally and the infant’s paternal grandmother was also affected bilaterally. His parents were not related to each other. Physical examination of the patient was normal, apart from the pectus excavatus and pes planus of the feet. Dermatological examination showed a non-inflammatory oedema located on the dorsum of the feet, giving a puffy appearance, and congenital misalignment of the left foot big toe (Fig. 1). Laboratory investigations, including urine analysis, total protein and albumin levels in the blood, abdominal ultrasonography and echocardiography were normal. The patient was started on elastic bandage compression therapy.