Cihangir Aliagaoglu

Treatment of Confluent and Reticulated Papillomatosis with Azithromycin

Confluent and reticulated papillomatosis (CRP) is a relatively rare disorder of unknown origin, mostly affecting young female adults. We here present the case of a 21‐year‐old male patient with confluent and reticulated papillomatosis. Skin examination revealed brownish, verrucous, hyperkeratotic, 2 to 5 mm papules, which formed confluent patches and plaques with a reticulate network on the interscapular area. The patient was initially treated with ketoconazole cream for two weeks without improvement. The disease can be rather persistent and resistant to topical therapy. Our case showed a satisfactory response to treatment with azithromycin. Although this treatment is known to be effective in some cases, the action mechanism of azithromycin on CRP is not fully understood.

Allergic contact dermatitis to para-phenylenediamine in a tattoo: a case report

It is highly popular among children and young adults to have temporary henna tattoos on their bodies in different colors and figures. Henna is a greenish natural powder obtained from the flowers and dry leaves of Lawsonia alba plant and its allergenicity is very low. Henna is also used in combination with other coloring substances such as para-phenylenediamine in order to darken the color and create a permanent tattoo effect. Para-phenylenediamine is a substance with high allergenicity potential and may cause serious allergic reactions. Here, we aimed to draw attention to the potential harms of para-phenylenediamine containing temporary tattoos by presenting a child patient who developed allergic contact dermatitis after having a scorpion-shaped temporary tattoo on his forearm.

Pyogenic granuloma with multiple and satellite involvement after a burn in a 5-year-old child

Dear Editor, Pyogenic granuloma (PG) is a common vascular hyperplasia of the skin and mucous membranes. PG usually occurs in children and young adults, and is usually seen on the face, trunk and limbs. There are also subcutaneous and intravenous variants. PG is often solitary, but multiple satellite lesions may occur.1 Although there are many cases with different etiologies in the published work, PG secondary to a burn is rare.2 We have found only five cases in the published work of the last 25 years.2–4 For these reasons, we report a case of a child with PG that developed on the area of a second degree burn. A 5-year-old female patient was brought to our Dermatology Clinics from a rural area for a burn on her upper arm. The child had no congenital etiology. The patient came to us 15 days after the burn. The patient’s medical history was unremarkable, and there was no personal or family history of skin disease. On dermatological examination, there were two big lesions (5 and 3 cm in diameter) surrounded by multiple small lesions on the hypopigmented area secondary to the burn injury, extending from left ankle to shoulder (Fig. 1). The big lesions had irregular borders and slight surface bleeding, were elevated from skin, and were polypoid and soft. The small lesions surrounding the big ones were red papules of varying sizes (0.25–0.5 cm in diameter). Laboratory tests were within normal limits. Serology for Venereal Disease Research Laboratory (VDRL) and HIV antibody was non-reactive/negative. Fungal and standard bacterial cultures from the lesions were negative. An incisional biopsy was performed before surgery. In histopathological examination, widelydilated, blood-filled vascular channels surrounded by small proliferating capillary buds were observed (Fig. 2). Nodularity surrounded by fibrous septa was also observed. These findings were consistent with the diagnosis of PG. The lesions were treated by total excision and primary closure. There were no recurrences at the end of a 6-month follow up. Pyogenic granuloma nodules may have a propensity to develop at sites of microscopic arteriovenous anastomoses. Consistent with this idea is the observation that the frequency of PG and the density of

A case of early onset confluent and reticulated papillomatosis with an unusual localization

Confluent and reticulated papillomatosis is a relatively rare dermatosis of unknown origin. It is characterized by papules that become confluent in the center and reticulated at the periphery. The sites of predilection are the neck, interscapular region, inframammary area and abdomen. In a 15‐year‐old girl diagnosed with confluent and reticulated papillomatosis, the lesions first appeared on her knees and elbows when she was 4‐years‐old, and on the interscapular area when she was 13. Similar lesions arose on the left hand a few weeks previous to her visit. Two biopsy specimens were taken from the interscapular and elbow areas. The histopathological findings of this case fit the diagnosis of confluent and reticulated papillomatosis. We expect good results from azithromycin therapy.

Frequency of sister chromatid exchanges in the lymphocytes of patients with atopic dermatitis

The combination of genetic susceptibility and environmental factors can induce allergic sensitization and subsequent local inflammation, resulting in atopic dermatitis (AD). Sister chromatid exchange (SCE) is a sensitive method that may reflect an instability in DNA or a deficiency in DNA repair. The aim of the present study was to investigate whether patients with AD have defects in DNA repair and whether SCE frequency can be used as a genetic marker in the pathogenesis of AD. Between September 2004 and July 2005, SCE was analyzed in the peripheral blood lymphocyte chromosomes of 32 patients with AD and 28 control subjects at the Dermatology Unit of Erzurum State Hospital. This study found that the SCE frequency was significantly increased in patients with AD (P < 0.00001). The prevalence of SCE was not correlated with patient age, sex, disease duration or AD disease severity. Our results indicate that increased chromosome instability may play an important role in the etiology of AD.

Rapidly developing giant sized lupus vulgaris on the chest associated with bilateral scrofuloderma on the neck

Lupus vulgaris and scrofuloderma are the opposite poles of cutaneous tuberculosis. Lupus vulgaris of a giant size and scrofuloderma in the vicinity of this lesion were both present in a 70‐year‐old female patient. The purified protein derivative of tuberculin (PPD) skin test was strongly positive. In histopathological examination, granulomatous infiltration without caseation necrosis was seen in the dermis. The patient was treated with a four‐drug therapy consisting of pyrazinamide (25 mg/kg), isoniazid (5 mg/kg), rifampin (10 mg/kg) and ethambutol (15 mg/kg) daily for 2 months, followed by dual therapy with isoniazid and rifampin for 6 months. Her cutaneous lesions significantly regressed after 4 months, leaving keloid scars.

Absence of a Sphenoid Wing in Neurofibromatosis Type 1 Disease: Imaging with Multidetector Computed Tomography

Neurofibromatosis type 1 disease is characterized by pigmented cutaneous lesions and generalized tumors of a neural crest origin and it may affect all the systems of the human body. Sphenoid dysplasia is one of the characteristics of this syndrome and it occurs in 5-10% of the cases; further, abnormalities of the sphenoid wings are often considered pathognomonic. However, complete agenesis of a sphenoid wing is very rare. We report here on an unusual case of neurofibromatosis type 1 disease with the associated absence of a sphenoid wing that was diagnosed by using multidetector computed tomography.

A very large, rapidly developing, congenital giant cell fibroblastoma in a 5-month old infant.

Giant cell fibroblastoma is an uncommon soft tissue neoplasm that occurs in childhood. It seems to be the juvenile form of dermatofibrosarcoma protuberans, which is seen less frequently in children. Only one congenital case has been reported previously. In this report, we present a 5‐month‐old girl with a rapidly and atypically growing mass located on the upper part of the right scapula. We think that our case is very interesting, because no similarly large lesion (12 cm × 10 cm × 8 cm) related to giant cell fibroblastoma has been previously reported in the published work.

Association between Alopecia Areata and HLA Class I and II in Turkey

HLA class I and II alleles have been described in patients with alopecia areata (AA). As in other immune mediated diseases, the HLA alleles associated with AA may influence the patients ability to respond to immune challenges from both self and non‐self antigens and can offer clues to the cause, prognosis, and potential therapy for the disease. The aim of this study was to determine which HLA class I and II alleles are associated with Turkish alopecia areata patients. Sixty‐three patients with AA, alopecia totalis, or alopecia universalis were included in this study and compared with seventy‐six healthy transplant donors. HLA DNA typing was performed by the PCR/SSP method. The frequency of HLA‐B62 was significantly higher in patients than in controls. HLA‐A2, HLA‐A24, HLA‐B35, HLA‐DRB1*11, and HLA‐DRB1*15 were significantly less common in patients than in the control group.

Pustular irritant contact dermatitis caused by dexpanthenol in a child

Abstract Pustular irritant contact dermatitis is rare and unusual clinic form of contact dermatitis. Dexpanthenol is the stable alcoholic analogue of pantothenic acid. It is widely used in cosmetics and topical medical products for several purposes. We present the case of 8-year-old girl with pustules over erythematous and eczematous areas on the face and neck. To the best of our knowledge, this is the first case reported that is diagnosed as pustular irritant contact dermatitis caused by dexpanthenol.