Despina Ioannidou

Dermatological Manifestations in Primary Biliary Cirrhosis Patients: A Case Control Study

OBJECTIVES:Primary biliary cirrhosis (PBC), a disease of probable autoimmune etiology that affects the small intrahepatic bile ducts of mainly middle-aged women is commonly associated with pruritus, xanthomatous lesions, and melanosis. We conducted a prospective study to systematically describe the skin disorders of a group of PBC patients.METHODS:A prospective evaluation and analysis of dermatological manifestations including oral and genital lesions was carried out, in 49 PBC patients (45 females and 4 males). Median age 63 yr (range 35–87 yr). They were compared with 45 age and sex matched controls, selected among persons attending the dermatologic outpatient clinic.RESULTS:A total of 330 skin disorders were found in the 49 PBC patients versus 76 in the 45 controls; 31.5% of all lesions were skin fungal infections. Of all lesions analyzed with the Bonferonni rule of multiple comparisons significantly more common in PBC patients were plantar mycoses, onychomycoses, and interdigital mycoses. Pruritus was found in 69.3% of patients versus 22.2% of controls, xerosis in 69.3%versus 2.2%, dermographism in 57.1%versus 4.4%, and melanosis in 46.9%versus 0%. In 38.7% of the PBC patients the dermatologic lesion was the presenting symptom.CONCLUSIONS:PBC patients present with a wide variety of cutaneous manifestations varying in severity. Multiple skin fungal infections have been found even in the early stages. Since in more than one third of our PBC patients the dermatologic lesion was the presenting sign or symptom leading to diagnosis we believe that physicians should be aware so that a prompt and early diagnosis may be achieved.

Early development of multiple epithelial neoplasms in Netherton syndrome.

We report a case of Netherton syndrome manifested as congenital ichthyosiform erythroderma, trichorrhexis invaginata and atopy, who in early adulthood developed multiple, aggressive epithelial neoplasms in sun-exposed areas of the skin, in areas with papillomatous skin hyperplasia and at the left parotid region. The occurrence of cutaneous neoplasia has been reported in syndromes with congenital ichthyosis and suggests that the underlying genetic defects may cause the development of cancer in prone patients.

Nevus lipomatosus cutaneous superficialis (Hoffmann-Zurhelle) with localized scleroderma like appearance.

An otherwise healthy 56‐year‐old woman presented with three symptomless unilateral plaques extending from the right lower lip to the submandibular region and the posterior lateral cervical area. Initially, one year previously, a solitary 2 × 3 cm plaque appeared with irregular distinctive borders that extended progressively. Two new plaques with the same characteristics developed slowly near the initial one within six months. Their color was ivory‐pale, with a hyperpigmented margin. The lesions were primarily soft but later became firm and indurated with smooth, shiny, mild scaling, and wrinkled surfaces. A unilateral distribution with no contraction of the skin over the affected area was observed ( Fig. 1 ).

Cutaneous alternariosis in a patient with idiopathic pulmonary fibrosis

A 78‐year‐old farmer presented with symptomless skin lesions for evaluation. Two years prior, he had developed idiopathic pulmonary fibrosis (IPF) and had been treated thereafter with oral prednisolone 20 mg/day and occasionally with colchicine 1 mg/day.

The incidence of cutaneous melanoma on Crete, Greece

Background  For Greece, no data regarding the incidence of cutaneous melanoma (CM) have been reported. In this report, we present epidemiologic data for CM on Crete, an island in southern Greece, during the years 1999–2002. We attempt a comparison with corresponding data reported for the Italian population.

Guttate psoriasis occurring on varicella lesions

Dear Editor, Psoriasis is a common chronic inflammatory skin disease with 1–3% prevalence in the white population. Approximately one-third of patients mention onset during childhood, where it accounts for 10% of the cutaneous disorders occurring in pediatric dermatology. Psoriasis is characterized by hyperproliferation and altered differentiation of keratinocytes, increased vascular permeability and inflammatory infiltrate in reply to cytokines, such as tumor necrosis factor (TNF-a), c-interferon (IFN-c), IL-8, provided by CD4 and CD8 T cells and natural killer cells. Varicella zoster virus (VZV) is a herpesvirus that causes varicella in young children and, after endogenous reactivation, herpes zoster in older individuals. Varicella is recognized by fever usually coincident with self-limited pruritic vesicular rash. CD4 and CD8 T cells mediate the VZV infection by delivering the virus to the skin during primary infection as well

How important is the pus culture obtained from epithelial growth factor receptor (EGFR) inhibitors' associated rash?

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