Erdal Basaran

Cimetidine therapy for warts: a placebo-controlled, double-blind study.

BACKGROUND Cimetidine, an H2-receptor antagonist, has been used successfully to treat patients with mucocutaneous candidiasis, common variable immunodeficiency, herpes simplex, and herpes zoster because of its immunomodulatory effects. Recently, some trials have suggested that cimetidine may also be useful for the treatment of warts. OBJECTIVE The aim of the present study was to determine whether cimetidine is effective in the treatment of warts. METHODS Seventy patients with multiple warts were included in a placebo-controlled, double-blind study. Patients were randomly allocated to treatment groups equally. The groups received cimetidine, 25 to 40 mg/kg daily, or placebo for 3 months. Patients were examined at monthly intervals. RESULTS At the end of the therapy, 28 cimetidine-treated and 26 placebo-treated patients were examined to determine the efficacy of treatment. Cure rates obtained were 32% (9 of 28) in the cimetidine-treated group and 30.7% (8 of 26) in the placebo-treated group. No significant difference was found between cimetidine and placebo in effectiveness (p = 0.85). CONCLUSION Our results show that cimetidine is no more effective than placebo in the treatment of patients with common warts.

Intermittent Therapy with Terbinafine for Dermatophyte Toe‐Onychomycosis: A New Approach

Terbinafine, an orally active antifungal agent of the allylamine class, is effective in the treatment of dermatophyte onycomycosis. Its pharmacologic and pharmacokinetic properties give strong support to the possibility that intermittent treatment courses may be equally effective in onychomycosis in general.

Interferon therapy for Behçet's disease

BACKGROUND Behçets disease was first described in 1937 as a trisymptom complex. No standard therapy has been established. Its cause is presumed to be viral or immunologic. OBJECTIVE We sought to determine whether patients with Behçets disease benefit from interferon, which has antiviral, immunomodulatory, antiproliferative, and antitumoral properties. METHODS Fourteen patients were initially given 3 MU interferon alfa-2a subcutaneously three times per week. The doses were gradually increased to 12 MU. Each patient received a total dose of 216 MU during the 2-month study. Therapy with 9 MU interferon alfa-2a once a month was continued in half the patients. All patients were observed before and after treatment for 6-month periods, and all symptoms were recorded. RESULTS All patients were symptom free by the end of the 2-month treatment period. The frequencies of oral and genital ulcers as well as pustular vasculitis decreased significantly in the posttreatment period as compared with the pretreatment period. CONCLUSION The data suggest that interferon treatment appears to be effective for patients with Behçets disease.

Histological and immunofluorescence findings of non-follicular papulopustular lesions in patients with Behçet's disease

Background Papulopustular lesions (PPL), the most common type of cutaneous lesions in Behçets disease (BD), clinically may not be differentiated from ordinary acne. Disagreement exists as to the exact nature of these acneiform and folliculitis‐like lesions and whether to include them as a major criterion.

Comparison of the Effects of Intralesional Interferon Alfa‐2a, 2b and the Combination of 2a and 2b in the Treatment of Basal Cell Carcinoma

Interferons (IFN), especially alfa‐2a and 2b, are potent inhibitors of normal and malignant cell growth and effective choices in the treatment of basal cell carcinoma (BCC).

Efficacy of Silver Nitrate Pencils in the Treatment of Common Warts

Common warts are an important issue, especially in children and young adults. The methods proposed for common wart treatment are painful, destructive, and require special experience and devices. The chemical cauterization effect of silver nitrate on warts is noted in the classical pharmaceutical textbooks. In order to test this effect for this purpose, a placebo controlled clinical study was performed on 70 patients.

Treatment of arsenical keratosis and Bowen’s disease with acitretin

Background Long‐term exposure to arsenic is associated with the development of arsenical keratosis, Bowen’s disease, squamous cell carcinoma, and basal cell carcinoma. The efficacy of acitretin therapy was examined in two patients with cutaneous arsenical neoplasms.

Keratoderma, hypotrichosis and leukonychia totalis: a new syndrome?

Summary We report three members of a family with congenital hypotrichosis, characterized by trichorrhexis nodosa and trichoptilosis, dry skin, keratosis pilaris and leukonychia totalis. They also developed a progressive transgrediens type of palmoplantar keratoderma, and hyperkeratotic lesions on the knees, elbows and perianal region. As far as we are aware, this combination of clinical features has not been described previously.

Pemphigus vegetans in a 4-year-old boy

To the Editor: Pemphigus vegetans is a distinct and rare variety of pemphigus vulgaris. Disease distribution includes mouth and flexures. Flaccid bullae rapture, erode and form vegetations. Developing vegetations on these lesions, especially in body folds is typical for pemphigus vegetans [1,2]. A 4-year-old boy presented to our clinic with a 6-month history of blisters, initially in the mouth and on the scalp and gradually involving the nostrils, perioral, periorbital and anogenitai regions. The boy could hardly speak and walk due to painful eroded lesions. Physical examination on admission showed height 101 cm, weight 17 kg, temperature 37.5°C. His dermatologic examination revealed well-defined, oozing, malodorous vegetating and indurated plaques on the occipital and anogenital regions, especially on the penis, scrotum and inguinal area (Fig. 1). Examination of the perioral and periorbital area showed numerous eroded, crusted, oozing, ulcerating lesions on erythematous skin. Balanitis was also observed, and there was both cervical and inguinal lymphadenopathy. Routine laboratory tests were normal with the exception of WBC: 13500/mm\ Staphylococcus aureus was cultured from the skin lesions. Biopsy of an eroded lesion from the lip showed an intraepidermal vesicle and clefts with suprabasal acantholysis, mild epidermal papillomatosis and a perivascular and periadnexal lymphocytic infiltrate in the dermis. Direct immunoflourescent studies on a biopsy specimen revealed the presence of IgG and C, in the epidermal intercellular cement substance on perilesionai skin (Fig. 2). According to these findings, the diagnosis of pemphigus vegetans, Neumann type, was made. The patient was initially treated with 1.5 mg/kg/day of prednisone, and 50 mg/kg/day of cephalotin. In addition, antibacterial ointment was applied topically. By the 7th day of therapy, symptoms of secondary infection had disappeared and then hydrocortisone butyrate cream was used on the lesions. By the end of the first month of prednisone therapy, the patient was free of lesions and no new attacks were observed. Subsequently, the dose of prednisone was gradually tapered. The patient has been followed up for 12 months with 0.5 mg/kg of prednisone daily without new attacks. Pemphigus vegetans has two clinical subtypes, the Neumann type and the Hallopeau type. In the Neumann type (the usual type of pemphigus vegetans) the lesions begin as vesicles and erosions. Old lesions manifest as vegetating plaques that bleed easily on trauma [1,2]. The patient exhibited clinical and histopathological findings typical for Neumann type pemphigus vegetans. Cases of pemphigus in children are exceedingly rare in the literature. Although pemphigus vulgaris [3,4], foliaceus [5] and fogo selvagem [6] are reported in children, there are a very limited number of cases of pemphigus vegetans in children[3,7]. We describe a 4-year-old boy with pemphigus vegetans to be one of the youngest cases in the literature.

Bloom's syndrome in a Turkish individual

Blooms syndrome (BS) is a rare autosomal recessive disease characterised by short stature, sun sensitivity, facial erythema, and telangiectasia distributed in a butterfly configuration resembling lupus erythematosus. The syndrome was first described by D. Bloom in 1954. Affected individuals tend to have recurrent gastrointestinal system problems in infancy and respiratory infections associated with immune dysfunction (Kraemer 1993, Passarge 1991). Increased chromosomal breakage and sister chromatid exchanges (SCE) are hallmarks of the disorder (German 1969). The increased risk of neoplasia is a life-threatening feature of this syndrome. The incidence of neoplasia at an early age is marked when compared to the normal population (Kraemer 1993, Passarge 1991). BS is seen more commonly among Jews of Eastern European origin than in other groups (Kraemer 1993). We describe here the 4th Turkish person diagnosed BS.