Filiz Cebeci

Effectiveness of medium-dose ultraviolet A1 phototherapy in localized scleroderma

Background  Recently, ultraviolet (UV) A1 phototherapy has been suggested as an effective treatment for localized scleroderma (LS); however, the optimal dose of UVA1 still has not been determined.

Insulin resistance in women with hirsutism.

Introduction There are still not enough data showing whether patients with idiopathic hirsutism (IH) also have insulin resistance. The association between polycystic ovary syndrome (PCOS) and insulin resistance is well documented in the literature, but the Rotterdam Consensus has concluded that principally obese women with PCOS should be screened for the metabolic syndrome. We intended to investigate the presence/absence of insulin resistance in non-obese women with hirsutism. Material and methods Twenty-eight women with PCOS (14 non-obese and 14 obese), 12 non-obese with IH, and 16 non-obese healthy women were included in the study. The presence of insulin resistance was investigated by using basal insulin levels and the homeostasis model assessment (HOMA) score in the study group. Results Patients with obese and nonobese PCOS had significantly (p < 0.05) higher basal insulin levels and HOMA scores than IH and control subjects. Insulin levels and HOMA scores did not differ between obese and non-obese PCOS patients. Patients with IH did not show any difference from the control group. Conclusions Insulin resistance exists in non-obese women with PCOS as well as obese women with PCOS. The PCOS is associated with insulin resistance independent of obesity. Insulin resistance should be assessed in all hirsute women with PCOS regardless of their body mass index. More studies in larger numbers of patients should be performed to investigate the role of insulin resistance in women with IH.

Nonclassical yellow nail syndrome in six-year-old girl: a case report

IntroductionThe yellow nail syndrome is usually described as the combination of yellow nails with lymphoedema and often with respiratory manifestations such as pleural effusions, chronic sinusitis and bronchiectasis. The syndrome is most often seen in the middle-aged individuals.Case presentationWe present a 6-year-old girl with yellow nail syndrome having pansinusitis and bronchiectasis.ConclusionThe components comprising the classical triad of yellow nail syndrome in children may not necessarily be present altogether. Therefore, yellow nail syndrome should be suspected in children having only typical nail changes.

Henoch-Schönlein purpura without systemic involvement beginning with acute scrotum and mimicking torsion of testis.

Henoch-Schönlein purpura (HSP) is the most common systemic vasculitis in children. Typical presentations of HSP are palpable purpura of the small vessels in the hips and lower limbs, abdominal pain, arthritis, and hematuria. Scrotal involvement manifested by the presence of scrotal pain and swelling during the course of the disease is rarely seen. HSP without systemic involvement with acute scrotum mimicking testicular torsion is even rare in the medical literature. In most cases, patients with this disease achieve complete recovery. Herein, we report an interesting HSP case with skin symptoms but without systemic involvement and then progression to acute scrotum resembling torsion of testis.

Thyroid Autoimmunity and Behçet’s Disease: Is There a Significant Association?

Background. Behcets disease (BD) could be regarded as an autoimmune disease in many aspects. Autoimmune thyroid disease (ATD) is frequently accompanied by other various autoimmune diseases. Nevertheless, there is not still enough data showing the association between BD and ATD. In addition, no controlled study is present in the PubMed, which evaluates thyroidal autoimmunity using antithyroid peroxidase antibody in a large series of patients with BD. Methods. We aimed to investigate the frequency of ATD in patients with BD. The study included 124 patients with BD and 99 age- and sex-matched healthy volunteers. Results. Autoimmune thyroiditis was noted in 21 cases (16.9%) with BD. In the control group, 22 cases (22.22%) were diagnosed as autoimmune thyroiditis. There was no difference between the groups in respect to thyroid autoantibodies (P > 0.05). There were no statistically significant differences between baseline TSH levels of the BD patients and of the controls (P > 0.05). Statistically, the mean serum free T4 levels of the patients with BD were higher than those of the controls (P < 0.001). Conclusions. No association could be found between BD and ATD. Therefore, it is not of significance to investigate thyroid autoimmunity in BD.

Do we have to pay more attention to vitiligo patients? Peculiar histopathological features of primary cutaneous melanoma preceded by vitiligo

Vitiligo is an acquired depigmenting skin disease characterized by the loss of functioning epidermal melanocytes. Vitiligo can be associated with an autoimmune disorder. An unusual and important aspect of vitiligo is its relationship to melanoma. We present herein a 34‐year‐old man who developed regional lymph node metastases of malignant melanoma 2 years after the diagnosis of vitiligo.

Unusual F-18 FDG Uptake at the Ears of a Patient with Discoid Lupus Erythematosus Diskoid Lupus Eritamatozus

A 55-year-old patient, who had undergone excisional biopsy of upper lip two years ago and diagnosed to have squamous cell carcinoma, was referred to us for evaluation with Fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography (PET)/CT (F-18 FDG-PET/CT) scan. F-18 FDG-PET/CT scan was performed and the maximum intensity projection images (MIP) showed unusual FDG uptake at both ears. Histopathological examination of the biopsy specimen obtained from the ears revealed discoid lupus erythematosus (DLE). Conflict of interest:None declared.

Factor V Leiden Mutation–Related Chronic Skin Ulcers

Chronic skin ulcers require extensive, systemic differential diagnosis; thus, they are difficult to diagnose and treat. Transient or persistent hypercoagulable states are among the rare causes of skin ulcers. Here, we present the case of a 27-year-old woman patient with recurrent, nonhealing skin ulcers of 8 years’ duration, who had been treated unsuccessfully with various medications under different diagnoses at different clinics. On admission, a skin biopsy demonstrated occlusive vasculopathy, and the search for an inherited hypercoagulable state revealed a heterozygous factor V Leiden mutation. The patient was treated with anticoagulants and hyperbaric oxygen. On treatment, the skin lesions healed and did not recur.

Frictional melanosis of the areola associated with severe atopic dermatitis: A case report with striking dermoscopic features

To the editor, The nipple and areola region are affected by various skin disorders, including eczema, Paget’s disease, and nevoid hyperkeratosis. Pigmented lesions are produced on the nipple and areola by pigmented Paget’s disease (PPD), melanoma, pigmented basal cell carcinoma, and melanosis of the nipple and areola (MNA). Herein, we report a female patient who had severe atopic dermatitis with areolar frictional melanosis. A 38-year-old female patient presented with bilateral darkbrown-colored reticulated plaques on the areola and inverted nipples for approximately 5 years. Additionally, she had pruritus for approximately 10 years. She did not have any history of using prescription or over-the-counter drugs or any herbal supplements other than topical corticosteroids and moisturizers. She claimed to have made no contact with any foreign substances or excessive heat. She did not have any chronic illness, and her family history was unremarkable. A dermatological examination revealed widespread lichenified plaques and severe eczema affecting her wholebody area (Figure 1a). There were sclerosing pinkish-white lesions, impetiginous crusts, and different-sized dark-brown reticulate, irregular, asymmetrical pigmented lesions located on the outer part of the areola, and the normal anatomical structure of the nipple and areola region was destroyed (Figure 1b). Dermoscopic examination of the areolar lesions showed yellow crusts, pinkish-white structureless areas, and a pigmented thick, regular reticular network of thick lines, similar to a cross embroidery (Figure 1c). Physical examination showed no palpable mass or axillary lymphadenopathy. The mammary ultrasonography was normal. Neither she nor her family had a history of breast cancer. Laboratory tests showed a high level of immunoglobulin E and hypereosinophilia with Anahtar Kelimeler: Areola, melanozis, dermoskopi

Verruciform Xanthoma of a Lower Lip Lesion: A New Case and Review of the Literature

A non-smoking man in his seventh decade presented with a lesion he had had for about 5 years on the right external surface of the lip 1 mm from the vermilion border. On physical examination, a yellowish-coloured, non-tender, verrucous mass of 0.5 × 0.7 cm was observed. A histopathological examination of the first 3-mm punch biopsy was non-diagnostic. The histopathological evaluation of a second, 5-mm-deep punch biopsy made by a pathology expert in oral lesions revealed a diagnosis of verruciform xanthoma. The key to the diagnosis of verruciform xanthoma is to recognize xanthoma cells. However, these cells may be insufficient in number in small and superficial biopsy material and overlooked by a pathologist especially when lacking knowledge of this uncommon lesion. Verruciform xanthoma of the lower lip at the vermilion border is an extremely rare entity described in 5 cases worldwide to date. We aimed to bring verruciform xanthoma to readers’ attention for a differential diagnosis of lower lip diseases and to prevent overdiagnosis and overtreatment of this lesion unfamiliar to otorhinolaryngologists.