Gamze Serarslan

Pustular psoriasis-like tinea incognito due to Trichophyton rubrum.

Tinea incognito describes fungal infections with atypical clinical features and is usually caused by administration of steroids. We describe an 11‐year‐old girl who presented with widespread erythematous and pustular lesions being treated with topical corticosteroid. The diagnosis was confirmed by mycological examination including culture. Complete clinical resolution was observed with oral and topical antimycotic treatment.

The relationship between nail- and distal phalangeal bone involvement severity in patients with psoriasis.

We aimed to investigate the relationship between nail involvement and joint manifestations and whether there was a correlation between nail psoriasis severity and bone manifestations in psoriatic patients without symptomatic psoriatic arthritis in plaque type psoriasis. Thirty-one patients with nail involvement (16 men, 15 women, mean age 45.29 ± 18.73) and 39 patients without nail involvement (16 men, 23 women, mean age 38.41 ± 17.33) were enrolled in the study. X-ray of the hands and feet with magnification were performed. The distal interphalangeal (DIP) joint and bone (tuft of terminal phalanx) were evaluated. A scoring method was performed on the patients with nail involvement. There was no difference in DIP joint involvement in patients with or without finger- and toenail involvement (p = 0.085 and p = 0.062, respectively). However, the prevalence of bone involvement was higher in patients with finger- and toenail involvement than without finger- and toenail involvement (p = 0.039 and p = 0.021, respectively). A positive correlation was also determined between finger- and toenail psoriasis severity and bone involvement severity (r = 0.379, p = 0.001 and r = 0.288, p = 0.015).

Vitamin D Concentrations are Decreased in Patients with Alopecia Areata

Vitamin D has been of increased interest in the role of maintaining immune system balance. Alopecia Areata (AA) is a T-cell mediated autoimmune disease which causes anagen-stage hair follicles. Low concentration of vitamin D may be a risk factor for AA. We aimed to determine vitamin D concentrations in patients with AA. 25-hydroxyvitamin D (25(OH)-D) concentrations and 1,25 dihydroxyvitamin D3 (1,25(OH)2D3) were determined from sera collected from patients with AA (n=42) and healthy controls (n=42). 25(OH)-D and 1,25(OH)2D3 concentrations were measured by ELISA method. The concentrations of both 25(OH)-D and 1,25(OH)2D3 were found to be significantly lower in patients with AA than control group (p<0.001 for each analysis). The results show that there is a significant difference between AA patients and normal subjects in terms of serum vitamin D concentrations. Therefore, it is suggested that vitamin D deficiency may have a role in the setting of AA.

Acral lentiginous melanoma misdiagnosed as tinea pedis: a case report

The incidence of acral lentiginous melanoma (ALM) varies in different ethnic groups. Volar skin is a relatively infrequent site of malignant melanoma in Caucasian patients, although the foot is the most common site of involvement in Asian and African populations. Diagnosis of ALM is usually delayed and melanomas can be diagnosed at advanced clinical stages, so the prognosis is often poor. We present a Caucasian Turkish man with ALM on the interdigital site of his foot, however, as a result of maceration of the surrounding skin, it seemed to be tinea pedis.

Acitretin treatment in acrokeratosis verruciformis of Hopf

Acrokeratosis verruciformis of Hopf is a rare disorder and characterized by flesh‐coloured, wart‐like, flat papules on the dorsum of the hands and feet. The disease is an autosomal disorder, but sporadic cases also occur. We present a 38‐year‐old woman diagnosed with acrokeratosis verruciformis without family history and treated successfully with acitretin.

Audiological and transient evoked otoacoustic emission findings in patients with vitiligo

Objective: To investigate hearing loss in patients with vitiligo. Study Design: Case-control study. setting: University hospital. subjects and Methods: Conventional pure-tone and high-frequency audiometric tests were obtained, and pure-tone average hearing thresholds were calculated for 22 consecutive cases with vitiligo and 22 sex- and age-matched controls. Transient evoked otoacoustic emission testing was also performed. Results: There was sensorineural hearing loss on pure-tone audiogram in 16 (36.4%) ears in patients with vitiligo. The hearing thresholds (in dB) were 16.02 ± 6.61 versus 12.39 ± 6.05, 15.68 ± 6.34 versus 13.18 ± 3.75, 15.80 ± 13.93 versus 7.39 ± 6.95, 25.11 ± 17.40 versus 15.91 ± 12.91, 29.89 ± 18.57 versus 17.84 ± 12.36, and 45.91 ± 23.31 versus 33.86 ± 15.99 in the patient and control groups at 0.25, 1, 4, 8, 10, and 12.5 kHz, respectively, and were statistically significantly different. Reduction of transient evoked otoacoustic emission amplitude was statistically significant at 4 kHz in patients with vitiligo (6.34 ± 3.98 dB vs 8.63 ± 5.15 dB, P = 0.023). There was no significant difference in reproducibility, stimulus intensity, stability, and average transient evoked otoacoustic emission amplitudes in patients with vitiligo. Conclusion: Hearing thresholds at pure-tone and high-frequency audiometry were higher in patients with vitiligo. Also, significantly lower high-frequency amplitudes were recorded during transient evoked otoacoustic emission testing in the disease group.

High Prevalence of Pulmonary Hypertension in Homozygous Sickle Cell Patients with Leg Ulceration

Pulmonary hypertension is a common complication and is a risk factor for death in adult patients with sickle cell disease. Chronic leg ulceration is a major cause of morbidity in homozygous sickle cell disease. We aimed to determine prevalence of pulmonary hypertension in homozygous sickle cell patients and if there is any relation of pulmonary hypertension with leg ulceration. A total of 88 patients, asymptomatic for pulmonary hypertension, were enrolled in the study. Doppler echocardiography was performed on homozygous sickle cell patients with and without leg ulceration. 12 patients (10 male, 2 female) had active ulcer or healed scar (group I) and 76 patients (40 male, 36 female) had no active leg ulcer or history of (group II). The prevalence of pulmonary hypertension in group I and group II were 91.6% (n = 11) and 31.6% (n = 24), respectively (p = 0.0001). Patients with leg ulceration had increased left atrium and right ventricular diameters at diastole and also had increased left ventricular end-diastolic and end-systolic diameters. We determined an increased prevalence of pulmonary hypertension in patients with leg ulceration. Patients with homozygous sickle cell disease, especially those with leg ulcers should be screened for pulmonary hypertension, since pulmonary hypertension is a frequent and generally asymptomatic complication and a risk factor of mortality.

Expression of inducible nitric oxide synthase in human cutaneous leishmaniasis

Cutaneous leishmaniasis (CL) is an infectious disease caused by Leishmania parasite. The expression of inducible nitric oxide synthase (iNOS) and generation of nitric oxide in response to IFN-γ and TNF-α is important in control of infection. The aim of the study was to determine the expression of iNOS in the lesions of Leishmania tropica, and whether there was a correlation between the level of expression and the duration of the disease. Punch biopsy was performed from patients (n = 29) and iNOS immunohistochemical staining was applied. Expression of iNOS protein was detected 82.8% of patients. There was a strong expression with the duration of the disease less than 6 months (p < 0.002). These findings demonstrate that iNOS has a role in L. tropica especially during the early stages of the infection. (Mol Cell Biochem xxx: 147–149, 2005)

Periorbital edema and erythema: An unusual localization of DLE in a patient with psoriasis

Discoid lupus erythematosus (DLE) is characterized by erythematous, raised, indurated papules or plaques. DLE may rarely present as periorbital erythema and edema. We report the case of a 33‐year‐old woman with psoriasis localized on the trunk and extremities who developed prominent periorbital edema and erythema diagnosed as DLE.

Hearing loss in patients with Behçet's disease: an audiological and transient evoked otoacoustic emission study

OBJECTIVE To investigate hearing loss in patients with Behçets disease. MATERIALS AND METHODS Twenty-four consecutive cases of Behçets disease and 24 sex- and age-matched controls were included in this study. Pure tone and high frequency audiometric tests were performed and pure tone average hearing thresholds calculated for both groups. Transient evoked otoacoustic emission testing was also performed. RESULTS Pure tone audiometry showed a sensorineural hearing loss in 15 of the Behçets disease ears. Hearing thresholds were significantly higher in the study group than in the control group, on both pure tone frequency (except 0.5 kHz) and high frequency audiometry. Significant reductions in transient evoked otoacoustic emission amplitude were found at 1.4 and 2 kHz in the Behçets disease patients. There were no significant differences in reproducibility, stimulus intensity or stability, comparing the Behçets disease patients and controls. CONCLUSION Significantly lower mid-frequency amplitudes were found in Behçets patients on transient evoked otoacoustic emission testing.