Göksun Karaman

Notalgia paresthetica : a study on pathogenesis

Abstract

Acne: prevalence, perceptions and effects on psychological health among adolescents in Aydin, Turkey.

Background  Acne vulgaris is a common disease among adolescents and known to have adverse effects on psychological status.

Paederus Dermatitis: A Report of 46 Cases in Aydın, Turkey

Paederus dermatitis is a specific form of acute irritant contact dermatitis caused by pederin, a secretion of insects of the genus Paederus. The disease is characterized by vesicles, bullae and sometimes small pustules on an erythematous base with sudden onset of a stinging, burning sensation. The dermatitis is most frequently seen in regions with a hot, tropical climate. We present 46 cases from Aydın, Turkey, a province well known for its long hot summers. These are the first cases reported from this region. We would like to point out the possibility of Paederus dermatitis in regions with a similar climate and suggest that ‘night burn’ be included among other differential diagnoses of a grouped vesicular and/or pustular lesion on an erythematous base.

Immunohistochemical Findings in Notalgia paresthetica

Background: Notalgia paresthetica (NP) is a sensory neuropathy the pathogenesis of which is not yet completely elucidated. Objective: The aim of this study was to investigate the histopathological changes in NP with special emphasis on cutaneous innervation. Methods: Along with site-matched biopsies from 5 healthy individuals, lesional skin biopsies from 14 cases of NP and biopsies from contralateral nonlesional skin in 9 of these cases were stained with hematoxylin-eosin and Congo red. For immunohistochemical analysis, all samples were stained with two general neural markers (S-100 protein and protein gene product 9.5) and two neuropeptides (vasoactive intestinal polypeptide and substance P). Results: Light microscopy was compatible with postinflammatory hyperpigmentation. Immunohistochemistry did not reveal a significant difference in the staining pattern of lesional skin and control tissue (p > 0.05). Although not reaching statistical significance, the percentage of cases which showed no staining was higher in the group of patients with more chronic NP. Conclusion: The finding of less immunohistochemical staining in cases with more chronicity could be of clinical importance and is worth investigating further.

Cutaneous basosquamous carcinoma infiltrating cerebral tissue.

Basosquamous carcinoma of the skin is a rare malignancy with specific histopathological features of both basal cell carcinoma and squamous cell carcinoma. Some authors believe that basosquamous carcinoma is a variant of basal cell carcinoma, while others suggest that this tumour may behave more aggressively.

Topical pimecrolimus: A new horizon for vitiligo treatment?

Objectives: The purpose of this study was to assess the efficacy of pimecrolimus cream 1% in vitiligo and to evaluate the effects of age of the patients, age of onset and duration of disease on response rate. Materials and methods: Twenty‐three patients with vitiligo were enrolled in our study; 19 patients (seven male, 12 female) completed the 6‐month study period. Patients were treated with topical pimecrolimus 1% cream once daily. The response was evaluated as excellent (76–100%), moderate (51–75%), mild (26–50%), minimal (1–25%), or no response. Results: The mean age of the 19 patients was 29.3±16.6 (range 7–62 years) and the mean duration of vitiligo was 68.4±81.3 months. Three patients demonstrated an excellent response to the therapy. Four patients had moderate, six patients had mild and five patients had minimal responses; one patient had no response to the treatment. Side effects were noted as a burning and stinging sensation in only three patients. The correlations between response rate and duration of the disease (r = 0.02, p = 0.95), onset age (r = −0.17, p = 0.48), and age of the patients (r = −0.16, p = 0.53) were not significant. Conclusions: Pimecrolimus has a mild therapeutic effect on vitiligo without significant side effects and can be an alternative therapy agent.

Epididymoorchitis mimicking testicular torsion in Henoch-Schönlein purpura

Abstract. Henoch-Schönlein purpura, although being a systemic vasculitis, mostly involves skin, gastrointestinal system, joints, and kidneys. Testicular involvement is a rare occurrence. A 7-year-old boy with Henoch-Schönlein purpura developed acute scrotum and was referred to rule out testicular torsion. On gray-scale ultrasonography, the testes and epididymis were slightly enlarged, and had heterogeneous and hypoechoic echotexture. The scrotal wall was thickened as well. Color and power Doppler ultrasonography revealed increased vascularity in scrotal contents. Testicular torsion was excluded and the diagnosis of testicular involvement of Henoch-Schönlein purpura was established. Color Doppler US, together with gray-scale findings, can be useful in the evaluation of Henoch-Schönlein purpura with acute scrotum, excluding testicular torsion and preventing unnecessary surgery.

Rosacea treatment with intermediate-dose isotretinoin: follow-up with erythema and sebum measurements.

Isotretinoin is one of the therapeutic options for rosacea. However, the response of erythema to treatment with isotretinoin is usually slow and incomplete with common (0.5-1 mg/kg/day) or low (10 mg/day) doses. This study investigated the efficacy of, and relapse on, 20 mg/day isotretinoin treatment in rosacea, with the aid of instrumental measurement of facial erythema and sebum levels. A 20 mg/day dose of isotretinoin was given for 4 months, and then the dose was tapered off within the following 6 months. A total of 25 patients were included in the study. Papule and pustule counts, erythema index, sebum level, dermatologists and patients erythema scores, and dermatologists sebum scores were significantly lower in the first month of therapy compared with pre-treatment values (p < 0.05). Within a median follow-up of 11 months (95% confidence interval: 8.4-13.5 months) 45% of patients had a relapse. In conclusion, 20 mg/day isotretinoin was rapidly efficient for reducing both inflammatory lesions and erythema in rosacea.

Power Doppler ultrasonography for the evaluation of skin tumors other than malignant melanoma

Abstract. The purpose of this prospective study was to evaluate the value of power Doppler ultrasonography (PDUS) in assessing the vascularity of skin tumors other than malignant melanoma, and to investigate possible diagnostic criteria to help to distinguish malignant from benign tumors preoperatively. Seventy-one patients with the clinical diagnosis of a skin tumor were initially evaluated by ultrasonography. Then PDUS was performed and the presence and type of vascularity (peripheral or mixed) were investigated. Of the 19 benign and 52 malignant lesions, 3 could not be visualized with US. Forty-nine lesions were found to have vascularity (21 peripheral, 28 mixed-type) on PDUS. Of the malignant lesions, 26 showed mixed and 17 showed peripheral-type vascularity; for benign lesions these numbers were 2 and 4 respectively. The presence of vascularity correlated well with pathological behavior (malignant versus benign) (P=0.00002), width (P=0.0001), thickness (P=0.001), dermal disruption (P=0.0018), and subdermal extension (P=0.002) of the tumor; however, the type of vascularity correlated only with thickness (P=0.014). In relation to malignancy, the sensitivity of the presence of vascularity on PDUS was 88% and the specificity was 63%. These values were 93% and 40% respectively, for the mixed type of vascularity when it was accepted as a feature of malignancy. PDUS may help to distinguish malignant from benign skin tumors during preoperative evaluation.

Adiponectin levels, insulin resistance and their relationship with serum levels of inflammatory cytokines in patients with Behçet’s disease

Aim  Increased frequency of cardiovascular disease and its possible relations with insulin resistance have been reported in patients with inflammatory diseases. The aim of our study was to investigate insulin resistance and serum adiponectin levels as cardiovascular risk markers in patients with Behçet’s disease.