Nesimi Buyukbabani

Clinicopathologic Evaluation of Nodular Cutaneous Lesions of Behçet Syndrome

Among the cutaneous manifestations, nodular lesions are rather common in Behçet syndrome. The histologic nature of these lesions has been a matter of controversy. To establish their distinguishing features, biopsy specimens from nodular lesions of 24 patients with Behçet syndrome, 25 with nodular vasculitis (NV), and 20 with erythema nodosum (EN) were compared. Statistical analysis revealed insignificant differences between most of the histologic features of Behçed syndrome and NV. However, neutrophil-predominating infiltrate in the subcutis was more common in Behçet syndrome, while necrosis and granuloma formation were encountered more frequently in NV. The differences between Behçed syndrome and EN were more significant. Septal panniculitis, lymphocyte-predominating infiltrate, absence of many vascular changes as well as vasculitis, and necrosis were features in favor of EN. Nodular lesions of Behçet syndrome are mainly neutrophilic vascular reactions with histologic features similar to NV but significantly differing from EN associated with other systemic diseases.

Human ocular filariasis: further evidence on the zoonotic role of Onchocerca lupi.

BackgroundAmong ocular vector-borne pathogens, Onchocerca volvulus, the agent of the so-called “river blindness”, affects about 37 million people globally. Other Onchocerca spp. have been sporadically reported as zoonotic agents. Cases of canine onchocerciasis caused by Onchocerca lupi are on the rise in the United States and Europe. Its zoonotic role has been suspected but only recently ascertained in a single case from Turkey. The present study provides further evidence on the occurrence of O. lupi infesting human eyes in two patients from Turkey (case 1) and Tunisia (case 2). The importance of obtaining a correct sample collection and preparation of nematodes infesting human eyes is highlighted.MethodsIn both cases the parasites were identified with morpho-anatomical characters at the gross examination, histological analysis and anatomical description and also molecularly in case 1.ResultsThe nematode from the first case was obviously O. lupi based on their morphology at the gross examination, histological analysis and anatomical description. In the second case, although the diagnostic cuticular characters were not completely developed, other features were congruent with the identification of O. lupi. Furthermore, the morphological identification was also molecularly confirmed in the Turkish case.ConclusionsThe results of this study suggest that O. lupi infestation is not an occasional finding but it should be considered in the differential diagnosis of other zoonotic helminths causing eye infestation in humans (e.g., D. immitis and Dirofilaria repens). Both cases came from areas where no cases of canine onchocerciasis were previously reported in the literature, suggesting that an in depth appraisal of the infestation in canine populations is necessary. Physicians and ophthalmologists are advised on how to preserve nematode samples recovered surgically, to allow a definitive, correct etiological diagnosis.

Prurigo pigmentosa: not an uncommon disease in the Turkish population.

Background  Prurigo pigmentosa (PP) is a rare inflammatory dermatosis of unknown etiology. It is characterized by erythematous papules of the trunk that resolve leaving a reticulate hyperpigmentation. The original report from Japan in 1971 was followed by new cases, mostly of Japanese origin.

Tumors associated with nevus sebaceous

Background: Nevus sebaceus (NS) is a congenital hamartomatous lesion, usually involving the scalp or the face. Various benign and malignant neoplasms can develop in association with NS, the most common being trichoblastoma, syringocystadenoma papilliferum, viral warts and basal cell carcinoma (BCC).

Childhood mycosis fungoides: a report of 20 cases from Turkey

Background  Mycosis fungoides (MF) is the most common type of cutaneous T‐cell lymphomas in adults. In the recent past, several reports have focused on an increased prevalence of MF in children.

HSP 60 expression in recurrent oral ulcerations of Behçet's disease.

OBJECTIVE The aim was to investigate heat shock protein 60 (HSP60) expression in oral ulcerations of Behçets disease (BD). STUDY DESIGN Biopsy specimens were obtained from patients with BD (n = 11), recurrent aphthous stomatitis (RAS) (n = 11), oral lichen planus (OLP) (n = 11) and healthy individuals (HI) (n = 11). Eight samples in BD and RAS groups were evaluable. All groups were analyzed by biotin streptavidin-aminoethylcarbazole using monoclonal mouse antibodies to HSP60 Ab-1 (clone LK1). RESULTS Immunostaining indicative of HSP60 expression in BD and RAS were significantly higher than HI. No significant difference was found between BD and OLP except in the suprabasal layer of epithelium. CONCLUSIONS Altered expression of HSP60 was found in ulcerative lesions of BD and RAS suggesting that HSP60 has an association with the etiology or chronicity of these inflammatory lesions.

Cutaneous angiomyolipoma: report of two cases with emphasis on HMB-45 utility

Angiomyolipomas are tumors composed of adipose tissue, blood vessels and smooth muscle. Although renal angiomyolipomas are well known, cutaneous tumors have been described only recently. HMB‐45 reactivity, reported for renal angiomyolipomas, has been suggested as a useful tool in differential diagnosis.

Add-on therapy with topiramate in progressive myoclonic epilepsy

We evaluated the clinical responses to add-on therapy with topiramate in eight patients with progressive myoclonic epilepsy (PME). Severe myoclonic seizures disturbing daily activities were persistent despite adequate trials of various combinations of antiepileptic drugs in all patients. After the initiation of topiramate therapy, five patients had a marked decrease in myoclonic seizure frequency, prominent improvement of daily functioning, and recovery from previous drug-related side effects such as weight gain and irregularities of menstruation due to polycystic ovary syndrome. However, we had to discontinue topiramate in three patients because of side effects. Topiramate seems to be a useful alternative agent in the treatment of PME. The antimyoclonic effect provides some independence in daily activities and decreases the side effects related to other antiepileptic drugs, which are clear benefits for this grave disease, although having a short-term effect in some patients.

Efficacy of narrowband UVB phototherapy in early stage of mycosis fungoides

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Dyskeratosis congenita associated with three malignancies

Dyskeratosis congenita is a rare inheritable disorder characterized by abnormalities of the skin, nails and oral mucosa. Aplastic anaemia resulting from bone marrow hypoplasia is a frequent cause of death. Squamous cell carcinoma developing from leukoplakia and visceral malignancies are other complications of the disease. We report here a case of dyskeratosis congenita in a man who developed three neoplasias of different systems over a period of many years. Squamous cell carcinoma and gastric adenocarcinoma manifested 17 years after the man was diagnosed with Hodgkins disease.