Özay Özkaya

Coenzyme Q10 concentrations and antioxidant status in tissues of breast cancer patients.

OBJECTIVES An increasing amount of experimental and epidemiological evidence implicates the involvement of oxygen derived radicals in the pathogenesis of cancer development. Oxygen derived radicals are able to cause damage to membranes, mitochondria, and macromolecules including proteins, lipids and DNA. Accumulation of DNA damages has been suggested to contribute to carcinogenesis. It would, therefore, be advantageous to pinpoint the effects of oxygen derived radicals in cancer development. DESIGN AND METHODS In the present study, we investigated the relationship between oxidative stress and breast cancer development in tissue level. Breast cancer is the most common malignant disease in Western women. Twenty-one breast cancer patients, who underwent radical mastectomy and diagnosed with infiltrative ductal carcinoma, were used in the study. We determined coenzyme Q10 (Q) concentrations, antioxidant enzyme activities (mitochondrial and total superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), catalase), and malondialdehyde (MDA) levels in tumor and surrounding tumor-free tissues. RESULTS Q concentrations in tumor tissues significantly decreased as compared to the surrounding normal tissues (p < 0.001). Higher MDA levels were observed in tumor tissues than noncancerous tissues (p < 0.001). The activities of MnSOD, total SOD, GSH-Px and catalase in tumor tissues significantly increased (p < 0.001) compared to the controls. CONCLUSIONS These findings may support that reactive oxygen species increased in malignant cells, and may cause overexpression of antioxidant enzymes and the consumption of coenzyme Q10. Increased antioxidant enzyme activities may be related with the susceptibility of cells to carcinogenic agents and the response of tumor cells to the chemotherapeutic agents. Administration of coenzyme Q10 by nutrition may induce the protective effect of coenzyme Q10 on breast tissue.

An unusual form of generalized granuloma annulare in a patient with insulin-dependent diabetes mellitus.

The generalized form of granuloma annulare may be associated with systemic disorders, including diabetes mellitus. We describe here an unusual form of generalized granuloma annulare in a patient with complicated insulin-dependent diabetes mellitus. The cutaneous eruption had been present for decades as non-pruritic, persistent, violet-brown patches with raised edges. There were flexion deformities of the small joints of the hands and feet associated with thickening of the skin over dorsa of the fingers. The patient is currently on isotretinoin therapy, with partial resolution of lesions at 3 months follow-up.

A case of lupus vulgaris successfully treated with antituberculous therapy despite negative PCR and culture

A 14-year-old boy presented with a pink firm plaque with well-defined borders in the right infra-orbital skin area. On diascopy, the infiltrate exhibited a typical apple-jelly appearance. No acid-fast bacilli could be demonstrated. A polymerase chain reaction (PCR) assay did not reveal the presence of mycobacteria in a lesional biopsy sample. Culture of biopsied tissue on Loewenstein-Jensen medium was negative. Although the tuberculosis culture and PCR did not confirm tuberculosis, a diagnosis of lupus vulgaris was made considering the clinical and histopathological findings. After a 9-month antituberculous therapy, the lesion disappeared. We believe that a diagnosis of lupus vulgaris still depends more on clinical and histopathological findings than on tuberculosis culture or PCR.

Acitretin is a safe treatment option for infantile pustular psoriasis

Generalized pustular psoriasis (GPP) is a rare type of psoriasis and is considered the most severe variant. Infantile pustular psoriasis (IPP) is a very rare form of GPP. Severe IPP may be difficult to control and is complicated by bacterial superinfection, dehydration, and sepsis. Herein, a 2.5‐month‐old infant with IPP is presented, who was successfully treated with systemic retinoid therapy, which appears to be a safe and effective option for this challenging pustular eruption of childhood.

Gianotti-Crosti syndrome preceded by oral polio vaccine and followed by varicella infection

Gianotti–Crosti syndrome (papular acrodermatitis of childhood) is considered a nonspecific cutaneous host response to a variety of infectious agents, particularly viruses. Herein we report a case of Gianotti– Crosti syndrome preceded by oral polio vaccine and followed by varicella infection. The present case may support the hypothesis of initial immunization and following viral infection as a possible mechanism for Gianotti–Crosti syndrome.

Acute generalized exanthematous pustulosis induced by bleomycin and confirmed by patch testing

Acute generalized exanthematous pustulosis is a potentially severe disease caused by drugs in about 90% of cases. To the best of our knowledge, acute generalized exanthematous pustulosis following use of bleomycin has not been previously reported. Here we report a case of acute generalized exanthematous pustulosis induced by bleomycin, which was confirmed by patch testing.

Intravascular papillary endothelial hyperplasia in the finger: not a premier diagnosis

To the Editor, A 58-year-old lady was seen for a tender swelling in her left hand. Two days before, she had noticed a small purplish swelling on the dorsal side of her left fourth finger. Despite her medical history being otherwise non-contributory, on detailed questioning, she recalled having dealt with different types of vegetables (including squash, okra) just one day before she noticed the lesion. She also declared that the bruised area eventually became a lentil-sized nodule. On physical examination, a slightly tender moveable nodule was palpated adjacent to the proximal interphalangeal joint of the fourth finger in the left hand. There were no signs of local inflammation nor any problem pertaining to the tendons, and the digital nerves could be uncovered. An immediate sonography was performed and it revealed a 1.5 3 2.1 mm mass with mixed echogenicity without any relation to the extensor tendon. Then she was consulted to the hand surgeons and, as the patient also accepted, the mass was excised. The pathological diagnosis was established as intravascular papillary endothelial hyperplasia (IPEH). IPEH was first described by the French pathologist Masson as a neoplastic lesion vegetant intravascular hemangioendothelioma’. In 1976, Clerkin and Enzinger proposed the term IPEH, which is currently known as a non-neoplastic reactive endothelial proliferation. It is most commonly located in the skin or the subcutaneous tissue, usually in various vessels following thrombosis. Although there is a predilection for the deep dermis and subcutis of the head, neck, fingers and trunk; IPEH may occur in any location in the body. In subcutaneous localizations the lesion may appear clinically as a small, firm, superficial nodule imparting a red to blue discoloration of the overlying skin. The exact pathogenesis is unknown, but an unusual form of thrombus organization following a trauma is considered to play role. The release of b-fibroblast growth factor (b-FGF) from macrophages attracted to the site is proposed to trigger the proliferation of endothelial cells, which in turn release more b-FGF, leading to a vicious cycle. On the other hand, a history of trauma is rarely noted by the patients – in only 4%. Endothelial proliferation and obstruction of the luminal space of the vascular structures may lead to the enlargement of the mass lesion, necessitating differentiation from a neoplasm. In this regard, intravascular confinement of IPEH, absence of pleomorphism and mitotic atypia are helpful for histological distinction. Overall, excision of the lesion seems to be quite reasonable both for the diagnosis and the treatment.

Search for problem areas in endometrial biopsies to achieve quality assurance

The aim of this study was to underline the frequently seen problems in diagnosing the lesions seen in the hyperplasia-carcinoma sequence by evaluating the variances between the observers. Four pathologists re-evaluated 137 endometrial biopsies and grouped them into diagnostic categories. The results were analyzed by Kappa statistics. Full agreement was reached in 89 cases (64.96%), with Kappa values ranging between 0.63-0.74. Three observers rendered the same diagnosis in 34 (24.81%) cases, and only one pathologist disagreed. Two or more observers held different views in 16 cases (10.95%). The problem areas were as follows: criteria distinguishing simple hyperplasia from other benign lesions, discrimination between atypical hyperplasia and carcinoma, and decision-making regarding the presence of atypia. There was a tendency towards overdiagnosis of hyperplasia in our department. Since the progression to carcinoma is a sequential event, borderline cases will exist if categories based on simple and clear cut off points are not defined.

A rare anatomical location of human papillomavirus-related penile warty carcinoma: Simultaneous axillary involvement

Indian Journal of Dermatology, Venereology and Leprology | Volume 84 | Issue 3 | May-June 2018 336 erythema associated with an automatic implantable cardioverter defibrillator. Br J Dermatol 1997;136:633. 5. Wimmershoff MB, Landthaler M, Stolz W. The artificial pace‐ maker erythema. Dtsch Med Wochenschr 1998;123:441. 6. Dinulos JG, Vath B, Beckmann C, Welch MP, Piepkorn M. Reticular telangiectatic erythema associated with an implantable cardioverter defibrillator. Arch Dermatol 2001;137:1259‐61. 7. Herbst RA, Weiss J. Reticular telangiectatic erythema associated with an implantable cardioverter defibrillator: an underpublished entity? Arch Dermatol 2003;139:100‐1. 8. Lin YC, Chiu HC, Chu CY, Sun CC. Telangiectatic pacemaker erythema. Clin Exp Dermatol 2003;28:447‐8. 9. Pitarch G, Mercader P, Torrijos A, Martínez‐Menchón T, Fortea JM. Reticular telangiectatic erythema associated with an implantable cardioverter defibrillator. Cutis 2006;78:329‐31. 10. García SM, González IR, Sambucety PS, Rodríguez Prieto MA. Reticulated telangiectatic erythema associated with automatic implanted defibrillator. J Eur Acad Dermatol Venereol 2008;22:115‐6. 11. Martin LK, Wendschuh P, Wendschuh P. Reticulated telangiectatic erythema of the pacemaker. Pacing Clin Electrophysiol 2008;31:624‐6. 12. Rodríguez‐Lojo R, Verea MM, Godoy J, Barja JM. Reticular telangiectatic erythema in a patient with a cardioverter defibrillator. Actas Dermosifiliogr 2010;101:183‐4. 13. Hinterberger L, Müller CS, Vogt T, Pföhler C. Reticulated teleangiectatic erythema after implantation of medical devices. An increasingly occurring phenomenon? Hautarzt 2011;62:770‐3. 14. Ringrose JS, Banerjee T, Hull PR. Angiosarcoma‐like presentation of pacemaker‐related vascular proliferation. Clin Exp Dermatol 2012;37:143‐5. 15. Ocampo OV, Marín VM, Idarraga JC. Reticulated telangiectatic erythema related to an implantable carioverter defibrillator: Case report and review of the literature. Dermatol Argent 2012;18:49‐52. 16. Beutler BD, Cohen PR. Reticular telangiectatic erythema: Case report and literature review. Dermatol Pract Concept 2015;5:71‐5.