Rebiay Apaydin

Steatocystoma multiplex suppurativum: Oral isotretinoin treatment combined with cryotherapy

A 30‐year‐old man presented with numerous papules, nodules and inflamed cysts. The lesions were located all over the body, including the scalp, except the palms and soles. His mother and one sister had had similar but less extensive lesions. Histopathology of the biopsy specimens obtained from the anterior chest wall, axillae and the back region was consistent with steatocystoma multiplex (SM). A diagnosis of steatocystoma multiplex suppurativum was made. The inflamed lesions were treated with oral isotretinoin (1 mg/kg per daily) for 6 months. At the same time, cryotherapy was used for non‐suppurating lesions smaller than 2 cm. When the patient was evaluated 6 months later, cosmetic results were good. No new lesions have appeared in the subsequent 12‐month follow up.

Cytokeratin expression in lichen amyloidosus and macular amyloidosis

Aim  To understand the role of epidermal cells in the pathogenesis of lichen amyloidosus (LA) and macular amyloidosis (MA).

Heat shock proteins 60 and 70 expression of cutaneous lichen planus: comparison with normal skin and psoriasis vulgaris*

Background:  Heat shock proteins (HSPs) are expressed by most living cells and play fundamental roles in many biological processes. Their synthesis increases by a variety of stresses in order to enable cellular survival. Although it is known that they play an important role in immune and inflammatory responses of the skin, the role of HSPs in the pathogenesis of skin diseases has been studied in only limited skin diseases. Lichen planus (LP) is a relatively common papulosquamous dermatosis, and cell‐mediated immunity plays an important role in its pathogenesis. Although an altered expression of certain HSPs was reported in oral LP lesions, the expression of HSPs in cutaneous lesions of LP has not been investigated. In this immunohistochemical study, we aimed at investigating the role of HSPs in the pathogenesis of LP by studying whether there is any difference in HSP expression in cutaneous lesions of LP when compared to normal skin and psoriasis vulgaris (PV).

Possible role of Mycobacterium tuberculosis complex in Melkersson–Rosenthal syndrome demonstrated with Gen‐Probe amplified Mycobacterium tuberculosis direct test

Melkersson–Rosenthal (MRS) syndrome is characterized by a classical triad of recurrent or persistent orofacial swelling, peripheral facial nerve paralysis and lingua plicata. Granulomatous cheilitis (GC) is regarded as a monosymptomatic form of MRS. The exact aetiologies of MRS and GC are unknown. In this study we investigated the possible role of mycobacteria in these two conditions. A ribosomal RNA amplification‐based Gen‐Probe amplified Mycobacterium tuberculosis direct test was used to investigate the presence of M. tuberculosis complex in paraffin‐embedded skin biopsy specimens from five patients with MRS and one patient with GC. Three of the six specimens were shown to be positive using this system; one of the positive specimens also showed positive Ziehl–Neelsen staining. These results suggest a possible mycobacterial aetiology for MRS and GC.

Limited benefit of topical calcipotriol in lichen planus treatment: a preliminary study

BACKGROUND: Lichen planus (LP) is a papulosquamous dermatosis in which immunologic mechanisms play an important role in its pathogenesis. Topical calcipotriol, which mainly stimulates differentiation and inhibits proliferation of keratinocytes, also has immunosuppressive and anti-inflammatory functions. AIM: To investigate the therapeutical effects of topical calcipotriol in LP. METHODS: A total of 18 histopathologically proved LP patients were advised to apply calcipotriol ointment twice daily to all affected skin areas except genitalia. Clinical evaluation of all patients was performed monthly and response to treatment was assessed on clinical grounds (erythematous and/or violaceous color, thickness and scale of the lesions) as partial, complete or no response. If there was no response at the end of the second month, topical calcipotriol was stopped. If there was partial clinical improvement at the end of the second month, the treatment was continued for one additional month. RESULTS: In all, 16 patients completed the study. Of the study population, 56.25% (9/16) responded to topical calcipotriol treatment which was used for a maximum of 3 months. Complete clearing of the lesions with post-inflammatory hyperpigmentation and partial improvement were obtained in 31.25% (5/16) and 25% (4/16) of the patients, respectively. No improvement was observed in 43.75% (7/16) of the patients. CONCLUSION: Topical calcipotriol can be used in the treatment of LP as a therapeutic option, although it is not the first-choice drug.

Lichen amyloidosis, ankylosing spondylitis and autoimmune thyroiditis: coincidence or association?

Primary localized cutaneous amyloidosis (PLCA) is characterized by the deposition of amyloid in a previously apparently normal skin with the absence of other systemic or cutaneous disorder. Although ankylosing spondylitis may be associated with secondary systemic amyloidosis, no reports have been found showing the association of this disease with PLCA. In addition, the association of PLCA with autoimmune thyroiditis has not been previously reported. We report a concomitant occurrence of lichen amyloidosis, ankylosing spondylitis and autoimmune thyroiditis in a caucasian woman.

Effects of acitretin on spermatogenesis of rats

In this experimental study the possible effects of the acitretin on the spermatogenesis of the rats were investigated histopathologically. Thirty‐nine male adult Wistar albino rats were divided into 3 groups as two experimental groups and one control group. The first group consisting 14 rats were applied orally standard dose (0.75 mg/kg/day) acitretin and the second group consisting 16 rats were applied high dose (1.5 mg/kg/day) acitretin. Acitretin was given within dimetil sulphoxide (DMSO), which was diluted with saline solution as a ratio of 1/10, in order to increase its solubility. The control group consisting 9 rats were given only saline solution including DMSO for 8 weeks. After 8 weeks of the administration, half of the rats in the first and second groups and the entire control group were sacrificed under deep ether anaesthesia and bilateral orchiectomy was made. The remaining rats were compared with the control group using a similar method at the end of 8 weeks of wash‐off period. The orchiectomy materials were histopathologically evaluated under the light microscope for spermatogenesis according to parameters including spermatogenetic activity, spermatogenetic organization, seminiferous tubular diameter, interstitial Leydig cells and fibroblasts. The groups, which were evaluated at the end of the 8th and 16th weeks, were compared with the control group regarding the mentioned parameters and no statistical significance was observed among the groups. In our study it was concluded that the standard and high doses of acitretin do not have any effect on the spermatogenesis of the rats.

Confluent and reticulate papillomatosis: response to topical calcipotriol

Confluent and reticulate papillomatosis of Gougerot and Carteaud (CRP) is a rare dermatosis that is probably a disorder of keratinization. Calcipotriol, a vitamin D analogue, regulates keratinocyte differentiation and proliferation. We describe a 21 year old woman who was diagnosed as having CRP and was treated with topical calcipotriol ointment twice daily. A marked clinical improvement was achieved after 2 months of treatment. In conclusion we suggest that topical calcipotriol, when used at a safe dose, is a ligitamate treatment for CRP and offers an alternative to oral vitamin A. (J Dermatol Treat (2000) 11:109-111)

The effects of 17 August Marmara earthquake on patient admittances to our dermatology department

On 17 August 1999 a devastating earthquake with a magnitude of 7.4 on the Richter scale occurred in Marmara region of Turkey and the epicentre of the earthquake was our city. In this study we aimed to determine the influence of a major earthquake on patient admittances to the outpatient clinic of our dematology department. All the registrations of the outpatient clinic of our dermatology department in a period of 6 months after the earthquake and the same period last year were revised retrospectively and categorized into 15 subgroups. The first 3 months registrations (earthquake group 1) and the second 3 months registrations (earthquake group 2) after the earthquake were compared with those of the same periods in last year, respectively (control group 1 and control group 2). Also the earthquake group 1 was compared with the earthquake group 2. When the results were evaluated, it was seen that the incidence of infections‐infestations was significantly higher in the earthquake group 1 when compared with the control group 1. When the earthquake group 2 and the control group 2 were compared with each other regarding the incidences of the skin diseases, no statistically significant difference was found. The incidences of erythematous‐squamous skin diseases, pruritus and neurocutaneous dermatoses and eczemas were significantly higher in the earthquake group 2 when compared with the earthquake group 1. On the other hand, the incidences of infections‐infestations and dermatoses due to physical factors were significantly lower in the earthquake group 2 when compared with the earthquake group 1. We think that the alteration in the admittances to outpatient clinic of our dermatology department in the first 3 months after the earthquake is due to the damaged infrastructures and unhygienic life conditions and in the second 3 months is due to psycho‐emotional factors related to earthquake.

Amiodarone pigmentation, eye and thyroid alterations

Amiodarone is an effective cardiac antiarytmic drug. Long‐term, high dose use of the drug is associated with skin discolouration, corneal deposition and alterations in thyroid hormone levels. We present the case of a 61‐year‐old woman suffering from the combination of these three side‐effects.