Saniye Çinar

Oxidative stress in acne vulgaris

Background  Acne vulgaris is one of the common dermatological diseases and its pathogenesis is multifactorial. In this study, we aimed to determine the effects of oxidative stress in acne vulgaris.

Purified protein derivative: The vital part of the cervical tuberculous adenitis diagnosis

OBJECTIVE: The purpose of this study was to review the diagnostic procedures for tuberculous cervical adenitis (TCA) and state the most valuable diagnostic protocol. PATIENTS AND METHODS: Fifty-eight patients who presented with progressive, painless, enlarging neck masses and were diagnosed with TCA between 1988 and 1998 at Beyoglu Hospital, Istanbul, were retrospectively reviewed. RESULTS: The chest roentgenograms were normal in all patients. The purified protein derivative skin testing was positive in every case. The fine needle aspiration biopsy was consistent with mycobacterial infection in 27 (46%) of 58 cases, and biopsy results correctly diagnosed TCA in all masses excised. CONCLUSION: Tuberculosis should be considered in the differential diagnosis of the neck masses. Purified protein derivative with detailed history and physical examination should be the first step in the diagnosis.

Autologous Serum Skin Test versus Autologous Plasma Skin Test in Patients with Chronic Spontaneous Urticaria

Previous studies indicate that 25–45% of chronic urticaria patients have an autoimmune etiology. Autologous serum skin test (ASST) and autologous plasma skin test (APST) are simple tests for diagnosing chronic autoimmune urticaria (CAU). However, there are still some questions about the specificity of these tests. This study consisted of 50 patients with chronic spontaneous urticaria (CSU) and 50 sex- and age-matched healthy individuals aged 18 years, and older. A total of 31 (62%) patients and 5 (10%) control patients had positive ASST; 21 (42%) patients and 3 (6%) control patients had positive APST. Statistically significant differences were noted in ASST and APST positivity between the patient and control groups (ASST P < 0.001; APST P < 0.001). Thirteen (26%) patients and 5 (10%) control patients had antithyroglobulin antibodies or antithyroid peroxidase antibody positivity. No statistically significant differences were noted in thyroid autoantibodies between the patient and control groups (anti-TG P = 0.317; anti-TPO P = 0.269). We consider that the ASST and APST can both be used as in vivo tests for the assessment of autoimmunity in the etiology of CSU and that thyroid autoantibodies should be checked even when thyroid function tests reveal normal results in patients with CSU.

Gradual nose enlargement: pachydermoperiostosis.

Pachydermoperiostosis, also known as the Touraine-Solente-Golé syndrome, is characterized by thickening of the skin in folds, clubbing of the fingers, and periostosis of the long bones. It may be associated with additional features such as thickening of the ears and enlargement of the tongue. Coarsening of the facial features may lead to acromegalic facies. The scalp may be thickened and show cutis verticis gyrata that is characterized by the formation of furrows that resemble cerebriform pattern. We report a case of pachydermoperiostosis with an unusual presentation: gradual nose enlargement. A 21-year-old man presented to our department with complaint of gradual swelling of the nose. The patient had been in excellent health until 18 months earlier when he began to have nasal enlargement and headache that gradually worsened. He denied any nasal obstruction, rhinorrea, or epistaxis. Externally, he had a large nose (Fig 1A). Endoscopic examination of the nose revealed patent nasal passages bilaterally. No localized mass was palpated in the nasal dorsum except a grossly thickened skin. There was no tenderness to palpation and no discoloration over the skin. Further examination of the head and neck revealed no abnormalities except scalp lesions resembling the sulci of the brain (Fig 1B). A radiograph of the nose showed soft-tissue expansion around the nasal bones. The patient was referred to the dermatology and physiotherapy departments because of scalp lesion and pain in joints of the hand. Physical examination revealed clubbing of the fingers. CT scan and chest radiograph were normal as were laboratory examinations including complete blood count, plasma glucose, growth hormone, and thyroid function tests. Radiologic examination showed periosteal new bone formation in the distal ends of the ulna, radius, and phalanges. Biopsy of the skin showed superficial hyperker-