Sukran Tunali

A case of epidermodysplasia verruciformis associated with squamous cell carcinoma and Bowen's disease: a therapeutic challenge.

Epidermodysplasia verruciformis (EV) is a very rare and chronic disease characterized by a susceptibility to cutaneous infections by a group of phylogenetically related human papillomavirus (HPV) types. We present here a 52‐year‐old man previously diagnosed and treated as squamous cell carcinoma but also found to have epidermodysplasia verruciformis lesions in association with Bowens disease. The patient was effectively treated with a combination of interferon therapy (6 million units, twice a week) and topical imiquimod for Bowens disease (five times a week). We conclude that topical imiquimod is very effective in the treatment of Bowens disease and may be combined with systemic interferon therapy in rare cases with multiple vivid presentations of HPV infections.

Miliary osteoma cutis of the face: treatment with the needle microincision-extirpation method.

Multiple miliary osteoma cutis of the face represents primary extra‐skeletal bone formation that arises within the skin of the face. Multiple miliary osteoma cutis of the face is a rare complication of chronic inflammatory acne vulgaris and has invasive and non‐invasive treatment alternatives different from acne vulgaris. Invasive techniques should be simple, easy, and inexpensive, with minimal risk of scarring and pigmentation. We used a needle microincision‐extirpation technique in a patient with multiple miliary osteoma cutis unresponsive to non‐invasive treatment modalities. Skin overlying the papules was incised with a needle and then the calcificated papules were extirpated by using a small curettage device. Lesions were left to secondary healing. Results were quite good and cosmetically acceptable.

Narrowband UVB therapy in the treatment of lichen planus.

Background: Recently, UVB lamps with a peak emission around 311u2003nm have been used successfully for the treatment of many dermatologic diseases known to be treated with psoralen plus UVA (PUVA). Narrowband UVB (NBUVB) radiation causes less erythema and carcinogenicity with lower cumulative doses than PUVA, while the treatment response remains high. Lichen planus (LP) is a cell‐mediated immune response of unknown origin.

Benign neonatal hemangiomatosis with conjunctival involvement. Report of a case and review of the literature.

Hemangiomas are the most common tumours of infancy. When limited to the skin, multiple lesions have a benign course and excellent prognosis but in cases of visceral involvement, the morbidity and mortality rates are high. We report a rare case of a female infant with benign neonatal hemangiomatosis who had dramatic conjunctival involvement. The spectrum of neonatal hemangiomatosis is reviewed, highlighting the importance of differentiation of the two extremes of this disorder.

Pityriasis Rosea-Like Eruption due to Ergotamine: A Case Report

To the Editor: Pityriasis rosea (PR) is a common skin disorder with a self-limited papulosquamous presentation (1). PR-like eruptions due to various drugs and chemicals have previously been reported (1–7). The lesions in PR-like drug eruptions are generally fewer, larger and more scaly than those in classical PR; the fir tree pattern and herald lesions of PR are frequently absent, while associated oral lesions are more common. In addition to these atypical clinical features, it often has a protracted course, striking resistance to therapy, subsequent marked postinflammatory hyperpigmentation, and transformation to lichenoid dermatitis (1, 2, 4). The clinical suspect of an iatrogenic etiology is confirmed by the rapid recovery after withdrawal of the drug. PR-like drug eruption usually manifests with the typical features mentioned above, but it may also occasionally present with atypical features (6). However, the histopathological features of PRlike eruptions are almost always indistinguishable from PR (1). We report herein a case of PR-like eruptioin induced by ergotamine tartrate. A 36-year-old man presented with 10 days of slightly pruritic eruptions on the trunk and extremities. He had been suffering from migraine for a year, and ergotamine tartrate (2 mg/d, PO) had been started two weeks previously. After three weeks of ergotamine, he developed PR-like skin eruptions; a herald patch followed by symmetrical erythematous smaller patches, maculopapules, and papules with peripheral scales scattered particularly on the trunk and extremities. The long axies of the lesions were parallel to the skin lines, giving the “fir tree” distribution pattern characteristic of PR (Fig. 1). Oral mucosa, nails, and palmoplantar regions were spared. He had no history of any other medications. Hemogram and urine analysis were normal. Rheumatoid factor, C reactive protein, serum autoantibodies and serologic tests for syphilis were negative or normal. The erythrocyte sedimentation rate and serum IgA and IgE levels were elevated. No hyphal elements were observed on native examination. The specific antibodies against virus (hepatitis B and C virus, cytomegalovirus, Epstein-Barr virus, human herpes virus type 1 and 2, human parvovirus B19) were negative. Since viral antibodies for human herpes virus-6 (HHV-6) and HHV-7 were not available, no antibodies against HHV-6 and HHV-7 were tested. Histopathological findings were consistent with PR (Fig. 2). These anamnestic, clinical, and histopathological features verified the diagnosis of PR-like eruption. The lesions resolved in a month after cessation of ergotamine and initiation of systemic antihistamines and topical corticosteroid. We did not perform a rechallenge for ethical reasons. Although we recommended that the patient The Journal of Dermatology Vol. 32: 407–409, 2005

Effects of Malassezia yeasts on serum Th1 and Th2 cytokines in patients with guttate psoriasis

Backgroundu2002 Systemic and focal infections caused by microorganisms have been known to induce or exacerbate psoriasis. Although the role of yeast species of the genus Malassezia in the pathogenesis of psoriasis is not fully understood, it is thought that these lipophilic yeasts may represent a triggering factor in the exacerbation of psoriatic lesions.

Acquired bilateral nevoid telangiectasia syndrome with gastrointestinal involvement

ejd.2011.1404 Auteur(s) : Aysegul Turan1 draysegulgocer@yahoo.com, Hayriye Saricaoglu1, Emel Bulbul Baskan1, Murat Keskin2, Saduman Balaban Adim3, Hakan Turan4, Sukran Tunali1 1 Uludag University Medical Faculty, Dermatology Department, Bursa, Turkey 2 Uludag University Medical Faculty, Gastroenterology Department, Bursa, Turkey 3 Uludag University Medical Faculty, Pathology Department, Bursa, Turkey 4 Duzce University Medical Faculty, Dermatology Department, Duzce, Turkey Unilateral nevoid telangiectasia [...]

A case of Sjögren-Larsson syndrome

usually a warty plaque, which most commonly occurs on the scalp but may also be found on the face, neck or trunk. Only 5% of the lesions are located on the extremities, usually the thigh as in our patient. In about half of the cases the lesions are present at birth. To our knowledge, only six cases of multiple syringocystadenoma papilliferum in a linear or segmental distribution have been described [%lo]. The arrangement of the lesions according to the lines of Blaschko in our case suggests the possibility of genetic mosaicism. Syringocystadenoma papilliferum may thus occur as a solitary tumor and as multiple lesions in a linear pattern as is seen in other benign adnexal tumors of the skin, such as trichoepithelioma, basaloid follicular hamartoma and eccrine spiradenoma. However, an important feature specific to syringocystadenoma papilliferum is the association with organoid (sebaceous) naevus in 40% of cases and secondary basal cell carcinoma in 9% of the lesions [l]. The occurrence of secondary basal cell carcinoma should be considered as a consequence of the coexisting organoid (sebaceus) naevus and has been noted only in those examples of syringocystadenoma papilliferum that also exhibit an organoid (sebaceus) naevus. So far, no such association with organoid (sebaceus) naevus and basal cell carcinoma has been demonstrated in the multiple linear form of syringocystadenoma papilliferum. Therefore, multiple linear syringocystadenoma papilliferum may represent a distinct clinical form in which surgical excision for the possible risk of basal cell carcinoma may not be mandatory.