Turna Ilknur

Interobserver reliability of the Nail Psoriasis Severity Index

Background.  Because the Psoriasis Area and Severity Index (PASI) does not consider the severity of nail disease, a scale that assesses the extent of involvement of psoriatic nails is needed. A new grading system, the Nail Psoriasis Severity Index (NAPSI) has been proposed.

Evaluation of dermoscopic and histopathologic features and their correlations in pigmented basal cell carcinomas

Background  Because of their clinical similarities, pigmented basal cell carcinomas (BCCs) can be confused with melanocytic pigmented lesions especially with melanoma. Since special dermoscopic features have been described for pigmented BCCs, dermoscopy is accepted as a useful tool for the diagnosis of pigmented BCCs.

Comparison of the Effects of Pulsed Dye Laser, Pulsed Dye Laser+Salicylic Acid, and Clobetasole Propionate+Salicylic Acid on Psoriatic Plaques

BACKGROUND Studies show that pulsed dye laser (PDL) has some clinical benefits on psoriasis with a low clearance rate. In addition, it has been suggested that applying keratolytics before treatment might be helpful in PDL therapy. Topical corticosteroids remain the most commonly prescribed agents for psoriasis. OBJECTIVE This study was designed to compare the efficacy of the PDL treatment with that of PDL treatment after salicylic acid on psoriatic plaques. The other goal of this study was to compare the efficacy of the PDL treatment with that of clobetasol propionate treatment. METHODS Twenty-two patients with chronic, stable psoriatic plaques that involved less than 20% of their body were included in the study. Three similar-appearing psoriasis plaques in these patients were selected. Whereas the first plaque received only PDL, the second plaque received PDL after salicylic acid, and the third plaque received clobetasol propionate ointment and salicylic acid. Evaluation of the study plaques was carried out by the modified Psoriasis Area and Severity Index (mPASI) score and by measuring the area of the plaques. RESULTS Of the 21 patients, 19 completed the study. Although the decrease in mPASI scores was determined to be maximum for clobetasol propionate + salicylic acid-treated plaques and minimum for only PDL-treated plaques, the decrease was statistically significant in all groups when compared with baseline (p < .003). At the 3- and 6-week evaluations, there was a statistically significant difference between clobetasol propionate + salicylic acid-treated plaques and the two PDL-treated plaques (p < .003); however, the difference observed at the 9-, 12-, and 15-week evaluations was statistically significant only between clobetasol propionate + salicylic acid-treated plaques and PDL-treated plaques (p < .003). When the baseline and 15-week evaluations were compared, there was no statistically significant increase in the mean lesion areas of clobetasol propionate + salicylic acid-treated psoriatic plaques (p > .003), but there was a statistically significant increase in the mean lesion areas of two PDL-treated psoriatic plaques (p < .003). CONCLUSION The results of this study showed that the effect of PDL could be increased when salicylic acid was added to treatment, although there was no statistically significant difference between both treatment protocols. However, clobetasol propionate + salicylic acid treatment is more effective than both PDL and PDL + salicylic acid treatment.

Verruca vulgaris : pulsed dye laser therapy compared with salicylic acid + pulsed dye laser therapy

Background  In recent years, lasers have been used in verruca therapy and some successful results have been obtained in some types of verruca. In some of these laser studies, peeling processes have been used to increase penetration.

Glycolic Acid Peels Versus Amino Fruit Acid Peels in the Treatment of Melasma

BACKGROUND Chemical peels are becoming more popular as a treatment modality for melasma. OBJECTIVE To compare the therapeutic effects of glycolic acid (GA) peels and amino fruit acid (AFA) peels in patients with melasma. METHODS In this single‐blind, randomized right–left comparison study, patients received 12 serial peels on the two halves of the face at 2‐week intervals for 6 months. Clinical evaluation based on the modified Melasma Area and Severity Index (MASI) scores was performed at baseline and at 3 and 6 months. RESULTS The modified MASI scores at 3 and 6 months in both application areas decreased significantly from baseline (p<.05). When the two applications were compared with each other, there was no statistically significant difference between GA and AFA in terms of regression of melasma (p>.05). During the application, it was observed that AFA peels caused fewer problems than GA peels did. CONCLUSIONS Based on the results of this study, GA and AFA peels for melasma therapy were efficacious, but the AFA peel was found to be less irritating and was better tolerated.

Angioma serpiginosum: Dermoscopy for diagnosis, pulsed dye laser for treatment

Angioma serpiginosum is a rare benign vascular disorder, characterized clinically by multiple minute, red to purple, grouped macules in serpiginous and gyrate patterns and histopathologically by ectatic dilatation of capillaries. Patients can undergo unnecessary hematological tests, because the condition can be confused with chronic purpuric dermatoses. An 18‐year‐old man with angioma serpiginosum of his left arm was evaluated by dermoscopy and treated with pulsed dye laser. Numerous small, relatively well‐demarcated, round to oval red lagoons were determined with dermoscopy, and approximately 75% of the area of his lesion disappeared after four sessions of pulsed dye laser. Our case supports the hypothesis that dermoscopy is beneficial in the diagnosis of angioma serpiginosum and that pulsed dye laser is effective in the treatment of this disorder.

Papular acantholytic dyskeratosis of the anogenital area with positive direct immunofluorescence results

Acantholytic dyskeratosis is a distinct histological pattern characterized by hyperkeratotic and parakeratotic epidermis with intraepidermal clefts harbouring acantholytic and dyskeratotic keratinocytes. This histopathological pattern is uncommon in dermatoses of the anogenital region. We report a 30‐year‐old woman who had numerous smooth whitish papules on the labia majora, perineum and perianal region, which coalesced into plaques in some areas. Microscopically, the lesions showed prominent suprabasal and intraspinous acantholysis with dyskeratotic keratinocytes. Direct immunofluorescence examination revealed intercellular Ig G and C3 within the epidermis. We were unable to find a similar case of papular acantholytic dyskeratosis of the anogenital area with positive direct immunofluorescence findings reported in the literature, thus in this report, the clinicopathological features of a unique case are presented.

Naproxen-induced lichen planus: report of 55 cases.

Background  Clinical and histopathological differential diagnosis is usually impossible in drug‐induced lichen planus (LP) and idiopathic LP. Naproxen is a nonsteroidal anti‐inflammatory drug, which is widely used for its analgesic, antipyretic and anti‐inflammatory effects. To the best of our knowledge, two case reports on naproxen‐induced LP have been reported.

Multiple pilomatricoma with perforation

A 22‐year‐old woman presented to our clinic with a complaint of masses on various parts of her body. A mass on her right forearm had appeared 5 years ago and had enlarged during the past 6 months. Two lesions on the back of her neck had a 3‐year history, one lesion on her eyebrow had a 2‐year history, and one lesion on her left forearm had a 1‐year history. The lesion on her left forearm was discharging purulent material.

Heterogeneous disease: a child case of lichen planus pemphigoides triggered by varicella.

Lichen planus pemphigoides (LPP) is a rare and controversial disease. It is characterized clinically by tense bullae arising both on lichen planus papules and on uninvolved skin, histologically by the demonstration of subepidermal bullae and by linear deposits of immunoglobulin G and C3 along the basement membrane zone on immunofluorescence of peribullous skin. Some authors consider LPP as the combination of lichen planus and bullous pemphigoid. Others think that it most likely encompasses a heterogeneous group of subepidermal autoimmune blistering disorders occurring in association with lichen planus. We present a child case that supports the heterogeneous condition of this disease triggered by varicella.