Yasemin Saray

Treatment of keloids and hypertrophic scars with dermojet injections of bleomycin: a preliminary study

Background  Numerous treatment modalities have been used to treat keloids and hypertrophic scars, but the optimal treatment has not been established.

Superficial fungal infections in 102 renal transplant recipients: a case-control study

BACKGROUND Renal transplant recipients are predisposed to superficial fungal infections caused by graft-preserving immunosuppressive therapy. Reports have documented a wide range of prevalence rates for superficial fungal infections in this patient group. OBJECTIVE The aim of this study was to determine the prevalence and clinical and mycological features of superficial fungal infections in renal transplant recipients at our center. METHODS One hundred two consecutively registered renal transplant recipients (34 women, 68 men) and 88 healthy age- and sex-matched persons acting as controls (30 women, 58 men) underwent screening for the presence of superficial fungal infection. Skin scrapings and swabs were obtained from the dorsum of the tongue, upper part of the back, toe webs, and any suspicious lesions. Nail clippings were also collected. All samples were examined by direct microscopy and were stained with calcofluor white. The samples were cultured in Sabouraud dextrose agar, mycobiotic agar, and dermatophyte test medium. Candida species were identified on the basis of germ-tube production, spore formation in cornmeal agar, and results of biochemical testing. Dermatophytes were identified on the basis of colonial and microscopic morphologic features in conjunction with results of physiologic evaluation (in vitro hair perforation test, urease activity, temperature tolerance test, and nutritional test). RESULTS Sixty-five (63.7%) of the 102 renal transplant recipients had cutaneous-oral candidiasis, dermatophytosis, or pityriasis versicolor, whereas only 27 (30.7%) of controls had fungal infection. Pityriasis versicolor was the most common fungal infection in the patient group (36.3%), followed by cutaneous-oral candidiasis (25.5%), onychomycosis (12.7%), and fungal toe-web infection (11.8%). Pityriasis versicolor and oral candidiasis were significantly more common among the renal transplant recipients, whereas the frequency of dermatophytosis in patients and controls was similar. Candida albicans was the main agent responsible for oral candidiasis, and Trichophyton rubrum was the most common dermatophyte isolated. Analysis showed that age, sex, and duration of immunosuppression did not significantly affect the prevalence of superficial fungal infection. Cyclosporine treatment and azathioprine therapy were identified as independent risk factors for superficial fungal disease. CONCLUSIONS The prevalence of opportunistic infections with Pityrosporum ovale and C albicans is increased among renal transplant recipients, probably owing to the immunosuppressed state of this patient population. However, renal transplant recipients are not at increased risk of dermatophytosis.

The role of psychological factors in alopecia areata and the impact of the disease on the quality of life

Background  The role of psychological factors in the pathogenesis of alopecia areata (AA) has long been the subject of debate. Numerous studies have provided controversial results.

Familial aquagenic acrokeratoderma: case reports and review of the literature

In recent years, a number of authors have described the development of palmar or palmoplantar keratoderma after brief exposure to water. Herein, we report a father and son with this condition, which we prefer to call aquagenic acrokeratoderma. These cases are interesting because they mark the first documentation of this entity in males. Also, they provide further evidence of familial occurrence.

Acute infantile haemorrhagic oedema: measles vaccination as possible triggering factor.

Sir, The entity now known as acute infantile haemorrhagic oedema (AIHO) of the skin was ® rst described by Snow (1) in 1913. This disease primarily affects infants younger than 24 months of age, and is characterized by low-grade fever, sudden-onset purpura (often in a cockade pattern) and in ammatory oedema of the limbs and face. The most striking feature of AIHO is the contrast of these dramatic cutaneous signs in a patient who is otherwise in good general condition. In most cases of AIHO, the disease is con® ned to the skin with no visceral involvement. The course of the disease is short and benign, and patients show complete spontaneous recovery (2 ± 6). The aetiopathogenesis of AIHO is not well understood, but bacterial (3 ± 5, 8) or viral infection (3, 4, 10), vaccination (3, 4) and drug intake (3, 4, 7 ± 9) have all been proposed as causes. The authors of previous case reports agree that AIHO should be classi® ed within the spectrum of leucocytoclastic vasculitis (3 ± 9, 11, 12); however, the histopathological ® ndings do not always meet the criteria for leucocytoclastic vasculitis (4). Here, we report an infant with AIHO that may have been triggered by measles vaccination. The histopathologic criteria for leucocytoclastic vasculitis were absent in this case. To our knowledge, this is the ® rst report of AIHO occurring after measles vaccination.