[ review of mastocytosis with best practices]

Mastocytosis most frequently manifests in the skin, so most often is diagnosed by dermatologists at first. Low threshold in clinical suspicion helps early detection of these cases. Cutaneous mastocytosis is an increase of cutaneous mast cells without known underlying disease or inflammatory infiltrate. A skin biopsy with staining specific for mast cells [toluidine blue, Wright-Giemsa] and tryptase immunohistochemical analysis should be considered in all patients with characteristic skin lesions. There is no treatment that cures cutaneous matocytosis and the major concern in the treatment is patient's quality of life. Although systemic mastocytosis occurs in greater than 25% of cases of cutaneous matocytosis in adults, there is little evidence that symptomatic therapy substantially alters the course of the disease. Almost all patients with cutaneous matocytosis belong to the indolent category of the consensus revised classification and have a good prognosis. This review aimed to provide best practices recommendations based on the evidence and patients perspectives

[ unusual presentation of deep morphea [morphea profunda]: peripheral sensory motor nerve involvement, insulin dependent diabetes mellitus and hypothyroidism]

This case report introduces a 28-year-old male patient with morphea profunda, peripheral sensory motor nerve involvement, insulin dependent diabetes mellitus and hypothyroidism as an unusual presentation of deep morphea who dramatically responded to prednisolone and metothrexate after 4 months of treatment

[Evaluation of skin pH in normal population and its relationship with age, sex and anatomic location]

Everal studies have been conducted to evaluate skin pH in various diseases, but there are few reports in normal population. The aim of this study was to evaluate skin pH in healthy individuals. Fifty healthy volunteers were enrolled in this study. The subjects were divided by age into 5 groups, i.e., 10-20, 21-30, 31-40, 41-50 and 51-60 years old. In each group, 5 females and 5 males were examined. A pH meter [Courage and Khazaka electronic GmbH, Germany] was used to measure pH in 8 different locations of the body [forehead, cheek, nasolabial fold, neck, forearm, dorsal side of hand, palm and leg]. The mean values for pH in these locations were 5.25, 5.15, 5.06, 4.90, 4.75, 4.80, 4.69, and 4.83 respectively. pH was significantly higher in women [P<0.001]. There was a significant difference between skin pH in different age groups [P=0.002]. The highest and lowest amounts of pH belonged to the forehead [5.26 +/- 0.68] and leg [4.69 +/- 0.40], respectively. Age and sex and location have remarkable effects on skin pH

[Combination techniques and applications of Mohs micrographic surgery in the surgical management of malignant melanoma]

Multiple surgical methods are available for the management of malignant melanoma. Often, these methods have limitations in terms of the ability of obtaining margin clearance in the context of an appropriate cosmetic outcome. This article, briefly reviews the use of different simple and excisional techniques as well as that of Mohs micrographic in the surgical management of malignant melanomas