Staphylococcus aureus carriage in patients with psoriasis

The aggravating role of Staphylococcus aureus is well known in atopic dermatitis but has not yet been proven in psoriasis. The role of Staphylococcus aureus superantigens is emphasized in the initiation, maintenance and complications of psoriasis. We investigated the frequency of nasal, axillary, and perineal carriage of Staphylococcus aureus [SA] in patients with psoriasis and its possible influence on the severity of the disease. One hundred patients with the clinical diagnosis of psoriasis participated in the study. Cultures of the bacterial flora were obtained from the right and left axilla and nasal nares and perineum, inoculated on standard bacterial medium [blood agar], and incubated at 37°C degrees for 48 h. One hundred patients with the clinical diagnosis of psoriasis [42% female and 58% male] comprised the study group. Mean age of the patients was 41.1 +/- 17.1 years. About 42% of the patients carried S. aureus; of these, 32% were from the nose, 13% from axilla, and 11% from the perineum. Three patients were carriers in all 3 sites. There was no significant difference in the severity of the disease between the carriers and non-carriers measured by the psoriasis area and severity index [PASI] score. According to our findings, S.aureus carriage in psoriasis had no significant influence on disease severity. It might be relevant for a subgroup of patients only when superantigen productions are found

Case: multiple painful nodules on the back

A 43-year-old middle-eastern woman was visited with a 15-year history of multiple painful cutaneous nodules on her back. The first lesion appeared on her back when she was 28 years old. As she aged, the lesions became larger, more numerous, and more painful with cold or physical contact. Her medical history was not significant. The patient's medications included naproxen, calcium-D, and vitamins. Her family history was notable as her brother had developed similar cutaneous lesions. Physical examination revealed more than 30 pinkish papules, measuring up to 1 cm in diameter, in a grouped arrangement on her back [Figure 1]. The complete blood cell count, serum chemistry profile, and serum erythropoietin levels were within normal limits. Abdominal ultrasonography was normal. A skin biopsy specimen was obtained from a nodule on her back [Figure 2]

Adult Case of Hydroa Vacciniforme

Hydroa vacciniforme [HV] is a rare acquired photodermatosis, usually with onset in childhood and characterized by vesicles, crust and scar formation that follow exposure to sunlight.Vacciniform scars of face and dorsa of the hands are common features but oral ulcer and eye signs also rarely occur. It usually resolves before adult age. A rare manifestation of the disease would be persistence until adult age which is presented in this report

[Ichthyosiform parapsoriasis: report of a case]

Acquired ichthyosis is a known paraneoplastic sign of lymphoproliferative malignancies with nonspecific histopathologic findings revealing no implication of the underlying neoplasm. However, ichthyosiform eruption is considered as a specific manifestation of mycosis fungoides [MF], i.e., ichthyosiform MF. There are a few reports of ichthyotic manifestation of MF, but only one report of this presentation in parapsoriasis. We present a case of ichthyosiform parapsoriasis in a 22-year-old woman with hyperpigmented ichthyosiform scaly patches on her trunk and extremities. The histopathologic findings were hyperkeratosis, parakeratosis and acanthosis with scattered lymphocytic infiltration, also could be seen in parapsoriasis. The patient responded well to oral photochemotherapy

Congenital diffuse melanosis in a father and two Sons

Congenital diffuse melanosis is one of the rarest clinical manifestations of hereditary universal melanosis and only few cases have been reported all over the world. The presented case is a 54-year-old man who presented to us complaining of erythematous annular lesions on his face and neck 8 months ago. Diffuse pigmentation of his skin took our attention. According to the patient, diffuse hyperpigmentation was present at birth and there was no obvious changes up to now. His mother and sister had similar hyperpigmentation. He had two sons with a similar hyperpigmentaion, but his daughter had normal skin pigmentation. All laboratory investigation for the causes of hyperpigmentaion were reported normal and investigation for causes of secondary hyperpigmentation did not reveal any abnormality. In histopathologic assay, the erythematous lesion was reported to be discoid lupus erythematosus and the diagnosis of hyperpigmented lesion reported as congenital diffuse melanosis

[Localized darier's disease or acantholytic dyskeratotic epidermal nevus: a case report]

Patients with keratotic lesions distributed in a unilateral, linear, zosteriform or localized pattern and revealing histopathologic features of dyskeratoticacantholysis have been reported previously. There is some controversy in the appropriate nosologic classification of this entity. Some authors consider it as a localized form of Darier's disease while others place it as a variant of epidermal nevus. We report a 19-year-old girl who presented with 14 years history of an asymptomatic, hyperkeratotic area of skin-colored papules in a dermatomal distribution on the dorsum of her left hand and forearm. Pathological evaluation showed acantholysis and dyskeratosis. The controversy regarding the correct classification of such a patient is discussed