Nail changes in minimal alopecia areata

Nail involvement in alopecia areata is relatively common. The reported incidence ranged from 10 to 66%, and in another it was as low as 3.65%. Onychodystrophy generally is most common and severe in patients with extensive alopecia, but it has been reported with minimal hair loss. This work aimed at evaluating the types and the prevalence of nail changes occurring in the patchy type of alopecia areata with minimal hair loss. Eighty four patients with patchy type of alopecia areata of minimal hair loss were included in this study. Full clinical examination and pertinent laboratory investigations were done for them. 44.1% of patients presented with nail changes; 36.84% had maturity onset and 59.25% had juvenile onset alopecia areata. 48.27% gave history of recurrence of alopecia areata. Fine pitting occurred in 32.43%, fine pitting with longitudinal ridging in 24.32%, longitudinal ridging alone in 8.11%, punctuate Leukonychia in 16.22%, Beau's lines in 10.81%, onycholysis and nail shedding in 5.41%, and reddening of the nail in 2.70% of patients. Nail changes are common in alopecia areata, occurring even in mild cases with minimal hair loss, being more with longer duration and recurrence. Children and adolescents are more prone to nail changes than adults. Diffuse fine pitting and longitudinal ridging are the commonest nail affection

Dermatologic disorders associated viral hepatitis in Egypt

Subjective: Viral hepatitis can present with a wide variety of cutaneous manifestations. Of all bloodborne infections, hepatitis has the greatest chance for accidental transmission through breaks in the skin during surgical procedures, needle pricks, etc. The aim of this work is to study the cutaneous manifestations of viral hepatitis in Egypt. Also to booster the dermatologist awareness of the various associations, so that an early diagnosis of and precautions against such a serious disorder could be undertaken. Patients and Hepatitis patients were taken at random from the inpatient and outpatient clinics of the university hospitals and liver institute in Egypt. The patients had complete history taking, physical and dermatological examination. Hepatitis serology, blood chemistry for liver functions, lipids, diabetes, and kidney function, skin biopsy, bacterial and mycological culture were done for the patients as indicated. 900 hepatitis patients [520 males, 380 females] were examined. Of them, 500 had Hepatitis C virus [HCV] and 400 had Hepatitis B virus [HBV] infection. 60% were patients residing in rural regions, and 55.5% were workers and farmers infested with Bilharzia. 15% gave different histories of blood transfusion, [27.7%] I.V. drug administration specially for Bilharziasis, and 5.5% were in contact with other hepatitis patients. Skin manifestations of liver disease as a whole comprised 48.1% of the total, and 6.1% had skin manifestations of hepatitis. 80% had skin manifestations with HCV, and 20% with HBV infection. The most prevalent diseases were lichen planus, urticaria, erythema multiforme, psoriasis, leucocytoclastic vasculitis, and erythema nodosum. Viral hepatitis is a prevalent infectious disease in Egypt, the commonest types being HCV and HBV most probably as a result of repeated I.V. treatment of Bilharzial patients. Male workers outnumbered females. Skin diseases occurred more with HCV patients. Not all types of the reported skin associations were found in this study, and there has not been a previous report about the prevalence of associated skin disorders in Egypt for comparison. However, a wider scale study is required for a more precise evaluation. Dermatologists should be aware of the various cutaneous associations of such a serious disease

Transfusion associated graft versus host disease

A 70-year-old man developed a skin rash with fever, vomiting and diarrhea ten days after partial gastrectomy for gastric adenocarcinoma which had metastasized to intra-abdominal lymph nodes and liver. Four days later a skin biopsy confirmed the clinical diagnosis of transfusion associated graft versus host disease. His condition deteriorated with jaundice, high liver enzymes, leukopenia and thrombocytopenia. He died 19 days after surgery

Humoral immunological study of pityriasis alba

Humoral and complement C3 studies were conducted on 29 Pityriasis alba patients, 18 males and 11 females, whose ages ranged 5-15 years and the mean duration of the disease was 5.4 months. No significant difference was found in serum IgG, IgM, IgE, IgA, and C3 between the patients and the control group. This is in controversy with the hypothesis of Pityriasis alba being a form of atopy and also with the old theory of Pityriasis alba being related to a septic focus or infection, since variations of serum antibodies are expected in these conditions