Vascular structures in dermoscopy

AbstractDermoscopy is an aiding method in the visualization of the epidermis and dermis. It is usually used to diagnose melanocytic lesions. In recent years, dermoscopy has increasingly been used to diagnose non-melanocytic lesions. Certain vascular structures, their patterns of arrangement and additional criteria may demonstrate lesion-specific characteristics. In this review, vascular structures and their arrangements are discussed separately in the light of conflicting views and an overview of recent literature.

Prevalencia de trastornos de la piel en niños que asisten a la escuela primaria en Diyarbakir, Turquía / Prevalence of skin disorders among primary school children in Diyarbakir, Turkey

Antecedentes. El objetivo de este estudio fue determinar la prevalencia de dermatosis pediátricas en Diyarbakir, provincia ubicada en la región sudeste de Turquía. Materiales y métodos. Este fue un estudio transversal realizado en abril de 2008 en alumnos que asistían a ocho escuelas primarias públicas de Diyarbakir seleccionadas al azar. Se examinó a los alumnos y se les administró un cuestionario para determinar el nivel socioeconómico y las características sociodemográficas. Resultados. Los dermatólogos evaluaron, en total, a 1932 alumnos. De ellos, 953 (49,32%) eran niñas, con una media de edad de 11,06 ± 2,13 años (rango: 6-17 años). La prevalencia puntual global de trastornos de la piel fue del 59,1%. En esta muestra, 776 niños (40,2%) tenían solamente una enfermedad de la piel, mientras que 299 (15,5%) tenían dos, y 67 (3,5%), al menos tres. La prevalencia puntual de los trastornos de la piel fue del 33,1% en los alumnos de primer grado y del 78,9% en los alumnos de octavo grado (p < 0,05). Las enfermedades de la piel más frecuentes fueron en primer lugar el eccema (32,8%), seguido de los trastornos de la pigmentación (17,2%), las infecciones cutáneas (13,4%), los trastornos del cuero cabelludo (10,1%) y el acné vulgar (9,6%). Las infecciones cutáneas, los trastornos de la pigmentación, los trastornos del cabello y del cuero cabelludo y el acné vulgar fueron mucho más frecuentes en las niñas que en los varones (p < 0,05). Además, las infecciones cutáneas fueron mucho más habituales en los alumnos pupilos que en los medio pupilos (p < 0,05). Conclusión. Los trastornos de la piel afectaron al 59,1% de los niños estudiados, y se observaron con mayor frecuencia en las niñas y en los pupilos. Es necesario prestar mayor atención a estos grupos a la hora de formular medidas preventivas.

Background. The purpose of this study was to determine the prevalence of childhood dermatoses in Diyarbakir, which is located in the southeastern region of Turkey. Material and Method. This cross-sectional study was carried out in April 2008 among students of eight randomly selected public primary schools in Diyarbakir. Students were examined and questionnaire was applied to determine socioeconomic levels and socio-demographic features. Results. A total of 1932 students were examined by dermatologists. Nine hundred and fifty three (49.32%) girls, mean age was 11.06±2.13 (range 6-17). The overall point prevalence of skin disorders was 59.1%. Among this sample 776 children (40.2%) had only one skin disease whereas 299 (15.5%) had two and 67 (3.5%) had at least three. The point prevalence of skin disorders was 33.1% among students in grade 1 and 78.9% among students in grade 8 (p<0.05). The most common skin disease was eczema (32.8%), followed by pigmentation disorders (17.2%), skin infections (13.4%), scalp disorders (10.1%) and acne vulgaris (9.6%). Infectious skin problems, pigmentation disorders, hair and scalp disorders and acne vulgaris were more common among girls compared to boys (p<0.05). In addition, infectious skin problems were more common among boarders (p<0.05) compared to day students. Conclusion. Skin disorders affected 59.1% of the studied children. Skin disorders were more common among girls and boarders in this study, this group of children should be given specific attention in formulating preventive measures.

Atypical cutaneous features in adult onset Still's disease.

Adult onset Still's disease is a rare but potentially serious disease. We present five cases of adult-onset Still's disease seen by us over a period of one year. The patients were all females and 28-39 years of age. Symptoms had been present for 2-6 weeks in three patients. The other two had been on a few years' follow-up for rheumatoid arthritis before the onset of rashes and fever. The patients had persistent erythematous maculopapular eruptions on face, body and extremities, with moderate to severe pruritus and/or a burning sensation that decreased their quality of life. The typical evanescent rash was not observed. High ferritin values were detected in all the patients and total serum IgE was increased in two. All the patients were started on oral prednisolone (0.5-1.0 mg/kg/day), and methotrexate (10-15 mg/week) had to be added in three patients. One patient was started on tocilizumab due to recalcitrant disease and one was lost to follow-up. Further investigation and classification of the various atypical cutaneous findings in adult-onset Still's disease is necessary.

Chilblains in Turkey: a case-control study

BACKGROUND: Chilblains are rather common in winter months in our country. OBJECTIVES: Determination of demographical and clinical characteristics of patients presenting with chilblains in Diyarbakir, Turkey. Evaluation of body mass index (BMI) as risk factor for development of chilblains. METHODS: Sixty-nine patients who were diagnosed as chilblains at our outpatient clinics were included in this study. No exclusion criteria were sought. Demographical data including height and weight and answers to questions related to personal history were recorded. A control group consisting of 108 controls were chosen from among patients presenting with complaints of hair loss. Statistical analyses were conducted using SPSS 17.0. RESULTS: Of the 69 patients with chilblains, 45 (65.2%) were females and 24 (34.8%) were males. Mean age (±SD) of the patients was 21±9. 71.2% of the patients complained of itching, 51.6% of pain, 31.3% of burning in the lesions. 61.3% of the patients reported recurrence of the lesions every winter season. Mean BMI of the patients was 20.5±2.9. Mean BMI of the controls was 22.4±3.7 and the difference was statistically significant (p=0.01). CONCLUSIONS: Low BMI may be a risk factor contributing to development of chilblains in persons exposed to cold weather conditions. Apart from external factors, there seems to be a personal tendency to develop lesions, as many patients report recurrences every year. Diagnosis of chilblains requires wariness, as history of cold exposure may not be evident. .

The frequency of osteoporosis in patients with pemphigus vulgaris on treatment.

Background: Pemphigus vulgaris was almost fatal before the advent of glucocorticoids. Unfortunately, the high doses and prolonged administration of glucocorticoids, which often needed to control the disease, result in numerous adverse effects many of which are serious. Aims: To evaluate the patients with pemphigus vulgaris on treatment in respect of osteoporosis and to compare the frequency of osteoporosis in these patients with the healthy ones. Methods: The study consisted of 40 patients with pemphigus vulgaris and 34 healthy controls. Bone mineral density measurements were obtained by dual- energy X-ray absorptiometry. Blood serum, bone parameters, and biochemical hormonal measurements were examined in both groups. Results: When the bone mineral density values of patients with pemphigus vulgaris were compared with those of the control group, there was no significant difference between hip bone mineral density values, while lumbar region T and Z scores were found significantly low in the patient group (p = 0.034 and p = 0.006, respectively). Osteoporosis, osteopenia, and normal dual-energy X-ray absorptiometry rates in the patient group were found to be 32.5%, 32.5%, and 35%, respectively. These rates were found to be 18%, 23%, and 59% in control group, respectively. There were more fractures in the patient group and the difference was statistically significant (p = 0.004). Conclusion: An increase in osteoporosis frequency and secondary fracture to osteoporosis in the patients with pemphigus vulgaris was detected.

Tubercúlide papulonecrótica: Caso clínico / Papulonecrotic tuberculid: Case report

Una niña de 12 años fue atendida por presentar pápulas milimétricas diseminadas que involucionaron hacia escaras varioliformes. La prueba de tuberculina fue fuertemente reactiva. Se diagnosticó una tuberculosis pulmonar subyacente y la paciente respondió al tratamiento antituberculoso. La tubercúlide papulonecrótica es una erupción cutánea que se cree debida a hipersensibilidad ante un foco subyacente de tuberculosis y sería un indicador de buen estado inmunitario.

A 12-year-old girl was seen with widespread millimetric papules which resolved leaving varioliform scars. Tuberculin test was strongly reactive. Underlying pulmonary tuberculosis was diagnosed. The patient responded to antituberculous treatment. Papulonecrotic tuberculid is a skin eruption thought to be due to hypersensitivity to an underlying focus of tuberculosis and is an indicator of good immunologic status.