Viral infections of the face.

Viral infections affecting the face may cause significant morbidity, cosmetic disfigurement, and psychological distress. The success of therapy needs whole and correct evaluation of the clinical signs and symptoms. Some viruses such as Papillomaviridae, Herpesviridae, and Polyomaviridae primarily infect the facial skin, whereas others affect the face infrequently, as in parapox virus infections. Sometimes, involvement of the face can be a part of more generalized eruption and systemic symptoms in viral infections caused by Todaviridae, Flaviviridae, Arenaviridiae, and Flaviviridae. Clinical diagnosis can be challenging in various viral diseases when they occur in nonendemic geographic areas. The objective of this review was to concentrate on epidemiologic and clinical characteristics of the viral illnesses with facial skin involvement.

A comparison between the effectiveness of erythromycin, single-dose clarithromycin and topical fusidic acid in the treatment of erythrasma.

UNLABELLED: Although erythrasma is a superficial skin infection, there is no consensus on the treatment model of erythrasma. OBJECTIVE: To compare the efficacy of erythromycin, single-dose clarithromycin and topical fusidic acid in the treatment of erythrasma in a double-blind, placebo-controlled, randomized trial. METHODS: Hundred and fifty-one patients over 18 years of age were included in this study. Patients were randomized and divided into five groups. They received clarithromycin, erythromycin, fusidic acid cream, placebo cream or placebo tablets. Patients were evaluated by Wood's light reflection scores and the initial score values and the values on the days of 2, 7 and 14 were compared statistically. RESULTS: According to the mean of Wood's light reflection scores, the efficacy of fusidic acid cream therapy was significantly higher than other therapies. When the efficacy of clarithromycin and erythromycin therapy was compared, clarithromycin therapy was significantly more effective than erythromycin therapy at 48 h. However, there was no statistical difference on the days of 7 and 14. CONCLUSION: Topical fusidic acid proved to be the most effective treatment; however, clarithromycin therapy may be an alternative regimen in the treatment of erythrasma because of its efficiency and better patient's compliance.

Basal cell carcinoma of the nipple - an unusual location in a male patient.

Although basal cell carcinoma is extremely common, it only rarely occurs on the nipple. Men are affected more often than women. Basal cell carcinoma of the nipple-areola complex may be more aggressive as metastases to regional lymph nodes have been reported. We report a basal cell carcinoma of the nipple with features of a fibroepithelioma of Pinkus in a man and review the literature.

Rapid clearance of psoriatic skin lesions induced by topical cyclopamine. A preliminary proof of concept study.

BACKGROUND: We have earlier found a highly efficient induction of the differentiation of epidermal lineage skin tumors by cyclopamine, a steroidal alkaloid inhibitor of the hedgehog/smoothened signaling, under conditions in which cyclopamine exerted no adverse effect on skin. OBJECTIVE: We aimed to develop a mechanism-based treatment for psoriasis with cyclopamine. METHODS: We subjected psoriatic skin lesions to cyclopamine under conditions similar to those we used for skin tumors and evaluated the responses of lesions clinically and by histopathological/immunohistochemical analyses. RESULTS: All treated lesions in different patients having plaque and guttate forms of psoriasis regressed rapidly. Differentiation of the epidermal cells of lesional skin and disappearances of infiltrating inflammatory cells were evident within a day. Lesions were cleared commonly on days 3-4. Former treatment sites followed up for more than 24 months now show a lack of adverse effects in the long term. CONCLUSION: An effective treatment for psoriasis is described, consistent with intervention in a proximal/key pathogenic event.

Induction of the differentiation and apoptosis of tumor cells in vivo with efficiency and selectivity.

Hedgehog/smoothened signaling is active in a variety of tumors and is also involved in the maintenance of normal stem cells in vivo. We evaluated the possibility of preferential affection of tumor versus normal cells following inhibition of this signaling. We applied a cream preparation of cyclopamine (an inhibitor of the hedgehog/smoothened signaling) onto skin tumors in patients who were scheduled for the excision of these tumors (four basal cell carcinomas and a trichoepithelioma in four unrelated patients). All of the cyclopamine-treated tumors regressed rapidly. Histological and immunohistochemical analyses showed inhibition of the proliferation and highly efficient induction of the differentiation and apoptosis of tumor cells by a non-genotoxic mechanism. No adverse effects were noted and normal skin tissue and putative stem cells that were exposed to cyclopamine together with tumors were well preserved under the conditions we describe. Our findings show selective and highly efficient induction of the differentiation and apoptosis of tumor cells in vivo by transient inhibition of the hedgehog/ smoothened signaling and provide a rational cancer therapy.