Bilateral Sacroiliitis Confirmed with Magnetic Resonance Imaging during Isotretinoin Treatment: Assessment of 11 Patients and a Review of the Literature.

In recent years, several cases pointing at sacroiliitis due to isotretinoin treatment have been reported, but a causal association remains unproven. The aim of this study was to assess the characteristics of patients in whom bilateral sacroiliitis was detected while using isotretinoin treatment for acne and to review previous sacroiliitis cases treated with isotretinoin. In total, 11 patients who were diagnosed with sacroiliitis during isotretinoin treatment were identified, and patient characteristics were noted. Patients were classified according to magnetic resonance imaging (MRI) findings. The 11 patients (3 men and 8 women) ranged in age from 16 to 37 years (mean age 24.27 years). All the 11 (100.00%) patients presented with hip pain, which in 3 (27.27%) patients started in the first month, in 3 (27.27%) in the second, in 2 (18.18%) in the third, in 2 (18.18%) in the fourth, and in 1 (9%) in the fifth. HLA-B27 (human leucocyte antigen) was negative in all cases. MRI findings confirmed mild bilateral sacroiliitis in 5 (45.45%) patients, moderate in 3 (27.27%), and severe in 2 (18.18%). Although our study included a small number of cases, it indicates a strong association between isotretinoin and sacroiliitis.

A Case of Woolly Hair Nevus Associated with Pigmentary Demarcation Lines and Heterochromia Iridis: Coincidence or a New Association?

We report a case of woolly hair nevus with pigmentary demarcation lines and heterochromia iridis. Woolly hair nevus is a rare abnormality of the scalp hair characterized by the patch of hair, which is curlier and light colored than the rest of the scalp hair. Association of woolly hair nevus with some other ectodermal defects effecting skin and eyes has been reported before. Here, woolly hair nevus associated with demarcation lines and heterochromia iridis, to our knowledge, have not been previously reported.

Methotrexate toxicity presenting as cutaneous ulcerations on psoriatic plaques.

Methotrexate (MTX) is an effective but potentially toxic treatment for psoriasis. We describe a patient who administered 20 mg daily of MTX for 5 d and presented with ulcerated and necrotic lesions on the psoriatic plaques, mouth erosions and hair loss. However, his psoriatic plaques and ulcerations totally healed rapidly within two weeks and no recurrence has been observed for the 6 months of follow up.

Sildenafil-induced pigmented purpuric dermatosis.

We present a patient who experienced pigmented purpura 10 days after initiating sildenafil. The eruption cleared several weeks after discontinuation of the medication. To the best of our knowledge, this is the first case of pigmented purpuric dermatosis reported due to sildenafil.

Onychomadesis in two sisters induced by varicella infection.

Onychomadesis is separation of the nail plate from the nail matrix due to arrest of nail growth for a certain period. Here we describe two patients with onychomadesis on the hands after varicella infection. To our knowledge, this is the first case of onychomadesis reported after varicella infection.

Acquired ichthyosis associated with type 1 diabetes mellitus.

Acquired ichthyosis is an uncommon disease which is characterized by symmetric scaling of the skin. Acquired ichthyosis has been described in association with a variety of underlying causes, including malignancies, drugs, infections, endocrine, metabolic and autoimmune diseases. Acquired ichthyosis associated with diabetes mellitus has been reported only in one case. We report the case of a new-onset diabetes mellitus with a one-month history of generalized acquired ichthyosis and palmoplantar keratoderma corroborated with skin biopsy, which completely disappeared after regulation of blood glucose levels with insulin therapy.