Is diastolic dysfunction associated with atrial electrocardiographic parameters in Behçet's disease?

BACKGROUND: The impact of Behçet's disease (BD) on the vascular bed is highly important, as this condition may lead to heart failure from asymptomatic systolic and diastolic dysfunction. Our aim was to evaluate diastolic functions using new echocardiographic parameters and the correlation of these parameters with atrial electrocardiographic (ECG) indices in patients with BD. METHODS: 31 patients with BD and 31 healthy control subjects were enrolled to this study. Left ventricular (LV) diastolic functions were examined with conventional and tissue Doppler echocardiography. P-wave dispersion (PD) was calculated by measuring minimum and maximum P-wave duration values on the 12-lead surface ECG. The relationship between PD and echocardiographic parameters of diastolic dysfunction were investigated. RESULTS: The mitral inflow E/A ratio and diastolic myocardial velocity ratio (Em/Am) were lower in the BD group (P < 0.001 and P < 0.001, respectively). The E/Em ratio and left atrial volume index (LAVi) were higher in the BD group (P < 0.001 and P = 0.014, respectively) compared to healthy control subjects. P max and PD were significantly higher in the BD group (P < 0.001 and P < 0.001). PD correlated positively with the duration of BD. Also, PD correlated positively with LAVi and E/Em ratio, but negatively with E/A and Em/Am ratios. CONCLUSION: In this study, we demonstrated that LV diastolic functions are impaired in BD patients. Furthermore, P-wave abnormalities were demonstrated in BD patients and there was a significant correlation between PD and diastolic dysfunction.

Transcutaneous electrical nerve stimulation for reduction of pruritus in macular amyloidosis and lichen simplex.

Lichen simplex (LS) is characterized by circumscribed, lichenified, pruritic patches that may develop on any part of the body. Macular amyloidosis (MA) is the form of primary localized cutaneous amyloidosis. Transcutaneous electrical nerve stimulation (TENS) uses a pulsed electric current generated transcutaneously by a device to cause impulses to be carried along large-diameter afferent nerves. In this article, we report the effects of TENS on the Dermatology Life Quality Index (DLQI) measures and visual analogue scale (VAS) scores in patients with pruritus, in whom LS and MA were diagnosed. All patients with MA and six (75%) patients with LS had relief of their pruritus with TENS therapy. At week 2, there was a significant difference in median VAS scores between baseline in the group of LS (P = 0.007). At 4 weeks of therapy, statistically significant differences were observed compared with the baseline and week 2 in the median VAS scores in the group of MA (P < 0.001). There was also a statistically significant improvement in median DLQI total scores with respect to baseline, which was achieved as early as week 2 in patients with LS and MA who were on the TENS treatment (P = 0.006, P = 0.001, respectively).

Morbilliform drug eruption due to pegylated α-interferon can show complete regression after switching to non-pegylated interferon.

Pegylated or non-pegylated α-interferon are frequently used medications for the treatment of both chronic hepatitis B and chronic hepatitis C. Skin disorders, which are mainly comprised of eczematous dermatitis, are frequently seen during treatment with this drug. However, drug eruption or morbilliform eruptions due to interferons have been rarely reported so far. We herein describe a patient who developed morbilliform drug eruption under treatment with pegylated interferon. She was able to continue treatment after switching from pegylated interferon to conventional interferon.

Scleredema treated with broad-band ultraviolet A phototherapy plus colchicine.

Scleredema is an uncommon condition characterized by induration of skin. The pathogenesis is not known, although the increased expression of collagen-producing fibroblasts in the skin has been demonstrated. Scleredema has been difficult to treat with scattered reports of success with bath psoralen plus ultraviolet A (PUVA), cream PUVA, UVA1 and others. The use of low-dose broad-band UVA phototherapy was found to be effective in the treatment of morphea. Colchicine has been shown to interfere with collagen synthesis and is used successfully in scleroderma. We report the first case of scleredema that improved markedly with low-dose broad-band UVA plus colchicine treatment.

Warty and clear-cell Bowen's disease successfully treated with photodynamic treatment.

Clear cell Bowen's disease (BD) is a rare histopathological subtype of BD, characterized by epidermal atypical keratinocytes with clear-cell changes exceeding 80% of the tumor population. Warty and clear cell Bowen's disease (WCCBD) is a recently described variant of clear cell BD, with verrucous and hyperkeratotic surface changes in addition to pathological features consisting of an extremely acanthotic epidermis, hyperkeratosis and clear-cell changes. Herein we present a 72-year-old man with a 1-year history of tumoral lesion located on the left cheek with a diagnosis of WCCBD, in whom we achieved excellent result with photodynamic treatment. To the best of our knowledge, this is the second reported case of this entity.

Linear and whorled nevoid hypermelanosis.

Linear and whorled nevoid hypermelanosis (LWNH) is a rare skin condition characterized by swirls and whorls of hyperpigmented macules in a reticulate pattern along Blaschko's lines; approximately 40 cases have been reported in the English language literature. We report a case of LWNH occurring in a 20-year-old man with widespread involvement over the trunk, face, upper limbs, and genitalia in association with scoliosis. A small hyperpigmented area on the abdomen was treated with a medium-depth chemical peel regimen using 70 percent glycolic acid and 35 percent trichloroacetic acid with no benefit. This is the first report of LWNH treated with medium-depth chemical peel.