Dermoscopy 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.
When the findings obtained in this study were evaluated along with those reported in the literature, it became apparent that follicular plugs, also called "teardrop-like structures", seen on the face and neck may be a dermoscopic feature specific to CL. As hairpin-like vessels seen in an asymmetric radial arrangement were often observed on parts of the body other than the face, further dermoscopic studies comparing the lesions of CL with other ulcerating lesions are necessary.
Objectives In this study covering all of Turkey, we aimed to define cutaneous and systemic adverse reactions in our patient population after COVID‐19 vaccination with the Sinovac/CoronaVac (inactivated SARS‐CoV‐2) and Pfizer/BioNTech (BNT162b2) vaccines. Methods This prospective, cross‐sectional study included individuals presenting to the dermatology or emergency outpatient clinics of a total of 19 centers after having been vaccinated with the COVID‐19 vaccines. Systemic, local injection site, and non‐local cutaneous reactions after vaccination were identified, and their rates were determined. Results Of the 2290 individuals vaccinated between April 15 and July 15, 2021, 2097 (91.6%) received the CoronaVac vaccine and 183 (8%) BioNTech. Systemic reactions were observed at a rate of 31.0% after the first CoronaVac dose, 31.1% after the second CoronaVac dose, 46.4% after the first BioNTech dose, and 46.2% after the second BioNTech dose. Local injection site reactions were detected at a rate of 35.6% after the first CoronaVac dose, 35.7% after the second CoronaVac dose, 86.9% after the first BioNTech dose, and 94.1% after the second BioNTech dose. A total of 133 non‐local cutaneous reactions were identified after the CoronaVac vaccine (2.9% after the first dose and 3.5% after the second dose), with the most common being urticaria/angioedema, pityriasis rosea, herpes zoster, and maculopapular rash. After BioNTech, 39 non‐local cutaneous reactions were observed to have developed (24.8% after the first dose and 5% after the second dose), and the most common were herpes zoster, delayed large local reaction, pityriasis rosea, and urticaria/angioedema in order of frequency. Existing autoimmune diseases were triggered in 2.1% of the patients vaccinated with CoronaVac and 8.2% of those vaccinated with BioNTech. Conclusions There are no comprehensive data on cutaneous adverse reactions specific to the CoronaVac vaccine. We determined the frequency of adverse reactions from the dermatologist's point of view after CoronaVac and BioNTech vaccination and identified a wide spectrum of non‐local cutaneous reactions. Our data show that CoronaVac is associated with less harmful reactions while BioNTech may result in more serious reactions, such as herpes zoster, anaphylaxis, and triggering of autoimmunity. However, most of these reactions were self‐limiting or required little therapeutic intervention.
Isotretinoin (ISO) is a first‐generation retinoid discovered in 1952 and approved by the FDA for the treatment of nodulocystic acne in 1982. The anti‐inflammatory properties of ISO have found its use in disorders other than acne. ISO can create psychiatric problems, including depression and suicidal ideation. These neuropsychiatric problems are very similar to disorders secondary to hyperhomocysteinemia (HHcy), vitamin B12, and folic acid (vitamin B9) deficiencies. Given that previous literature suggested folate supplementation improved the efficacy of traditional antidepressant medications, clinicians may wish to consider folate supplementation for patients with depression or possible depressive symptoms, such as acne patients with genetic susceptibility. Brain‐derived neurotrophic factor may be a cytokine‐specific screening biomarker in immune‐based antidepressive therapy.
Oral isotretinoin (13-cis-retinoic acid), a synthetic analog of vitamin A, is a first-generation retinoid approved for the treatment of severe cases of acne vulgaris. Isotretinoin can only be used as second-line treatment for acne when appropriate response to systemic antibiotics,
Lupus miliaris disseminatus faciei (LMDF) is a chronic and uncommon inflammatory dermatosis, characterized by yellowish-red papules, especially on the face and around the eyelids. It is considered to be a reaction to destroyed hair follicles. We dermoscopically evaluated two patients diagnosed with LMDF. Dermoscopy revealed follicular keratotic plugs and vascular structures. We discuss these cases and other diseases dermoscopically showing keratotic plugs.
IntroductionOrf and milker’s nodule are zoonotic cutaneous diseases generated by parapoxviruses. Contribution of dermoscopy to the diagnosis of these diseases has not been studied in the medical literature as to our knowledge.AimTo investigate whether dermoscopy is a valuable diagnostic tool in orf and milker’s nodule diagnosis or not.Material and methodsIn this study, macroscopic and dermoscopic features have been evaluated by including 46 lesions of 32 patients who have orf and milker’s nodule.Results56.5% (26) of lesions were orf, while 43.5% (20) of lesions were milker’s nodule (MN). Non-vascular dermoscopic structures have been determined as follows: blue-gray area (23.1% of orf, 35% of MN), orange-yellow streaks (19.2% of orf, 19.2% of MN), grayish-whitish streaks (26.9% of orf, 55% of MN), central yellow-white area (26.9% of orf, 35% of MN), crust (46.2% of orf, 40% of MN), erosion-ulceration (69.2% of orf, 55% of MN), yellow-white globule (11.5% of orf, 15% of MN), and yellow-white ring (57.7% of orf, 35% of MN). Limitations: Lack of PCR analysis, based of patient anamnesis types of orf and milker’s nodule.ConclusionsNo significant dermoscopic differences have been determined between orf and milker’s nodule patients’ lesions. In our opinion, dermoscopy may be a useful tool to develop diagnosis of these diseases.
Objective Cutaneous leishmaniasis (CL) is a skin disease characterised by prolonged nodulo‐ulcerative lesions of the skin that heals with atrophic scar. Clinical features of CL vary depending on the type of parasite and host immune resistance. The aim of this study was to investigate the clinical features of atypical and unusual morphological variants of CL patients diagnosed in our clinic. Materials and Methods In this prospective study, 27 CL patients with atypical clinical features among 486 patients admitted to our clinic between July 2018 and September 2019 and diagnosed as CL by slit‐skin smear examination or histopathological examination were included. Results Of 27 patients, 15 (55.5%) were male and 12 (44.5%) were female. The mean age of the patients was 25.8 ± 7.62 years. Seven (25.9%) patients had lupoid lesions, five (18.6%) patients had eczematoid lesions, four (14.8%) patients had lip lesions, three (11.1%) patients had erysipelas‐like lesions, two (7.4%) patients had eyelid lesions, two (7.4%) patients had sporotrichoid lesions, two (7.4%) patients had verrucous lesions, one (3.7%) patient had psoriasiform lesion and one (3.7%) patient had paronychial lesion. Conclusion In conclusion, rare clinical forms of CL are presented in this study. It should be kept in mind that CL may have very different clinical features and should be considered in the differential diagnosis of eczema, psoriasis, erysipelas, sporotrichosis, paronychia and verrucous lesions.
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