IntroductionDermoscopy is a non-invasive imaging method that enables the evaluation of pigmented and non-pigmented skin lesions. More recently, dermoscopy has been recognized as an effective tool in the diagnosis of nail diseases.AimTo evaluate the dermoscopic features of nail psoriasis and to assess the relationship between these features and disease severity.Material and methodsA total of 67 patients with clinically evident nail psoriasis (14 women, 53 men) were prospectively enrolled. Following a thorough clinical examination, patients were graded according to the Nail Psoriasis Severity Index and physician’s global assessment score. A dermoscopic examination of all fingernails and toenails was performed using a videodermatoscope. Mann-Whitney U and χ2 tests were used for statistical analysis, with a significance threshold of p < 0.05.ResultsThe most frequently observed dermoscopic features were splinter haemorrhage (73.1%), pitting (58.2%), distal onycholysis (55.2%), dilated hyponychial capillaries (35.8%) and the pseudo-fiber sign (34.3%). The pseudo-fiber sign, dilated hyponychial capillaries, nail plate thickening and crumbling, subungual hyperkeratosis, transverse grooves, trachyonychia, pitting and salmon patches were positively associated with disease severity.ConclusionsThe pseudo-fiber sign described in this study appears to be a novel dermoscopic feature of nail psoriasis. We have demonstrated positive associations between a number of dermoscopic manifestations and disease severity. Further studies are required to support the present findings.

Punctate palmoplantar keratoderma (PPPK) is a rare entity with an estimated prevalence rate of about 1.17 per 100,000. The exact etiology of the disorder is not known but a dual influence of genetic and environmental factors may trigger the disease. We report the case of a 70-year-old male patient with punctate palmoplantar keratodermic lesions for more than 40 years. Histopathologic examination revealed a hyperkeratotic epidermis without columns of parakeratosis or elastorhexis. On electron microscopy, the basal cells of the epidermis were found to have enlarged nucleoli and abundant tonofilaments, with keratohyalin-like granules confined to the upper part of the stratum spinosum, findings that were consistent with PPPK. Topical keratolytic agents were used with little success. Patients with PPPK and their next of kin should be investigated for possible associated malignancies.

Hcy levels are elevated in patients on Iso treatment for CA. It may be due to either the inhibition of cystathionine-beta-synthase, an enzyme required in the metabolism of Hcy, by the drug and/or the liver dysfunction. Daily supplementation with vitamin B12 and folate, which are the cofactors of the enzymatic reactions involved in Hcy metabolism, can lower plasma levels of Hcy, so it is recommended to take these vitamins in case of deficiency along with Iso to prevent premature occlusive vascular disease.

Aims Our aim was to investigate the skin‐homing T‐cell immune responses triggered in patients with Demodex infestation and/or rosacea. Methods Collected whole blood samples were divided into four groups: control subjects; nonrosacea patients with Demodex infestation (Demodex group); papulopustular rosacea (PPR) patients without Demodex infestation (Rosacea group); and PPR patients with Demodex infestation (Rosacea/Demodex group). Following ex vivo activation, skin‐homing CLA+CD4+ T‐cell subset levels were monitored by flow cytometry. Results When compared with control subjects, among skin‐homing CD4+ T‐cell subsets analysed, Demodex patients had higher TH9 and Treg cell levels; Rosacea subjects displayed elevated TH1 cell levels; and Rosacea/Demodex patients exhibited increased frequencies of TH9 and TH22 cells. In contrast to Rosacea subjects, Rosacea/Demodex group members displayed higher TH2 cell levels; and when compared with Demodex groups, they had higher TH1 and TH2 but lower Treg cell levels. Demodex group members also exhibited higher Treg but lower TH1 and TH22 levels than Rosacea/Demodex group subjects. Conclusions The skin‐homing T‐cell responses associated with Demodex infestation and rosacea formation seem to influence each other. The present as well as future studies could contribute to the development of effective treatment strategies for demodicosis and rosacea.

IntroductionMelasma is a common chronic, acquired pigmentation disorder with a significant impact on the quality of life of patients.AimTo investigate the etiopathogenetic factors, thyroid functions and thyroid autoimmunity in patients with melasma.Material and methodsForty-five women with melasma and 45 age-matched healthy women were included in the study group. A detailed history was taken from the patients including triggering factors of melasma. Serum free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), anti-thyroglobulin (AbTG) and anti-thyroid peroxidase (Ab-TPO) were measured and thyroid ultrasonography was performed for each subject.ResultsIn 26.7% of patients, pregnancy, in 17.8%, oral contraceptive use and in 13.3%, intense sunlight exposure were the triggering factors. 17.8% of patients had a family history of melasma. FT4, TSH and AbTG levels were significantly higher in the patient group.ConclusionsThe results suggest that a combination of factors including pregnancy, oral contraceptive use, sunlight and genetic factors often trigger melasma. Thyroid hormones and thyroid autoimmunity may also play a role in the pathogenesis which needs to be proven by further studies.

We report the case of a healthy 16-year-old male with progressively increasing brown macules arranged in a zosteriform pattern on the left abdomen and back. The lesion appeared at the age of 15 and has been enlarged since then. He had no history of any preceding eruption or injury to the area. He had no evidence of internal diseases. His family had no history of skin abnormalities. He was not taking any medications. Physical examination revealed linear, cribriform, brown macular pigmentation arranged in a zosteriform pattern on the left abdomen and back ( fig. 1). All macules were uniformly tan. Laboratory studies, including complete blood cell count, liver and renal function tests and serum electrolyte, had negative results. A skin boipsy specimen from the abdomen revealed increased pigmentation within the basal keratinocytes. There were a few dermal melanophages. No nevus cells were present ( fig. 2). Fontana-Masson stain showed an increase in melanin in the basal keratinocytes. The diagnosis of progressive cribriform and zosteriform hyperpigmentation -the late onset linear and whorled nevoid hypermelanosis was made. No treatments were given.Progressive cribriform and zosteriform hyperpigmentation was first described by Rower and colleagues in 1978. 1 The following criteria were suggested: (1) uniformly tan cribriform macular pigmentation in a zosteriform distribution; (2) a histologic pattern that consisted of a mild increase in melanin pigment in the basal cell layer and complete absence of nevus cells; (3) no history of rash, injury, or inflammation to suggest postinflammatory hyperpigmentation; (4) onset well after birth with gradual extension -age at onset was in the second decade of life in every case; and (5) lack of other associated cutaneous or internal abnormalities. 1 Linear and whorled nevoid hypermelanosis was first described by Kalter and colleagues in 1988. 2 It is characterized by swirls and streaks of macular hyperpigmentation along the lines of Blaschko. It usually appears early during the first year of life. In some patients, the lesions are quite stable, while in others they spread but then stabilize by the age of 2-3. The linear hyperpigmentation tends to persist indefinitely. Occasionally, there are associated systemic abnormalities. 2 Somatic mosaicism that develops during embryogenesis appears to be the underlying aetiology. The linear nature of the pigmented bands probably reflects the clonal migration and proliferation of embryonic melanocyte precursors (melanoblasts). 3 Recently, linear and whorled nevoid hypermelanosis have been used to encompass a wide spectrum of clinical entities, ranging from the congenital or perinatal form of Kalter and colleagues to the segmentary and delayed form of Rower and colleagues, for which there is a tendency to use the term progressive cribriform and zosteriform hyperpigmentation. 4 We report herein a case of progressive cribriform and zosteriform hyperpigmentation -the late onset linear and whorled nevoid hypermelanosis which is not associated with ...

Prurigo pigmentosa is a relatively new clinical entity, and we believe that a more widespread knowledge of this disease will lessen its misdiagnosis. We find it noteworthy to point out that there may be a predisposition to prurigo pigmentosa amongst the Turkish and Sicilian populations.

IntroductionPsoriasis is an inflammatory and immune-mediated papulosquamous disease with unknown etiology. It is characterized by abnormal epidermal hyperproliferation and differentiation, and it affects 1%-2% of the population (1).Uric acid is an endogenously produced end-product of adenosine-and guanosine-based purine metabolism (2). A number of studies showed strong correlation among high uric acid levels, insulin resistance, and metabolic syndrome, which has been suggested to develop secondary to insulin resistance (3,4).Few studies in the literature investigated serum uric acid levels in patients with psoriasis, and those studies reported that the levels of uric acid could be correlated with the activity of psoriasis. However, none of those studies evaluated metabolic syndrome, which could directly affect the uric acid level.Psoriasis has been accepted as a systemic disease and it is known to be associated with various disorders such as cardiovascular diseases, hepatosteatosis, obesity, diabetes mellitus, hypertension, and hyperlipidemia. High serum uric acid levels are also associated with components of metabolic syndrome such as obesity, cardiovascular diseases, and hypertension. In our study, we aimed to determine serum uric acid levels in patients with psoriasis and the association of uric acid levels with disease activity by taking the presence of metabolic syndrome into account, since it is one of the most important factors that affect serum uric acid levels. Material and methodsSeventy patients with psoriasis aged between 17 and 82 years who were untreated for psoriasis in the previous 6 months and 70 age-and sex-matched healthy subjects were included in this cross-sectional study. The Scientific Research Assessment Committee of our hospital approved the study protocol and all participants provided written informed consent.The demographic characteristics of the patients such as age and sex, as well as disease characteristics including dermatological examination, type of psoriasis, Background/aim: Psoriasis has been accepted as a systemic disease and it is known to be associated with various disorders including metabolic syndrome. High serum uric acid levels are also associated with the components of metabolic syndrome. In this study, we aimed to determine serum uric acid levels in patients with psoriasis and the association of uric acid levels with disease activity by taking the presence of metabolic syndrome criteria into account, since it is one of the most important factors that affect serum uric acid levels. Materials and methods:In this cross-sectional study, we evaluated 70 psoriasis patients and 70 healthy individuals who were matched with the patients according to the presence of metabolic syndrome. We evaluated the demographic features, levels of serum uric acid, Psoriasis Area Severity Index (PASI) scores, presence of psoriatic arthritis, nail involvement, and metabolic syndrome criteria of the patients.Results: Serum uric acid levels of psoriasis patients were significantly higher than thos...