No abstract

Dsg ELISA is not only a sensitive tool for the diagnosis of PV, it can also serve as a predictive means for assessing the severity as well as for monitoring the disease activity. Although, in general, the clinical phenotype is related to the antibody profile, there are occasional cases with discordant phenotype and antibody profile. These discrepancies might be explained by genetic variations or the presence of possible minor antigens involved in the pathogenesis of pemphigus.

Background. Autoimmune process and immunosuppressive therapy of pemphigus vulgaris would predispose the patients to infections. Aim. We aimed to study the prevalence of infection and pathogenic agents in pemphigus vulgaris patients admitted to dermatology service. Material and methods. This retrospective study was conducted on 155 pemphigus vulgaris patients (68 males, 87 females) admitted to dermatology service between 2009 and 2011. In this study, the diagnosis of pemphigus vulgaris was confirmed by light microscopic and direct immunofluorescence findings. Data were collected through a questionnaire. Results. Of 155 pemphigus vulgaris patients, 33 had infection at admission and 9 acquired nosocomial infection. In addition, 37 cases of oral candidiasis and 15 cases of localized herpes simplex were recorded. Totally, 94 cases of infection were recorded. The occurrence of infection was significantly related to the severity of disease, number of hospital admissions, and presence of diabetes mellitus. The most common pathogenic germs isolated from cultures were Staphylococcus aureus and Escherichia coli. Conclusion. Severity of pemphigus vulgaris and diabetes were directly related with tendency to infections. Staphylococcus aureus and Escherichia coli were the most common pathogenic agents. Due to limitations of retrospective study, a prospective study is recommended.

Azathioprine helps to reduce prednisolone dose in long-run.

No abstract

This study showed that factors such as primary clinical signs, stage of primary tumor, and adjacent organ involvement are significant with respect to the time for recurrence of colorectal cancer. It is important to take these characteristics into account in patient care management after curative resection for colorectal cancer.

Saliva Dsg ELISA could be used for diagnosis of PV. Salivary Dsg1 antibodies had a significant correlation with mucosal severity.

Laugier-Hunziker syndrome (LHS) is a rare disorder characterized by melanotic pigmentation of the mouth and lips which is frequently associated with longitudinal melanonychia. Laugier and Hunziker described lenticular melanotic pigmentation of the oral cavity and lips in 1970. 1 Some cases have been described in which the neck, thorax, abdomen, fingers and soles have been involved. Fingernails are more frequently involved than the toenails. 2 Melanonychia may also be seen with or after lichen planus (LP). 3,4 We report a case of LHS associated with actinic LP.A 37-year-old Turkish woman was referred to our clinic with melanotic macules on the face, a pruritic annular plaque on the malar area of her face and hyperpigmented streaks on her nails, which had appeared for 19 years, 10 months and 6 years, respectively.Examination revealed the patient's pigmented macules on the lips, gums, buccal mucosa and midline of the hard palate ( fig. 1a). There were melasma and pinkish annular plaque, with a hyperpigmented centre ( fig. 1b). There were longitudinal melanonychia on her fingernails ( fig. 1c) and toenails. Hyperpigmented slate-grey to brown macular lesions were seen over her back. Examination of intertriginous areas did not reveal any evidence of acanthosis nigiricans. The skin phototype according to Fitzpatrick's scale was IV.Results of routine laboratory tests were within normal ranges, including triiodothyronine (T3), thyroxine (T4) and thyrotropin (TSH). The patient had smoked for 20 years. Her mother had melasma. Histopathological examination of pigmented macula on the buccal mucosa showed an accumulation of melanin in the cells of the basal layer of the acanthotic epidermis and an increased number of melanophages in the upper dermis ( fig. 2). Histopathologically, there was thinning of the epidermis with vacuolar alteration of the basal layer, an artifactural cleft between the epidermis and the lichenoid infiltrate and pigment incontinence in the upper dermis on the annular lesion over the cheek (fig. 3).Since the first description by Laugier and Hunziker, many cases of LHS have been reported. 2,[5][6][7] In this syndrome, the essential lesions are manifested as lenticular-pigmented macules, which have different colours (from grey to brown to blueblack) and a smooth surface. Generally symptoms are absent. The most common sites are the lips (especially the lower lip) and the oral cavity (buccal mucosa and hard palate). Other sites such as labial comissure, the gums the floor of the mouth and the tongue are less frequent. Other locations such as the abdomen and the fingers have been involved. Fingernail involvement can present as a single longitudinal 1-2-mm-wide streak or as a double 2-3-mm-wide longitudinal streak on the lateral parts of the nail plate, as a homogeneous pigmentation of the radial or ulnar half of the nail, and complete pigmentation of the nail. All four types of nail involvement may simultaneously involve one or more nails of the fingers and /or toes. 2 fig. 1 (a) Multiple pigmented macules lo...