Consumption of salty foods was significantly higher among patients with acne compared to acne free subjects, making the consumption of salty food a possible participating factor in the development of acne.
The significantly increased level of serum TNF-a in OCP as compared to controls proves that TNF-a has an important role in the pathogenesis of this disease. The study illustrates that the addition of pentoxifylline to pulse steroid cyclophosphamide therapy is an effective, safe, and economical method in controlling OCP through directly reducing TNF-a levels, with long periods of remission as detected in our 18-month follow-up period.
A combination of both intralesional stibogluconate injection and superficial cryotherapy (not including the base of the lesion nor the 1-2 mm rim of the surrounding normal skin) was performed in an attempt to improve the therapeutic efficacy of either of the two modalities when used separately in the treatment of cutaneous leishmaniasis. This combined therapy resulted in a 100% cure rate in 15 patients with 23 lesions of cutaneous leishmaniasis. Two control groups, one treated with superficial cryo and the other treated with intralesional stibogluconate injection alone were included in the study for evaluation. The results obtained by combined superficial freezing and intralesional stibogluconate injection were much more impressive than those obtained by each of the two modalities when used alone.
A 7 year‐old male child presented with erythematous erosive plaques affecting the upper and lower eyelids of the left eye and extending to the cheek. Crustations over the right nostril were also evident. His general health status was normal. His medical history revealed that he was suffering from chronic myeloid leukemia for which he was receiving cyclic pulse therapy of cytarabine, doxorubicin and prednisone. It was noticed that the skin eruption was activated after each cycle and faded in 2–3 weeks to reappear after the next cycle but it never really cleared completely. The clinical differential diagnosis included herpes simplex, contact dermatitis, neutrophilic eccrine hidradenitis (NEH) and atypical fungal infection. The investigations included a complete blood count which showed a picture of improving leukemia with a total leucocytic count of 60 000/cc, RBCs count 3.7 × 106/cc, and platelet count of 110 000/cc. His hemoglobin was 9% The differential leucocytic count was as follows: basophils 0; eosinophils 4; blast cells 0; promyelocytes 0; myelocytes 10; juvenile cells 7; staff cells 14; segmented 45; lymphocytes 18 and monocytes 2. Cultures for fungi were negative, and serological examination for HIV, herpes simplex (IgG and IgM) cytomegalovirus and Epstein‐Barr virus antibodies were within normal ranges. Examination of a skin biopsy taken from the periorbital lesions revealed the presence of numerous islands of squamous cells extending from the epidermis into the upper‐ and mid‐dermis. Some of the islands were typically present around sweat ducts. On higher magnification, the cells forming the islands and lining the ducts were found to have abundant eosinophilic cytoplasm and large pale nuclei with prominent nucleoli. Some of the cells were dyskeratotic and there were occasional mitotic figures. Sparse lymphoid cell infiltrate was found surrounding some of the squamous cell islands. Based on the findings of squamous metaplasia of the cells lining the sweat ducts as well as the resemblance of some islands to squamous cell carcinoma, the diagnosis of eccrine syringosquamous metaplasia was made. Apart from the use of topical antibiotic creams, the patient received no therapy for his condition. Spontaneous improvement occured within 18 days after initial presentation but it recurred after the next cycle of chemotherapy.
Kallin syndrome (KS) is a variant of epidermolysis bullosa simplex (EBS), which, in addition to the classic features of EBS, also presents with deafness, alopecia, hypodontia and nail dystrophy. We report the case of a 17-year-old boy who presented to our clinic with trauma-induced skin blistering, alopecia, deafness, dental caries, nail dystrophy and vitiliginous areas. The skin blisters had been appearing since birth, and healed without scarring. The vitiliginous areas were unrelated to the sites of the blisters. Electron microscopy of the skin blisters was diagnostic of EBS, and the depigmented lesions were similar to those of vitiligo. An association of vitiligo with EBS has not been reported previously. Multiple genetic findings have confirmed a role for keratin in regulating skin pigmentation. Apoptosis of melanosome-bearing keratinocytes may participate in the reduction of melanin density and result in depigmentation. Further studies on the defective proteins in KS may clarify the mechanism underlying the association with vitiligo.
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