Our study confirms that oxidative stress is involved in the pathophysiology of vitiligo, as indicated by the high levels of erythrocyte superoxide dismutase activity and plasma nitrite/nitrate.

Demodex folliculorum (D. folliculorum), found in the pilosebaceous unit, is the most common ectoparasite of humans. Various clinical forms such as pustular folliculitis, papulopustular scalp eruptions, perioral dermatitis, and blepharitis have been defined, although in general, the disease has been classified into three main groups as "pityriasis folliculitis", "rosacea-like demodicidosis", and granulomatous rosacea-like "demodicidosis gravis". Our aim was to test for the presence of D. folliculorum in pathogenic numbers in patients who came to our clinic with non-specific symptoms such as facial itching with or without erythema, seborrheic dermatitis-like or perioral dermatitis-like lesions, papulopustular lesions, and an acneiform clinical appearance without telengiectasia or flushing. Twenty-eight (87.5%) female and 4 male (12.5%), patients and 33 age-and-sex matched healthy subjects enrolled in this study. D. folliculorum was sought in the lesion sites using the non-invasive method known as the Standardised Skin Surface Biopsy (SSSB). The discovery of more than five parasites in an area of 1 cm2, was evaluated as pathogenic. For treatment, 5% permethrine cream was applied twice daily for 15 to 30 days. The clinical symptoms of the patients were classified into clinical groups and evaluated as facial itching in 2 (6.3%), nonspecific erythema and itching in 21 (65.6%), erythema and pityriasiform squamous lesions in 3 (9.4%), acneiform in 3 (9.4%), papulopustular lesions in 1 (3.1%), granulomatous rosacea-like in 1 (3.1%), and perioral dermatitis-like symptoms in 1 (3.3%), D. folliculorum density was determined as 5>D/cm2 in all clinical lesions. A significant clinical healing and density of D. folliculorum at <=5 D/cm2 was determined in all but two patients after treatment. We consider that D. folliculorum presentation with different symptoms and signs than classical forms is not rare. For this reason, we suggest that it is useful to test for D. folliculorum in patients with non-classical presentations like facial itching, itching accompanied by non-specific erythema, itching and non-specific pityriasiform squamous lesions, and acneiform lesions.

Since we found salivary SOD and CAT levels were high whereas plasma levels were low, it has been thought that, salivary defence mechanisms via antioxidant agents may be stimulated against to the ulcerous lesion. We consider that the organism might mobilize the antioxidant potential to the sites where they were needed. At this point, decrease of SOD and CAT levels in the plasma may be related to this shift. It is also thought that GSHPx secretion in the saliva may also be increased but the increase in its turnover may be responsible for the diminished activity.

A 60-year-old woman was admitted to our clinic with a gradually enlarging red papule on her face. Her history revealed that, 9 months previously, a painless, red papule of 1-2 cm in diameter had occurred in the middle of her face and, with time, had enlarged to cover her nose, both cheeks, and eyelids. It was diagnosed as a superficial skin infection, and topical and systemic antibiotics were prescribed; however, no response was obtained. In the last 2 months, a sore had formed in the middle of her nose. The patient lives in the east of Eastern Anatolia, where no case of cutaneous leishmaniasis has been reported in the last 20 years.On dermatologic examination of the patient, an erythematous, indurated, slightly squamous, 10 cm × 5 cm, butterfly-shaped plaque with sharply defined borders was seen on both cheeks, lower eyelids, and the whole nose (Fig. 1). In smears taken from the lesion, a number of amastigotes belonging to Leishmania were determined in the intracellular and extracellular area ( Fig. 2). Histopathologic examination of the cutaneous lesion showed scattered infiltration composed of mononuclear cells, histiocytes, plasma cells, and small epithelioid granulomas.Gram smear and anaerobe-aerobe culture prepared from the lesion were negative. The total blood count and sedimentation rate of the patient were within normal limits. Routine biochemical tests, urine analysis, chest radiography, and intradermal purified protein derivative (PPD) skin test were all normal. Antinuclear antibody and antistreptolysin antibody examinations were negative.The patient was treated intramuscularly with 10 mg / kg / day systemic meglumine antimoniate, divided into two doses, for 20 days, with good control.