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Open access

Bojana Spasić, Marina Jovanović, Zoran Golušin, Olivera Ivanov and Dušanka Tešanović

Abstract

Radiation dermatitis is one of the commonest side effects of ionizing radiation which is applied in radiotherapy of carcinoma of all localizations, most frequently of tumors of breast, head and neck region, lungs and soft tissue sarcomas. It usually occurs as a complication of breast radiotherapy and thus it is more often recorded in female patients on the skin in the region of breast subjected to radiation. Clinical manifestations of radiation dermatitis can be divided into four phases: acute phase (erythema, dry desquamation, moist desquamation, ulceration and necrosis with resulting re-epithelialization, residual post-inflammatory hyperpigmentation, reduction and suppression of sebaceous and sweat glands and epilation); subacute phase (hyperpigmentation and hypopigmentation, telangiectasia, skin atrophy, even ulceration); chronic phase (skin atrophy, dermal fibrosis and permanent skin epilation) and late phase (increased risk of skin cancer). In order to prevent radiation dermatitis, skin care products should be applied throughout radiotherapy that will decrease the frequency of skin reactions or block them and thus improve life quality. Although the therapy includes not only topical corticosteroids but numerous other products with active ingredients such as aloe vera, calendula, hyaluronic acid, sucralfat, sorbolene, mineral and olive oil, honey, vitamin C, zinc, antimicrobials and silver, common therapeutic consensus has not been reached on their application in radiation dermatitis. Therefore, the treatment should be conducted according to the basic guidelines but tailor-made for each individual patient.

Open access

Igor Kapetanović, Vesna Reljić, Martina Bosić and Svetlana Popadić

Abstract

Basal cell carcinoma is the most common form of cutaneous cancer. In majority of cases it is locally invasive with slow growth, ranging in size from a couple of milimeters to a couple of centimeters and located primarily on sun-exposed regions. Giant basal cell carcinoma, defined as a tumor that is larger than 5 cm in diameter, is a very rare type of cutaneous malignancy accounting for 0.5-1% of all basal cell carcinomas. We present a case of a 74-year-old man with a 17 x 14 cm giant basal cell carcinoma in the right supraclavicular region. Detailed history revealed that the lesion had started as a papule 15 years before presentation. Despite its growth, the lesion was neglected until admission. Histological examination of skin lesion confirmed superficial and focally infiltrative types of basal cell carcinoma. Electron radiotherapy was administered with 54 Gy total dose delivered in 20 daily fractions which resulted in healing of lesions and adequate response. Thus, definitive radiotherapy can be just as effective as excision when the criteria are met.

Open access

Hendra Gunawan, Irma Fakhrosa, Nia Ayu Saraswati, Muljaningsih Sasmojo, Reti Hindritiani and Oki Suwarsa

Abstract

One of the success indicators of the World Health Organization (WHO) leprosy eradication program is the decreasing number of new cases of pediatric leprosy with a grade 2 disability. A case of borderline lepromatous (BL) leprosy with partial claw hand in a 13-year-old boy was reported. On physical examination, we found claw fingers on the fourth and fifth fingers of the left hand accompanied by hypoesthetic erythematous plaques on both cheeks. The patient also presented with the enlargement of bilateral great auricular, ulnar, and peroneal nerves. The bacteriological examination showed the bacterial index 3+ and morphological index 35%. The results of histopathological and serological anti-phenolic glycolipid-I examinations supported the diagnosis of BL type of leprosy. Genotyping of Mycobacterium leprae by variable number tandem repeat of the patient showed 24 copies thymine-thymine-cytosine that were similar to his father, who had been diagnosed with leprosy 12 years before, without adequate therapy. The result indicated the possibility of leprosy transmission from the father to a son. This case report revealed the presence of leprosy in children with a multibacillary infection who have been living with leprosy family members. Genotyping seems to be feasible for epidemiological analysis of leprosy transmission.

Open access

Mufutau Muphy Oripelaye, Ayodeji Olanrewaju Oladele, Fatai Olatunde Olanrewaju and Olaejirinde Olaniyi Olaofe

Abstract

Background. The increasing solar intensity and HIV epidemic have progressively eroded the protective effects of melanin among black race. This study was aimed at evaluating the pattern of primary skin cancers in Ile-Ife, Nigeria.

Methods. This retrospective study, which was conducted at the Obafemi Awolowo University Teaching Hospital, Ile-Ife, included the patients diagnosed with primary skin cancers between January 2008 and December 2017. The data were analyzed using SPSS version20.

Results. The frequency of primary skin cancers was 1.0%. Females (58.3%) outnumbered the males (41.7%), the ratio being 1.4:1. The spectrum of primary skin cancers documented by this study are squamous cell carcinoma (33.3%), malignant melanoma (25%), Kaposi sarcoma (15.3%), basal cell carcinoma (9.7%), and cutaneous lymphoma (6.9%).

Conclusion. Melanin remains a major protective factor for skin cancers among negroids. Albinism and high burden of HIV were identified risk groups for skin cancers. The eradication of HIV and enhanced sun protection will reduce the prevalence of skin cancers.

Open access

Dermoscopy of the Month

Azithromycin-Induced Longitudinal Melanonychia in a Child-a Case Report

Andrija Jović, Danica Tiodorović, Danijela Popović, Hristina Kocić, Zorana Zlatanović, Milan Kostić and Giovanni Damiani

Abstract

Melanonychia refers to a brown or black coloration of the nail plate caused by numerous factors. Regarding the arrangement of pigmentation, we can differentiate between total melanonychia, when pigmentation involves the whole nail plate, or transverse or longitudinal melanonychia, when pigmentation involves the nail in a form of transverse or longitudinal band of pigmentation, respectively. Since longitudinal melanonychia can be a sign of numerous benign and malignant lesions, it often poses a diagnostic challenge for a dermatologist. Herein, we report a case of a 13-year-old girl who developed longitudinal melanonychia on multiple nails after receiving a therapy with azithromycin.

Open access

Farrokh Rad, Ebrahim Ghaderi, Bahram Nikkhoo and Mohammad Aziz Rasouli

Abstract

Introduction. Hepatitis C virus (HCV) infection is one of the factors which can lead to a chronic liver disease and hepatocellular carcinoma. There have been several reports on the association of oral lichen planus with hepatic disorders, i.e. hepatitis C infection in particular. Considering the controversies about the association of lichen planus with HCV infection on one hand and considerable impact of hepatitis C on the occurrence of chronic liver disease on the other hand, we investigated the association between lichen planus and HCV infection in Sanandaj City. Methods. This cross sectional study included 168 patients with lichen planus, who were referred to the Dermatology Clinic of Besat Hospital between 2014 and 2016. The diagnosis of lichen planus was made by our dermatologist and HCV antibody titer was determined for every patient. Results. Mean age of the patients was 39.7±13.3 years and mean duration of the disease was 14.8 months. 107 (63.7%) patients were men. The highest frequency of lichen planus was recorded in the housewives (30.4%). In 52 (31%) patients the genital area was involved and it was the most common site. In 6 (3.6%) patients the oral mucosa was involved and it was the least common site in our study. Only 4 (2.7%) patients had family history of lichen planus. None of 168 patients included in this study was found to have HCV infection. Conclusion. In this study, we found no relationship between lichen planus and HCV infection. Yet, the exact mechanism underlying the occurrence of lichen planus in the patients with HCV infection has not been determined. Therefore more studies on this subject are recommended.

Open access

Morgan Covington, Juliana Gao, Farah Abdulla and Vesna Petronić Rosić

Abstract

Fusarium is a ubiquitous fungal species found in soil and water. While fusarium can cause localized infection in healthy individuals, it most commonly affects those with compromised immune systems, particularly those with prolonged neutropenia. The morality rate of systemic infection approaches one-hundred percent. Here we present two cases of disseminated fusarium infection in two patients with acute lymphoblastic leukemia (ALL) along with review of literatures regarding prophylaxis and treatment.

Open access

Zorana Kremić, Aleksandra Vojvodić, Miroslav Dinić, Nenad Petrov, Olga Radić Tasić and Lidija Kandolf Sekulović

Abstract

Primary cutaneous B- cell lymphomas (PCBLs) are B-cell malignant neoplasms that originate in the skin, and have no extracutaneous manifestations of disease at the time of diagnosis. PCBLs are classified into three main types: primary cutaneous marginal zone lymphoma (PCMZL), primary cutaneous follicle center lymphoma (PCFCL), and primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL- LT). Dermoscopic characterization of PCBLs has been limited and dermoscopy may help to augment the clinical recognition of PCBLs with the most common dermoscopic findings of salmon colored areas and serpentine vessels. Recognition of dermoscopic features of primary cutaneous B- cell lymphomas can improve the early diagnosis of these tumors and their proper management.

Open access

Branislav Lekić, Danijela Milčić, Mirjana Popadić, Dušan Škiljević and Mirjana Milinković Srećković

Abstract

Cutaneous polyarteritis nodosa (CPAN) is a variant of polyarteritis nodosa that is limited primarily to the skin. It is a chronic recurrent disorder characterized by the presence of nodular lesions with or without ulceration on the distal third of the lower limbs. Nodular vasculitis and thrombophlebitis can be clinically or pathologically mistaken for CPAN. We present a case of a 51-year-old woman with painful nodules on the lower limbs. Some of the nodules were ulcerated. Histopathological examination of a nodule on deep incisional biopsy revealed fibrinoid necrosis of a medium-sized artery in the subcutis along with perivascular mixed infiltrate. The patient did not have any symptoms or signs of internal organ involvement. The possible etiological factor has not been detected. The patient was treated with oral prednisone 0.5 mg/kg/day and dapson 150 mg/day. Over the one-year follow-up the lesions showed regression, with one minimal relapse which resolved after the short course of oral prednisone.

Open access

Bisera Kotevska Trifunova, Zdravka V. Demerdjieva, Nikolay K. Tsankov and Jana S. Kazandjieva

Abstract

Nowadays, allergic reactions in children are seen in dermatological practice on a daily basis. The most common reasons for allergic contact dermatitis (ACD) are piercings, temporary tattoos, a wide range of cosmetic products, substances related to the practice of a variety of hobbies and sports, etc. Slime is a new hobby and has become an obsession for some kids. There are many homemade slime recipes. The most common recipe for slime is glue, borax and food coloring for all kinds of rainbow effects. We present a case of an 11-year-old Caucasian girl with hand contact dermatitis caused by an allergic reaction to Slime.