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Open access

Katarina Runtić, Sonja Prćić, Milana Ivkov Simić, Zorica Gajinov, Anica Radulović, Aleksandra Matić and Milan Matić

Abstract

Terra firma-forme dermatosis (TFFD) or Duncan’s dirty dermatosis is a bizarre, acquired, and idiopathic dermatosis. It is characterized by its asymptomatic, yellowish, or brownish dirt-like lesions, resistant to usual washing with soap and water, but disappearing when rubbed with 70% ethyl alcohol or isopropyl alcohol. Swabbing with alcohol is both diagnostic and therapeutic means for this disorder. We present two boys, aged 14 and 11, with asymptomatic brownish, dirt-like lesions on the chest and forearms, respectively. Skin lesions were continuously present for more than a month. Both of the patients had usual hygiene habits. The diagnosis of TFFD was confirmed by rubbing with 70% ethyl alcohol which led to disappearance of the lesions. TFFD often causes much concern in patients and parents of affected children. Since its clinical picture is similar to some other dermatoses, the disease can be misdiagnosed. Therefore, it is important to recognize this dermatosis in dermatological and pediatric practice in order to explain the benign nature of the disease to patients and to avoid unnecessary diagnostic tests.

Open access

Zeinab Javid, Abdolreza Norouzy, Zahra Bangaleh and Mahdi Shadnoush

Abstract

Introduction: Skin flap application in the clinical practice is restricted due to the ischemic damage and flap necrosis. Rosmarinus oil has been shown to improve a skin flap survival. In the present work we studied the role of mammalian target of rapamycin (mTOR) signaling on rosmarinus-induced flap protection. Methods: A flap surgery was performed on Sprauge-Dawley rats (8 cm in by 3 cm). A week before and a week after the surgery the flaps were treated with topical rosmarinus oil (twice per day). Rapamycin (m-TOR inhibitor) was administered 30 minutes before the flap surgery in rosmarinus-treated or not treated groups. A week after the surgery the malondialdehyde (MDA) contents, myeloperoxidase (MPO) and superoxide dismutase (SOD) activities, expression of Bax, Bcl-2, mTOR and p-mTOR were measured in the flap tissue. Results: Topical application of the rosmarinus increased the flap survival (p<0.05), anti-oxidative enzyme activity (SOD, p<0.05) and anti-apoptotic protein Bcl-2 expression. Rosmarinus treatment decreased the flap MDA content, MPO activity, and pro-apoptotic protein Bax expression (p<0.05). Rosmarinus topical application did not change mTOR expression and phosphorylation in the flap tissue. Expression of p-mTOR in rosmarinus treated group was suppressed by rapamycin pre-treatment, which also abolished rosmarinus effects on the flap survival (p<0.05). Conclusion: These data suggested p-mTOR dependent mechanism in rosmarinus-induced flap survival.

Open access

Dušan Mihajlović, Miroslav Dinić, Željko Mijušković, Nenad Petrov, Olga Radić Tasić, Marija Elez and Lidija Kandolf Sekulović

Abstract

Leukemia cutis is a specific skin lesion which is characterized by diffuse infiltration of neoplastic cells and can occur in all types of leukemia. Leukemia cutis can have varied cutaneous presentations such as papules, macules, nodules, plaques and ulcers. We report a case of 52-year-old woman who presented with erythematous macules and papules over her trunk, thighs and upper arms. A skin punch biopsy showed monomorphic, perivascular and periadnexal infiltration by the cells positive for CD45, CD15, CD68 and lysozyme. According to the subsequent bone marrow biopsy and immunophenotypic analysis of peripheral blood cells, the diagnosis of acute monocytic leukemia (FAB AML-M5b) was made. In our case, the first clinical sign suggestive of the diagnosis of leukemia was the presence of erythematous macules and papules. Therefore, we believe that leukemia cutis should be taken into consideration in the differential diagnosis of maculopapular rush on the trunk, upper arms and leg

Open access

Tanja Tirnanić and Željko Mijušković

Abstract

Sebaceous nevus is a congenital hamartoma commonly associated with the development of secondary neoplasms. It has a predilection for the scalp and less commonly manifests on the face, the neck, and the trunk. The lesions presented in our cases are from the trunk of a 19-year old man, the forehead of a 25-year old man, the scalp of a 22-year old woman and from the face of a 45-year old man. Two of four cases were associated with secondary neoplasms, syringoma and basal cell carcinoma. Dermoscopy of nevus sebaceous demonstrated yellowish-brown globular structures, presenting either singly or in clusters and pink-brown-grey papillary appearance. The specific dermoscopic findings in our case associated with basal cell carcinoma were fine arborizing and serpiginous vessels at the periphery of the lesion and exophytic grey papillary structures. Dermoscopy can be a useful diagnostic tool for diagnosing and monitoring nevus sebaceous in order to detect different tumors associated with nevus sebaceous and avoid unnecessary excisions and scars in aesthetically sensitive locations.

Open access

Oki Suwarsa, Lengga Herlina, Endang Sutedja, Hartati Purbo Dharmadji, Reti Hindritiani and Hendra Gunawan

Abstract

Bullous pemphigoid (BP) and psoriasis are chronic recurrent inflammatory skin diseases. The pathogenesis of concurrence of BP with psoriasis is still unknown. A 39-year-old male with a five-year history of chronic plaque psoriasis developed itchy large tense bullae on the trunk and upper extremities after he had been receiving narrow band ultraviolet B (NBUVB) therapy over five months. Skin biopsy from bulla on the trunk showed typical histological features of BP. Direct immunofluorescent staining showed deposit of immunoglobulin G and C3 in the basement membrane zone (BMZ) which supported the diagnosis of BP. It has been postulated that the autoimmune process responsible for BP lesions might be induced by ultraviolet light therapy and/or the inflammatory processes that occur in psoriasis.

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.