Published monthly, the International Journal of Dermatology is specifically designed to provide dermatologists around the world with a regular, up-to-date source of information on all aspects of the diagnosis and management of skin diseases. Accepted articles regularly cover clinical trials; education; morphology; pharmacology and therapeutics; case reports, and reviews. Additional features include tropical medical reports, news, correspondence, proceedings and transactions, and education. The International Journal of Dermatology is guided by a distinguished, international editorial board and emphasizes a global approach to continuing medical education for physicians and other providers of health care with a specific interest in problems relating to the skin.
Zeynep Demirçay, Oya Gürbüz, Tülin Budak Alpdoğan, Deniz Yücelten, Önder Alpdoǧan, Özlem Kurtkaya, Mahmut Bayık
AbstractBackground Chemotherapy‐induced acral erythema is a distinct localized cutaneous response to certain systemic chemotherapeutic agents.Methods Between January 1990 and December 1994, from a total of 76 leukemic patients who have received combination chemotherapy consisting of cytosine arabinoside and anthracycline antibiotics, 15 patients developed chemotherapy‐induced acral erythema. Fourteen of the patients had acute myelocytic leukemia, and one of them had chronic myelogenous leukemia in blast phase. Clinical features of these 15 patients have been analysed. Biopsy specimens obtained from eight of the patients were also evaluated for histopathologic alterations.Results The overall incidence of this reaction was found to be 19.7% in our group of patients receiving this chemotherapy protocol. The onset of reaction varied from the fourth to the seventeenth days of the chemotherapy and resolved within 2 weeks in most of the patients. Lesions appeared as well‐defined erythema and edema involving the palmar surfaces in all of the patients. In nine of the patients the reaction recurred with subsequent chemotherapies. Scattered necrotic keratinocytes, vacuolar alterations of the basal layer, and mild to moderate perivascular lymphocytic infiltration in the dermis were the histopathologic findings observed in the biopsy specimens.Conclusions Chemotherapy‐induced acral erythema is a frequent reaction in patients who are receiving high‐dose chemotherapy. For patients in whom this self‐limited condition develops, reassurance is the mainstay of therapy. Awareness of this reaction is also important to be able to differentiate it from acute graft versus host disease in patients who receive bone marrow transplants.
AbstractBackground Acne affects a large number of young adults, including women, who often present with facial as well as truncal involvement. Systemic antimicrobial agents currently used for the reduction of inflammatory papules and cysts require frequent administration and are sometimes associated with uncomfortable side‐effects contributing to a decrease in compliance.Methods Ninety‐nine episodes of inflammatory acne in 79 patients treated with oral antimicrobial agents were studied retrospectively over a period of 46 weeks. Patients were treated with tetracycline, erythromycin, minocycline, and doxycycline, the most commonly prescribed oral antimicrobials used to treat acne. Individuals that were unable to tolerate this therapy or had failed conventional therapy were treated with the azalide antibiotic azithromycin, given in a single oral 250‐mg dose three times a week. The other agents were administered daily in divided doses as is current practice. Patients were also on topical care.Results The efficacy and reported side‐effects were examined for all agents. Significant improvement was noted in 4 weeks. All agents were effective in reducing inflammatory lesions and improving acne. Azithromycin produced a slightly higher percentage of patients with a greater than 80% reduction in their inflammatory acne lesions (85.7%) vs. an average of 77.1% for all other agents. All differences observed were not statistically significant.Conclusions The results show that azithromycin is a safe and effective alternative in the treatment of inflammatory acne with few side‐effects and good compliance, and suggest the need for further investigation with a clinical trial that will compare the long‐term efficacy and tolerability.
Ines Dammak, S. Boudaya, Fatma Ben Abdallah, H. Turki, Hamadi Attia, Basma Hentati
AbstractBackground The pathogenetic mechanisms in vitiligo have not been clarified completely. One of the major hypotheses in the pathogenesis of vitiligo is the oxidative stress hypothesis. The active and stable phases of vitiligo are defined as the progression or appearance of new lesions in the last 3 months and the absence of new lesions or progression in the last 6 months, respectively.Methods We examined the levels of malondialdehyde, catalase, glutathione peroxidase, and superoxide dismutase in the tissues of 10 patients with active vitiligo, 10 patients with stable vitiligo, and 20 matched healthy controls.Results The results revealed that the levels of superoxide dismutase, glutathione peroxidase, and malondialdehyde in tissues were increased significantly in patients with active vitiligo relative to those in patients with stable vitiligo and matched controls; however, the levels of catalase in tissues were decreased significantly in patients with active vitiligo relative to those in patients with stable vitiligo and matched controls.Conclusions Our study shows that oxidative stress is involved in the pathophysiology of both active and stable vitiligo, but an increased imbalance of antioxidants is observed in the tissues of patients with active vitiligo.
AbstractBackground Vitiligo is an acquired, idiopathic, and worldwide common depigmentation disorder with an estimated prevalence from 0.1 to 8%. These numbers are based on clinical population studies and field research examining inhabitants of geographically enclosed areas. Our aim was to collect all available data on the prevalence of vitiligo in the general population, paying particular attention to children/adolescent groups and adults.Materials and methods Screening of available literature and online databases using several key words.Results We found more than 50 studies that used several methods and subgroups of the general population. The prevalence of vitiligo ranges from 0.06 to 2.28%, whereas this was 0.0–2.16% in children/adolescents populations.Conclusions The often cited prevalence of 8% could not be confirmed after excluding clinical patient populations. Accordingly, the worldwide prevalence of vitiligo ranges between 0.5 and 2%.
AbstractBackground. Necrolytic acral erythema (NAE) is a distinctive skin lesion that was found to affect the dorsa of the feet of seven patients having active viral hepatitis C. Necrolytic acral erythema occurs in the form of well circumscribed dusky erythematous areas that develop flaccid blisters in their early stages and a hyperkeratotic surface in their chronic form. Microscopically, lesions of NAE are similar to those of other necrolytic erythemas such as necrolytic migratory erythema, pellagra, and zinc deficiency.Method. Seven patients with NAE were included in this study. These patients underwent microscopic examination of punch biopsy specimens of the affected skin, abdominal sonography, ct scan of pancreas, and a liver biopsy. Blood samples were obtained for complete blood picture, serum glucose, zinc, amino acids, liver function tests, and markers of hepatitis.Results. All patients with nae were found to have hepatitis C by elisa and pcr.Conclusions. Necrolytic acral erythema is a distinctive type of necrolytic erythemas that was observed to occur almost exclusively with viral hepatitis C. Therefore, it should be considered an important cutaneous marker of hepatitis C, particularly in areas showing a high incidence of this form of hepatitis.
Mohammed S. Amer, M. Bahgat ., Zienab Tosson, Y M M B Mahmoud Abdel Mowla, Kawather Amer
ABSTRACT: Serum zinc levels In acne patients and in matched healthy controls of both sexes and within the same age group (16–20 years age) were estimated. Women, whether diseased or healthy, have shown a significantly lower mean serum zinc level than the corresponding men. In advanced grades of acne, both men and women have a significantly lower level than the corresponding control groups. Within the same sex group, those with advanced grades have revealed a significantly lower level than those with flight grades.