Segmental tuberous sclerosis in a patient presenting as unilateral facial angiofibromas, periungual fibromas and Shagreen patch.

Tuberous sclerosis (TS) known as Epiloia and Bourneville's disease is an autosomal dominant inherited disorder that can affect many organ systems. Tuberous sclerosis has many forms of clinical presentation. Rarely, multiple facial angiofibromas of unilateral distribution have been reported. We describe a patient with unilateral facial angiofibromas, periungual fibromas and Shagreen patch.

A viral infection of the hand commonly seen after the feast of sacrifice: human orf (orf of the hand).

Orf of the hand is an uncommon zoonotic infection caused by a dermotropic DNA virus that belongs to the Parapoxvirus genus of the family Poxviridae. It is transmitted to humans through contact with infected sheep and goats and is reported as an occupational disease. We report nine cases of human orf seen in the hands of individuals, who were not occupationally exposed, after the feast of sacrifice in Turkey. Three cases were teachers and six out of the nine were housewives. We observed musculoskeletal complications and misdiagnoses. It is important to consider human orf in the differential diagnosis of hand lesions to prevent overtreatment and complications.

Disseminated lupus vulgaris and papulonecrotic tuberculid: case report.

The incidence of tuberculosis and extrapulmonary forms of this disease is increasing all over the world. Lupus vulgaris is the most prevalent form of cutaneous tuberculosis in Europe and the Middle East. Papulonecrotic tuberculid, the most common form of hyperergic response to mycobacteria or their fragments, is uncommon in children. We report lupus vulgaris with papulonecrotic tuberculid in a 12-year-old girl who had a 3-year history of slowly growing plaques on her trunk, extremities, and the tip of her nose and papuloulcerative lesions over her entire body. A skin biopsy specimen showed minimally caseating granulomatous inflammation. Staining for acid-fast bacilli was negative in both plaques and papules. Polymerase chain reaction identified Mycobacterium tuberculosis DNA in the patient's sputum, gastric fluid, and plaques and was negative in the papules. She was started on antituberculous therapy with four drugs and her lesions responded rapidly.

The risk of coronary heart disease in men with androgenetic alopecia.

BACKGROUND: The meaningful association of androgenetic alopecia and coronary heart disease has been well documented, but few studies have focused on the importance of lipid parameters, such as total cholesterol, triglycerides, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, lipoprotein (a), apolipoprotein A1 and apolipoprotein B in patients with androgenetic alopecia. OBJECTIVE: The aim of this study is to investigate the relation between androgenetic alopecia and coronary heart disease and to determine the significance of certain lipid parameters on this relationship. SUBJECTS: Forty-one men with vertex type androgenetic alopecia (study group) and 36 men, age-matched, with normal hair status (control group) were the subjects of this study. RESULTS: We found significant differences in serum lipoprotein (a) and triglyceride levels between the study and control groups (P < 0.05). Forty-seven percent of patients and 30% of controls had a lipoprotein (a) level more than 30 mg/dl higher than the level critical for atherosclerotic heart disease. CONCLUSION: Dermatologists should investigate lipid profile, especially lipoprotein (a), of patients with androgenetic alopecia and refer to a cardiologist if necessary.

Giant vascular eccrine spiradenoma.

A 60-year-old man suffering from cardiac insufficiency consulted the Dermatology Department, Inönü University Turgut Ozal Medical Center, because of a bleeding tumor on his right hypochondrium. The tumor had begun as a small nodule approximately 5 years before, and had grown slowly with time. A small, superficial ulcer had appeared on the lesion approximately 6 months previously, and slight bleeding had occasionally occurred. The patient had no pain and no other complaint except bleeding. Dermatologic examination revealed a violaceous, ulcerated, and bleeding tumoral lesion below the mid-portion of the right costochondral line. The tumor was a non-tender, hemispheric mass, approximately 3-4 cm in size, adherent to the epidermis, but movable on the underlying tissue. An incisional biopsy was performed with diagnoses of dermatofibrosarcoma protuberans and desmoid tumor. Histopathologic examination revealed prominent blood-filled vascular spaces and clearly delimited cords, showing two types of cell. The vascular spaces contained a periodic acid-Schiff (PAS)-positive, granular, eosinophilic material. There was no malignant transformation. The lesion was totally excised and primarily sutured.