Lichen nitidus with involvement of the palms.

A 14-year-old girl presented with hyperkeratotic, pitted, skin-colored papules on a slightly erythematous surface on her palms and erythematous and squamous papules around her ankles. She was clinically and histopathologically diagnosed with lichen nitidus, which is observed rarely on the palms.

What is the Critical age for the Improvement of Parenchymal Thickness after Pyeloplasty?

PURPOSE: The most important point in cases of ureteropelvic junction obstruction (UPJO) is to decide on the need and timing of surgical treatment. Renal damage may become irreversible as the duration of the obstruction is prolonged. Worsening of hydronephrosis and decrease in renal parenchymal thickness after pyeloplasty may herald an irreversible renal damage. It is important to know at what age this damage begins. In this study, we aimed to determine the relationship between the age of the patients at the time of pyeloplasty performed for UPJO and parenchymal recovery. MATERIALS AND METHODS: In our study, 156 patients (mean age: 43.5 months) who underwent pyeloplasty with the diagnosis of UPJO between 2007 and 2019 were evaluated retrospectively. Demographic characteristics, ultrasonographic (USG) and nuclear renal scintigraphy findings, previous surgeries  â€‹of the patients  were recorded. RESULTS: Numerical variables were evaluated statistically, and the best cut-off point was determined. Parenchymal thickening was determined as the most important criterion in postoperative renal recovery which was more evident at early ages. Based on statistical assessments , the cut-off age for renal parenchymal recovery was determined as 38 months. While parenchymal recovery was inadequate after pyeloplasty performed in patients older than 38 months, the most significant improvement in renal functions was seen in children younger than 13 months of age. CONCLUSION: Pyeloplasty should be performed in patients with UPJO before development of severe renal damage. Statistically, the best parameter to evaluate the recovery after pyeloplasty is the change in parenchymal thickness. With advancing age, it is impossible to reverse the obstructive nephropathy.

Effect of intraperitoneal erythropoietin on the degree of mucosal damage of left colon flaps in rats.

BACKGROUND: Several modifications to an esophageal replacement approach have been described, using the left, the right, or the transverse colon as an interposition flap. Interposition of the left colon has become the most popular procedure. Intraoperative clamping of the arterial blood supply and venous drainage of the flap is a possible reason for ischemic flap failure. Thus, we designed a novel model to investigate whether erythropoietin (EPO), which has a tissue-protective effect in ischemia, would have any protective effect on prepared colon flaps in rats. METHODS: A total of 56 rats were randomly divided into four main groups, consisting of sham, sham + EPO, colon flap, and colon flap + EPO, and each main group was divided into two sub-groups. In the colon flap and colon flap + EPO groups, the colon flap was prepared and the pediculated free flap fixed tautly to the anterior abdominal wall. The sub-groups were subjected to post-reoperative histopathological investigation on the first and the seventh days, respectively. RESULTS: Our model was reliable for research related to colon interposition techniques. There was significant histopathological damage in the colon flap group both for the long and short limbs of the flap. On the other hand, EPO administration prevented the mucosal damage seen in the colon flap group. CONCLUSIONS: This study suggests that a colon flap attached tautly to the abdominal side wall simulates colon transposition techniques and also shows that intraperitoneal EPO markedly decreases flap damage in rats with prepared colon flaps.

Dermoscopic Findings in Patients with Pigmented Purpuric Dermatoses.

Pigmented purpuric dermatoses (PPD) are a group of chronic and relapsing cutaneous disorders characterized by a distinct purpuric rash. The diagnosis is made with clinical and histopathological findings. Dermoscopy has rarely been used in the diagnosis of PPD. The aim of our study is to describe the dermoscopic findings in patients with PPD. Eighteen patients who were clinically and histopathologically diagnosed with PPD were studied prospectively. The type and duration of PPD, associated diseases, and medication history of the patients were noted. Dermoscopic examination was performed in all of the patients. Four of the patients were women and 14 of them were men. 16 (88.8%) of them had Shamberg's disease, 1 of them had lichen aureus, and 1 had purpura annularis telangiectoides. Dermoscopic examination revealed multiple irregular red dots, globules and/or patches and brown-coppery coloration on the background in all of the patients, a network of interconnected brown lines in 8, linear vessels in 9, brown dots in 3, grey dots in 3, twisted red loops in 5, comma-like vessels in 2, and red lacunae in 1 patient. The dermoscopic examination of PPD might improve the accuracy of clinical diagnosis.

Surgical management of complete penile duplication accompanied by multiple anomalies.

Diphallus (penile duplication) is very rare and seen once every 5.5 million births. It can be isolated, but is usually accompanied by other congenital anomalies. Previous studies have reported many concurrent anomalies, such as bladder extrophy, cloacal extrophy, duplicated bladder, scrotal abnormalities, hypospadias, separated symphysis pubis, intestinal anomalies and imperforate anus; no penile duplication case accompanied by omphalocele has been reported. We present the surgical management of a patient with multiple anomalies, including complete penile duplication, hypo-gastric omphalocele and extrophic rectal duplication.

Two cases of unilateral lichen planus following the lines of blaschko.

A 50-year-old man and 71-year-old woman presented to our clinic with unilateral, linear, erythematous, pruritic lesions along the lines of Blaschko. On the basis of clinical and histopathological findings, the lesions were diagnosed as lichen planus with a Blaschkoian distribution, which is a rare form of lichen planus. The patients were treated with topical corticosteroids and antihistamines.

Granulomatous appendicitis in a 12-year-old boy.

Isolated granulomatous inflammation of the appendix is extremely rare, and its etiology is still unknown. We describe a 12-year-old boy with isolated granulomatous appendicitis where the etiology could not be clarified despite infectious criteria such as high fever and gastroenteritis. Children with epithelioid granulomatous appendicitis have a good prognosis following appendectomy.