Erythema elevatum diutinum coexisting with ankylosing spondylitis.

A 43-year-old woman presented to our hospital with the complaint of a reddish-purple rash on the extensor sides of her forearms. She had been diagnosed with ankylosing spondylitis 7 years ago. On physical examination, reddish-purple nodules were detected on the pretibial areas of both legs and extensor sides of both hands and forearms. Neutrophil, eosinophil, lymphocyte, and mixed-type leukocyte infiltration and erythrocyte extravasation were observed in skin biopsy. Erythema elevatum diutinum (EED) was diagnosed. For treatment, sulphasalazine, colchicine, and diclofenac were started. After 3 months of treatment, the lesions were healed. To the best of our knowledge, this is the first report of EED coexisting with ankylosing spondylitis.

Acute generalized exanthematous pustulosis induced by iodixanol (Visipaque): a serious reaction to a commonly used drug.

Acute generalized exanthematous pustulosis (AGEP) is an acute sterile pustular eruption most commonly induced by medications. Although antibiotics are the most commonly accused drugs in AGEP, non-antibiotic agents may also cause this disease. We present a case of AGEP following use of iodixanol for coronary angiography in a 61-year-old woman. Given the wide use of this substance in cardiology, clinicians should be aware of this potential complication.

Oxidative stress in patients with scalp seborrheic dermatitis.

Seborrheic dermatitis (SD) is a common, chronic inflammatory skin disease that mainly affects the scalp. The objective of this study was to evaluate the activities of superoxide dismutase (SOD) and catalase (CAT) and the levels of malondialdehyde (MDA) in scraping samples of patients with scalp SD. Thirty consecutive patients with a diagnosis of scalp SD and thirty-one healthy volunteers were enrolled. The samples were obtained by scraping the skin surface of the scalp. SOD and CAT activities and MDA levels were measured in scraping samples by spectrophotometric method. SOD and CAT activities and MDA levels were significantly higher in patients than in controls (p<0.001 all). There was a positive correlation between the severity of the disease and itching scores (contingency coefficient = 0.671, p<0.001). Except for this correlation, there was no significant correlation among age, sex, duration and severity of the disease, itching scores, antioxidant enzymes and MDA levels in the patient group (p>0.05). Cutaneous oxidative stress in patients with SD may play an important role in the pathogenesis of the disease. Further clinical and laboratory evaluation of the oxidant/antioxidant system in patients with SD is warranted.

Pigmented purpuric dermatosis associated with primary antiphospholipid syndrome.

Pigmented purpuric dermatosis (PPD) is a group of chronic disorders characterized by the extravasation of erythrocytes and marked hemosiderin deposits in the dermis. Schamberg disease is a subtype of pigmented purpuric dermatosis in which nonpalpable purpura is prominent on the lower extremities. No cases of primary antiphospholipid syndrome and pigmented purpuric dermatosis have so far been reported in the literature. We herein report a case of pigmented purpuric dermatosis associated with primary antiphospholipid syndrome.

Local oxidative stress in interdigital tinea pedis.

Several skin diseases are believed to be associated with oxidative stress. Tinea pedis is an infection of the feet caused by fungi. The infectious diseases caused by dermatophytes are mainly related to the enzymes produced by these fungi. The cutaneous oxidative stress status of tinea pedis has not been demonstrated in the published work up to now. The aim of the present study was to evaluate the role of oxidative stress in affected skin areas in a group of patients with interdigital tinea pedis. Thirty-one consecutive patients with a diagnosis of unilateral interdigital tinea pedis were enrolled. The samples were obtained by scraping the skin surface. Oxidative stress biomarkers such as superoxide dismutase, catalase and malondialdehyde levels were measured spectrophotometrically. The activities of superoxide dismutase and catalase and the levels of malondialdehyde were significantly higher on the lesional area than the non-lesional area (P < 0.001). According to sex and fungal subtypes, there was no significant difference in the levels of oxidative stress biomarkers in patients with tinea pedis (P > 0.05). Our results suggested that antioxidant defense of lesional skin surface was higher compared to non-lesional skin. This is possibly due to a compensatory response to various fungal infections and thereby protects the cells against oxidative damage.

Assessment of temperament and character profile with anxiety and depression in patients with acne.

BACKGROUND: Acne is the most common skin disease, affecting nearly 85% of the population as well as their lives. Acne can severely affect social and psychological functioning. Patients with acne may have anxiety, depression, decreased self-esteem, interpersonal difficulties, unemployment, social withdrawal, and even suicidal intent. AIMS: The aim of this study was to evaluate the temperament and character inventory (TCI) of patients with acne and to compare the results with those of healthy controls. STUDY DESIGN: Case-control study. METHODS: The study population consisted of 47 patients with acne, and 40 healthy control subjects. All participants were instructed to complete a self-administered 240-item TCI and the Hospital Anxiety and Depression Scale. RESULTS: In this study, the scores for the temperament properties Worry and pessimism (HA1) and Dependence (RD4) and the character properties Social acceptance (C1) and Integrated conscience (C5) were found to be higher in acne patients than in healthy controls (p<0.05). Compared to the controls, depression and anxiety scores were found to be markedly higher in the patients with acne. Acne type correlated positively with the Disorderliness (NS4) subscale of Novelty seeking (NS) and anxiety. Additionally, acne type correlated negatively with the Attachment (RD3) subscale of Reward Dependence (RD), with the Transpersonal identification (ST2) and Spiritual acceptance (ST3) subscales of Self-Trancendence (ST), and with the Compassion (C4) sub-scale of Cooperativeness (C). CONCLUSION: Studies in this area may lead to the development of specific and focused interventions for TCI in patients with acne vulgaris. We suggest that the evaluation and treatment of acne should also include psychosomatic approaches in clinical practice.