Folliculitis might be associated with pathergy-positivity in patients with Behçet syndrome.

Pathergy test indicates nonspecific hyper-reactivity of the skin to aseptic trauma in Behçet syndrome (BS) and is considered as an adjunctive diagnostic test with a good specificity albeit with low sensitivity. We tested the hypothesis that a relationship exists between active clinical manifestations of BS and the pathergy-positivity when performed simultaneously. Pathergy test and detailed dermatologic examination were done in 105 BS patients (60M/45F); who were seen consecutively at the multi-disciplinary BS outpatient clinic in a single tertiary center. Information regarding demographic and clinical characteristics, pathergy test results at diagnosis, and details about treatment were obtained from patient charts. Disease activity was assessed using Behçet Disease Current Activity Form. Among 105 patients, 27 (25.7%) were pathergy-positive at the time of the study visit whereas 40.9% were pathergy-positive at the time of the diagnosis. There was no relation between pathergy test and patient age or disease duration, either. Pathergy-positivity was significantly more common in patients with folliculitis compared to those without folliculitis (40.7% vs 19.2%; P = .026). The test was also positive in all 3 patients with leg ulcers due to venous stasis. We found that among all skin-mucosa lesions only the presence of folliculitis was associated with pathergy positivity with statistical significance. It was also remarkable that the current pathergy was positive in all 3 patients with active leg ulcers but this finding warrants further studies because of the low patient numbers.

The role of dermoscopy in the diagnosis of subungual glomus tumors.

BACKGROUND AND OBJECTIVES: The dermoscopic features of glomus tumors have only been described in a few case reports. The aim of this research was to define the clinical and dermoscopic features of subungual glomus tumors. METHODS: Thirty-two patients with subungual glomus tumors were evaluated retrospectively. RESULTS: On the photographs, longitudinal erythronychia, longitudinal leukonychia, punctate leukonychia, splinter hemorrhage, isolated capillaries, distal notching, distal subungual hyperkeratosis, onycholysis, and onychoschizia were found. There was no statistical difference between the rates of detection of these findings by evaluation from clinical photographs alone and from both clinical and dermoscopic photographs. While ramified vessels with bluish spots could be detected in only five of 26 cases with bluish spots in their clinical photographs, these ramified vessels were seen in 14 cases in bluish spots in dermoscopic photographs (P = 0.004). Compared to clinical examination, dermoscopy was able to detect blue spots in three more cases. Lesion duration was higher in the cases with ramified vessels (P = 0.018). CONCLUSIONS: Dermoscopy seems to contribute to the clinical examination in displaying only ramified vessels located in bluish spots and in determining the localization of the subungual tumors. The presence of ramified vessel in the bluish spots is strongly related to lesion duration.

Morphology, growth rate, and thickness of the nail plate during the pregnancy.

Pregnancy causes some physiological skin changes, such as hyperpigmentation and striae gravidarum. Thickening of scalp hair and a prolonged anagen phase are also known to occur during pregnancy. However, a limited number of studies have been conducted on the effect of pregnancy on the nails. We aimed to investigate the effect of pregnancy on the morphology of the nail plate, specifically its growth rate and thickness. Pregnant women and a control group consisting of healthy female volunteers were included in the study. The distance from the apical point of the lunula to the midpoint of the free edge of the nail plate of the the thumb was measured with digital calipers. The measurement was repeated during the control visits and recorded in millimeters per day. The thickness of the nail plate of the thumb was measured at the midpoint of the free edge of the nail plate. A dermatological examination of the fingernails was performed for both groups. A survey was also conducted to identify any changes that occurred in the nails during pregnancy. The mean growth rate of the nail plate in pregnant women was 0.1 ± 0.05 mm/day, and in the control group it was 0.09 ± 0.05 mm/day. There was no statistically significant difference between the pregnant and control groups regarding the growth rate of the nail plate (P = 0.438). The mean thickness of the nail plate in pregnant women was 0.87 ± 0.19 mm, and in the control group it was 0.75 ± 0.17 mm. There was a statistically significant difference between the groups with respect to nail plate thickness (P < 0.001). A dermatological examination of the fingernails in the two groups did not reveal any statistically significant differences with respect to the nail findings. We determined in our study that pregnancy did not affect the growth rate and the morphology of the nails but increased the thickness of the nail plates.

A Proposal for a New Severity Index for the Evaluation of Chronic Paronychia.

INTRODUCTION: Chronic paronychia (CP) is an inflammatory disease of the nail folds. Staging of CP is important for clinicians. We developed an objective scale that evaluates each finding of CP separately in addition to evaluating the treatment process and follow-up. METHODS: A new "chronic paronychia severity index scale" was developed to enable dermatologists to examine all features of CP. A previous categorical severity scale and this new scale were used for the evaluation of CP by 6 different dermatologists. The dermatologists evaluated the nails with both scales again 20 days later using randomly ordered photographs. RESULTS: Using the previous scale, the intra-observer intraclass correlation coefficient (ICC) values between the first and second evaluations were 0.767, 0.860, 0.734, 0.609, 0.900, and 0.840 for the 6 dermatologists. Using the new proposed scale, the intra-observer ICC values between the first and second evaluations were 0.930, 0.931, 0.942, 0.934, 0.938, and 0.920 for the 6 dermatologists. All intra-observer ICC values were higher for the results of the proposed scale than for those of the previous scale. The inter-observer ICC values were also higher for the proposed scale than for the previous scale for the 6 dermatologists. CONCLUSION: The new scale is a standardized, more suitable, objective, and valuable method to use in clinical practice and studies on CP.