Journal of the Saudi Society of Dermatology & Dermatologic Surgery最新文献

Crohn’s disease (CD) is a granulomatous inflammatory bowel disease (IBD) of unknown etiology, classically presenting with abdominal pain and diarrhea as the first symptoms. Only 5–10% of patients may have skin manifestations as the initial clue to the disease (1). We present a case of a 9 year old girl whose diagnosis of CD had been delayed due to lack of gastrointestinal (GI) symptoms, and a presentation of vulvovaginal maceration and perianal skin tags masquerading as child abuse. After thoroughly evaluating the patient, our suspicion of CD was confirmed by lower GI endoscopy.

Introduction

Silymarin (SM), was reported to have anti-inflammatory and antioxidant activities and has been suggested as a positively effective agent on skin tissue regeneration and wound healing. In this study we aimed to determine the effect of topical administration of SM on stereological parameters of the wound healing process in rats.

Material and methods

Thirty six Wistar rats, with a 1 cm² full-thickness wound created on the posterior of their neck, were divided into three groups; the control group which received no treatment; the SM-treated group that received 2% SM-gel, and the gel-base treated group. At the end, full thickness skin samples from the wound site were obtained to determine volume density of collagen bundles, vessels, and hair follicles as well as fibroblast population, length density, vessel’s mean diameter, and wound closure rates by using unbiased stereological methods.

Result

SM increased fibroblast proliferation, collagen bundle synthesis, hair follicle population and consequently wound closure in comparison to the gel-base and the control groups (P < 0.05) according to stereological parameters of the skin. Angiogenesis was also intensified in the SM-treated group although it was not statistically significant.

Conclusion

Results of this stereological study indicated that SM possesses positive impact on the process of wound healing.

Hidradenitis suppurativa, or Verneuil’s disease, is somewhat common, especially in women, but is often unrecognized. Clinical manifestations include painful nodules, abscesses, sinus tracts, and ropelike hypertrophic scars in the apocrine gland-bearing areas. It is a chronic disease. Severe dramatic forms are rare. Treatment is both medical and surgical: wide-spectrum antibiotics and excisions tailored to the extent of involvement. Quality of life is severely affected even in mild forms.

Background

Lichen planus is an inflammatory skin disorder of unknown etiology. Recently, increased reactive oxygen species (ROS) and lipid peroxides have been implicated in the pathogenesis of various inflammatory dermatoses including lichen planus.

Aims

The present study was designed to evaluate the oxidative stress and the antioxidant defense status in Kashmiri patients suffering from lichen planus.

Methods

A total of 60 patients with lichen planus (27 males, 33 females) and 60 control subjects, matched for age and gender were enrolled in this prospective case control study. Serum levels of Superoxide dismutase (SOD), malondialdehyde (MDA), reduced glutathione (GSH), glutathione peroxidase (GPX) and Nitric oxide (NO) levels were measured in both patients and controls.

Results

Plasma levels of MDA, NO and SOD enzymes were significantly higher (p < 0.05) in patients than in controls. Plasma levels of GSH and GPX were significantly lower in patients than in controls (p < 0.05).

Conclusions

The findings in our study suggest an increased lipid peroxidation and an imbalance in the antioxidant defense mechanisms in lichen planus. This may play a role in the pathogenesis of lichen planus.

Lichen planus (LP) is a chronic inflammatory dermatological condition usually affecting adults, but rare in children. Lichen planus pigmentosus (LPP) is an uncommon variant of LP seen mostly in India or Middle East. LPP as such is rare and its presentation as childhood LPP rarer. We report a case of LPP in a 3 year old Kashmiri male child, which is a rare presentation.

Acne scarring is a very common and a distressing condition presenting to a dermatologist. The treatment of acne scars is a real therapeutic challenge. No single therapy is effective and it often requires multiple modalities. The aim of the present study was to assess the efficacy of plain catgut in the tissue augmentation of acne scars. Acne scars of rolling, depressed and atrophic variants over cheeks were taken for study. Plain surgical catgut 3–0, cut into small pieces measuring 1/2–1 cm was used for tissue augmentation. A total of 15 patients were enrolled in the study. Out of 15 patients, 8 patients showed more than 75% improvement, 4 patients showed 50% improvement and 3 patients were lost to follow up.

Lupus panniculitis (LP) is a rare finding in children. We describe one case of LP in 8 year old boy with subcutaneous erythematous nodules affecting the nose and right side of the cheek of one year duration. Histological examination reveled features of lupus panniculitis. The patient was treated with oral chloroquine with complete resolution of the swellings on the cheek and nose after one year treatment.

We report a case of Kikuchi’s disease (KD) in a 19 year old Saudi woman who initially presented with fever, myalgia, headaches and cervical and supraclavicular lymphadenopathy at the age of 10 years. A lymph node biopsy demonstrated the typical necrotizing lymphadenitis of KD. Her disease was controlled with oral corticosteroids and remained quiescent for 7 years without treatment. Recently, her systemic symptoms reappeared and she developed an acneiform eruption consisting of scaly, erythematous macules and indurated papules, with no comedones, over face, neck and mid chest. Skin biopsy was consistent with the diagnosis of KD. The majority of cutaneous lesions of KD show the characteristic histological changes that parallel those of the lymph nodes. Few have non-specific clinical and histological findings as this case, and are a diagnostic challenge. Dermatologists should be aware of this rare entity when evaluating acneiform eruptions with concomitant systemic symptoms. Screening and intermittent observation and evaluation for autoimmune disease, specifically systemic lupus erythematosus (SLE) is recommended in confirmed KD.

Most patients respond well to anti-acne therapies yet others show no response despite an effective treatment regimen. One of the main reasons of unresponsiveness is the presence of conditions mimicking acne. Physicians must distinguish acne vulgaris from a range of skin disorders which produce follicular papules and pustules. The key distinguishing feature is the presence of comedones, which is characteristic for acne vulgaris.

This review highlights the main conditions that can be misdiagnosed as acne. These include the non-acne conditions presenting with comedones or with acne in their names, those with appendageal abnormalities, or a follicular component and those occurring in the neonate.