Skin cancer is common problem that sometimes might need surgery and skin grafting. The aim of the present case report is to record the observation that grafted skin is highly resistant to develop skin malignancy even after prolonged time of observation.
Eruptive syringoma is a rare adnexal tumor characterized by a flesh-colored papules that occurs in crops mainly on the anterior surfaces of the body. The lesions are benign, and treatment options are generally unsatisfactory. The case of a 21-year-old women with a 1-year history of eruptive syringoma and vitiligo of 2 years duration is presented.
Acne vulgaris is a common disturbing disease that affects the majority of adolescents, but its impact on mental health in this age group is poorly understood.
(1) To raise the awareness of psychological impact of acne on adolescents. (2) Identify high risk patients and provide appropriate intervention to avoid long term consequences.
A literature review was based on Medline search, PsychINFO, EMBASE and CINHAL using the terms acne vulgaris in combination with adolescents, self-esteem, psychology, psychiatry, suicide, anxiety and depression. Cross sectional and cohort studies of the last 10 years (2000–2010) were selected to be analyzed and discussed in this review.
We identified 7 cross sectional studies and 1 cohort study (6918 patients). Overall reviewing of these articles showed that adolescents with acne suffer from more depressive symptoms, lower self esteem and lower quality of life when compared to adolescents without acne. Severity of acne was not related to these morbidities.
How acne affects an adolescent’s wellbeing is underappreciated. Increased understanding of the psychiatric comorbidities associated with acne and identifying the high-risk patients and intervening early will ultimately improve the patient’s life.
Cutaneous involvement is a well-recognized manifestation of Crohn’s disease. The incidence of these manifestations varies widely and occur in 14–40% of patients with Crohn’s disease. These can be either metastatic, contiguous or reactive. Cutaneous Crohn’s disease, also known as metastatic Crohn’s disease, refers to noncaseating cutaneous granulomatous lesions that are not contiguous with intestinal Crohn’s disease. This clinical presentation is rare, especially in children.
We report a case of metastatic Crohn’s disease manifesting as scrotal swelling and eczematous eruption over genitalia and around anus in a 6 years old boy which dramatically responded to Metronidazole.
Epidermodysplasia verruciformis (EV) is a well known inherited autosomal recessive skin disease associated with numerous early onset viral warts on the sun exposed parts of the body that usually progress into skin malignancies. Kidney transplant patients are also commonly associated with viral warts that might change into skin cancers.
To describe the clinical pictures of extensive viral warts with skin malignancies in kidney transplant patients in comparison with inherited (EV) features.
This case controlled study that included 130 patients with kidney transplantation was done in kidney transplantation centers in Baghdad and Al-Karma Teaching Hospitals during December 2002 to September 2004. All recruited patients were receiving multiple immunosuppressive drugs like methyl prednisolone succinate, oral prednisolone, azathioprine and cyclosporine. History was taken from all patients including all the relevant points. These patients were divided into three groups according to the duration of kidney transplant: group A 1–10 years, group B 11–20 years and group C more than 20 years. Biopsies were performed from the viral warts lesions and the associated tumors.
Two hundred and sixty apparently healthy individuals, 206 males and 54 females had been examined as control cases for the presence of viral warts and tumors. These control cases had been taken randomly from general population in multiple regions in Baghdad.
Sixty-five patients out of 130 with kidney transplantation had viral warts. Their ages ranged from 20 to 71 (45.49 ± SD 10.82) years, 51 males and 14 females, while the duration of the warts ranged from 0.5 to 10 (3.74 ± SD 2.67) years. The distribution of patients with viral warts among the groups was as follows: group A 28 (43.1%), group B 30 (46.2%) and group C 7 (10.7%) cases. Viral warts were seen in 10 (3.8%) of the control group. There were statistically significant differences between patients and control cases (P value <0.001). Most of the viral warts in patients with kidney transplantation were multiple and of the verrucae vulgaris type. They were mainly located on the exposed areas of the body, mostly on the face and dorsa of hands.
Skin malignancies were observed in 6 (9.2%) cases: five squamous cell carcinomas and one case of basal cell carcinoma. Squamous cell carcinoma was mainly located on the lower lips in 3 cases and 2 on the dorsa of hands, while basal cell carcinoma was observed on the nose. Two cases (7.1%) of squamous cell carcinoma were seen in group A, 2 (6.6%) in group B and 1 (14%) in group C. One case of basal cell carcinoma was noted in group B .No skin malignancy was observed in the control gr
Psoriasis is a genetically determined chronic inflammatory and immunologically mediated disease. At an early age, the presentation of psoriasis may be atypical. Among all types of childhood psoriasis, plaque type is the most common. In this article, we report our data analysis on the main clinical aspects of childhood psoriasis, its onset, risk factors, demographics and therapeutic options. A total of 36 patients with childhood psoriasis were evaluated at the dermatology out-patient clinic in the college of medicine at King Saud University during the period from April 2002 to June 2007. All patients were diagnosed based on clinical findings. Of the 36 patients, 24 (66.67%) had generalized plaque type psoriasis, 8 (22.2%) had guttate psoriasis, 4 (11.1%) had mixed plaque type and guttate psoriasis, 6 (16.67%) had localized plaque type (on elbows and knees), 4 (11.11%) had palmoplanter psoriasis and 1 (2.77%) had scalp psoriasis. Among those, one patient had congenital psoriasis. The age of patients ranged from 8 months to 18 years (mean = 11.3 years). There were 15 males and 21 females. The mean duration of the disease was 3.04 years and family history was positive in 10 patients (27.78%). All patients were treated by topical medications and/or narrow-band ultraviolet-B phototherapy. Apart from prolonged tanning no significant adverse effects were reported. Of particular interest, skin cancer was not detected in this series of children even after repeated courses. In conclusion, childhood psoriasis is more common in girls with plaque type psoriasis being the most common type. Topical therapy is the mainstay treatment for localized disease and narrow-band ultraviolet-B phototherapy is considered safe and effective for moderately severe conditions. More studies are required to define the safety of systemic therapy and biologic treatment in this age group of psoriasis.
Thallium is the most suitable agent for criminal poisoning of human beings as it is tasteless and odorless. It is usually associated with typical clinical features, mainly dermatological and neurological manifestations.
To report an outbreak of thallium poisoning in Iraq and to review the literatures.
This descriptive study was conducted in the Department of Dermatology-Baghdad Teaching Hospital from February 2008 to April 2008. Twenty-two patients with thallium poisoning were seen in the Poisoning Consultation Center during this period and thallium in urine has been measured using the colorimetric method and was positive in all of them.
We had the opportunity to see five cases referred for skin manifestations. Detailed history was done regarding all demographics points related to this poisoning. Full clinical examination was performed looking for skin manifestations, and other systemic involvements were also assessed.
Five male patients with thallium poisoning were evaluated. Their ages ranged from 10 to 32 years with a mean of 24 years. All patients gave history of eating cakes laced with thallium. The dermatological findings were mainly anagen hair loss in diffuse and patchy pattern which affected the scalp and limbs. Also dusk ecchymotic red rash dermatitis-like picture was observed on the face, especially perioral region and dorsum of hands and legs. Neurological manifestations consisted of mainly peripheral neuropathy and muscular weakness was also recorded. Psychiatric findings were also observed, mainly depression and apathy.
Outbreak of thallium poisoning is now occurring in Iraq killing many people mainly for political reasons. It gives characteristic cutaneous, neurological and psychological features that can lead to the right diagnosis.
In 1939, Ota described the first case of a benign dermal melanocytosis known as nevus of Ota. This condition involves the skin and mucosa innervated by the ophthalmic, maxillary and, rarely, the mandibular division of the trigeminal nerve. It is frequent in people of Japanese descent but is also seen in individuals of Chinese, Indian, African and European descent. Nevus of Ota is non-hereditary pigmentation disorder, which is more frequent in females than males. Unilateral presentation is typically seen, but bilateral involvement is described in 5–10% of patients. We report a 10-year-old Saudi girl with bilateral nevus of Ota associated with Turner syndrome. This is the first report of such an association.
Pemphigus foliaceus is a rare autoimmune blistering disease comprising two major types: endemic and sporadic. The endemic form, also known as fogo selvagem, affects children and young adults in rural Brazil while the sporadic form generally affects the middle-aged and the elderly. Here we report a sporadic form of pemphigus foliaceus in a child in which the skin eruption responded to flucloxacillin. Upon discontinuation of flucloxacillin, lesions reappeared and then cleared upon resuming the antibiotic. Dapsone was thereafter administered with good control.
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