R. Eldawla, Fatma El-Zahraa El-Deen Yassin, Aya Al-Shandawely, S. Aboeldahab
Background Striae distensae (SD) are linear scars that develop in the areas of dermal damage owing to overstretching of the skin. No gold standard line of treatment has been determined. Objectives To compare the efficacy and safety of carboxytherapy, platelet-rich plasma (PRP), and fractional carbon dioxide (CO2) laser in the treatment of SD clinically and histopathologically. Patients and methods The study included 37 female patients with SD, aged 18–50 years. Complete history taking and general and dermatological examinations were performed. The study population was randomly divided into three groups: group A was treated with carboxytherapy, group B was treated with PRP, and group C was treated with fractional CO2 laser. The groups were treated each for six sessions with 3-week intervals and followed up after a month from the last treatment session. The session showing the beginning of improvement and the overall improvement were recorded in each group. Adverse effects, as well as the satisfaction of patient and dermatologist, were also evaluated and graded. The pretreatment and posttreatment histopathological changes in each group were evaluated and recorded according to a modified scoring system. Masson’s Trichrome staining was performed to evaluate the collagen content. Results In the present study, the highest ratio of the overall improvement was observed in group C followed by group B and group A. Histopathological improvement was observed in the three groups with different mechanisms according to the applied treatment. Fractional CO2 laser showed more histopathological improvement than the other treatment modalities. Conclusions The present study concluded that carboxytherapy, PRP, and fractional CO2 laser were clinically and histopathologically effective and safe treatment options for mild to severe SD. Fractional CO2 laser was more effective especially in cases of moderate to severe striae albae. Although it is an expensive treatment method, it resulted in a higher satisfaction rate between the patient and dermatologist with a good safety profile and tolerability.
{"title":"A clinical and histopathological study comparing the efficacy and safety of carboxytherapy, platelet-rich plasma, and fractional carbon dioxide laser in the treatment of striae distensae","authors":"R. Eldawla, Fatma El-Zahraa El-Deen Yassin, Aya Al-Shandawely, S. Aboeldahab","doi":"10.4103/ejdv.ejdv_16_22","DOIUrl":"https://doi.org/10.4103/ejdv.ejdv_16_22","url":null,"abstract":"Background Striae distensae (SD) are linear scars that develop in the areas of dermal damage owing to overstretching of the skin. No gold standard line of treatment has been determined. Objectives To compare the efficacy and safety of carboxytherapy, platelet-rich plasma (PRP), and fractional carbon dioxide (CO2) laser in the treatment of SD clinically and histopathologically. Patients and methods The study included 37 female patients with SD, aged 18–50 years. Complete history taking and general and dermatological examinations were performed. The study population was randomly divided into three groups: group A was treated with carboxytherapy, group B was treated with PRP, and group C was treated with fractional CO2 laser. The groups were treated each for six sessions with 3-week intervals and followed up after a month from the last treatment session. The session showing the beginning of improvement and the overall improvement were recorded in each group. Adverse effects, as well as the satisfaction of patient and dermatologist, were also evaluated and graded. The pretreatment and posttreatment histopathological changes in each group were evaluated and recorded according to a modified scoring system. Masson’s Trichrome staining was performed to evaluate the collagen content. Results In the present study, the highest ratio of the overall improvement was observed in group C followed by group B and group A. Histopathological improvement was observed in the three groups with different mechanisms according to the applied treatment. Fractional CO2 laser showed more histopathological improvement than the other treatment modalities. Conclusions The present study concluded that carboxytherapy, PRP, and fractional CO2 laser were clinically and histopathologically effective and safe treatment options for mild to severe SD. Fractional CO2 laser was more effective especially in cases of moderate to severe striae albae. Although it is an expensive treatment method, it resulted in a higher satisfaction rate between the patient and dermatologist with a good safety profile and tolerability.","PeriodicalId":40542,"journal":{"name":"Egyptian Journal of Dermatology and Venereology","volume":"43 1","pages":"41 - 54"},"PeriodicalIF":0.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41925624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acne vulgaris is a chronic inflammatory disorder of the skin, which presents as comedones, papules, pustules, nodules, and cysts. Based on the multifactorial pathogenesis, a range of treatment options exists. Isotretinoin is a wonder drug commonly used in the management of acne. Unfortunately, it is associated with specific adverse effects on account of the ubiquitous nature of the retinoic acid receptors, which regulate its mechanism of action. Majorly, these side effects are mild and can be taken care of by altering the dose or frequency. Severe side effects need more attention and have to be recognized early. The present article pertinently focuses on the side-effect profile of the drug isotretinoin and the management of those side effects for safer treatment of acne vulgaris.
{"title":"Isotretinoin: an updated review on the profile of its side-effects and the management","authors":"Rajat Kandhari","doi":"10.4103/ejdv.ejdv_10_22","DOIUrl":"https://doi.org/10.4103/ejdv.ejdv_10_22","url":null,"abstract":"Acne vulgaris is a chronic inflammatory disorder of the skin, which presents as comedones, papules, pustules, nodules, and cysts. Based on the multifactorial pathogenesis, a range of treatment options exists. Isotretinoin is a wonder drug commonly used in the management of acne. Unfortunately, it is associated with specific adverse effects on account of the ubiquitous nature of the retinoic acid receptors, which regulate its mechanism of action. Majorly, these side effects are mild and can be taken care of by altering the dose or frequency. Severe side effects need more attention and have to be recognized early. The present article pertinently focuses on the side-effect profile of the drug isotretinoin and the management of those side effects for safer treatment of acne vulgaris.","PeriodicalId":40542,"journal":{"name":"Egyptian Journal of Dermatology and Venereology","volume":"43 1","pages":"1 - 7"},"PeriodicalIF":0.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41936266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Kar, Subhor Nandwani, Safa Patrick, N. Gangane, A. Deshmukh
{"title":"Verrucous disseminated discoid lupus erythematosus with oral and palmoplantar lesions treated with hydroxychloroquine","authors":"S. Kar, Subhor Nandwani, Safa Patrick, N. Gangane, A. Deshmukh","doi":"10.4103/ejdv.ejdv_28_22","DOIUrl":"https://doi.org/10.4103/ejdv.ejdv_28_22","url":null,"abstract":"","PeriodicalId":40542,"journal":{"name":"Egyptian Journal of Dermatology and Venereology","volume":"1 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70716479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective The study was done to compare the clinical efficacy rate, patient satisfaction, and side effects of fractional carbon dioxide (CO2) laser-assisted topical therapy with amorolfine versus amorolfine alone for the treatment of onychomycosis. Patients and methods In all, 100 patients were recruited for the study and were divided based on the lottery system into two groups. Group 1 (50 patients) received a combination of fractional CO2 laser and topical amorolfine (5%) and group 2 (n=50) received 5% amorolfine alone. The overall treatment efficacy was determined using clinical examination, onychoscopic pattern, and mycological clearance by comparing the infected area at baseline and 12 weeks after last treatment. Results Compared with group 2, clinical efficacy rate was significantly more in group 1 (22 vs. 0%, P<0.0001). Patient satisfaction rate was also higher in group 1 (64 vs. 6%, P<0.0001). Among the side-effects, mild pain was noted in group 1 with none in group 2 patients. Conclusion Fractional CO2 laser-assisted delivery of topical amorolfine (5%) therapy of onychomycosis showed a better clinical response than topical amorolfine (5%) alone. Fractional CO2 lasers may be explored further for use by standardizing the parameters and number of sessions to achieve better cure rates and thereby can replace systemic treatment.
{"title":"A randomized comparative study of fractional carbon dioxide laser-assisted drug delivery with amorolfine versus amorolfine alone for the treatment of onychomycosis","authors":"Prateek Sharma, Niti Khunger","doi":"10.4103/ejdv.ejdv_42_21","DOIUrl":"https://doi.org/10.4103/ejdv.ejdv_42_21","url":null,"abstract":"Objective The study was done to compare the clinical efficacy rate, patient satisfaction, and side effects of fractional carbon dioxide (CO2) laser-assisted topical therapy with amorolfine versus amorolfine alone for the treatment of onychomycosis. Patients and methods In all, 100 patients were recruited for the study and were divided based on the lottery system into two groups. Group 1 (50 patients) received a combination of fractional CO2 laser and topical amorolfine (5%) and group 2 (n=50) received 5% amorolfine alone. The overall treatment efficacy was determined using clinical examination, onychoscopic pattern, and mycological clearance by comparing the infected area at baseline and 12 weeks after last treatment. Results Compared with group 2, clinical efficacy rate was significantly more in group 1 (22 vs. 0%, P<0.0001). Patient satisfaction rate was also higher in group 1 (64 vs. 6%, P<0.0001). Among the side-effects, mild pain was noted in group 1 with none in group 2 patients. Conclusion Fractional CO2 laser-assisted delivery of topical amorolfine (5%) therapy of onychomycosis showed a better clinical response than topical amorolfine (5%) alone. Fractional CO2 lasers may be explored further for use by standardizing the parameters and number of sessions to achieve better cure rates and thereby can replace systemic treatment.","PeriodicalId":40542,"journal":{"name":"Egyptian Journal of Dermatology and Venereology","volume":"42 1","pages":"183 - 192"},"PeriodicalIF":0.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49607452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Vitiligo is a skin and less common hair disease characterized by a decline in melanocyte function with a prevalence of 0.5–1% in most populations. Micro-RNAs (miRNAs) are single-stranded, noncoding, short RNA molecules, they act as regulators of gene expression and play critical roles in many biological processes such as differentiation, development, and metabolism of the human-body cells. Aim This case–control study aimed at detection of the expression of miRNA-224-3p in lesional skin of vitiligo patients as compared with normal-control persons to detect the possible role of miRNA-224-3p in the pathogenesis of vitiligo. Patients and methods This study included 30 patients with vitiligo and 30 healthy controls. About 4-mm punch skin biopsy was taken from patients (vitiligo lesion) and controls and it was kept in lysis solution for the stability of the studied parameters and was kept frozen at −80°C till analysis of miRNA-224-3p by quantitative reverse-transcription-PCR. Results The level of miRNA-224-3p in lesional skin of vitiligo was significantly higher as compared with normal-control persons. Conclusion MiRNA-224-3p may play an important role in pathogenesis of vitiligo, so it can be used as a biomarker to evaluate its progression and effect of therapeutic interventions.
{"title":"The importance of micro-RNA 224-3p in pathogenesis of NonSegmental Vitiligo","authors":"Rehab Naguib, H. Ibrahim, L. Rashed, A. El-Rifaie","doi":"10.4103/ejdv.ejdv_35_21","DOIUrl":"https://doi.org/10.4103/ejdv.ejdv_35_21","url":null,"abstract":"Background Vitiligo is a skin and less common hair disease characterized by a decline in melanocyte function with a prevalence of 0.5–1% in most populations. Micro-RNAs (miRNAs) are single-stranded, noncoding, short RNA molecules, they act as regulators of gene expression and play critical roles in many biological processes such as differentiation, development, and metabolism of the human-body cells. Aim This case–control study aimed at detection of the expression of miRNA-224-3p in lesional skin of vitiligo patients as compared with normal-control persons to detect the possible role of miRNA-224-3p in the pathogenesis of vitiligo. Patients and methods This study included 30 patients with vitiligo and 30 healthy controls. About 4-mm punch skin biopsy was taken from patients (vitiligo lesion) and controls and it was kept in lysis solution for the stability of the studied parameters and was kept frozen at −80°C till analysis of miRNA-224-3p by quantitative reverse-transcription-PCR. Results The level of miRNA-224-3p in lesional skin of vitiligo was significantly higher as compared with normal-control persons. Conclusion MiRNA-224-3p may play an important role in pathogenesis of vitiligo, so it can be used as a biomarker to evaluate its progression and effect of therapeutic interventions.","PeriodicalId":40542,"journal":{"name":"Egyptian Journal of Dermatology and Venereology","volume":"42 1","pages":"151 - 154"},"PeriodicalIF":0.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46588383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Noha Z Tawfik, Ghada S. Mahmoud, H. Omar, A. Gomaa
Background Plantar warts are a common viral infection affecting adults and children. Many studies concerning bleomycin show discrepancies in cure rates. Macrophage migration inhibitory factor (MIF) plays an important role in the skin regarding inflammation and immune response. However, little is known about its relation to cutaneous warts. Aim To assess serum MIF levels in patients with common warts before and after treatment by microneedling-assisted topical bleomycin (MATB). Patients and methods This quasi experimental study included 33 patients with cutaneous warts treated by MATB. MIF levels were assessed before and after treatment. Results The mean serum MIF level was significantly lower before bleomycin treatment and increased after treatment. Conclusion The serum MIF has a role in the immunity against human papillomavirus infection and MATB is a promising noninvasive therapeutic modality for cutaneous warts.
{"title":"Serum levels of macrophage migration inhibitory factor in cutaneous warts after microneedling-assisted topical bleomycin as a novel modality","authors":"Noha Z Tawfik, Ghada S. Mahmoud, H. Omar, A. Gomaa","doi":"10.4103/ejdv.ejdv_47_21","DOIUrl":"https://doi.org/10.4103/ejdv.ejdv_47_21","url":null,"abstract":"Background Plantar warts are a common viral infection affecting adults and children. Many studies concerning bleomycin show discrepancies in cure rates. Macrophage migration inhibitory factor (MIF) plays an important role in the skin regarding inflammation and immune response. However, little is known about its relation to cutaneous warts. Aim To assess serum MIF levels in patients with common warts before and after treatment by microneedling-assisted topical bleomycin (MATB). Patients and methods This quasi experimental study included 33 patients with cutaneous warts treated by MATB. MIF levels were assessed before and after treatment. Results The mean serum MIF level was significantly lower before bleomycin treatment and increased after treatment. Conclusion The serum MIF has a role in the immunity against human papillomavirus infection and MATB is a promising noninvasive therapeutic modality for cutaneous warts.","PeriodicalId":40542,"journal":{"name":"Egyptian Journal of Dermatology and Venereology","volume":"42 1","pages":"193 - 197"},"PeriodicalIF":0.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46757440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Manickam Navakumar, G. Seethalakshmi, Lalu Meera, G. Kannan
We report a case of a 22-year-old male patient with angiokeratoma corporis diffusum, which is a cutaneous feature of many lysosomal storage disorders, but we diagnosed it as Fabry disease (FD) as our patient had normal intelligence associated with coarse facies, acroparesthesia, ocular changes like dilated vessels in conjunctiva, and presence of vacuolated endothelial cells in histopathological examination. It is an X-linked inborn error of the glycosphingolipid metabolic pathway that is associated with protean manifestations and is a paradigm of a multi-system condition with symptoms expressing themselves in many organs. We report this rare case mainly to stress the importance of proper clinical evaluation in the diagnosis of FD in today’s era of costly investigations like enzyme assay, which is not feasible in our setting. It also shows the importance of proper dermatological assessment, which has a highly positive predictive value in terms of assessing systemic morbidity in FD.
{"title":"Angiokeratoma corporis diffusum − a rare case report","authors":"Manickam Navakumar, G. Seethalakshmi, Lalu Meera, G. Kannan","doi":"10.4103/ejdv.ejdv_7_22","DOIUrl":"https://doi.org/10.4103/ejdv.ejdv_7_22","url":null,"abstract":"We report a case of a 22-year-old male patient with angiokeratoma corporis diffusum, which is a cutaneous feature of many lysosomal storage disorders, but we diagnosed it as Fabry disease (FD) as our patient had normal intelligence associated with coarse facies, acroparesthesia, ocular changes like dilated vessels in conjunctiva, and presence of vacuolated endothelial cells in histopathological examination. It is an X-linked inborn error of the glycosphingolipid metabolic pathway that is associated with protean manifestations and is a paradigm of a multi-system condition with symptoms expressing themselves in many organs. We report this rare case mainly to stress the importance of proper clinical evaluation in the diagnosis of FD in today’s era of costly investigations like enzyme assay, which is not feasible in our setting. It also shows the importance of proper dermatological assessment, which has a highly positive predictive value in terms of assessing systemic morbidity in FD.","PeriodicalId":40542,"journal":{"name":"Egyptian Journal of Dermatology and Venereology","volume":"42 1","pages":"209 - 212"},"PeriodicalIF":0.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47782601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Samar Mohammed, M. Eyada, Mohammed Elokda, G. Mohammed
Background Vitiligo is a common acquired depigmentary disorder characterized by milky-white cutaneous macules devoid of identifiable functional melanocytes of unknown origin. Several hypotheses have been advanced to explain the link between matrix metalloproteinase-9 (MMP-9) and vitiligo. Aim We aimed to compare the tissue expression of MMP-9 in vitiligo lesions with that of healthy controls. Patients and methods A case–control study was performed to evaluate MMP-9 levels by punch biopsies using an immunohistochemistry technique in lesional and nonlesional tissues of the same patient with vitiligo and in comparison with healthy controls. The study included 20 patients (10 patients with vitiligo and 10 healthy controls). Patients included were 18 years of age and older of both sexes, any duration, and any subtype. Results MMP-9 expression was found to be lower in the lesional skin of patients with vitiligo at the basal cell layer, follicular epithelium, and stromal cell layer when compared with nonlesional skin of the same patient with vitiligo and matched control individuals. Conclusion Tissue MMP-9 imbalance has a role in the etiopathogenesis of vitiligo. The low MMP-9 tissue expression may not facilitate the migration of melanoblasts. Tissue MMP-9 is a significant predictor of severity of vitiligo.
{"title":"Assessment of tissue expression of matrix metalloproteinase-9 level in patients with vitiligo and its relation to disease pattern, activity, and severity","authors":"Samar Mohammed, M. Eyada, Mohammed Elokda, G. Mohammed","doi":"10.4103/ejdv.ejdv_37_21","DOIUrl":"https://doi.org/10.4103/ejdv.ejdv_37_21","url":null,"abstract":"Background Vitiligo is a common acquired depigmentary disorder characterized by milky-white cutaneous macules devoid of identifiable functional melanocytes of unknown origin. Several hypotheses have been advanced to explain the link between matrix metalloproteinase-9 (MMP-9) and vitiligo. Aim We aimed to compare the tissue expression of MMP-9 in vitiligo lesions with that of healthy controls. Patients and methods A case–control study was performed to evaluate MMP-9 levels by punch biopsies using an immunohistochemistry technique in lesional and nonlesional tissues of the same patient with vitiligo and in comparison with healthy controls. The study included 20 patients (10 patients with vitiligo and 10 healthy controls). Patients included were 18 years of age and older of both sexes, any duration, and any subtype. Results MMP-9 expression was found to be lower in the lesional skin of patients with vitiligo at the basal cell layer, follicular epithelium, and stromal cell layer when compared with nonlesional skin of the same patient with vitiligo and matched control individuals. Conclusion Tissue MMP-9 imbalance has a role in the etiopathogenesis of vitiligo. The low MMP-9 tissue expression may not facilitate the migration of melanoblasts. Tissue MMP-9 is a significant predictor of severity of vitiligo.","PeriodicalId":40542,"journal":{"name":"Egyptian Journal of Dermatology and Venereology","volume":"42 1","pages":"159 - 166"},"PeriodicalIF":0.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44019504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Seborrheic keratosis is one of the most common benign epidermal tumors seen in elderly individuals. It has slow growth and presents with a varied degree of pigmentation in skin color closely resembling many other pigmented dermatoses. Dermoscopy, a noninvasive technique, could increase the accuracy of diagnosis and can differentiate it from various closest mimickers and malignancies. Aim This study aims to describe the various dermoscopic features of seborrheic keratosis in a series of cases. Patients and methods A hospital-based, descriptive study was conducted over 12 months from January 2018 to December 2018 in the Department of Dermatology, a tertiary-care center. A total of 100 patients were selected and evaluated in a prestructured proforma concerning age, sex, site of lesion, number and duration, and associated comorbidities. The lesion is observed on dermoscopy, and the dermoscopic patterns were then documented and analyzed. Result Among a total of 100 (32%) cases, the most common age group was between 41 and 50 years with females (52%) outnumbering males (48%). The most common site was the face (38%), and the common morphology was plaque (60%). Sign of Leser-Trélat was observed in five patients of which three were associated with malignancy that includes two lymphomas and one breast carcinoma. The color on dermoscopy was predominant dark brown (43%) and brownish-black (32%). The common element was clod (39%) and combined clod and dots (18%). More than three colors and more than two elements in a single lesion were observed in 15 and 11% of cases, respectively. The dermoscopic clues of seborrheic keratosis with highest to lowest prevalence were cerebriform pattern (76%), sharp demarcation (64%), comedone-like opening (56%), milia-like cyst (54%), mica-like scales (52%), moth-eaten border (46%), jelly sign (40%), fingerprint-like pattern (40%), fat fingers (36%), peripheral globules/network (34%), coral-like structure (26%), papillary structures (26%), irregular globules (12%), irregular opaque brown pigmentation (12%), and yellow-orange areas (3%). The flat seborrheic keratosis predominantly showed an irregular network-like structure, fat fingers, milia-like cyst, and accentuation of two adjacent perifollicular pigmentations forming a double ring-like structure (16%). The raised lesions predominantly showed fissures/ridges (cerebriform pattern), exophytic papillary structures, opaque pigmentation, and a mica-like pattern. Ten lesions were misinterpreted as seborrheic keratosis clinically and on dermoscopy were verruca vulgaris (2/10, 20%), melanocytic nevus (3/10, 30%), and basal cell carcinoma (5/10, 50%), which were confirmed on histopathology. Conclusion The study emphasizes the use of dermoscopy in seborrheic keratosis to improve the clinical accuracy of diagnosis and also to differentiate from its common mimickers.
{"title":"Role of dermoscopy in diagnosing and differentiating seborrheic keratoses: a case study of 100 patients","authors":"Aswath Rajan, P. Shukla, V. Pai","doi":"10.4103/ejdv.ejdv_39_21","DOIUrl":"https://doi.org/10.4103/ejdv.ejdv_39_21","url":null,"abstract":"Background Seborrheic keratosis is one of the most common benign epidermal tumors seen in elderly individuals. It has slow growth and presents with a varied degree of pigmentation in skin color closely resembling many other pigmented dermatoses. Dermoscopy, a noninvasive technique, could increase the accuracy of diagnosis and can differentiate it from various closest mimickers and malignancies. Aim This study aims to describe the various dermoscopic features of seborrheic keratosis in a series of cases. Patients and methods A hospital-based, descriptive study was conducted over 12 months from January 2018 to December 2018 in the Department of Dermatology, a tertiary-care center. A total of 100 patients were selected and evaluated in a prestructured proforma concerning age, sex, site of lesion, number and duration, and associated comorbidities. The lesion is observed on dermoscopy, and the dermoscopic patterns were then documented and analyzed. Result Among a total of 100 (32%) cases, the most common age group was between 41 and 50 years with females (52%) outnumbering males (48%). The most common site was the face (38%), and the common morphology was plaque (60%). Sign of Leser-Trélat was observed in five patients of which three were associated with malignancy that includes two lymphomas and one breast carcinoma. The color on dermoscopy was predominant dark brown (43%) and brownish-black (32%). The common element was clod (39%) and combined clod and dots (18%). More than three colors and more than two elements in a single lesion were observed in 15 and 11% of cases, respectively. The dermoscopic clues of seborrheic keratosis with highest to lowest prevalence were cerebriform pattern (76%), sharp demarcation (64%), comedone-like opening (56%), milia-like cyst (54%), mica-like scales (52%), moth-eaten border (46%), jelly sign (40%), fingerprint-like pattern (40%), fat fingers (36%), peripheral globules/network (34%), coral-like structure (26%), papillary structures (26%), irregular globules (12%), irregular opaque brown pigmentation (12%), and yellow-orange areas (3%). The flat seborrheic keratosis predominantly showed an irregular network-like structure, fat fingers, milia-like cyst, and accentuation of two adjacent perifollicular pigmentations forming a double ring-like structure (16%). The raised lesions predominantly showed fissures/ridges (cerebriform pattern), exophytic papillary structures, opaque pigmentation, and a mica-like pattern. Ten lesions were misinterpreted as seborrheic keratosis clinically and on dermoscopy were verruca vulgaris (2/10, 20%), melanocytic nevus (3/10, 30%), and basal cell carcinoma (5/10, 50%), which were confirmed on histopathology. Conclusion The study emphasizes the use of dermoscopy in seborrheic keratosis to improve the clinical accuracy of diagnosis and also to differentiate from its common mimickers.","PeriodicalId":40542,"journal":{"name":"Egyptian Journal of Dermatology and Venereology","volume":"42 1","pages":"174 - 182"},"PeriodicalIF":0.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41674009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Roma Dhande, Bhushan Madke, A. Singh, Sugat A Jawade, Praveen Maheshwari
Aim To study the involvement of terminal and vellus hair follicle in dermatophytic infections. Objectives Methodology A 4mm punch biopsy was collected from the active border involving the hairy part of the skin and stained with Hematyoxylin and Eosin and Periodic acid schiff stain . Hair follicle portions were examined to check if there are any fungal elements in the follicle. Result It was found that there was correlation between duration of disease and involvement of hair follicle. Conclusion Chronicity is associated with hair follicle involvement, requiring longer duration of oral Antifungals for complete clearance of infection.
{"title":"Study of involvement of terminal and vellus hair follicle in dermatophytic infections","authors":"Roma Dhande, Bhushan Madke, A. Singh, Sugat A Jawade, Praveen Maheshwari","doi":"10.4103/ejdv.ejdv_5_22","DOIUrl":"https://doi.org/10.4103/ejdv.ejdv_5_22","url":null,"abstract":"Aim To study the involvement of terminal and vellus hair follicle in dermatophytic infections. Objectives Methodology A 4mm punch biopsy was collected from the active border involving the hairy part of the skin and stained with Hematyoxylin and Eosin and Periodic acid schiff stain . Hair follicle portions were examined to check if there are any fungal elements in the follicle. Result It was found that there was correlation between duration of disease and involvement of hair follicle. Conclusion Chronicity is associated with hair follicle involvement, requiring longer duration of oral Antifungals for complete clearance of infection.","PeriodicalId":40542,"journal":{"name":"Egyptian Journal of Dermatology and Venereology","volume":"42 1","pages":"198 - 205"},"PeriodicalIF":0.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43567209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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