Acta Dermatovenerologica Croatica : ADC

The association of cutaneous and extracutaneous abnormalities is a common phenomenon, widely described in a variety of genetic syndromes. Nevertheless, yet undescribed syndromic combinations may still exist. Herein we present a case report of a patient who was admitted to the Dermatology Department due to multiple basal cell carcinomas arising from nevus sebaceous. In addition to the cutaneous malignancies, the patient presented with palmoplantar keratoderma, prurigo nodularis, hypothyroidism, multiple lumbar abnormalities, uterine myoma, an ovarian cyst, and highly dysplastic colon adenoma...

Drug-induced vasculitis occurs after drug exposure and consequent inflammation of small blood vessels which can lead to damage of affected tissue. Rare cases of drug-induced vasculitis during chemotherapy or concomitant chemoradiotherapy have been described in the literature. Our patient was diagnosed with stage IIIA (cT4N1M0) small cell lung cancer (SCLC). Four weeks after the application of the second cycle carboplatin and etoposide (CE) chemotherapy, the patient developed cutaneous vasculitis and rash on the lower extremities...

Allergic contact dermatitis (ACD) caused by (meth)acrylates is traditionally an occupational disease among dentists, printers, and fiberglass workers. With the use of artificial nails, cases have been reported both in nail technicians and in users. ACD caused by (meth)acrylates used in artificial nails is a relevant problem for both nail artists and consumers. We present the case of a 34-year-old woman who was working in a nail art salon for two years prior to the appearance of severe hand dermatitis, especially on her fingertips together, with frequent appearance of face dermatitis...

Benign, atypical, or malignant chondroid syringoma (mixed tumor of the skin) have almost identical clinical presentation with similar histological features, except for infiltrative growth, and perineural and vascular invasion in the malignant type. Tumors with borderline features are described as atypical chondroid syringoma. Immunohistochemical profiles in all three types are similar, with the the main difference in the expression of the p16 stain. We present a case of an atypical chondroid syringoma in an 88-year-old female patient with a subcutaneous, painless nodule in the gluteal region and with diffuse, strong nuclear immunohistochemical staining for p16...

The number and variety of patients admitted to hospitals have changed due to the COVID-19 pandemic. These changes have also affected dermatology clinics. The pandemic has had an adverse effect on the psychology of people by negatively affecting their quality of life. Patients who were admitted to the Bursa City Hospital Dermatology Clinic between July 15, 2020 and October 15, 2020 and from July 15, 2019 to October 15, 2019 were included in this study. The data of patients were gathered retrospectively by reviewing the electronic medical records and International Classification Diseases (ICD-10) codes...

Dystrophic epidermolysis bullosa inversa is a very rare subtype of inherited dystrophic epidermolysis bullosa with a unique clinical manifestation. Generalized blistering in the neonatal period and in early infancy improves with age, with lesions becoming restricted to intertriginous areas, axial parts of the trunk, and mucous membranes. In contrast to other variants of dystrophic epidermolysis bullosa, the inverse type has a more favorable prognosis. We present a case of a 45-year-old female patient with dystrophic epidermolysis bullosa inversa, diagnosed in adulthood based on typical clinical presentation, transmission electron microscopic findings, and genetic analysis...

Vitiligo is a recalcitrant depigmentary autoimmune skin disorder. Hydroxychloroquine (HCQ) is an effective immunomodulatory drug which is widely used in treatment of autoimmune disorders. HCQ-induced pigmentation has been previously found in patients taking HCQ due to other autoimmune diseases. The present study aimed to determine whether HCQ improves re-pigmentation of generalized vitiligo. HCQ was orally administered 400 mg daily (6.5 mg/Kg of body weight) by 15 patients with generalized vitiligo (more than 10% involvement of body surface area) for three months...

Mycosis Fungoides (MF) and Sézary syndrome (SS) are the most common forms of cutaneous T-cell lymphomas. Few validated prognostic factors have been reported in MF/SS, especially when compared with non-cutaneous lymphomas. Increased C-reactive protein (CRP) levels have recently been associated with poor clinical outcome in various malignancies. The aim of this study was to evaluate the prognostic significance of serum CRP levels at diagnosis in patients with MF/SS. This retrospective study included 76 patients with MF/SS...

Contact dermatitis (CD), including its irritant (ICD) and allergic (ACD) types, is a complex, often chronic and therapy-resistant disease that significantly affects patient quality of life and healthcare systems. Objective of this study was to examine the main clinical features of patients with ICD and ACD on the hands through follow-up in correlation with baseline skin CD44 expression. Our prospective study involved 100 patients with hand CD (50 with ACD; 50 with ICD) who initially underwent biopsies of skin lesions with pathohistology, patch tests to contact allergens, and immunohistochemistry for lesional CD44 expression...

Dear Editor, cutaneous chronic graft versus host disease (cGVHD) is a pathological process consisting of donor-derived T-cells aimed at the antigens of the recipient. It exhibits a large range of clinical presentations resembling morphea and deep sclerosis/fasciitis, all characterized by both inflammation and progressive dermal and hypodermic fibrosis (1). Although classic scleroderma-like lesions in cGVHD are nummular or irregular plaques and linear bundles associated with hypo- or hyperpigmentation (2), we report an atypical case with ulcerative presentation...

A previous study has found an association between chronic inflammatory disorders e.g. psoriasis, rheumatoid arthritis, and inflammatory bowel disease and increased vascular stiffness(1). Psoriasis and hidradenitis suppurativa (HS) are believed to have shared comorbidities and pathophysiology despite their morphologically different manifestations in the skin. In order to evaluate a putative association between the chronic inflammatory skin disease HS and arterial stiffness, an observational cross-sectional retrospective study was carried out as part of the Danish General Suburban Population Study (GESUS) (1), in which 430 patients with HS from the general population (representing mild HS; Table 1), 32 patients with HS from a hospital-based out-patient clinic (representing severe HS, Table 1), and 20,780 controls underwent measurements of arterial vascular tone and stiffness using photoplethysmography (Pulse Trace PCA2®; Micro Medical Ltd, Kent, UK)...

Torasemide is a loop diuretic with a molecule that is chemically similar to the sulphonamides described as eosinophilic granulomatosis with polyangiitis (EGPA) triggering drugs. The presented case is probably the first description of torasemide-induced vascular purpura in the course of EGPA. Any diagnosis of vasculitis should be followed by an identification of drugs that may aggravate the disease. A 74-year-old patient was admitted to the Department of Dermatology with purpura-like skin lesions on the upper, and lower extremities, including the buttocks...

Dear Editor, Morphea profunda (MP) is a chronic autoimmune disease, a subtype of localized scleroderma that presents clinically as local discomfort due to the impairment of skin motility (1). Dermatofibrosarcoma protuberans (DFSP) is a rare soft tissue neoplasm that not only infiltrates the dermis and subcutaneous tissue, but can also affect the muscles and bones with finger-like extensions, usually present on the trunk and the proximal extremities (2). DFSP is known for its indolent clinical course, locally aggressive behavior, and high local recurrence rates, but relatively low risk of metastatic spread (2)...

Lichen planus pemphigoides (LPP) is a very rare autoimmune blistering disease associated with lichenoid skin changes. Unna-Thost palmoplantar keratoderma (PKK) is a type of diffuse palmoplantar keratoderma that mostly affects the palms of the hands and soles of the feet. It usually begins in early childhood. We present a unique case of coexistence of LPP, Unna-Thost PPK, and atopic dermatitis (AD). To our knowledge, there are three reported cases of both LPP and Unna-Thost PPK and a few reports of coexistence of Unna-Thost PKK and AD...

Protein loss is often the result of kidney or intestinal disease (protein-losing enteropathy) and can cause a number of serious, potentially life-threatening complications such as hypotension, thrombocytosis, electrolyte imbalance, and cerebellar ischemia. Recent research suggests an association between extremely severe atopic dermatitis (AD) and allergic enteropathy. An exclusively breastfed 6-month-old infant was admitted to our institution due to failure to thrive, electrolyte imbalance, and severe AD (SCORing Atopic Dermatitis; SCORAD 40)...

Psoriasis is a chronic inflammatory disease associated with a defective epidermal barrier, in which the immune system is already activated in lesional sites of the skin, and it is thus possible that affected individuals can have different immunologic rates of viral response. This is especially important in the era of the novel coronavirus disease (COVID-19) that is affecting the entire world. Patients with psoriasis are often receiving systemic therapy which includes immunosuppressive and biologic therapy, so this new infectious disease has raised concerns among dermatologists regarding psoriasis treatment...

Hereditary hemorrhagic telangiectasia (HHT), also called Rendu-Osler-Weber syndrome, is a rare autosomal dominant multisystemic vascular disorder, characterized by widespread mucocutaneous teleangiectasias, frequent visceral arteriovenous malformations (AVM) and a tendency for bleeding. This diagnosis should be suspected in all dermatological patients with generalized mucocutaneous vascular lesions at sites of predilection, associated frequent epistaxis and a positive family history. The aim of this paper is to emphasize the importance of a multidisciplinary approach, the role and timely cooperation of dermatologists and otorhinolaryngologists in the early clinical recognition and diagnosis of the disease...

Determinants of early referral to healthcare providers, which may be useful for health policy, have not been investigated in pediatric cutaneous leishmaniasis with multivariate analyses. We aimed to explore determinants of early healthcare seeking in children with cutaneous leishmaniasis. Records of 1115 children with cutaneous leishmaniasis admitted to our hospital in Adana, Turkey were reviewed. Effects of age, sex, residential distance, lesion number, and faciocervical onset on early referral were evaluated with multivariate logistic regression analyses...

Mucosal melanoma, or so-called mucosal-oral melanoma is a rare but serious diagnostic and therapeutic problem. The "primary mixed" mucocutaneous forms of melanoma, which affect both the mucosa and the adjacent skin, are also particularly problematic and rare. Given that the staging, diagnosis, and treatment of mucosal (oral) melanoma differs from that of cutaneous melanoma, staging in mixed melanoma (primary mucocutaneous melanoma) as well as decisions for each subsequent diagnostic and therapeutic step should be individualized and modified according to the recommendations of the respective two classifications (for cutaneous but also mucosal melanomas), while at the same time or at least to a large extent overlapping with them...

By definition, the term "collision lesion" refers to two or more tumors coinciding in the same anatomic position or visceral organ. Collision lesions coexisting on the same skin location are defined as collision skin lesions (CSLs). Although this term implies a conflict between the tumors, this is not the case. CSLs appear to be rare, but still pose a significant diagnostic problem in everyday clinical practice and clinicians should be aware of their existence. The aim of this study was to elucidate the problem of CSLs in clinical practice, with an emphasis on classification of CSLs according to position dependence, tumor histogenesis, etiology, and possible lesion combinations in CSLs, as well as diagnostic possibilities...