Acta Dermatovenerologica Croatica : ADC

Darier disease (DD), also known as Darier-White disease, follicular keratosis, or dyskeratosis follicularis, is an uncommon autosomal dominant genodermatosis with complete penetrance and variable expressivity. This disorder is caused by mutations in the ATP2A2 gene and affects the skin, nails, and mucous membranes (1,2). A 40-year-old woman, without comorbidities, presented with pruritic, unilateral skin lesions on the trunk since she was 37 years old. Lesions had remained stable since onset, with physical examination revealing tiny scattered erythematous to light brown keratotic papules beginning at the patient's abdominal midline, extending over her left flank and onto her back (Figure 1, a, b)...

INTRODUCTION Genital herpes is the most common sexually transmitted disease and is most commonly caused by herpes simplex virus -2 (HSV2) which is usually sexually transmitted (1). We report a case of a 28-year-old woman with an unusual case of HSV presentation that rapidly resulted in necrosis and rupturing of the labia less than 48 hours after first appearance of symptoms. CASE PRESENTATION We report the case of a 28-year-old female patient who presented to our clinic with painful necrotic ulcers of both labia minora, urinary retention, and extreme discomfort (Figure 1)...

Dear Editor, Photoallergic reactions are classic T-cell-mediated or delayed-type hypersensitivity reactions of the skin in response to a photoallergen (or a cross-reacting chemical) to which a subject was sensitized in the past (1). The immune system recognizes the changes caused by ultraviolet (UV) radiation; it produces antibodies and causes inflammation of the skin in the exposed areas (2). Common photoallergic drugs and ingredients are included in some sunscreens, aftershave lotions, antimicrobials (especially sulfonamides), non-steroidal anti-inflammatory drugs (NSAIDs), diuretics, anticonvulsants, chemotherapy drugs, fragrances, and other hygiene products (1,3,4)...

Dear Editor, Pilonidal cyst disease is a common, acquired, inflammatory disease predominantly affecting the natal clefts of the buttocks (1,2). The disease has a predilection for men, with a male-to-female ratio of 3-4:1. Patients are generally young, towards the end of second decade of life. Lesions are initially asymptomatic, while the development of complications such as abscess formation is associated with pain and discharge (1). Patients with pilonidal cyst disease may present to dermatology outpatient clinics, especially when the disease is asymptomatic...

Dear Editor, Segmental Darier disease (DD) is a rare disease with around 40 described English literature cases. It is hypothesized that one of the causes of the disease is a post-zygotic somatic mutation for the calcium ATPase pump, only present in lesional skin. There are two types of segmental DD: type 1, where lesions follow Blaschko's lines unilaterally, and type 2, characterized by focal areas of increased severity in patients with generalized DD (1). Type 1 segmental DD is not easily diagnosed due to the lack of positive family history, the late onset of the disease in the third or fourth decade of life, and lack of DD-associated features...

Condyloma acuminatum relatively rarely involves the urethra, and when it does it is usually only in the most distal portion of the urethra. A number of treatments have been described for urethral condylomas. These treatments are extensive and variable, comprising laser treatment, electrosurgery, cryotherapy, and topical application of cytotoxic agents such as 80% trichloroacetic acid, 5-fluorouracil cream (5-FU), podophyllin, podophyllotoxin, and imiquimod. Laser is still considered to be therapy of choice for treatment of intrauretral condylomata...

Ichthyoses are a heterogeneous group of skin disorders featuring erythroderma and generalized scaling. The relationship between ichthyosis and melanoma has not been well-characterized. Herein we present a unique case of acral melanoma of the palm developing in an elderly patient with congenital ichthyosis vulgaris. Biopsy revealed a superficially spreading melanoma with ulceration. To the best of our knowledge, no acral melanomas have been reported so far in patients with congenital ichthyosis. Nevertheless, considering the potential for invasion and metastasis, patients with ichthyosis vulgaris should undergo regular clinical and dermatoscopic screening for melanoma...

We report the case of a 55-year-old man with penile squamous cell carcinoma (SCC). We found a mass in the patient's penis, which gradually increased in size. We performed a partial penectomy to remove the mass. Histopathology revealed a highly differentiated squamous cell carcinoma. Human papillomavirus (HPV) DNA was detected by polymerase chain reaction. HPV was found to be present in the squamous cell carcinoma, and sequencing analysis showed that it was type 58.

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...