since 11.April 2014

 

C O N T E N T S   2.2014

 

 

 

 


ORIGINAL ARTICLES


Doaa Mahgoub, Amira M. El Tawdy, Dina Metwally, Amin Manar, Laila Rashed
Estimation of peroxisome proliferators – activated receptor γ gene expression in inflammatory skin diseases: atopic dermatitis and psoriasis

      Our Dermatol Online 2014; 5(2): 107-112          DOI: 10.7241/ourd.20142.27

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Paper titled as „Estimation of peroxisome proliferators-activated receptors γ gene expression in inflammatory skin diseases: atopic dermatitis and psoriasis“ represents an original work that point on the importance of decreased expression nucler receptors PPRγ in the pathogenesis of psoriasis and dermatitis atopica. The results of this study indicates that activation of this receptors and its signaling pathways could be very important therapeutic approach for the inflammatory skin diseases such as psoriasis and dermatitis atopica.   Slavic Vjeroslava, MD PhD (Montenegro)

Ana Maria Abreu Velez, Juliana Calle-Isaza, Michael S. Howard

CD1a, HAM56, CD68 and S-100 are present in lesional skin biopsies from patients affected by autoimmune blistering diseases

      Our Dermatol Online 2014; 5(2): 113-117          DOI: 10.7241/ourd.20142.28

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Vasanthada Deepthi, PM Vasanth Kumar, Pasagadagula Krishna Rao, Tatapudi Ramesh, Malothu Ramesh

Evaluation of therapeutic response of methotrexate and calcipotriol combination compared with methotrexate alone in plaque psoriasis

      Our Dermatol Online 2014; 5(2): 118-123          DOI: 10.7241/ourd.20142.29

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It is very useful study with very important finding showing efficacy of combination treatment using methotrexate and calcipotriol over methotrexate alone for chronic plaque psoriasis of scalp and palmoplantar area.   Dr. Sudip Parajuli (Nepal)  

Comment by: Ass. Prof. Antonio Chuh and Prof. Vijay Zawar 

      Our Dermatol Online 2014; 5(2): 124
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Ana Maria Abreu Velez, Juliana Calle-Isaza, Michael S. Howard
HLA-DPDQDR is expressed in lesional skin from patients with autoimmune skin diseases

      Our Dermatol Online 2014; 5(2): 125-128          DOI: 10.7241/ourd.20142.30

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Original article titled as „HLA-DPDQDR is expressed in all lesional skin from patients with autoimmune skin diseases“ is aimed at identifying genetic predispositions for autoimmune skin blistering diseases. The results have indicated that antigen recognition and its presentation to immune system occurs in multiple skin structures. This findings indicate on the existence of a large number of target cells and/or their junctions-like structures that could be very important in achieving better control of inflammation.    Slavic Vjeroslava, MD PhD (Montenegro)  

Doaa Mahgoub, Amira M. El Tawdy, Mariam Makari, Laila Rashed

Toll 7 and Toll 9 in psoriasis vulgaris before and after phototherapy

      Our Dermatol Online 2014; 5(2): 129-134          DOI: 10.7241/ourd.20142.31

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This is a very interesting paper that features an in-vivo study of pattern recognition receptors, recently studied by other authors [1,2] in animal models. As far as I am aware is the first in vivo research that evaluates the effect of phototherapy with UVB-NB on TLR 7 and 9.In a recent publication Jian et al1 evaluated an antagonist of TLR 7, 8 and 9 in a mouse model of psoriasis. Their results demonstrated  inhibition of IL-6, IFN-γ, IL-12, IL-23, IL-21, and IL-17. Thus demonstrating reduced reponses of Th1 and Th17. They have also suggested an inhibition of inflammsome activation.It would be interesting to study the TLR 8 response to phototherapy with UVB-NB. As explained by Suarez-Fariñas et al [2], activation of this receptor would activate NFkB responsive pathways with production of IL23 from dendritic cells. References:   1. Jiang W, Zhu FG, Bhagat L, Yu D, Tang JX, Kandimalla ER, et al. A Toll-like receptor 7, 8, and 9 antagonist inhibits Th1 and Th17 responses and inflammasome activation in a model of IL-23-induced psoriasis. J Invest Dermatol. 2013;133:1777-84.   2. Suárez-Fariñas M, Arbeit R, Jiang W, Ortenzio FS, Sullivan T, Krueger JG. Suppression of molecular inflammatory pathways by Toll-like receptor 7, 8, and 9 antagonists in a model of IL-23-induced skin inflammation. PLoS One. 2013;8:e84634.   Dr. Manuel Valdebran (Dominican Republic)

Neerja Puri, B B Mahajan
A study of clinical and biochemical correlation in patients of psoriasis in acute exacerbation

      Our Dermatol Online 2014; 5(2): 135-139          DOI: 10.7241/ourd.20142.32

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Fanciful argumentation!Never found before a so complete and lucid statistical study that analyses the single cases of neurological factors inducing and/or aggravating psoriasis: e.g. the death of a dear family member, monetary or matrimonial tensors!Even the revelation of the odd behavior of Koebner’s effect tends to explain so many strange and unusual cases of psoriasis, sometimes  very difficult to diagnosticate.   Lorenzo Martini, M.Sc. (Italy) 

This study analyses in detail the participation of various trigger factors in the onset or exacerbation of psoriasis. It also confirms that stress, drugs and infection are the most common triggers of psoriatic process. Regarding the biochemical parameters which were analyzed in patients with psoriasis (Tabl. IV), it would be interesting to show a biochemical correlation before and after the administration of a particular drug (similar to what is shown in the connection of skin changes before and after the administration of methotrexate, cyclosporine etc., Fig. A1B1-A4B4).   Dr. Nermina Ovčina-Kurtović (Bosnia and Herzegovina)

Ana Maria Abreu Velez, Daniel Alberto Vásquez Hincapié, Michael S. Howard

Vimentin may reflect areas of pathologic involvement in biopsies from patients with autoimmune skin diseases

      Our Dermatol Online 2014; 5(2): 140-143          DOI: 10.7241/ourd.20142.33

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Lorenzo Martini, Roberto Solimé

Seyle’s biological stressors influence dramatically skin physiology: our experiences with electrical admittance magnitude measurements

      Our Dermatol Online 2014; 5(2): 144-147          DOI: 10.7241/ourd.20142.34

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CASE REPORTS


Snehal Balvant Lunge, Vijaya V. Sajjan, Ashok M. Pandit, B.S. Manjunathswamy, Shivakumar Patil, Anshul Agrawal
Amoxicillin and clavulanate potassium related Leucocytoclastic vasculitis

      Our Dermatol Online 2014; 5(2): 148-150          DOI: 10.7241/ourd.20142.35

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Ilteris Oguz Topal, Ilknur Mansuroglu Sahin, Betül Berberoglu, Mehmet Ozer

Keratosis follicularis spinulosa decalvans associated with acne keloidalis nuchae

      Our Dermatol Online 2014; 5(2): 151-154        DOI: 10.7241/ourd.20142.36

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Mankesh Lal Gambhir, Kritika Pandey, Tejinder Kaur

Herpes zoster on segmental vitiligo: Wolf’s isotopic response?

      Our Dermatol Online 2014; 5(2): 155-156          DOI: 10.7241/ourd.20142.37

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 This is a peculiar phenomenon I am most interested. The “isotopic response” implies that the new skin disease appeared at the site of an already healed primary skin disease. It is also essential that the second skin disease to be a new and unrelated one. Here we do not know the vitiliginous area having active disease or not hence to name this skin reaction as a isotopic response is problematic. If vitiligo is stable it falls to this category.If vitiliginous area is active I would like to propose a new term ( If the second skin disease appeared on the site of previous active dermatosus)  -“ Isotopic co- response”Fallowing cases are example to new category. References:   1. Göktay F, Mansur AT, Aydingöz IE. Colocalization of vitiligo and lichen planus on scrotal skin: a finding contrary to the actinic damage theory. Dermatology. 2006;212:390-2.   2. Ujiie H, Sawamura D, Shimizu H. Development of lichen planus and psoriasis on lesions of vitiligo vulgaris.Clin Exp Dermatol. 2006;31:375-7.   Dr. Ajith P. Kannangara (Sri Lanka)

Vandini Kabra, Kanthilatha Pai, Sathish Pai B, Shrutakirthi Shenoi, Raghavendra Rao
Pemphigus vulgaris masquerading as subcorneal pustular dermatoses – a case report

      Our Dermatol Online 2014; 5(2): 157-159          DOI: 10.7241/ourd.20142.38

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 Many dermatology problems have atypical presentation, which require skin biopsy and further specific diagnostic methods to differentiates between any similar problems as in this case. Pemphigus vulgaris patients with generalized disease may require more aggressive immunosuppression to suppress blistering, Prednisolone with an adjuvant is the preferred treatment for pemphigus vulgaris rather than steroid only.  Dr Amani Tresh (Libya)

Sanjay N. Agrawal, Yoganand A. Kulkarni, Yogeshree R. Deshmukh, Subodh D. Jane
Tuberous Sclerosis in Pregnancy

      Our Dermatol Online 2014; 5(2): 160-162          DOI: 10.7241/ourd.20142.39

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Celeste Valiente Rebull, Lourdes Rodríguez, Gabriela Martinez Braga, Beatriz Di Martino Ortiz, Mirtha Rodriguez Masi, Oilda Knopfelmacher, Lourdes Bolla de Lezcano

Poroqueratosis. Reporte de tres casos
[Porokeratosis. Report of three cases]
      Our Dermatol Online 2014; 5(2): 163-168          DOI: 10.7241/ourd.20142.40

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 Very interesting article focusing 3 cases of this rare disorder of keratinization. The term porokeratosis was coined in 1893, by Italian dermatologist Vittorio Mibelli  who was born in Portoferraio, Elba. The lesion he described was hyperkeratosis originating at the orifice of a sweat duct then the name “poro”. It is a quite typical  well-de? ned lesion with a hyperkeratotic ridge on the border that contains the coronoid lamella.Malignant transformation is a known complication and has been reported as high as 7.5%; therefore, it is advisable to treat these lesions. Successful treatment of these lesions with imiquimod 5% cream has been reported although redness of skin usually complicates patient adherence.  Dr César Bimbi (Brasil)

Safia Rana, Seema Monga, Sabina Khan, Shaan Khetrapal, Sujata Jetley
Tubercular abscess of the lower lip: a rare case of mistaken identity

      Our Dermatol Online 2014; 5(2): 169-171          DOI: 10.7241/ourd.20142.41

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A rare clinical picture of tuberculosis presenting as a lip abscess is presented by the authors,that should be considered in the differential diagnosis particularly in a patient with underlying tuberculosis.Prof. Kanthilatha Pai (India) 

Thank you for the nice presentation. Going back to the last statement in the conclusion “Definitive tissue diagnosis along with demonstration of AFB, as in the present case remains the gold standard.”With its easily handled procedure unfortunately the demonstration of AFB by ZN staining method has its limitation as its sensitivity remains obviously low.Different diagnostic modes have been implemented for TB diagnosis.Conventional methods for the diagnosis of tuberculosis include smear andculture for Mycobacterium tuberculosis. Ziehl-Neelsen staining for acid-fast bacilli requires 104-106bacilli/ml of tissue or fluid specimens to give a positive result. Although culture for mycobacterium is more sensitive, it still needs 101-102 bacilli/ml of sample for the diagnostic yield and requires two to four weeks for the growth of M. tuberculosis. Diagnosis of tuberculosis from tissue samples is usually made by histopathological examination (HPE) that depends on the presence of granulomatous inflammation and caseous necrosis. It requires high expertise. Advanced molecular methods such as Polymerase chain reaction (PCR), a type ofnucleic acid amplification system, have shown very promising results for early and rapid diagnosis of the disease due to its detection limit of one to ten bacilli in various clinical samples.   Dr. Mohamed Wael Daboul (Syrian Arab Republic)

Gayatri Khatri, Vikram K Mahajan, Pushpinder S. Chauhan, Karaninder S. Mehta, Bal Chander, Mrinal Gupta
Plasmoacanthoma of oral cavity and plasma cell cheilitis: two sides of same disorder “oral plasma cell mucositis” ?

      Our Dermatol Online 2014; 5(2): 172-175         DOI: 10.7241/ourd.20142.42

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Yugandar Inakanti, Akshaya Nagaraja, Srilakshmi Peddireddy, Vijayshankar Metikurke
A case of Pyogenic Granuloma at an unusual location

      Our Dermatol Online 2014; 5(2): 176-178          DOI: 10.7241/ourd.20142.43

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 Reporting interesting case with an atypical presentation of pyogenic granuloma in the glans penis. The approach was correct, beyond all preoperative investigation, the surgical indication was perfect, the procedure, the principle would be diagnosed, eventually becoming therapeutic.  Dr. Roni Leonardo Teixeira (Brazil) 

 This case highlights the unusual presentation of Pyogenic granuloma, which should be kept in mind while encountering a erythematous papule in the urethra.   Prof. Kanthilatha Pai (India)

Yosep Chong, Dae-Hyun Song, Kee-Taek Jang, Kwang Hwa Park, Eun Jung Lee
Concurrent occurrence of Seborrheic Keratosis and Melanocytic Nevus in the same lesion

      Our Dermatol Online 2014; 5(2): 179-182          DOI: 10.7241/ourd.20142.44

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Seborrheic keratosis (SK) is a one of the most benign condition in aging skin of either white or skin of colour.Melanocytic naevus also falls to the frequently seeing dermatosus especially in Asian population. Association between Seborrheic keratosis and Melanocytic naevus is most probably a coincidental occurrence because so far there is no documented hard evidence to suggest the co-occurrence is a collision. Dr. Ajith P. Kannangara (Sri Lanka)

Ryszard Galus, Katarzyna Borowska, Marian Jędrych, Barbara Jodłowska-Jędrych, Longin Niemczyk, Marek Antiszko, Stanisław Zabielski
Melkersson-Rosenthal syndrome associated with psoriasis vulgaris and orofacial impetiginization

      Our Dermatol Online 2014; 5(2): 183-184         DOI: 10.7241/ourd.20142.45

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 The authors describe an interesting and still debatable case, when referring to diagnosis, prevalence and terms of definition.A few remarks:Cheilitis granulomatosa  is a chronic swelling of one or both  lips due to granulomatous inflammation. It is a monosymptomatic form or an incomplete variant of Melkersson-Rosenthal syndrome, defined by the triad of recurrent orofacial swelling, facial nerve palsy and fissuring of the tongue (lingua plicata).Wiesenfield [1] introduced the concept of orofacial granulomatosis and cheilitis granulomatosa  and Melkersson-Rosenthal syndrome are considered subsets of this new entity. Cheilitis granulomatosa without lingua plicata or facial palsies also is called Miescher syndrome or Miescher’s Cheilitis [2].The classic triad of Melkersson-Rosenthal syndrome is seen in only 25% of cases [3] and perhaps the syndrome is sometimes over or under diagnosed. Being a granulomatous disease granulomatous inflammation is the histological hallmark of the disease, although some reports have not been so drastic in this regard, as is the case of present communication.Fissured tongue  has been reported in 10% of normal population and in  Melkersson-Rosenthal syndrome,  Coffin-Lowry syndrome, Fraser’s Syndrome, Down’s syndrome,  Oral-Facial-Digital (OFD) Syndrome Type I, Mohr Syndrome (the OFD syndrome, type II), Pierre Robin Syndrome,  Maroteaux Lamy Syndrome,  ECC syndrome [4]. The association with psoriasis is intrigue and confirmed lately in different studies with a  variable prevalence: 6-47.5% [5]We congratulate the authors for the presentation that draws attention to many interesting clinical issues.  References:   1. Wiesenfeld D, Ferguson MM, Mitchell DN, MacDonald DG, Scully C, Cochran K, et al. Oro-facial granulomatosis–a clinical and pathological analysis. Q J Med. 1985;54:101-13.2. van der Waal RI, Schulten EA, van de Scheur MR, Wauters IM, Starink TM, van der Waal. Review Cheilitis granulomatosa.J Eur Acad Dermatol Venereol. 2001;15:519-23.3. Chen C, Huilgol SC, James C, Selva D. Melkersson-Rosenthal syndrome presenting with upper lid edema and facial palsy. Can J Ophthalmol. 2002;37:361-3.4. Gorlin Robert J, Cohen M Michael, Hennekam Raoul CM. Syndromes of head and neck. 4th edition. Oxford University Press Inc; 2001.5. Zargari O. The prevalence and significance of fissured tongue and geographical tongue in psoriatic patients. Clin Exp Dermatol. 2006;31:192-5.  Prof. Anca Chiriac MD, PhD (Romania) 

 Given the unusual association, it would be interesting to watch an intraoral images of the patient (including the tongue), an image of treatment outcome and histopathology.   Dr José López-López (Spain)

Keerthi Jampani, Akshaya Nagaraja, Srilakshmi Peddireddy, Shiva Kumar V.
Linear scleroderma: a series of all clinical variants

      Our Dermatol Online 2014; 5(2): 185-187          DOI: 10.7241/ourd.20142.46

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 Comentario:   La esclerodermia localizada linear se caracteriza por lesiones cutáneas en banda o alargadas  que presenta substrato de fibrosis.  En los casos 2 y 3, si bien es factible que comenzarán en forma lineal, en la actual presentación se constata compromiso de la mitad de la cara.  /Hemifacial/  Parece correcto mencionar esta dificultad de ubicación de ambos casos y  referir la clasificación en la cual se han basado los autores.  De esta manera el articulo tendría mayor valor docente.      Comment:    Linear localized scleroderma characterized by skin lesions or elongated strip substrate having fibrosis. In cases 2 and 3, although it is likely to start in a linear fashion, in the current presentation compromise half of the face is found. /hemifacial/  It seems right to mention the difficulty of both location and refer the classification in which the authors have been based. In this way the article would have greater educational value. Dra. María Bibiana Leroux (Argentina) 

 As clinical dermatologist, I have found this article is of great interest and I feel readers will find it so: A brief and good review of the three types of linear scleroderma, which in certain cases may be considered a challenge-to-treat condition. Unfortunately, my personal experience on therapies for this disease is not satisfactory, so there future researches are warranted on this way. Good quality clinical images are accompanied in this easy-to-read, well-structured article.   Dr. Husein Husein-ElAhmed (Spain)

Neerja Puri
Actinic lichen planus in a child – a rare entity

      Our Dermatol Online 2014; 5(2): 188-189          DOI: 10.7241/ourd.20142.47

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REVIEW ARTICLE


Yugandar Inakanti, Shiva Kumar
Forgive sins: rise of thalidomide

      Our Dermatol Online 2014; 5(2): 190-196          DOI: 10.7241/ourd.20142.48

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 A very interesting -up to date- review of thalidomide, a drug labeled pregnancy category X, but many dermatologist around the world are using currently at least in recurrent aphthous, actinic prurigo and prurigo nodularis, but anyone using it should follow the S.T.E.P.S. program, taking account the irreversible peripheral neuropathy as a complication.Now days the only FDA-approved indication is erythema nodosum leprosum and the rest of indications are off-labeled dermatological uses. Prof. Roberto Arenas (Mexico)


CLINICAL IMAGES


Niloofar Mehrolhasani
Diffuse cutaneous leishmaniasis in HIV positive woman

      Our Dermatol Online 2014; 5(2): 197          DOI: 10.7241/ourd.20142.49

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Patricia Chang, Mónica Vanesa Vásquez Acajabón
Beau´s lines due to cytostatic drugs in a patient with breast cancer

      Our Dermatol Online 2014; 5(2): 198-200          DOI: 10.7241/ourd.20142.50

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Patricia Chang, Mónica Vanesa Vásquez Acajabón
Onycholysis due to trauma

      Our Dermatol Online 2014; 5(2): 201-204          DOI: 10.7241/ourd.20142.51

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LETTER TO THE EDITOR  –  Observation


Masataka Satoh, Toshiyuki Yamamoto
A case of symmetrical drug-related intertriginous and flexural exanthema caused by valacyclovir

      Our Dermatol Online 2014; 5(2): 205-206             DOI: 10.7241/ourd.20142.52

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LETTER TO THE EDITOR  –  Practical Issues


Anca Chiriac, Meda Bradeanu, Piotr Brzezinski
Confusion between vascular malformations and hemangiomas-practical issues

      Our Dermatol Online 2014; 5(2): 207-209             DOI: 10.7241/ourd.20142.53

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 As noted by the authors it is very important to differentiate between vascular malformations and vascular neoplasms especially infantile hemangiomas. Not only because of its origin but because these entities have different therapeutic approaches. Infantile hemangiomas are benign self-limited neoplasms that are very susceptible to the treatment with systemic and topical propranolol, used in cases of functional or aesthetic compromise. Conversely vascular malformations do not involute and necessitate imaging studies for further categorization. Different modalities of treatment are described for this entity depending on the type of malformation, its location, the areas involved. Certainly it is important for dermatologists to instruct colleagues from other specialties about the difference between vascular malformations and vascular tumors and the recent advances in their therapeutic approaches.   Dr. Manuel Valdebran (Dominican Republic)


LETTER TO THE EDITOR


Toshiyuki Yamamoto
Epidermotropic pagetoid spread and squamous cell carcinoma in situ in the overlying epidermis of Merkel cell carcinoma

      Our Dermatol Online 2014; 5(2): 210-211             DOI: 10.7241/ourd.20142.54

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 Clear concepts that unfortunately not all pathologists know and confusion of nomenclature and classification is created. Excellent job. There are several curiosities in this diagnosis:  1. Merkel cell carcinoma shows epithelial and neuroendocrine differentiation. Tumour cells express low molecular weight cytokeratins (detectable by specific or broad spectrum cytokeratins such as AE1/AE3, CAM5.2, pan-cytokeratin), epithelial membrane antigen and the epithelial marker BER-EP4. Cytokeratin 20 is a sensitive and quite specific marker for Merkel cell carcinoma, and was not done in this case. CK20 is useful in combination with thyroid-transcription factor-1 to differentiate between Merkel cell carcinoma (CK20 positive,TTF-1negative) and small cell carcinoma of the lung (<10% CK20 positive, TTF-1 positive). Markers of neuroendocrine differentiation include chromogranin, synaptophysin, neuronspecific enolase, bombesin, somatostatin, calcitonin, gastrin and others.Merkel cell carcinoma also expresses CD117, the KIT receptor tyrosine kinase, and in approximately a third of cases CD99. The tumour cells are negative for leukocyte common antigen and S-100.  2. The epidermis may be involved in a pagetoid fashion as a feature of this tumor, and in exceptional cases the tumour cells are entirely limited to the epidermis. Although most MCCs are entirely dermal or subcutaneous, some of them have an intraepidermal component (epidermotropic MCC). 3. Not infrequently, Merkel cell carcinoma occurs in intimate association with an in situ or invasive squamous cell carcinoma.   Reference: https://www.inkling.com/read/dermatopathology-busam-goldblum-1st/chapter-16/merkel-cell-carcinoma   Prof. Ass. Beatriz Di Martino (Paraguay)

Ilteris Oguz Topal, Yunus Topal, Nilgun Bahcetepe, Sule Gungor
Early diagnosis of the colon carcinoma during the treatment with acitretin

      Our Dermatol Online 2014; 5(2): 212             DOI: 10.7241/ourd.20142.55

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Khalid Al Aboud
Remarks on the prescriptions and the dispensing of the medications

      Our Dermatol Online 2014; 5(2): 213-214             DOI: 10.7241/ourd.20142.56

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HISTORICAL ARTICLES


Daifullah Al Aboud
Hairy ears; Revisited

      Our Dermatol Online 2014; 5(2): 215-216          DOI: 10.7241/ourd.20142.57

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Piotr Brzeziński, Anca Chiriac, Roberto Arenas, Geme Urge Dori, Rodrigo Monteiro, Sandy Cairncross, Gilles Safa, Essam El Toukhy
Dermatology Eponyms – sign –Lexicon (L)

      Our Dermatol Online 2014; 5(2): 217-230          DOI: 10.7241/ourd.20142.58

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