Acne and smoking: is there a relationship?

Background

There are contradictory reports on the relationship between acne vulgaris and cigarette smoking. The objective of this study was to examine the relation between acne and cigarette smoking in a case-control study.

Methods

A questionnaire on smoking habits was offered to 350 patients with acne vulgaris and 350 patients suffering from skin diseases other than acne, aged 15 – 40 years, attending in a skin clinic in Tehran, Iran. The patients completed the questionnaires anonymously in the waiting room.

Results

Two hundred and ninety-three patients with acne (response rate 83.7 %) and 301 patients with other skin diseases (response rate 86.0 %) completed the questionnaires. Twelve acne patients (4.1 %) and 27 control patients (9.0 %) were current smokers (odds ratio = 0.43, 95% confidence limits 0.22 – 0.87, p < 0.05). But after adjustment for sex, this difference was not significant (odds ratio: 0.61, 95% CI: 0.30–1.26, p > 0.05, Mantel-Haenszel test).

Conclusion

An association between acne and cigarette smoking was not found in this study.     

Anetoderma and borreliosis: is there a pathogenetic relationship?

A 32-year-old man simultaneously developed anetoderma and acrodermatitis chronica atrophicans on his left arm and showed a positive serology for borreliosis with ELISA and Western Blot tests. In addition, a 45 year-old man is presented with anetoderma without any associated systemic or cutaneous diseases, with B. afzelii confirmed as a singular causality through serology (ELISA, Western Blot) and amplification of B. afzelii-specific DNA from the skin by PCR. These two observations highly suggest that anetoderma can be the result of an infection with B. afzelii. We conclude that in patients with anetoderma a serological investigation for Borreliosis should be performed.     

Marginal acrokeratoderma and psoriasis: is there an association?

Case 1 A 70‐year‐old housewife presented to us with multiple, asymptomatic, depressed, crateriform plaque lesions over the radial margin of the index finger and thumb and thenar and hypothenar eminences of both hands of 25 years' duration ( Fig. 1 ). There was no history of prolonged sun exposure or repeated trauma to the hands and there were no such lesions on the soles. None of her other family members were affected. We made a provisional diagnosis of keratoelastoidosis marginalis. Skin biopsy revealed an unremarkable epidermis, with minimal lymphocytic infiltration in the upper dermis and hyalinization in the reticular dermis, extending to the deeper dermis. Two years later she returned with well‐defined, erythematous, scaly, mildly itchy plaque lesions over the instep of both feet and the center of both palms. A clinical diagnosis of palmoplantar psoriasis was made.

Figure 1 Open in figure viewer PowerPoint Case 1. Crateriform plaque lesions on the hands. Note the palmoplantar psoriasis     

Vinorelbine therapy in classic Kaposi’s sarcoma: a retrospective study of 20 patients

Background

Systemic chemotherapy is the main treatment of diffuse and/or aggressive classic Kaposi’s sarcoma (KS) but there are no standard treatment guidelines and published literature regarding vinorelbine is lacking.

Objective

To assess the safety and effectiveness of intravenous vinorelbine in the treatment of classic KS.

Materials and Methods

We performed a retrospective study of a departmental database in histologically proven classic KS.

Results

Twenty patients received intravenous vinorelbine as cycles of 20 mg/m² once every two weeks for 5 cycles and subsequently at a dose of 30 mg/m² once every three weeks. Of 19 assessable patients, three (16%) had a complete remission and 11 (58%) had a partial response, for an overall response rate of 74%. The remaining 5 patients had a stable disease (26%). Grade 3 or 4 toxicities were neutropenia (3/20 patients), deep vein thrombosis (1/20 patients) and constipation (1/20 patients). The median progression-free survival from the start of therapy until the development of progressive disease was 35.1 months.

Conclusions

Vinorelbine is an effective and overall well tolerated treatment for classic KS.

     

Pemphigus vulgaris and herpesviruses: is there any relationship?

Background Pemphigus is an autoimmune disorder, which results from interaction of exogenous and endogenous factors. One of these environmental factors is viral infections particularly, herpesviruses. We aimed to detect the presence of HSV 1 and 2 (herpes simplex virus) and HHV8 (human herpesvirus 8) in our patients who were suffering from pemphigus vulgaris. Methods In this cross‐sectional study, 38 patients (19 male and 19 female patients) with pemphigus vulgaris were entered, 32 skins and six peripheral blood cells samples were obtained from the study population. Thereafter, the presence of HHV8 and HSV DNA were evaluated by using polymerase chain reaction (PCR). Results The mean age of patients was 45.05 ± 17.24 years (range: 16–81 years). Twelve patients mentioned history of herpes labial in the past (31.57%). Results of PCR test for detection of HSV and HHV8 DNA in all 32 skin samples and five peripheral blood samples and one case with skin and blood samples were reported negative. Conclusion Inability to detect HHV8 and HSV DNA in this study suggests that herpesviruses may be only occasional factors for development or exacerbation of pemphigus vulgaris.     

Basaloid follicular hamartoma with eruptive milia and hypohidrosis: is there a pathogenic relationship ?

We report a sporadic case of eruptive milia with histopathological features of basaloid follicular hamartoma which developed in an 8 year-old Japanese girl. Multiple milia and comedo-like eruptions were present at birth and gradually increased in number and spread over the extremities. Histopathologically, keratotic cysts with trichilemmal keratinization and features of basaloid follicular hamartoma were observed without any histological findings of basal cell epithelioma or trichoepithelioma. Reduced sweating was observed after iontophoretically applied acetylcholine on the forearm. Nevus of Ota and thyroid goiter were complications.