Demodex positive discoid lupus erythematosus: Is it a separate entity or an overlap syndrome?

Discoid lupus erythematosus (DLE) is a chronic inflammatory erythematous skin disease that can be triggered by several factors. Rosacea is another skin disease that causes facial redness and tenderness. Demodex mites have been reported in rosacea and DLE patients commonly in the literature. These two diseases can be seen concomitant, mimic each other clinically and share common possible etiologic factors. To assess demodex mite infestation in both clinical and histopathological findings in DLE patients. We retrospectively evaluated the files of 42 patients with DLE who had been diagnosed DLE based on clinical and histopathological findings between August 2018 and August 2019. Demodex positivity was detected 50% of patients (n = 21). Neutrophile percentages in the dermal and perivascular area were higher in the demodex positive patients (4.43%) than in the Demodex negative patients (2.19%). The intensity of demodex mites correlated positively with dermal neutrophile percentages. ANA was negative in 29 patients (69%) and positive in 13 patients (31%). Anti‐dsDNA was negative in serology and follicular plugging was positive in histopathology in all 42 patients (100%). This was a retrospective study. DLE and rosacea share common features in etiopathogenesis and clinical presentation. Inflammation and exacerbations caused by the demodex mites may increase the clinical severity of DLE. Although the position of demodex mites in DLE etiopathogenesis is not known exactly, the presence of high demodex in DLE patients has been determined. Standard skin surface biopsy can be a routine procedure for the evaluation of DLE patients in daily clinical practice.     

Testicular persistence of Parvovirus B19: evidence for preferential infection of germ cell tumors

Human Parvovirus B19 has previously been implicated in the pathogenesis of testicular germ cell tumors, but this could not have been confirmed. This study was designed to investigate the testicular persistence of Parvovirus B19 and possible associations with germ cell tumors. Paraffin-embedded or fresh tissues from 36 germ cell tumors, 20 germ cell aplasias, 26 normal testicular tissues, 20 liver tissues, and 20 spleen tissues were evaluated by two different molecular assays: a nested PCR for Parvovirus B19 capsid genes and a commercial quantitative real-time PCR. Positive results were further confirmed by another commercial real-time PCR assay. Viral DNA was detected in 3 of 36 (8.3%) germ cell tumors, but not in other groups. Viral loads observed in all positive samples were less than 20 IU/reaction, suggesting very low levels of viral replication or latency. These results either directly or indirectly imply the involvement of Parvovirus B19 with testicular germ cell tumors. Viral persistence in normal testis, germ cell aplasia tissues, or hepatic/splenic tissues was not observed in this study.     

Novel noninvasive detection method for endometriosis: research and development of scintigraphic survey on endometrial implants in rats

In this experimental study on endometriosis, the majority of the implants were successfully detected with technetium-(99mTc) labeled red blood cell scintigraphy.     

Ultrasonography in patients with ulnar neuropathy at the elbow: Comparison of cross‐sectional area and swelling ratio with electrophysiological severity

The aim of this study was to determine the diagnostic value of ultrasonographic measurements in ulnar neuropathy at the elbow (UNE) and to assess the relationship between the measurements and the electrophysiological severity. The largest anteroposterior diameter (LAPD) and cross‐sectional area (CSA) measurements of the ulnar nerve were noted at multiple levels along the arm, and the distal‐to‐proximal ratios were calculated. Almost all of the measurements and swelling ratios between patients and controls showed statistically significant differences. The largest CSA, distal/largest CSA ratio, CSA at the epicondyle, and proximal LAPD had larger areas under the curve than other measurements. The sensitivity and specificity in diagnosing UNE were 95% and 71% for the largest CSA, 83% and 85% for the distal/largest CSA ratio, 83% and 81% for the CSA at the epicondyle, and 93% and 43% for the proximal LAPD, respectively. There was a statistically significant correlation between the electrophysiological severity scale score (ESSS) and the largest CSA, the CSA at the epicondyle and 2 cm proximal to the epicondyle, and the LAPD at the level of the epicondyle (P < 0.05). None of the swelling ratios showed a significant correlation with the ESSS. The largest CSA measurement is the most valuable ultrasonographic measurement both for diagnosis and determining the severity of UNE. Muscle Nerve, 2010     

Vesiculopustular Eruption in Neonatal Transient Myeloproliferative Disorder

Transient myeloproliferative disorder (TMD) typically presents with pancytopenia, hepatosplenomegaly, and immature circulating white blood cells, and affects approximately 10 % of neonates with Down syndrome. The authors report a neonate with Down syndrome who developed acute widespread pustular eruptions as a sign of TMD. The white blood cell counts on the first day of life were markedly elevated, with blasts seen on examination of the peripheral blood smear. And the patient was noted to have a few erythematous papules and pustules especially on the face. On the following days pathergy positive crusted papules and pustules were increased and spread to trunk and extremities. Skin biopsy specimens showed pustular dermatitis, with subcorneal vesiculopustules and perivascular inflammation in superficial dermis. These lesions improved parallel with the hematologic improvement within two weeks. The authors aim to alert clinicians about this uncommon cause of vesiculopustular eruption with the present illustrative case and review the literature.     

Multiple spurting test in microsurgical reconstruction of the lower extremities

Appropriate recipient artery is essential for the success of free flap reconstruction, however the selection could be difficult in a traumatized lower extremity. To detect unnoticed damage of the recipient artery, vascular integrity should be verified. For that purpose, we propose a simple and effective evaluation method, called Multiple Spurting Test (MST) this test esteems the dynamic status of the recipient arteries by measuring the length of arterial spurting. All the microsurgeons usually do something like MST: but it is not a standardized test yet.     

Capsulorhexis in white cataract using a green-light endoillumination probe.

The authors describe a technique for performing a safe and controlled continuous curvilinear capsulorhexis (CCC) in white cataracts using the contrast-enhancing effect of green light from an endoillumination probe. After attaching a green filter to the endoillumination unit of the vitrectomy set, a CCC was performed under the green light of the endoillumination probe, which was placed on the periphery of the cornea in a manner that followed the tearing edge of the capsulorhexis. This technique may be an alternative to capsular dyes in performing a safe and controlled CCC in white cataracts.