Three cases of lymphocytic thrombophilic arteritis presenting with an annular eruption

We describe three patients who presented with a striking erythematous non‐blanching annular eruption and features of lymphocytic thrombophilic arteritis (LTA), with a prominent lymphocytic vasculitis involving deep dermal vessels. Lymphocytic inflammation was also evident in the superficial vessels and one patient had small superficial ulcers over the ankle area resembling livedoid vasculopathy (LV). Multiple biopsies demonstrated a persistent absence of neutrophils in the infiltrate consistent with a lymphocytic process. In addition to highlighting the annular morphology as a novel presentation of LTA, these cases suggest a possible relationship between LV and LTA and support the notion that they are distinct from neutrophilic vasculitides such as cutaneous polyarteritis nodosa.     

Long-term results of cataract surgery in patients with anterior uveitis

Purpose

This study was aimed to assess the long-term results of phacoemulsification and posterior chamber intraocular lens implantation in patients with anterior uveitis.

Methods

Patients with complicated cataract secondary to anterior uveitis who underwent phacoemulsification and posterior chamber intraocular lens implantation were included in this study. Long-term results and all complications were evaluated throughout the postoperative 4 years.

Results

A total of 55 eyes of 48 patients were identified in this study. Cases with anterior uveitis were categorised into four aetiologic groups. Of the 55 eyes, 22 (19 patients) had idiopathic anterior uveitis, 10 (9 patients) had viral anterior uveitis, 10 (9 patients) had Fuchs’ anterior uveitis and 13 (11 patients) had anterior uveitis associated with collagen vascular diseases. Preoperative macular oedema was more frequent (63.6%) in the idiopathic group than in the other groups (p < 0.001). The success rates of the best corrected visual acuity of 20/40 or better ranged from 80.0 to 100.0% in the groups. While postoperative increased intraocular pressure rate was statistically significantly higher in the Fuchs’ group (p = 0.047), there was no statistically significant difference in other complication rates between the groups.

Conclusions

The long-term outcomes of phacoemulsification with intraocular lens implantation in patients with uveitic cataract were satisfactory with excellent visual acuity and relatively low complication rates.

     

Treatment of actinic keratosis through inhibition of cyclooxygenase‐2: Potential mechanism of action of diclofenac sodium 3% in hyaluronic acid 2.5%

Cyclooxygenase‐2 (COX‐2) and its metabolic product prostaglandin E₂ (PGE₂) are induced in response to growth factors, inflammatory cytokines, tumor promoters, activated oncogenes, and, in the skin, ultraviolet (UV) radiation. Accumulating evidence suggests a role for the COX‐2/PGE₂ pathway in tumorigenesis in various tissue types including cutaneous squamous cell carcinoma. There is also strong evidence for a role in the development of actinic keratoses (AKs) — common dysplastic lesions of the skin associated with UV radiation overexposure — considered as part of a continuum with skin cancer. Non‐steroidal anti‐inflammatory drugs (NSAIDs) exert their anti‐inflammatory, analgesic, and antipyretic effects by reversibly or irreversibly acetylating COX isoforms, inhibiting downstream prostaglandins, and may have a chemopreventive role in malignancies, including skin cancer. Topical treatment of AK lesions with the NSAID diclofenac sodium 3% in combination with hyaluronic acid 2.5% has been shown to be effective and well tolerated, although the mechanism of action remains to be elucidated.     

Vesiculobullous eruption of the right arm after intravenous clarithromycin

Clarithromycin is a macrolide antibiotic. In clinical trials, adverse drug reactions of clarithromycin are usually mild and transient. Only 1% of the adverse reactions are severe. Herein, we present a case with vesiculobullous skin reaction and vein thrombosis caused by administration of intravenous clarithromycin.     

Association between some educational indicators and dental caries experience of 12-year-old children in developing countries: an ecological approach

OBJECTIVE: The aim of this study was to investigate the association between some educational indicators and dental caries experience of 12-year-old children in developing countries. BASIC RESEARCH DESIGN: The ecological association between DMFT levels amongst 12 year olds (DMFT-12 index) with six educational indicators (adult literacy rate, mean years of schooling, pupil-teacher ratio for primary level, educational expenditure as a percentage of gross national product, primary enrollment ratio and percent completing primary level) has been studied using developing countries as the unit of analysis. Pearson's correlation analysis and stepwise linear multiple regression technique were used to identify the significantly associated educational indicators with the DMFT-12 index. RESULTS: A negative association between DMFT-12 index and percent completing primary education level has been observed (r = -0.509; p < 0.01). Also, stepwise regression analysis results have shown that only percent completing primary level education is significantly associated with DMFT-12 index scores (partial regression coefficient = -0.042; 95% confidence intervals: -0.064, -0.021). CONCLUSION: Dental caries experience of 12-year-old children appears to be highest in countries with low percent of primary level completion. Percent completing primary level education may be considered a good predictor of DMFT-12 index in developing countries.