皮膚科および皮膚科疾患ジャーナル

Background: Oral acitretin, a synthetic compound of retinoids, seems to be a promising modality in treating warts. To the best of our knowledge, no studies regarding its use have been performed on Egyptian patients. Objectives: Evaluating the role of acitretin in the treatment of multiple recalcitrant common warts. Patients and Methods: Forty adult patients with multiple recalcitrant warts were treated with oral acitretin [20 with 1 mg/kg/day for 3 month (group A), 20 with 0.5 mg/kg/day for 3 months (group B), and 20 served as controls and were given placebo (group C)]. Results: Oral acitretin was found to be a statistically significant therapy compared to placebo in treating warts. Total clearance of lesions was noted in 70% of group A compared to 80% in group B and none in group C. A non significant difference between group A and B was noted. However, there was a significant relation between the clinical response and the duration of disease, as the longer the duration of the disease, the higher was the percentage of patients showing complete response to therapy. Conclusions: Acitretin can be used as an effective non-invasive alternative form of therapy for multiple recalcitrant common warts.

Objective: The main purpose of this study was to carry out a clinical evaluation about anthropometric measurements (weight, length and head circumference) of a group of Brazilian Neurofibromatosis type 1 (NF1) children and adolescent individuals. Patients and Methods: This was an observational and cross-sectional study. The patient sample included 146 children and adolescents of both sexes; aged zero to 19 years and each individual was measured just once. The dispersion of the anthropometric measurements was evaluated and their position in relation to the percentiles of standard WHO growth charts were used as a reference in pediatric practice. Results: Short stature was present in 17.1% of the subjects; the higher frequency was observed in males aged 5-19 years (20.4%). The heritability of NF1 in patients with short stature was not statistically significant (p value >0.05) when we compared the individuals that presented short stature or not and positive or negative familial history of NF1 using a 2×2 Table (χ2 analysis). In males, the percentage of low birth weight was 5.5% while in females it was 1.4%. The percentage of underweight individuals was 3.7%. Macrocephaly was observed in 25.0% of boys and girls aged 0-5 years. Conclusions: In a group of Brazilian NF1 patients, we found cases of short stature even in the first five years of life. Weight below percentile 50 was predominant in girls aged 0-5 years (72.2%) and head circumference above percentile 50 with macrocephaly was also present. Birth’s mean weight and length below average apparently are not general characteristics of NF1 individuals from Brazil.

Vogt-Koyanagi-Harada syndrome (VKHS) is a multi-organ disorder with well-established diagnostic criteria, which is little known by the dermatologist. We emphasize the importance of early recognition and treatment of VKHS, avoiding especially the ophthalmologic sequels. Since vitiligo is closely related to the syndrome and other autoimmune disorders, we question the need for a better evaluation of patients with vitiligo by dermatologists.

We report a 70-year-old woman who presented a superficial spreading malignant melanoma with a nodular melanoma appearance, located on her leg. Most common clinicopathological types of malignant melanoma are lentigo maligna, superficial spreading, nodular, and acral lentiginous melanoma. Unusual variants of melanoma are rare but important. These are amelanotic melanoma, neurotropic melanoma, desmoplastic melanoma, metastatic melanoma, invisible melanoma, balloon cell melanoma, melanoma arising within a benign nevus and pedunculated melanoma. The lesion of our patient simulated a nodular or a pedunculated melanoma clinically, but its histopathological examination showed a superficial spreading melanoma arising from the surface of an Unna nevus. To the best of our knowledge, such misleading nodular appearance of a superficial melanoma arising from an intradermal nevus of Unna which seems to be a unique finding has not been reported previously.

Vitiligo is the most common depigmenting disorder having a major impact on the quality of life of patients. Despite continued progress toward an elucidation of the biochemical, genetic and immunopathological pathways in vitiligo, a definitive cure remains elusive. During the past few decades, advances in the field of molecular genetics have enriched us in understanding the etiopathogenesis of vitiligo. Several candidate genes have been associated with susceptibility to vitiligo. They include genes important for melanin biosynthesis, response to oxidative stress and/or regulation of autoimmunity. A recent genome-wide scan performed on families with numerous members presenting with vitiligo has clearly revealed linkage of susceptibility loci especially autoimmune susceptibility loci. Genetic studies have helped us identify not only the natural course and clinical aspects of vitiligo but also the shed profound light on the inverse relationship between genetic susceptibility to GV and malignant melanoma. In the future, dissection of the complex genetic architecture of vitiligo will provide new approaches for treatment and prevention. In this article, we review the genes involved in vitiligo and also focus on the pathogenic mechanisms of the same.