Asian Journal of Research in Dermatological Science

Aim: Lymphangiomas are malformations of the lymphatic system that are located in the skin and subcutaneous tissues. We report a case of invasive lymphangioma circumscriptum successfully treated by surgery.

Presentation of a Case: A 10-year female presented with asymptomatic lesions over the left side of the abdomen since birth. Dermoscopy showed characteristic multiple yellow lacunae surrounded by septa, as well as with few lacunae showing hypopion sign. Histopathology of the lesion was suggestive of lymphangioma circumscritum.

Discussion:  Depending on the size and depth of the lymph vessels, lymphangiomas are separated into two categories; the superficial group and deeper group. The superficial group contains only lymphangioma circumscriptum, whereas deeper group is comprised of caverneous lymphangioma and cystic hygroma. Of the three types lymphangioma circumscriptum is the most common. Diagnosis of lymphangioma circumscriptum was made and surgical excision of the lesions was done.

Conclusion: we report a case of invasive lymphangioma circumscriptum which is managed successfully by surgical excision.

Pemphigus vulgaris is an autoimmune blistering disease with great diagnostic and therapeutic challenge in the pediatric age group. The severe clinical course is often complicated with substantial morbidity and mortality, attributed to treatment side effects. Rituximab proves effective in cases unresponsive to conventional immunosuppressive therapy, corticosteroid-resistant patients and in those who experience unbearable and severe side effects. We present a recalcitrant case of juvenile pemphigus vulgaris treated with rituximab. Additionally, highlights of the currently reported cases of pediatric pemphigus, who received anti-CD20 monoclonal antibody therapy, are provided.

This is a case report of a 20 year old female who presented with recurrent pre auricular swelling and ear discharge since childhood. Upon further investigation, she was found to have left superficial preauricular fistula communicating with posterior auricle with no communication with internal or external auditory meatus. Cervico-aural fistula is a rare variant which accounts for less than 8% of all branchial arch abnormality [1].

Introduction: The microscopic examination of skin, nails and hairs scrapings to detect the pathogenic fungi in patients with superficial fungal infections is very important step in the management, and this would be helpful to choose the most appropriate antifungals, and to expect their efficacy and needed duration of therapy.

Aims: This study was done to evaluate the sensitivity of KOH mounts as well as the sensitivity of fungal cultures on Sabouraudꞌs dextrose agar media in Zliten Teaching Hospital.

Methods: The data of eighty four patients with confirmed superficial fungal infections were enrolled in this retrospective study. The sites of samples intake from skin, nails or hairs were cleaned with ethanol 70%, and the scraped material was collected with use of sterile scalpel, and placed on a slide and covered with a drop of a 10% Potassium Hydroxide (KOH) solution, then a coverslip was applied, and after 10 minutes examined under microscope with power (x10) and (40). Part of collected scrapings was placed on Sabouraudꞌs dextrose agar media. The media were incubated in 26°C, and were examined twice weekly, over 4 weeks, to determine the specific etiologic fungus. The final results were made by interpretation of macroscopic and microscope features of grown fungal colonies.

Results: Males with confirmed fungal infection were 37 (represented 44%), while females were 47(represented 56%). The mean age of patients was 16.5 years (16.5±18). The most frequently diagnosed fungal infection was Tinea capitis, that its causative dermatophytes were isolated from 55 patients (consisted 65.5% of total number of patients).

The presence of superficial fungal infections was confirmed with direct microscopy of KOH mounts in 40 patients out of 54 patients, (represented 74% of performed KOH exams). The more frequently isolated dermatophytes were Trichophyton rubrum and Microsporum canis, which represented 14.29% and 13.9% respectively. While, no growth of pathogenic fungi was found in 25 patients, although, the presence of fungal skin infections was confirmed with examination of KOH preparations.

Conclusion: In Zliten Teaching Hospital, the sensitivity of direct microscopic examination of KOH mounts for fungal elements was 74%, and the sensitivity of cultural method with cultivation on Sabouraudꞌs dextrose agar media was 70%, this make use of both available methods would be very helpful as a diagnostic tools for patients with fungal infections.

Background: The skin described as the mirror of the mind. In primary psychocutaneous diseases patients have no primary skin disease and all of the cutaneous findings are self-induced. Establishing rapport has great effect on patient compliance and considered the initial and the most important step in the successful management of psychocutaneous patients.

Aims: To highlight the role of rapport on the compliance of patients with primary psychocutaneous diseases to visit psychiatry department.

Study Design:  Descriptive study.

Place and Duration of Study: Center of Dermatology/Medical City in Baghdad,between December 2017- June 2018.

Methodology: A total 47 patients with primary psychocutaneous diseases were enrolled in the study. Detailed history was taken from each patient with special attention to establish rapport. Referral to psychiatry department was offered to the patients emphasizing on the relationship between mental health and dermatological diseases.

Results: A total of 47 patients diagnosed with primary psychocutaneous disorders were assessed and enrolled in this study. 37 were females and 10 were males with female to male ratio: 3.7:1. Age of patients ranged from (11-63) years with mean and standard deviation of   (37.978±15.597) years. The enrolled diseases and their frequency were: Neurotic excoriations 34%, dermatitis artefacta 21%, lichen simplex chronicus 19%, Prurigo nodularis 10.6%, trichotillomania 10.6% and delusion of parasitosis 4%. In the present study 72.3% of the enrolled psychocutaneous patients eventually accepted psychiatric referral.

Conclusion: Primary psychocutaneous diseases are found to affect patients with a mean age 38 years and female preponderance, neurotic excoriations was the most common of these diseases.  Rapport building is very important in dealing with psychocutaneous patients and has a major role in improving referral rate to psychiatry department.