I. Karaarslan | Ege University (original) (raw)
Papers by I. Karaarslan
Journal of the European Academy of Dermatology and Venereology
Dermatologica Sinica, 2018
Background: Basal cell carcinoma (BCC) is the most frequent of all skin cancers in the white popu... more Background: Basal cell carcinoma (BCC) is the most frequent of all skin cancers in the white population. The typical dermoscopic features of pigmented BCCs have been well known. In the literature a new dermoscopic pattern of BCC has been reported as "blue-white variant". Objective: In this study, we aimed to evaluate the blue-white variant of BCC's seen in our cases at our Dermato-oncology Unit. Methods: Patient files between the years 2003e2011 were searched for the cases with the histopathologic diagnosis of BCC. Among them, the cases that were compatible with the diagnosis of blue-white variant of BCC were determined. The morphological and clinical features of the lesions, dermoscopic images together with the histopathological slides were all evaluated. Results: Among 350 histopathologically proven BCCs, 3.1% of them showed diffuse blue-white areas, namely "the blue-white variant". On histopathological examination, typical aggregates of basaloid cells with nuclear atypia connected focally to the epidermis were observed. To our knowledge, this is the first research about the blue-white variant of pigmented BCC. Conclusion: The blue-white variant of pigmented BCC seems to be the most challenging type of BCC in the diagnosis for the clinician.
Dermatology (Basel, Switzerland), Jan 26, 2015
Nodular hidradenoma is an uncommon, benign, adnexal neoplasm of apocrine origin which is a clinic... more Nodular hidradenoma is an uncommon, benign, adnexal neoplasm of apocrine origin which is a clinical simulator of other tumours. The aim of this study was to evaluate the morphological findings of a large series of nodular hidradenomas under dermoscopic observation. Dermoscopic examination of 28 cases of nodular hidradenomas was performed to evaluate specific dermoscopic criteria and patterns. The most frequently occurring dermoscopic features were: (1) in 96.4% of cases, a homogeneous area that covered the lesion partially or totally, the colour of which was pinkish in 46.4% of cases, bluish in 28.6%, red-blue in 14.3%, and brownish in 10.7%; (2) white structures were found in 89.3% of cases; (3) in 82.1% of cases, vascular structures were also observed, especially arborising telangiectasias (39.3%) and polymorphous atypical vessels (28.6%). Nodular hidradenomas represent a dermoscopic pitfall, being difficult to differentiate clinically and dermoscopically from basal cell carcinoma...
The Journal of Dermatology, 2007
A 62-year-old male Turkish patient had a pigmented lesion on the sole with a 10-year history. It ... more A 62-year-old male Turkish patient had a pigmented lesion on the sole with a 10-year history. It was an asymmetrical macular lesion with an irregular border and irregular brown pigmentation and had a diameter of 1.2 cm × 1.7 cm. Dermoscopy revealed a parallel ridge pattern and an abrupt cutoff of pigmentation on the upper edge. Histologically lentiginous hyperplasia decorated by innocent melanocytes and scattered melanocytic proliferation with slight to moderate cytological atypia were seen. Atypical melanocytes were very scattered and it was insufficient to call it a melanoma in situ. A second finding was a microvascular proliferation located in the papillary dermis. There was no sign of regression such as fibrous tissue or host reaction. Atypical melanosis of the foot has rarely been reported in the published work, which are from Japan and Korea. This case is presented to emphasize the significance of this rare entity which has recently been reported to be a very early phase of acral melanoma.
SKINmed, 2008
Case 1: A 58-year-old man presented with a solitary asymptomatic nodule on his thumb (Figure A). ... more Case 1: A 58-year-old man presented with a solitary asymptomatic nodule on his thumb (Figure A). After trauma with a rusty nail approximately 20 years ago, he had developed a small papule, which had enlarged gradually for a few days initially before stabilizing. His personal and family medical histories were unremarkable. Dermatologic examination revealed a 1-cm crater-like nodule on the left palmar area. This was a firm and nontender lesion that was fixed to the overlying skin but moved freely from underlying structures. There were no similar lesions elsewhere on his body. Case 2: A 52-year-old man presented with a nodular lesion on the left palmar surface of his thumb. The 0.8-cm lesion was lightly colored, with a central cup-shaped epidermal depression and thin epidermis. The patient described an insect bite to the area 15 years earlier as the precipitating event. The firm and nontender lesion was fixed to the overlying skin but moved freely from underlying structures (Figure B). Case 3: A 36-year-old man consulted for a nodular lesion, located on his left palmar surface, that had not enlarged or changed since appearing 3 years ago. He described mechanical trauma to the area as precipitating the lesion. Clinical examination revealed a 0.6-cm, well-circumscribed nodule, with a dome shape and colored skin. Clinically, the nodular lesion appeared to be a benign tumor (Figure C). In each case, the nodule was excised totally and histopathologic examination revealed a well-circumscribed, nonencapsulated nodule within the mid-dermis. Thick, acellular collagen bundles were arranged randomly in short fascicles through the center of the lesion. Cellular areas consisting of histiocytes and fibroblasts with a storiform pattern at the periphery of lesion were observed, but nuclear atypia and mitotic activity were not. Results of immunohistochemical stain with CD34 were negative, but in all cases were strongly positive for Factor XIIIa. Slight epidermal hyperplasia was present with orthokeratotic hyperkeratosis and flattened rete ridges in the overlying epidermis (Figure A-1, Figure B-1, Figure C-1). The subcutaneous fat and adjacent skin were normal. No folliculosebaceous units at the periphery of the lesion were seen, but a few eccrine sweet glands were noted. No recurrence appeared in 18 months of follow-up.
Clinical and Experimental Dermatology, 2014
Background. Data on the dermoscopic features of fungal melanonychia are limited. Aim. To identify... more Background. Data on the dermoscopic features of fungal melanonychia are limited. Aim. To identify the dermoscopic features of fungal melanonychia. Methods. We reviewed patient files, clinical history and dermoscopic images of all cases with a diagnosis of fungal melanonychia seen at our dermoscopy unit within the past year. Results. In total, 14 cases with 20 involved nails were reviewed. The most common type of melanonychia was melanonychia striata (7/20). Multicoloured pigmentation was observed in 19 of the nails. The main dermoscopic pattern was homogeneous pigmentation; however, black pigmented aggregates, presenting as either coarse granules or pigmented clumps, accompanied this homogeneous pigmentation in 16 lesions. Matt black pigmentation, matt white pigmentation, yellow to brown pigmentation, black reverse triangle (wider at the distal than the proximal end), superficial transverse striation and blurred appearance were the other features. Conclusions. We have identified a number of dermoscopic features appearing in fungal melanonychia, which should help in diagnosis of this disease.
Journal of the European Academy of Dermatology and Venereology, 2011
Journal of the European Academy of Dermatology and Venereology, 2009
© 2008 The Authors JEADV 2009, 23 , 702–738 Journal compilation © 2008 European Academy of Dermat... more © 2008 The Authors JEADV 2009, 23 , 702–738 Journal compilation © 2008 European Academy of Dermatology and Venereology studies have shown that facial ACD occurred at younger ages, predominantly between 20 and 40 years of age. While the frequency of patch test allergens differed between the age groups and the sites of the skin involved, the most common allergen was nickel, irrespective of the age and the localization of the ACD, similar to the previous studies. 1 High prevalence of nickel sensitization in Turkey has been attributed to ear piercing during childhood. 4,5 The frequency of allergens identified in malar, periorbital and perioral ACD indicated a possible relationship with cosmetic products and were similar to those recently reported. 6–10 Periorbital region was the most common affected site in age groups 20–39 years and > 60 years, possibly related to more common use of cosmetic products to this area, which is also more sensitive than any other part of the face. The predominance of women also supported this possibility. On the other hand, some of the allergens were not specific for face and were probably carried by hand to the face (e.g. primin). Because of this, it is very difficult to prepare a specific list of allergens for face. As previously suggested, 9,10 screening standard allergens may be beneficial but not sufficient for most of the patients with facial ACD; therefore, testing to different groups of allergens is recommended for these patients. On the other hand, some of standard allergens showed very low rates of sensitization (< 1% of patients), which may question their presence in standard series for facial ACD. Preparing special trays for patients with face involvement may have value in accelerating the diagnosis, but our results indicated that this was almost impossible since facial ACD may occur by various routes.
Journal of the European Academy of Dermatology and Venereology, 2006
Journal of the European Academy of Dermatology and Venereology, 2007
Background Although phototherapeutic modalities are commonly used for the treatment of skin disea... more Background Although phototherapeutic modalities are commonly used for the treatment of skin diseases, the effects of therapeutic ultraviolet (UV) irradiation on the dermoscopic appearance of melanocytic naevi are unknown. Objectives We aimed to analyse the effects of photochemotherapy (psoralen plus ultraviolet A, PUVA) and narrow-band ultraviolet B phototherapy (NB-UVB) on the dermoscopic appearance of naevi. Patients and methods We monitored 187 melanocytic naevi of 38 patients receiving NB-UVB or PUVA treatment for miscellaneous skin diseases. Dermoscopic images of naevi were taken before, shortly after, and after a median of 31 weeks after the UV therapy. A random selection of naevi was covered during UV treatment, the others remained uncovered. Baseline and follow-up images of naevi were viewed side by side on a computer screen to compare size, pigmentation, and dermoscopic structure of naevi. Results Twenty-one patients received NB-UVB treatment, and 17 patients received PUVA treatment. Of 187 naevi, 70 (37%) were covered and 117 (63%) were uncovered during UV treatment. When NB-UVB-and PUVA-treated patients were analysed together, an increase in size of uncovered lesions was seen in both treatment groups. Pigmentation appeared darker at the end of UV treatment in 67.5% (n = 79) of uncovered naevi compared with 41.4% (n = 29) of covered naevi (P < 0.001). In patients receiving NB-UVB therapy, a significant increase in the number of dots or globules in 20.3% (n = 14) of uncovered naevi compared with only 5.0% (n = 2) of covered naevi (P = 0.03) was found. This effect was not observed after PUVA therapy. With the exception of four naevi with continuous enlargement and seven naevi with a persisting increase in dots and globules, the observed changes were reversible. All naevi with persistent changes belonged to the NB-UVB group. Conclusion In general, PUVA and NB-UVB therapy cause reversible dermoscopic changes in melanocytic naevi. Increase in dots and globules is more frequent with NB-UVB.
Journal of the European Academy of Dermatology and Venereology, 2009
© 2008 The Authors JEADV 2009, 23, 570–620 Journal compilation © 2008 European Academy of Dermato... more © 2008 The Authors JEADV 2009, 23, 570–620 Journal compilation © 2008 European Academy of Dermatology and Venereology further destruction, resulting in vitiligo progression or transformation into malignant melanoma. The primary immune mechanism for melanocyte injury remains obscure, but in vivo studies of vitiligo implicate both complement-dependent and antibody-dependent cellular toxicity. It is also under investigation whether patients with melanoma who develop vitiligo have a prognosis benefit, since activated T cells might destroy melanoma cells, as well as normal melanocytes. In those cases, humoral and cellular immunity to common antigens of melanocytes and melanoma cells are suspected to be responsible.2,5,6 According to these observations, we could consider the presence of vitiligo combined with naevus regression in our patient as an indication of lower risk for the development of melanoma within the congenital nevus. However, vitiliginous changes in patients with congenital melanocytic lesions demand further investigation in order to exclude melanoma-associated leukoderma.
Journal of the European Academy of Dermatology and Venereology, 2009
© 2008 The Authors JEADV 2009, 23, 570–620 Journal compilation © 2008 European Academy of Dermato... more © 2008 The Authors JEADV 2009, 23, 570–620 Journal compilation © 2008 European Academy of Dermatology and Venereology has been missed by this screen. However, a more likely explanation is that there are other genes involved in DC, particularly in the autosomal-recessive form of the disease, the identities of which remain unknown. A recent study showed that two thirds of the families included such as our patient did not have mutations in DKC1 and TERC genes.4 Cutaneous findings are the most consistent feature of DC. The degree of pigmentation increases with age and can involve the entire skin surface. Dermal pigmentation was reported in the cases with DC in the literature.5 We demonstrated hyperkeratinization in the dermis and basal pigmentation in the epidermis, but there was no dermal pigmentation in our case. Lack of dermal pigmentation is not inconsistent with DC, since the physical appearance can be highly variable. Our patient had unilateral renal agenesis. A patient with DC and horseshoe kidney was previously reported.6 Renal agenesis occurs in 1 of 1000 births; thus, it may be a coincidental finding. In this report, we present an atypical case with DC and unilateral renal agenesis from Turkey. Reporting cases with DC will highlight the mechanisms underlying a broad range of biological processes like ageing and many forms of cancer.
Journal of the American Academy of Dermatology, 2007
Background: Central white scarlike patch and a delicate pigment network at the periphery is the t... more Background: Central white scarlike patch and a delicate pigment network at the periphery is the typical appearance of dermatofibromas on dermoscopy. Objective: We aimed to analyze the different dermoscopic appearances of dermatofibromas. Methods: Fifty-two dermatofibromas with dermoscopic features different from the classic type, which were detected between May 2003 and July 2005, were evaluated. Results: Globules in the scarlike area (38.5%), linear/irregular crypts (26.9%), lentigo-like reticular pigmentation (23%), homogeneous blue-gray pigmentation (5.9%), and erythematous homogeneous area surrounding the white patch (3.8%) were the patterns observed. In addition, dermoscopic features of an atrophic variant of dermatofibroma are described, which was seen in one lesion (1.9%). Limitations: None. Conclusion: Dermatofibromas have various dermoscopic features. Among them, ''linear, irregular crypts'' is not unusual and is described in this study. Homogeneous bluish pigmentation on dermoscopy may be a possible clue for the diagnosis of hemosiderotic variants of dermatofibromas.
Journal of the American Academy of Dermatology, 2011
Turkiye Klinikleri Journal …, 2007
... Devamı... Journal of The American Academy of Dermatology Year: 2007 / Volume: 4 / No: 3. Derm... more ... Devamı... Journal of The American Academy of Dermatology Year: 2007 / Volume: 4 / No: 3. Dermatofibromların Farklı Dermoskopik Yönleri Dr. Isıl Kılınç Karaarslan, Dr. Gülsüm Gençoglan, Dr. Taner Akalın, ve Dr. Fezal Özdemir. ...
Clinical and Experimental Dermatology, 2010
Clinical and Experimental Dermatology, 2009
Eruptive disseminated Spitz naevi is a rarely reported condition. Although the dermatoscopic feat... more Eruptive disseminated Spitz naevi is a rarely reported condition. Although the dermatoscopic features of nondisseminated, solitary forms of Spitz naevi are well known, there are no reports describing the dermatoscopic features of eruptive disseminated variant. We report an additional case and describe the dermatoscopic features. Two patterns were observed. In all pink lesions, the vascular pattern was seen, composed of dotted, linear or comma-like vessels located at the centre of the meshes of the reticular depigmentation. In all brown lesions, we observed only the reticular pattern, which is quite interesting as the reticular pattern is a rare feature of Spitz naevi. This observation may be a special feature particularly seen in the eruptive disseminated variant. A superficial black network also accompanied reticular pattern in some lesions. In dichromatic lesions, both patterns were observed in different areas of the body.
Clinical and Experimental Dermatology, 2010
Australasian Journal of Dermatology, 2012
Background: Epidermolysis bullosa (EB) nevi are acquired pigmented melanocytic lesions which may ... more Background: Epidermolysis bullosa (EB) nevi are acquired pigmented melanocytic lesions which may have clinical and dermoscopic features quite similar to those found in melanoma. More detailed information on this phenomenon is still lacking. Objectives: To evaluate clinical, dermoscopic, and histopathological features of melanocytic lesions in 13 patients with dystrophic EB (DEB). Patients and Methods: Patients underwent clinical and dermoscopic evaluation. Suspicious lesions were excised and examined microscopically. Results: There were 12 cases of recessive DEB and one of dominant DEB. Five patients were men; 8 were women; the ages ranged from 2 to 27 years old. All patients had at least 2 atypical melanocytic lesions. Two of the 5 biopsied patients showed an atypical nevus or lentigo on histopathological examination. Conclusions: We observed a high incidence of large and atypical melanocytic lesions in DEB patients. Although the exact explanation for this is still unclear, it seems that re-epithelization and the chronic inflammatory process may stimulate the proliferation of melanocytes, as well as the emergence of lesions with atypical clinical and dermoscopic features. As an unequivocal discrimination from malignant melanoma in vivo is not always possible, regular clinical follow-up and histopathological evaluation of suspicious lesions in EB patients are mandatory.
Journal of the European Academy of Dermatology and Venereology
Dermatologica Sinica, 2018
Background: Basal cell carcinoma (BCC) is the most frequent of all skin cancers in the white popu... more Background: Basal cell carcinoma (BCC) is the most frequent of all skin cancers in the white population. The typical dermoscopic features of pigmented BCCs have been well known. In the literature a new dermoscopic pattern of BCC has been reported as "blue-white variant". Objective: In this study, we aimed to evaluate the blue-white variant of BCC's seen in our cases at our Dermato-oncology Unit. Methods: Patient files between the years 2003e2011 were searched for the cases with the histopathologic diagnosis of BCC. Among them, the cases that were compatible with the diagnosis of blue-white variant of BCC were determined. The morphological and clinical features of the lesions, dermoscopic images together with the histopathological slides were all evaluated. Results: Among 350 histopathologically proven BCCs, 3.1% of them showed diffuse blue-white areas, namely "the blue-white variant". On histopathological examination, typical aggregates of basaloid cells with nuclear atypia connected focally to the epidermis were observed. To our knowledge, this is the first research about the blue-white variant of pigmented BCC. Conclusion: The blue-white variant of pigmented BCC seems to be the most challenging type of BCC in the diagnosis for the clinician.
Dermatology (Basel, Switzerland), Jan 26, 2015
Nodular hidradenoma is an uncommon, benign, adnexal neoplasm of apocrine origin which is a clinic... more Nodular hidradenoma is an uncommon, benign, adnexal neoplasm of apocrine origin which is a clinical simulator of other tumours. The aim of this study was to evaluate the morphological findings of a large series of nodular hidradenomas under dermoscopic observation. Dermoscopic examination of 28 cases of nodular hidradenomas was performed to evaluate specific dermoscopic criteria and patterns. The most frequently occurring dermoscopic features were: (1) in 96.4% of cases, a homogeneous area that covered the lesion partially or totally, the colour of which was pinkish in 46.4% of cases, bluish in 28.6%, red-blue in 14.3%, and brownish in 10.7%; (2) white structures were found in 89.3% of cases; (3) in 82.1% of cases, vascular structures were also observed, especially arborising telangiectasias (39.3%) and polymorphous atypical vessels (28.6%). Nodular hidradenomas represent a dermoscopic pitfall, being difficult to differentiate clinically and dermoscopically from basal cell carcinoma...
The Journal of Dermatology, 2007
A 62-year-old male Turkish patient had a pigmented lesion on the sole with a 10-year history. It ... more A 62-year-old male Turkish patient had a pigmented lesion on the sole with a 10-year history. It was an asymmetrical macular lesion with an irregular border and irregular brown pigmentation and had a diameter of 1.2 cm × 1.7 cm. Dermoscopy revealed a parallel ridge pattern and an abrupt cutoff of pigmentation on the upper edge. Histologically lentiginous hyperplasia decorated by innocent melanocytes and scattered melanocytic proliferation with slight to moderate cytological atypia were seen. Atypical melanocytes were very scattered and it was insufficient to call it a melanoma in situ. A second finding was a microvascular proliferation located in the papillary dermis. There was no sign of regression such as fibrous tissue or host reaction. Atypical melanosis of the foot has rarely been reported in the published work, which are from Japan and Korea. This case is presented to emphasize the significance of this rare entity which has recently been reported to be a very early phase of acral melanoma.
SKINmed, 2008
Case 1: A 58-year-old man presented with a solitary asymptomatic nodule on his thumb (Figure A). ... more Case 1: A 58-year-old man presented with a solitary asymptomatic nodule on his thumb (Figure A). After trauma with a rusty nail approximately 20 years ago, he had developed a small papule, which had enlarged gradually for a few days initially before stabilizing. His personal and family medical histories were unremarkable. Dermatologic examination revealed a 1-cm crater-like nodule on the left palmar area. This was a firm and nontender lesion that was fixed to the overlying skin but moved freely from underlying structures. There were no similar lesions elsewhere on his body. Case 2: A 52-year-old man presented with a nodular lesion on the left palmar surface of his thumb. The 0.8-cm lesion was lightly colored, with a central cup-shaped epidermal depression and thin epidermis. The patient described an insect bite to the area 15 years earlier as the precipitating event. The firm and nontender lesion was fixed to the overlying skin but moved freely from underlying structures (Figure B). Case 3: A 36-year-old man consulted for a nodular lesion, located on his left palmar surface, that had not enlarged or changed since appearing 3 years ago. He described mechanical trauma to the area as precipitating the lesion. Clinical examination revealed a 0.6-cm, well-circumscribed nodule, with a dome shape and colored skin. Clinically, the nodular lesion appeared to be a benign tumor (Figure C). In each case, the nodule was excised totally and histopathologic examination revealed a well-circumscribed, nonencapsulated nodule within the mid-dermis. Thick, acellular collagen bundles were arranged randomly in short fascicles through the center of the lesion. Cellular areas consisting of histiocytes and fibroblasts with a storiform pattern at the periphery of lesion were observed, but nuclear atypia and mitotic activity were not. Results of immunohistochemical stain with CD34 were negative, but in all cases were strongly positive for Factor XIIIa. Slight epidermal hyperplasia was present with orthokeratotic hyperkeratosis and flattened rete ridges in the overlying epidermis (Figure A-1, Figure B-1, Figure C-1). The subcutaneous fat and adjacent skin were normal. No folliculosebaceous units at the periphery of the lesion were seen, but a few eccrine sweet glands were noted. No recurrence appeared in 18 months of follow-up.
Clinical and Experimental Dermatology, 2014
Background. Data on the dermoscopic features of fungal melanonychia are limited. Aim. To identify... more Background. Data on the dermoscopic features of fungal melanonychia are limited. Aim. To identify the dermoscopic features of fungal melanonychia. Methods. We reviewed patient files, clinical history and dermoscopic images of all cases with a diagnosis of fungal melanonychia seen at our dermoscopy unit within the past year. Results. In total, 14 cases with 20 involved nails were reviewed. The most common type of melanonychia was melanonychia striata (7/20). Multicoloured pigmentation was observed in 19 of the nails. The main dermoscopic pattern was homogeneous pigmentation; however, black pigmented aggregates, presenting as either coarse granules or pigmented clumps, accompanied this homogeneous pigmentation in 16 lesions. Matt black pigmentation, matt white pigmentation, yellow to brown pigmentation, black reverse triangle (wider at the distal than the proximal end), superficial transverse striation and blurred appearance were the other features. Conclusions. We have identified a number of dermoscopic features appearing in fungal melanonychia, which should help in diagnosis of this disease.
Journal of the European Academy of Dermatology and Venereology, 2011
Journal of the European Academy of Dermatology and Venereology, 2009
© 2008 The Authors JEADV 2009, 23 , 702–738 Journal compilation © 2008 European Academy of Dermat... more © 2008 The Authors JEADV 2009, 23 , 702–738 Journal compilation © 2008 European Academy of Dermatology and Venereology studies have shown that facial ACD occurred at younger ages, predominantly between 20 and 40 years of age. While the frequency of patch test allergens differed between the age groups and the sites of the skin involved, the most common allergen was nickel, irrespective of the age and the localization of the ACD, similar to the previous studies. 1 High prevalence of nickel sensitization in Turkey has been attributed to ear piercing during childhood. 4,5 The frequency of allergens identified in malar, periorbital and perioral ACD indicated a possible relationship with cosmetic products and were similar to those recently reported. 6–10 Periorbital region was the most common affected site in age groups 20–39 years and > 60 years, possibly related to more common use of cosmetic products to this area, which is also more sensitive than any other part of the face. The predominance of women also supported this possibility. On the other hand, some of the allergens were not specific for face and were probably carried by hand to the face (e.g. primin). Because of this, it is very difficult to prepare a specific list of allergens for face. As previously suggested, 9,10 screening standard allergens may be beneficial but not sufficient for most of the patients with facial ACD; therefore, testing to different groups of allergens is recommended for these patients. On the other hand, some of standard allergens showed very low rates of sensitization (< 1% of patients), which may question their presence in standard series for facial ACD. Preparing special trays for patients with face involvement may have value in accelerating the diagnosis, but our results indicated that this was almost impossible since facial ACD may occur by various routes.
Journal of the European Academy of Dermatology and Venereology, 2006
Journal of the European Academy of Dermatology and Venereology, 2007
Background Although phototherapeutic modalities are commonly used for the treatment of skin disea... more Background Although phototherapeutic modalities are commonly used for the treatment of skin diseases, the effects of therapeutic ultraviolet (UV) irradiation on the dermoscopic appearance of melanocytic naevi are unknown. Objectives We aimed to analyse the effects of photochemotherapy (psoralen plus ultraviolet A, PUVA) and narrow-band ultraviolet B phototherapy (NB-UVB) on the dermoscopic appearance of naevi. Patients and methods We monitored 187 melanocytic naevi of 38 patients receiving NB-UVB or PUVA treatment for miscellaneous skin diseases. Dermoscopic images of naevi were taken before, shortly after, and after a median of 31 weeks after the UV therapy. A random selection of naevi was covered during UV treatment, the others remained uncovered. Baseline and follow-up images of naevi were viewed side by side on a computer screen to compare size, pigmentation, and dermoscopic structure of naevi. Results Twenty-one patients received NB-UVB treatment, and 17 patients received PUVA treatment. Of 187 naevi, 70 (37%) were covered and 117 (63%) were uncovered during UV treatment. When NB-UVB-and PUVA-treated patients were analysed together, an increase in size of uncovered lesions was seen in both treatment groups. Pigmentation appeared darker at the end of UV treatment in 67.5% (n = 79) of uncovered naevi compared with 41.4% (n = 29) of covered naevi (P < 0.001). In patients receiving NB-UVB therapy, a significant increase in the number of dots or globules in 20.3% (n = 14) of uncovered naevi compared with only 5.0% (n = 2) of covered naevi (P = 0.03) was found. This effect was not observed after PUVA therapy. With the exception of four naevi with continuous enlargement and seven naevi with a persisting increase in dots and globules, the observed changes were reversible. All naevi with persistent changes belonged to the NB-UVB group. Conclusion In general, PUVA and NB-UVB therapy cause reversible dermoscopic changes in melanocytic naevi. Increase in dots and globules is more frequent with NB-UVB.
Journal of the European Academy of Dermatology and Venereology, 2009
© 2008 The Authors JEADV 2009, 23, 570–620 Journal compilation © 2008 European Academy of Dermato... more © 2008 The Authors JEADV 2009, 23, 570–620 Journal compilation © 2008 European Academy of Dermatology and Venereology further destruction, resulting in vitiligo progression or transformation into malignant melanoma. The primary immune mechanism for melanocyte injury remains obscure, but in vivo studies of vitiligo implicate both complement-dependent and antibody-dependent cellular toxicity. It is also under investigation whether patients with melanoma who develop vitiligo have a prognosis benefit, since activated T cells might destroy melanoma cells, as well as normal melanocytes. In those cases, humoral and cellular immunity to common antigens of melanocytes and melanoma cells are suspected to be responsible.2,5,6 According to these observations, we could consider the presence of vitiligo combined with naevus regression in our patient as an indication of lower risk for the development of melanoma within the congenital nevus. However, vitiliginous changes in patients with congenital melanocytic lesions demand further investigation in order to exclude melanoma-associated leukoderma.
Journal of the European Academy of Dermatology and Venereology, 2009
© 2008 The Authors JEADV 2009, 23, 570–620 Journal compilation © 2008 European Academy of Dermato... more © 2008 The Authors JEADV 2009, 23, 570–620 Journal compilation © 2008 European Academy of Dermatology and Venereology has been missed by this screen. However, a more likely explanation is that there are other genes involved in DC, particularly in the autosomal-recessive form of the disease, the identities of which remain unknown. A recent study showed that two thirds of the families included such as our patient did not have mutations in DKC1 and TERC genes.4 Cutaneous findings are the most consistent feature of DC. The degree of pigmentation increases with age and can involve the entire skin surface. Dermal pigmentation was reported in the cases with DC in the literature.5 We demonstrated hyperkeratinization in the dermis and basal pigmentation in the epidermis, but there was no dermal pigmentation in our case. Lack of dermal pigmentation is not inconsistent with DC, since the physical appearance can be highly variable. Our patient had unilateral renal agenesis. A patient with DC and horseshoe kidney was previously reported.6 Renal agenesis occurs in 1 of 1000 births; thus, it may be a coincidental finding. In this report, we present an atypical case with DC and unilateral renal agenesis from Turkey. Reporting cases with DC will highlight the mechanisms underlying a broad range of biological processes like ageing and many forms of cancer.
Journal of the American Academy of Dermatology, 2007
Background: Central white scarlike patch and a delicate pigment network at the periphery is the t... more Background: Central white scarlike patch and a delicate pigment network at the periphery is the typical appearance of dermatofibromas on dermoscopy. Objective: We aimed to analyze the different dermoscopic appearances of dermatofibromas. Methods: Fifty-two dermatofibromas with dermoscopic features different from the classic type, which were detected between May 2003 and July 2005, were evaluated. Results: Globules in the scarlike area (38.5%), linear/irregular crypts (26.9%), lentigo-like reticular pigmentation (23%), homogeneous blue-gray pigmentation (5.9%), and erythematous homogeneous area surrounding the white patch (3.8%) were the patterns observed. In addition, dermoscopic features of an atrophic variant of dermatofibroma are described, which was seen in one lesion (1.9%). Limitations: None. Conclusion: Dermatofibromas have various dermoscopic features. Among them, ''linear, irregular crypts'' is not unusual and is described in this study. Homogeneous bluish pigmentation on dermoscopy may be a possible clue for the diagnosis of hemosiderotic variants of dermatofibromas.
Journal of the American Academy of Dermatology, 2011
Turkiye Klinikleri Journal …, 2007
... Devamı... Journal of The American Academy of Dermatology Year: 2007 / Volume: 4 / No: 3. Derm... more ... Devamı... Journal of The American Academy of Dermatology Year: 2007 / Volume: 4 / No: 3. Dermatofibromların Farklı Dermoskopik Yönleri Dr. Isıl Kılınç Karaarslan, Dr. Gülsüm Gençoglan, Dr. Taner Akalın, ve Dr. Fezal Özdemir. ...
Clinical and Experimental Dermatology, 2010
Clinical and Experimental Dermatology, 2009
Eruptive disseminated Spitz naevi is a rarely reported condition. Although the dermatoscopic feat... more Eruptive disseminated Spitz naevi is a rarely reported condition. Although the dermatoscopic features of nondisseminated, solitary forms of Spitz naevi are well known, there are no reports describing the dermatoscopic features of eruptive disseminated variant. We report an additional case and describe the dermatoscopic features. Two patterns were observed. In all pink lesions, the vascular pattern was seen, composed of dotted, linear or comma-like vessels located at the centre of the meshes of the reticular depigmentation. In all brown lesions, we observed only the reticular pattern, which is quite interesting as the reticular pattern is a rare feature of Spitz naevi. This observation may be a special feature particularly seen in the eruptive disseminated variant. A superficial black network also accompanied reticular pattern in some lesions. In dichromatic lesions, both patterns were observed in different areas of the body.
Clinical and Experimental Dermatology, 2010
Australasian Journal of Dermatology, 2012
Background: Epidermolysis bullosa (EB) nevi are acquired pigmented melanocytic lesions which may ... more Background: Epidermolysis bullosa (EB) nevi are acquired pigmented melanocytic lesions which may have clinical and dermoscopic features quite similar to those found in melanoma. More detailed information on this phenomenon is still lacking. Objectives: To evaluate clinical, dermoscopic, and histopathological features of melanocytic lesions in 13 patients with dystrophic EB (DEB). Patients and Methods: Patients underwent clinical and dermoscopic evaluation. Suspicious lesions were excised and examined microscopically. Results: There were 12 cases of recessive DEB and one of dominant DEB. Five patients were men; 8 were women; the ages ranged from 2 to 27 years old. All patients had at least 2 atypical melanocytic lesions. Two of the 5 biopsied patients showed an atypical nevus or lentigo on histopathological examination. Conclusions: We observed a high incidence of large and atypical melanocytic lesions in DEB patients. Although the exact explanation for this is still unclear, it seems that re-epithelization and the chronic inflammatory process may stimulate the proliferation of melanocytes, as well as the emergence of lesions with atypical clinical and dermoscopic features. As an unequivocal discrimination from malignant melanoma in vivo is not always possible, regular clinical follow-up and histopathological evaluation of suspicious lesions in EB patients are mandatory.