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   2015| July-December  | Volume 35 | Issue 2  
    Online since March 10, 2016

 
 
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ORIGINAL ARTICLES
Risks for metabolic syndrome and cardiovascular diseases in both male and female patients with androgenetic alopecia
Naglaa Agamia
July-December 2015, 35(2):49-55
DOI:10.4103/1110-6530.178459  
Background Androgenetic alopecia (AGA) is a nonscarring progressive miniaturization of the hair follicle with a usually characteristic pattern of distribution in genetically predisposed men and women. Although several previous studies have investigated the association of metabolic syndrome (MS) and cardiovascular risks with AGA, the results have been inconsistent. Aim We attempted to evaluate the possible association between MS and cardiovascular risks with AGA in both male and female patients. This may help to detect whether AGA can be considered as a clue for underlying serious systemic diseases. Patients and methods A total of 50 patients (38 male and 12 female) and 50 normal sex-matched and age-matched controls were included. Anthropometric measures, blood pressure, fasting glucose, high-density lipoprotein cholesterol, triglycerides, testosterone, sex hormone binding globulin, and serum insulin levels were evaluated. Acute phase reactants (C-reactive protein, fibrinogen, and erythrocyte sedimentation rate) were measured for all participants. The presence of MS, insulin resistance, and cardiovascular risk factors were evaluated. Results There were statistically significant differences with regard to the mean values of waist circumference, BMI, systolic blood pressure, fasting blood sugar, fibrinogen, and Homeostasis Model Assessment of Insulin Resistance in both male and female patients. In contrast, triglycerides, cholesterol, MS, erythrocyte sedimentation rate, and sex hormone binding globulin were significantly elevated in male patients only in relation to their sex-matched controls. Conclusion Patients of both sexes with AGA are more susceptible to have cardiovascular diseases in future compared with people who do not have AGA.
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CASE REPORT
Phocomelia: case report of a rare congenital disorder
Ishrat H Dar, Mohammed I Dar, Omar Farooq, Samia R Mir
July-December 2015, 35(2):82-84
DOI:10.4103/1110-6530.162227  
Phocomelia is an extremely rare malformation in which babies are born with limbs that appear similar to the flippers of a seal. Although various factors can cause phocomelia, the prominent roots came from the use of thalidomide and from genetic inheritance. Phocomelia is transmitted as an autosomal recessive trait with variable expressivity, and malformation is linked to chromosome 8. Presented here is the incidental detection of phocomelia in a young man with no history of thalidomide intake and for whom evaluation of other family members/siblings failed to reveal any substantial abnormality, making it a probable case of sporadic mutation-induced phocomelia.
  5,309 272 -
ORIGINAL ARTICLES
Cryoglobulinemia presenting as digital gangrene with underlying malignancy
Mansoor C Abdulla, Jemshad Alungal
July-December 2015, 35(2):56-58
DOI:10.4103/1110-6530.178460  
A 55-year-old man presented with multiple joint pains, low-grade fever for 6 months, and blackish discoloration over both feet, which aggravated on exposure to cold, for 2 months. On examination, he was found to have multiple digital gangrene of the lower extremities. On evaluation, he was diagnosed to have multiple myeloma with type 1 cryoglobulinemia. The case is reported to remind the readers to be aware of an underlying plasma cell disease in patients presenting with digital gangrene due to type 1 cryoglobulinemia, which if treated early has good prognosis.
  1,541 1,264 -
Role of dermatoscope in diagnosing and differentiating different types of seborrheic keratoses
Amira A Abdel-Azim, Nagla A Ahmed, Gamal El-Din A Hamid, Nora T Abdel Moaty
July-December 2015, 35(2):75-81
DOI:10.4103/1110-6530.178474  
Background Seborrheic keratosis (SK) is the most common benign skin tumour to be misdiagnosed clinically as melanoma. SK may grow rapidly, is dark coloured with black areas and is accompanied with itching. Thus, it is difficult to distinguish it from malignant melanoma on clinical basis. Dermatoscope is a simple noninvasive tool useful for the early recognition of pigmented skin tumours, especially SK, melanoma and pigmented basal cell carcinoma, as it helps in differentiating each of them by specific criteria. In case a doubt about the diagnosis persists, biopsy is carried out for confirmation. Aim of the work The aim of the present study was to determine the role of dermatoscope in diagnosing and differentiating different types of SK, and its ability to detect suspicious lesions and confirm diagnosis by using histopathology. Patients and methods This study was carried out on 50 SK patients; out of them nine had suspicious lesions. All patients were subjected to dermatological, dermoscopic and histopathological examinations for suspicious lesions. Results In our study, the most common dermoscopic findings for different types of SK (stucco, dermatosis papulosa nigra, melanoacanthoma, flat type) were sharp demarcated border, comedo-like openings, milia-like cysts, moth-eaten borders and cribriform pattern. In addition, hairpin blood vessels and fat finger appeared in flat type SK. In our study, the dermoscopic criteria of suspicious lesions (n = 9, 18%) was diagnostic by 22.2% to tumour, as it showed structureless area and blue gray clods (n = 1, 11.1%); structureless area, yellow clods and blue gray clods (n = 1, 11.1%); and sharp demarcated borders, comedo-like openings, moth-eaten borders, milia-like cysts and fissures and ridges (n = 7, 77.8%). Overall, 22.2% of the biopsied cases were basal cell carcinoma and 77.8% were SK. Conclusion SK must be taken seriously with close follow-up by using dermoscopy to detect any malignant changes.
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Assessment of serum homocysteine level in patients with nonsegmental vitiligo
Ashraf M Hamza, Carmen I Farid, Eman T El-sayed, Heba AR Kadeeb
July-December 2015, 35(2):59-64
DOI:10.4103/1110-6530.178461  
Aim To evaluate the serum level of homocysteine in non-segmental vitiligo cases compared to controls and its relation to the progression of the disease. Subjects and methods Serum Hcy levels were assessed in 40 patients diagnosed with non-segmental vitiligo (active and stable) in comparison to 40 age and sex matched healthy controls, using enzyme immunoassay technique (EIA). Relation to disease clinical phenotype, extent, severity and progression was assessed. Results An insignificantly higher level of serum homocysteine was detectable in vitiligo patients compared to controls. Patients with progressive disease had significantly higher levels than those with stable course. No significant relation was found to clinical phenotype, extent or clinical severity of the disease. Conclusion Hyperhomocysteinemia cannot be considered as a risk factor for development of non-segmental vitiligo, but it contributes to its activity and progression. It is not related to disease clinical phenotype, extent or severity.
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The evaluation of saphenofemoral insufficiency in primary adult varicocele
Mohamed A Sallam, Mohamed Khalil, Mahmoud A Abdallah
July-December 2015, 35(2):65-68
DOI:10.4103/1110-6530.178463  
Purpose The aim of this study was to evaluate the possible relationship between varicocele and saphenofemoral insufficiency in patients diagnosed with primary varicocele. Patients and methods A total of 40 patients with the primary diagnosis of varicocele were included in the study. A total of 40 age-matched healthy adults were also included in the study as a control group. Varicocele was diagnosed by means of palpation and observation of each spermatic cord in standing position before and during a Valsalva maneuver. In addition, scrotal Doppler and lower extremity venous Doppler ultrasonography (US) were performed. Patients who had spermatic varicose vein larger than 3.0 mm were included in the study group as a varicocele patient. At the lower extremity venous Doppler US, a retrograde flow lasting longer than 0.5 s during normal breathing or at the Valsalva maneuver was considered to be indicative of saphenofemoral junction (SFJ) insufficiency. Results Twenty-five (62.5%) patients had SFJ insufficiency in the study group, whereas 11 patients (27.5%) had insufficiency in the control group. Of the 40 study participants, 10 participants had recurrent varicocele. All of them were seen to have SFJ reflux on Doppler US (100%) (P = 0.014). The patients with primary varicocele had a statistically significantly (P = 0.02) higher rate of venous insufficiency in their SFJs when compared with the control group. Conclusion The results of the present study show that the incidence of SFJ reflux increases in individuals with varicocele, with a higher incidence in cases of recurrent varicocele. Depending on the common presence of valvular insufficiency, we believe that the presence of varicocele should be investigated in the young population suffering from SFJ insufficiency.
  1,871 175 -
Estimation of the serum level of a proliferation-inducing ligand in patients with psoriasis and lichen planus
Amal A El-Ashmawy, Manal M El-Batch
July-December 2015, 35(2):69-74
DOI:10.4103/1110-6530.178465  
Background A proliferation-inducing ligand (APRIL) is a new member of the tumor-necrosis factor superfamily. Elevated serum APRIL level has been found in some autoimmune diseases. APRIL costimulates B cells in vitro and in vivo. In addition, APRIL also has an important role in T-cell activation and survival. Objective The aim of the present study was to determine the serum level of APRIL in patients with psoriasis and lichen planus (LP) to evaluate its role in the pathogenesis of both diseases. Patients and methods This study included 40 patients with psoriasis (group II), 40 patients with LP (group III), and 20 healthy individuals who served as controls (group I). Serum samples were taken from all patients and controls for the detection of serum APRIL level by using the enzyme-linked immunosorbent assay. Results A significant increase was found in the mean serum APRIL level in patients with psoriasis and LP when compared with controls. Serum APRIL level was significantly correlated with severity of psoriasis, as determined by the psoriasis area and severity index score. Conclusion APRIL could be implicated as an important cytokine in the pathogenesis of psoriasis and LP. APRIL could be used as a useful marker for assessing psoriasis severity and open the way for further therapeutic approaches for both diseases.
  1,179 125 -
ERRATUM
Erratum: Oral manifestations of patients with leprosy: A disease, actually infectious but not always, still a stigma in society
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July-December 2015, 35(2):85-85
DOI:10.4103/1110-6530.178475  
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