Salmon Patch Research Articles

Clinical Correlation Between Alopecia Areata and Salmon Patches: A Case Series

Alopecia areata (AA) has different clinical types moreover its severity can be predicted by the extra-follicular involvement such as nails, eyes, and salmon patch (SP) on the nape of the neck. As provided by previous authors the aim of this study was to determine whether the presence of a salmon patch on the midline of the nape of the neck and whether its size is related to the recurrence of AA after treatment withdrawal and a more severe prognosis. We report a case series of 24 patients with recurrent AA having congenital SP from March 2022 to April 2023 at Tripoli Central Hospital (TCH) and in a private clinic. We found that the majority of the cases were diagnosed with recurrent AA ophiasis (AAO) (n= 11, 45.8%) of which Ten (91%) of them were females and that can be interpreted as an indication of severity since AAO carries the risk of the worst prognosis. The other cases were AA Universalis (n=9, 37.5%), AA Totalis (n=2, 8.3%), and multiple patches AA (n=1, 4.2%). and 11 (45.8%) patients demonstrated large SP and Ten (41.7%) had a small SP. In some cases of SP areas, hair growth was noticed after the treatment. As an alternative in other cases, the areas of SP didn’t show hair growth compared to the other sites.

What Is Nevus Simplex?

Nevus simplex, also called a "salmon patch" or "stork bite," is a special mark that some babies are born with. It is very common and doesn't hurt.

BG09 RASA1 exon deletion in a neonate with vascular malformations

Abstract A full-term infant was noted to have a large, macular, pale-pink vascular birthmark across the left side of the chest, extending to the upper arm. Three smaller pale-pink irregular birthmarks on the elbow, thigh and flank were noted, as was an enlarged left upper arm. He had an oxygen dependency shortly after birth for which he required admission to the neonatal unit. A detailed history revealed that his father, paternal grandmother and aunt had similar birthmarks. His paternal aunt had an episode of bleeding from a spinal arteriovenous malformation (AVM) in her teens, which had been investigated with genetic testing by Sanger sequencing, but this did not identify a variant in RASA1. Following involvement from the dermatology, neonatology, genetics and radiology teams, investigations were organized. Findings included a high-flow vascular malformation with arteriovenous shunting on magnetic resonance imaging (MRI) of the left arm, normal MRI head and spine, and normal cardiac anatomy. Genetic testing by next-generation sequencing detected a heterozygous exon 21–23 deletion in RASA1. A diagnosis of capillary malformation–AVM syndrome (CM–AVM) was confirmed. Results of genetic testing of the father are awaited. Referral to a tertiary centre for consideration of management of AVM is underway. CM–AVM is a rare autosomal dominant condition. Pathogenic variants in RASA1 result in a lack of functional p120-RasGAP protein, which leads to abnormalities in angiogenesis, although this pathway is not well understood (Wooderchak-Donahue W, Johnson P, McDonald J et al. Expanding the clinical and molecular findings in RASA1 capillary malformation-arteriovenous malformation. Eur J Hum Genet 2018; 26:1521–36). Cutaneous vascular malformations, classically pink–red with a pale halo, are the most consistent cutaneous manifestation, but they may be subtle and can mimic other vascular birthmarks such as segmental infantile haemangioma, salmon patches or port wine stain. In our patient, pale halos were not apparent until 4 months of age. Identification is important as life-threatening complications from cutaneous vascular arteriovenous fistulas can occur (Wooderchak-Donahue et al.). This case highlights the importance of clarifying a family history, classifying vascular birthmarks and working with the multidisciplinary team. Genetic testing should be considered, even with previous negative analysis, as test sensitivity has improved and will now include analysis of EPHB4, which has also been associated with CM–AVM.

What the skin of 341 premature newborns says - a transversal study

ObjectivesDetermine the frequency of dermatological diagnoses in preterm newborns up to 28 days of life and associated perinatal factors. Methoda cross-sectional analytical study with a convenience sample and prospective data collection, was conducted between November 2017 and August 2019. Overall, 341 preterm newborns who had been admitted to a University hospital – including those admitted to the Neonatal Intensive Care Unit – were evaluated. Results61 (17.9%) had less than 32 weeks gestational age (GA), with a mean GA and birth weight of 33.9 ± 2.8 weeks and 2107.8 ± 679.8g (465 to 4230g), respectively. The median age at the time of evaluation was 2.9 days (4 h to 27 days). The frequency of dermatological diagnoses was 100% and 98.5% of the sample had two or more, with an average of 4.67+1.53 dermatoses for each newborn. The 10 most frequent diagnoses were lanugo (85.9%), salmon patch (72.4%), sebaceous hyperplasia (68.6%), physiological desquamation (54.8%), dermal melanocytosis (38.7%), Epstein pearls (37.2%), milia (32.2%), traumatic skin lesions (24%), toxic erythema (16.7%), and contact dermatitis (5%). Those with GA< 28 weeks showed more traumatic injuries and abrasions, whereas those with ≥ 28 weeks had physiological changes more frequently, and those with GA between 34-366/7 weeks, had transient changes. ConclusionDermatological diagnoses were frequent in our sample and those with higher GA showed a higher frequency of physiological (lanugo and salmon patch) and transient changes (toxic erythema and miliaria). Traumatic lesions and contact dermatitis were among the 10 most frequent injuries, reinforcing the need to effectively implement neonatal skin care protocols, especially in preterm.

Nevus Simplex

ABSTRACT Nevus simplex, or salmon patch, is a benign vascular malformation seen in 30%–40% of infants. Most lesions are self-limiting, resolving spontaneously between the ages of 1 and 2 years. The most affected areas of the skin are the occiput and posterior neck; however, facial, scalp, and sacral involvement can also be seen. A nevus simplex must be differentiated from a port wine stain, as port wine stains are persistent and can be associated with genetic syndromes. Although sacral lesions can be common in nevus simplex complex, when associated with a second lumbosacral anomaly, further evaluation for underlying spinal dysraphism should be considered.

Epidemiological study of capillary malformation among 7299 infants under 1 year of age in China.

Capillary malformation (CM) is the most common vascular malformation. Large scale studies on its incidence and risk factors are limited in China. Our study aimed to investigate the incidence of CM in Chinese infants and to evaluate its potential risk factors. A cross-sectional study, including 7299 infants (aged < 1year) were collected by a self-administered questionnaire. Independent-samples T tests or χ2 tests and multivariable logistic models were used to examine the potential risk factors for CM. The incidences of salmon patches and port-wine stains (PWSs) were 9.10% and 0.80%, respectively. In analyses, male sex (OR: 1.32, 95% CI: 1.12-1.55) and birth hypoxia (OR: 5.61, 95% CI: 4.39-7.16) were risk factors for salmon patches. Birth hypoxia (OR: 12.58, 95% CI: 7.26-21.79) and pregnancy-induced hypertension syndrome (PIH; OR: 3.66, 95% CI: 1.49-8.99) were associated with a higher risk of PWSs. This epidemiological study had the largest sample size of infants with CM in the world thus far, which updated its incidence in Chinese infants and found the potential risk factors for CM.

Mucosal associated Lymphoid Tissue Lymphoma of the uvea: an analysis of 3 cases

BackgroundOcular mucosa-associated lymphoid tissue (MALT) lymphoma involving orbit and conjunctiva usually has an indolent clinical course with “salmon patch” mass as typical presentation. This study is to report a series of rare cases and investigate the clinical and pathological features of ocular MALT lymphoma that involved uveal tissue primarily and presented as posterior scleritis.MethodsThis retrospective, observational study was conducted at Beijing Tongren Hospital. From 2018 to 2020, 3 cases of 3 eyes (2 female patients and 1 male patient) with ocular MALT lymphoma that involved uveal tissue primarily and presented as posterior scleritis were included in the study. All patients had complaints of red eyes with blurred vision. The average age was 56.33 ± 2.08 years old and the average time from initial diagnosis to pathological diagnosis was 3.00 ± 1.73 months. Ophthalmic examinations including best-corrected visual acuity (BCVA), intraocular pressure (IOP), slit lamp microscope examinations, fundus photography, B-scan ultrasonography, ultrasound biomicroscope (UBM), optical coherence tomography (OCT), fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were conducted. Systemic workups including orbital magnetic resonance imaging (MRI), positron emission tomography-computed tomography (PET-CT) and blood autoimmune antibody tests were also conducted. Pathological tissue from patients were obtained through surgeries. Biopsy examinations were performed to accurately determine pathological diagnosis. All the information of clinical, imaging and pathological changes were collected and analyzed.ResultsAt the initial diagnosis, the BCVA of involved eyes decreased seriously while the IOP were normal. All involved eyeball showed extensive hyperemia and local thickening in the wall of eyeballs. B-scan ultrasonography showed mass with abundant blood and irregular cysts inside the eyeball wall and in the retrobulbar orbit, surrounding the ocular wall and optic nerve. UBM showed solid lesions with low and medium echo under the conjunctiva and inside the ciliary body of 2 cases. OCT showed posterior polar wavy rise of RPE and local neuroepithelial detachment in all cases. FFA and ICGA showed vascular abnormalities (patch-like strong fluorescence and fluorescence leakage) and local thickening in retina and choroid (Rectangle-like weak fluorescence below the macula). The posterior wall of the eyeball was thickened and enhanced in MRI. PET-CT also showed thickening of posterior wall of eyeballs and increased metabolic activity but there was no sign of autoimmune disease. All patients were diagnosed as MALT lymphoma through pathologic examinations of biopsy tissue.ConclusionsThe onset of primary ocular MALT lymphoma in uvea is hidden. The early clinical manifestations are lack of specificity and misleading. B-scan ultrasonography has characteristic manifestations and is valuable in diagnosis. However, pathological diagnosis through tissue biopsy is irreplaceable.

Orbital Lymphoma: Clinical Features and Management at Dr. M. Djamil General Hospital in 2018

Background: Orbital lymphoma is found in 50-60% of ocular adnexal lymphomas, with approximately 90% of orbital lymphomas being Non-Hodgkin's lymphomas. Clinical features may include proptosis, ptosis, limitation of eye movement, and salmon patch lesions on the conjunctiva. If an orbital tumor is present, an accurate histopathological examination is important in the management of orbital lymphoma. Because of nonspecific clinical signs and symptoms, some diagnostic delays may occur. The purpose of the study was to evaluate the clinical features, diagnostic approach, and treatment choice in orbital lymphomas.&#x0D; Methods: We identified patients diagnosed with orbital lymphoma in an outpatient clinic in Dr. M. Djamil General Hospital from January to December 2018. Patients’ medical records were reviewed retrospectively.&#x0D; Results: The patient group consisted of 6 patients (five males and one female) with a median age of 58 years. Proptosis and orbital swelling were the leading clinical symptoms, mainly found unilateral (five cases). The diagnosis was confirmed by a surgical biopsy. One histology result showed lymph node hyperplasia, which didn't suit the clinical manifestation and got re-reviewed. All histology results then showed non-Hodgkin’s lymphoma with the small lymphocytic type (100%). Five patients received systemic chemotherapy with the CHOP regimen protocol, and one patient refused to get further chemotherapy treatment.&#x0D; Conclusion: When unmatched orbital symptoms with histology results are present, re-reviewing the histology result is essential. Once the diagnosis is established, systemic chemotherapy is indicated and can proceed so there will be no delay in treatment

Management of primary choroidal lymphoma presenting as extensive serous retinal detachment and salmon patch of bulbar conjunctiva: a case report

BackgroundWe describe the outcome of ultra-low-dose radiotherapy plus intravitreal methotrexate and rituximab injections for a patient with primary choroidal lymphoma who presented with nodular conjunctival salmon patches and extensive serous retinal detachment.Case presentationA 34-year-old Iranian man presented with a nodular patch of bulbar conjunctiva in the right eye, and 1+ vitritis. A nearly complete shallow serous retinal detachment, retinal folds, and multifocal yellow choroidal infiltrates were seen during a fundus examination of the right eye. Enhanced depth imaging optical coherence tomography revealed macular retinal folds and an uneven, undulating, “seasick” appearance of the choroidal surface with choriocapillaris compression, intraretinal and subretinal fluid, and clusters of optically dense material at the outer retinal level. An incisional biopsy of the conjunctival lesion confirmed the diagnosis of primary choroidal lymphoma with epibulbar involvement. The patient was treated with ultra-low-dose “boom-boom” radiation (4 Gy delivered in two fractions over two consecutive days) as well as intravitreal methotrexate and rituximab injections. After a year, the lesions had completely disappeared, with no adverse effects or recurrence.ConclusionUltra-low-dose (boom-boom) radiotherapy combined with intravitreal chemotherapy and/or immunotherapy may be an effective treatment for primary choroidal lymphoma with anterior epibulbar extension and diffuse subretinal fluid with favorable response and minimal side effects.

Vascular Birthmarks as a Clue for Complex and Syndromic Vascular Anomalies.

Vascular birthmarks are common in neonates (prevalence: 20–30%) and mostly incidental findings sometimes with spontaneous regression (salmon patch and nevus simplex). Capillary malformations are found in about 1% and infantile hemangiomas are found in 4% of mature newborns. Vascular malformations are classified according to their most prominent vessel type. The term “capillary malformation” (port wine stain) includes a wide range of vascular lesions with different characteristics; they may be isolated or part of specific syndromic conditions. Part of the infantile hemangiomas and of the vascular malformations may require treatment for functional or cosmetic reasons, and in rare cases, investigations are also necessary as they represent a clue for the diagnosis of complex vascular malformation or tumors associated with extracutaneous abnormalities. Complex vascular malformations are mostly mosaicism due to early somatic mutations. Genetic advances have led to identify the main pathogenic pathways involved in this disease group. Diffuse capillary malformation with overgrowth, Klippel–Trenaunay syndrome, CLAPO syndrome, CLOVES syndrome, and megalencephaly-capillary malformation belong to the PIK3CA-related overgrowth. Capillary malformation–arteriovenous malformation underlies a fast-flow vascular malformation, sometimes manifesting as Parkes–Weber syndrome. Recognition of these different types of capillary vascular stains is sometimes difficult; however, associated findings may orient the clinicians while genetic testing may confirm the diagnosis. Lymphatic malformation frequently manifests as large masses that compress and/or infiltrate the surrounding tissues, representing a neonatal emergency when airways are involved. Infantile hemangiomas may cause functional and/or permanent esthetical damage, depending on their localization (such as periorbital area, lip, nose); large (more than 5 cm) infantile hemangiomas with a segmental distribution can be associated with obstruction or malformations of the underneath organs with complications: PHACE syndrome, LUMBAR/SACRAL syndrome, and beard infantile hemangioma. In our review, we discuss controversies regarding the international classification and emerging concepts in the field of vascular anomalies. Finally, we discuss potential developments of new, non-invasive diagnostic techniques and repurposing of target therapies from oncology. Complex and/or life-threatening vascular tumors and malformations are extremely rare events and they represent a considerable therapeutic challenge. Early recognition of clinical signs suggestive for a specific disease may improve therapeutic outcomes and avoid severe complications.

Ocular adnexal mucosa-associated lymphoid tissue lymphoma: a narrative review.

Lymphoma is the most common primary tumor of the orbit, accounting for 55% of all orbital malignancies. When divided into histopathological subtypes, extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) comprises the largest proportion. Clinical manifestations are unspecific, but in patients with slow-growing painless orbital mass, or red conjunctival lesion suggestive of ‘salmon patch’, ocular adnexa lymphoma (OAL) should be suspected. Although the pathogenetic mechanism of ocular adnexal MALT lymphoma (OAML) is not yet fully understood, the relationship between OAML and Chlamydia psittaci has been hypothesized recently, similar to that between gastric MALT lymphoma and Helicobacter pylori. This suggests a new treatment option for OAML; bacterial eradication therapy with systemic antibiotics. Several other treatment methods for OAML have been introduced, but no treatment guidelines have been established yet. In this article, we summarize the current knowledge on the clinical features, pathogenesis, diagnostic methods, therapeutic strategies, and prognosis of OAML.

A clinical study of dermatotses in neonates in Silchar medical college

According to WHO a neonate, is a child under 28 days of age. The neonatal skin changes show a wide geographic and ethnic variation. It is important to know the pattern of dermatoses prevalent among Indian children during the neonatal period. The current study was conducted to study the prevalence of neonatal dermatoses in southern Assam and to study relationship of neonatal dermatoses with maturity and birth weight of neonates.150 neonates who developed cutaneous lesions over a period of one year were examined. Proportion of each dermatoses and prevalence ratio were calculated using relevant formulae. Out of the 150 neonates, 66 % neonates had transient physiological changes, 11.33% had congenital disorders and genodermatoses, 4.67% had iatrogenic complications, 30% had acquired skin diseases, 8% had neonatal infections and 2% had other miscellaneous diseases. The five most common dermatoses overall were diaper dermatitis (17.33%), miliaria (14%), erythema toxicum neonatorum (13.33%), infantile seborrheic dermatitis (12.67%), sebaceous gland hyperplasia (6%) and Mongolian spot (6%). Low birth weight babies had predilection for vernix caseosa, sucking blisters, candidiasis, miniature puberty, caput succedaneum, cephalohematoma, physiological jaundice, infantile acropustulosis, salmon patch, Epstein’s pearls/ Bohn's nodules, miliaria, sebaceous gland hyperplasia, neonatal acne, Mongolian spot, bullous impetigo, erythroderma Preterm neonates had predilection for vernix caseosa, sucking blisters, miniature puberty, candidiasis, Mongolian spot, caput succedaneum, cephalohematoma, erythroderma, miliaria, Epstein’s pearls/ Bohn's nodules and a positive association was seen between post-term neonates and physiological desquamation, diaper dermatitis. Neonatal psoriasis and neonatal dermatophyte infection were the unusual findings which we found in our study.

Transcriptome Analysis of Endothelial Colony-Forming Cells Isolated from Patients with HbSC Hemoglobinopathy and Proliferative Retinopathy

Introduction: Retinopathy is one of the major clinical manifestations of sickle cell disease. Although systemic disease is more severe in sickle cell anemia, ocular disease is apparently more severe in hemoglobin SC disease (HbSC). Sickle cell retinopathy can be classified as non-proliferative or proliferative. In the non-proliferative form, the most common clinical findings are salmon patch hemorrhages, iridescent spots and black sunbursts, which can be observed in the peripheral retina. In the proliferative form, peripheral retinal neovascularization develops after vaso-occlusion and grows anteriorly from perfused to non-perfused retina. These new vessels can lead to vitreous hemorrhage, retinal breaks, tractional or rhegmatogenous retinal detachments, and consequently vision loss can occur. The precise pathogenesis of neovascular formation in sickle cell disease is not fully understood. Endothelial Colony-Forming Cells (ECFC) have been shown to play a role in angiogenesis and could become accessible informers of vascular status and enable the study of vascular disorders. Objective: The aim of this study was to compare differential gene expression profiles of ECFC from HbSC patients with and without retinopathy. Methods: ECFCs were cultured after isolation from peripheral blood samples of three HbSC patients with proliferative retinopathy and five HbSC patients without retinopathy. RNA was extracted from the cell cultures and transcriptome analysis was performed with HiSeq 2500 sequencer (Illumina, Inc., San Diego, CA, USA) with eight RNA-seq libraries per lane (2 × 101-bp paired-end reads). Results: Ten genes were upregulated in cultures from patients with retinopathy when compared with those without retinopathy: ROBO1, SLC38A5, SLC38A5, DDR2, PEG3, PLPP7, TRBJ2-1, PLPP4, APCDD1L and SEMA3B . Discussion and Conclusion: Among these genes, we highlight the most upregulated gene encoding Robo1, a member of the roundabout (Robo) family that serves as a neuronal guidance receptor and has been reported to mediate tumor and retinal angiogenesis. The Robo1-mediated pathway has been proposed as a target for the treatment of several ocular neovascular diseases, so our data support that sickle cell proliferative retinopathy may also benefit from therapeutic strategies blocking this pathway. DisclosuresOzelo:Novo Nordisk: Consultancy, Research Funding, Speakers Bureau; Pfizer: Consultancy, Research Funding, Speakers Bureau; CSL Behing: Consultancy; Roche: Consultancy, Speakers Bureau; Biogen: Consultancy, Research Funding, Speakers Bureau; Shire: Consultancy, Research Funding, Speakers Bureau; Grifols: Speakers Bureau. Fertrin:Alexion Pharmaceuticals: Consultancy.

Oral mucosal and skin lesions observed in the first 48 hr in newborns

Newborn period is a definition used for the first 4weeks of life and it has some different characteristics compared with adult skin. In this study, we tried to define the pathological and physiological skin manifestations and demographic data observed in newborns PATIENTS/METHODS: In this study, newborns born between 2018 and 2019 were evaluated prospectively. Along with demographic findings, temporary neonatal skin manifestations, congenital spots, benign neonatal pustulosis, congenital anomalies and other lesions were statistically evaluated. A total of 2109 newborns, consisting of 1157 (54.9%) boys and 952 (45.1%) girls, were enrolled in the study. 94% of the newborns evaluated had at least one skin lesion. The most common skin manifestations in the study were Epstein pearls at a rate of 49.4%. This was followed by salmon patch (38.4%), Mongolian spot (20.1%), edema in the eyelids (15.5%), lanugo (15.4%), and erythema toxicum neonatarum (11.6%), respectively. Several studies on dermatological findings observed in newborns have been conducted in many different countries around the world. In this study, we tried to identify many temporary and pathological skin manifestations and congenital anomalies observed in the first 48h in newborns.

Clinical profile and severity of nail involvement in psoriasis

Material and Methods: This is prospective and observational study conducted in the Department of Dermatology. Dermatological examination specified the clinical form of psoriasis, nail alterations type, and number of fingernails involved, the Psoriasis Area and Severity Index (PASI) score assessing the severity of skin involvement, and based on PASI score, patients were classified into mild (PASI20). Nail Area Psoriasis Severity Index (NAPSI) score assessing the severity of nail involvement (pitting, leukonychia, red spots in lunula, and nail plate crumbling) and for nail bed disease (oil drop [salmon patch] discoloration, onycholysis, nail bed hyperkeratosis, and splinter hemorrhage).

Cutaneous Lesions in Iranian Neonates and Their Relationships with Maternal-Neonatal Factors: A Prospective Cross-Sectional Study.

Cutaneous lesions are common in the neonatal period and mostly physiological, transient, and self-limited; uncommonly, they are pathological and require treatment and cooperation between neonatologists and dermatologists. Particular conditions, like prematurity, can influence the onset, type, and evolution of cutaneous manifestations. Of the several articles in the literature about skin findings in newborns, only a few were performed in Iran. We aimed to investigate dermatological findings in a sample of neonates within the first three days of life and to evaluate the association between skin lesions and neonatal- or maternal-related variables. A total of 1202 newborns, hospitalized in the Department of Pediatrics of Imam Sajjad Hospital of Ramsar and Shahid Rajaee Hospital of Tonekabon, Iran, for two years, were examined. All skin findings were recorded, and information on neonatal and maternal variables was collected and analyzed to detect statistically significant associations. Skin lesions were present in 958 newborns (79.8%). The prevalence of milia, erythema toxicum, salmon patch, and Mongolian spots were 45.2%, 43%, 37.3%, and 37%, respectively. Natural vaginal delivery, use of medication, term gestation, and maternal disease were associated with a higher incidence of cutaneous lesions in neonates. Milia, erythema toxicum, Mongolian spots, and genital hyperpigmentation were seen more frequently in the male gender. Conversely, skin desquamation was seen more frequently in females. Among maternal diseases, gestational diabetes mellitus, urinary tract infection, preeclampsia, hypertension, psychiatric disorders, and uterine infection were associated with a higher prevalence of cutaneous lesions. Neonatal cutaneous lesions are a common source of concern in parents and inexperienced physicians. Therefore, prompt recognition of neonatal cutaneous lesions is essential in order to avoid unnecessary diagnostic and therapeutic procedures.

Evaluation of Subclinical Nail changes in Patients with Chronic Plaque Psoriasis using Dermoscopy

Abstract Background Dermoscopy is a non-invasive technique that allows the visualization of subtle clinical features of the skin surface and appendages details not visible to the naked eye, allowing magnifications of up to 200x. It is widely used for evaluating and diagnosing all nail diseases, as it provides important information. As any other examination, nail dermoscopy (onychoscopy) requires a good knowledge of nail anatomy &amp; physiology and the pathogenesis of the nail diseases, and it is helpful for the diagnosis of numerous nail diseases and tumors. Nail disorders are defined according to their appearance and the part of the nail affected (from distal to proximal): hyponychium, onychodermal band (ODB), nail bed, nail plate, lateral nail folds (perionychium), lunula (distal part of the matrix), cuticle, nail matrix and proximal nail fold. Objective To study the dermoscopic findings of subtle nail changes in patients with chronic plaque psoriasis and compare it with that nail changes in healthy controls by both polarized and non polarized mode of dermoscope, aiming to assist clinicians in correctly evaluating and diagnosing nail changes with the help of dermoscopy. Methods We conducted a comparative descriptive study on 50 patients having chronic plaque psoriasis, 26 were males (52.0%) and 24 were females (48.0%), as well as 50 normal healthy control subjects, 31 were males (62.0%) and 19 were females (38.0%). Patients and controls were randomly recruited from the outpatient clinic of dermatology department at Ain Shams University Hospitals, during the period from February 2018 till September 2018. And the age of both groups ranged from 14 to 70 years. Results Our study revealed that the most common fingernail changes found in psoriatic patients were nail plate thickening and crumbling followed by Dilated nailbed capillaries at the onychodermal band, Oncholysis, Subungual hyperkeratosis, Pitting, Longitudinal ridges, Scales, Salmon patch, Leukonychia, Splinter hemorrhage, Lunula red spot and Trachyonychia. And the most common toenail changes found in psoriatic patients were Subungual hyperkeratosis followed by Nail Plate Thickening &amp;Crumbling, Oncholysis, Pitting, Longitudinal ridges, Scales, Salmon patch, Trachyonychia, Dilated nailbed capillaries at the onychodermal band, Splinter hemorrhage, Leukonychia and Lunula red spot. We found there was no difference between polarized and non polarized mode of dermoscope in examination of fingernails and toenails except that the non polarized mode showed the changes of the Dilated capillaries at the onychodermal band more obviously. And also, there was no difference between wet and dry method of polarized mode of dermoscope. Conclusion This study confirms that a handheld dermoscope is a very efficient and simple tool for detection of any nail abnormality.

Incidence and characterization of early- and late-onset skin diseases in neonates – A hospital-based cross-sectional study

Background: Neonatal skin diseases occur in almost every newborn baby. Many are transient, involute rapidly and require no management. Objective: The objective of the study was to study the incidence and characterization of early and late onset of various skin diseases in the neonates. Methods: A cross-sectional observational study was carried out among 200 neonates in a tertiary care hospital in Central India. Skin lesions which appeared on or before 48 h before birth were categorized as early onset and skin lesion appearing after 48 h were considered as late onset and the characteristics of lesions were highlighted. Results: The most common skin lesions identified within 48 h of birth were Epstein pearl’s (77.0%), followed by Mongolian spot (45.5%), desquamation of skin (35%), sebaceous gland hypertrophy (31.5%), and milia (28.4%), respectively. Less incidence of salmon patch, erythema toxicum neonatorum, impetigo, miliaria rubra, accessory auricles, pigmented nevi, port-wine stain, and lamellar ichthyosis also was recorded. Impetigo (11.2%) and candidiasis (11.2%) were commonly seen after 48 h of birth followed by dermatitis 6.4% and a few cases of birthmarks. Conclusion: Along with increasing awareness of neonatal diseases, our study results also aid in better identification and diagnosis of these diseases.

Comparative Study of Clinical and Dermoscopic Features in Nail Psoriasis.

Background, Aims, and Objectives:Nail changes have been reported in approximately 40% of psoriasis patients. Occasionally nail psoriasis may be the sole finding or the first presentation of the disease. Assessment of the nail changes associated with psoriasis can be done clinically, ultrasonographically, and most recently using a dermoscope. The aim of this study is to assess the dermoscopic features in nails of psoriasis as well as to compare the dermoscopic with the clinical findings. This study has also assessed the correlation between disease duration and the severity of skin and nail involvement.Materials and Methods:A total of 50 patients with psoriatic nail changes were recruited in the study. The psoriasis area severity index (PASI) was used to assess the severity of the disease. The nail psoriasis severity index (NAPSI) was used to determine the severity of nail involvement. The patient's nails were examined both clinically and dermoscopically.Results:Pitting was the commonest feature (84%) noted both clinically and dermoscopically. A statistically significant higher NAPSI score (P < 0.05) was obtained by a dermoscope than by clinical examination. Salmon patch and splinter hemorrhage were better visualized using a dermoscope than by clinical evaluation (P < 0.05). The duration of the disease had a strong positive correlation (R = 0.901) with the duration of nail involvement whereas there was a weak correlation between the duration of the disease and the clinical NAPSI (R = 0.23) and dermoscopic NAPSI (R = 0.28). A weak positive correlation (R = 0.3) was noted between the PASI and NAPSI scores.Conclusion:Dermoscopy of nails proved to be an efficient, supportive, easy, noninvasive method that provides a better insight into the subtle nail changes in psoriatic patients, which may have been missed clinically.

Conjunctival lymphoma a case report

AbstractPurposeOrbital lymphomas are not frequent within orbital pathologies; they are commonly found associated to systemic diseases. Lymphomas affecting only the conjunctiva are even less frequent and their bilateral manifestation are uncommon. The characteristic lesion of conjunctival lymphomas is an orange‐pink mass at the bottom of the bag, without adhesion to deep planes. Patients are often asymptomatic but they may also complain of irritation of the eye. Painful proptosis or ptosis may appear if the affectation extends to the orbit. The average age of presentation is 60–70 years and it is more common in women. The diagnosis is confirmed by biopsy of the lesion.MethodsWe report the case of a 55‐year‐old woman with a conjunctival bilateral mucosa associated lymphoid tissue (MALT) lymphoma, not associated to systemic disease. The patient came to the service complaining of one month of epifora and itching in both eyes, with a salmon patch conjunctival mass in the temporal tarsal conjunctiva of the left eye, without any inflammatory signs or decreased visual acuity.ResultsA partial exeresis and biopsy of the left eye subconjunctival mass was performed. An extranodal lymphoma of the lymphoid tissue associated with mucosa was diagnosed (MALT lymphoma), CD20: positive, BCL2: positive and Ki67: 5%. Ocular ECO and MRI demonstrated infiltration of the external rectus muscle, being in contact with the superior rectus muscle, and PET CT confirmed a normal metabolic pattern. The patient was followed up for several months in the departments of Ophthalmology and Oncology, treatment was initiated with radical radiotherapy 30 Gy, fractionation cGy 200 in the left conjunctiva, which started on January 30 2017 and ended on February 18 2017.ConclusionBiopsy offers an early diagnosis for conjunctival lymphoma, being its prognosis very good. Because of this, ophthalmologists should be aware of this pathology, its characteristics and diagnosis.