Yellowish Dots Research Articles

Dermoscopy of Actinic Keratosis: Is There a True Differentiation between Non-Pigmented and Pigmented Lesions?

Dermoscopic features of actinic keratosis (AK) have been widely studied, but there is still little evidence for their diagnostic accuracy. Our study investigates whether established dermoscopic criteria are reliable predictors in differentiating non-pigmented actinic keratosis (NPAK) from pigmented actinic keratosis (PAK). For this purpose, dermoscopic images of 83 clinically diagnosed AK (45 NPAK, 38PAK) were examined, and the sensitivity (Se), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) were assessed. Features with statistical significance were the red pseudo-network (p = 0.02) for NPAK and the pigmented pseudo-network (p < 0.001) with a pigment intensity value even less than 10% for PAK (p = 0.001). Pigmented pseudo-network (Se: 89%, Sp: 77%, PPV: 77%, NPV: 89%) with a pigment intensity value of more than 10% (Se: 90%, Sp: 86%, PPV: 79%, NPV: 93%) had excellent diagnostic accuracy for PAK. Scale and widened follicular openings with yellowish dots surrounded by white circles were equally represented in both variants of AK. Linear wavy vessels and shiny streaks were more prominently observed in NPAK, as were rosettes in PAK, but these results failed to meet statistical significance. The red starburst pattern was near statistical significance for PAK. Therefore, pigmentation is the strongest dermoscopic predictor for the differentiation between NPAK and PAK.

Fireflies in Art: Emphasis on Japanese Woodblock Prints from the Edo, Meiji, and Taishō Periods.

Simple SummaryFireflies are beetles (Coleoptera: Lampyridae) famous for their bioluminescence. This study examined artistic representations of fireflies and depictions of how people interacted with these insects in Japan from a historical perspective. Visual information from the artwork was summarized, highlighting themes and connections to firefly biology and cultural entomology. Multiple artists were represented, including several renowned masters, and the artwork highlights the complex interactions between fireflies and humans. Analyzing artwork can enhance awareness of the historical and cultural significance of insects and may help with conservation efforts.Examining how insects are represented in artwork can provide insight into people’s perceptions and attitudes towards arthropods, as well as document human–insect interactions and how they change through time. Fireflies are well-known bioluminescent beetles (Coleoptera: Lampyridae) of great cultural significance, especially in Japan. A selection of online museum collections, art databases, and dealer websites were used to find artwork featuring fireflies, with an emphasis on Japanese ukiyo-e wood block prints from the Edo, Meiji, and Taishō time periods (1600–1926). Quotes from early twentieth century texts were used to provide additional historical context. Over 90 different artists created artwork featuring fireflies, including several renowned masters. Artists depicted adult fireflies in a variety of ways (e.g., relatively accurately, more generalized, symbolic or abstract, yellowish dots) in the absence and presence of people. Most images were set outdoors during the evening near water, and primarily featured women and children, groups of women, and large parties catching fireflies or observing caged fireflies. ‘Beauties’, geisha, courtesans, kabuki actors, and insect vendors were also common subjects. Various types of collecting tools and a diversity of cages were featured, as well as insect vendors. The artwork highlights the complex connections between fireflies and humans. Insect-related art can contribute to education and conservation efforts, particularly for dynamic insects such as fireflies that are facing global population declines.

THE TARGET SIGN: A Near Infrared Feature and Multimodal Imaging in a Pluri-Ethnic Cohort with RDH5-Related Fundus Albipunctatus.

Retinol dehydrogenase 5 (RDH5)-related fundus albipunctatus can present with phenotypic variability. Our purpose was to investigate new clinical characteristics and multimodal imaging findings in patients from different ethnic origins, carrying different mutations. Multicenter international retrospective case series of 18 patients with genetically confirmed RDH5-related fundus albipunctatus. Patients' files were reviewed for fundus images, visual acuity, macular optical coherence tomography scans, near-infrared images, fundus autofluorescence, electroretinogram, and genetic mutations. Imaging and electroretinogram findings. All eyes (n = 36, 100%) showed small circular findings seen on near-infrared images, termed as the "target sign," correlating to the yellowish dots seen clinically and to the distinct hyperreflective linear lesions on optical coherence tomography at the level between external limiting membrane and retinal pigment epithelium. Perifoveal atrophy with foveal sparing was seen in 4 eyes of 2 patients (both RDH5-c.160C>T, p.R54X mutation). Fundus autofluorescence revealed small hyperautofluorescent dots (n = 16, 44.4%). Scotopic electroretinograms were significantly reduced in all cases with an electronegative pattern, 66.7% displayed cone dysfunction. Our results show distinct imaging findings present in all patients with fundus albipunctatus independent of ethnicity or genetic mutation. Our results can facilitate the current algorithm to diagnose RDH5-related fundus albipunctatus and allow for targeted genetic testing.

A Rare Case of Juvenile Xanthogranuloma in 8 Months Old Baby with Dyslipidemia

Background: Juvenile xanthogranuloma (JXG) is a non-Langerhans cell histiocytosis disease of childhood. But due to rarity of non Langerhans cell hystiosis itself, the exact prevalence of juvenile xanthogranuloma remain unknown with only a few epidemiological journal ever published. Juvenile xanthogranuloma usually wihout lipid abnormality and systemic involvement. But association between JXG and lipid abnormalities is still not well understood. We describe a patient with multiple cutaneous JXG who also developed hyperlipidemia.&#x0D; Case: A case of a 8 months-old baby patient with juvenile xanthogranuloma is reported. Patient parents noticed yellowish dots on child’s face since six months ago, and it was gradually increase in size and number, and spread to trunks, upper and lower limb since 2 months ago. Patients got formula milk since 7 months ago. Patients father has uncontrolled hypercholesterolemia, and grandparents had controlled dyslipidemia. Dermatological state showed yellowish plaque and papule on the face, trunk, lower limb, and upper limb. Dermoscopy show yellowish papule with sun setting appearance and branched and linear vessel on orange yellow background. Laboratory finding showed elevated lipid serum. Foam cell and Touton giant cell is found on histopathology examination.&#x0D; Discussion: The presented case demonstrates that skin lesions in patients with diagnosed JXG may have a variable clinical presentation, ranging from single to diffuse skin lesions, also present from the birth to childhood. The diagnosis requires histopathological confirmation to avoid misdiagnosis of malignant disease. Association between JXG and lipid abnormalities remain unknown, with most of the patient show normal lipid serum. Majority of patients presenting lesions limited to the skin requires only a strict dermatological observation.

On the taxonomy and distribution of Varanus salvator andamanensis Deraniyagala, 1944 (Reptilia: Varanidae), including a redescription of the type specimens and a discussion about its allopatric co-occurrence with V. s. macromaculatus on the Nicobar Islands.

We provide a detailed redescription of the two original type specimens of the little-known, endemic Andaman water monitor, Varanus salvator andamanensis Deraniyagala, 1944. Examination of further voucher specimens allows for an expanded morphological diagnosis of this island taxon and comparison with other currently recognized subspecies of the wide-spread Southeast Asian water monitor. Based on the specimens examined, V. s andamanensis is characterized by a homogenous black dorsal background colour, with five to seven, more or less distinctive transverse rows of small spots or ocelli, light yellowish dots arranged sporadically between transverse spot/ocelli rows on the body, light yellowish coloured spots distributed sporadically throughout both forelimbs and hind limbs; 17-18 prominent rows of light spots continuing from base of tail to its tip dorsally with sporadically arranged dots on lateral sides of tail; and higher scale counts in transverse dorsal scale rows. Based on photographic evidence and examination of museum specimens, V. s. andamanensis inhabits both the Andaman and southern Nicobar Islands, which politically belong to the Republic ofIndia. In addition, we confirm the presence of V. s. macromaculatus in the northern and central Nicobar Islands, thus providing evidence for the allopatric co-occurrence of two different water monitor subspecies in these remote archipelagos.

Novel clinical findings in autosomal recessive NR2E3-related retinal dystrophy.

To evaluate the clinical phenotype of autosomal recessive NR2E3-related retinal dystrophy. We retrospectively studied 11 patients carrying out at least 2 NR2E3 mutations; they had undergone comprehensive ophthalmological examination, fundus photography, optical coherence tomography, electrophysiological testing, and visual field at the Regional Reference Center for Hereditary Retinal Degenerations of the Eye Clinic in Florence. Five females and six males with a diagnosis of NR2E3-related retinal dystrophy were included in the study. All patients complained of nyctalopia. Visual acuity ranged from 0.00 logMAR to hand motion. Two patients presented bull's eye maculopathy, and one of these was characterized by a triple hyper-autofluorescent ring at the fundus autofluorescence examination. Three patients showed small yellowish dots and spots at the mid-periphery. One patient was characterized by widespread subretinal drusenoid deposits (SDD) at the posterior pole. Four patients showed vitreous abnormalities. Optical coherence tomography (OCT) examinations detected variable degrees of abnormal retinal lamination and schitic changes. Seven patients were compound heterozygous and four were homozygous for mutations in NR2E3. Our study confirmed high variable phenotype in autosomal recessive NR2E3-related retinal dystrophy. Bull's eye maculopathy, subretinal drusenoid deposits, and foveal hypoplasia represent novel clinical findings in NR2E3-related retinal dystrophy. Macular involvement was detectable in all the patients, and the abnormal foveal avascular zone (FAZ) supports the role of NR2E3 in retinal development.

Retinal dystrophy and subretinal drusenoid deposits in female choroideremia carriers.

To describe clinical and molecular characteristics in a group of Italian female choroideremia (CHM) carriers and report fundus patterns. We retrospectively studied 11 female carriers belonging to six CHM families examined at the Regional Reference Center for Hereditary Retinal Degenerations at the Eye Clinic in Florence. We took into consideration patients with a comprehensive ophthalmological examination, fundus photography, optical coherence tomography (OCT), full field electro-retinography (ERG), and visual field (VF). All patients were screened for mutations of the CHM gene. Fundus examination revealed retinal abnormalities in all female carriers (11/11) in the study; in particular four fundus patterns were identified: pattern A (RPE dystrophy involving only the peripheral retina), pattern B (RPE dystrophy involving the peripheral retina and the posterior pole with small hypo-pigmented RPE areas), pattern C (RPE dystrophy involving the peripheral retina and the posterior pole with small yellowish well-defined dots), and pattern D (RPE dystrophy involving the peripheral retina and the posterior pole with large hypo-pigmented RPE areas and well-defined yellowish dots). Pattern D was characterized by widespread macular subretinal drusenoid deposits (SDD). Half of the observed mutations were novel mutations. A genotype-phenotype correlation was not identified. Retinal dystrophy and SDD were detected in our female CHM carriers, and fundus patterns have been described in this study. The recognition of specific fundoscopic patterns may permit a correct diagnosis, an appropriate molecular investigation and genetic counseling.

Giant choroid plexus papilloma in Mulibrey nanism syndrome

Mulibrey (muscle, liver, brain, eye) nanism (MUL) is an autosomal recessive disorder caused by mutations in the TRIM37 gene encoding a protein of unknown function. MUL is characterized by progressive growth failure of prenatal onset, tri- angular face with hydrocephaloid skull, general thinness and muscular hypotonicity, peculiar voice, venous congestion caused by pericardial constriction, and pigment dispersion and yellowish dots in ocular fundi. Many studies in MUL patients showed that MUL is associated with frequent malignant tumors, benign adenomas and vascular lesions. Generally, MUL patients are consid- ered neurologically normal. Up to today, several arachnoidal cysts have been demonstrated in MUL patients. A nodular lesion of the plexus choroideus has been detected only in one MUL patient. Thus, choroid plexus papilloma has never been demonstrated in MUL patients. Our patient is an unusual example of MUL with giant choroid plexus papilloma and the first case in literature.

Taxonomic revision of SpectracanthicusNijssen &amp; Isbrücker (Loricariidae: Hypostominae: Ancistrini), with description of three new species

A taxonomic review of Spectracanthicus Nijssen &amp; Isbrücker, including Oligancistrus Rapp Py-Daniel, following a phylogenetic study, is presented. Additionally to S. punctatissimus(Steindachner) and S. murinus Nijssen &amp; Isbrücker, three new species are recognized based on the examination of 159 specimens: S. immaculatus n. sp. from rio Tapajós basin, differs from its congeners by its color pattern consisting of a dark gray body, with no dots or spots, and by having very slender teeth; Spectracanthicus tocantinensisn. sp., from the rio Tocantins drainage is distinguished by the color pattern consisting of dark brown or black body with small, yellowish dots (except in S. punctatissimus), presence of thick teeth, infraorbital 4 forming most of the posterior edge of the orbit and the large basipterigium fenestrae; and Spectracanthicus zuanonin. sp., from the rio Xingu basin is diagnosed by its color pattern consisting of large, white spots and by the larger orbital diameter. Other characters based on osteological features are also usefull to distinguish the species. A key to the species of the genus and a brief discussion of their threats and conservation are also provided.

Danger of research in lasers: about two examples of retinal impacts in senior researchers

AbstractPurpose We report two cases of accidental retinal lesions made by diode and femtosecond lasers in senior researchers in optics.Methods The first case concerned a 29‐year old caucasian woman exposed to a 1053 nm wavelength femtosecond laser (0.5 mW) during mirror alignment. Immediately after exposure, she felt blurry central vision and scotoma in her left eye. Visual acuity was 20/60. Clinical examination showed yellowish dots in foveal region. No treatment was given. Two years later, visual acuity remained low. The second case was a 40‐year old causasian woman exposed to 670 nm wavelength diode laser (3 mW) in both eyes during repeated experiments. The patient had no symptoms. Visual acuity was 20/20 without central scotoma. The fundus revealed several extrafoveal macular white and yellow impacts of different ages. Ten years later, no neovascular complication was observedResults These two different cases illustrate the danger of any type of laser. Thermic or blast effect can caused permanent damage to the retinal pigment epithelium affecting the fixation point with permanent visual acuity decrease. Choroidal infarction has been described in the literature. Main risks are neovascularization and enlargement of the impacts involving the fovea. When patient does not consult immediately after accidental exposition, differential diagnosis of white retinal infiltrates, as multifocal choroiditis, should be ruled out.Conclusion Whatever their skill, researchers and workers exposed to any type of lasers should be reminded the importance of wearing suitable eye protections. Considering the possibility of asymptomatic lesions, a periodical screening remains justified.

Einseitiges Verzerrtsehen bei einer jungen Patientin

A 31 year old woman complained about metamorphopsia on her right eye. Multiple yellowish dots were seen on the retina. The fluorescein angiography showed fluorescein leakage and the indocyanine green angiography showed multiple hypofluorescent areas. The diagnosis of choroidal neovascularization (CNV) due to punctate inner choroidopathy (PIC) was made. Bevacizumab injections and corticosteroid were given as a therapy.

Gene encoding a new RING-B-box-Coiled-coil protein is mutated in mulibrey nanism.

Mulibrey nanism (for muscle-liver-brain-eye nanism, MUL; MIM 253250) is an autosomal recessive disorder that involves several tissues of mesodermal origin, implying a defect in a highly pleiotropic gene. Characteristic features include severe growth failure of prenatal onset and constrictive pericardium with consequent hepatomegaly. In addition, muscle hypotonia, J-shaped sella turcica, yellowish dots in the ocular fundi, typical dysmorphic features and hypoplasia of various endocrine glands causing hormonal deficiency are common. About 4% of MUL patients develop Wilms' tumour. MUL is enriched in the Finnish population, but is rare elsewhere. We previously assigned MUL to chromosome 17q22-q23 and constructed a physical contig over the critical MUL region. The region has now been further refined by haplotype analysis and new positional candidate genes have been localized. We identified a gene with four independent MUL-associated mutations that all cause a frameshift and predict a truncated protein. MUL is ubiquitously expressed and encodes a new member of the RING-B-box-Coiled-coil (RBCC) family of zinc-finger proteins, whose members are involved in diverse cellular functions such as developmental patterning and oncogenesis.

Punctate Inner Choroidopathy

BACKGROUND Punctate inner choroidopathy is a rare disease, which involves the outer retina and inner choroid. The ethiology is still unknown. PATIENT The case of a 23-year-old female patient, who noticed a central scotoma on the right eye, is presented. A mild decreased visual acuity of 0.7 was noted and on ophthalmoscopy multiple, yellowish dots on the level of RPE and choroid near the fovea were found. Angiography showed a hyperfluorescence of the dots in the early phase and marked leakage in the late phase. TREATMENT Under systemic treatment with corticosteroids the acuity and the fundus changes improved. Two weeks after corticosteroidtherapy was finished, a new onset with massive exsudation occurred accompanied by a sudden decrease in vision in her right eye to 0.1. On the last examination a parafoveal suretinal scar was discovered. CONCLUSION Punctate inner choroidopathy recurrences are common. However secondary neovascular membranes are described, in general the visual outcome is good.

MULIBREY NANISM, AN AUTOSOMAL RECESSIVE SYNDROME WITH PERICARDIAL CONSTRICTION

"Mulibrey" (muscle, liver, brain, eye) nanism, a previously unknown syndrome, probably determined by an autosomal recessive gene, has been described in twenty-three patients aged 4 months to 23 years. Growth failure was evident at birth and was progressive. The characteristics are triangular face often with hydrocephaloid skull, gracility and muscular hypotonia, peculiar voice, enlarged liver, raised venous pressure, and yellowish dots and pigment dispersion in ocular fundi. Pericardial constriction seems to be a regular component of the syndrome. Two-thirds of the patients had cutaneous nævi flammei and a third had cystic dysplasia of tibia. The physical capacity and life expectancy seem to vary, depending on the degree of the cardiac lesion. Probably, a proportion of the affected offspring is lost by early abortion or infant death.