Photo-epilation: guidelines for care from the European Society for Laser Dermatology (ESLD).
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Biomedical subjects
Publications and source records attributed to Iqbal A Bukhari.
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Malignant peripheral nerve sheath tumors (MPNSTs) are rare tumors derived from Schwann cells or pluripotent cells of the neural crest. In this report, we describe a 21-year-old Saudi woman who presented with an asymptomatic, solid, round, protruding tumor on the right upper back which was diagnosed as an MPNST with no stigmata of neurofibromatosis. It was completely excised with a wide surgical margin. The patient was followed up for 9 months with no evidence of recurrence.
Vulvar basal cell carcinoma is a rare cutaneous neoplasm occurring mainly in white postmenopausal females. It can be misdiagnosed due to its nonspecific physical appearance. Here, we report a 59-year-old white female who had vulvar basal cell carcinoma misdiagnosed for 4 years.
Mycosis Fungoides (MF) is a T-cell lymphoma initially presenting in the skin. Many clinical variants exist including follicular, vesicular, poikilodermic, hypo- and hyperpigmented, ichthyosiform and pigmented purpura-like lesions. We present an unusual variant in a case of poikilodermic MF.
Familial cutaneous collagenoma is an inherited connective tissue nevus, which presents with asymptomatic symmetrically distributed skin nodules on the trunk or upper limbs. Here, we describe a case of a 12-year-old girl with collagenoma affecting the lower back.
BACKGROUND AND OBJECTIVES: Tattoos in Arabic society used to have a cosmetic importance on the face of females. These were usually amateur tattoos done by non-professional women in the tribe. Because Islam as a religion prohibited its practice and its application, people became concerned about removing the old tattoos by any means. Nowadays, laser is considered an effective method of tattoo removal. Here, we report our experience in the removal of tattoos in Arabic women of skin type III-IV using the Q-switched alexandrite laser. STUDY DESIGN/MATERIALS AND METHODS: Twenty female subjects aged 35-50 years from similar racial and ethnic background with amateur tattoos were treated using the Q-switched alexandrite laser. Fluence threshold was determined and a spot test was made. Q-switched alexandrite laser with a fluence range 4.0-7.5 J/cm(2) (mean 6.05) was used at 6-12-week intervals. Total treatment numbers ranged from three to six sessions (mean 4.15) with single-pulse technique application. RESULTS: More than 95% lightening was achieved in five patients after three to six sessions at fluence range of 6-7.5 J/cm(2) and > 75% lightening in 10 subjects after three to six sessions of treatment at fluence range of 4-7.5 J/cm(2). Pinpoint bleeding was observed in one case but no pigmentary alteration or scarring was seen. CONCLUSION: Tattoo pigment removal by Q-switched alexandrite laser is an effective method in skin type (III-IV) with minimal side effects, which gives high patient satisfaction.
Decorative henna skin painting can provoke severe reactions in the skin. We report 3 cases of unusual and persistent hyperpigmentation following nonpermanent henna tattoo, which alerted us to identify an additional side effect.
Hand dermatitis is a common chronic skin condition that has many clinical forms including contact, hyperkeratotic, frictional, nummular, atopic, pompholyx and chronic vesicular hand dermatitis. Topical steroids are the first line agents used. Here, we report the successful response to topical pimecrolimus 1% cream in a patient with steroid resistant chronic vesicular hand dermatitis.
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Subungual epidermoid inclusions are protrusions of the nail bed epithelium into the upper most bed stroma. They may be associated with hyperplasia of the bed epithelium resulting in subungual keratosis, onycholysis or even clubbing. An 11-year-old girl presented to our dermatology clinic with a one year history of progressive increase in the size of the distal part of her left thumb associated with mild pain on pressure. The diagnosis became evident perioperatively, which showed multiple subungual epidermoid inclusions.
OBJECTIVE: Naxos disease is a rare hereditary disorder characterized by palmoplantar keratoderma, woolly hair and cardiomyopathy. This study aims to determine whether Naxos disease in a Saudi Arab family is caused by the Pk2157del2 mutation that was identified in Greek families from Naxos Island where the disease had originally been described. METHODS: This study was undertaken at King Fahad Hospital of the University, Al-Khobar, and the Medical University of Hannover, in the spring of 2003. Naxos disease has been encountered in a 2-year-old girl and her 30-year-old aunt of a Saudi Arab family. Deoxyribonucleic acid samples of this family were analyzed by polymerase chain-reaction (PCR) amplification of the respective region of the plakoglobin gene, and direct nucleotide sequencing of the PCR-products. Segregation analysis was performed employing the newly detected IVS11+22G/A polymorphism. RESULTS: Molecular genetic analysis of the DNA sample of the child diagnosed with Naxos disease showed absence of the Pk2157del2 mutation. In addition, the segregation analysis revealed heterozygosity for IVS11+22G/A in the affected girl. CONCLUSION: Absence of the Pk2157del2 frameshift in the affected child proved that Naxos disease in this Saudi Arab family is not caused by the same mutation that was identified in the Greek families. Furthermore, heterozygosity for the IVS11+22G/A polymorphism provided evidence for exclusion of the plakoglobin gene in this consanguineous family.
Erythrokeratoderma variabilis is a rare autosomal dominant genodermatosis of variable expressivity. In this report, we describe the clinical features and microscopic findings in one of our patients born to unaffected parents. We also briefly review the literature on this disorder.
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We report a case of solitary mastocytoma in a child which was successfully treated with a topical steroid of moderate potency. The patient was an 18-month-old girl who presented with localized oval shape yellowish to hyperpigmented lesion on the medial aspect of her right forearm noticed accidentally by the parents since the age of 6 months. The lesion was observed to get urticated mainly after bathing, toweling, and scratching of the area, associated with reddening and itching confined to the lesion (Figure 1). No other area of the body was affected with any similar lesion. Examination of the skin revealed a yellow-tan oval shape patch 1 x 3 cm in diameter which was firm to the touch with intact overlying skin. The lesion became swollen and itchy when it was rubbed vigorously (positive Darier's sign). Systemic examination was unremarkable. The patient investigations including complete blood count, routine biochemical data, plasma histamine level, and urinalysis were within normal levels. Skin biopsy was cancelled because the parents refused, so our clinical diagnosis was solitary mastocytoma even though it was not confirmed histologically. We started the patient on a moderate potency corticosteroid (betamethasone valerate 0.1% cream) twice a day for six weeks after which the lesion became softer with a weak Darier's sign. This treatment was continued for another four months which led to resolution of the lesion with residual hyperpigmentation, negative Darier's sign, and no signs of atrophy (Figure 2). Follow up of the patient for another 8 weeks without treatment did not reveal any recurrence of the lesion.
Impetigo herpetiformis (IH) is a rare dermatosis which usually occurs during the third trimester of pregnancy. It is characterized by acute erythematosquamous plaques covered with tiny superficial pustules in a herpetiform distribution with less likely mucus membranes involvement. It can be associated with constitutional symptom s such as fever, chills, nausea, vomiting and diarrhea. Impetigo herpetiformis can cause serious complications to the mother and fetus which include: maternal hypocalcemia leading to delirium, convulsions, and tetany in the mother, and placental insufficiency leading to still birth, neonatal death or fetal abnormalities. Lesions are expected to disappear after birth but may recur during subsequent pregnancies at an earlier gestational age. Presented here is a case of IH occurring during the 37th week of gestation in a primigravida who failed to respond to oral steroid but successfully cleared with oral etretinate.
Undifferentiated connective tissue disease (UCTD) is a condition characterized by the presence of clinical manifestations suggestive of a connective tissue disease and at least one non-organ specific autoantibody. In this report I am presenting three types of cutaneous pigmentary changes are presented in three patients which were the clue to the diagnosis of UCTD.