Journal of Dermatology and Dermatologic Diseases

Here we present a case of multiple systemic metastasis of missed malignant melanoma in a 26 year old male who was admitted to medical floor because of abdominal pain and B- symptoms. Abdominal Ultrasound revealed Right liver lobe mass with hepatomegaly. True cut biopsy of liver mass revealed an undifferntiated malignant tumor. The tumor cells were immunoreactive for Melan-A, Vimentin and focally for S-100 protein where the diagnosis of metastatic malignant melanoma was made.

Frontal Fibrosing Alopecia (FFA) is a primary cicatricial alopecia that presents with alopecia over the frontal hairline. Skin involvement in FFA was first acknowledged in 2012 when the association between FFA and Lichen Planus (LP) pigmentosus was described. Here we present a Caucasian FFA female patient with vitiligo-like patches over the front and neck whose biopsy showed epidermal interface changes. This is the first time achromic lesions due to interface dermatitis are associated to FFA, adding evidence for the extra-follicular epithelial involvement of the disease. True vitiligo, as well as subacute lupus erythematosus, are differential diagnoses that must be excluded.

Although the pathogenesis of vitiligo is not yet fully understood, the autoimmune hypothesis is the most commonly accepted. The aim of this study was to study the frequency of autoimmune diseases in a group of Egyptian patients with vitiligo compared with control. This study involved 50 Egyptian patients with vitiligo and 50 healthy subjects as control group. Patients should be made aware of signs and symptoms that suggest the onset of thyroid dysfunction, diabetes, or other autoimmune disease. If signs or symptoms occur, appropriate tests were performed. Screenings for thyroid disease were through evaluation of thyroid antibodies (anti-thyroidperoxidase, anti-thyroglobulin antibody), serum thyrotropin (TSH), free tri-iodothyronine (T3) and free thyroxine (T4). Screening for diabetes was done with fasting blood glucose or glycosylated hemoglobin testing. A complete blood count with indices helped rule out anemia. Antinuclear antibody screening was also done. Screening for celiac disease, IgA anti-glutaminase antibody was measured. The frequencies of autoimmune disorders were significantly elevated in vitiligo patients: vitiligo itself, autoimmune thyroid disease (particularly hypothyroidism), alopecia areata, pernicious anaemia, adult-onset type 1 diabetes mellitus, psoriasis and probably inflammatory bowel disease. These associations indicate that vitiligo shares common genetic aetiologic links with these other autoimmune disorders.

Background: Vitiligo is a patchy depigmentation of skin with a prevalence of 1-2% globally, with three probable mechanisms among which immunologic affairs are most prominent. Higher blood concentrations of prolactin in autoimmune diseases like thyroiditis, rheumatoid arthritis and SLE have identified a vital role for the hormone in this regard. So we conducted the current study to evaluate serum levels of prolactin in cases of vitiligo comparing to healthy subjects to detect any relationship and responsibility of prolactin in this disease. Methods: Through a case-control design, vitiligo sufferers referring to two university centers in Tehran were recruited beside a sex- and age-matched control group. Peripheral blood serum prolactin levels were measured to compare cases and controls in order to find any relevant changes. Results: 110 subjects including 55 cases of vitiligo and 55 controls were evaluated but no relationship was found between serum prolactin levels and existence or severity of vitiligo. Conclusion: Since prolactin is also produced locally in the skin, it is supposed that local release of hormone cannot hit the threshold of serum identified levels of prolactin resulting in normal concentrations in vitiligo. This study advises bigger study and measurement of prolactin in skin patches to detect lower levels of prolactin in addition to serum.

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Periocular pigmentation is bilateral, round, homogeneous macules especially on the infraorbital regions. Despite its prevalence, there are few published studies about dark circles and its pathogenesis. Possible causative factors of the dark circles include excessive pigmentation, periorbital edema, thin-translucent lower eye-lid skin overlying the orbicularis oculi muscle; and shadowing due to skin laxity and tear trough. A clinical approach to the treatment of periocular pigmentation should include identification and therapeutic targeting of each contributing etiologic factor for an individual patient. Treatment modalities, both monotherapy and in combination, have been used for periocular hyperpigmentation. They include bleaching creams, topical retinoic acid, chemical peels, laser therapies, injectable fillers, fat transfer and surgery.