Earlobe dermatitis.
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Biomedical subjects
Publications and source records attributed to Can Baykal.
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Pemphigus vulgaris is an autoimmune blistering disease characterized by disseminated bullae and erosions of the mucosal surfaces and skin. Cases of pemphigus vulgaris with localized lesions on glabrous skin have been reported, and most of them have been attributed to the Koebner phenomenon. Lesions limited to the nose have mostly been described in pemphigus foliaceus, but the nose has also been the initial site of pemphigus vulgaris in a few patients. We report 4 cases of localized pemphigus vulgaris: one case with lesions limited to the nose and cheeks and 3 cases with isolated lesions on the nose. Recurrent episodes in these patients also occurred on the nose. None of them showed mucosal involvement or dissemination during a follow-up period of 2 to 9 years. Three patients had autoantibodies against desmoglein-3 as detected by immunoblot. In the other patient, antibodies against desmoglein-3 were detected by enzyme-linked immunosorbent assay. These localized lesions may represent a subgroup of pemphigus vulgaris or a period of limited activity during this chronic disease.
Although nevoid hyperkeratosis of the nipple and areola was initially described in 1923, there are only case reports or reviews about it; no large series have been documented to date. The clinical features of the reported cases in the literature are not uniform, and it is questioned whether nevoid hyperkeratosis of the nipple and areola is a distinct clinicopathologic entity or a clinical presentation of various dermatoses. We describe 7 cases with hyperkeratotic nevoid lesions localized on the nipple and areola with different clinical features. None of them had any other associated dermatologic or systemic disease. Histopathologic examination was performed in 6 patients. Four of them had common histopathologic features suggesting a distinct entity, namely, nevoid hyperkeratosis of the nipple and areola; 2 of them had histopathologic features consistent with seborrheic keratosis. Seborrheic keratosis presents as sharply demarcated papules or plaques, whereas nevoid hyperkeratosis of the nipple or areola presents as a plaque diffusely involving the nipple or the areola.
OBJECTIVE: Psychogenic excoriation (PE), which is characterized by lesions formed by self-picking, has a significant place among the dermatoses related to psychological factors. Emotions, particularly anger that cannot be expressed, may be important in the etiology. The objective of this study was to evaluate the sociodemographic characteristics of patients with PE and with another psychodermatosis, and compare them in terms of anger, manner of anger expression, and alexithymia. METHODS: Thirty-one consecutive subjects with PE and thirty-one patients with chronic urticaria were recruited from an outpatient dermatology clinic. All of the subjects completed Toronto Alexithymia Scale and Trait Anger and Anger Expression Scale. RESULTS: PE patients had higher levels of anger (p < .01), tended not to show their anger (p < .05), and were more alexithymic (p < .05). There was also a positive correlation between anger and alexithymia scores (r = .49, p < .05). DISCUSSION: PE, a severe and chronic psychiatric and dermatological problem, may be related to affect-regulation, particularly anger and alexithymia. Due to the fact that it has a different place among psychodermatoses, individuals with PE might benefit from learning how to regulate their affects other than by excoriation.
OBJECTIVE: Psychogenic excoriation (PE), characterized by excessive scratching or picking of the skin, is not yet recognized as a symptom of a distinct DSM-IV disorder. It is a chronic disorder with a high rate of psychiatric comorbidity. The purpose of this study was to compare patients diagnosed with PE and another group of psychodermatosis patients in terms of comorbid psychiatric disorders. METHOD: Thirty-one consecutive subjects were recruited from an outpatient dermatology clinic. The control group was composed of 31 patients with a dermatological disease other than PE. Subjects were interviewed using the Structured Clinical Interview for DSM-III-R, Beck Depression Inventory (BDI), Hamilton Anxiety Rating Scale (HARS) and the Yale-Brown Obsession and Compulsion Scale (YBOCS). Subjects also completed a semi-structured questionnaire for socio-demographic data and clinical features. RESULTS: Current major depressive syndrome was the most common psychiatric disorder in the PE group. There was a statistically significant difference between the two groups in terms of current major depressive syndrome (PE group 58.1%, control group 6.5%, p<0.01). Some 45.2% of the PE group was diagnosed with obsessive compulsive disorder (OCD) while the proportion was only 3.7% in the control group. This difference was also statistically significant (p<0.01). The PE group scored significantly higher in the BDI, HARS and the YBOCS. CONCLUSION: The results of this study point to a close relationship between PE and depression and OCD.
Psychogenic excoriation (PE), characterized by excessive scratching or picking of the skin, is not yet recognized as a symptom of a distinct DSM-IV disorder. It is a chronic disorder with a high rate of psychiatric comorbidity. The purpose of this study was to compare patients diagnosed with PE and patients with another dermatological disease in terms of comorbid psychiatric disorders. Thirty-one consecutive subjects were recruited from an outpatient dermatology clinic. The control group was composed of 31 patients with chronic urticaria. All subjects were interviewed using the Structured Clinical Interview for DSM-III-R (SCID-I), Beck Depression Inventory (BDI), Hamilton Anxiety Rating Scale (HARS), and Yale-Brown Obsession and Compulsion Scale (Y-BOCS) and also completed a semistructured questionnaire. Current major depressive syndrome was the most common psychiatric disorder in the PE group. There was a statistically significant difference between the two groups in terms of current major depressive syndrome (PE group 58.1%, control group 6.5%, P<.01). In the PE group, 45.2% of subjects were diagnosed with obsessive compulsive disorder (OCD), while the rate of OCD was only 3.7% in the control group (P <.01). The PE group scored significantly higher on the BDI, HARS, and Y-BOCS. The results of this study point to the close relationship of PE to depression and OCD.