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An algorithmic and computerized approach for urticaria
s314
Posters - Vrticaria
to implementation of this method the cells become purple and clearly contrast with the background. The latter condition is prerequisite for performing a proper image analysis methods using a computer system. These methods allow to extract mast cell objects from the analyzed image and calculate for each detected mast cell the set of geometrical features such as area, edge and cell maximal diameter. Pinacyanol erythrosinate allowed to recognize a sufficient difference in contrast between the examined mast cells and image background. The implemented image analysis methods provide fast and automated skin mast cell description.
P546 The mast cells in skin tumors R. Apaydm’, G. Harova’, N. Bilen’, D. Bayramgtlrler’, Y. Gilrbtlz’, S. Dokmeci ’ . ‘Faculty . of Medicine, Kocaeli Ut’iversity,
Izn’it,
lbrkey
In this prospective study, the number of mast cells surrounding squamous cell carcinomas (MC-S), basal cell carcinomas (MC-B) and malignant melanoma (MC-M) was assessed. The results were compared with the number of mast cells in uninvolved skin (MC-U) in each case. The mast cell number surrounding the tumor was divided by the mast cell number in uninvolved skin to have a mast cell index (MC-I). The study group consisted of a total number of 29 cases including 8 cases of SCC. 20 cases of BCC and I case of MM. The number of MC-S was statistically higher than that of MC-U (p = 0.0117). The number of MC-B was also greater than the number of MC-U (p = 0.0002). The number of MC-M was almost equal to that of MC-U. MC-I in BCCs was statistically insignificant compared with MC-I in SCCs (p = 0.415). Our results indicate that there is a positive correlation between the mast cell density and above mentioned skin tumors excluding MM.
IP547
An algorithmic and computerized approach for urticarla
V.L. Aksungur, H. Boga, S. Uzun, I. Ceken, A. Pelit. Qrkurova Vr’iversity
Medical
School,
Adar’a,
7hkey
Our approach starts with seeking own clinical features of an urticarial eruption. If an individual lesion persists longer than 24 hours or is associated with purpura or pigmentation, a biopsy is obtained to exclude urticarial vasculitis. If the eruption is acute or severe, symptomatic treatment has priority. If physical factors are predominated, special provocation tests are done. If the eruption is chronic, etiological factors are investigated in detail by a questionnaire, a systemic physical examination, erythrocyte sedimentation rate, complete blood counts, urine analysis and stool examination for parasites and ova. Further investigations are planned to do in according to the clinical findings. We developed special computer forms and procedures to record and evaluate data of patients with urticarial eruptions. The records of 391 patients were re-evaluated. The approach was completely carried out in 64% of 224 patients in whom the special computer programs were used and only in 4% of 167 patients in whom these programs were not used. A history of drug intake was obtained in 93% of 100 patients with chronic urticaria who completed the questionnaire. Symptomatic and asymptomatic patients had laboratory findings of urinary infec-
mrd mast cell disorders
tions and intestinal parasitoses in almost same frequencies (23% vs 16% for leukocytes in urine and 26% vs 16% for parasites in stool). In conclusion, computer programs for our approach and a questionnaire for history taking are useful. Urine analysis and stool examination should be done in all patients with chronic urticaria. I P546
Urticaria pigmentosa in an adult with indolent systemic mastocytosis
F. Arttlz’, N. Alli’, M. Ayh’, G. Karakayal”. E. Gtlngor’. of Dern’atology;
Ankara Nartturre Hospital; ‘Departmeats ZHer’ratology, Ankara, Turkey
Urticaria pigmentosa and systemic mastocytosis are idiopathic proliferative mast cell diseases that present widespread focal cutaneous and multi-organ involvement at any age. We report a case of urticaria pigmentosa in a 50-year-old patient with liver, spleen, lymph node and bone marrow involvement who was diagnosed as urticaria pigmentosa when he was five years old only with skin disease. We want to emphasize the need of carefull follow-up of patients with mastocytosis for systemic involvement. I P549
lmmunopathological urticaria
findings in chronic
D. Deviren’. S. Erboz’, S. Alper’, G. Kandiloglu*, A. bzttlrk’ , S. KtlctlktaS’ . ‘Ege University Medical Department of Dermatology, hir; ZEge University Faculty, Department of Pathology, hrir; Tiirkiye
T. Akalin*, Faculty, Medical
The aim of the study was to determine the incidence of vasculitis in patients clinically diagnosed as chronic urticaria. Biopsy specimens of 55 patients were examined histopathologically and DIF findings of each patient was reported. Only 3 of the patients (%5.4) showed vasculitis histopathologically and 13 patients were DIF positive. According to the literature, the incidence of vasculitis in chronic urticaria ranges between %2 and %52. We believe that further investigation is needed to reach a definite result and conclude that DIF and histopathology is important in chronic urticaria in order to diagnose vasculitis and perform a proper treatment. I P550
Detailed etiological investigation in chronic urticarla: Results obtained from 55 patients
D. Deviren’, S. Erboz’, S. Alper’, E Gzdemir’, I Unal’. ‘Ege Ur’iversity, Medical Faculty, Department of Dermatology, hir;
Turkey
55 patients diagnosed as chronic urticaria were investigated in order to find an etiological agent. History of the disease and the results of bacterial cultures, X-rays, ultrasound, rutine blood tests, serological tests were evaluated. Nine patients had urinary tract infection, 7 patients had upper respiratory tract infection, 3 had streptococcal infection, 2 patients had intestinal parasitosis and I2 patients had otoimmune tiroiditis.
Posters - Vrticaria
to implementation of this method the cells become purple and clearly contrast with the background. The latter condition is prerequisite for performing a proper image analysis methods using a computer system. These methods allow to extract mast cell objects from the analyzed image and calculate for each detected mast cell the set of geometrical features such as area, edge and cell maximal diameter. Pinacyanol erythrosinate allowed to recognize a sufficient difference in contrast between the examined mast cells and image background. The implemented image analysis methods provide fast and automated skin mast cell description.
P546 The mast cells in skin tumors R. Apaydm’, G. Harova’, N. Bilen’, D. Bayramgtlrler’, Y. Gilrbtlz’, S. Dokmeci ’ . ‘Faculty . of Medicine, Kocaeli Ut’iversity,
Izn’it,
lbrkey
In this prospective study, the number of mast cells surrounding squamous cell carcinomas (MC-S), basal cell carcinomas (MC-B) and malignant melanoma (MC-M) was assessed. The results were compared with the number of mast cells in uninvolved skin (MC-U) in each case. The mast cell number surrounding the tumor was divided by the mast cell number in uninvolved skin to have a mast cell index (MC-I). The study group consisted of a total number of 29 cases including 8 cases of SCC. 20 cases of BCC and I case of MM. The number of MC-S was statistically higher than that of MC-U (p = 0.0117). The number of MC-B was also greater than the number of MC-U (p = 0.0002). The number of MC-M was almost equal to that of MC-U. MC-I in BCCs was statistically insignificant compared with MC-I in SCCs (p = 0.415). Our results indicate that there is a positive correlation between the mast cell density and above mentioned skin tumors excluding MM.
IP547
An algorithmic and computerized approach for urticarla
V.L. Aksungur, H. Boga, S. Uzun, I. Ceken, A. Pelit. Qrkurova Vr’iversity
Medical
School,
Adar’a,
7hkey
Our approach starts with seeking own clinical features of an urticarial eruption. If an individual lesion persists longer than 24 hours or is associated with purpura or pigmentation, a biopsy is obtained to exclude urticarial vasculitis. If the eruption is acute or severe, symptomatic treatment has priority. If physical factors are predominated, special provocation tests are done. If the eruption is chronic, etiological factors are investigated in detail by a questionnaire, a systemic physical examination, erythrocyte sedimentation rate, complete blood counts, urine analysis and stool examination for parasites and ova. Further investigations are planned to do in according to the clinical findings. We developed special computer forms and procedures to record and evaluate data of patients with urticarial eruptions. The records of 391 patients were re-evaluated. The approach was completely carried out in 64% of 224 patients in whom the special computer programs were used and only in 4% of 167 patients in whom these programs were not used. A history of drug intake was obtained in 93% of 100 patients with chronic urticaria who completed the questionnaire. Symptomatic and asymptomatic patients had laboratory findings of urinary infec-
mrd mast cell disorders
tions and intestinal parasitoses in almost same frequencies (23% vs 16% for leukocytes in urine and 26% vs 16% for parasites in stool). In conclusion, computer programs for our approach and a questionnaire for history taking are useful. Urine analysis and stool examination should be done in all patients with chronic urticaria. I P546
Urticaria pigmentosa in an adult with indolent systemic mastocytosis
F. Arttlz’, N. Alli’, M. Ayh’, G. Karakayal”. E. Gtlngor’. of Dern’atology;
Ankara Nartturre Hospital; ‘Departmeats ZHer’ratology, Ankara, Turkey
Urticaria pigmentosa and systemic mastocytosis are idiopathic proliferative mast cell diseases that present widespread focal cutaneous and multi-organ involvement at any age. We report a case of urticaria pigmentosa in a 50-year-old patient with liver, spleen, lymph node and bone marrow involvement who was diagnosed as urticaria pigmentosa when he was five years old only with skin disease. We want to emphasize the need of carefull follow-up of patients with mastocytosis for systemic involvement. I P549
lmmunopathological urticaria
findings in chronic
D. Deviren’. S. Erboz’, S. Alper’, G. Kandiloglu*, A. bzttlrk’ , S. KtlctlktaS’ . ‘Ege University Medical Department of Dermatology, hir; ZEge University Faculty, Department of Pathology, hrir; Tiirkiye
T. Akalin*, Faculty, Medical
The aim of the study was to determine the incidence of vasculitis in patients clinically diagnosed as chronic urticaria. Biopsy specimens of 55 patients were examined histopathologically and DIF findings of each patient was reported. Only 3 of the patients (%5.4) showed vasculitis histopathologically and 13 patients were DIF positive. According to the literature, the incidence of vasculitis in chronic urticaria ranges between %2 and %52. We believe that further investigation is needed to reach a definite result and conclude that DIF and histopathology is important in chronic urticaria in order to diagnose vasculitis and perform a proper treatment. I P550
Detailed etiological investigation in chronic urticarla: Results obtained from 55 patients
D. Deviren’, S. Erboz’, S. Alper’, E Gzdemir’, I Unal’. ‘Ege Ur’iversity, Medical Faculty, Department of Dermatology, hir;
Turkey
55 patients diagnosed as chronic urticaria were investigated in order to find an etiological agent. History of the disease and the results of bacterial cultures, X-rays, ultrasound, rutine blood tests, serological tests were evaluated. Nine patients had urinary tract infection, 7 patients had upper respiratory tract infection, 3 had streptococcal infection, 2 patients had intestinal parasitosis and I2 patients had otoimmune tiroiditis.