- Email: [email protected]
Cutaneous leishmaniasis in Turkey: Is the eastern sore becoming the western sore?
Posrers - Iafections/Infestaliorls
S240
face is even in the immunocompetent host a therapeutic challenge. We report on a 1Cyear-old girl who had suffered from increasing eruption of multiple verrucae planae et filiformes of the face for 18 months. Before admission to our outpatient department mechanical manipulation by curettage had been performed leading to further deterioration. As an alternative to silk-touch CO&ser, contact cryotherapy or systemic immune enhancer we performed a topical immunotherapy with diphenylcyclopropenone(DCP). The initial challenge with DCP 2% was performed on the forehead and the challenge was done with DCP 0.01% once a week. Except for weak itching and erythema no adverse effects wefe observed. After four treatments the girl reported of peeling of single warts and after eight weeks her face was free of lesions. So far, the patient has remained free of any relapse. This is the first case report on successful topical immunotherapy with DCP in facial verrucae planae and should be regarded as an effective therapeutic instrument in those indications.
reaction. He was highly sensitive to PPD and was given triple antituberculous therapy. He was free of lesions after the first week of treatment. Serologic examination is the most important diagnosing tool in Lyme borreliosis. Currently used serologic tests such as ELISA and indirect immunofluoresence assay are not completely specific as false-negative and especially false-positive results are common. Western blotting is more specific and sensitive but usually preferred as a confirmatory test for ELISA. Immunologic crossreactivity. lack of standardization between laboratories, are some of tile causes of false-positive and negative results. Therefore, serologic testing in LB must be correlated with clinical picture and interpreted with caution. To our knowledge, false-positive Borelia burgdorferi serology associating EIB has not been reported previously. I P234 Cutaneous leishmaniasis in Turkey: Is the
eastern sore becoming the western sore?
ElP232
Recurrent erythema multiforme and hepatitis C: Efficacy of interferon (II
V. Dumas, N. Thieulent, A.L. Souillet, C. Stamm, M. Faure, A. Claudy. HBpital Edouard Herriot, Lyon, France Erythema multiforme (EM) is an acute self-limiting muco-cutaneous disorder which has been described in association with a wide range of factors, among them HCV infection. We report the case of a 40-year-old man who presented with a two-years history of seven episodes of EM. Due to the fact that the patient had had labial herpes simplex virus (HSV) infection two years before the onset of EM, oral acyclovir was given at a dosage of 800 mg daily for 6 months without suppression of EM. An elevation of serum aminotransferase activity was then noted. Serological markers for HSV, mycoplasma. CMV, EBV, VII-I were negative. Anti-HCV tests were positive in serum, and PCR detected replicating HCV in serum but not in skin lesions. The patient was treated with interferon alpha, 9 MU/week for 6 months. HCV replication was no longer detectable in the serum and EM did not manifest during the treatment but recurred soon after discontinuation of the treatment. The association between recurrent EM and HCV infection may be explained by cell-mediated immune mechanisms. We recommand to perform an HCV screening in patients with recurrent EM. Further studies will be needed to evaluate the incidence of EM in HCV hepatitis. I P233 Erythema incluratum of bazin with
false-positive Borrelia burgdorferi serology
T.O. Giilep, D. Seqkin. Departwent
Bafkent Uuiversity Faculty of Dermatology, Ankara, Turkey
of Medicine,
A 52-year-old man presented with recurrent, painful, non-ulcerated erythematous nodules on his anterior right thigh and calf over the last 3 months. A positive serology (ELISA) for Borrelia burgdorferi was found and he was given doxycyline therapy but did not respond, the diagnosis of Lyme borreliosis (LB) was considered incorrect. A skin biopsy revealed granulomatous panniculitis consistent with erythema induratum of Bazin (EIB) and mycobacterial DNA was detected by polymerase chain
E. Bozkurt, N. $endur, G. Karaman. Adnan University
Medical
School,
Aydul,
Menderes
Turkey
Cutaneous leishmaniasis (CL) is a well known protozoan infestation of the skin. Clinical presentation and course vary according to the species of Leishmania, geography and the immune status of the host. Local names for the disease are “the Eastern boil” or “the Eastern sore” which emphasise the specific geographic distribution of the infestation. In Turkey case reports have been limited to South-Eastern and Middle Anatolia and the Mediterranean. There have been no cases reported from the Western parts of the country between 1989-1996. We present 22 cases of CL which were diagnosed at our clinic between September 1996-December 1997. Clinical diagnosis of all cases have been confirmed by demonstration of the parasite on stained impression smears. These are the first cases to be reported from our region. Clinical features of the cases are presented along with a discussion about a possible explanation of the “westemisation” of CL - at least in Turkey. I P235 Antibacterial effect of tarivid in burn patiens R. Orasan, E Kevorkian, M. Crisan, C. Has, R. Popa, N. Gavan. Clinic of Dermatology CJMF Cluj-Napoca, Romania The main complication of bum injured patients is the bacterial infection, especially with Staphylococcal flora resistant to usual antibacterial drugs. Our study proposes a new antibacterial drug - ofloxacin - with certain anti-staphylococcal effects, controlled both in vitro (the Microbiology Laboratory of the Dermatology Hospital of Cluj) and in vivo on a series of bum patiens. Ofloxacin (Tarivid) is a 4-quinolon with a broad antibacterial spec-trum, acting through bacterial DNA inhibition. The utili-ty of Ofloxacin as an antistaphylococcal drug in bum injuries is based on its highly inhibiting effect on Staphylococcus aureus, both on metycillin sensitive and resistant species at relative low doses. In the Dermatology Hospital of Cluj we utilized, on a lot of 7 patients with superficial bum injuries (I and.11 degree), alternative applications of Tarivid 1% epithelizating cream and dressings with Tarivid solution 1%. This treatment was compared with a standard treatment applied on similar lesions located in symmetrical areas in the same patient.
S240
face is even in the immunocompetent host a therapeutic challenge. We report on a 1Cyear-old girl who had suffered from increasing eruption of multiple verrucae planae et filiformes of the face for 18 months. Before admission to our outpatient department mechanical manipulation by curettage had been performed leading to further deterioration. As an alternative to silk-touch CO&ser, contact cryotherapy or systemic immune enhancer we performed a topical immunotherapy with diphenylcyclopropenone(DCP). The initial challenge with DCP 2% was performed on the forehead and the challenge was done with DCP 0.01% once a week. Except for weak itching and erythema no adverse effects wefe observed. After four treatments the girl reported of peeling of single warts and after eight weeks her face was free of lesions. So far, the patient has remained free of any relapse. This is the first case report on successful topical immunotherapy with DCP in facial verrucae planae and should be regarded as an effective therapeutic instrument in those indications.
reaction. He was highly sensitive to PPD and was given triple antituberculous therapy. He was free of lesions after the first week of treatment. Serologic examination is the most important diagnosing tool in Lyme borreliosis. Currently used serologic tests such as ELISA and indirect immunofluoresence assay are not completely specific as false-negative and especially false-positive results are common. Western blotting is more specific and sensitive but usually preferred as a confirmatory test for ELISA. Immunologic crossreactivity. lack of standardization between laboratories, are some of tile causes of false-positive and negative results. Therefore, serologic testing in LB must be correlated with clinical picture and interpreted with caution. To our knowledge, false-positive Borelia burgdorferi serology associating EIB has not been reported previously. I P234 Cutaneous leishmaniasis in Turkey: Is the
eastern sore becoming the western sore?
ElP232
Recurrent erythema multiforme and hepatitis C: Efficacy of interferon (II
V. Dumas, N. Thieulent, A.L. Souillet, C. Stamm, M. Faure, A. Claudy. HBpital Edouard Herriot, Lyon, France Erythema multiforme (EM) is an acute self-limiting muco-cutaneous disorder which has been described in association with a wide range of factors, among them HCV infection. We report the case of a 40-year-old man who presented with a two-years history of seven episodes of EM. Due to the fact that the patient had had labial herpes simplex virus (HSV) infection two years before the onset of EM, oral acyclovir was given at a dosage of 800 mg daily for 6 months without suppression of EM. An elevation of serum aminotransferase activity was then noted. Serological markers for HSV, mycoplasma. CMV, EBV, VII-I were negative. Anti-HCV tests were positive in serum, and PCR detected replicating HCV in serum but not in skin lesions. The patient was treated with interferon alpha, 9 MU/week for 6 months. HCV replication was no longer detectable in the serum and EM did not manifest during the treatment but recurred soon after discontinuation of the treatment. The association between recurrent EM and HCV infection may be explained by cell-mediated immune mechanisms. We recommand to perform an HCV screening in patients with recurrent EM. Further studies will be needed to evaluate the incidence of EM in HCV hepatitis. I P233 Erythema incluratum of bazin with
false-positive Borrelia burgdorferi serology
T.O. Giilep, D. Seqkin. Departwent
Bafkent Uuiversity Faculty of Dermatology, Ankara, Turkey
of Medicine,
A 52-year-old man presented with recurrent, painful, non-ulcerated erythematous nodules on his anterior right thigh and calf over the last 3 months. A positive serology (ELISA) for Borrelia burgdorferi was found and he was given doxycyline therapy but did not respond, the diagnosis of Lyme borreliosis (LB) was considered incorrect. A skin biopsy revealed granulomatous panniculitis consistent with erythema induratum of Bazin (EIB) and mycobacterial DNA was detected by polymerase chain
E. Bozkurt, N. $endur, G. Karaman. Adnan University
Medical
School,
Aydul,
Menderes
Turkey
Cutaneous leishmaniasis (CL) is a well known protozoan infestation of the skin. Clinical presentation and course vary according to the species of Leishmania, geography and the immune status of the host. Local names for the disease are “the Eastern boil” or “the Eastern sore” which emphasise the specific geographic distribution of the infestation. In Turkey case reports have been limited to South-Eastern and Middle Anatolia and the Mediterranean. There have been no cases reported from the Western parts of the country between 1989-1996. We present 22 cases of CL which were diagnosed at our clinic between September 1996-December 1997. Clinical diagnosis of all cases have been confirmed by demonstration of the parasite on stained impression smears. These are the first cases to be reported from our region. Clinical features of the cases are presented along with a discussion about a possible explanation of the “westemisation” of CL - at least in Turkey. I P235 Antibacterial effect of tarivid in burn patiens R. Orasan, E Kevorkian, M. Crisan, C. Has, R. Popa, N. Gavan. Clinic of Dermatology CJMF Cluj-Napoca, Romania The main complication of bum injured patients is the bacterial infection, especially with Staphylococcal flora resistant to usual antibacterial drugs. Our study proposes a new antibacterial drug - ofloxacin - with certain anti-staphylococcal effects, controlled both in vitro (the Microbiology Laboratory of the Dermatology Hospital of Cluj) and in vivo on a series of bum patiens. Ofloxacin (Tarivid) is a 4-quinolon with a broad antibacterial spec-trum, acting through bacterial DNA inhibition. The utili-ty of Ofloxacin as an antistaphylococcal drug in bum injuries is based on its highly inhibiting effect on Staphylococcus aureus, both on metycillin sensitive and resistant species at relative low doses. In the Dermatology Hospital of Cluj we utilized, on a lot of 7 patients with superficial bum injuries (I and.11 degree), alternative applications of Tarivid 1% epithelizating cream and dressings with Tarivid solution 1%. This treatment was compared with a standard treatment applied on similar lesions located in symmetrical areas in the same patient.