Background: The Nikolskiy sign is a well- known mechanical Symptom that can be helpful in the diagnosis of pemphigus. The reports about associations with other than pemphigus cause confusion concerning the diagnostic ...Background: The Nikolskiy sign is a well- known mechanical Symptom that can be helpful in the diagnosis of pemphigus. The reports about associations with other than pemphigus cause confusion concerning the diagnostic importance of the Nikolskiy sign in pemphigus. Objective: Our purpose was to examine the significance and usefulness of the Nikolskiy sign on the clinical diagnosis of pemphigus by determination of its sensitivity and specificity. Methods: Presence of the Nikolskiy sign with the modifications of “ direct” and “ marginal” on 123 consecutive patients with various cutaneous diseases presenting as intact blisters andor erosions was sought. Results: A positive Nikolskiy sign was demonstrated in 24 (19.5% ) of the 123 patients. Of the positive 24 patients, 18 had pemphigus, 4 had bullous pemphigoid, 1 had linear IgA dermatosis, and 1 had staphylococcal scalded skin syndrome. The sensitivity of “ direct” Nikolskiy sign (38% ) was less than that of the “ marginal” form (69% ), but the specificity of “ direct” Nikolskiy sign (100% )was higher than that of the “ marginal” form (94% ) in the diagnosis of pemphigus. Limitations: This study was primarily concernedwith the diagnostic importance of the Nikolskiy sign in pemphigus. We did not focus on its prognostic value in pemphigus. The small size of the group of patientswith pemphigus, which is related to low annual incidence of pemphigus in our region, is another limitation of this study. Conclusions: The Nikolskiy sign offers a moderately sensitive but highly specific tool for the diagnosis of pemphigus.展开更多
Background: The purpose of this study was to describe the epidemiological and clinical features, course, response to treatment, and prognosis of pemphigus in the Mediterranean region of Turkey. Methods: All patients w...Background: The purpose of this study was to describe the epidemiological and clinical features, course, response to treatment, and prognosis of pemphigus in the Mediterranean region of Turkey. Methods: All patients with confirmed pemphigus were prospectively enrolled in two major dermatology departments in the cities of Adana and Antalya in the Mediterranean region between March 1998 and March 2004. Details including demography, findings of clinical examinations, treatment, course, and prognosis were recorded. Results: One hundred and forty-eight patients with pemphigus were diagnosed during the 6-year period, with a prevalence of 1.46 and an annual incidence of 0.24 per 100,000 in this region. There was a female predominance with a male to female ratio of 1: 1.4. Pemphigus vulgaris (PV) was the most common clinical subtype, identified in 123 patients (83% ). The mean age of onset was 43. In 101 (82% ) patients with PV, disease began as persistent oral ulcers. The majority of the patients with PV could be managed with middle or high-dose steroids (60- 140 mg/ day). Complete clinical remission was obtained in 41 (39.4% ) patients. The mortality rate was 4.8% . Conclusions: A moderately high incidence of pemphigus was found in the Mediterranean region of Turkey as compared with that encountered in other countries. The commonest clinical subtype was PV with a 9.5-fold higher incidence than pemphigus foliaceus. It is more frequent in middle-aged people and has a female predominance. Although a relatively higher dose of steroid was needed to control the PV, the disease completely remitted in a significant proportion of the patients.展开更多
Background: Cutaneous leishmaniasis (CL) has long been reported in the Cukurova region. We have compared the sensitivity of the conventional methods of diagnosis by microscopy and cultivation of lesion aspirates again...Background: Cutaneous leishmaniasis (CL) has long been reported in the Cukurova region. We have compared the sensitivity of the conventional methods of diagnosis by microscopy and cultivation of lesion aspirates against polymerase chain reaction (PCR) amplification of parasite-specific DNA from these samples. Methods: The samples (n = 25) were obtained from patients clinically diagnosed with CL at the regional dermatology clinic. Aliquots of the samples were stained with Giemsa for microscopy and cultured in Novy-Nicolle-McNeal(NNN) blood agar for promastigote growth. The remainder were subjected to DNA extraction for PCR amplification of the conserved region of kinetoplastmini circle DNA. PCR products of the expected size (120 bp) were observed after agarose gel electrophoresis, followed by staining with ethidium bromide. Results: The positive rates from 25 samples were 44% , 68% , and 100% for cultivation, microscopy, and, respectively. Conclusions: The PCR method used appears to be the most sensitive for the diagnosis of CL in this region.展开更多
文摘Background: The Nikolskiy sign is a well- known mechanical Symptom that can be helpful in the diagnosis of pemphigus. The reports about associations with other than pemphigus cause confusion concerning the diagnostic importance of the Nikolskiy sign in pemphigus. Objective: Our purpose was to examine the significance and usefulness of the Nikolskiy sign on the clinical diagnosis of pemphigus by determination of its sensitivity and specificity. Methods: Presence of the Nikolskiy sign with the modifications of “ direct” and “ marginal” on 123 consecutive patients with various cutaneous diseases presenting as intact blisters andor erosions was sought. Results: A positive Nikolskiy sign was demonstrated in 24 (19.5% ) of the 123 patients. Of the positive 24 patients, 18 had pemphigus, 4 had bullous pemphigoid, 1 had linear IgA dermatosis, and 1 had staphylococcal scalded skin syndrome. The sensitivity of “ direct” Nikolskiy sign (38% ) was less than that of the “ marginal” form (69% ), but the specificity of “ direct” Nikolskiy sign (100% )was higher than that of the “ marginal” form (94% ) in the diagnosis of pemphigus. Limitations: This study was primarily concernedwith the diagnostic importance of the Nikolskiy sign in pemphigus. We did not focus on its prognostic value in pemphigus. The small size of the group of patientswith pemphigus, which is related to low annual incidence of pemphigus in our region, is another limitation of this study. Conclusions: The Nikolskiy sign offers a moderately sensitive but highly specific tool for the diagnosis of pemphigus.
文摘Background: The purpose of this study was to describe the epidemiological and clinical features, course, response to treatment, and prognosis of pemphigus in the Mediterranean region of Turkey. Methods: All patients with confirmed pemphigus were prospectively enrolled in two major dermatology departments in the cities of Adana and Antalya in the Mediterranean region between March 1998 and March 2004. Details including demography, findings of clinical examinations, treatment, course, and prognosis were recorded. Results: One hundred and forty-eight patients with pemphigus were diagnosed during the 6-year period, with a prevalence of 1.46 and an annual incidence of 0.24 per 100,000 in this region. There was a female predominance with a male to female ratio of 1: 1.4. Pemphigus vulgaris (PV) was the most common clinical subtype, identified in 123 patients (83% ). The mean age of onset was 43. In 101 (82% ) patients with PV, disease began as persistent oral ulcers. The majority of the patients with PV could be managed with middle or high-dose steroids (60- 140 mg/ day). Complete clinical remission was obtained in 41 (39.4% ) patients. The mortality rate was 4.8% . Conclusions: A moderately high incidence of pemphigus was found in the Mediterranean region of Turkey as compared with that encountered in other countries. The commonest clinical subtype was PV with a 9.5-fold higher incidence than pemphigus foliaceus. It is more frequent in middle-aged people and has a female predominance. Although a relatively higher dose of steroid was needed to control the PV, the disease completely remitted in a significant proportion of the patients.
文摘Background: Cutaneous leishmaniasis (CL) has long been reported in the Cukurova region. We have compared the sensitivity of the conventional methods of diagnosis by microscopy and cultivation of lesion aspirates against polymerase chain reaction (PCR) amplification of parasite-specific DNA from these samples. Methods: The samples (n = 25) were obtained from patients clinically diagnosed with CL at the regional dermatology clinic. Aliquots of the samples were stained with Giemsa for microscopy and cultured in Novy-Nicolle-McNeal(NNN) blood agar for promastigote growth. The remainder were subjected to DNA extraction for PCR amplification of the conserved region of kinetoplastmini circle DNA. PCR products of the expected size (120 bp) were observed after agarose gel electrophoresis, followed by staining with ethidium bromide. Results: The positive rates from 25 samples were 44% , 68% , and 100% for cultivation, microscopy, and, respectively. Conclusions: The PCR method used appears to be the most sensitive for the diagnosis of CL in this region.
