Trichoscopic Signs in Dermatomyositis, Systemic Lupus Erythematosus, and Systemic Sclerosis: A Comparative Study of 150 Patients

<b><i>Background:</i></b> Hair and scalp involvement is prevalent in connective tissue diseases (CTDs). Trichoscopic features may provide a diagnostic implementation and enable differentiation among CTDs; however, a direct comparison of these signs among CTD patients is lacking. <b><i>Objectives:</i></b> To compare trichoscopic findings in dermatomyositis (DM), systemic lupus erythematosus (SLE), and systemic sclerosis (SSc) as well as determine their distinctive features and associations with disease activity. <b><i>Methods:</i></b> Trichoscopic photographs were taken from DM, SLE, and SSc patients and further evaluated for hair shaft and scalp surface abnormalities. Data regarding patients’ clinical manifestations, laboratory results, and disease activity were analyzed. <b><i>Results:</i></b> One hundred fifty participants, consisting of 30 DM, 60 SLE, and 60 SSc patients, were included. Perifollicular red-brown pigmentation, brown scattered pigmentation, and white patches were exclusive findings in DM, SLE, and SSc, respectively (<i>p</i> &#x3c; 0.001). A multinomial logistic regression analysis revealed that DM demonstrated higher odds for having microaneurysmal blood vessels than SLE and SSc (odds ratio [OR] = 22.22, 95% confidence interval [CI] = 1.73–285.13, <i>p</i> = 0.017, and OR = 15.34, 95% CI = 1.36–177.59, <i>p</i> = 0.029, respectively). Polymorphic vessels forming a telangiectatic network suggested SSc over SLE (OR = 12.83, 95% CI = 1.35–121.98, <i>p</i> = 0.026), while avascular areas were more pronounced in SSc than DM and SLE (OR = 43.24, 95% CI = 5.17–361.67, <i>p</i> = 0.001, and OR = 0.03, 95% CI = 0.01–0.24, <i>p</i> = 0.001, respectively). In a quantile regression analysis, perifollicular red-brown pigmentation, reduction in hair diameter, and the absence of thin arborizing vessels were linked to higher disease activity in DM, SLE, and SSc, respectively (all <i>p</i> &#x3c; 0.05). <b><i>Conclusions:</i></b> Trichoscopy is a valuable tool possessing diagnostic and prognostic values for CTDs. Specific trichoscopic features allow adequate distinction between DM, SLE, and SSc and may help identify active disease.

A new species of Expanathura (Crustacea: Isopoda: Anthuroidea) from Iriomote Island, Japan, with a note on male polymorphism

We describe Expanathura monile sp. nov. from Iriomote Island, Okinawa, Japan, northwestern Pacific. This species resembles E. collaris, E. macronesia, and E. haddae in having very broad uropodal rami, a broad telson, and a moderately shortened pleopod 1 endopod, but differs from these three species in the female having (1) the head with a dorsal V-shaped band of brown pigmentation, (2) the antennular flagellum with 3–4 articles, (3) antennal peduncular article 2 with an outer triangular projection, (4) the uropodal endopod longer than wide, (5) the uropodal exopod with an acute triangular projection, (6) an oval telson, and (7) the posterolateral setae on the telson similar in length. We present a revised key to known species in the genus Expanathura and briefly discuss the male polymorphism observed in E. monile.

Nevoid hyperkeratosis of the nipple and areola

Nevoid hyperkeratosis of the nipple and areola is an extremely rare and benign skin disease of unknown etiology, predominantly seen in childbearing aging women, especially in the second and third decades of life. The disease is characterized by gradually growing verrucous thickening and brown pigmentation of the nipple. Here, we present a case of nevoid hyperkeratosis of the nipple and areola in a 42-year-old female patient. Although nevoid hyperkeratosis of the nipple and areola has a benign character, it is a problem for patients due to deformity and for clinicians because of its similarity to paget disease. There is no consensus on treatment; Topical agents such as keratolytics, steroids, retinoids or calcipotriol, and ablative methods such as cryotherapy, carbon dioxide laser, radiofrequency, or shaving excision are treatment options.

New insights in the biogeographical distributions of two Spionidae (Annelida) from the NE Atlantic and Mediterranean French coasts

We report the first occurrences of Spiophanes afer Meißner, 2005 and Prionospio cristaventralis Delgado-Blas, Díaz-Díaz & Viéitez, 2018 from French marine waters (from the southern part of the Bay of Biscay in NE Atlantic, and the Gulf of Lion in the Mediterranean Sea). Morphological characters of S. afer include the presence of an occipital antenna, dorsal ciliated organs extending to chaetigers 13–15, neuropodial hooks from chaetiger 15, ventrolateral intersegmental pouches from chaetigers 14–15, chaetal spreaders of “2+3 type”, and conspicuous dark brown pigmentation on parapodia of chaetigers 9–13. Prionospio cristaventralis has four pairs of branchiae (1st and 4th pinnate, 2nd and 3rd apinnate), ventral crests from chaetigers 11–12, high dorsal crests on chaetigers 10–11, and very large notopodial prechaetal lamellae on anterior chaetigers. Both records represent northern extensions of their known distributions. However, the presence of S. afer on French coasts may have been overlooked for several decades. The validity of the recently proposed Spiophanes adriaticus is questioned.

A case of post-inflammatory warty dyskeratoma of the chest: Other dermoscopic features

Warty Dyskeratoma (WD) is a rare condition consisting in single or multiple papular or nodular lesions of the skin or of the oral mucosamucosa. Histologically, a cupshaped epidermal invagination centred by a plug of epidermal hyperparakeratosis with suprabasal acantholysis and dyskeratosis is typically observed. A case of post-inflammatory WD, which was also observed by dermoscopy, is described. Dermoscopy showed an eight-shape whitish collarette surrounded by light brown pigmentation. A central white structureless area with an adjacent rosette were observed. Some small rust-coloured blood crusts were also observed in the centre of the lesion; no prominent vascular pattern was detected. The etiopathogenesis of this benign neoplasm could be multifactorial. Dermoscopy of WD is not specific but may help to ruling out other skin tumors.

Prevalence and progression of macroscopic lesions in Orbicella annularis and O. faveolata on shallow fringing reefs of St. Kitts

The endangered corals Orbicella annularis and O. faveolata are crucial to Caribbean reefs because of their large size and contribution to reef framework. The objective of this study was to describe the prevalence and progression of macroscopically evident lesions affecting Orbicella spp. in shallow fringing reefs in St. Kitts. Cross-sectional surveys in the spring of 2017 demonstrated 8 predominant lesion patterns affecting 59% of corals (95% CI: 55.8-62.1%), including annular yellow-brown pigmentation, focal brown pigmentation, focal bleaching, diffuse bleaching, annular black surface deposit, focal tissue loss with skeletal erosion, focal grey pigmentation, and growth anomaly. Longitudinal surveys of 47 tagged corals were performed from August 2016-May 2017 to track lesion progression. The 2 most common lesions, annular yellow-brown pigmentation (n = 30), and focal brown pigmentation (n = 21), showed mean (±SD) partial colony mortality growth of 0.26 ± 0.5 and 0.21 ± 0.45 cm2 d-1, respectively. Annular pigmentation progression severity was associated with a marginating band of bleaching (ordinal odds ratio [OOR] = 11.0), and yellow rather than brown color (OOR = 3.8). Bleaching lesions (n = 13), occurring during a time of elevated sea surface temperature, were most severe during October-December 2016, and persisted through April 2017, months after heat stress had subsided. Annular black surface deposits (n = 3) were associated with rapid progression of acute tissue loss, whereas focal tissue loss with skeletal erosion (n = 2) regressed within months, and focal grey pigmentation (n = 2) was quiescent for the length of the study. This study enforces concern for the extent to which Orbicella spp. are declining due to disease.

Clinicopathologic and Dermoscopic Features of Acquired Perforating Dermatosis: A Case Report

Acquired perforating dermatosis represents one of the perforating skin disorders showing transepidermal elimination of dermal contents. Dermoscopy showing concentric zones of a central keratotic plug, white-gray structureless area and peripheral brown pigmentation may aid in diagnosis and in sample selection for biopsy.

Indian Dermoscopic Study of Forty Six Cases of Lichen Planus Pigmentosus - New Dermoscopy Signs Discovered

Lichen planus pigmentosus (LPP) is a atypical pigmented variety of lichen planus. Lichen planus pigmentosus is an unpredictable relapsing idiopathic dermatosis with periods of activation and remission with poor response to treatment and may leads to cosmetically disfiguring post inflammatory pigmentation. Aim - To study dermoscopic features of untreated cases of Lichen planus pigmentosus. Study subjects - All the patients who attended the dermatology clinic from November 2015 to November 2017 with the clinical diagnosis of LPP and who fulfilled the inclusion and exclusion criteria. Methodology - All the patients who attended the dermatology clinic with the diagnosis of LPP were examined by a dermatoscope. Dermoscopy was performed with DL4 dermatoscope. The images were further magnified with smart phone. Results - Our study showed various dermoscopic signs in cases of LPP like annular granular pattern (35 cases), annular globular pattern (5 cases), homogeneous brown pigmentation (12 cases), homogeneous brownish black pigmentation (8 cases), brownish ovoid nests (3 cases), bluish blackish fine dots (4 cases), Wickham’s striae(2 cases) and pigmented targetoid globules(3 cases). Discussion - Dermatoscope is an indispensible valuable tool in clinical practice which helps in making early lucid diagnosis of LPP with very high accuracy. Our study showed that annular granular pattern is the commonest pattern in Indian LPP cases followed by homogeneous brown pigmentation. In our Indian LPP dermoscopy study we discovered three novel dermoscopic signs which includes brownish globular nests, pigmented targetoid globules and bluish blackish fine dots. In our study we got few unique cases where Wickham’s striae was also present with other dermoscopic signs which supports the link of LPP to lichen planus. Dermatoscopic diagnosis of LPP is made by combination of various signs and should not be dependent on the presence of single marker.

Occurrences and characterization of endophytic Gluconacetobacter isolated from sugarcane tissues of North Eastern region of India

Sugarcane plants including roots were collected from 21 sugarcane growing locations of Golaghat, Dimapur and Jorhat districts of North Eastern region for isolation of endophytic Gluconacetobacter. Based on the nitrogenase activity, only eight isolates were selected for further characterization of Gluconacetobacter. The nitrogenase activity of the isolates ranged in between 12.4 to 72.4 n mole C2H4 h-1 culture-1. The characteristic yellowish surface pellicles were formed on inoculating the selected isolates into semisolid LGI medium and acetic LGI medium. On enumeration in LGI plates, the frequencies of well recognized Gluconacetobacter like colonies ranged in between 0.75 and 7.68 x 105 (cfu g-1 fresh tissue). Colony morphology of the isolates was irregular flat, irregular raised or circular raised yellow colonies of 1-5 mm in diameter. Light brown to brown pigmentation was observed on potato agar plates and light brown pigmentation with clearing of plates was observed on GYC plates. All the isolates exhibited gram negative and shape of the cells were rods. Reactions to extracellular and intracellular enzymes as well as to the various carbon sources by the isolates explained the diversity among them. The IAR profiles of the eight isolates against twelve antibiotics exhibited wide variation in their response to various antibiotics.