El-Darouti, M. A., S. A. Marzouk, N. Nabil, M. R. E. Abdel-Halim, M. H. M. El-Komy, and M. Abdel-Latif,
"Pachyonychia congenita: treatment of the thickened nails and palmoplantar circumscribed callosities with urea 40% paste",
Journal of the European Academy of Dermatology and Venereology, vol. 20, no. 5: Wiley Online Library, pp. 615–617, 2006.
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El-Nabarawy, E. A., N. Saleh, and M. R. E. Abdel-Halim,
"Peculiar papular eruption on the vulva and inguinal folds.",
Journal of clinical pathology, vol. 72, issue 2, pp. 185, 2018 Dec 20, 2019.
AbstractCLINICAL QUESTION: A 26-year-old woman presented with asymptomatic skin coloured to whitish keratotic papules on the vulva, inguinal folds and inner thighs of 6 years duration. She had no similar lesions elsewhere and no family history. A biopsy was taken from one of the papules.Review the high-quality, interactive digital Aperio slide at http://virtualacp.com/JCPCases/jclinpath-2018-205434/ and consider your diagnosis. WHAT IS YOUR DIAGNOSIS?: Darrier's diseaseHailey-Hailey diseaseGenital wartsPapular acantholytic dyskeratosis of genitocrural areaPemphigus vegetansThe correct answer is after the discussion.
DISCUSSION: Papular acantholytic dyskeratosis (PAD) of the genitocrural area is a peculiar acantholytic dermatosis with dyskeratosis localised to the vulva and inguinal folds with possible extension to the thighs and perineum.1 It mainly involves young or middle-aged females.1 Cases affecting males and involving genitalia, thighs and perianal region have been reported.2 It represents an allelic variant of Hailey-Hailey disease as heterozygous mutations in gene (intron 5 and exon 24) have been reported in some cases.3 Clinically, PAD of the genitocrural area is typically characterised by solitary or grouped keratotic flesh coloured or white papules.1 Other clinical presentations include: vesicles, bullae, patches and plaques.4 Although the lesions are mainly asymptomatic, patients may experience variable degrees of itching or burning sensation.Histopathologically, the lesions show hyperkeratosis, hypergranulosis, acanthosis and acantholytic dyskeratosis in the spinous layer (figure 1). Typically, direct immunoflourescence (DIF) is negative.5 jclinpath;jclinpath-2018-205434v1/F1F1F1Figure 1Photomicrograph representing histopathological findings: hyperkeratosis, hypergranulosis, acanthosis and acanthloytic dyskeratosis involving the spinous layer; 254×143 mm.The most important differential diagnoses of this sporadic condition include: Darier's and Hailey-Hailey, both of which are familial. Hailey-Hailey involves also other flexural areas and presents with eroded crusted lesions with foul odour. Pathologically, the acantholytic process in PAD of the genitocrural area is rather focal compared with the broad zone of acantholysis in Hailey-Hailey, and columns of parakeratosis overlying suprabasilar acantholysis are characteristic of Darier's disease. Although, some cases of PAD of the genitocrural area can present with vesicles and bullae, the presence of dyskeratotic cells and the negative DIF speaks against pemphigus.Treatment options for this condition include topical and systemic retinoids. Cryotherapy and laser have been also reported to be effective. Topical steroids might be effective in reducing pruritus.
Abdalla, D., M. Bosseila, M. R. E. Abdel-Halim, and I. Sany,
"Peripilar Sign in Androgenetic Alopecia: Does It Really Indicate Peripilar Infiltrate?",
Dermatology practical & conceptual, vol. 14, issue 1, 2024.
AbstractINTRODUCTION: Peripilar sign (PPS) is a trichoscopic sign that was first described in androgenetic alopecia (AGA) and is thought to reflect the presence of perifollicular infiltrate (PFI) in histopathology.
OBJECTIVES: To study PPS in a cohort of patients with AGA and to assess its validity as a sign indicative of PFI.
METHODS: One hundred patients with AGA (confirmed by trichoscopic examination) were recruited in this cross-sectional study. From those patients, frontal scalp biopsy was done for two subgroups, 22 patients with PPS and 23 patients without PPS. Both groups were compared as regards the presence of PFI.
RESULTS: Peripilar sign was present in 50% of the 100 studied cases. No significant difference existed between those with and those without PPS as regards PFI. Peripilar sign was significantly more encountered in patients with skin type III (p=0.001). Its absence was significantly associated with lower interpretability of yellow dots (p<0.001) and their scores were significantly positively correlated (r=0.498, p<0.001). Peripilar sign was significantly associated with absent melanophages histopathologically (p=0.011).
CONCLUSION: Peripilar sign as a trichoscopic sign in AGA does not reflect PFI. It represents a dark color more encountered in patients with lighter skin types. This can be explained by the increased contrast between the dark PPS and the lighter surrounding skin in lighter skin types. Further studies using melanocyte markers and Masson Fontana's stain are needed to further verify the cause of this peri-follicular dark color.
Komy, M. E. L., E. El-Nabarawy, H. Abdelkader, M. R. E. Abdel-Halim, and R. AlAguizy,
"Pigmentary mosaicism and extracutaneous defects: a case report of a rare form of twin spotting",
Pigment International, vol. 8, pp. 176-8, 2021.
El-Enany, G., M. El-Mofty, M. R. E. Abdel-Halim, D. Dermpath, N. Nagui, H. Nada, M. A. Saleh, I. Sany, A. Nada, O. El-Ghanam, et al.,
"Postpartum Castleman disease presenting as paraneoplastic pemphigus: a case report.",
International journal of dermatology, vol. 62, issue 3, pp. e111-e113, 2023.
El-Darouti, M. A., S. A. Marzouk, M. H. M. El-Komy, and M. RE,
"Preliminary Clinical, Histopathological and Laboratory Study of Cases Presenting with Pruriginous Edematous Excoriated Papular Eruption (Subacute Prurigo)",
Kasr Al Aini Medical Journal, vol. 13, no. 1, pp. 7–13, 2007.
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