Zeitschrift für Dermatologie und dermatologische Erkrankungen

Introduction: Despite the dramatic success of the MDT by WHO regimens, a newer generation such as Ofloxacin displayed very promising bactericidal activity and in combination with Rifampicin by far is the highly bactericidal drug against M. leprae.
Case summary: A 38 year old Javanese man presented with relapsed leprosy after a 14 month course of WHO MDT. He complained persisted lesions all over his body lasting 1 year and several well demarcated erythematous and hyperpigmented plaques were observed. There were sensory impairment on some lesions and thickening of nerve on extremities. Leprosy was diagnosed in 2014 and after he completed WHO-MDT for 1 year, his BI was found to be 3+ and MI of 10%. A skin biopsy revealed borderline lepromatous and upgrading reaction. He was started on re-treatment MBMDT for two months but lesions persist and skin smear increased, showed a BI 5+ with MI of 60%. He was commenced on daily 600 mg rifampicin, 400 mg ofloxacin and 500 mg aspirin three times daily for six months. The patient completed the treatment and his lesions regressed. Conclusion: This case highlights therapeutic efficacy of Rifampicin and Ofloxacin in producing clinical improvement and bacterial killing. Additionally it resurrects the use of aspirin to treat type 1 reaction.Introduction: Despite the dramatic success of the MDT by WHO regimens, a newer generation such as Ofloxacin displayed very promising bactericidal activity and in combination with Rifampicin by far is the highly bactericidal drug against M. leprae. Case summary: A 38 year old Javanese man presented with relapsed leprosy after a 14 month course of WHO MDT. He complained persisted lesions all over his body lasting 1 year and several well demarcated erythematous and hyperpigmented plaques were observed. There were sensory impairment on some lesions and thickening of nerve on extremities. Leprosy was diagnosed in 2014 and after he completed WHO-MDT for 1 year, his BI was found to be 3+ and MI of 10%. A skin biopsy revealed borderline lepromatous and upgrading reaction. He was started on re-treatment MBMDT for two months but lesions persist and skin smear increased, showed a BI 5+ with MI of 60%. He was commenced on daily 600 mg rifampicin, 400 mg ofloxacin and 500 mg aspirin three times daily for six months. The patient completed the treatment and his lesions regressed.
Conclusion: This case highlights therapeutic efficacy of Rifampicin and Ofloxacin in producing clinical improvement and bacterial killing. Additionally it resurrects the use of aspirin to treat type 1 reaction.

Erythema dyscromicum perstans (EDP) or Ashy dermatosis is an uncommon pigmentary disorders which characterized with asymptomatic gray symmetric confluent macules over the body. It usually starts between first to three decades of the life and has a slow onset. This ailment can affect the palms, soles, scalp, nails and mucous membranes. Despite the definition of some etiological factors, the exact etiology of EDP is not clear. In this paper, we present a 24 years old patient with EDP.

Hypertrophic and keloid scars represent one of the main aesthetic and functional defects in patients after trauma, surgery, or burn. There are different therapeutic approaches used for these conditions, each showing varied results. Verapamil is a selective L-type calcium channel antagonist, which is currently considered as an alternative treatment in hypertrophic and keloid scars. Verapamil reduces the production of extracellular matrix, enhances collagenase secretion, and inhibits Interleukin 6 (IL-6), vascular endothelial growth factor (VEGF) and fibroblast cell proliferation. It also reduces the expression of transforming growth factor beta 1 (TGF-β1), subsequently inducing apoptosis. Verapamil is hereby proposed as an alternative and effective therapy for hypertrophic and keloid scars.

Background: Predilection sites of melanocytic nevi are highly variable; however, individual patterns (e.g. preponderant involvement of extremities, trunk, etc.) are often noticed. A symmetric appearance of nevi on both sides of the body has not been reported.
Objective: Guided by an initial, incidental observation of symmetrically arranged plantar nevi, a prospective survey of palmoplantar nevi was carried out.
Methods: Between January 2016, and January 2017, 886 patients underwent a full-body examination for skin cancer screening. Special attention was paid to the pigmentary characteristics of the palms and soles. Results: 12/886 patients exhibited symmetrically or nearly symmetrically distributed plantar nevi (1.35%; mean age 45 years; male-female ratio 1:1). The nevi were mostly situated on the medial part of the plantar arch (9/12 cases; 75%). Remarkably, not a single case of symmetric nevi was identified on the palms.
Conclusion: Arguments in favour of the specifity of the finding are: 1) the lack of comparable findings in palmar skin, i.e., in a similar histological compartment and 2) the predominant localization in the foot arch. Symmetric plantar nevi appear to be a rare, but not a random event. Possible underlying causes of this phenomenon are discussed.

Dermoscopy is valid, non-invasive technique for the visualization of different morphological structures within pigmented melanocytic skin lesion. In clinical practice, positive personal history is considered to be as an indication of increased melanoma risk. The thickness of melanoma (Breslow Index) is the most important independent predicting factor of survival for stage I patients. We aimed to present two cases of head-melanoma and discuss prominent clinical and dermoscopic features across the spectrum of “hidden-melanoma” and differential diagnosis.

A case of superficial skin lesions due to T. asahii is reported, concerning an immune-deficient patient while receiving micafungin. Yet, T. asahii is assumed as intrinsically resistant to echinocandines. Thus, compared to echinocandines, azoles should be preferred in antifungal prophylaxis of immunosuppressed patients because they treat a wider variety of opportunistic fungi, including T. asahii. Additionally, T. asahii should be regarded as a potential pathogen causing skin lesions in immune-depressed or surgical patients.