Pityriasis rubra pilaris (PRP) and plaque psoriasis (PP) are two distinctive erythemato-squamous skin diseases that often have to be differentiated from each other and from other similar dermatoses. Dermoscopy has been proven to aid the clinical diagnosis of several inflammatory disorders, minimizing the need for skin biopsy. Our aim was to determine the dermoscopic patterns of PRP compared to PP and to assess the significance of certain dermoscopic criteria in the diagnosis of PRP. This case-control study included 11 patients with biopsy proven PRP and 25 patients with biopsy proven plaque psoriasis. The most recently developed lesion of each patient was examined by non-contact dermoscopy. Whitish keratotic plugs and linear vessels in yellowish background are significant dermoscopic features of PRP compared to white diffuse scales and dotted vessels in a light red background in PP. In conclusion, PRP and PP reveal specific distinguishing dermoscopic patterns that may assist in their clinical diagnosis and may also be useful for the differential diagnosis from other resembling dermatoses.

BackgroundBronchial vascular remodeling is an underresearched component of airway remodeling in COPD. Image-enhanced bronchoscopy may offer a less invasive method for studying bronchial microvasculature in COPD.ObjectivesTo evaluate endobronchial mucosal vasculature and changes in COPD by image-enhanced i-scan3 bronchoscopy and correlate them pathologically by analyzing bronchial mucosal biopsies.MethodsThis case–control study analyzed 29 COPD patients (41.4% Global initiative for chronic Obstructive Lung Disease B [GOLD B] and 58.6% GOLD D) and ten healthy controls admitted at Alexandria Main University Hospital, Egypt. Combined high-definition white light bronchoscopy (HD WLB) with i-scan3 was used to evaluate endobronchial mucosal microvasculature. The vascularity was graded according to the level of mucosal red discoloration (ie, endobronchial erythema) from decreased discoloration to normal, mild, moderate, and severe increased red discoloration (G−1, G0, G+1, G+2, and G+3, respectively) and scored by three bronchoscopists independently. Bronchial mucosal biopsies were taken for microvascular density counting using anti-CD34 antibody as angiogenesis marker.ResultsDifferent grades of endobronchial erythema were observed across/within COPD patients using combined HD WLB + i-scan3, with significant agreement among scorers (P=0.031; median score of G+1 [G−1–G+2]) being higher in GOLD D (P=0.001). Endobronchial erythema significantly correlated with COPD duration, exacerbation frequency, and body mass index (P<0.05). Angiogenesis was significantly decreased among COPD patients versus controls (10.6 [8–13.3] vs 14 [11–17.1]; P=0.02). Mucosal surface changes (including edema, atrophy, and nodules) were better visualized by the combined HD WLB + i-scan3 rather than HD WLB alone.ConclusionCombined HD WLB + i-scan3 seems to be valuable in evaluating mucosal microvasculature and surface changes in COPD, which may represent vasodilatation rather than angiogenesis.

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Background: MRU is an excellent technique for the evaluation of the entire urinary tract. The aim of the study is to assess the capability of delayed sequence of MRU to distinguish between transient ureteric spasm that caused by ureteric peristalsis and ureteric stricture. Patients and Methods: The study carried on 30 referred patients for MRU examination (15 males and 15 females). Adding multiple delayed sequential T2 coronal as well as sagittal fat suppressed single shot fast spin echo images after 2 ,4 or more minutes for visualization of the entire ureter and distinguish between transient ureteric spasm and fixed pathological stricture. Result : As regard ureteric spasm that caused by normal peristaltic movements, 36,7% of the examined cases (11 patients) showed relieved spasm in the subsequent images repeated after 2 minutes ,while 43.3% (13 cases) showed relieved spasm in the images repeated after more than 2 minutes. As regard pathological spasm 20% of cases (6 patients) had fixed true strictures which were not relieved in the subsequent delayed images. Conclusion: T2-weighted MRU with multiple delayed sequence images is sufficient to identify all segments of the non-dilated ureter. It offers information on ureteral peristalsis and can distinguish between transient ureteric spasm due to peristalsis rather than the fixed pathological stricture. By adding multiple T2 fat suppressed single shot fast spin echo sequences after 2 ,4 or more minutes, all ureteric segments were visualized and the entire ureteric course was evaluated .