Dyschromatosis symmetrica hereditaria: A case report from Turkey, a new association and a novel gene mutation

the antigen-presenting activity of Langerhans cells and keratinocytes, and suppresses the transcriptional activity of the androgen receptor. These non-antibiotic effects are known as novel or anti-inflammatory effects. Due to its topical application, it acts directly on epidermal keratinocytes at high local concentrations. The skin concentration of nadifloxacin 4 h after application was 82.3 ± 21.1 lg ⁄ g, and that at 12 h after application was 6.7 ± 5.8 lg ⁄ g, which is similar to the concentration used in our experiment. Matrix metalloproteinases are produced as inactive pro-MMP, which are then activated by proteolysis to become active MMP. In inflammatory tissues, pro-MMP are activated by the proteolytic enzymes which exist abundantly in inflammatory skin. In acne lesions, MMP-1, -13 and -9 are abundant, and are thought to be induced by the inflammatory cytokines such as TNF-a produced by inflammatory infiltration or by P. acnes and involved in the scar formation of acne lesions. The inhibitory effect of nadifloxacin on these MMP could partly explain its clinical effectiveness in acne treatment. We also speculate that nadifloxacin has a preventive effect on scar formation. The induction of and the inhibitory effect on MMP-9 and -13 were controlled at the RNA level, while those of MMP-1 were not. The mechanism of the suppression of MMP-1 production is not clear and needs to be elucidated. Acne vulgaris could be considered as a kind of chronic inflammatory condition, rather than as a bacterial infection. Topical application of nadifloxacin could be considered as one such anti-inflammatory treatment for acne vulgaris in addition to antimicrobial treatment. ACKNOWLEDGMENTS