Search

Psoriasis is a chronic inflammatory disease associated with obesity and metabolic syndrome. Adipokines are thought to be a link between psoriasis and obesity. Leptin, adiponectin, and omentin are bioactive adipokines thought to play a role in both metabolic comorbidities and inflammation. Anti-tumour necrosis factor alfa (anti-TNF-α) agents are effective for psoriasis treatment, although significant weight gain has been reported during anti-TNF-α therapy. The interleukin 12/23 (IL 12/23) inhibitor ustekinumab is also effective for psoriasis treatment. We compared the effects of three anti-TNF-α drugs and an IL-12/23 inhibitor on adipokines and weight gain during treatment. This prospective study included 80 patients (37 women, 43 men) with moderate to severe plaque psoriasis whose age and weight were matched. The patients were divided into four equal groups: etanercept, infliximab, adalimumab, and ustekinumab treatment groups. Psoriasis Area Severity Index (PASI) score, body weight (muscle and fat compartments), and leptin, adiponectin, and omentin levels were evaluated at baseline and weeks 4, 12, 24, and 48 of treatment. There were no differences between drug groups in terms of weight parameters or biochemical parameters at baseline. At the end of 48 weeks, there was significant weight gain in the adalimumab group. Patients who received infliximab showed significant weight gain by week 12, but in the following weeks they returned to their initial weight. Body weight reached a maximum level by week 12 in patients using etanercept, but they lost weight in the following weeks and finished the study below their initial weight. Patients using ustekinumab did not demonstrate significant weight change during the 48 weeks except at week 12. At the end of week 48, PASI75 (improvement in PASI ≥75%) response rates were approximately 85% for the ustekinumab group, 80% for the adalimumab group, 75% for the infliximab group, and 50% for the etanercept group. Leptin, adiponectin, and omentin levels were higher in the ustekinumab group at all weeks except baseline. The lowest levels were observed in the etanercept group. The treatment response rate was also lower in the etanercept group. We did not evaluate visfatin and resistin levels, insulin sensitivity, and cardiovascular risk that may be associated with weight gain and adipokine levels. Unlike TNF inhibitors, ustekinumab does not cause significant weight changes and it increases adipokine levels more than TNF inhibitors. Adipokine levels seem to be related to the treatment response. [ABSTRACT FROM AUTHOR]

Cyclosporine is an immunosuppressive agent used in the treatment of psoriasis. It shows its action through calcineurin inhibition and T-lymphocytes. With its rapid effect, it can be used as an induction therapy in plaque, pustular and erythrodermic psoriasis. Its most common side effects are elevated serum creatinin values and arterial hypertension. In long-term treatment not to exceed 2 years, it may be used under nephrology control. [ABSTRACT FROM AUTHOR]

There have been a number of investigations of the efficacy and safety of etanercept. This study was performed to obtain long‐term drug survival data (ie, time to drug discontinuation) for etanercept, and the reasons for its discontinuation. The study population consisted of patients with psoriatic arthritis and psoriasis followed up by our clinic, registered in the Turkish Psoriasis Registry (PSR‐TR) and treated with etanercept for at least 4 weeks between January 1, 2005, and January 31, 2020. The efficacy of etanercept was evaluated in terms of the Psoriasis Area and Severity Index (PASI) 75, PASI 90 and PASI 100 response rates at 12, 24, 36, and 48 weeks, and annually thereafter. The behaviors of the patients with respect to the use of etanercept, and the outcomes of those who continued to use it during the COVID‐19 pandemic, were also investigated. [ABSTRACT FROM AUTHOR]

Introduction: Psoriasis is a chronic, immune-mediated inflammatory disease predominantly affecting the skin, with a complex aetiology. Recently it has been suggested that the chronic inflammation of psoriasis may cause metabolic and vascular disorders. The relationship between obesity and psoriatic arthritis (PsA) is not clear, and there are insufficient prospective studies addressing this subject. Aim: To investigate the relationship between psoriatic arthritis, severity of psoriasis and obesity in the Turkish population. Material and methods: Patient data from psoriasis outpatient clinics from February 2007 to July 2013 were reviewed retrospectively using the Psoriasis-Turkey (PSR-TR) registration system. Patients' age, onset age, body mass index (BMI), waist circumference, psoriasis area and severity index (PASI), and arthritis information were reviewed. In the outpatient clinics, patients who had joint pain consulted rheumatology clinics. The CASPAR criteria were used for the diagnosis of arthritis. Results: A total of 443 males and 495 females enrolled in this study. The mean age of females was 43.9 years (18-93 years) and the mean age of males was 44.6 years (18-89 years). A total of 231 (25%) patients had psoriatic arthritis. Investigation of the relationship between PASI, BMI, waist circumference (WC) and arthritis revealed a statistically significant relationship between each variable. Conclusions: In this study we observed a relationship between PsA and high BMI, high WC and high PASI. Psoriatic arthritis is a chronic inflammatory disorder and a chronic inflammatory state induced by adiposity may lead to PsA. [ABSTRACT FROM AUTHOR]

Background and Design: Psoriasis is a chronic immune-mediated inflammatory disease affecting 1-3% of the general population. Recently, it has been suggested that chronic inflammation in psoriasis may cause metabolic and vascular disorders. Most of recent studies focused on the comorbidities and the mechanisms of comorbidities associated with psoriasis. Obesity may lead to cardiovascular disorders, diyabetes mellitus, hypertension, malignancies, musculoskeleteal system diseases, impaired quality of life, and death. In this study, we aimed to investigate the prevalence of obesity in patients with psoriasis and the relationship between the disease severity and body mass index (BMI) in Turkish psoriasis population. Materials and Methods: The patients who attended the Dermatovenerology outpatient clinics at Bezmialem Vakıf University Medical Faculty between February 2007 and March 2013 were enrolled in the study. We retrospectively evaluated the medical records of the patients obtained from the PSR-TR psoriasis follow-up system. Results: Five hundred forty-five women and 474 men were included in the study. The mean age of the female and male patients was 41.3 years, 43.3 years, respectively. The mean body mass index of the patients was 27.5 (26.7 for men and 28.2 for women). 54.6% of obese patients had a psoriasis area and severity index (PASI) score of less than 5, 20.5% had PASI scores between 5-10 and 24.8% had a PASI score of more than 10. Conclusion: In our study, there was a poor relationship between obesity and severity of psoriasis. The prevalence of obesity in psoriasis patients was similar to that in the Turkish population. [ABSTRACT FROM AUTHOR]

Objective: Hirsutism is a common endocrinological clinical problem seen in women at reproductive age. Although its cause is usually a benign condition, it may rarely be an indication of a more serious endocrine disease, such as Cushing syndrome or an androgen-secreting tumor. The objective of this study was to investigate the clinical features of hirsutism and its etiologic factors in women with hirsutism at reproductive age. Material and Method: This study included the patients followed-up at our hirsutism outpatient clinic between 2000 and 2006. Data were collected retrospectively from the medical records of the patients. The data included the detailed clinical assesment, endocrinologic work-up and pelvic ultrasonography. Results: Polycystic ovary syndrome (PCOS) idiopathic hirsutism (IH) were identified as the two mojor groups in the etiology of hirsutism, at a rate of 49.8% and 39.5%, respectively. These groups were followed by unidentified group (idiopathic hyperandrogenemia), late onset congenital adrenal hyperplasia, hypothyroiditis, prolactinoma, Cushing syndrome and overian tumor, 5.9%, 1.8%, 1.5%, 0.7%, 0.4%, 0.4% respectively. The accompanying clinical features were as folows: increased total testosterone in 47% of patients; acne in 46.5%; menstrual irregularity 40.2%. Obesity was found in 25% of the cases and 3% had diabetes. Regular mentrual cycle was observed in 59.8% of patients with hirsutism and in 35.6% of patients with PCOS. Of the patients, 52% had a family history. Conclusion: Hirsute patients frequently have either elevated androgen levels or they are present with the clinical conditions associated with hyperandrogenemia. Eumenorrhea per se is not enough to ride out endocrine pathology and particularly PCOS which is a common cause of hirsutism. Given that the other metabolic findings such as diabetes may coincide with the condition it is necessary to perform a detailed endocrinologic investigation; ethnic and genetic background must be taken into consideration while getting medical history. [ABSTRACT FROM AUTHOR]

CoronoVac is a non-viable vaccine for severe acute respiratory syndrome coronavirus 2 (SARSCoV-2). Nowadays, there has been vaccination program for at-risk groups and older adults in Turkey. We here present 72-year-old male psoriasis patient who developed generalized pustular psoriasis flare after administration of CoronoVac. The COVID-PCR test was negative and investigations for flare etiology were all normal. He was first (to the best of our knowledge) psoriasis patient who developed an erythrodermic flare after the first dose of CoronaVac vaccine. [ABSTRACT FROM AUTHOR]

Background and Design: Our aim was to evaluate and compare the effects, side effects, and onset and duration of action of etanercept, infliximab and adalimumab on patients followed in our psoriasis outpatient clinic. Material and Method: Data was collected retrospectively from patient medical records. The study group was divided into three groups as follows: group 1 (n: 48) - patients on etanercept treatment, group 2 (n: 49) - on infliximab treatment and group 3 (n: 18) - on adalimumab treatment. Age, gender, duration of disease, PASI values at 0 (baseline), 6, 12, 24, 36, and 52 weeks and side effects were evaluated. Results: 55.7% (n=64) of patients were male, 44.3% (n=51) were female. The median age of study group was 44.53±12.91 (13-79) years, the median duration of the disease was 17.02±10.24 (1-60) years, and the median initial PASI value was 15.31±8.45. The treatment was discontinued because of side effects: One of four patients had elevated liver enzymes, 1 - herpes zoster besides increased liver enzymes, 1 - congestive heart failure, and 1 patient had pneumonia, in group 1, two of three patients developed severe infusion reaction, 1 had severe nausea and fatigue, in group 2. Isoniazid intolerance was established in 1 patient in group 1, group 2 and group 3. PASI 75 values at 6th week in groups 1, 2 and 3 were 27.27%,49.99%,46.66%; at 12th week 75.75%, 85.28%, 66.66%; at 24th week 93.54%, 86.66%, 83.33%; and at 52nd week 92.3%, 84%, 81.81%, respectively. Conclusion: Our data showed that all three biologic agents were effective in the treatment of moderate to severe psoriasis patients. Although not statistically significant, infliximab and adalimumab were more successful in terms of rapid control, whereas etanercept was more promising for continuous and high efficiency in chronic plaque psoriasis. [ABSTRACT FROM AUTHOR]

Background Recently, ultraviolet (UV) A1 phototherapy has been suggested as an effective treatment for localized scleroderma (LS); however, the optimal dose of UVA1 still has not been determined. Objective We aimed to evaluate the therapeutic effectiveness of medium-dose (30 J/cm2) UVA1 phototherapy and to show that 13 MHz ultrasound is a valuable tool for assessing the results of UVA1 phototherapy in LS. Methods Thirty-five patients with LS were treated with medium-dose (30 J/cm2) UVA1. In total, 30-45 treatments and 900-1350 J/cm2 cumulative UVA1 doses were evaluated by clinical scoring in all patients. In 14 patients, skin thickness was also determined by 13 MHz ultrasound examination. Results In all patients, medium-dose UVA1 therapy softened sclerotic plaques, and marked clinical improvement was observed in 29 of 35 (82. 85%) patients. Ultrasound measurements showed that skin thickness was significantly reduced. No side effects were observed during or after treatment. Conclusion Medium-dose UVA1 phototherapy is a highly effective, safe, and well-tolerated therapeutic modality for treatment of all types of LS. A 13 MHz ultrasound probe may be used for evaluating UVA1 phototherapy results. [ABSTRACT FROM AUTHOR]

Background Over the past decade, many dermoscopic criteria and algorithmic methods have been developed for the early diagnosis of cutaneous melanoma. Objective To compare the sensitivity, specificity, and diagnostic accuracy of the seven-point and three-point checklist methods in a series of dermoscopic images. The diagnostic value of dermoscopic criteria was also determined on the basis of their frequency. Methods Forty-eight preoperative dermoscopic images of histopathologically proven melanoma lesions and 48 preoperative dermoscopic images of clinically atypical but histopathologically proven nonmelanoma pigmented skin lesions were reviewed retrospectively. The seven-point and three-point checklist methods were used to assess each lesion. The Statistical Package for Social Sciences for Windows 15.0, descriptive statistical tests, and screening tests were used for statistical analyses. Results The sensitivity, specificity, and positive and negative predictive values of the seven-point checklist method were 87.50%, 16.17%, 51.22%, and 57.14%, respectively. The sensitivity, specificity, and positive and negative predictive values of the three-point checklist method were 89.58%, 31.25%, 56.58%, and 75%, respectively. Conclusion The three-point checklist was observed to be a superior screening test. The seven-point checklist provided a more detailed analysis, especially for thin melanomas. In comparison with the seven-point method, the three-point method may be useful for less experienced observers when they need to obtain greater diagnostic accuracy. [ABSTRACT FROM AUTHOR]

Background and Design: Classic Kaposi sarcoma (KS) occurs predominantly among the elderly, with Jews, Italians and Greeks. Classic KS has been seen relatively frequently in Turkey. Our aim was to evaluate the demographic, clinical features of Kaposi sarcoma and etiopathological role of human herpesvirus-8 (HHV-8). Treatment results of 18 classic Kaposi's sarcoma were also concluded. Material and Method: Eighteen cases of classic Kaposi sarcoma diagnosed as clinically and histopathologically between January 2001 and August 2008 in our dermatology department were taken to this study. Demographic, clinical features and treatment results were reviewed retrospectively in all patients. HHV-8 was investigated in the lesional skin of 7 patients. Results: A male/female ratio of 2/1 was found. Mean age at diagnosis was 67.2 (37-94) years. Bilaterally lower extremities were involved in 15 patients (83.3%), the trunk was involved in 3 patients (16.6%). Plaques and nodules were the common type of lesions (66.6% and 55.5%). Nine patients had no symptoms (50%). Edema was the most common symptom (38.8%). A second primary malignancy was found in 2 patients (11.1%). HHV-8 was detected in 6 of the 7 patients(85.7%). Majority of the patients were treated with interferon alfa (subcutaneously) and cryotherapy as a monotherapy or a combination therapy. Imiquimod was the second agent in combined treatment (27.7%). Conclusion: We suggest that interferon alfa and imiquimod can be used as first line therapy agents with their antiviral and immunmodulatuar features in the treatment of KKS. [ABSTRACT FROM AUTHOR]

Psoriasis is a common, chronic, inflammatory, multisystem disease with predominantly skin manifestations. Every patient needs to be treated individually upon to the severity of the disease, associated comorbidites and life style. Under the light of recent studies and publications proposing algorithms and treatment stratetegies psoriasis treatment is discussed here. [ABSTRACT FROM AUTHOR]

Background and Design: Classic Kaposi sarcoma (KS) occurs predominantly among the elderly, with Jews, Italians and Greeks. Classic KS has been seen relatively frequently in Turkey. Our aim was to evaluate the demographic, clinical features of Kaposi sarcoma and etiopathological role of human herpesvirus-8 (HHV-8). Treatment results of 18 classic Kaposi's sarcoma were also concluded. Material and Method: Eighteen cases of classic Kaposi sarcoma diagnosed as clinically and histopathologically between January 2001 and August 2008 in our dermatology department were taken to this study. Demographic, clinical features and treatment results were reviewed retrospectively in all patients. HHV-8 was investigated in the lesional skin of 7 patients. Results: A male/female ratio of 2/1 was found. Mean age at diagnosis was 67.2 (37-94) years. Bilaterally lower extremities were involved in 15 patients (83.3%), the trunk was involved in 3 patients (16.6%). Plaques and nodules were the common type of lesions (66.6% and 55.5%). Nine patients had no symptoms (50%). Edema was the most common symptom (38.8%). A second primary malignancy was found in 2 patients (11.1%). HHV-8 was detected in 6 of the 7 patients(85.7%). Majority of the patients were treated with interferon alfa (subcutaneously) and cryotherapy as a monotherapy or a combination therapy. Imiquimod was the second agent in combined treatment (27.7%). Conclusion: We suggest that interferon alfa and imiquimod can be used as first line therapy agents with their antiviral and immunmodulatuar features in the treatment of KKS. (Turkderm 2008; 42: 122-6). [ABSTRACT FROM AUTHOR]

Background and Design: The pemphigus family includes a number of disease which feature intraepidermal blisters with acantholysis. Pemphigus vulgaris(PV) is the most common form of pemphigus, affects the skin and mucous membranes. Although oral mucosa is the most commonly affected site, all stratified squamous epithelium can be involved like pharynx, larynx, oesophagus, conjunctiva, vaginal, penile, and anal mucosa. We planned our study aiming to find frequency of oesophagus involvement in PV patients and to compare them immunohistopathologically with skin findings. Material and Method: Twenty three female and seven male patients, who were admitted to The Health Ministry Vakıf Gureba Education and Research Hospital, Dermatology Clinic, in between January 2004 and March 2005, and were accepted as PV according to clinical and immunohistopathological findings. Mucosal biopsies were taken by oesophagoscopy from patients in the same time with skin biopsies for DIF examination. Antibody titers in serum was detected by indirect immunofluorescein method. Results: DIF was positive in twenty eight patients while two patients had negative results. During oesophagoscopy, macroscopically nine patients (%30) had esophageal lesions supporting pemphigus vulgaris.When a relationship were examined between dysphagia with endoscopic pemphigus vulgaris findings, skin involvement, oral mucosal involvement, genital mucosal involvement, skin DIF positivity, oesophagus DIF positivity, IIF positivity, no meaningful difference was found istatistically. In our study, four patients had endoscopic findings and nineteen patients had positive DIF results although they did not have gastrointestinal symptoms. When relationship between oesophageal DIF positivity and skin DIF positivity was examined, there was a positive correlation meaningfully. Conclusion: According to our article we believe that upper GI endoscopy is a useful and neccessary diagnostic method in pemphigus vulgaris patients who have gastrointestinal symptoms without looking for oral mucosa involvement and it should be a standard diagnostic procedure in these patients. [ABSTRACT FROM AUTHOR]

Background and Design: Our purpose was to compare the sensitivity, specificity, and diagnostic accuracy of the 7-point and 3-point checklist, on a series of dermoscopic images of melanoma lesions diagnosed as histopathologically. Material and Method: Fourty-seven preoperative dermoscopic photographs of histopathologically proven melanoma lesions were studied retroscopically. Each lesion was assessed using the 7-point and the 3-point checklist. Statistical Package for Social Sciences for Windows 10.0, decriptive statistical analyses and screening tests were performed. Results: The 3-point checklist gave a sensitivity of %91,5 compared with the %89,4 sensitivity of the 7-point checklist. Conclusion: Both the 7-point checklist and the 3-point checklist can be easily learned and easily applied. The 7-point checklist, based on pattern analysis, provides more detailed analysis especially for the thin melanomas. The 3-point checklist, with its higher sensitivity, can allow to obtain higher diagnostic accuracy values. [ABSTRACT FROM AUTHOR]

Introduction: Scleromyxedema is a rare primary cutaneous mucinosis characterized by numerous firm, waxy, confluent papules. Recently, intravenous immunoglobulin (IVIG) is accepted by many authors as the first‐line treatment option for severe cases. We report a 69‐year‐old male patient who has been suffering from scleromyxedema, with reduced mouth opening. He has been on a high‐dose IVIG regime for 5 years. Methods: The patient stated that he had difficulty in wearing and removing his dentures because of reduced mouth opening lately. Before considering to add any other immunosuppressants to his regime, we injected 1500 IU of hyaluronidase in total in one session periorally. The patient has been told open his mouth maximum and photographs have been taken before injections and after one month. We used a photo measurement application when evaluating microstomia to increase accuracy. We also took punch biopsies in order to evaluate effect of hyaluronidase histopathologically before and one month after injections. Results: One month later, he was able to reattach and remove his dentures without adding any adjuvant immunosuppressants other than hyaluronidase. Mouth opening was increased in measurements and histopathologically, mucin deposition, fibroblastic proliferation, and perivascular lymphocytic infiltration were decreased. Conclusions: We think hyaluronidase is a safe, easily accessible, and effective treatment option for microstomia caused by scleromyxedema. [ABSTRACT FROM AUTHOR]

Background: Clinical features, types of Kaposi sarcoma, and treatment outcomes have not been well‐defined in Turkey. In this study, we reviewed records of the patients who had been diagnosed with Kaposi sarcoma in the last decade in a single center and evaluated treatment results. Methods: Medical records of the Kaposi sarcoma patients seen in the last decade in a single tertiary center were evaluated in detail. Results: A total of 27 patients were identified; 18 patients had been checked for HHV8; and 16 of those patients were positive for HHV8. One patient was positive for HIV. Two patients having mycosis fungoides and myasthenia graves developed iatrogenic KS after immunosuppressive treatments. Interferon α was used in 21 patients; 8 patients achieved complete response; and 11 patients achieved a partial response. No serious side effects were observed. Systemic involvement did not develop in any patients except lymph node involvement in a patient with widespread skin lesions. [ABSTRACT FROM AUTHOR]

The article discusses the treatment and outcome of primary cutaneous B-cell lymphomas (CBCLs). It presents three classification according to world Health Organization-European Orgnanization for Research and Treatment of Cancer (WHO-EORTC) such as the marginal zone B-cell lymphoma (MZL), follicle center lymphoma (FCL), and diffuse large B-cell lymphoma, leg type (DLBL). It highlights cases of 10 patients who received the diagnosis and undergone complete staging of physical examinations.

Atopic dermatitis is an inflammatory skin disease with a chronic relapsing course. The benefical effects of ultraviolet light on atopic dermatitis has been appreciated for many years. Along with topical and systemic treatment, photo(chemo)therapy is one of the three fundamental alternatives for managing atopic dermatitis. While broadband UVB and psoralen UVA (PUVA) have been the mainstay of phototherapy more new modalities including UVA-1 and narrow-band UVB have been used successfully in recent years. [ABSTRACT FROM AUTHOR]

Background and Design: Previous studies reported that there are some relations between psoriasis and the diabetes mellitus. However, incidence rates of diabetes mellitus in psoriasis and also incidence rates of psoriasis in diabetes mellitus are lacking. Our aim was to assess and compare incidence rates of diabetes mellitus in patients with psoriasis and incidence rates of psorasis in diabetes mellitus and also evaluate the role of psoriasis as a risk factor for diabetes mellitus. Material and Method: Four hundred eighteen patients with psoriasis and one hundred fifty four patients with diabetes were included. Blood glucose, oral glucose tolerance test (OGTT), glycolised hemoglobine (HbA1C) were performed in psoriatic patients and these results were consulted with diabetes clinic. Psoriasis screening by clinical history, dermatologic examination, skin biopsy; if it is necessary were held for patients with diabetes. Results: Prevalance of diabetes was 9.3% in psoriatic patients; prevalance of psoriasis was 1.3% in diabetic patients. The proportion of diabetes was significantly higher in psoriatic patients compared to the proportion of psoriasis in diabetic patients (odds ratio (OR): 7.82, confidence interval (CI): 1.86-32.79, p=0.001). The age and sex-adjusted proportion of diabetes was significantly higher in psoriatic patients as compared the proportion of psoriasis in diabetic patients (OR: 18.35, p<0.001). Differences of mean duration of disease and mean PASİ (psorasis area severity index) were not significant between the psoriatic patients without diabetes mellitus and with diabetes mellitus. Conclusion: Risk rate of diabetes is increased in psoriatic patients. Chronic inflammation may lead insulin resistance and diabetes. We think that development of diabetes in patients with psoriasis depends on chronic inflammation. Unfortunately we could not assess the role of therapeutical agents especially effect of potent corticosteroids in development of diabetes. Patients with psoriasis should be closely followed up for type 2 diabetes mellitus and other metabolic disorders regardless of cause of these disorders. [ABSTRACT FROM AUTHOR]

Background and Design: Using an ultrasensitive assay, PSA has been detected in female serum and has been proposed as a potential marker of androgen excess in hirsute women. The object of this present study was to investigate an association between hirsutism and serum PSA levels. Material and Method: A total of 47 women with hirsutism and 24 age-matched nonhirsute women were included in this study. Using an ultrasensitive chemiluminescent immunoassay serum PSA were determined in all subjects. Results: Serum levels of PSA were higher in hirsute women than in nonhirsute controls (p<0.05). Conclusion: If more sensitive assays become available, PSA might be used as biochemical marker of peripheral androgen excess in women with hirsutism. [ABSTRACT FROM AUTHOR]

It is known that omalizumab (OMA) is an effective and safe treatment option in the treatment of chronic spontaneous urticaria (CSU). In the literature, there are vary studies about effect of OMA treatment in CSU such as different response rates to treatment, different dose / time regime and different relapse rates after treatment. To investigate the evaluate the effect of at least 1 year continuous OMA treatment on relapse in CSU patients. Fifty patients were included in this study. There was a significant decreased between UAS7 score before and after OMA treatment. There was no significant difference between the sixth and 12th month after OMA for UAS 7 scores. At the end of 12 month,84% of patients had complete or good response to OMA treatment. Twenty‐three of 34 patients (67.6%) who discontinued treatment had relapse and 11 patients had no relapse. Duration of disease was significantly higher in patients who had relapse. Based on our study result we suggest that long disease duration may increase the risk of relapse. Although it is not statistically significant, without interruption OMA treatment for more than 1 year may decrease relapse risk in patients who respond well to the therapy. [ABSTRACT FROM AUTHOR]

The article reports on the use of topical isoconazole with a corticosteroid in the treatment tinea cruris. It mentions that the condition is caused by a fungal infection and that treatment includes anti-fungal cream. It presents the case of a 21 year-old male with erythema who was diagnosed with tinea cruris. Treatment included topical isoconazole cream with a corticosteroid.

Objective: Platelets play an important role in the pathogenesis of disorders associated with the local or systemic inflammation. Mean platelet volume (MPV) is a marker for platelet activation, and larger platelets are more activated. In this study, we aimed to investigate MPV values in patients with Behcet's disease, patients with recurrent aphthous stomatitis, and controls. Methods: Patients with Behcet's disease and patients with recurrent aphthous stomatitis who presented to a dermatology outpatients clinic were enrolled in this study. Age, sex, MPV values, vitamin B12, and TSH were retrospectively recorded. Results: A total of 113 patients with recurrent aphthous stomatitis, 87 patients with Behcet's disease, and 71 healthy controls were enrolled in this study. Among them, 74 (65.5%) of the patients with recurrent aphthous stomatitis were females, and 39 (35.5%) were males. Additionally, 50 (63.4%) of the patients with Behcet's disease were females, and 37 (42.5%) were males. Finally, 45 (63.4%) of the controls were females, and 26 (36.6%) were males. There was no statistically significant difference in MPV values in patients with Behcet's disease, patients with recurrent aphthous stomatitis, and control group. Conclusion: MPV is a simple and useful parameter seen in routine complete blood count (CBC) laboratory tests. It is investigated as an inflammation marker. Although in some studies, MPV was high in patients with Behcet's disease, in our study, we did not observe any statistically significant difference in patients with Behcet's disease, patients with recurrent aphthous stomatitis, and control group. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor about male breast cancer with skin invasion, published in January 1997 issue of "Journal of the European Academy of Dermatology and Vernereology."

Background: Dermoscopy is a useful tool for earlier diagnosis and differentiating benign lesions from melanoma. Objectives: We aim to investigate dermoscopic features of acral nevi, age, and localisation-related findings of these lesions. Methods: This was an observational, descriptive study. Patients were retrospectively collected from the Department of Dermatology. The patients with acral nevi were included in the study. Inclusion criteria were Turkish nationality and the presence of at least 1 acral nevus diagnosed both clinically and dermoscopically. Lesions in dorsal and subungual areas were excluded. All nevi were examined by the same dermatologist. Results: The most common dermoscopic patterns were as follows: parallel furrow (87 patients; 41.4%), globular (24 patients; 11.4%), fibrillar (22 patients; 10.5%), combination patterns (19 patients; 9.1%), globulostreak-like (16 patients; 7.6%), latticelike (15 patients; 7.1%), homogeneous (12 patients; 5.7%), nontypical (8 patients; 3.8%), parallel ridge (4 patients; 1.9%), reticular (2 patients; 1.0%), and crista dotted pattern (1 patient; 0.5%). The parallel furrow pattern was the most common pattern in all localisations. The number of parallel furrow patterns (5 lesions) was equal to the globulostreak-like pattern (5 lesions) on the thenar area. The number of parallel furrow patterns (4 lesions) was equal to the fibrillar pattern (4 lesions) on the heel. Parallel furrow (dotted variants) (11 lesions) and globulostreak-like patterns (5 lesions) were the most common patterns in the pediatric population (0-15 years old). The fibrillar pattern showed a tendency for soles (12 lesions), while a lattice-like pattern was seen more often in the plantar arch (3 lesions). Conclusions: Description of the dermoscopic features of acral nevi is important to improve management and reduce the number of unnecessary excisions. The most common patterns were parallel furrow, globular, and fibrillar in our study. Parallel furrow (dotted variants) and globulostreak-like patterns were the most common patterns in the pediatric population. The fibrillar pattern showed a tendency for soles, while a lattice-like pattern was seen more often on the plantar arch. Therefore, there may be a relation between anatomic localisation, age, and dermoscopic pattern. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented regarding the case of an 81-year-old woman who was diagnosed with clear cell acanthomas.

Background: Some studies have investigated the relationship between Behçet's disease (BD) and insulin resistance; however, since they did not exclude obese patients from their sample, it remains unclear whether BD itself causes insulin resistance independently of obesity. Methods: The study included 60 patients with BD and 45 age‐, gender‐, and body mass index (BMI)–matched healthy controls. Obese patients with a BMI of ≥30 kg/m² were excluded. Insulin resistance according to the homeostasis model assessment for insulin resistance (HOMA‐IR) and quantitative insulin sensitivity check index (QUICKI), fasting plasma glucose, and one‐hour and two‐hour plasma glucose in the oral glucose tolerance test (OGTT 1‐h and OGTT 2‐h PG, respectively) were evaluated in all patients. Results: The mean fasting plasma glucose levels and the rate of those with impaired glucose tolerance according to OGTT 2‐h PG were significantly higher in the BD patients compared to the controls. The rates of those with insulin resistance according to HOMA‐IR and QUICKI were significantly higher in the BD patients than in the controls. When compared to the control group, the rates of those with impaired fasting glucose and impaired glucose tolerance were significantly higher, and the mean QUICKI value was significantly lower in the active group, in contrast to the inactive group. Conclusions: Insulin resistance occurs in BD patients independently of obesity. In the follow‐up of BD patients, especially in the active phase, not only fasting blood glucose but also other diagnostic tests for insulin resistance should be added to the examination panels. [ABSTRACT FROM AUTHOR]

Coronavirus disease-2019 (COVID-19) is a serious cause of respiratory tract infection, and its severe course has been associated with some risk factors, including malignancies and immunosuppressive treatments. Primary cutaneous lymphomas (PCL) are a heterogeneous group of immune system neoplasms, which are subclassified as indolent and aggressive types according to their survival rates. PCL treatment ranges from skin-based therapies to systemic treatments, of which immunosuppressive effects occur in some. During the COVID-19 pandemic, patients with PCL should be protected from possible COVID-19 complications, and the optimal treatment should be provided to control the disease taking into account the treatment-related risks. Therefore, recommendations about the management of patients with PCL during the COVID-19 pandemic were overviewed in light of the literature. Topical treatments can generally be considered low-risk therapies and can be continued without interruption. Phototherapy, skin radiotherapy, and total skin electron beam therapy increase the risk of COVID-19 exposure due to hospital visits. Moderate-risk therapies like interferons, systemic retinoids, methotrexate, and systemic corticosteroids might be used with caution. Advanced-stage patients with COVID-19 related comorbidity and who previously received immunosuppressive therapy should be carefully evaluated. Biological agents and systemic chemotherapeutics, which are considered high-risk, should not be delayed when needed. However, increasing intervals between treatments or switching to alternative therapies may be preferable in stable diseases. Most importantly, all patients with PCL should be ensured to comply with general protection measures as long as the pandemic continues. [ABSTRACT FROM AUTHOR]

Background Even though several case studies have reported a relationship between Cutaneous T Cell Lymphoma (CTCL) and atopic diathesis, this association is still controversial. The aim of this study was to investigate the actual presence of atopic status in CTCL patients. Methods A total of 78 patients with both clinical and histological features typical of CTCL and 77 control cases from our outpatient dermatology clinic were included in this study. After initial evaluation and staging, all patients were investigated for history of atopic disease, serum total IgE and eosinophil cationic protein concentration (ECP), eosinophil count, serum specific IgE, and skin prick test positivity. Results Personal atopy in CTCL group was 23,1% (n = 18) and familial atopy was 9.0% (n = 7) whereas in the control group, these values were 11.7% (n = 9) and 7.8% (n = 6), respectively. There was no statistically significant difference, however, the number of atopic patients were higher in CTCL group than the control group (p = 0.151). Serum total IgE levels were significantly increased in patients with CTCL when compared to control group (p = 0.04). Serum specific IgE panel and prick test positivity between patients and controls were significantly different, respectively (p = 0. 03) (p = 0. 00). Eosinophil counts and ECP levels were not significantly different, respectively (p = 0.10) (p = 0.885). In high stages of CTCL, patients were found to have elevated IgE, ECP levels and eosinophil count. These results were statistically significant (p = 0.011) (p = 0.009) (p = 0.007). Conclusion Eventhough the number of patients with atopy in the CTCL group was higher than the control cases, there was no significant different. On the other hand high levels of serum IgE, elevated eosinophil count and specific IgE positivity may be found in CTCL patients with or without atopic disease, especially with high stages. [ABSTRACT FROM AUTHOR]

Background and Design: Behcet's disease is a chronic, multisystem inflammatory disease of unknown origin characterized mainly by recurrent oral aphthous ulceration, genital ulceration, skin lesions and uveitis. Thrombophilic defects, such as factor V Leiden (FVL) gene mutation may play a role in the pathogenesis of thrombosis in Behcet's disease (BD). Recently, an association of FVL mutation with thrombosis and ocular involvement in BD has been reported. The object of this present study was to investigate an association between systemic involvement and the presence of the FVL gene mutation in BD patients. Material and Method: One-hundred six patients with BD and 70 healthy subjects were included in the study. FVL gene mutation was determined by polymerase chain reaction. Results: The FVL mutation was detected in 20.8% of the BD patients (22/106) compared with 8.5% of the control subjects (6/71). The difference was not statistically significant (p=0.027). Systemic involvement were observed in 45 (42.4%) patients. No statistically significant association was found between patients with systemic involvement (26.7%) and without systemic involvement (16.4%) with respect to FVL gene mutation (p=0.197). All of the patients and controls tested positive were heterozygous for the mutation. Conclusion: Further studies in larger patients series with systemic involvement are needed to determine the prevalence of this mutation in BD with systemic involvement. [ABSTRACT FROM AUTHOR]

Objective: Psoriasis is a chronic skin disease that affects about 1.5-3% of the population and is a combination of genetic, environmental and immunological factors. The aim of our study was to determine the prevalence of obsessive-compulsive symptoms in patients with psoriasis and to investigate its relationship with sociodemographic factors. Method: Sixty five psoriasis patients and 65 healthy adults who were not diagnosed with obsessive-compulsive disorder were included in this study. All of the patients included in the study were selected from the patients who applied to Bezmialem Vakıf University Hospital Dermatology outpatient clinic. Both groups were given a form containing socio-demographic information and revision of the padua inventory of 41 questions. Results: A total of 130 adults, 65 psoriasis patients (27 women, 38 men) and 65 control group patients (39 women, 26 men), were included in the study. The mean age of the patient group was 43.63 years; the mean age of the control group was 38.55 years. There were no significant differences between the two groups in terms of impulse, thought and control obsession scores but the certainty and cleanliness obsession scores were significantly higher in the patient group compared to the control group (p<0.05). Although the level of education was considered as p=0.044 in terms of thought obsession, there was no statistically significant difference between the two comparisons. Conclusion: Consequently, it was thought that certainty and cleanliness obsessions were seen in psoriasis patients by looking for a higher score compared to healthy subjects; this suggests that properties of skin lesions in psoriasis such as crusting, thickening, and itching may have a serious association, especially with cleaning obsession and that psychological support could be positively reacted to treatment. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 13-year-old boy who was diagnosed with Milroy's Disease (MD). It states that the patient's physical examination showed mild lymphedema of the lower limbs. It notes that the patient was searched for etiology of edema of lower extremities, his hematological and biochemical parameters were within normal limits. It mentions that conservative treatment without surgical approach was preferred due to the mild symptoms of the patient.

Blastomycosis-like pyoderma is an unusual, exaggerated, vegetative-tissue reaction to a prolonged primary or secondary bacterial infection. It is a rare disease, usually seen in immunocompromized patients. We report a case of localized blastomycosis-like pyoderma responding poorly to classic treatments, but that gave a dramatic response to a combination treatment of cotrimoxazol and cryotherapy. [ABSTRACT FROM AUTHOR]

Introduction: Mycosis fungoides (MF) is the most common type of primary cutaneous T-cell lymphoma. Prognostic factors may help to evaluate the course of the disease and may also be useful in selecting appropriate treatment plans for patients. Aim: To investigate the potential prognostic factors of MF and their correlations with MF stage. Material and methods: We evaluated the records of patients with MF who were followed in our lymphoma clinic between 1998 and 2015. Age, sex, disease stage, peripheral blood eosinophilia, eosinophil cationic protein, serum total IgE, lactate dehydrogenase (LDH), and β2-microglobulin levels were investigated and recorded at the time of diagnosis. Results: There was a statistically significant positive correlation between high β2-microglobulin levels and the advanced stage of disease (p < 0.001). The older group of patients had statistically significantly higher levels of β2-microglobulin compared to the younger group (p = 0.001). We found strong, significantly positive correlations between disease stage and β2-microglobulin, LDH, and total IgE levels (p < 0.001, rho = 0.335; p = 0.001, r = 0.302; p = 0.001, r = 0.311, respectively). Additionally, there were significantly positive correlations between LDH levels and β2-microglobulin, total IgE levels (p < 0.001, rho = 0.484; p = 0.001, r = 0.212, respectively). Study limitations: A limited number of patients and the retrospective nature of the study. Conclusions: We found that β2-microglobulin was a significant prognostic factor in our study population of MF patients. Also, elevated LDH, β2-microglobulin, and total IgE levels were correlated with advanced disease. Thus, these parameters can be used together to identify patients who have progressed to the later stages of the disease and who require more aggressive treatment. [ABSTRACT FROM AUTHOR]

In the literature, there are reports about dermoscopic and size changes of nevi in patients undergoing biologic therapy and chemotherapeutics. There has not been any established data for melanoma and Rituximab therapy. Sixteen patients, with 94 nevi were included in this study. Dermoscopic images of follow‐up visits, which were performed at baseline, 3, 6, and 12 months after treatment, were evaluated. Suspicious lesions were excised. There was no increase in total nevus count. Although 61.7% of the 94 nevi have shown a stable duration without size changes, 26.5% had enlarged, and 11.7% had become smaller during our 1‐year experience of dermoscopic monitoring. There was not any pattern transformation. Atypical dots and clods appeared in 17% of nevi. All of the excised nevi were comparable with Clark nevi, there was no clue for melanoma development. According to our results, we found that Rituximab therapy influences nevus morphology, but there is no evidence that this was linked to melanoma development. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine alexithymia levels and abilities to recognize facial emotions among psoriasis patients and compare with healthy controls. Sixty psoriasis patients diagnosed in dermatology clinics, and 65 age, sex and educationally matched healthy controls were assessed for this randomized controlled trial. Psoriasis Area Severity Index (PASI) was applied to patients in dermatology clinics, Structured Clinical Interview for DSM-IV Axis-1 Disorders, 20-item Toronto Alexithymia Scale (TAS-20), Facial Emotion Recognition Test (FERT) were applied to patients and controls in psychiatry clinics. Patients' mean TAS-20 total scores were higher, while their ability to recognize negative facial emotions were lower than the control group Patients might have underestimated especially negative emotions over time, for a possible defense mechanism against depression and anxiety. Alexithymia levels were significantly related with psoriasis disease severity. Thus, alexithymia might be a predictor for severity of psoriasis. [ABSTRACT FROM AUTHOR]

Coronavirus disease, first emerged in Wuhan, rapidly spread all over the world since December 2019. There are concerns about elective dermatology appointments and its results. Herein, we aimed to find out which type of dermatologic patients attended to dermatology outpatient clinic. The patients visiting the clinics for elective dermatologic diseases between March 11 and 18, 2020, were included in this study. Their age, sex, diagnosis of disease, requirement for emergent intervention, and their medical records about COVID‐19 were obtained. There were 390 patients attending to the dermatology outpatient clinic in this period. The most common disease was acne (N: 94, 24%), only 19% of patients need emergent interventions or dose adjustment. There were 40 (10%) patients over the age of 65. After their visits, five patients were diagnosed as COVID‐19 in 2weeks. Dermatologic examinations may be a vector for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) transmission since being closed to the patient. Five of our patients were diagnosed as COVID‐19 after their elective visit to hospital. Since the asymptomatic course of some young patients, most of our patients were not screened for COVID‐19. Our findings support the concerns of elective physician examinations. [ABSTRACT FROM AUTHOR]

Objective: We aim to compare the efficacy of topical steroids and Capparis spinosa extract in the treatment of vitiligo. Methods: Patients were retrospectively identified from those treated by the Department of Dermatology. 60 vitiligo patients were included in the study. 30 of them were given topical steroids, and 30 of them were treated with Capparis spinosa extract. VASI (Vitiligo Area Scoring Index) were calculated statistically before treatment and during the 6. month of treatment. Results: Although the VASI value of patients who treated with topical corticosteroids decreased statistically, no statistically significant changes were observed in patients who treated with with Capparis spinosa extract. After treatment, VASI values were significantly lower in patients with treated topical corticosteroids than treated with Capparis spinosa extract (p<0.05). Discussion: In this study, topical corticosteroids were more effective than Capparis spinosa in the treatment of vitiligo. Although there was not statistically difference of VASI values in patients treated with Capparis spinosa. repigmentation was observed after treatment. Therefore Capparis spinosa is not enough alone but maybe it can be used in combination therapy of vitiligo. [ABSTRACT FROM AUTHOR]

Background/Objectives: The current literature suggests there is a possible connection between paediatric psoriasis and obesity. However, there is a paucity of research on the influence of increased adiposity on the severity of paediatric psoriasis and disease progression. We aimed to compare the prevalence of being overweight or obese in paediatric psoriasis patients and controls and assess the potential impact of being overweight/obese on disease severity and progression of disease. Methods: This multicentre prospective case-control study included 289 psoriasis patients (aged < 18 years) treated and followed up by one of the four university hospitals in Turkey. The control group consisted of 151 consecutive age-matched and sexmatched children who lacked a personal or family history of psoriasis. The participants’ characteristics, psoriasis-related parametres (e.g., initial subtype, psoriasis area and severity index, presence of psoriatic arthritis) and body mass index were determined. Results: The difference between the prevalence of being overweight/obese among psoriatics (28%) and the control group (19%) was significant (P = 0.024). Being overweight/obese had no significant impact on disease severity and unresponsiveness to topical treatment. Within a median follow-up time of 12 months, 23% of our patients with localised disease at disease onset progressed to generalised disease. The impact of being overweight/obese on disease progression was found to be non-significant; however, disease duration was found to have a significant impact on disease progression (P = 0.026). Conclusions: Although it is not associated with disease severity and course, increased bodyweight may be a health problem for psoriatic children. [ABSTRACT FROM AUTHOR]

Background/Objectives Spitz nevi are melanocytic lesions with clinical, dermoscopic, and histopathologic presentations that may resemble those of melanoma. The evolution of Spitz nevi is a well-known feature. The objectives of this study were to investigate the clinical and dermoscopic features of Spitz nevi and define their evolution. Methods A retrospective observational study was performed and 70 Spitz nevi were analyzed using clinical and dermoscopic examination. Results Seventy patients were included in the study. The most common dermoscopic pattern was globular ( n = 35 [50%]) followed by starburst ( n = 24 [34.3%]), reticular ( n = 8 [11.4%]), and homogeneous ( n = 3 [4.3%]). Follow-up data were available for 27 of 70 patients. Of these, 21 demonstrated evolution on the follow-up images. A stable pattern (no evolution) was noted in 6 of 27 lesions. The patients who exhibited evolution were younger on average than the stable group (p = 0.04). Conclusion Based on our study, the most common biologic behavior for Spitz nevi is evolution. Although no significant differences were observed in other clinical features, the inverse relationship between evolution and age is important to consider when attempting to differentiate Spitz nevus from melanoma. [ABSTRACT FROM AUTHOR]