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Background and Design: Oral lichenoid lesions (OLL) are contact stomatitis characterized by white reticular or erosive patches, plaque-like lesions that are clinically and histopathologically indistinguishable from oral lichen planus (OLP). Amalgam dental fillings and dental restoration materials are among the etiologic agents. In the present study, it was aimed to evaluate the standard and dental series patch tests in patients with OLL in comparison to a control group and evaluate our results. Materials and Methods: Thirty-three patients with OLL or OLP and 30 healthy control subjects, who had at least one dental restoration material and/or dental filling, were included in the study. Both groups received standard series and dental patch test and the results were evaluated simultaneously. Results: The most frequent allergens in the dental series patch test in the patient group were palladium chloride (n=4; 12.12%) and benzoyl peroxide (n=2, 6.06%). Of the 33 patients with OLL; 8 had positive reaction to allergents in the standard patch test series and 8 had positive reaction in the dental patch test series. There was no significant difference in the rate of patch test reaction to the dental and standard series between the groups. Ten patients were advised to have the dental restoration material removed according to the results of the patch tests. The lesions improved in three patients [removal of all amalgam dental fillings (n=1), replacement of all amalgam dental fillings with an alternative filling material (n=1) and replacement of the dental prosthesis (n=1)] following the removal or replacement of the dental restoration material. Conclusion: Dental patch test should be performed in patients with OLL and dental restoration material. Dental filling and/or prosthesis should be removed/replaced if there is a reaction against a dental restoration material-related allergen. [ABSTRACT FROM AUTHOR]

Background and Design: Classic Kaposi's sarkoma (CKS) is a rare disease, generally seen across Mediterranean and the Middle East region. It's an angioproliferative disorder associated with human herpes virus-8 infection. There is a few data on epidemiology and clinical characteristics among Turkish patients with CKS. This study aims to evaluate epidemiologic, clinical characteristics and treatment results in patients with the diagnosis of CKS in Zonguldak. Materials and Methods: We retrospectively evaluated the hospital records of patients with CKS who attended the dermatological and venereal diseases department between 2003 and 2014. Seventy-four patients were included in this study. Demographic and clinical characteristics, applied treatments and responses to treatments were evaluated. Results: During the eleven year examination period, 74 CKS patients have been diagnosed in the dermatology clinic. The prevalence of CKS among dermatologic patients was found to be 0.02%. Patient age at diagnosis ranged from 33 to 90 years (mean: 70.2±11.7). Fifty-two patients were male (70.3%) and 22 patients were female (29.7%). Multiple nodules were the most frequently seen clinical forms and the distal lower extremity was the most common site of involvement (80.6%). According to the CKS staging system, it was observed that 47 patients (62.7%) were at stage 1, 11 patients (15.49%) at stage 2, eight patients (10.7%) at stage 3, and six patients (8%) were at stage 4. Treatment options were excision for 35.1% of patients (n=26), radiotherapy for 25.7% of patients (n=19), cryosurgery for 14.9% of patients (n=11), and chemotherapy for 10.8% of patients (n=8). Relapse was found to occur most commonly after excision (58.3%). Conclusion: Larger, multicenter studies are needed in order to determine the prevalence of CKS and characteristics of patients with CKS in our country. [ABSTRACT FROM AUTHOR]

Background and Design: Pemphigus vulgaris (PV) is a severe, chronic, potentially life-threatening autoimmune blistering disease that affects the skin and mucous membranes, associated with the loss of cell-cell adhesion and blister formation. Systemic steroids in combination with immunosuppressive agents are the mainstay of therapy in pemphigus. Rituximab, a chimeric monoclonal anti-CD20 antibody, has been tried increasingly for the treatment of PV. Materials and Methods: We sought to test the efficacy and safety of rituximab as an adjuvant therapy by retrospective analysis of clinical and immunological data of patients. We performed a retrospective analysis of 13 patients with refractory pemphigus vulgaris who were treated with rituximab at Akdeniz University Hospital, Clinic of Dermatology and Venereology, Bullous Disease Unit. We evaluated clinical and immunological data with last treatments. Results: The patients were treated with one cycle of two biweekly infusions of rituximab at a dose of 1000 mg on days 1 and 15, except one received four doses of 375 mg/m2 weekly. The mean follow-up time was 18.5 months. All patients had a decrease in antibody titers or antibodies were completely undetected after treatment. Rituximab use resulted in a significant reduction in steroid dosage during follow-up. At the end of the follow-up period, 7 patients achieved complete disease remission without therapy, 1 patient achieved partial disease remission without therapy, 2 patients achieved complete remission on minimal therapy, 1 patient achieved complete remission on therapy, 1 patient achieved partial remission on minimal therapy, and one patient was lost to follow-up. Rituximab was well tolerated by all patients. Clinical relapse was seen in 7 patients (53.8%) in the mean period of 13.8 months. Relapses have been managed with additional infusions of rituximab. Conclusion: Rituximab is beneficial in the management of refractory PV, induces prolonged clinical remission and has a steroid-sparing effect. (Turkderm 2015; 49: 117-24) [ABSTRACT FROM AUTHOR]

Background and Design: Despite the development of effective systemic treatments and new biological agents for psoriasis nowadays, topical medications are still the mainstay of treatment. Topical calcineurin inhibitors are currently used in various skin diseases. We investigated the efficacy and safety of tacrolimus, which is an alternative in topical treatment, in comparison with the present medications in plaque psoriasis. Materials and Methods: This prospective double-blind placebo-controlled study was conducted in 24 patients with the diagnosis of plaque psoriasis who were seen in Uludağ University Hospital dermatology outpatient clinic. 0.1% tacrolimus ointment, 0.1% mometasone furoate ointment, 0.005% calcipotriol ointment and placebo in encrypted bottles were randomly applied under occlusion to 27 psoriatic plaques in test chambers, every other day, for a period of 19 days. Clinic sum scores, side effects, and epidermal thickness measured by superficial ultrasound were noted before and after treatment in all microplaques. Besides, histopathologic scoring and epidermal thickness were measured in 9 patients at the end of the study. Results: The clinic sum scores and ultrasonographic epidermal thickness at the end were both significantly lower than the beginning values in all microplaques (p<0.05). The reduction in these two values with tacrolimus were significantly higher than that with placebo (p<0.001), but no difference was observed with calcipotriol (p=0.287, p=0.813, respectively). On the other hand, the reduction in these values with mometasone was significantly higher than with tacrolimus (p<0.05). Mometasone furoate was the most effective when the three ointments were compared with placebo in terms of total histopathological score and epidermal thickness. Conclusion: Tacrolimus ointment applied under occlusion is an alternative topical medication in the treatment of plaque psoriasis. Occlusion in practice requires patient compliance. Thus, studies to find a new formulation that will increase absorption of drug from thick psoriatic plaques are needed. (Turkderm 2015; 49: 107-11) [ABSTRACT FROM AUTHOR]

Background and Design: Er: YAG lasers are precise ablation systems used in the treatment benign epidermal and dermal skin lesions. In this study, we retrospectively analysed the efficiency of Er: YAG laser therapy in the treatment of benign epidermal and dermal skin lesions. Materials and Methods: We retrospectively investigated the medical records of 116 patients treated with Er: YAG laser in our clinic between April 2011 and April 2013. The clinical data of 103 patients (47 men, 56 women) with xanthelasma, solar lentigo, epidermal nevus, seborrheic keratosis, nevus of ota, syringoma, cafe au lait macules (CALM) or other than these were included in the study. Treatment parameters, demographic features of the patients, and before and after photos of the lesions were investigated from patients’ records in order to evaluate the efficiency of Er: YAG laser therapy. Results: The patients included in the study were evaluated in 8 groups: xanthelasma (n=21), syringoma (n=17), solar lentigo (n=16), epidermal nevus (n=11), seborrheic keratosis (n=9), nevus of ota (n=5), CALM (n=3) and other than these (n=21). In the Er: YAG laser treatment, the average energy flow was 3-7 J/cm2, the average pulse duration was 300 ms, the average number of passes was 3-5 repeats, and the average pulse frequency was 3-7 Hz. While no improvement was observed in 4.9% of patients, 59.2% of subjects showed marked improvement, 26.2% showed moderate and 9.7% of patients showed mild improvement. Treatment responses in xanthelasma, syringoma, epidermal nevus, solar lentigo and CALM lesions were statistically significant. The observed side effects were hyperpigmentation in 4 patients, hypopigmentation in 3 patients, hypertrophic scar in 2 patients and persistent erythema in one patient. The treatment was well tolerated by all the subjects. Conclusion: Er: YAG laser is an effective and safe treatment option in the treatment of benign skin lesions especially in epidermal lesions. [ABSTRACT FROM AUTHOR]

Background and Design: Intense Pulsed Light (IPL) is a light system of 500-1200 nm wavelength which is used for hair removal and nonablative skin resurfacing as well as for the treatment of hyperpigmentation and superficial vascular lesions. The mechanism of action is thought to be the focal epidermal coagulation due to selective photothermolysis in the epidermal keratinocytes and melanocytes. A variety of laser systems can be used in the treatment of solar lentigo. The aim of this study was to investigate the effectiveness of IPL in solar lentigo. Materials and Methods: We retrospectively reviewed the medical records of patients with the diagnosis of solar lentigo in our Cosmetology Unit from March 2007 to November 2010. There were 139 files of patients who received clinical and dermoscopic diagnosis of solar lentigo and treated by IPL (L900 A&M). Informed consent was taken from all patients. Among them, 42 patients, who had attended regular follow-up visits and had pictures taken both before and after treatment, were included in the study. Results: A total of 52 lesions in 42 female and 1 male patients were included in the study. The mean age of the patients was 42±9.6 (33-88) years. Thirty-seven lesions (51.9%) were on the cheek, 7 lesions (13.5%) were on the zygoma, 6 lesions (11.5%) were on the chin, 4 lesions (7.7%) were on the hands, 4 lesions (7.7%) were on the forehead, 2 lesions (3.8%) were on the nose, and 2 lesions (3.8%) were on the forearm. The mean number of sessions was 3.28, ranging between 1 and 7. After treatment, more than 75% improvement was observed in 57.7% of the lesions, 50-75% in 17.3% of the lesions, 25-50% in 17.3% of the lesions, and less than 25% improvement was obtained in 7.7% of the lesions. Conclusion: According to the results of our work, IPL can be considered to be an effective, cheap and safe method in terms of its side effects in the treatment of solar lentigo. [ABSTRACT FROM AUTHOR]

Background and Design: Ultraviolet (UV) radiation can affect dermoscopic features of melanocytic nevi by inducing melanin synthesis or melanocyte proliferation. Despite widespread use of UV radiation in the treatment of several skin diseases, there have been only a few studies on its effects on the dermoscopic features of melanocytic nevi. The present study was designed to determine the effects of narrowband UVB, UVA1 and psoralen and UVA (PUVA) treatments on dermoscopic features of melanocytic nevi. Material and Method: A total of 55 patients, who were referred to our phototherapy unit for the treatment of various skin disorders, were enrolled in this prospective study. Twenty-one patients underwent narrowband UVB, 18 patients underwent UVA1 and 16 patients underwent PUVA treatment. Dermoscopic images of 233 nevi in narrowband UVB group, 233 nevi in UVA1 group and 229 nevi in PUVA group were evaluated for the alterations in dermoscopic structures at the end of three months. Total dermoscopic scores (TDSs) of melanocytic nevi were calculated according to the ABCD rule. Results: There was no statistically significant increase in the size of melanocytic nevi in the therapy groups. Narrowband UVB, UVA1, and PUVA resulted in statistically significant changes in the dermoscopic structures of melanocytic nevi. In narrowband UVB therapy group, de novo dot formation was documented (p=0.002). Only in narrowband UVB group, de novo dot formation was observed. There was no statistically significant change in the mean TDS. Conclusion: Narrowband UVB, UVA1 and PUVA therapies have significant effects on dermoscopic features of melanocytic nevi. [ABSTRACT FROM AUTHOR]

Background and Design: Although gingival hyperpigmentation is not a medical problem, people who have moderate or severe gingival pigmentation, particularly patients having a gummy smile, frequently request cosmetic treatment. For gingival depigmentation, different treatment modalities have been reported such as surgical treatment, cryotherapy, electrosurgery, and laser therapy. Materials and Methods: Twenty-one patients with gingival melanin pigmentation were included in the study. We applied liquid nitrogen to the hyperpigmented area for 5-10 seconds using open spray technique with a cryogun. Clinical observations for intensity of pigmentation were recorded at baseline and 3 months after the treatment. Clinical parameters, such as bleeding, swelling, redness, and healing, were evaluated immediately after the cryotherapy and 24 hours, and 1 week after the treatment. We used a numeric pain scale to evaluate the pain level. Results: Three months after the treatment, the mean gingival melanin pigmentation score decreased from 41.62±16.58 to 19.28±11.85. The difference between pretreatment and posttreatment mean scores was found to be statistically significant.Discussion: Removal of gingival melanin pigmentation can be performed safely by open spray cryotherapy in dermatology clinics. [ABSTRACT FROM AUTHOR]

Background and Design: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit. Oral antibiotics and topical retinoids are effective in the treatment of acne. Materials and Methods: In this study, 60 patients with moderate acne vulgaris were evaluated; the patients were randomized into two equal groups. The groups were matched with respect to age, gender and clinical severity of acne. The patients in group 1 received oral azithromycin (500 mg daily on 3 consecutive days per week) and the patients in group 2 received doxycycline (100 mg daily) for 12 weeks. Topical adapalene gel was added to the systemic treatment in both groups. Clinical evaluation was performed at baseline and at the end of first, second and third months. Side effects were recorded. Quality of life in patients was measured with Skindex-29 and Acne Quality of Life Scale before treatment and at the end of third month. Results: At the end of the treatment, the patients in the two treatment groups had clinical improvement of more than 50%. Twenty-one patients in the azithromycin-adapalene group and 23 patients in the doxycycline-adapelene group had more than 80% clinical improvement. There was not any statistically significant difference in the clinical efficacy between the two combinations. Both treatment regimens were safe with minimal side effects. There was statistically significant difference in Skindex-29 and Acne Quality of Life Scale scores at baseline and at the end of the treatment (p< 0.05). There was not any statistically significant difference in the mean scale scores of both quality life scales between the two groups (p>0.05). Conclusion: Both treatments were efficient and safe. There was significant improvement in quality of life scale scores in both groups. [ABSTRACT FROM AUTHOR]

Background and Design: There are numerous therapeutic methods for hair removal with various success rates. The aim of this study was to evaluate the efficacy of Intense Pulse Light (IPL) method for hair removal. Materials and Methods: Ninety patients, who applied for their unwanted hair, were included in the study. IPL was applied to the face, neck, axillary areas, bikini line, sternal area, periareolar areas, and upper and lower extremities. An IPL device (L900 A&M, France) was used for hair removal. The results were evaluated according to the clinical improvement (0-25%, 25-50%, 50-75%, 75% and more) and patients' satisfaction (very satisfied, satisfied, less satisfied, not satisfied). All results were analyzed using Chi-square test and statistical analysis was performed by SPSS 15.0 for Windows. Results: There were eighty-eight female (97.8%) and two male (2.2%) patients. The mean age of the patients was 33.62±11.11 (15-55) years. 13.3% of patients had polycystic ovary syndrome. The mean number of treatments was 6.5 (min-max= 2-11). 53.2% of patients had 50-75% clinical response and 53.2% of patients were satisfied. There were no side effects except mild erythema. Conclusion: We observed that IPL for hair removal was safe and moderately effective in our patients. (Turkderm 2012; 46: 94-7) [ABSTRACT FROM AUTHOR]

Background and Design: In this study, we aimed to evaluate the effects of a formula composed of millet extract, wheat germ oil, calcium pantothenate and L-cystine in women with diffuse alopecia by using Digital Phototrichogram (Trichoscan). Materials and methods: We evaluated female patients who presented to Gazi University Faculty of Medicine Department of Dermatology between January 2008 and November 2008 with the complaint of diffuse hair loss. Digital phototrichogram was performed in the frontal and occipital regions of the patients. Using this method, anagen:telogen ratios were determined. 53 female patients whose ages were between 18 and 50 and who were diagnosed as having telogen effluvium type diffuse alopecia were included in the study. The patients were given a capsule containing 140 mg millet extract, 271 mg wheat germ oil, 2 mg L-cystine and 10 mg calcium pantothenate three times a day for three months. The criteria for assessing the efficacy of the therapy included number of hair loss per day, hair pull test and digital phototrichogram. Results: The reduction of daily average hair loss after the treatment was statistically significant. Statistically significant difference was found between the pre- and post-treatment results of the hair pull test. Before the treatment, the average anagen ratio was determined to be 69.0±11.2 in the frontal region, and 72.3±9.4 in the occipital region. After the treatment, the anagen ratio increased to 76.4±11.2 in the frontal region and to 79.9±8.6 in the occipital region. The increase in the anagen hair rate in the frontal and occipital regions after the treatment was found to be statistically significant. Conclusion: As a result, it was found that the formula composed of millet extract, wheat germ oil, L-cystine and calcium pantothenate may be effective in the treatment of telogen effluvium. However, controlled studies including larger groups of diffuse alopecia patients and placebo groups are needed. (Turkderm 2012; 46: 78-83) [ABSTRACT FROM AUTHOR]