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Dermatoscopy is a useful, non-invasive method in the diagnosis of various dermatological diseases. Dermatoscopy of non-pigmented skin lesions shows additional morphologic features, such as cutaneous vascular pattern, scale color and scale distribution pattern, and background color. Dermatoscopy can be useful tool in differential diagnosis in palmoplantar dermatoses. The most specific dermatoscopic features of hand eczema include yellowish-orange globules, yellowish scales and yellowish crusts. Light red background color, regular vascular distribution pattern, dotted vessels and white scale color have been reported in previous studies as dermatoscopic features of palmoplantar psoriasis. Dotted vessels can be seen in various dermatoses, such as psoriasis, eczema, lichen planus, porokeratosis and keratodermas. The distribution pattern and color of the scales are also important in the differential diagnosis of palmoplantar dermatoses. Previous studies have shown that scales are mainly localized in skin furrows in patients with tinea manum. Patchy distributed, homogeneous, structureless, orange areas were reported in palmar keratoderma due to pityriasis rubra pilaris. Amber scales, white-to-pinkish background; sparse whitish scales were reported in palmar keratoderma due to mycosis fungoides. Dermatoscopical findings of palmoplantar area can help in the differential diagnosis of various dermatoses.

HS is a chronic, recurrent, and debilitating skin disease. Recent studies showed that inflammatory biomarkers, such as neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and Lymphocyte/HDL ratio (LHR), Neutrophil/HDL ratio (NHR), Monocyte/HDL ratio (MHR) are an indicator of inflammatory diseases and may be associated with disease severity and disease activity. To investigate NLR, PLR, LHR, NHR and MHR in HS patients. In addition, to compare erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), complete blood count, leukocyte profile and biochemical parameters between the control and the patient group. Clinical and biochemical data of patients and healthy subjects were collected from medical records, retrospectively. In total, 166 patients with HS and 124 control subjects were included. We found no significant difference in NLR (P = 0.207) and PLR (P = 0.257). LHR (P < 0.001), NHR (P < 0.001) and, MHR (P < 0.001) were significantly higher in the patient group. No positive correlation was found between any of these markers and disease severity according to Hurley staging system. However, MCV (Mean corpuscular volume), RDW (Red cell distribution width) and CRP showed a significant positive correlation with disease severity. Among these markers, only MHR was positively correlated with disease duration. Our study shows that CRP still maintains its value for HS patients compared to new inflammation markers. Unlike the studies in other inflammatory diseases, no significant relationship was found with most of these inflammatory parameters. MHR may be more useful in patients with HS as an indicator of inflammation compared to other parameters. This article is protected by copyright. All rights reserved.

Skin cancers are the most common type of cancer. Nonmelanoma skin cancers (NMSCs) are more common than melanoma. Although the mortality rate is low, cancer word can be frightening for patients. Surgery is the main treatment. As skin cancers are most commonly located on the face, undesirable cosmetic results can occur as a result of treatments or due to primary disease. Therefore, the quality of life of patients could be affected. To determine the effect of surgical treatment on quality of life of the patients with facial NMSC using the Dermatology Life Quality Index (DLQI) at baseline and 3 months after surgery. We aimed to see if there was any improvement in quality of life scores after surgery, and to identify factors affecting quality of life. A total of 255 patients; 174 basal cell carcinoma (BCC) (68.2%) and 81 squamous cell carcinoma (SCC) (31.8%) were included in our study. All participants completed DLQI at baseline and 3 months after surgery. The mean total DLQI scores were 6.37 ± 6.28 in patients with BCC, and 6.35 ± 6.16 in patients with SCC. The mean total DLQI scores were 3.96 ± 5.14 in patients with BCC (P < .001), and 4.49 ± 5.24 in patients with SCC (P < .001) 3 months after surgery. In patients with primary skin cancer, all subscale scores and total DLQI scores were worse than the recurrent skin cancer group in both BCC and SCC at baseline. According to the treatment modalities, total DLQI scores and all subscales were worse in the graft group in BCC and SCC patients at baseline. Interestingly, the sex and the type of skin cancer did not affect quality of life, but tumor localization ([auricula OR: 6.45 [95% CI: 1.28-37.47] and eyelid OR:0.20 [95% CI: 0.04-0.96]) treatment procedure ([flap procedure OR: 7.90 [95% CI: 2.64-23.62] and graft procedure OR: 5.47 [95% CI: 1.60-18.71]) and, primary tumor OR:3.86 (95% CI: 1.01-14.78) were significant. The quality of life of skin cancer patients was affected by tumor localization, treatment procedure, primary, or recurrent tumor. The quality of life showed a significant improvement in patients with facial NMSC after surgical treatment. However, the type of NMSC seems to have no effect on the quality of life.

Diagnosis can be difficult in isolated palmar and plantar lesions in patients with psoriasis and eczema. The purpose of our study is to compare the dermoscopic findings in patients with palmoplantar psoriasis and palmoplantar hyperkeratotic eczema. This prospective, comparative study included 90 patients histopathologically diagnosed with eczema or psoriasis (35 psoriasis and 55 eczema). The age range was 18-75 years. The most common vessel type was dot vessel in psoriasis. Red globular ring vessels were seen in five patients with psoriasis, but not in any with eczema (P = 0.007). The most common vascular distribution pattern was regular in psoriasis (40%). Patchy vascular pattern was significant in eczema. The most common background color was light red in psoriasis (48.6%) (P < 0.001). Brownish-orange globules were observed in 25.7% of patients with eczema and 5.7% in patients with psoriasis (P = 0.02). There is only one study in the published work about dermoscopy of palmoplantar psoriasis and eczema. In our study, yellow crusts, patchy scale distribution, patchy vascular pattern, yellow scale color, dull red background color and brownish-orange globules were significant in patients with palmoplantar eczema. On the other hand, patients with psoriasis had light red background color, regular vascular distribution pattern and white scale color. We observed globule structures with a pale center and dark peripheral rim only in patients with eczema, which was not identified in previous studies. This globule structure may be a new finding in eczema.

Background: Malignant proliferating trichilemmal tumor (MPTT) is very rare malignant tumors of hair follicles derived from outer root sheath. This tumor is mostly located on the head and neck of elderly women. Regional or distant metastasis is possible. In this study, we present clinical features and treatment outcomes of cases diagnosed as MPTT. Furthermore, we aimed to emphasize a different clinical form of the tumor that can be misdiagnosed clinically. Patients and Methods: A retrospective evaluation of five cases operated between September 2009 and February 2017 Celal Bayar University Faculty of Medicine, Plastic Reconstructive and Aesthetic Surgery Department at were included in the study. Clinicopathological features of patients, type of surgery, and follow-up information were evaluated. Results: Four patients were female. Average age was 72.2. All of the lesions were located on the head and neck. All patients had a history of rapid growth of lesions. Patients were scanned with computed tomography. There was no metastasis at the time of diagnosis. None of the patients needed adjuvant therapy. Mean follow-up time was 11.8 months. None of the patients developed recurrence or metastasis. Conclusions: These tumors resemble basal cell or squamous cell carcinoma. Rapid progress of benign form of the tumor should address malignant transformation. There is no consensus about adjuvant therapy. Screening for metastasis and close follow-up are mandatory. © 2018 Turkish Journal of Plastic Surgery.

Tuberculin skin test (TST), which is used in the diagnosis of latent tuberculosis infection, may cause Koebner's phenomenon and false-positive results in psoriasis patients. The purpose of this study is to compare TST with QuantiFERON-TB Gold Plus (QFT-plus) test in psoriasis patients and to determine the effects of psoriasis on TST results. Ninety-two psoriasis patients and 30 control subjects were included in the study. QFT-plus test, TST, and prick test to distinguish the increase of induration because of the skin trauma were performed on both groups. The demographics, risk factors for latent tuberculosis infection, BCG vaccination history, Koebner's history, psoriasis severity, and treatment history of the patients were recorded. The effects of these variables on test results were investigated by comparing those with control group. The criteria of National Tuberculosis Diagnosis and Treatment Guidelines were used in the evaluation of test results, and threshold value of positivity for TST was taken as 10 mm in BCG-vaccinated patients who are planned to start biological treatment. Prick test results were negative in the control group. There was no significant relation between the results of prick test and TST induration diameters in the patient group. Although TST positivity was significantly higher in patients (62%) compared with control group (33%), QFT-plus test results were not statistically different between two groups. Agreement between two tests was determined to be low in patient group with 48% (K = 0.1), and it was determined to be moderate with 77% in control group (K = 0.4). QFT-plus test was found to be negative in 46 of 57 TST-positive patients (80.7%) in patient group. It was determined in both groups that vaccination did not have any effect on test results. When threshold value was lowered to 5 mm in patient group without considering BCG reaction, the number of TST-positive patients increased from 57 to 65. Mean TST induration diameter was 10 mm and 14 mm in cases with mild and moderate to severe clinical manifestation, respectively (P =.04). However, no effect of disease period and treatment was determined on both test results. TST positivity was higher in psoriasis patients compared with control group. It was considered due to the increased reaction of the skin to mycobacterial antigens rather than the Koebner's response. Although TST results were not affected by BCG, it was concluded that a 10-mm threshold value of positivity was a suitable approach in order to reduce the number of patients receiving unnecessary preventive treatment in patients who are considered to initiate biologic agents. Furthermore, it was also concluded that QFT-plus test may be preferred in psoriasis patients since it is applied in vitro and its specificity is higher and not affected by disease severity. © 2020 Wiley Periodicals LLC

Öztürk, Savaş (Balikesir Author), BACKGROUND: There are only a few studies about epidemiological features of acne vulgaris in the literature. The aim of this study was to analyze demographic, clinical, familial and environmental characteristics of acne, the role of diet and aggravating factors and association of these factors with acne severity. METHODS: Patients with a diagnosis of mild-moderate to severe acne were consecutively interviewed at the participating centers during the study period. RESULTS: A total of 3826 patients and 759 control patients were involved in this study. Mild acne was the most common type of acne, and most of the lesions were localized on face followed by the trunk. The severity of acne was worse in patients who had a positive family history of acne. The most common triggering factor was psychological stress. We found a positive correlation with chocolate, bread, green tea, milk, white sugar, ripe banana, ice cream, apple, orange, and red meat consumption. As we compare the acne severity according to geographical features we detected mild-moderate acne was more common in Mediterranean region and severe acne was more common in East Anatolian region. Family history positivity was more common in Aegean region and least common in Central Anatolian region. There was statistically significant relationship as we compare acne severity and dietary factors such as chocolate, dairy products such as milk, sunflower seed consumption within the geographical regions. CONCLUSIONS: This study presents the demographic and clinical characteristics of acne patients in Asian and the European parts of Turkey. We believe that this study will provide a useful overview of acne in Turkey.

Skin cancer is the most common type of cancer. Nonmelanoma skin cancers (NMSCs) are more common than malignant melanoma. It is expected that the incidence of skin cancer will increase in the future. Although the mortality rate is low, cancer wording can be frightening for patients. Because skin cancers are most commonly located in the head and neck, unwanted cosmetic consequences can occur as a result of treatments. Therefore, the quality of life (QOL) of patients could be affected negatively. Today, there are various scales that assess the QOL of patients. These can be grouped as general, disease-specific, and cancer-specific questionnaires. Studies have been carried out and are still in progress to develop scales of QOL specific to skin cancers. In this paper, the questionnaires used in malignant melanoma and/or NMSCs and studies on this subject are reviewed.

Background/aim: Malignant melanoma is the most common cause of death due to skin cancers. The most common mutations in RAFRASpathway from tumor oncogenes are BRAF and NRAS. In this study, we analyzed the frequency of BRAF and NRAS gene mutationsand investigated their association with clinicopathological features of melanomas in the Turkish population.Materials and methods: 65 primary cutaneous melanoma were included in the study. The mutations were evaluated with real-time PCRbasedPCR-array through allele-specific amplification, and the results were correlated with various clinicopathological characteristics.Results: 52.3% of the patients were female and 47.7% were male. The mean age of the patients with a mutation was lower than thosewithout mutation. 16 patients had BRAF mutation. 12 patients had NRAS mutation. NRAS mutation was statistically more common inmen (P = 0.036). The number of mitoses increased with the increase of the tumor thickness (P = 0.003). There was more mitosis in thepresence of ulceration (P = 0.05). A total of 41.7% of NRAS mutations had adjuvant chemotherapy.Conclusion: We found lower mutation rate when compared to regional studies. NRAS mutation was common in men. This is the firststudy from our region evaluating the prognostic value of clinical stage and necessity of adjuvant treatment with the presence of BRAFand NRAS mutations.

Objectives: To emphasize different clinical features of tumor that can be misdiagnosed clinically. Methods: A total of 8 cases operated between September 2009 and 2016 at the Celal Bayar University, Faculty of Medicine were included in the study. Patients’ clinicopathological features, type of surgery and follow up information were evaluated. Results: Six patients were male. The average age was 75.50. The lesions were located on the head and neck, and chest wall. Six patients had a history of the rapid growth of lesion. There was no metastasis at the time of diagnosis. None of the patients needed adjuvant therapy. Mean follow up time was 19.37 months. None of the patients developed recurrence or metastasis. Conclusion: This tumor resembles basal or squamous cell carcinoma. The histopathological evaluation may lead to misdiagnosis. Regional or distant metastasis is very rare. There is no consensus about adjuvant therapy. Screening for metastasis and close follow up are mandatory. Saudi Med J 2018; Vol. 38 (2): 213-216 doi: 10.15537/smj.2018.2.21085 How to cite this article: Evrenos MK, Kerem H, Temiz P, Ermertcan AT, Yoleri L. Malignant tumor of outer root sheath epithelium, trichilemmal carcinoma. Clinical presentations, treatments and outcomes. Saudi Med J . 2018 Feb;39(2):213-216. doi: 10.15537/smj.2018.2.21085.

Oral cancer is the sixth most common cancer in the world with an estimated 300,000 new cases and 150,000 deaths annually. It is one of the growing causes of morbidity and mortality especially in South Asia, Europe, and North and South America. Tobacco use, alcohol consumption, and inadequate oral hygiene are the most common risk factors. The main therapeutic approaches are surgery, radiotherapy, chemotherapy, and combined treatments, which may generally lead to serious adverse effects and complications. Moreover, a remarkably poor prognosis with a significant decrease in locoregional control and survival may develop especially in patients with advanced stages, even after application of current treatment modalities. Therefore, diagnosis of oral cancer at early stage is utmost important. Unfortunately, conventional diagnostic and treatment techniques remain far from optimal. Recently, nanotechnology offer new strategies in cancer management: (1) early detection of cancers via probes and biosensors, (2) better diagnosis and staging via improving the imaging systems, (3) nanoscale drug delivery systems, which may provide a significant decrease in adverse effects and toxicities of chemotherapeutics, and (4) nanotheranostics that integrate both diagnosis and therapy simultaneously. This chapter presents the role and potential effectiveness of using nanomaterials in different aspects of oral cancer. © 2017 Elsevier Inc. All rights reserved.

Nonmelanoma skin cancer (NMSC) is one of the most prevalent types of cancer worldwide, with basal cell carcinoma and squamous cell carcinoma being the most frequent histologic types. Surgical excision remains the mainstay of treatment, but nonsurgical treatment options may be indicated in specific cases. Nonsurgical treatment options for NMSC may be preferred as good alternatives under certain circumstances. This review provides a comprehensive overview of the nonsurgical treatment modalities for NMSCs, such as curettage and electrodesiccation, cryotherapy, radiotherapy, laser, photodynamic therapy, immunotherapy, and retinoid therapy.

Wound healing is actually a complex, precisely coordinated interaction between inflammatory cells and mediators, establishing significant overlap between the phases of wound healing. Chronic wounds are defined as wounds that do not follow the well-defined stepwise process of physiologic healing. The true incidence and economic impact of chronic wounds are difficult to assess because of the wide range of causative diseases and available treatment options. Despite multiple simultaneous and sequential therapeutic approaches, chronic wounds are highly resistant to treatment and are often indolent or even slowly progressive. Hyperbaric oxygen therapy (HBOT) has been explored as a treatment modality for chronic wounds because of its potential to promote healing and reduce bioburden in the wound bed. Multiple potential beneficial effects for wound healing have been demonstrated in various laboratory studies and experimental animal models. In this manuscript, HBOT, its mechanism of action, adverse effects and usage in diabetic and nondiabetic chronic wounds have been reviewed.

OBJECTIVES This study aims to investigate the characteristic features of tumors and relationship between features in cases who underwent surgery for nonmelanoma skin cancer (NMSC) of the head and neck. PATIENTS AND METHODS Between December 2007 and March 2011, 106 lesions of 90 cases who underwent excision of NMSC of the head and neck in our clinic were included. The statistical analysis was performed by evaluating the demographic data, histopathologic type, size and thickness of tumor, location, Clark stage, T stage, risk of recurrence and the presence of recurrence, reconstruction technique and success rate of surgery. RESULTS Basal cell carcinoma (BCC) was approximately two-fold more common than squamous cell carcinoma (SCC). The most common locations of tumors were the nose and lip. Most of lesions (71.7%) were at high-risk of recurrence. When the relationship of histopathologic type with the size and depth of tumor were analyzed, it was found that the size and thickness of tumor in SCC were relatively higher with a statistically significant difference. The relationship between histopathologic type and the location of tumors was also statistically significant. CONCLUSION Basal cell carcinoma is the most common NMSC of the head and neck. Most of these cases have the potential of high rate of recurrence. The size and thickness of SCC are higher than BCC.

Heat has been used as a medicinal and healing modality throughout human history. Today, thermotherapy is being studied in the treatment of many diseases. Although the exact anti-infective mechanism of thermotherapy is yet to be solved, this historically important healing method has shown significant results in the treatments of a variety of dermatological infectious diseases ranging from simple acne to bacterial, parasitic and viral infections, in modern medicine. Induction of cellular apoptosis in medium doses and necrosis in high doses has made thermotherapy an important modality in the treatment of malignant tumors. Especially in dermatology, significant results have been achieved in the treatment of Bowen's disease, melanoma and simple warts. Thermotherapy, which today has also shown advancements in cosmetology, can be delivered by liquid nitrogen in the form of hypothermia and a variety of ways ranging from hot water pads to ultrasound and even to lasers, in the form of hyperthermia. In this article, the place of this historically important treatment method in modern medicine, especially in dermatology, has been reviewed by an extensive search of the literature.

Toll-like receptors are important pattern recognition receptors which have key roles in both innate and adaptive immune responses. They are strongly associated with the pathogenesis of inflammatory and autoimmune diseases. Furthermore, Toll-like receptors have also been implicated in the pathogenesis of several skin diseases such as skin infections, psoriasis, acne vulgaris, lichen planus, Behcet's disease, leprosy, syphilis, Lyme disease, atopic dermatitis and allergic contact dermatitis, mycosis fungoides, non-melanoma skin cancers and melanoma. In this manuscript, the structure and functions of Toll-like receptors in immune responses, their impact on skin diseases and recent advances on therapeutic usage have been reviewed.

Background Despite the multiple alternatives of treatment, it is well known that patients with obsessive-compulsive disorder (OCD) delay seeking treatment. In this study, the aim was to determine the risk factors for delaying treatment seeking in OCD patients. Methods The sample consisted of 132 OCD who completed the Yale-Brown Obsessive-Compulsive Scale, Yale-Brown Obsessive-Compulsive Scale Symptom Checklist, and Beck Depression Inventory. Results In univariate analyses with risk evaluation, income level, being single or divorced, having a history of psychiatric treatment, poor insight for the symptoms, and obsessions of hoarding were the variables that were found to be significant. In the regression model, history of psychiatric treatment and duration of OCD were the 2 variables that remained statistically significant. Conclusion This was the first study wherein the sample included patients who were recruited from a nonpsychiatric department: the dermatology clinic. Application to dermatology has not been determined as a risk factor for delaying treatment seeking in OCD patients.

OZET Netherton sendromu on tanisiyla, 12 yasinda erkek hastadan alinan sac ornekleri isik ve elektron mikroskobik yontemlerle degerlendirilmistir. Sac ornekleri rutin elektron mikroskop doku takibi sonucu Araldit karisimina gomuldu. Yari-ince kesitler metilen mavisi-azur II ile boyanarak isik mikroskopla, ince kesitler uranil asetat-kursun sitratla kontrastlanarak gecirmeli elektron mikroskopla degerlendirildi. Atopi bulgulari yanisira, histopatolojik incelemede hiperparakeratoz, dermiste enflamatuvar hucre infiltrasyonu gozlenen deri ornekleri iktiyosis linearis sirkumfleksa ile uyumlu bulundu. Sacin korteks kisminda noduler kalinlasma ve siskinlik gozlendi. Distal kil segmentinin teleskop gibi proksimal kisma girmis oldugu izlendi. Sac korteksini olusturan hucrelerin gevsek duzenlendigi, kutikulun dis kisminda hucreler arasinda acilmalar gozlendi. Bulgularla trikoreksis invaginata saptanarak Netherton Sendromu tanisi konuldu. Uzun sure atopik dermatit tanisiyla tedavi goren hastalarda, iktiyoz bulgularinin yanisira saclarda uzamada gerilik, kopmalar saptandiginda, Netherton sendromunun dusunulmesi ve sac orneklerinin incelenmesi taniyi desteklemek acisindan onemli bulunmustur.

In this study, we compared the effects of collagenase and Centella asiatica in the rat model. Twenty-seven female rats were divided into three groups, and two full-thickness wounds were made for each animal. Collagenase ointment was applied topically to Group I and C. asiatica ointment to Group II rats. In Group III, no treatment was applied. On the third day of treatment, wounds on the left side of three animals of each group were excised. On the fifth and eighth day of the treatments, the same procedure was performed for the remaining animals. Indirect immunohistochemical examination was performed to detect transforming growth factor beta (TGF)-beta, endothelial and inducible nitric oxide synthase (eNOS and iNOS), vascular endothelial growth factor, TGF-alpha, laminin, fibronectin, collagen I, and interleukin-1beta. According to the measurements of the wound areas and wound healing periodo, collagenase was superior to the control group. Immunohistochemical examinations showed strong (+++) iNOS and TGF-beta immunoreactivities in C. asiatica group. eNOS immunoreactivity was moderate (++) in this group. For the collagenase group, iNOS, eNOS, and TGF-beta immunoreactivities were moderate (++). In the collagenase group, while TGF-beta and iNOS immunoreactivities were weaker, laminin and fibronectin reactivities were stronger than in C. asiatica and control groups. Collagenase was superior to C. asiatica according to the immunohistochemical findings. Collagenase ointment significantly improves the quality of wound healing and scar formation and is a more appropriate treatment choice than extract of C. asiatica in the early stages of the wound healing process.

Acute generalized exanthematous pustulosis (AGEP, toxic pustuloderma, pustular drug eruption) is a not uncommon cutaneous reaction pattern that is usually related to drug administration. The eruption is of sudden onset and appears 7-10 days after the medication is started. A 22-year-old male patient who was a student at a chemical faculty attended our outpatient clinic with a complaint of pustular eruption on his face. According to his history, the eruption started with pruritus and erythema on his chin 3 days ago and spread to his face and chest. He explained that he had performed an experiment with sulfuric acid and bromic acid and was exposed to their vapor. His dermatological examination revealed erythema and pustules on his cheeks, on his chin, above his upper lip, and on his eyebrows. He also had a few pustules on his chest. There were no ocular, mucous membrane, or pulmonary symptoms. Histopathological examination of the skin biopsy specimen revealed superficial orthokeratosis, focal subcorneal pustule formation, and perivascular chronic inflammatory cell infiltration in superficial dermis. After administration of systemic antihistamines and wet dressing topically, we observed rapid healing of the lesions. Because there was no systemic drug intake in his history, we were concerned that exposure to sulfuric acid and bromic acid vapor caused AGEP in this patient. We present this rare case to show that the vapor of chemical materials may cause AGEP or other drug eruptions.

Introduction Hand eczema can cause considerable psychosocial disorders, such as anxiety, depression, and difficulties at work, and it may also cause sexual dysfunction. Aim The aim of this study was to investigate sexual function in patients with hand eczema and to find out whether concomitant depression has an additional negative effect on sexual function in these patients. Main Outcome Measures Sexual functions were evaluated in hand eczema patients. Methods Ninety-one female (43 patients vs. 48 controls) and 79 male (45 patients vs. 34 controls) subjects were enrolled in the study. Hand eczema severity index was used to determine severity of hand eczema. The Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF) were used to assess sexual function. Quality of life was assessed with the Dermatology Life Quality Index. Diagnosis of depression was made based on the Structured Clinical Interview for the DSM-IV, while the Hamilton Depression Rate Scale was used for grading depression. Results Among 43 female subjects with hand eczema, 26 had depression (60.46%); of the 45 male patients, 11 had depression (24.44%). FSFI total score was found to be significantly decreased in female patients with both eczema and depression compared with controls (20.84±9.19 vs. 24.04±3.40, P P P Conclusions The results of the study demonstrated that patients with hand eczema had sexual dysfunction, and concomitant depression had an additional negative effect on sexual dysfunction. Patients with hand eczema should be evaluated with regard to sexual function and depression to provide a better quality of life. Ergun M, Turel Ermertcan A, Ozturkcan S, Temeltas G, Deveci A, and Dinc G. Sexual dysfunction in patients with chronic hand eczema in the Turkish population.

Psoriasis can have a significant impact upon sexual function. The aim of this study was to investigate sexual function in females and males with psoriasis and to evaluate whether coexistent depression has an additional negative effect on sexual function in these patients. A total of 66 female subjects (39 with psoriasis and 27 healthy volunteers as a control group) and 70 male subjects (39 with psoriasis and 31 healthy volunteers as a control group) were enrolled in the study. A Psoriasis Area and Severity Index (PASI) was used to determine the severity of psoriasis for the patient groups. The Female Sexual Function Index (FSFI) was used to assess female sexual function and the International Index of Erectile Function (IIEF) was used to evaluate male sexual function. Quality of life was assessed with the Dermatology Life Quality Index (DLQI). The diagnosis of depression was made according to the Structured Clinical Interview for DSM-IV (SCID-I) interview and Hamilton Depression Rate Scale (HDRS) was used for grading depression. FSFI total score was found to be significantly decreased in female psoriatic patients without depression and psoriatic patients plus depression compared with healthy controls (24.09 +/- 5.33 vs. 24.25 +/- 4.52 vs. 28.12 +/- 3.48, respectively, p = 0.004). However, FSFI score was not significantly different between patients with psoriasis without depression and those with psoriasis plus depression (p > 0.05). IIEF total score was also found to be significantly decreased in male psoriasis without depression and psoriasis plus depression patients compared with healthy controls (54.21 +/- 13.07 vs. 52.0 +/- 14.73 vs. 61.69 +/- 9.49, respectively, p = 0.023). The difference in IIEF scores between patients with psoriasis without depression and in those with psoriasis plus depression were not statistically significant (p > 0.05). The results of the study demonstrated that patients with psoriasis, especially females have distinct sexual dysfunction compared with healthy controls, and coexistent depression has no additional negative effect on sexual dysfunction in our patients. Patients with psoriasis should be evaluated in terms of sexual function in order to provide a better quality of life.

Use of alpha hydroxy acids (AHA) to ameliorate specific dermatological problems with keratinization has become fairly widespread. The aim of this study was to evaluate the effects of the AHA derivative of glycolic acid, applied in different dosages, on rat skin using light and electron microscopy. Skin biopsies were taken from the dorsal side of rats (n=16) and at the end of each week after applying solutions containing AHA: week 1, 8% (n=5); week 2, 50% (n=5); week 3, 70% (n=6). The skin samples were fixed in 10% formalin for histology and 2.5% glutaraldehyde solution for electron microscopy and processed using routine protocols. Histological sections were stained with hematoxylin and eosin (H&E), Masson's trichrome and were also labelled for binding of a primary antibody against collagen I using the avidin-biotin-peroxidase method. The epidermal thicknesses were measured and the fibroblast count of the dermis was taken and the results compared using the statistical ANOVA test. Semi-thin sections were stained with toluidine blue-azure II solution and ultrathin sections were contrasted with uranyl acetate and lead citrate. Histochemical and immunohistochemical observations demonstrated that AHA treatment resulted in statistically significant increased thickness of the epidermis and an increase in numbers of active fibroblasts and in the amount of dense collagen, especially at higher dosages of AHA. Ultrastructural examination of rat skin from AHA-treated groups showed cytoplasmic vacuolization in epidermal keratinocytes, intercellular dysjunctions, and increased quantities of organized bundles of collagen fibers in the dermis. The use of AHA in appropriate dosages has been found to play an important role in the treatment of specific skin disorders, however, the harmful effects of use of AHAs at higher concentrations should not be ignored. We conclude that alpha hydroxyl acids have a wide spectrum of use in the field of dermatology but, due to side-effects, their use, dosage, and time frame should be restricted to the advice of dermatologists.

Objective The aims of present study were to (a) to determine the prevalence of obsessive–compulsive disorder (OCD) in dermatological patients, (b) to determine the possible relationship between dermatological lesions and OCD and (c) to determine the clinical and phenomenological features of the OCD subgroup. Method The sample consisted of 166 out of 250 consecutively presenting dermatological patients who agreed to participate in the study. The subjects were assessed with the Structured Clinical Interview for DSM-IV Turkish Version (SCID-I) and also completed the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Results Of the whole sample, 41 (24.7%) met DSM-IV criteria for OCD. Only 14.6% of them had previously been diagnosed as OCD. The mean score of Y-BOCS in the OCD group was 17.05±9.75. The most common obsessions were contamination (61%) and pathologic doubt (53.7%), while washing (61%) and checking (51.2%) were the most frequent compulsions. Those suffering from diseases of sebaceous glands were the only group that showed a significant difference between the OCD and non-OCD group. Conclusion There is a high prevalence of OCD in dermatological patients, although the nature of the relationship between OCD and dermatology has not previously been ascertained. Genetic-based studies and future researches focused on individual anxiety, and sensitivity may provide information that better explains this relationship.

Background/Purpose: The steady increase in the incidence of melanoma, non-melanoma cutaneous neoplasia and preneoplastic disorders has contributed to the demand for more effective protection from the sun. In this study, we aimed to determine the prevalence of sunscreen use and other sun protection behaviors in a large sample of students and personnel of Celal Bayar University, Manisa, Turkey. Methods: The study group included 1018 participants of whom 607 work in the Celal Bayar University Hospital and 411 are students from the Medical Faculty and School for Health Professionals. All participants completed a questionnaire composed of 45 items about sun protection and other health behaviors, such as sports activity, use of cigarettes, alcohol and seat-belts. Sun protection factor (SPF) of sunscreen, avoiding sun exposure during peak hours, wearing clothing, a hat and sunglasses were studied. Results: Of the 1018, 403 participants were male and 615 were female. While avoiding sun exposure during peak hours was the most popular preventive behavior for men (42.5%), wearing sunglasses was the most popular one for women (50.7%). Avoiding exposure was the second preventive behavior for women (42.1%). Use of sunscreen with SPF 15+ was the second popular protective measure for men (19.4%) and the third one for women (39.2%). There were no significant relationships between sun protection behaviors and obesity, use of cigarettes and alcohol. We also investigated behavioral changes with sunburn experience in the participants who had sunburn history. Among these behavioral changes, increased use of sunscreen and decreased sun exposure during peak hours with sunburn experience were significant. Conclusion: Our study demonstrated that the risk of sun exposure is largely unrecognized in Manisa, Turkey, and we have very incomplete information about protective measures. An efficient policy of education on the effective use of sun protection methods should be developed to prevent skin cancer.

Oral wide-spectrum antibiotics are the linchpin of rosacea treatment. Oral and topical metronidazole, topical tretinoin, and topical benzoyl peroxide may also be used in the treatment of rosacea. We aimed to show that benzoyl peroxide-erythromycin gel is efficient in the treatment of acne rosacea. Fifty-six patients with acne rosacea were enrolled in our study. We administered benzoyl peroxide-erythromycin gel to 27 patients and metronidazole gel to 29 patients. In all the patients, the intensities of erythema, telangiectasia, papules/pustules, and nodules were evaluated before, during and after the treatment. The positivity of Demodex folliculorum from skin scratches was compared between the two groups at each visit. At the end of the therapy on the third examination, in the benzoyl peroxide-erythromycin group, 91.7% of the patients showed marked clinical improvement, and 8.3% of them showed complete remission. In the metronidazole group, 73.3% showed marked clinical improvement, and 26.7% of them showed complete remission. Clinical improvement in the papular component was 65.2% for the benzoyl peroxide-erythromycin group, and 81.5% for metronidazole group. In the first examination, the clinical results of the agents were similar. Although both of the drugs were found to be effective in the second and third examinations, metronidazole gel was more effective than benzoyl peroxide-erythromycin. Both of the drugs were found to be significantly effective especially in treating the papular component of rosacea. Demodex folliculorum was found to be positive in 74.1% of the benzoyl peroxide-erythromycin group and in 62.1% of the metronidazole group at the beginning. In the benzoyl peroxide-erythromycin group, 40.7% of Demodex folliculorum positive patients, became negative by the first examination. This was 17.2% for the metronidazole group. In the benzoyl peroxide-erythromycin group, among the patients who were positive for Demodex folliculorum in the first examination, 37.5% of them became negative. This was 36.7% for the metronidazole group. Benzoyl peroxide-erythromycin gel was superior to metronidazole gel in decreasing Demodex folliculorum by the first examination, but the effect of the two drugs on Demodex folliculorum was similar by the second examination. As a result, topically applied combined benzoyl peroxide-erythromycin gel may be an alternative choice of treatment for acne rosacea.

Hypohidrotic ectodermal dysplasia (HED) is a syndrome characterized by hypodontia, hypotrichosis, and partial or total ecrine sweat gland deficiency. The most prevalent form of HED is inherited as an X linked pattern. Glucose-6-phosphate dehydrogenase (G-6-PD) deficiency is an X-linked recessive disease, which leads to hemolytic anemia and jaundice. It is expressed in males, while heterozygous females are usually clinically normal. A 12-year-old boy with the complaints of hair and eyebrow disturbances, teeth disfigurement, decreased sweating, and xerosis presented to the outpatient clinic. Dermatological examination revealed sparse hair and eyebrows, conical-shaped teeth, xerosis, syndactylia, transverse grooves, and discoloration of nails. Laboratory findings indicated anemia. His 3-year-old sister also had sparse hair and eyebrows, xerosis, and syndactylia. We learned that the patient had a previous history of neonatal jaundice and a diagnosis of G-6-PD deficiency. Although it has been shown that loci of ectodermal dysplasia and G-6-PD deficiency genes are near to one another, we did not find any case study reporting on occurrence of these two genetic diseases together. With the aspect of this rare and interesting case, the relationship between HED and G-6-PD deficiency was defined.

Background Lymphangiomas are congenital malformations of the lymphatic system characterized by clusters of translucent vesicles. Dermoscopically, yellow and bluish lacunea according to the lymphatic or haematic content were described previously, but it is difficult to distinguish them from haemangioma. Observations In nine patients with cutaneous lymphangioma circumscriptum (CLC), hypopyon-like features were observed. None of the 10 patients with haemangioma had this finding. Conclusion Hypopyon-like features can be a useful dermoscopic pattern in differentiating CLC from haemangioma.