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© 2022 Wiley Periodicals LLC.Objectives: In this study covering all of Turkey, we aimed to define cutaneous and systemic adverse reactions in our patient population after COVID-19 vaccination with the Sinovac/CoronaVac (inactivated SARS-CoV-2) and Pfizer/BioNTech (BNT162b2) vaccines. Methods: This prospective, cross-sectional study included individuals presenting to the dermatology or emergency outpatient clinics of a total of 19 centers after having been vaccinated with the COVID-19 vaccines. Systemic, local injection site, and non-local cutaneous reactions after vaccination were identified, and their rates were determined. Results: Of the 2290 individuals vaccinated between April 15 and July 15, 2021, 2097 (91.6%) received the CoronaVac vaccine and 183 (8%) BioNTech. Systemic reactions were observed at a rate of 31.0% after the first CoronaVac dose, 31.1% after the second CoronaVac dose, 46.4% after the first BioNTech dose, and 46.2% after the second BioNTech dose. Local injection site reactions were detected at a rate of 35.6% after the first CoronaVac dose, 35.7% after the second CoronaVac dose, 86.9% after the first BioNTech dose, and 94.1% after the second BioNTech dose. A total of 133 non-local cutaneous reactions were identified after the CoronaVac vaccine (2.9% after the first dose and 3.5% after the second dose), with the most common being urticaria/angioedema, pityriasis rosea, herpes zoster, and maculopapular rash. After BioNTech, 39 non-local cutaneous reactions were observed to have developed (24.8% after the first dose and 5% after the second dose), and the most common were herpes zoster, delayed large local reaction, pityriasis rosea, and urticaria/angioedema in order of frequency. Existing autoimmune diseases were triggered in 2.1% of the patients vaccinated with CoronaVac and 8.2% of those vaccinated with BioNTech. Conclusions: There are no comprehensive data on cutaneous adverse reactions specific to the CoronaVac vaccine. We determined the frequency of adverse reactions from the dermatologist's point of view after CoronaVac and BioNTech vaccination and identified a wide spectrum of non-local cutaneous reactions. Our data show that CoronaVac is associated with less harmful reactions while BioNTech may result in more serious reactions, such as herpes zoster, anaphylaxis, and triggering of autoimmunity. However, most of these reactions were self-limiting or required little therapeutic intervention.

Patients prone to psoriasis suffer after a breakdown of the epidermal barrier and develop poorly healing lesions with abnormal proliferation of keratinocytes.Strong inflammatory reactions with genotoxicity (short telomeres) suggest impaired immune defences with DNA damage repair response (DDR) in patients with psoriasis. Recent evidence indicates the existence of crosstalk mechanisms linking the DDR machinery and hormonal signalling pathways that cooperate to influence both progressions of many diseases and responses to treatment.The aim of this study was to clarify whether steroid biosynthesis and genomic stability markers are altered in parallel during the formation of psoriatic skin. Understanding between the interaction of the steroid pathway and DNA damage response is crucial to addressing underlying fundamental issues and managing resulting epidermal barrier disruption in psoriasis.Twenty patients with psoriasis and fifteen healthy volunteers were included in this study. Transcription levels of estrogen (ESR1, ESR2), androgen (AR), glucocorticoid/mineralocorticoid receptors (NR3C1, NR3C2),HSD11B1/HSD11B2genes, and DNA damage sensors (SMC1A, TREX1, TREX2, SSBP3, RAD1, RAD18, EXO1, POLH, HUS1) were determined by Real-Time-PCR in blood and skin samples (Lesional, non-lesional) from psoriasis and control groups.ResultsWe found thatESR1, ESR2, HSD11B1, NR3C1, NR3C2, POLH, andSMC1Atranscripts were significantly decreased andAR, TREX1, RAD1, andSSBP3transcripts were increased dramatically in the lesional skin compared to skin samples of controls.As a result, we found that the regulation of the steroidogenic pathway was disrupted in the lesional tissue of psoriasis patients and that a sufficient glucocorticoid and mineralocorticoid response did not form and the estrogen/androgen balance was altered in favour of androgens. We suggest that an increased androgen response in the presence of DDR increases the risk of developing psoriasis. Although this situation may be the cause or the consequence of a disruption of the epidermal barrier, our data suggest developing new therapeutic strategies.

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Objective We investigated newly diagnosed patients with endogenous CS for molecular changes in skin by biopsy before and a year after treatment of CS. Patients and methods 26 Patients with CS and 23 healthy controls were included. All the patients were evaluated before and a year after treatment. Skin biopsies were obtained from abdominal region before and a year after treatment in patients with CS and once from healthy volunteers. Total RNA was isolated from the skin biopsy samples and the real-time PCR system was used to determine the expression levels of 23 genes in the skin biopsy. Results Skin expression levels of HAS 1, 2 and 3 mRNAs were lower and COL1A2, COL2A1, COL3A1 mRNAs were higher in patients with CS than in normal controls. MMP-9, TIMP-1 and elastin mRNA expression levels were similar in two groups. Skin IL-1 beta mRNA expression level was significantly higher in patients with CS. None of these parameters changed significantly 12 months after treatment. Patients with CS showed higher skin GH and HSD11B1 mRNA expressions and lower GHR and IGF-1R mRNA expression compared to control. Expression levels of IGF-1, GR and HSD11B2 mRNA were similar in two groups. None of these parameters changed significantly 12 months after treatment. Conclusion CS is associated with increased expression levels of skin COL1A2, COL2A1, COL3A1 mRNAs (which are correlated with increased expression level of skin GH mRNA). Decreased skin HAS may cause decreased synthesis of HA that contributes to thinning of skin in CS. Increased local inflammatory cytokine and HSD11B1 mRNAs may be related to the acne formation in CS. Treatment of CS was not able to reverse these changes and ongoing changes were detected after treatment.

Long functional non-coding RNAs (lncRNAs) have been in the limelight in aging research because short telomeres are associated with higher levels of TERRA (Telomeric Repeat containing RNA). The genomic instability caused in Immune-mediated inflammatory diseases (IMID) especially in patients with psoriasis, which lead to short telomeres in psoriasis lesions, is a mechanism leading to cell aging. Research on the fraction of TERRA in hybrid with DNA offers avenues for new strategies. Skin samples were fractionated to obtain the RNA associated with DNA as a R-loop structure. TERRA analysis was performed by RT-qPCR and RNA-seq analysis. The higher amount of TERRA levels attached with each chromosome end was found with psoriasis patients. The increased levels of TERRA linked with telomeres correlate with the decrease in the RNase-HII transcript which means the unresolved DNA/RNA hybrids may ultimately facilitate the formation of skin lesions. LncRNAs have multiple molecular functions, including the regulation of heterochromatin, which controls genome stability and epigenome shaping and may be used as a trans-generational prognostic marker in patients with psoriasis.

Background: The differentiation between the pemphigoid diseases is essential for treatment and prognosis. In Turkey, data on the incidence of these diseases are insufficient. Our aim in this study is to determine the incidence, demographics and clinical characteristics associated with diseases of the pemphigoid group. Methods: We prospectively analysed 295 patients with pemphigoid who visited dermatology clinics of tertiary referral hospitals in 12 different regions of Turkey within a year. The diagnosis was based on clinical, histopathological, direct immunofluorescence (DIF) and serological (multivariant enzyme-linked immunosorbent assay [ELISA], indirect immunofluorescence and mosaic-based BIOCHIP) examinations. Clinical and demographic findings, aetiological factors and concomitant diseases observed in the patients were recorded. Results: A total of 295 (female/male ratio: 1.7/1) patients with pemphigoid were diagnosed in 1-year period. The overall incidence rate of pemphigoid diseases was found to be 3.55 cases per million-years. The ratio of pemphigoid group diseases to pemphigus group diseases was 1.6. The most common pemphigoid type was bullous pemphigoid (BP, 93.2%). The others were epidermolysis bullosa acquisita (3.1%), pemphigoid gestationis (2.4%), linear IgA disease (1%) and mucous membrane pemphigoid (0.3%). The most common (26.8%) possible trigger of the bullous pemphigoid was gliptin derivative drugs. The most common concomitant diseases with pemphigoid were cardiovascular (27.8%) and neurological diseases (23.7%). Conclusions: This study showed that the increased frequency of bullous pemphigoid reversed the pemphigoid/pemphigus ratio in Turkey. Further studies are warranted regarding the reasons for this increase. © 2021 The Australasian College of Dermatologists

© 2021 Taylor & Francis Group, LLC.Background: Immunosuppressive therapy has been a great concern during the pandemic. This study aimed to evaluate the pandemic's impact on psoriasis patients treated with immunosuppressive drugs. Material and Methods: The multicenter study was conducted in 14 tertiary dermatology centers. Demographic data, treatment status, disease course, and cases of COVID-19 were evaluated in patients with psoriasis using the immunosuppressive treatment. Results: Of 1827 patients included, the drug adherence rate was 68.2%. Those receiving anti-interleukin (anti-IL) drugs were more likely to continue treatment than patients receiving conventional drugs (OR = 1.50, 95% CI, 1.181–1.895, p =.001). Disease worsening rate was 24.2% and drug dose reduction increased this rate 3.26 and drug withdrawal 8.71 times. Receiving anti-TNF or anti-IL drugs was associated with less disease worsening compared to conventional drugs (p =.038, p =.032; respectively). Drug withdrawal causes were ‘unable to come’ (39.6%), ‘COVID concern’ (25.3%), and ‘physician’s and patient’s co-decision’ (17.4%). Four patients had COVID-19 infection with mild symptoms. The incidence was 0.0022% while it was 0.0025% in the general population. Conclusion: Our study shows that psoriasis patients using systemic immunosuppressive do not have a higher, but even lower COVID-19 risk than the general population, and treatment compliance with biological drugs is higher.

Introduction Cushing's syndrome is a rare condition characterized by increased glucocorticoid levels. Dermatologically, it causes a variety of skin conditions such as atrophy, striae, acne, plethora, hypertrichosis, hirsutism, acanthosis nigricans, hyperpigmentation, alopecia, purpura and fragile skin. Although skin lesions of Cushing's syndrome have been described, exogenous and endogenous types have not been studied in detail. Aim To determine differences in possible skin lesions depending on the cause of Cushing's syndrome. Material and methods A total of 35 patients - 16 iatrogenic Cushing's syndrome patients and 19 endogenous Cushing's syndrome patients - who were diagnosed in Erciyes University and 15 healthy individuals were included in this study. Results There was at least one skin finding in 34 (97.1%) of the patients with Cushing's syndrome and 9 (60%) in the control group (p = 0.001). Comparison regarding skin findings in patient and control groups revealed that hypertrichosis, hyperpigmentation, and fungal infections were significantly more frequent in the patient group than the control group. Hirsutism was found more frequently in the endogenous group whereas stria, hypertrichosis and fungal infections were more frequent in the exogenous group. Conclusions Since Cushing's syndrome is a rare disease and it is often diagnosed later in life, data on the frequency of skin findings are limited and sparse in the literature. In the comparison of endogenous Cushing's and exogenous Cushing's groups, acne, hypertrichosis, and fungal infections were found more frequently in the exogenous Cushing's group and hirsutism more frequently in the endogenous Cushing's group.

Objective: The aim of the study was to evaluate the efficacy and safety of rituximab treatment in patients with pemphigus vulgaris.

Background Several factors play a role in the pathogenesis of pruritus in uremic patients. The pathophysiology is complex and many factors have been identified in these patients. The aim of this study was to investigate the presence, severity, and possible causes of pruritus in patients with peritoneal dialysis (PD) . Methods Eighty patients, who received continuous ambulatory peritoneal dialysis (CAPD) treatment, were included in this study. Biochemical measurements, parathormone, C-reactive protein (CRP), and vitamin B12 levels of all the patients were recorded. Furthermore, substance P (SP) levels were measured by ELISA methods. Patients were examined by a dermatologist and pruritus degrees were queried using the visual analog score (VAS) with skin dryness. Results In generalized linear model analysis, total urea clearance and SP independently predicted VAS scores. SP was significantly predictive in ROC analysis in identifying the VAS score in patients with peritoneal dialysis. The sensitivity and specificity of SP were 80% and 67% (cut-off > 364), respectively, with an area under the ROC curve of 0.757 (95% CI 0.650-0.865, p < 0.001). SP also was significantly predictive in ROC analysis in identifying xerosis in PD patients. Conclusion Pruritus was proportional to the amount of substance P and total urea clearance was another reason affecting pruritus in peritoneal dialysis patients.

Purpose This study aimed to investigate the relationship between skin parameters and CAD. Materials and methods The study included 50 patients diagnosed with coronary artery disease as the patient group and 45 volunteers without any known coronary artery disease as the control group. The participants' skin TEWL, pH, temperature, electrical capacitance, sebum, and elasticity values were measured using noninvasive methods at the forehead, back, and forearm. Findings Skin temperature was significantly higher in the back and forehead regions in the patient group. No difference was found between the sebum values of the patient and control groups at the back and forehead. A significantly higher result was obtained for the forearm area. The pH was significantly lower in the patients' forearm, although the obtained values were within the normal range. The TEWL was significantly higher in patients in all three regions. In terms of flexibility, R2 was significantly higher in the back and forehead regions of the patient group, and the R6 was significantly higher in the patient group in all three regions. In addition, there was no correlation between skin parameter and SYNTAX score increase measurements. Conclusion It can be suggested that skin sebum and TEWL measurements can be accepted as cheap and noninvasive methods of predicting CAD.

Necrobiosis lipoidica is a rare chronic granulomatous disease that has historically been associated with diabetes mellitus, but recently it is thought to be secondary to microangiopathic changes. We report a necrobiosis lipoidica case of a five-year-old girl with diabetes since the age of two, because it is exceptionally unusual in pediatric diabetes. Necrobiosis lipoidica should be considered in pediatric patients with slowly expanded erythematous plaques and patches. This will help protect the patient from other important diabetic microangiopathic complications, such as nepropathy and retinopathy and also malignant progression, such as squamous cell carcinoma.

The COVID-19 infection, which emerged in December 2019 in China and has spread all over the world,1 continues to be a serious health problem and many dermatological findings have been reported.2-6 This study patients who had at least one positive COVID-19-PCR sample in Kayseri province and were followed up and treated for COVID-19 were contacted via the Internet and telephone. Hence, patients who might have been misdiagnosed were excluded. This way, data of a more specific patient group could be evaluated.

COVID-19 pandemic has a significant impact on public health, whether directly or indirectly. The first case was seen in Turkey on March 11, and the World Health Organization (WHO) declared a pandemic on March 12, 2020. The study aimed to document the effect of pandemic on dermatology outpatient clinics in Turkey. 15 tertiary hospitals from 13 provinces were included in the study, which was conducted between January 12 and May 12, 2020. The International Codes of Diseases (ICD-10) categories and patients' characteristics were evaluated before and after the pandemic. A total of 164878 patients, 133131 before and 31747 after the pandemic, were evaluated. The daily hospital applications were found reduced by 77%. The three of the most frequent diagnoses; dermatitis, acne, and psoriasis remained unchanged after the pandemic. While the frequency of herpes zoster, scabies, urticaria, pityriasis rosea and sexually transmitted diseases increased significantly; allergic and irritant contact dermatitis decreased after the pandemic. The applications regarding cutaneous neoplasms were considerably reduced during the pandemic, and this effect was more pronounced in cities with higher COVID incidence. The pandemic caused a noteworthy reduction in the number of patients accessing dermatological care. The pandemic caused significant changes in the frequency of a wide range of dermatological diseases. The application of cutaneous neoplasms is considerably reduced after the pandemic, and this effect was more pronounced in cities where pandemics are frequent. Therefore, the pandemic has resulted on numerous impacts on many critical issues in dermatology and dermatological care. This article is protected by copyright. All rights reserved.

A new type of coronavirus (coronavirus disease 2019; COVID-19), which emerged in the People's Republic of China, spread all over the world over time and became a pandemic. Dermatological symptoms seen during the course of the disease have gained importance over time. Studies have shown that many dermatological findings such as erythematous rash, urticaria, pseudo-chilblain, maculopapular, livedo/necrosis, and vesicular lesions may accompany the disease. In this study, a 24-year-old female patient with maculopapular lesions who had no previous history of allergy or dermatological disease and regressed without any dermatological treatment is presented.

Background: Internalized stigma, adoption of negative attitudes and stereotypes of the society regarding persons' illness, has not been studied previously in pediatric psoriasis patients. Objective: We aimed to investigate the internalized stigma in pediatric psoriasis patients and to determine differences according to factors affecting internalized stigma compared to adult psoriasis patients. Methods: This multicenter, cross-sectional, comparative study included 125 pediatric (55 female, 70 male; mean age±standard deviation [SD], 14.59±2.87 years) and 1,235 adult psoriasis patients (577 female, 658 male; mean age±SD, 43.3±13.7 years). Psoriasis Internalized Stigma Scale (PISS), Dermatology Life Quality Index (DLQI), Perceived Health Status (PHS), and the General Health Questionnaire (GHQ)-12 were the scales used in the study. Results: The mean PISS was 58.48±14.9 in pediatric group. When PISS subscales of groups were compared, the pediatric group had significantly higher stigma resistance (p=0.01) whereas adult group had higher scores of alienation (p=0.01) and stereotype endorsement (p=0.04). There was a strong correlation between mean values of PISS and DLQI (r=0.423, p=0.001). High internalized stigma scores had no relation to either the severity or localization of disease in pediatric group. However, poor PHS (p=0.007) and low-income levels (p=0.03) in both groups, and body mass index (r=0.181, p=0.04) in the pediatric group were related to high PISS scores. Conclusion: Internalized stigma in pediatric patients is as high as adults and is related to poor quality of life, general health, and psychological illnesses. Unlike adults, internalized stigma was mainly determined by psoriasis per se, rather than disease severity or involvement of visible body parts, genitalia or folds. Copyright © The Korean Dermatological Association and The Korean Society for Investigative Dermatology.

Background Melasma is a common, multifactorial, and recurring disease which is not easy to treat. Aims The purpose of this study is to evaluate the efficacy of microneedling in combination with Q-switched neodymium-doped yttrium aluminum garnet laser (QsNd-YAG laser) for treatment of melasma. Patients/methods Fifteen female patients with epidermal or mixed-type melasma on the face were included in the study. Patients were first treated with QsNd-YAG laser, and then with microneedling containing mesotherapy products of biomimetic peptides, at the same session. Modified Melasma Area Severity Index (mMASI) scores were calculated before the first session and again 2 weeks after the last session. The same treatment protocol was repeated every 2 weeks for five sessions within period of 3 months of therapy. The evaluation was performed according to the before and after photographs taken from three angles including 90-degree front and 45 degrees from left and right with the VISIA device. Results Of the 15 patients included in the study, the mean mMASI scores before and after treatment were 9.2 ± 5.7 (3.8-23.1) and 3.6 ± 4.0 (0.6-16.8), respectively. mMASI scores were significantly reduced after completion of the protocol. Six (40%) patients had "very good response," 4 (26.7%) patients had "good response," and 5 (33.3%) patients were "unresponsive." Six (40%) patients were followed up for 1 year, and only 1 patient had a recurrence (6.7%). Conclusions In addition to the use of photoprotective measures, multimodality treatment including QsNd-YAG laser and microneedling with mesotherapy products containing biomimetic peptides is effective to treat melasma and they work synergistically.

Systemic sclerosis (SSc) is a chronic, autoimmune disease which can affect the blood vessels, the visceral organs, and the skin. SSc, most commonly, develops between the ages of 30 and 50, but it can be seen at any age. In terms of skin involvement, SSc can be classified as limited or diffuse. Its etiopathogenesis is still unclear. Microvascular dysfunction is thought to be followed by immunological activation, collagen and extracellular matrix deposition, and finally fibrosis. Diagnosis is based on clinical presentation. Sclerosis of the metacarpophalangeal and/or metatarsophalangeal joints is the major diagnostic criterion, whereas sclerodactylia, digital ulcers (DU), and pulmonary fibrosis are the minor criteria. SSc is diagnosed with one major criterion or two minor criteria. Detection of autoantibodies can help the diagnosis. Antinuclear antibody (ANA), anti-centromere antibody, anti-scl 70, RNA polymerase 1 and 3, and anti-fibrillin antibody can be found positive in SSc. SSc must be differentiated from all sclerosing diseases and the diseases with Raynaud’s phenomenon. Visceral diseases, such as primary pulmonary hypertension, primary biliary cirrhosis, and infiltrative cardiomyopathy, should also be considered in its differential diagnosis. The main treatment goal is to target visceral involvement.

Amaç: Bu çalışmada vitiligolu hastaların serumlarında proinflamatuvar karakterde olan interferon-gamma (IFN-γ) ve antiinflamatuvar karakterde olan interlökin (IL)-10 seviyeleri ve bu sitokinlerin birbiriyle olan oranı; bunların hastalığın yaygınlığı ve aktivitesi ile ilişkili olup olmadığını araştırmak amaçlanmıştır. Gereç ve Yöntem: Çalışmaya klinik olarak vitiligo tanısı konulan 42 hasta ve 42 kontrol alındı. Serum IFN-γ, IL-10, antinükleer antikor (ANA), C-reaktif protein (CRP) seviyeleri ölçüldü; vitiligo alan şiddet indeksi (VASI) ve vitiligo hastalık aktivite skoru (VIDA) değerleri hesaplandı ve uygun istatiksel analizler yapıldı. Bulgular: Hasta ve kontrol grubu arasında IFN-γ, IL-10,ANA, CRP seviyeleri ve IFN-γ / IL-10 oranı açısından anlamlı fark bulunmadı. VASI > 200 (yaygın tutulumlu hastalar) olan hastalarla, kontrol grubu karşılaştırıldığında IL-10 değerleri arasında anlamlı farklılık saptandı (p= 0,02). VIDA > 2 (son 6 ayda yeni lezyon çıkışı olan, aktif hastalar) hastalarda IL-10 seviyeleri arasında yapılan korelasyon analizinde serum IL-10 değerinin pozitif yönde etki etkilendiği gözlendi (p= 0,028, r= 0,656). Hastalık süresinin IL-10 üzerine etkisi olup olmadığı değerlendirildiğinde korelasyon saptandı (p= 0,034). Bu korelasyonun negatif yönde orta derecede ilişkili olduğu saptandı (r = -0,502). IFN-γ / IL-10 oranı VASI >200 olan hastalar ile VIDA >2 olan hastalarda kontrole kıyasla anlamlı derecede yüksek bulundu (p= 0,04, p= 0,018). Sonuç: Çalışmamızda en çok dikkat çeken sonuç, IL-10 seviyesinin hastalığın aktif döneminde ve yaygın tutulumu olan hastalarda anlamlı derecede yüksek bulunmasıydı. Bu çalışma, yüksek sitokin seviyelerinin, melanosit hasarının daha geniş alanlarda gözlenmesinin nedeni olduğunu ve vitiligo patogenezinde otoimmün sürecin önemli derecede katkısı olduğunu göstermiştir.

Amaç: Kemoterapiyle indüklenen alopesi, onkoloji hastalarında psikososyal açıdan kanser tedavisinin en yıkıcı bulgularından bir tanesidir. Bu çalışmada, kemoterapiyle indüklenen alopesilerin değerlendirilmesinde videodermoskopik incelemenin yerinin belirlenmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya, kemoterapi alan ve klinik inceleme sonrası kemoterapiyle indüklenen alopesi tanısı konan ardışık 41 hasta dâhil edildi. Hastaların yaş, cinsiyet, deri fototipi, malignite tanısı, tedavi protokolündeki kemoterapi ajanları ve alopesinin yaygınlığı kaydedildi. Trikoskopik fotoğraflar X30-X50’lik büyütmeler ile elde edildi. Literatürdeki yayınlar ile oluşturulan kontrol listesine göre trikoskopik bulgular incelendi. Bulgular: Foliküler bulgulardan olan saç çapı değişkenliği hastaların tümünde saptandı. Siyah nokta %78, sarı nokta %75,6, kırık saç %51,2, Pohl-Pinkus %46,3, ünlem işareti saçlar ve alev figürleri %26,8 oranında izlendi. İki renkli, kısa vellus ve moniletrix-benzeri saçlar %22, domuz kuyruğu ve incelen saç %19,5, lale saç %14,6 ve zig zag saç ise %9,8 oranında görüldü. Daha nadir izlenen diğer bulgular V saç %7,3, virgül saç, peripilar bulgu ve boş folikül ise %4,9 oranında idi. Nötrofil benzeri saç (%7,3) ilk kez tanımlandı. Sonuç: Kemoterapi ile indüklenen alopesilerde zig zag saç, lale saç ve V saç yeni trikoskopik bulgulardı. Nötrofil benzeri saçlar ise ilk kez bu çalışmada tanımlandı. Kemoterapiyle indüklenen alopesilerin dermoskopisi, alopesi areata ve trikotillomani ile bazı benzer bulgular göstermektedir. Objective: Chemotherapy induced alopecia is one of the most devastating findings of cancer treatment for oncology patients psychologically. In this study, we aimed to investigate the significance of videodermoscopic features of chemotherapy induced alopecia. Material and Methods: Fourty-one patients, who were treated with chemotherapy and were diagnosed as chemotherapy induced alopecia after clinical evaluation, were included. The age, gender, skin phototype, diagnosis of malignancy, chemotherapy agents in the treatment protocol, location of the alopecia and the severity of alopecia were recorded. Trichoscopic photos were held in X30-X50 fold magnifications. All of the trichoscopic findings were examined in accordance with the checklist which was described by the features of the previous publications. Results: Hair diameter diversity were detected in all of the patients as a follicular feature. Black dots were established in 78%, yellow dots in 75.6%, broken hairs in 51.2%, Pohl-Pinkus in 46.3%, exclamation mark hairs and flame figures in 26.8% of the patients. Bicoulored, short vellus and moniletrix-like hairs were detected in 22%, pigtail and tapering hairs in 19.5%, tulip hairs in 14.6% and zigzag hairs in 9.8% of the patients. V hairs in 7.3%, comma hairs, peripilar finding and empty follicles were established in 4.9% of the patients as other rare findings. Neutrophil like hairs were detected in 7.3% of the patients for the first time. Conclusion: Zigzag hair, tulip hair and V hair were the new trichoscopy findings in chemotherapy induced alopecia. Neutrophil like hairs were defined for the first time in this study. Dermoscopic features of chemotherapy induced alopecia indicates some similar findings for alopecia areata and trichotillomania.

Background:Timely diagnosis is essential for the optimal management of psoriatic arthritis (PsA). Several instruments have been developed for screening PsA among patients with psoriasis. However, a delay in diagnosis is still frequently reported, possibly due to the lack of a wide use of these instruments.Objectives:We aimed to identify and compare the reported performance of these instruments with special emphasis on the PsA phenotypes.Methods:We conducted a systematic literature search on PubMed until 15 August 2020 using the keyword ‘psoriatic arthritis’. Two independent reviewers identified all studies published in English, that report on the validation, psychometric evaluation or use of an instrument for screening PsA. Any disagreements were resolved by the third investigator. Data on sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were extracted or calculated for each instrument. Additionally, instruments were assessed for their performance in patients with different disease phenotypes.Results:A total of 10754 references were screened, and 42 were identified that reported on 15 different screening instruments. Psoriatic Arthritis Screening and Evaluation (PASE), Psoriasis Epidemiology Screening Tool (PEST), Early Arthritis for Psoriatic Patients questionnaire (EARP) were the most commonly used instruments. There was important variability across studies regarding the sensitivity, specificity, PPV and NPV of these instruments based on the cut-offs for positivity, setting, patient population and disease phenotypes (Table 1). Specificity was higher when patients with a previous diagnosis of other rheumatic diseases were excluded. Lower sensitivity was reported among patients with shorter disease duration and when patients with a prior diagnosis of PsA were excluded from the study, whereas higher sensitivity was reported among patients with prior NSAID use. Screening tools showed differences in sensitivity in different domains (Figure 1).Figure 1.Performance Among Patients with Each DomainConclusion:This systematic literature review revealed wide variability in the diagnostic estimates of currently available questionnaire-based screening instruments for identifying PsA among psoriasis patients, depending on study populations and disease phenotypes. There is an unmet need for a screening instrument with a better performance in all disease domains.Table 1.Diagnostic estimates of screening tools in different studiesInstrumentNumber of studiesSensitivity%Specificity%PPV%NPV%PASE1824-9138-9518-8813-96PEST1140 – 8537.2-98.623-9647.1-99.3EARP941-97.234-97.214-93.357.5-100TOPAS641-89.129.7-9025.7-91.868-81.6TOPAS-II444-95.880.5-9863.4-95.891-98PsA-Disk questionnaire187.246.458.678.5CONTEST270-76.556.5-9116-8968-95STRIPP191.593.379.697.5SiPAS179877390PASQ267-92.764-81.84383GEPARD277706680Swedish- Psoriasis Assessment Questionnaire163724585PAQ160622687.5SiPAT169699169A novel, short, and simple screening questionnaire186.971.35393.6PASE: Psoriatic Arthritis Screening and Evaluation, PEST: Psoriasis Epidemiology Screening Tool, EARP: Early Arthritis for Psoriatic Patients questionnaire, TOPAS: Toronto Psoriatic Arthritis Screening Questionnaire, STRIPP: Screening Tool for Rheumatologic Investigation,SIPAS: Simple Psoriatic Arthritis Screening questionnaire, PASQ: Psoriasis and Arthritis Screening Questionnaire, GEPARD: German Psoriatic Arthritis Diagnostic Questionnaire, PAQ: Psoriatic and Arthritic Questionnaire, SiPAT: Siriraj Psoriatic Arthritis Screening ToolDisclosure of Interests:None declared.

Background: The skin is one of the most affected organs in tuberous sclerosis complex and angiofibromas are seen in almost 80% of such patients. These benign tumors impose a great psycho-social burden on patients. Objective: The aim of the study was to evaluate the effectiveness and tolerability of topical sirolimus for facial angiofibromas in patients with tuberous sclerosis complex. Methods: This was a prospective, single-blinded, cross-over study which involved twelve patients. We investigated the effect and safety of topical 0.1 % sirolimus, which was obtained by crushing sirolimus tablets and mixing it with petrolatum. The patients were asked to apply the cream to one side of their face, and vaseline to the other side. The effect of topical sirolimus was evaluated using the "facial angiofibroma severity index." Results: There was a significant improvement in the redness and extension of the tumors on the sides to which the active ingredient was applied. Some side effects such as itching and irritation occurred in three patients, which were treated with topical hydrocortisone cream. Conclusion: Topical sirolimus appears to be a promising, fairly well tolerated treatment for facial angiofibromas in patients with tuberous sclerosis complex. Although its efficacy diminishes with time, repetitive usage is effective.

Background Diagnosis of demodicosis is usually confirmed by standardized skin surface biopsy. The skin of the patients with demodicosis is usually very sensitive. There is a need for new noninvasive tests. Videodermoscopic findings of demodicosis have not been validated yet. Our aim was to provide a noninvasive and easy method for diagnosis of demodicosis by using videodermoscopy. Materials and methods This study included 26 patients with demodicosis which were confirmed with microscopy and responded well to anti-Demodex therapy Twenty-six age- and sex-matched individuals without demodicosis constituted the control group. Dermatologic evaluation included clinical observation along with microscopy. All photographs of the clinical and dermoscopic findings were taken with videodermoscope. Results Demodex tails representing "Demodex mites" were a common feature in all patients. Gray dots were described as the second major videodermoscopic finding. Epidermal scale and red dots were also observed with higher prevalence than the other videodermoscopic features. We defined a new finding as follicular annular pigmentation corresponding to the facial pigmentation with demodicosis by videodermoscopy. Conclusions We concluded that it seems possible to confirm the clinical diagnosis of demodicosis by videodermoscopy, with similar results to handheld dermoscopy. Demodex tails should be considered as a sign of demodicosis, whereas detection of gray dots, epidermal scale, and red dots may raise the suspicion of demodicosis.

DOI: 10.4328/JCAM.3881 Received: 15.09.2015 Accepted: 19.10.2015 Publihed Online: 20.10.2015 Corresponding Author: Emine Colgecen, Department of Dermatology, Bozok University Medical Faculty, 66200, Yozgat, Turkey. T.: +90 3542127060 F.: +90 3542177150 E-Mail: drecolgecen@hotmail.com Ozet Darier hastaligi (Darier-White hastaligi, keratozis follikularis), ozellikle seboreik bolgeleri tutan, keratinizasyon bozuklugu ile karakterize, otozomal dominant gecisli, nadir gozlenen bir hastaliktir. Bu makalede, klinik ve histopatolojik bulgular ile Darier’s disease tanisi konulan 47 ve 28 yaslarinda ki anne ve kiz iki kadin hasta, bu hastaligin nadir gorulmesi nedeniyle sunulmustur.

Uzm. Dr. Salih Levent Cinar, Erciyes Universitesi Tip Fakultesi, Deri ve Zuhrevi Hastaliklar Anabilim Dali, Talas 38039 Kayseri Turkiye, Tel. 0505 240 61 25 Email. sleventcinar@yahoo.com Gelis Tarihi: 28.09.2015 • Kabul Tarihi: 06.11.2015 ABSTRACT AIM: The number of pregnant women applying to dermatology outpatient clinics has increased. This has brought to notice the need for a specialized approach. In order to deal with pregnant women and their diseases, one must have a good knowledge of the skin disorders of pregnancy. Pregnant women and women who are considering pregnancy should be treated exclusively.

ObjectiveHirsutism results from hyperandrogenemia and/or exaggerated androgen responsiveness. Among various causes of hirsutism, some patients do not exhibit androgen excess which is called idiopathic hirsutism (IH). The pathogenesis of IH could not so far be clearly established.DesignTo investigate the mRNA expression of aromatase enzyme and the other enzymes having functional roles in the steroidogenic pathway, in freshly obtained skin tissue from subumbilical skin and the arm of the patients with IH and healthy women.MethodsTwenty-one women with IH and 15 healthy women were included in the study. We aimed to determine mRNA expressions of genes associated with local androgen synthesis and metabolism (CYP11A1, STS, CYP19A1, SRD5A1, SRD5A2, HSD3B1, AR, COMT, ESR1, ESR2, HSD3B2, CYP17A1, SULT2A1, SULT1E1, HSD17B2, IL6, TGFB1, TNFA) from skin biopsy and blood samples of patients with IH and the data compared with healthy subjects.ResultsPatients with IH exhibit significantly lower interleukin 6 (IL6) mRNA expression and higher steroid sulphatase (STS) and hydroxysteroid (17beta) dehydrogenase 2 (HSD17B2), gene mRNA expression, respectively, in the subumbilical region skin biopsies. Similarly, patients with IH exhibit significantly lowerIL6mRNA expression and higherSTSandHSD17B2gene mRNA expression, respectively, in the arm skin compared to healthy women's subumbilical region.ConclusionsIn both arm and subumbilical skin biopsy of patients with IH, we observed an up-regulation ofHSD17B2andSTS, decreasedIL6mRNA expression, probably determining an increase in the local amount of active androgens, which could then be used as substrate for other androgen metabolic routes.

Objective: Nail fold capillary changes are accepted as early symptoms of several rheumatic disorders such as scleroderma and dermatomyositis. In adults, nail fold capillary abnormality (NCA) has been described in Familial Mediterranean Fever (FMF). However, there is not enough study in children with FMF. The aim of the present study was (1) to investigate whether children with FMF have NCA in both active and/or remission period or not and (2) to assess insulin resistance in children with FMF in both active and/or remission period of the disease compared with the control group.

WOS: 000435797400003, Background and Design: Atopic dermatitis (AD) has a complicated etiopathogenesis and difficulties in diagnosis and treatment from time to time. Because of the disease which different approaches can be seen rationalize the need for an algorithm for the diagnosis, classification, etiopathogenesis, diagnostic tests and therapeutic approach. Therefore, authors from Dermatoallergy Working Group of the Turkish Society of Dermatology aimed to create an AD guideline for the diagnosis, treatment and followup. Materials and Methods: Each section of the guideline has been written by a different author. The prepared sections were evaluated in part by e-mail correspondence and have taken its final form after revision in the last meeting held by the participation of all authors. Results: The guideline includes the diagnosis, classification, etiopathogenesis, diagnostic tests and therapeutic approach of AD. Lesions show age-related morphology and distribution. There are no in vivo/in vitro tests that have high sensitivity and specificity that can be used to identify AD and trigger factors. The first step of treatment consists of moisturizers, topical corticosteroids and calcineurin inhibitors, respectively. Moisturizers are used therapeutically in all forms of AD. Topical corticosteroids are the first agents to be used when moisturizers are inadequate. Topical calcineurin inhibitors should be used in lesions resistant to corticosteroids, for proactive treatment, special areas. Antimicrobials agents and antiseptics should only be added to treatment when clinical signs of infection are present. And in topical treatment-resistant cases, second-line treatment is phototherapy or oral cyclosporine. The biologic agent, dupilumab, is promising in the treatment of severe AD. Conclusion: AD is a disease that can be challenging for the physician in terms of treatment and follow-up. Depending on evidence-based data (and individual experiences), this guideline will have a leading role in the diagnosis and treatment of AD and help the physician to overcome the challenges in the management.

WOS: 000437833900024, PubMed ID: 29663351, Background Cutaneous leishmaniasis ( CL) is a vector- born parasitic disease characterized by various skin lesions that cause disfiguration if healed spontaneously. Although CL has been endemic for many years in the southern regions of Turkey, an increasing incidence in nonendemic regions is being observed due to returning travelers and, more recently, due to Syrian refugees. Thus far, a limited number of national guidelines have been proposed, but no common Turkish consensus has emerged. Objectives The aim of this study was to develop diagnostic and therapeutic guidelines for the management of CL in Turkey. Methods This guideline is a consensus text prepared by 18 experienced CL specialists who have been working for many years in areas where the disease is endemic. The Delphi method was used to determine expert group consensus. Initially, a comprehensive list of items about CL was identified, and consensus was built from feedback provided by expert participants from the preceding rounds. Results Evidence- based and expert- based recommendations through diagnostic and therapeutic algorithms according to local availability and conditions are outlined. Conclusion Because CL can mimic many other skin diseases, early diagnosis and early treatment are very important to prevent complications and spread of the disease. The fastest and easiest diagnostic method is the leishmanial smear. The most common treatment is the use of local or systemic pentavalent antimony compounds.