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Acne scars lead to physical and psychological problems for young adults therefore they should be treated effectively. Fractional carbon dioxide (FCL) and radiofrequency (FRFL) lasers have been both used for acne scars. The aim of this study was to evaluate the effectivity and satisfaction of combined FCL and FRFL treatment for acne scars and evaluate effect of these treatments especially on atrophic scar types retrospectively. A total of 41 patients with acne scars who received FCL + FRFL were included in this study. Photographs of patients before treatment and 1 month following the last treatment session were scored by the other blinded clinician, according to the ECCA acne scar scoring method. A significant decrease was noted in clinical scores after the treatment. Side effects were minimal and acceptable. When comparing atrophic scars to erythematous ones laser treatment was more effective for atrophic types. In conclusion, our findings revealed that laser treatment with FCL + FRFL for acne scars is successful, effective and comfortable. These combination is more effective in atrophic type acne scars.

Objective: The aim of the study was to evaluation of neuropsychological areas to determine whether or not there were cognitive differences and whether the impairment was in a specific form in obsessive-compulsive disorder (OCD) patients compared to healthy control subjects. Materials-Methods: The sample comprised 30 patients aged 16-65 years diagnosed with OCD, and a control group of 30 age and gender-matched healthy volunteers. According to the DSM diagnostic criteria, various neurocognitive tests were applied to the patients diagnosed with OCD. Results: A statistically significant difference was determined between the two groups in respect of the WCST scores. No statistically significant difference was determined between the groups in respect of the Forward, Reverse, or total Digit Span Test values. WAIS-R; The results of this test were determined as a mean of 43.1 ± 15.4 in the OCD group and 56.2 ± 6.8 in the control group, and the difference between the groups was statistically significant. When the groups were examined in terms of interference errors, the value of 2.2 ± 2.8 in the OCD group was determined to be statistically significantly greater than the 0.8 ± 0.8 value of the control group. A statistically significant difference was determined between the groups in respect of the mean words counted with perseverance by the OCD group (1.7 ± 2.1) and the control group (0.6 ± 0.8). Conclusion: It can be said that combining cognitive function impairments specific to OCD with neuroimaging studies would be useful in understanding OCD symptoms in more detail. Thus, new treatment strategies could be developed.

Background: The permanence of Alexandrite laser hair removal (LHR) has been of great interest. However, studies on long-term outcome are lacking.Objective: To evaluate the hair reduction rates (HRR...

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Background Palmoplantar pustulosis (PPP) is a rare, chronic, inflammatory skin disease characterized by sterile pustules on palmar or plantar areas. Data on PPP are scarce. Aim To investigate the clinical characteristics and risk factors for disease severity in a large cohort of Turkish patients with PPP. Methods We conducted a cross-sectional, multicentre study of patients with PPP recruited from 21 tertiary centres across Turkey. Results In total, 263 patients (165 women, 98 men) were evaluated. Most patients (75.6%) were former or current smokers. The mean Palmoplantar Pustulosis Area and Severity Index (PPPASI) was 8.70 +/- 8.06 and the mean Dermatology Life Quality Index (DLQI) score was 6.87 +/- 6.08, and these scores were significantly correlated (r = 0.52, P < 0.001). Regression analysis showed that current smoking was significantly associated with increased PPPASI (P = 0.03). Coexisting psoriasis vulgaris (PsV) was reported by 70 (26.6%) patients. Male sex prevalence, PPP onset incidence, disease duration, DLQI, and prevalence of nail involvement and psoriatic arthritis (PsA) were significantly increased among patients with PPP with PsV. Of the 263 patients, 18 (6.8%) had paradoxical PPP induced by biologic therapy, and these patients had significantly increased mean DLQI and prevalence of PsA (r = 0.03, P = 0.001). Conclusion Our data suggest that smoking is a risk factor for both PPP development and disease severity. Patients with PPP with PsV present distinct clinical features and patients with biologic therapy-induced paradoxical PPP have reduced quality of life and are more likely to have PsA.

© 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.

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.

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.

Scabies outbreaks were reported in many countries especially from Africa, but had not been reported in Turkey before.1 This is a multicentre study with compiling the data of patients with scabies in 12 tertiary level dermatology clinics located in distinct geographical regions of Turkey. The medical ethical committee of Ondokuz Mayis University Medical Faculty approved the study.

Background Psoriasis is a chronic inflammatory skin disease in which lesions display angiogenesis and increased vascularity. Objective The long-pulsed 1,064-nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser treats vascular lesions which suggests that it might also be used to treat nail psoriasis. Methods Sixteen patients (10 males and 6 females) with isolated nail psoriasis or nail with only mild cutaneous involvement were enrolled in the study. Nails were treated for 3 sessions with long-pulsed 1,064-nm Nd:YAG laser once monthly. During the course of the treatment, nail bed and matrix Nail Psoriasis Severity Index (NAPSI) scores were recorded. Results The mean baseline NAPSI score was 26 ± 7.2. The means of total NAPSI scores after the first, second, and third treatment sessions were as follows: 22 ± 6.6, 13 ± 6, and 5.7 ± 4.3, respectively. The decline in NAPSI score was statistically significant. At the end of the 3 treatment sessions, both nail bed and matrix lesions significantly responded to Nd:YAG laser treatment. Conclusion The Nd:YAG laser is a promising treatment option for nail psoriasis.

Serkan Zincir,1 Pelin Öztürk,2 Ali Emrah Bilgen,3 Filiz Ä°zci,4 Cihad Yükselir5 1Department of Psychiatry, Gölcük Military Hospital, Kocaeli, 2Psychiatry Clinic, Erenkoy Training and Research Hospital for Psychiatric and Neurological Diseases, Istanbul, 3Department of Psychiatry, Etimesgut Military Hospital, Ankara, 4Department of Psychiatry, Istanbul Bilim University, Istanbul, 5Department of Psychiatry, Gulhane Military Medical Faculty, Ankara, Turkey Abstract: Studies in recent years have indicated that neuroimmunological events and immune activation may have a place in the etiology of depression. It has been suggested from data that there is a causal relationship between activation of the immune system and excessive release of proinflammatory cytokines, such as interleukin 1 (IL-1), IL-6, and tumor necrosis factor-alpha (TNF-alpha), and the etiology of depression. Although the mechanism of action of electroconvulsive therapy (ECT) is unclear, there is evidence that it can reduce cytokines and immune system changes. In our study, we aimed to determine how levels of serum immunomodulators were affected by ECT in major depression patients. This study was conducted on 50 patients with treatment-resistant major depression. The data of the patients were compared with 30 healthy individuals with similar demographic characteristics. A clinical response occurred in the patients and at the end of therapy, IL-1, IL-6, TNF-alpha, IL-10, IL-4, and interferon-gamma levels were measured. The disease severity was assessed with the 17-item Hamilton Depression Rating Scale. Data analysis was performed using SPSS Version 15. Significant differences were determined between the patients with major depression and control group with respect to basal serum IL-1, IL-6, TNF-alpha, IL-10, IL-4, and interferon-gamma levels. ECT treatment was shown to reduce these differences. ECT may cause significant changes in the activity of the immune system. The consideration of the relationship between the immune endocrine neurotransmitter systems could contribute to new theories regarding the mechanism of antidepressant treatment and biology of depression. Keywords: the pathophysiology of depression, the immune system, cytokines

WOS: 000408928500016, PubMed: 28407292, Internalized stigma is the adoption of negative attitudes and stereotypes of the society regarding a person's illness. It causes decreased self-esteem and life-satisfaction, increased depression and suicidality, and difficulty in coping with the illness. The primary aim of this study was to investigate the internalized stigma state of psoriatic patients and to identify the factors influencing internalized stigma. The secondary aim was to identify the correlation of internalized stigma with quality of life and perceived health status. This multicentre, cross-sectional study comprised 1485 patients. There was a significant positive correlation between mean values of Psoriasis Internalized Stigma Scale (PISS) and Psoriasis Area and Severity Index, Body Surface Area, Dermatological Life Quality Index and General Health Questionnaire-12 (P < 0.001 in all). Lower percieved health score (P = 0.001), early onset psoriasis (P = 0.016), family history of psoriasis (P = 0.0034), being illiterate (P < 0.001) and lower income level (P < 0.001) were determinants of high PISS scores. Mean PISS values were higher in erythrodermic and generalized pustular psoriasis. Involvement of scalp, face, hand, genitalia and finger nails as well as arthropathic and inverse psoriasis were also related to significantly higher PISS scores (P = 0.001). Our findings imply that psoriatic patients experience high levels of internalized stigma which are associated with psoriasis severity, involvement of visible body parts, genital area, folds or joints, poorer quality of life, negative perceptions of general health and psychological illnesses. Therefore, internalized stigma may be one of the major factors responsible from psychosocial burden of the disease.

Objective Although the etiology of Behcet’s disease is not clarified yet, the vascular endothelial damage and thrombosis are prominent features of the disease. The underlying mechanisms of increased risk of thrombosis in Behcet’s disease are not completely understood. It is stated that the changes in blood rheology such as erythrocyte deformability take part in the thrombosis. There are limited numbers of studies with conflicting results about the erythrocyte deformability in Behcet’s disease. The previous studies were not limited to the untreated patients with active disease. Method Blood samples were filtered immediately by “Imugard- leukocyte removal filter”. After plasma and erythrocytes were separated by centrifugation, 10% erythrocyte suspensions were prepared with isotonic Tris NaCl buffer solution. These erythrocyte suspensions were filtered under gravitational force by “Nucleopore” to determine the filtration time. The filtration times of the erythrocyte and buffer solutions were referred as t1 and t2 respectively. Finally, deformability indices were obtained by dividing the t1 by t2. A decrease in the deformability of the erythrocytes would result in an increase in the filtration time of the erythrocyte suspension and deformability indices. Results The median deformability indices were 3.090 and 2.170 for patients and control subjects respectively and the difference was statistically significant (P = 0.000). Conclusion We suggest that the decrease in erythrocyte deformability in Behcet’s disease may be related to oxidative damage of erythrocytes and subsequently takes part in the development of thrombosis in Behcet’s disease.

Background and Design: Behcet’s disease is a chronic, inflammatory and relapsing disorder with neutrophil and T lymphocyte activation and endothelial cell dysfunction. Resistin is a newly defined pro-inflammatory cytokine. In this study, we measured the serum resistin levels in active and inactive Behcet’s disease patients and healthy control subjects. The aim of this study was to investigate the role of resistin in the inflammatory process in Behcet’s disease and the correlation of the serum resistin levels with the disease activity.Material and Method: Twenty-one active and 21 inactive Behcet’s disease patients and 21 healthy control subjects were included in the study. Serum resistin levels were measured by a sandwich enzyme-linked immunosorbent assay. We also investigated the correlation of resistin levels with the levels of interleukin-6 and C-reactive protein, white blood cell count and erythrocyte sedimentation rate.Results: Age and gender distribution were similar for study groups (P=0,711; F: 0.343 and P=1.00; Chi-square: 0, respectively). The mean serum levels of resistin in active (20.56±5.22 ng/mL) and inactive Behcet’s disease patients (14.71±2.34 ng/mL) were significantly higher than the control subjects (10.98±3.46 ng/mL), (P

Background Interleukin-8 (IL-8) has been shown previously to associate with different individual clinical manifestations and activity of Behcet's disease (BD), but its association with vascular involvement has not been established. Methods Forty-five untreated patients with BD and 29 healthy individuals were included in the study. The activity of patients was based on the existence of two or more symptoms and a statistically significantly high Behcet's Disease Activity Index (BDAI) at the time of the study. IL-8, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) results were evaluated with respect to activity, vascular involvement, and other specific individual clinical manifestations of the disease. Results IL-8 levels were found to be significantly elevated in active BD compared with inactive BD (P = 0.006) and healthy controls (P = 0.000), with median values of 267 (53–2000), 137 (52–290), and 58 pg/mL (53–160 pg/mL), respectively. Unlike ESR and CRP, IL-8 levels showed a high correlation with BDAI scores (r = 0.743, P = 0.00) and the number of active clinical manifestations (r = 0.646, P = 0.00). Serum levels of IL-8 were increased in patients with oral ulcers, genital ulcers, eye lesions, and vascular lesions, with median values and significance levels of 254.5 (53–2000), P = 0.05; 254.5 (52–1400), P = 0.03; 254.5 (72–2000), P = 0.029; and 593 pg/mL (110–2000 pg/mL), P = 0.001, respectively. In addition, IL-8 levels in the active patient group with vascular involvement were significantly higher than the levels in those without vascular involvement. Conclusion Serum IL-8 levels are increased in the active phase of BD. This marker may be useful in the early detection of vascular involvement.

Objective. Our aim was to evaluate the significance of homocysteine (Hcy) in Behcet's disease (BD) and the association of elevated Hcy levels associated with the indices of inflammation in BD.Methods. Untreated 70 patients with BD and 33 healthy individuals were included into the study. Hcy, tumor necrosis alpha (TNF-), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were evaluated with respect to activity and specific individual clinical manifestations of the disease.Results. Hcy levels were found significantly elevated in active BD when compared to inactive BD and healthy controls. Hcy levels were found to have high correlation with the number of active clinical manifestations increased. A significant positive correlation was found between serum Hcy and TNF- levels, CRP, and ESR. Hcy was found to be the best predictor of TNF- among other parameters.Conclusion. Hcy may involve in the pathogenesis of BD by inducing inflammation.

Objectives Adenosine deaminase (ADA) is a non-specific marker of the activation of the T cell, which has an important role in the etiology of Behcet's disease (BD). The purpose of this study was to investigate the determination of ADA activity as an index of T-lymphocyte function in BD, which is known to have an T-cell-mediated immune response. Materials and Methods Adenosine deaminase activities in both serum and erythrocytes were measured in 23 untreated patients with BD and in 20 healthy controls. The patients with BD were divided into two groups: active (n = 10) and inactive (n = 13). Results When compared with the control group, serum ADA activity was high (P

Seborrheic dermatitis (SD) tends to reoccur frequently, so the therapeutic agent must have a high benefit versus adverse effect ratio for long-term and repetitive uses.To assess the efficacy and safety of retreatment with pimecrolimus in SD patients.A total of 45 patients who had been treated previously with pimecrolimus 1% cream were retreated with the same agent using the same treatment protocol after the disease reoccurred. The first and the second treatments were compared with regard to disease severity before treatment, complete cure times, remission times and side effects.The median severities of the disease were 5 and 4 before the first and second treatments, respectively. Retreatment of the disease with pimecrolimus resulted in shorter cure and longer remission times. Side effects were seen only on the first day of the retreatment and an increase in erythema was seen in fewer patients.Retreatment of the recurrence of SD with pimecrolimus as monotherapy is an effective and safe approach in the management of the disease.

Temporary henna tattoos have become increasingly widespread. Although reactions to henna tattoo are becoming progressively more common, only one case of a henna pseudotattoo resulting in temporary hypertrichosis has been reported so far. We report three patients who received paint-on henna tattoos on their right upper arm. Approximately 1 week later, localized hypertrichosis was observed over the same area as the tattoo, which resolved spontaneously within 3–4 months. Clinicians should be aware of this complication and it should be noted that treatment is not necessary as hypertrichosis resolves spontaneously.