Search

Summary: Background: Because skin lesions affect self‐image, vitiligo affects an individual's emotional and psychological well‐being, sexual life and relationships with other people. The literature contains a limited number of studies regarding the localization of vitiligo with respect to its effect on certain variables. Aim: To investigate the effects of the presence or absence of genital involvement in vitiligo on sexual dysfunction, dermatological quality of life (QoL), and susceptibility to other psychiatric disorders such as anxiety and depression. Methods: In total, 90 patients who were admitted to the dermatology outpatient clinic of a tertiary university hospital; the patients included 30 patients with vitiligo with genital involvement, 30 patients with vitiligo without genital involvement and 30 controls (HCs). All groups were evaluated with the Dermatological Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HAD), Arizona Sexual Experience Scale (ASEX) and Golombok–Rust Inventory of Sexual Satisfaction (GRISS). Results: The HC groups exhibited lower total scores on the DLQI, HAD total score, ASEX and GRISS compared with the vitiligo groups (P < 0.05). No statistically significant difference was found between the vitiligo group with genital involvement and the vitiligo group without genital involvement in terms of DLQI, and total scores for HAD, ASEX and GRISS (P > 0.05). Conclusion: The presence or absence of genital involvement in vitiligo did not have dissimilar effects on the individual's QoL, or their sexual and psychological state. [ABSTRACT FROM AUTHOR]

Panretinal photocoagulation still remains the gold standard for the treatment of ischaemic and neovascular diseases of the retina. Pulse energy is directly proportional to the pulse duration and power. Vascular endothelial growth factor (VEGF) is a well-known potent angiogenic factor and also acts as a proinflammatory cytokine and vascular permeability factor. The aim of this study was to investigate the differences in the expression of VEGF in mice subjects treated with argon (AG) or pattern scan laser (PASCAL) systems. Male C57BL/6 mice were randomly assigned to one of three groups: Group 1 (G1) AG photocoagulator (n=16), Group 2 (G2) PASCAL (n=16) and Group 3 (G3) control group (n=6). Molecular and morphological analyses of VEGF were performed on day 1, 2 and 5 by ELISA, Real-time PCR and immuno-histochemical analysis. G1 group showed VEGF mRNA level increased 2.4 folds on day 2, whereas it decreased on day 5 (p<0.001) compared to the G3. In G2, VEGF mRNA level increased 1.8 folds on day 1 and 2.2 folds on day 5 compared to the G3. In G1, VEGF protein level increased significantly on day 2, whereas it decreased on day 5 (p<0.001) compared to G3. In group G2, the VEGF levels significantly increased as compared to control groups at both 2 and 5 days after laser photocoagulation using PASCAL laser (p<0.001, both time points). The peak expressions of VEGF protein in samples which underwent PASCAL and conventional laser were found on day 5 and day 2 respectively. In PASCAL photocoagulation pattern, VEGF-induced vascularization started late and gradually increased; in AG, VEGFinduced VEGFinduced vascularization started early on day 2, then decreased on day 5. Conclusion: AG laser may imposed a higher risk for early complications due to early increase in VEGF levels, whereas the complications due to increment in VEGF level is not expected to be different between conventional and PASCAL laser treatment in the late phase. [ABSTRACT FROM AUTHOR]

Objectives To study the effects of cigarette smoke and vitamin E on the development of endometrial pinopods. Study design Eighteen female and 12 male Swiss albino mice, 12-14 weeks old, with a mean weight of 25 g (standard deviation 5 g) were used in this study. Female mice were divided into three equal groups. Every day for 10 weeks, mice in Group 1 (control group) received normal saline intraperitoneally; mice in Group 2 were exposed to smoke from 20 cigarettes/day using a smoke machine; and mice in Group 3 were exposed to smoke from 20 cigarettes/day using a smoke machine and also received 50 mg/kg vitamin E intraperitoneally. After 10 weeks, vaginal smears were taken from the female mice and they were copulated with the 12 male Swiss albino mice on the day of oestrus. Day 0 was defined as the day on which sperm were detected in the vagina by smear test. Mice were killed at the end of Day 5, which was considered to represent the optimal day for implantation. The uteri were removed and the effects of cigarette smoke and vitamin E on the development of endometrial pinopods were studied using an electron microscope. Results The endometrial tissue of the control group appeared morphologically normal, with short microvilli, cytoplasm and pinopods in the form of cytoplasm and cell membrane enlargements in patches. In total, 149 pinopods were counted in the control group using a scanning electron microscope (two histologists performed the analysis and were blinded to each other's findings). In the smoke-exposed group, the cytoplasmic structure was degenerated considerably, and fewer pinopods were counted (n = 11). The number of pinopods in mice who were exposed to cigarette smoke and vitamin E (n = 67) was significantly higher compared with the cigarette-exposed group (p = 0.002), but considerably lower compared with the control group (p = 0.002). Conclusion Smoke exposure led to a significant decrease in the development of endometrial pinopods. Vitamin E, an antioxidant, partially reversed the adverse effects of cigarette smoke. This suggests that cigarettes may have a negative effect on fertility by decreasing the number of pinopods. However, this negative effect can be reduced using vitamin E. More studies should be conducted to support this finding. [ABSTRACT FROM AUTHOR]

Introduction: Alopecia areata (AA) is a non-cicatricial inflammatory and autoimmune hair loss disease. In recent studies, it has been reported that hematological parameters can be used as oxidative stress markers in the diagnosis of many inflammatory diseases due to their low cost and widespread use., Objectives: In this study, it was aimed to reveal the significant cut-off points of hematological inflammatory markers in AA that can guide clinicians in clinical practice and determine how many times they increase the risk of disease., Methods: The present study is retrospective case-control type. Seventy patients with AA and seventy healthy controls were included in the study. The hematological parameters in both groups were evaluated retrospectively., Results: Hemoglobulin, monocyte, platelet, monocyte high-density lipoprotein cholesterol (HDL-C) ratio (MHR), monocyte lymphocyte ratio (MLR), platelet lymphocyte ratio (PLR) were high in patients with AA, while the number of lymphocytes was low. In ROC analysis, the optimal cut-off values for the diagnosis of AA were as follows: MLR 0.216, MHR 0.010, and PLR 111.715. In regression analysis, being above the following values of MLR 0.216, MHR 0.010, and PLR 111.715 increased the risk of developing AA by 6.3, 3.8, and 2.7 times, respectively., Conclusions: It was seen that MHR and PLR, especially MLR, can significantly increase the risk of developing the disease in AA and can also be used as diagnostic markers.

Background: Polycaprolactone (PCL) is a semi-permanent filler stimulating neocollagenesis. Lidocaine is frequently used to reduce the pain and, however, may have negative effects on collagen. It was aimed to compare the histological changes on rat skin and efficacies of PCL filler and lidocaine addition., Objective: In this study, results of PCL and PCL+Lidocaine application on rat skin were compared using hematoxylin-eosin (H&E) staining, Masson's trichrome (MT) staining, and electron microscope (EM)., Methods: A total of 30 adult female rats were divided into three groups: the control group, the PCL group, and the PCL+Lidocaine group. The tissue samples taken at months 2 and 4 were examined using H&E, MT, and EM., Results: At month 2, dermis thickness, fibroblast count, and collagen fiber diameter increased similarly in the PCL and PCL+Lidocaine groups. Collagen fiber diameter was significantly higher in the PCL group than in the PCL+Lidocaine (p:0.016) and control groups (p:0.009). At month 4, no significant difference was detected between the PCL and PCL+Lidocaine groups in terms of fibroblast count, collagen fiber count, and collagen fiber diameter; dermis thickness was lower in the PCL+Lidocaine group at month 4 (p < 0.46). Dermis thickness, fibroblast count, collagen fiber count, and collagen fiber diameter were found to be significantly lower than in the PCL and PCL+Lidocaine groups., Conclusions: Our study showed that lidocaine addition to PCL filler does not affect the efficacy of the filler and PCL filler stimulates neocollagenesis., (© 2021 Wiley Periodicals LLC.)

Background: Psoriasis is a chronic, inflammatory skin disease that is common in both adult and childhood. Patients with psoriasis are at significant risk for the development of many comorbid conditions, including cardiovascular diseases., Objectives: We aimed to investigate the cardiovascular risk status and serum lipid parameters in patients with psoriasis and to determine the risk of cardiovascular disease by atherogenic indices obtained accordingly., Methods: This retrospective case-control study was conducted with a total of 142 individuals, 72 patients with psoriasis vulgaris and 70 healthy volunteers over the age of 18 who were admitted to the dermatology outpatient clinic. Demographic information and laboratory values were retrieved from the hospital database. Afterward, atherogenic indexes such as Atherogenic index of plasma (AIP), Castelli Risk Index I and II (CRI-I and II), and Atherogenic coefficient (AC) were calculated., Results: There was a significant difference in lipid profile between the psoriasis patients and the control group. In patients with psoriasis, triglyceride level (140.09 ± 71.20 mg/dl vs. 116.10 ± 63.95, p = 0.037) was higher, while HDL level (44.34 ± 11.77 mg/dl vs. 50.31 ± 11.62, p = 0.003) was lower. Regarding atherogenic indices; AIP (0.10 ± 0.24 vs. -0.04 ± 0.27, p = 0.001), CRI-I (4.63 ± 1.40 vs. 3.94 ± 1.02, p = 0.001), CRI-II (2.98 ± 1.01 vs. 2.61 ± 0.82, p = 0.019) and AC (3.63 ± 1.40 vs.. 2.94 ± 1.02, p = 0.001) were significantly higher in patients with psoriasis., Conclusion: Our study shows that patients with psoriasis have higher pro-atherogenic lipid profile and atherogenic indexes at a high risk level. Patients with psoriasis have an increased risk of cardiovascular diseases., (© 2022 Wiley Periodicals LLC.)

Introduction: The elderly population is vulnerable to experience a great number of dermatological diseases thanks to the intrinsic and extrinsic process of aging., Objectives: The aim of this study is to retrospectively investigate the prevalence of dermatological diseases in geriatric patients, their distribution by age and gender, and to provide a reference for studies on aging and skin problems., Methods: In the present study, patients who reported to the dermatology outpatient clinic between January 1 2019, and January 1 2021, were evaluated retrospectively. As a result of examining the records of patients, 887 patients over the age of 65 who met the study protocol were included., Results: The three most common diseases in all geriatric patients were fungal infections, eczematous dermatitis, and pruritus. Fungal infections were frequent in males and the 65-74 age group. In the males, the more frequent were precancerous lesions and malignant neoplasms, whereas in the females it was urticaria and adverse drug reactions. In the logistic regression model, the risk of fungal infection in geriatric patients was increased by being male (odds ratio 1.55, P = 0.006) and being in the range of 65-74 years old (odds ratio 1.46, P = 0.025). Male patients were at significantly higher risk for precancerous and malignant lesions (OR:2.81 P < 0.001) and actinic keratosis (odds ratio 3.26, P < 0.001) in this disease group., Conclusions: Men are more vulnerable to life-threatening skin diseases. It is important to determine risk factors for individuals who are more sensitive to environmental factors in terms of increasing the quality of life and protection from diseases., Competing Interests: Competing interests: None., (©2022 Akoy Sarac et al.)

Background: Lasers have great importance in the management of vascular skin lesions., Aim: To determine the efficacy of 577-nm pro-yellow laser in cure of certain vascular skin diseases., Material and Methods: Seventy-four patients who are diagnosed as vascular skin diseases were involved in this study. All participants were treated with 577-nm pro-yellow laser with 4-week intervals. The photographs that were taken before and at every following visit were used to evaluate improvement., Results: A significant improvement occurred in port-wine stain, rosacea, facial telangiectasia, venous lake, scrotal angiokeratoma, and cherry angioma cases., Conclusion: Vascular skin lesions can be treated with 577-nm pro-yellow laser with a minimal adverse effect and great success rate., (© 2021 Wiley Periodicals LLC.)

Background: Deliberate self-harm (DSH) can be defined as self-inflicted injury without an intention to suicide, and it may result in scar formation with a particular shape., Aims: There is no treatment algorithm for DSH scars, nor is there a gold standard for the treatment of hypertrophic scars. Therefore, we aimed to share our experience with Er: YAG laser treatment of self-inflicted razor blade incision scars., Patients/methods: The study involved 18 patients with DSH scars treated with fractional ablative Er: YAG laser (MCL 31 Asclepion laser Technologies) between 2017 and 2020, with the parameters of 40 J/cm 2 , 300 µs, and 4 Hz. The sessions were repeated by increasing 10 joules in every session with 4-week intervals until reaching a maximum of 80 joules. The patients were evaluated retrospectively by two different dermatologists in terms of scar improvement over digital photographs taken before and 4 weeks after the treatment. Evaluations have been made based on a 4-point score (0:no change, 1:1%-25% mild, 2:26%-50% moderate, 3:51%-75% well, and 4:76%-100% excellent improvement)., Results: After the third session, 90.9% of the patients showed a moderate improvement. After the fourth session, only 27.2% of the patients had a good, and 63.2% of the patients had a moderate improvement rate., Conclusions: Er: YAG laser is a safe and effective treatment method for the hypertrophic scars induced by razor blades. Also, we believe that combined treatments with other treatment modalities will provide better results in DSH scars., (© 2021 Wiley Periodicals LLC.)

Background: Although many laser systems have been used in the treatment for Poikiloderma of Civatte (POC), there is no standard treatment guideline., Objectives: We aimed to present our data on the efficacy and safety of single-session pro-yellow laser treatment for POC., Methods: The study included 14 patients treated with pro-yellow laser (QuadroStarPRO YELLOW ® Asclepion Laser Technologies, Germany) between 2017 and 2019. Treatment had been applied in two passes during the same session; a general pass with 22 j/cm 2 over the whole lesion, then, one more pass only on the telangiectatic lesions with 18 j/cm 2 fluence. They were evaluated based on their pictures taken before and 4 weeks after the treatment and scored by a 4-item scoring in terms of the improvement (0:no change, 1:1%-25% mild, 2:26%-50% moderate, 3:51%-75% well, and 4:76%-100% excellent improvement)., Results: The mean age of the patients (1 female, 13 males) was 59.64 ± 8.16 years. Five patients had Fitzpatrick-2 and 9 patients had Fitzpatrick-3 skin types. Six patients had mild, 8 patients had moderate improvement, one of them has been illustrated in Figure 1. Sixty-minute mild erythema was the only adverse effect observed., Conclusions: We think that pro-yellow laser is a good treatment option for POC treatment. Repeated sessions are required for the complete healing of the lesions, while one single session has proved to be deficient. We observed that it was a quite safe treatment option, especially for the neck region, which was inclined to scarring and atrophy development., (© 2021 Wiley Periodicals LLC.)

Background: Syringoma is a benign sweat gland tumor., Aim: Vulvar location of syringoma is rare. Although the lesions are asymptomatic, it requires treatment due to the cosmetic concerns., Patients/methods: We present a 42-year-old woman with vulvar syringoma., Results: The patient treated with 577 nm pro-yellow laser with a great success., Conclusion: A 577 nm pro-yellow laser is a good alternative in the treatment of vulvar syringoma., (© 2021 Wiley Periodicals LLC.)

Background: Onychocryptosis, frequently termed ''ingrown toenail'' is a common foot problem in routine dermatology and orthopaedic clinical practice which leads to pain and disability. Although the aetiology of ingrown toenail is not well understood various associated risk factors have been identified with the pathogenesis., Material and Methods: This study was a retrospective investigation of 170 patients with hallux valgus and lateral border ingrown toenail of all stages. The patients were compared with a control group. The radiologic assessment in both groups included right hallux valgus angle, left hallux valgus angle, right first and second intermetatarsal angle, and left first and second intermetatarsal angle., Results: There were 121 female and 49 male patients in the case group and 68 female and 32 male in the control group. The mean age of the case group was 41.1 years and 41.1 years in the control group. A statistically significant difference was found between the case and the control groups in terms of the right hallux valgus angle variable., Conclusion: The abnormal hallux valgus angle and the abnormal intermetatarsal angle plays an important role in ingrown toenail aetiology. The X-rays of the feet should be performed to determine the susceptibility of the patients who are admitted to the hospital for ingrown toenail in order to prevent other toes ingrown toenail and for planning the treatment of the patients with an ingrown toenail., (© 2021 John Wiley & Sons Ltd.)

Background: In recent years, the number of liver transplantations for advanced-stage liver diseases has considerably increased and the patients have a wide range of dermatologic manifestations., Aim: This study aims to reveal cutaneous, mucosal, and nail lesions in liver transplant recipients in quite large patient series., Patients/methods: The study included 520 patients in the Inonu University Liver Transplantation Institute. New and followed-up patients attended to the study between May and October 2019. The patients were examined by a dermatologist, and their data were recorded., Results: The study included 163 female and 357 male patients with the main age of 44.20 ± 18.18 (range: 1-83 years), and 465 livers (89.4%) were taken from live donors, while 54 livers (10.4%) were taken from cadavers. A total of 314 (60.4%) patients had dermatophyte infections, 174 (33.4%) patients had pathological nail changes, and 427 (82.1%) patients had oral mucosal lesions. Graft-versus-host disease (GVHD) developed in 9 (1.73%) patients after the transplantation, and 5 patients died of GVHD. Four patients had cutaneous malignancies., Conclusions: Tumoral and nontumoral dermatological diseases may be encountered following the transplantation depending on underlying liver disease, immunosuppressive treatment, the graft itself, or any primary cutaneous disease. Liver transplantation recipients require a multidisciplinary clinical approach, and dermatological care must be an integral part of this approach., (© 2021 Wiley Periodicals LLC.)

Aim of the study is to compare efficacy of targeted broad-band UVB phototherapy and topical psoralen with targeted UVA phototherapy treatments in localized vitiligo for 3 months prospectively. The cases with symmetrical vitiligo lesions were included in the study. Broad-band targeted UVB was applied on one side and targeted UVA phototherapy with topical psoralen on the other side. Twenty-two patients who were diagnosed with localized vitiligo were enrolled in this study. These cases consisted of 6 (27.3%) females and 16 (72.7%) males aging between 17 and 69 (34.22 ± 14.15). Fifty-four lesions (27 left, 27 right) were compared for treatments. After the first month of the treatments, the sides of the lesions were compared in order to evaluate improvement. Percentages of success were 25% for targeted broad-band UVB microphototherapy and 75% for topical psoralen with targeted UVA microphototherapy. When the two treatment methods were compared with each other, a significant difference was found in terms of treatment response (P = .017). At the end of the third month, the success rates were 37.5% for targeted broad-band UVB microphototherapy and 62.5% for topical psoralen with targeted UVA microphototherapy, however a statistically significant difference was not determined between the two treatments (P > .05). Both targeted broad-band UVB phototherapy and topical psoralen with targeted UVA phototherapy provided repigmentation for localized vitiligo at the end of the third month. Our investigation shows that both treatments are safe and they provide repigmentation with a limited response., (© 2020 Wiley Periodicals LLC.)

Erythema and scarring are among the most common complications of severe inflammatory acne. In this study, we aimed to share our experience with pro-yellow laser and document the efficacy and safety of this treatment in postacne erythema and scarring. The study included 40 patients, 24 (60%) females, and 16 (40%) males with a mean age of 29.5 ± 8.16 (min. 18 years, max. 57 years). The pro-yellow laser was applied to all patients as a single session with irradiation of 22 J/cm 2 . Improvement in postacne erythema and scars were evaluated after the treatment. The study included 40 patients, 24 patients (60%) were females and 16 patients (40%) were males with the mean age of 29.5 ± 8.16 (ranged between 18 and 57 years old). A total of 21 patients (52.5%) had good improvement (51%-75% regression), 10 patients (25%) had excellent improvement (76%-100% regression), and a moderate improvement (26%-50%) was detected in 9 patients (22.5%). Also, there were mild improvement (1%-25%) in 20 patients (76.9%) and a moderate improvement (26%-50%) in 6 patients (23.1%). We found that pro-yellow laser is highly effective in the treatment of postacne erythema, while its effectiveness was mild to moderate in atrophic acne scars. Also, it has been observed that the pro-yellow laser system can be used safely immediately after cessation of systemic isotretinoin treatment., (© 2020 Wiley Periodicals LLC.)

Polycaprolactone (PCL) and calcium hydroxylapatite (CaHA) are semipermanent dermal fillers that are frequently preferred in the last decade. This study aims to compare the effects of these two fillers in the rat skin. A total of 30 female rats were divided into; control, PCL, and CaHA group. Tissue samples taken at the second and fourth month were stained with hematoxylin-eosin, Masson trichrome, collagen type 1, and 3 immunohistochemical antibodies. Collagen density was quantitatively compared using the Image J computer program. At 2 and 4 months, the density of collagen increased in both filler groups compared to the control group. There was no significant difference between collagen density or type 1 and type 3 collagen H scores in the filler groups. The number of fibroblast nuclei was significantly higher in the PCL group at 4 months compared to the other two groups. Dermis thickness was found to be superior in both filler groups compared to the control group at the fourth month, there was no significant difference between the filler groups. We compared the effect of CaHA and PCL filler on collagenization histologically and immunohistochemically. We found that PCL and CaHA fillers are effective in increasing dermal collagen density, type 1 and type 3 collagen amount, and preventing dermis atrophy and showed that they have no advantage over each other in this respect. We have shown that PCL filler provides more fibroblast increase compared to CaHA filler and the effect of stimulating fibroblast proliferation takes longer., (© 2020 Wiley Periodicals LLC.)

The aim of this study was to evaluate the changing trends in dermatology clinical practice at a tertiary center during the coronavirus disease 2019 (COVID-19) pandemic. This retrospective cohort study was conducted on patients who were admitted to Ufuk University Hospital with dermatologic complaints/diseases before and during the pandemic. The patients were divided into two groups: (a) the pre-pandemic period (March-May 2019) and (b) the Pandemic period (March-May 2020). Demographic features, clinical characteristics, dermatologic diseases/complaints, dermatologic procedures/interventions, hospitalization rate, and use of biologic agents were compared between the two groups. Total number of hospital admissions have decreased from 1165 to 717. Admission rates for acne, dermatophytosis, and benign neoplasm of the skin significantly lower during the pandemic period (P values were .02, .04, and .006, respectively). Contact dermatitis, acne accompanying dermatitis, cicatricial hair loss, lichen planus, and zona zoster infection rates were significantly higher (P values were .007, <.001, .009, .04, and .03, respectively). Rates of biopsy and electrocautery procedures were decreased significantly (P values were <.001 and .002, respectively). The hospitalization rate was similar between the groups (P = .51). However, the use of biologic agents significantly decreased during the pandemic period (P = .01). Updated clinical protocols should be established for the new normal period in accordance with these findings., (© 2020 Wiley Periodicals LLC.)

Erbium: Yttrium-aluminum-garnet laser (Er: YAG) treatment has been used in resurfacing the acne scars for a long time; however, we could not find any study reporting the recovery rates after each session of the treatment. In this study, we aimed to report the improvement rates after each session. We retrospectively analyzed the data of 35 patients with acne scars treated with fractional ablative Er: YAG laser. The patients received one to four sessions of treatment with 4-week intervals and improvement rates were recorded after each session. Data are available on request from the authors. The improvement rate of the lesions varied between 1% and 25% in 34 patients at the end of the first session, while in one patient, the improvement rate was detected as 26% to 50%. At the end of the fourth session, the rate of improvement was 26% to 50% in 14 out of 24 patients and 51% to 75% in 10 patients. None of the patients showed a 76% to 100% improvement at the end of the fourth session, whereas 48.6% of the patients were satisfied with the treatment. In patients with a high expectation of an excellent improvement, a higher number of sessions of the laser treatment and/or combination treatments with different treatment methods should be planned., (© 2020 Wiley Periodicals LLC.)

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare, benign vascular tumor. Although its etiology is not clearly known, infection, hormonal factors, and trauma are the suspected reasons. There are few cases considered to be related to pregnancy described in the literature. Granulomas are rarely seen in the histopathology and only four patients with granulomas have been described. Herein, we will present a 28-year-old woman who has been pregnant three times; in every pregnancy, she developed pink nodular lesions on the back of her ear. In the first two pregnancies, the lesions had appeared during the pregnancy and regressed completely in the postpartum period. In her third pregnancy, the condition emerged again and lasted 1.5 years after birth of her child. Histopathology exhibited ALHE with granulomas. Although the relationship between ALHE and pregnancy is already known, there are few cutaneous ALHE cases associated with pregnancy reported in the literature. This association is further supported by this case having recurrent ALHE during each pregnancy period. Also, the presence of naked granuloma in histopathology, unlike most of the cases, contributes to the current histopathological data.

Intravascular lymphomatosis (IVL) is a rare type of B-cell non-Hodgkin lymphoma (BCNHL), which can mimic many other diseases. Fever, neurological symptoms, and skin findings are the most frequent clinical findings. Intravascular lymphomatosis may be associated with genetic factors and infection with human immunodeficiency virus (HIV), human herpesvirus 8 (HHV-8), human T-lymphotropic virus 1 (HTLV1), Epstein-Barr virus (EBV), and hepatitis B virus (HBV). A 50-year-old man was hospitalized with recalcitrant hyponatremia of unknown cause. He had also telangiectatic, indurated, slightly erythematous plaques on his trunk for the last 10 days. His past medical history was unremarkable, although he was a carrier of hepatitis B. Multiple skin biopsies were performed and were considered to be diagnostic of IVL. The hyponatremia was unresponsive to water restriction and hypertonic solution support but it resolved with B cell directed chemotherapy. A final diagnosis was made as syndrome of inappropriate antidiuretic hormone (SIADH) in the setting of IVL. This case had a relatively early diagnosis with just 10-days of skin lesions. Intravascular lymphomatosis is a very rare disease and is usually difficult to diagnose. An even more uncommon presentation is IVL complicated by a paraneoplastic syndrome. There are prior reported cases of SIADH in the setting of IVL. However, this case underscores the importance of evaluating patients with SIADH for potential IVL.

Background: Rosacea is an inflammatory disease with 50% of ocular involvement rate. Primary demodicosis is an eruption caused by Demodex mites, and there is no data about the rate of ocular involvement in primary demodicosis., Aims: In this cross-sectional study, it is aimed to reveal the frequency of Demodex blepharitis in rosacea and primary demodicosis patients., Methods: In total, 58 rosacea, 33 primary demodicosis patients, and 31 healthy volunteers were included in the study. Four samples were obtained from eyelashes with a forceps and from facial skin by standardized skin surface biopsy. A positive result is described as detecting at least one Demodex mite on an eyelash or at five mites in the face. The patients were also examined by an ophthalmologist in terms of ocular involvement., Results: Both rosacea and primary demodicosis patients had significantly more complaints like burning and stinging in the eyes compared to the control patients (P = .001). Primary demodicosis and papulopustular rosacea patients had the highest numbers of eyelash mites, respectively, and significantly a higher rate of blepharitis than the control group., Conclusion: As a result, the Demodex count was significantly higher in the primary demodicosis and rosacea patients than the control group. We think that every Demodex-positive patients should be evaluated for also eyelash mites to prevent a possible chronic blepharitis., (© 2019 Wiley Periodicals, Inc.)

Background: Demodex spp. is the most common ectoparasite in humans. This parasite is believed to play a role in the etiology of many dermatological and ocular disorders., Aim: The aim of this study was to compare the efficacy and tolerability of the sulfur-sodium sulfacetamide combination, crotamiton, and permethrin, which are three topical agents commonly used in Demodex treatment., Methods: A total of 28 patients with primary demodicosis and 44 patients with Rosacea + Demodex were included in the study. The pretreatment and post-treatment Demodex spp. counts, patient satisfaction, and erythema decrease rates were compared., Results: Analysis of the efficacy of these topical agents on Demodex revealed that all three significantly decreased the number of parasites. The patient satisfaction was higher in the sodium acetamide group than the 10% crotamiton and 5% permethrin groups, and clinical evaluation (erythema/ papulopustules and white plugs) was better in the sodium acetamide group than the other groups but no statistically significant difference was found in terms of patient satisfaction and clinical evaluation., Conclusion: The sulfur-sodium combination, crotamiton, and permethrin are the three agents commonly used in the treatment of Demodex spp. and all significantly decreased the Demodex count. The three agents were similar in terms of tolerability. Our study needs to be supported with others on larger patient series., (© 2019 Wiley Periodicals, Inc.)

A port-wine stain (PWS) is a congenital capillary malformation that is seen in 0.3-0.5% of newborns. Although many types of lasers have been used to treat PWSs, few studies have investigated the efficacy of 577-nm Pro-Yellow lasers. The aim of this study was to establish the efficacy of Pro-Yellow lasers in PWS treatment. In total, 26 patients, comprising 15 females (57.7%) and 11 males (42.3%) with a mean age of 24.7 ± 11.8 (range 1-50) years were included in the study. All were treated with a 577-nm Pro-Yellow laser at 4-week intervals, 3-10 times. The sessions initially used scan mode and a fluence dose of 24 J/cm 2 per session, on average. The mean dose was increased by 4 J/cm each session and the maximum dose administered was 44 J/cm 2 . A mean regression of 68.8 ± 13.9% in the size of the lesions over 5.23 ± 2.7 sessions was observed. There was no statistically significant difference between the female and male patients when they were compared in terms of the number of treatment sessions (p = .789) and treatment success (p = .39). These case series demonstrate that the Pro-Yellow laser is a safe and well-tolerated treatment for PWSs. However, deep-seated lesions required more treatment sessions and it was observed that clinically the lesions did not completely disappear., (© 2019 Wiley Periodicals, Inc.)

Vitiligo is a pigment disease characterized by the disruption of melanocyte structure and function. Its etiology is unknown; however, genetic predisposition, biochemical factors, and neural mechanisms are thought to be effective. Although many agents are being used for its treatment, generally there is no absolute cure. The aim of the present study is to evaluate the effectiveness of topical Nigella sativa seed oil on vitiligo patients. Thirty-three vitiligo patients were included in the study. Totally 47 areas were evaluated in all patients. Cream containing N sativa seed oil was topically applied to hands, face, and genital region two times a day for 6 months. Statistically significant repigmentation was detected in hands, face, and genital region, the three treatment areas, and the p values are found .005, .001, and .004, respectively. N sativa can be used as an adjuvant therapy that can contribute to the treatment especially in sensitive skin areas like genital region., (© 2019 Wiley Periodicals, Inc.)

Various lasers have been used for the treatment of erythematotelangiectatic rosacea (ETR), facial erythema (FE), and facial telangiectasias (FT). The assessment of the treatments of all of these conditions with a 577-nm pro-yellow laser has not been reported yet. The aim of this work was to assess the efficacy and safety of the 577-nm pro-yellow laser in ETR, FE, and FT. Forty patients suffering from ETR, FE, and FT (25 female and 15 male) were enrolled in this study. All of the patients were treated with 577-nm pro-yellow laser (QuadroStarPRO YELLOW® Asclepion Laser Technologies, Germany) at 4-week intervals, for one to four sessions. The assessment of the treatment was made based on the digital photographs and the percentage of fading of the erythema and telangiectasias in the lesions. Significant clinical improvement (80-100%) was observed in the first or second sessions of the treatment in FE and ETR patients and in second and fourth sessions of the treatment in FT patients. The treatment was very well tolerated. No side effect was observed except for a few patients who had mild to moderate erythema fading away in 12-24 h. This case series has shown that the pro-yellow laser is a very effective, safe, and well-tolerated treatment for ETR, FE, and FT.

Acquired progressive lymphangioma (APL), or benign lymphangioendothelioma, is an unusual entity derived from vascular structures. Clinically and histopathologically it may resemble Kaposi's sarcoma and well-differentiated angiosarcoma, causing a diagnostic problem. We report an individual with APL initially diagnosed with Kaposi's sarcoma who underwent unnecessary laboratory testing. Imiquimod 5% cream stopped the progression of the lesion. Awareness of this rare entity may prevent patients from undergoing excessive testing. Imiquimod may be used as a safe, effective treatment option., (© 2017 Wiley Periodicals, Inc.)

Janus kinase inhibitors are emerging treatment alternatives in various immune-mediated diseases including alopecia universalis. Herein, we report a patient with psoriasis and alopecia universalis in whom treatment with tofacitinib led to remission of psoriasis without improvement in alopecia universalis. Despite the promising potential in alopecia areata treatment, research evaluating the efficacy of different Janus kinase inhibitors and possible prognostic factors related with a more favorable response are warranted.

Psoriasis is a chronic inflammatory dermatosis that is thought to onset as a result of T lymphocyte-mediated immunological response. Disease may manifest itself in different modalities with regard to clinical features and severity. Clinical type of psoriasis is an important element in determining the therapy regimen. This article reviews clinical types of psoriasis., Competing Interests: Conflicts of Interest: None declared.