The COVID-19 Pandemic Affects Male Patients With Chronic Spontaneous Urticaria More Than Female Patients

Introduction: The COVID-19 pandemic dramatically disrupts health care for patients with chronic diseases including chronic spontaneous urticaria (CSU). As of now, it is unknown if the effects of the pandemic in CSU are different than in other chronic diseases. We also do not know, if different groups of CSU patients, for example female and male patients, are affected differently. Aim: To understand how CSU patients and subgroups are affected by the COVID-19 pandemic in their disease activity and control and treatment, using psoriasis as control. Patients and Methods: We analyzed 399 patients (450 visits) with CSU or psoriasis assessed during August 2019, i.e. before the pandemic, or August 2020, i.e. during the pandemic, for changes in disease activity, disease control, and the treatment they used, and how these changes are linked to age, gender, and disease duration. Results: Male but not female patients with CSU had markedly increased disease activity during the pandemic. CSU patients' age or disease duration were not linked to changes. Male and female patients with psoriasis showed similar increases in disease activity and decreases in disease control. The rate of omalizumab treatment, during the pandemic, was unchanged in male patients and increased in female patients with CSU. The efficacy of omalizumab treatment, during the pandemic, was reduced in male patients but not female patients with CSU. Conclusion: Male but not female CSU patients, during the COVID-19 pandemic, show loss of disease control linked to loss of omalizumab efficacy. The reasons for this need to be investigated

In Chronic Spontaneous Urticaria, Complete Response to Antihistamine Treatment Is Linked to Low Disease Activity

Introduction: The use of predictors of response to a specific treatment in patients with chronic spontaneous urticaria (CSU) can improve disease management, help prevent unnecessary healthcare costs, and save time. In this study, we aimed to identify predictors of complete response to standard-dosed and higher than standard-dosed antihistamine treatments in patients with CSU. Methods: Medical records of 475 CSU patients, 120 of them <18 years old, from 3 different centers were analyzed. We used 15 machine learning (ML) models as well as traditional statistical methods to predict complete response to standard-dosed and higher than standard-dosed antihistamine treatment based on 17 clinical parameters. Results: CSU disease activity, which was assessed by urticaria activity score (UAS), was the only clinical parameter that predicted complete response to standard-dosed and higher than standard-dosed antihistamine treatment, with ML models and traditional statistics, for all age groups. Based on ROC analyses, optimal cut-off values of disease activity to predict complete response were UAS <3 and UAS <4 for standard-dosed (area under the ROC curve [AUC] = 0.69; p = 0.001) and higher than standard-dosed (AUC = 0.79; p = 0.001) antihistamine treatments, respectively. Also, ML models identified lower total IgE (<150 IU/mL) as a predictor of complete response to a standard-dosed antihistamine and lower CRP (<3.4 mg/mL) as a predictor of complete response to higher than standard-dose antihistamine treatment. Discussion: In this study, we showed that patients with UAS <3 are highly likely to have complete response to standard-dosed AH and those with a UAS <4 are highly likely to have complete response to higher than standard-dosed AH treatment. Low CSU disease activity is the only universal predictor of complete response to AH treatment with both ML models and traditional statistics for all age groups

A Case of Bullous Pemphigoid as A Complication of Human Orf

Many complications followed by orf infection have been reported. Among these, there are also erythema multiforme, secondary bacterial infections, lymphadenopathies and bullous pemphigoid. Here we indicate the unusual association of clinically, histopathologically and mmunohistochemically diagnosed bullous pemphigoid with the clinically diagnosed orf disease. This uncommon association has been reported in a few case reports in the literature before. We searched Turkish medicine literature and we couldn't find a report about this association so we want to report the association by this article

A Case of Bullous Pemphigoid as A Complication of Human Orf

Many complications followed by orf infection have been reported. Among these, there are also erythema multiforme, secondary bacterial infections, lymphadenopathies and bullous pemphigoid. Here we indicate the unusual association of clinically, histopathologically and mmunohistochemically diagnosed bullous pemphigoid with the clinically diagnosed orf disease. This uncommon association has been reported in a few case reports in the literature before. We searched Turkish medicine literature and we couldn't find a report about this association so we want to report the association by this article

Dermatological Disorders in Geriatric Patients

Objective: Nowadays diagnosis and treatment of diseases of geriatric population are becoming increasingly important. Especially, dermatological diseases are frequent and affect life quality of elders. Epidemiological investigations for this population will be important for more effective medical care, according to the changing needing. Methods: Seven-hundred twenty geriatric outpatients admitted to the dermatology clinic, between the June 2012-June 2013, conducted to our study. Data of patients, which were collected from patient registry records on hospital computer automation system, were analyzed retrospectively. Results: A total of 820 dermatological diseases in geriatric patients were analyzed in 13 groups. The five most frequently encountered diseases were eczematous dermatitis 32.9%, senile pruritus 14.6%, superficial fungal infections 14.5%, urticarial diseases 7.4%, and benign and malign skin tumors 5%, respectively. Conclusion: As a result, we suggest, successful diagnosis and treatment of frequent dermatological diseases of elderly are important for health and life quality of patients. However, dermatological examinations, focusing only on complaints of patients, may contribute delayed diagnosis of superficial fungal diseases and some premalignant skin diseases

Dermatological disorders in geriatric patients Geriatrik hastalarda dermatolojik sorunlar

© 2014 Aves Yayincilik. All rights reserved.Objective: Nowadays diagnosis and treatment of diseases of geriatric population are becoming increasingly important. Especially, dermatological diseases are frequent and affect life quality of elders. Epidemiological investigations for this population will be important for more effective medical care, according to the changing needing. Methods: Seven-hundred twenty geriatric outpatients admitted to the dermatology clinic, between the June 2012-June 2013, conducted to our study. Data of patients, which were collected from patient registry records on hospital computer automation system, were analyzed retrospectively.Results: A total of 820 dermatological diseases in geriatric patients were analyzed in 13 groups. The five most frequently encountered diseases were eczematous dermatitis 32.9%, senile pruritus 14.6%, superficial fungal infections 14.5%, urticarial diseases 7.4%, and benign and malign skin tumors 5%, respectively.Conclusion: As a result, we suggest, successful diagnosis and treatment of frequent dermatological diseases of elderly are important for health and life quality of patients. However, dermatological examinations, focusing only on complaints of patients, may contribute delayed diagnosis of superficial fungal diseases and some premalignant skin diseases

Case Report: Behçet’s disease accompanied with vitiligo [version 1; referees: 2 approved]

Recently, a few case reports and clinical studies have been published that explore the association of Behçet’s Disease (BD) and vitiligo, with conflicting results. Genetic and immunological properties of BD and presence of autoantibodies support autoimmunity, but clinical features suggest autoinflammatory diseases. BD is thought to be a cornerstone between autoimmune and autoinflammatory diseases. On the other hand, vitiligo has been accepted as an autoimmune disease with associations of other autoimmune disorders and there is a possible role of autoimmunity in pathogenesis of the disease. Significant advances have been made understanding the pathogenesis and genetics of BD. However, it is worth presenting rare clinical variants for improving the clinical understanding of BD. Herein, we are presenting a case with diagnosis of both Behçet’s disease and vitiligo in same patient, which is a rare occurrence. Discussion and demonstrating the association of these two diseases may give rise to understanding similar and different aspects of autoimmunity and autoinflammatory pathogenesis of both diseases

Results of Skin Prick Tests in Dermatology Outpatient Allergy Unit

WOS: 000518456300009Amaç: Deri prick testi (DPT) başlıca atopik dermatit (AD), kronik ürtiker (KÜ), alerjik astma (AA), ve alerjik rinit (AR) gibi hastalıkların tanı ve takibinde kullanılmaktadır. Bu çalışmanın amacı, Dermatoloji Kliniği Alerji Ünitesi (DKAÜ)'nde yapılan DPT sonuçlarının geriye dönük olarak incelenerek, endikasyonları ve pozitiflik oranlarının araştırılmasıdır. Gereç ve Yöntem: DKAÜ arşivi kullanılarak 2014-2016 yıllarında yapılan DPT sonuçları incelenmiştir. DPT sonuçları, her hasta için ayrıca arşivlenen DPT formları okunarak yapılmıştır. Bulgular: DKAÜ'nde 2014-2016 yılları arasında 1916 hastaya DPT yapılmıştır. Bu hastaların 941'inde AA, 133'ünde AR, 842'sinde dermatolojik hastalık olduğu görülmüştür. En az bir ve birden fazla alerjen madde ile DPT pozitiflik oranı, sırasıyla AA, AR ve dermatolojik hastalıklarda; %92.1, %71.4 ve %50 olarak saptanmıştır. Dermatolojik hastalıklar incelendiğinde, 69 kronik ürtiker (KÜ), 55 atopik dermatit (AD) hastası haricinde, geriye kalan 718 hastada, başlıca dermatit, idiopatik generalize pruritus (İGP) olmak üzere farklı dermatolojik hastalıkların olduğu görülmüştür. DPT pozitifliği KÜ’de %55.1, AD’te %52.7 ve diğer dermatolojik hastalıklarda %48.6 olarak saptanmıştır. Sonuç: Bu çalışmanın sonuçlarına göre DPT pozitiflik oranı, AR ve AA hastalarında hem KÜ ve AD hem de diğer dermatolojik hastalıklara göre daha yüksektir. Bunun nedeni, KÜ ve AD etyopatogenezinde tip 1 aşırı duyarlılık reaksiyonlarının rolünün daha az olması ve/veya farklı dermatolojik tanılarla yönlendirilen hastalarda doğru olmayan DPT endikasyonları olabilirObjective: Skin prick test (SPT) is mainly used for diagnosis and follow-up of diseases like atopic dermatitis (AD), chronic urticaria (CU), allergic asthma (AA) and allegic rhinitis (AR). The aim of current study is to explore the results of SPT retrospectively which were performed in Dermatology Outpatient Allergy Unit (DOAU) for identifying indications and positivity. Methods: Results of SPT which were performed on 2014-2016 were investigated based on archives of DOAU. Results of SPT were analyzed from the SPT Forms which were prepared for each patient. Results: SPT were performed on 1916 individuals who admitted to DOAU during 2015-2016. AA was determined in 941, AR in 133 and dermatological diseases were 842 patients. SPT positive results, for at least one or more allergen agents, of patients with AA, AR and dermatological diseases were 92.1%, 71.4% and 50% respectively. Dermatological diseases included; except CU in 69 patients and AD in 55 patients. In the remaining 718 patients were diagnosed with dermatitis, idiopathic generalised pruritus (IGP) and other dermatological disorders. SPT positivity rates in CU was 55.1%, 52.7% in AD and 48.6% in several dermatological diseases. Conclusions: As a result, the rate of SPT positivity in patients with AA and AR were higher than both CU, AD and several dermatological diseases. The reason of this may be related with lesser role of type 1 hypersensivity reaction in etiopathogenesis of CU and AD, and/or improper SPT indications who were directed with diagnosis of several dermatological diseases