Drug-Induced Acneiform Eruptions

Acne vulgaris is a chronic skin disease that develops as a result of inflammation of the pilosebaceous unit and its clinical course is accompanied by comedones, papules, pustules, and nodules. A different group of disease, which is clinically similar to acne vulgaris but with a different etiopathogenesis, is called “acneiform eruptions.” In clinical practice, acneiform eruptions are generally the answer of the question “What is it if it is not an acne?” Although there are many subgroups of acneiform eruptions, drugs are common cause of acneiform eruptions, and this clinical picture is called “drug-induced acneiform eruptions.” There are many drugs related to drug-induced acneiform eruptions. Discontinuation of the responsible drug is generally sufficient in treatment

Grinspan’s Syndrome: A Rare Case with Malignant Transformation

Aim. Oral lichen planus (OLP) is one of the common chronic inflammatory, noninfectious, and precancerous oral mucosal diseases that affect the stratified squamous epithelium in adults. Grinspan et al. reported an association of OLP with diabetes mellitus and vascular hypertension and called that Grinspan’s syndrome in 1966. We aim to present a case of Grinspan’s syndrome with malignant transformation. Case Presentation. A 60-year-old man who presented with a ten-year history of OLP diagnosed clinically and histologically was referred to our otolaryngology department with a painless swallowing in the left buccal mucosa for 3 months. Clinical examination revealed several plaques, striated white lesions in the buccal mucosa bilaterally, and an exophytic tumor in the left buccal mucosa. Histopathological examination showed lichen planus bilaterally and oral squamous cell carcinoma in the left buccal mucosa. The tumor had been developed on the preexisting areas of lichen planus which had been histologically proven before. The tumor was removed completely, and the tissue defect on the buccal mucosa was repaired with a split-thickness skin graft. Conclusion. Patients with OLP should be followed up periodically in a long term at close intervals for early diagnosis of malignant transformation

Türkiye’de ulusal akne haftasında yapılan bilgilendirme seminerlerinin katılımcıların akne hakkındaki bilgi düzeylerine etkisi

Background and Design: To investigate the contribution of informative presentations about acne vulgaris and questionnaires administered before and after informative meetings on patients' awareness and consciousness. Materials and Methods: Participants were asked to fill out a 20-question survey before and after informative seminars in hospitals and secondary and high schools as part of National Acne Week. The level of statistical significance was set as p <= 0.05. Results: A total of 466 participants completed the survey before and after the seminar, and the mean age of the participants was 17.4 +/- 6.9. Before the seminar, 31.1% of participants thought that acne is originated from the liver, whereas this figure decreased to 16.7% after the seminar. In all, 47.6% of participants consulted doctors and 23.9% consulted social media to seek information about acne; however, after receiving training, 77% preferred to consult a doctor. Of the participants, 51.1% were expecting to see the results of acne treatment in 1 or 2 weeks, whereas 83.3% stated that the effects would be seen in 2 or 3 months after the seminar. When the participants' educational background was grouped as "secondary-high school-other," a statistically significant difference was obtained (p<0.05). Conclusion: Our study features both patients' misconceptions and their incorrect attitudes about acne, and their level of knowledge improved significantly as a result of educational seminars. The relative benefit derived from educational seminars was positively related to the participants' highest level of education.Amaç: Akne vulgaris ile ilgili bilgilendirme toplantısı öncesi ve sonrasında uygulanan anket formları ile bilgilendirici sunumların akne hakkındaki farkındalık ve bilinç düzeylerine katkısını incelemek amaçlanmaktadır. Gereç ve Yöntem: Ulusal Akne Haftası kapsamında hastane, ortaokul ve lise dengi okullarda verilen bilinçlendirme eğitimi öncesi ve sonrasında katılımcılardan 20 soruluk bir anket doldurmaları istendi. İstatistiksel anlamlılık düzeyi p≤0,05 olarak kabul edildi. Bulgular: Eğitim öncesi ve sonrasında anket formunu dolduran 466 kişinin yaş ortalaması 17,4±6,9 idi. Eğitim öncesi katılımcıların %31,1’i aknenin karaciğer kaynaklı olduğunu düşünürken, eğitim sonrası bu oran %16,7’ye indi. Akne hakkında bilgi almak için eğitim öncesi katılımcıların %47,6’sı doktora, %23,9’u sosyal medyaya başvururken, eğitim sonrası %77’si doktora başvurmayı tercih edeceğini belirtti. Katılımcıların %51,1’i akne tedavisinin 1-2 hafta içerisinde etkisini göstereceğini beklerken, eğitim sonrası %83,3’ü 2-3 ay kullandıktan sonra yanıt alınabileceğini belirtti. Kişilerin öğrenim durumları, “ortaokul-lise-diğer” olarak gruplandırıldığında, eğitim sonrası gruplar arasında öğrenim durumlarına göre istatistiksel olarak anlamlı bir farklılık saptandı (p=0,005). Sonuç: Çalışmamız bireylerin hem akne hakkındaki yanlış bilgi ve tutumlarını ön plana çıkarmakta, hem de hekimlerin vereceği eğitim seminerleri ve bilgilendirme toplantıları ile bilgi düzeylerinde kayda değer bir gelişme sağlanacağını göstermektedir

Clinical course of psoriasis patients that discontinued biologics during the COVID-19 pandemic

BackgroundSince psoriasis is a chronic disease, it is not recommended to discontinue the treatment agents used. However, in real life, the treatment of psoriasis patients may be interrupted for various reasons. During the pandemic period, the treatment of many patients was also interrupted. ObjectivesTo evaluate relapse and clinical worsening in psoriasis patients whose biological therapy was interrupted during the pandemic and reveal associated factors. MethodsThe study included patients aged >= 18 years, who were followed up with moderate and severe chronic psoriasis controlled by the last biological agent [Psoriasis Area Severity Index (PASI) 75 response achieved] but had to discontinue their treatment during the pandemic. The patients' demographic and clinical characteristics, clinical course after the discontinuation of these agents, presence of clinical worsening, and relapse were evaluated. Risk factors were analyzed with the logistic regression analysis. ResultsThe study included 169 patients, with a mean age of 47.3 +/- 14.5 (18-87) years. The mean biologics-free time was 18.2 +/- 12.3 (2-56) weeks. Clinical worsening was detected in 41.4% and relapse in 48.5% of the patients. The significant risk factors for clinical worsening and relapse in both univariate and multivariate analyses were alcohol use during the biologics-free period, total time off biologics, and the presence of an additional triggering factor. The use of secukinumab and ustekinumab was found to be a protective factor against clinical worsening in multivariate analyses. ConclusionAs the biologics-free period is prolonged, the likelihood of clinical worsening and relapse increases, therefore, we do not recommend discontinuing biological agents

Evaluation of the efficacy, safety, and side effects of secukinumab in patients with moderate-to-severe psoriasis: Real-world data from a retrospective multicenter study

Background: Clinical studies have demonstrated that IL-17A inhibition with secukinumab is effective for clearing the skin of patients with psoriasis and has a favorable safety profile. Objective: The authors aim to determine whether secukinumab is effective and safe for the treatment of moderate-to-severe chronic psoriasis based on clinical experience with this drug. Method: The authors conducted a multicenter retrospective study in nine referral centers and included patients with psoriasis who had received secukinumab between March 2018 to November 2020. Data on demographic characteristics, Psoriasis Area and Severity Index (PASI) scores, and previous treatments were collected from medical records. Patients were evaluated at 12, 24, and 52 weeks with respect to response to treatment and side effects. Results: In total, 229 patients were recruited for the study. A PASI score improvement of ≥90 points over the baseline was achieved by 79%, 69.8%, and 49.3% of patients at weeks 12, 24, and 52, respectively. The most common adverse events wereCandida infections and fatigue. In total, 74 (32%) patients discontinued treatment by week 52, including due to adverse events, or secondary ineffectiveness. Study limitations: Retrospective design. Conclusions: These findings suggest that secukinumab therapy is reasonably effective in patients with moderate-to-severe psoriasis. Comorbidities and time length of the disease can affect the response to treatment. The rates of adverse events were high in this patient population

Skin manifestations following anti-COVID-19 vaccination: A multicentricstudy from Turkey

Purpose: After the emergence of the pandemic caused by the COVID-19 virus, vaccination with various vaccines has started to be implemented across the world. To identify dermatological reactions developing after the COVID-19 vaccines administered in Turkey and determine their clinical features and risk factors that may play a role in their development. Materials and Methods: The study included patients aged ≥18 years, who presented to 13 different dermatology clinics in Turkey between July 2021 and September 2021 after developing dermatological reactions following the administration of the COVID-19 vaccine. After providing written consent, the patients were asked to complete a standard survey including questions related to age, gender, occupation, comorbidities, the regular medication used, the onset of cutaneous reactions after vaccination, and localization of reactions. Dermatological reactions were categorized according to whether they developed after the first or second dose of the vaccine or whether they occurred after the inactivated or messenger RNA (mRNA) vaccine. The relationship between dermatological reactions and some variables such as gender and comorbidities was also evaluated. Results: A total of 269 patients [116 women (43.1%), 153 men (56.9%)] were included in the study. It was observed that the dermatological diseases and reactions that most frequently developed after vaccination were urticaria (25.7%), herpes zoster (24.9%), maculopapular eruption (12.3%), and pityriasis rosea (4.5%). The rate of dermatological reactions was 60.6% after the administration of the mRNA vaccine and 39.4% after that of the inactivated vaccine. There was a statistically significantly higher number of reactions among the patients that received the mRNA vaccine (p = 0.001). Conclusion: The most common reactions in our sample were urticaria, herpes zoster, and maculopapular eruption. Physicians should know the dermatological side effects of COVID-19 vaccines and their clinical features

Patient use of complementary and alternative medicine for psoriasis vulgaris and factors believed to trigger the disease: A multicenter cross-sectional study with 1621 patients

Introduction: Due to the chronic recurrent nature of psoriasis vulgaris (PV) and lack of definitive treatment for the disease, patients often resort to alternative treatments. Physicians seem to have low awareness of this issue. Objectives: To elicit the perceptions of 1,621 PV patients on complementary and alternative medicine (CAM) and examine factors reported to worsen PV. Methods: The patients sociodemographic characteristics, Psoriasis Area Severity Index (PASI), Dermatology Life Quality Index (DLQI), disease duration, and severity were recorded, and the patients CAM use was questioned in detail. The patients were also asked about factors that worsened PV and their experiences with a gluten-free diet. Results: Of the patients, 56.51% had used CAM. The mean age, illness duration, PASI scores and DLQI of those using CAM were significantly higher. CAM use was significantly higher in those with facial, genital involvement, and arthralgia/arthritis. The patients mostly referred to CAM when PV became severe (46.4%). Of the CAM users, 45.52% used herbal topicals. The physicians of 67.03% did not inquire whether they used CAM. Of the participants, 37.73% considered that stress worsened their disease. Gluten-free diet did not affect PV symptoms in 52.22%. Conclusions: Patients CAM use is often overlooked by dermatologists. Our results showed that more than half the patients used CAM and did not share this information with their physicians. Therefore, the awareness of physicians should be increased and patients should be asked about the use of CAM and directed to the appropriate medical treatment options by physicians

Habits of using social media and the internet in psoriasis patients

Introduction: Psoriasis significantly affects the patients quality of life, which often leads patients to seek online information about this disease. Objectives: To explore the habits of patients with psoriasis related to their use of social media (SM) and the internet to obtain information about their disease. Methods: 1,520 patients completed the survey and the Dermatology Life Quality Index (DLQI) questionnaire. The Psoriasis Area Severity Index scores (PASI) and clinical data of the patients were recorded by their physicians. Results: Of the 1,114 patients that reported using SM and internet, 48.38% regularly and 31.14% sometimes resorted to obtain information about psoriasis. The use of SM and internet for psoriasis was statistically significantly higher among young people (P = 0.000), those with university or higher education (P = 0.009), higher DLQI (P = 0.000) and PASI (P = 0.011) scores, facial (P = 0.050), scalp (P = 0.032), hand (P = 0.048), genital (P = 0.001) and inverse (P = 0.000) involvement, and arthralgia/arthritis (P = 0.006). The participants mostly used the Google (86%) and Facebook (41%). More than half of the participants (62.8%) expected dermatologists to inform society that psoriasis is not contagious. Conclusions: Internet and SM being widely available and offering substantial information to be easily accessed make it very attractive for patients to use these platforms to investigate diseases, including psoriasis. If what is presented on SM conflicts with what the physician says, patients mostly trust the latter, but at the same time, they tend not to share the results of their online inquiries with their physicians

The Significance of Scars: Patient and Clinician Perspectives

The formation of a scar represents the extension of regenerative wound repair mechanisms. On the one hand, scar tissue helps in wound closure by supporting wound contracture and reepithelization. There is no doubt that the scar formation developed in response to an injury facilitates the organism’s survival process directly and effectively. On the other hand, the effect of the pathologically developed scarring on the global disease burden has still not been accurately defined. There are three basic subtypes of scars, namely simple, atrophic, and hypertrophic/pathological (hypertrophic scars and keloids), and they have different histopathological features, development, dispersion patterns, and remission phases. There are important consequences when scars’ global and individual effects are considered. Patients with scars face long-term functional and psychological problems. In interpreting scars for both individuals and society, individual, cultural, psychological, and social effects and prejudices play a crucial role. Both the psychosocial and financial aspects of the scars, as well as the effects on the patient and society, should be considered. © 2019 by Nova Science Publishers, Inc