Blastic Plasmacytoid Dendritic Cell Neoplasm: Skin and Bone Marrow Infiltration of Three Cases and the Review of the Literature

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a distinct and rare neoplastic entity and was classified as a subgroup of acute myeloblastic leukemia by the WHO in 2008. The median survival of patients was 15.2 months in a large case series. Allogeneic or autologous bone marrow transplantation has been recommended by some reports because of the disease's poor prognosis. We present three patients who presented with both skin and bone marrow infiltration. A 57-year-old man, a 62-year-old woman, a 64-year-old man were admitted to our outpatient clinic because of skin lesions. All of the patient's had bone marrow infiltration with positivity of the CD4, CD56, and CD123 staining. Survival of the patient's were 42, 6 and 12 months, respectively. Two of the patients who presented as blastic form didn't respond to any chemotherapy. BPDCN is a difficult disease to diagnosis and manage. CD4, CD56, CD123, CD303, and T cell leukemia/lymphoma 1. Cutaneous lesions can present as isolated nodules, macules, and disseminated macules and nodules. Positivities are crucial to the diagnosis of the disease in histological examination. Bone marrow infiltration or disease relapse at presentation were related to poor prognosis. Complete immunocytochemical staining must be performed for all patients who have cutaneous lesions with or without blood count abnormalities. Bone marrow (allogeneic or autologous) transplantation should be considered at the first remission

Multicenter study evaluating the impact of COVID-19 outbreak on dermatology outpatients in Turkey.

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. Fifteen 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 164 878 patients, 133 131 before and 31 747 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

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Alopecia Areata: Clinical Treatment

Alopecia areata is a complex immune-mediated disease that targets anagen hair follicles. Therapeutic strategies must be directed as either immunosuppressive or immunomodulating and may consist of monotherapy or combination therapy and should be different depending on patient’s age, extent, and chronicity of the disease. The physician must discuss mild and aggressive options, as well as the possibility of no treatment, camouflage options, and social/psychological support. Topical, intralesional, and systemic steroids, as well as corticosteroid-sparing agents and disease-modifying antirheumatic drugs are useful as local or systemic immunosuppressors. Topical immunotherapy, anthralin, and phototherapy have proved useful as immunomodulators. Target therapy with JAK inhibitors is useful in alopecia areata totalis or universalis. Treatment in special areas such as eyelashes, eyebrows, or beard benefit from treatment with steroids, minoxidil, prostaglandin F2a analogs, and topical tofacitinib. Vitamin D3, ezetimibe/simvastatin, platelet-rich plasma, antihistamines, and aromatherapy may be used as adjuvant therapies. We discuss a practical but evidence-based approach for treatment in different cases of alopecia areata with detailed information about doses, administration, and possible side effects