The relationship between acne vulgaris and irritable bowel syndrome: A preliminary study

Background: Irritable bowel syndrome (IBS) is a functional gastrointestinal disease characterized by chronic abdominal pain and changes in bowel movements without underlying organic pathology. Many skin diseases have been reported to be more common in individuals with functional bowel diseases. Aims: In this study, we aimed to investigate a possible relationship between acne vulgaris (AV) and IBS. Patients/Methods: This prospective controlled study included patients with AV and healthy volunteers. All the subjects were evaluated in terms of the presence of IBS. The diagnosis of IBS was made based on the ROME IV diagnostic criteria. The clinical severity of AV was calculated using the global acne grading system (GAGS). Results: A total of 300 patients with acne vulgaris and 300 age and gender-matched healthy controls were included in the study. The majority of the patients were female (n = 175, 58.3%). The mean ages of the patients and controls were 20.22 ± 5.24 years and 20.49 ± 5.36 years, respectively. A total of 183 patients (61.0%) and 84 (28.0%) controls were diagnosed with IBS based on the Rome IV diagnostic criteria. The frequency of IBS was statistically significantly higher in the patient group than in the control group. (P =.001). There was also statistically significant relationship between the GAGS scores and IBS diagnosis (P =.001), abnormal stool form (P =.001), abdominal distention (P =.001), and feeling of incomplete evacuation (P =.001). Conclusion: Our study showed that IBS is significantly more common in patients with AV than in healthy controls. Additionally, GAGS scores were higher in patients diagnosed with IBS. To the best of our knowledge, this is the first study focusing on the subject. © 2020 Wiley Periodicals LL

Handheld dermatoscopy as an easy-to-use capillaroscopic instrument in rheumatoid arthritis: A cross-sectional study

Background/aim: Nailfold video capillaroscopy is considered as a reliable method for evaluating peripheral microangiopathy in rheumatologic diseases. In this study, we aimed to demonstrate the utility of handheld dermatoscopy as an easy-to-use nailfold capillaroscopic instrument in patients with rheumatoid arthritis. Materials and methods: This cross-sectional study included patients with rheumatoid arthritis and healthy subjects. A handheld dermatoscopic examination of proximal nail fold was performed in each subject. The possible correlation of capillaroscopic findings with disease activity was evaluated using the disease activity score 28 (DAS28). Results: A total of 59 patients with rheumatoid arthritis and 60 healthy subjects were enrolled in the study. The presence of capillary enlargement, avascular areas, capillary deformities, and capillary vascular anomalies in the group of patients showed a statistically significant difference when compared with the healthy subjects. No correlation was found between the nail fold capillaroscopic findings and DAS28 score. Conclusion: Hand-held dermatoscopy seems to be a useful technique in the evaluation of nail fold capillary changes. We suggest that in patients with rheumatoid arthritis, when capillaroscopic examination is needed, it can be evaluated using handheld dermatoscopy. Selected patients who showed findings using this method can be further examined with classical capillaroscopy to obtain more quantitative data. © TÜBİTAK

The use of dermatoscopy in the diagnosis of erythema ab igne

We have read with great interest the original article by Ozturk et al, which was recently published in the Journal of Cosmetic Dermatology.1 In their retrospective multicenter study, the authors investigated demographic and clinical features of patients with ery-thema ab igne (EAI). They stated that the diagnosis of EAI was made based on the clinical history along with the appearance, and local-ization of the lesions..

Pemphigus and COVID-19: Critical overview of management with a focus on treatment choice

COVID-19 is a serious multisystem disease caused by severe acute respiratory syndrome coronavirus 2. Due to the COVID-19 crisis, that still keeps its impacts worldwide, numerous scheduled medical activities have been postponed and this interruption has a potential to modify the management of many cutaneous conditions including pemphigus. This narrative review aims to discuss the management of pemphigus in the era of COVID-19, considering the necessity to balance suitable pemphigus treatment with minimal risk of COVID-19-related mortality and morbidity. The data on the effect of treatments used for pemphigus on COVID-19 are limited. However, the evidence to manage patients properly is evolving and our knowledge is updated. Current expert recommendations include that patients with pemphigus should be informed clearly to avoid mismanagement and they should be monitored regularly for symptoms of COVID-19. Patients with mild disease can be managed with topical or intralesional corticosteroids, dapsone, or doxycycline. Systemic corticosteroids should be tapered to the lowest effective dose during the pandemic. Prednis(ol)one ≤10 mg/d can be continued in patients with COVID-19 while prednis(ol)one >10 mg/d may be reduced considering the activity of the disease. Conventional immunosuppressive therapies should only be discontinued in confirmed cases of COVID-19. Postponing rituximab treatment should be considered on a case by case basis. Intravenous immunoglobulin is not likely to increase the risk of infection and may be considered a safe option in patients with COVID-19. Given the psychological burden brought by COVID 19, online or face-to-face psychological support programs should be considered. © 2020 Wiley Periodicals LLC

Utility of dermatoscopy in the diagnosis of acanthosis nigricans

We have read with great interest the review article by Das et al, which was recently published in the Journal of Cosmetic Dermatology.1The authors provided a comprehensive and updated review of cur-rent knowledge on acanthosis nigricans (AN) with particular empha-sis on diagnostic testing strategies. They pointed out that AN can imitate many different clinical entities, including epidermal nevus, psoriasis, fungal infections, atopic dirty neck, confluent and retic-ulated papillomatosis, Hailey-Hailey disease, and terra firma-forme dermatosis. The authors also underlined the importance of proper history, physical examination, and histopathological evaluation in the differential diagnosis.1 Here, we would like to briefly discuss the role of dermatoscopy as an adjunctive diagnostic tool that will facil-itate the diagnosis of AN..

Melanoma and COVID-19: A narrative review focused on treatment

Melanoma is the most severe form of skin cancer and its incidence has increased over the past few decades. COVID-19 pandemic affected the diagnosis and management of many diseases including melanoma. In this study, we aimed to provide a review focused on the diagnosis and management of melanoma in the era of COVID-19. A comprehensive search was conducted on PubMed, Web of Science, and Google Scholar databases using the keywords “melanoma,” “coronavirus,” “COVID 19,” and “SARS-CoV-2.” The relevant guidelines published by the European Society for Medical Oncology and the National Comprehensive Cancer Network were also included. The current guidelines recommend that surgical interventions for new diagnosis of invasive primary melanoma, patients with postoperative complications, wide resection and sentinel lymph node biopsy for newly diagnosed T3-T4 melanoma, and planned surgical procedures for patients in neo-adjuvant trials should be prioritized. Surgical treatment of T3/T4 melanomas should be prioritized over T1/T2 melanomas except for any melanoma in which large clinical residual lesion is visible. Adjuvant therapies can be postponed for up to 12 weeks depending on the local center circumstances. PD-1 inhibitor monotherapy is recommended for patients starting immunologic therapy. Combination immunotherapy is still considered suitable for patients with higher-risk disease. Encorafenib and binimetinib should be prioritized for patients requiring BRAF-targeted therapy due to the lower chance of symptoms mimicking COVID-19 infection. © 2020 Wiley Periodicals LLC

A novel marker of systemic inflammation in psoriasis and related comorbidities: Chitotriosidase

Background/aim: Chitotriosidase (ChT) is an enzyme secreted by activated macrophages and neutrophils in response to proinflammatory signals. There is growing evidence indicating that ChT activity reflects the systemic inflammatory status. This study aimed to investigate whether serum ChT activity increased in patients with psoriasis and related comorbidities. Materials and methods: This cross-sectional study included 53 (28 with associated comorbidities and 25 without comorbidities) patients with psoriasis and 52 healthy volunteers. All participants underwent laboratory investigations for serum ChT levels, complete blood count, erythrocyte sedimentation rate, C-reactive protein, and serum lipid levels. Results: The patients with psoriasis showed significantly higher levels of ChT activity as compared to the healthy controls (23.5 ± 11.4 vs. 17.5 ± 10.4 μmol/mL/hour; p = 0.015). Additionally, the ChT activity was significantly higher in patients with comorbidities than in those without (p = 0.042). Conclusion: Our data support the pathogenetic role of inflammatory processes induced by macrophage activation in patients with psoriasis and related comorbidities. We believe that high ChT activity in patients with psoriasis may serve as an early prediction of the possible related comorbidities. © TÜBİTAK

Clinical, Demographic and Treatment Characteristics of Pediatric Psoriasis: A Multicenter Study of 150 Patients

BACKGROUND/AIMS: Many studies have focused on the epidemiological features of adult and childhood psoriasis. However, only a few studies have been conducted to demonstrate the clinical and demographic characteristics of pediatric psoriasis in Turkey. This study aimed to determine clinical, demographic, and treatment characteristics of childhood psoriasis in a multicenter series.MATERIALS and METHODS: This study was conducted in four different centers that are located in four cities of Turkey between June 2016 and June 2020. The demographic parameters, possible triggering factors (emotional stress, physical trauma, infection, and medication), and clinical characteristics (psoriasis type, psoriasis area severity index, involved areas, nail involvement, joint involvement, subjective symptoms, disease duration, last treatments and duration of use, and history of accompanying diseases) of pediatric patients with psoriasis were retrospectively analyzed.RESULTS: A total of 150 patients from four different centers were enrolled in the study, of whom 71 (47.30%) were males and 79 (52.70%) were females, with a mean age of 13.71 +/- 42 years (age range: 1-18 years). A family history of psoriasis was determined in 20 (13.33%) patients. Possible triggering factors included emotional stress (n=90, 60%), physical trauma (n=21, 14%), infection (n=14, 9.33%), and medication (n=1, 1.67%). The most common area of involvement was the trunk (n=69, 46%) followed by the scalp (n=42, 28%), hand (n=20, 13.33%), and face (n=19, 12.67%). The prevalence of clinical types was as follows: plaque (n=125,83.33%), guttate (n=10, 6.67%), palmoplantar (n=7, 4.67%), inverse (n=6, 4%), and pustular (n=2, 1.33%) psoriasis. Nail and joint involvement were observed in 30 (20%) and 15 (10%) patients, respectively. The last treatments received included topical treatment (n=101, 67.33%), phototherapy (n=23, 15.33%), acitretin (n=16,10.67%), methotrexate (n=9, 6%), and cyclosporine (n=1, 0.67%).CONCLUSION: In our cohort, the clinical types and treatments used for childhood psoriasis were similar to those of other studies, but the rate of family history was lower, whereas the incidence of emotional stress was higher. Addressing the psychological impacts of psoriasis along with its physical aspects may provide better treatment outcomes

Psöriasisde Tamamlayıcı Ve Alternatif Tıp Yöntemleri Kullanımı Ve Beslenmeyle Olan İlişki: Bir Anket Çalışması

Amaç: Bu çalışmayla dermatoloji polikliniğimize başvuran psöriasis hastalarının Tamamlayıcı ve Alternatif Tıp TAT yöntemleri hakkındaki bilgi ve yaklaşımları ile psöriasis hastalığının besinlerle olabilecek ilişkisini değerlendirmeyi amaçladık.Gereç ve Yöntem: Çalışmamız Mayıs 2018-Temmuz 2018 tarihleri arasında dermatoloji polikliniğine psöriasis nedeniyle başvuran 111 hasta ile anket çalışması olarak planlandı. Anket soruları hastalarla poliklinik ortamında yüz yüze soru-cevap şeklinde uygulandı.Bulgular: Çalışmamıza gönüllü olarak katılan 111 hastanın 58'i %52,3 erkek, 53'ü %47,7 kadın idi. Ankete katılanların 59’u %53,2 herhangi bir TAT yöntemi kullanmadığını,52’si %46,8 ise kullandığını bildirdi. Kullanan ve kullanmayanlar arasında cinsiyet, eğitim düzeyi, hastalık süresi, yaşadığı yer açısından istatistiksel olarak anlamlı farklılık saptanmadı. Ancak yaş olarak kullananların yaş ortalamasının kullanmayan gruptan anlamlı olarak düşük olduğu bulundu t 109 =2.484; p=0.01

The Role of Dermoscopy in Diagnosis: A Case Presentation of Pseudoxanthoma Elasticum Initially Misdiagnosed as Pigmented Contact Dermatitis

A 45-year-old female with a three-year history of bilateral ocular angioid streaks was referred to our dermatology department Kırşehir Ahi Evran University for the evaluation of persistent cutaneous lesions, present since childhood ( Figure 1, A–D )