Evaluation of self-esteem and dermatological quality of life in adolescents with atopic dermatitis

Background and Design: Atopic dermatitis is a chronic, inflammatory skin disease characterized by itchy skin lesions. Since adolescents are intensely interested in their physical appearance, chronic skin diseases in this period can adversely affect the development of self esteem. Atopic dermatitis is a skin disease that affects the appearance and there is an heightened attention to the body image in adolescence which is an important period of time in the development of self-esteem. Therefore, we aimed to investigate self-esteem and dermatological quality of life in adolescents with atopic dermatitis. Materials and Methods: Thirty-three patients with atopic dermatitis and 33 healthy controls were included in the study. The Piers-Harris Children’s Self-Concept Scale and the Children’s Dermatology Life Quality Index (CDLQI) were used for determining self-esteem and quality of life. The Scoring of Atopic Dermatitis (SCORAD) Index was used to assess the severity of atopic dermatitis. Results: It was found that patient group had lower self-esteem than healthy controls according to the Piers-Harris Children’s Self-Concept Scale. A statistically significant difference was observed in happiness/satisfaction and anxiety subscale scores between the patients and healthy controls while there was no significant difference between the other sub-scale scores. Mean value of dermatological quality of life in patients with atopic dermatitis was significantly lower than in healthy controls. A moderate negative correlation was found between self-esteem and CDLQI scores among adolescents with atopic dermatitis. Discussion: This study results have shown that self-esteem and dermatological quality of life were adversely affected in adolescents with atopic dermatitis irrespective of gender. These patients should be examined psychiatrically besides dermatological examination and treatment. We suggest that improvement will be observed in self-esteem and quality of life of adolescents with atopic dermatitis by providing the necessary psychosocial support

Dermatology life quality ındex scores in lichen planus : Comparison of psoriasis and healthy controls

Amaç: Deri hastalıkları fiziksel ve sosyal aktiviteler ile psikolojik durumu etkiler. Bu çalışmanın amacı liken planuslu hastaların Dermatoloji Yaşam Kalite İndeksi (DYKİ) skorlarını belirlemek, bu skorları psoriyazisli hastalarla ve sağlıklı kontrollerle karşılaştırmaktı. Gereç ve Yöntem: Otuz ardışık liken planuslu hasta, 30 psoriyazis vulgarisli hasta ve 30 yaş ve cinsiyet açısından eşleştirilmiş sağlıklı kontrol DYKİ’i doldurdu. Bulgular: Liken planuslu hastaların toplam DYKİ skorları (9.60±7.32) psoriasisli hastaların toplam DYKİ skorları (9.50±6.10) ile benzer (p>0.05), kontrollerinkinden (0.67±0.80) anlamlı derecede yüksekti (p0.05). Oral tutulumu olan liken planuslu hastaların ortalama toplam DYKİ skoru (13.27±8.05) oral tutulumu olmayan liken planuslu hastaların ortalama toplam DYKİ skoru (7.47±6.11)’ndan istatistiksel olarak daha yüksek değer gösterdi (p=0.034). Sonuç: Liken planuslu hastaların yaşam kalitesi psoriyazisli hastalar kadar etkilenmiştir. DYKİ liken planuslu hastaların yaşam kalitesini değerlendirmede güvenilir ve geçerli bir ölçektir.Background and Design: Skin diseases affect physical and social activities and psychological status. The aim of this study was to investigate the Dermatology Life Quality Index (DLQI) scores in patients with lichen planus and compared with that in psoriasis patients and healthy controls. Material and Method: Thirty consecutive patients with lichen planus, 30 with psoriasis vulgaris attending our dermatology outpatient clinic and 30 sex- and age-matched healthy controls completed the DLQI. Results: Total DLQI scores of patients with lichen planus (9.60±7.32) and psoriasis (9.50±6.10) were comparable (p>0.05) and significantly higher than that of healthy controls (0.67±0.80) (p<0.001). No significant difference were detected between the subscale scores in patients with lichen planus and psoriasis (p>0.05). Lichen planus patients with oral involvement demonstrated higher mean DLQI score than that of lichen planus patients without oral involvement (13.27±8.05 vs. 7.47±6.11, p=0.034). Conclusion: The quality of life (QoL) of patients with lichen planus is impaired as much as that of psoriasis. The DLQI questionnaire is a reliable and valid instrument for assessing the QoL in patients with lichen planus

Ichthyosis vulgaris coexisted with acrokeratosis verruciformis : A case report

İktiyozis vulgaris, otozomal dominant geşiş gösteren bir keratinizasyon hastalığıdır ve yaygın pullanma ile karakterizedir. Akrokeratozis verrusiformis de otozomal dominant, nadir görülen bir keratinizasyon hastalığı olup, el ve ayak dorsal yüzde siğilimsi, kahverengi-deri renginde papüller ile karakterizedir. Burada, iktiyozis vulgaris ve akrokeratozis verrüsiformisin bir arada olduğu, 24 yaşında bir bayan hastayı sunmaktayızIchthyosis vulgaris is an autosomal dominant inherited, keratinization disorder and characterized by diffuse scaling. Acrokeratosis verruciformis is also an autosomal dominant, rare keratinization disorder and characterized by warty, brownish to skin colored papules on the dorsa of the hands and feet. We present a case of ichthyosis vulgaris coexisted with acrokeratosis verruciformis in a 24-year-old woman

Delayed diagnosis : Giant basal cell carcinoma of scalp

Derinin en sık görülen kanseri bazal hücreli karsinom (BHK) olmasına rağmen, saçlı deri lokalizasyonu oldukça nadir bildirilmektedir. BHK’ların %0.5-1’i 5cm’den geniş olup, “dev BHK” olarak tanımlanmaktadır. Bu bildiride, topikal kortikosteroid ve antifungal şampuan ile beş yıldır tedavi edilen bir dev saçlı deri BHK olgusu sunulmaktadır. Saçlı deride uzun süreli tedaviye dirençli eritematöz plak tip lezyonlarda ayırıcı tanıda BHK düşünülmelidir.Although basal cell carcinoma (BCC) is the most common form of skin cancer, the scalp lesions of BCC have been rarely reported. Giant BCC is defined as a tumor larger than 5 cm in diameter and only 0.5-1 % of all BCCs achieve this size. We report a case of giant BCC on the scalp that was treated with topical coticosteroids and antifungal shampoo for five years. BCC should be considered in the differential diagnosis in erythematous plaque type lesions resistant to therapy with long duration localized on the scalp

Effectiveness and safety of ustekinumab for the treatment of psoriasis; six years of clinical experience

Background This work aimed to investigate the long-term clinical experience with ustekinumab in cases with psoriasis. Materials and methods This retrospective cohort research group consisted of cases who presented to the dermatology outpatient clinics between January 2015 and January 2021, diagnosed with psoriasis, and were treated with ustekinumab. Data including gender, age, weight, disease duration, naïve and non-naïve status, psoriasis type, duration of medication, comorbidities, psoriasis area and severity index scores, the causes of treatment discontinuation, and previous treatments were retrospectively reviewed and analyzed. Results 160 cases with psoriasis were treated with ustekinumab during the research period. Twenty-four patients were excluded. Among 136 cases, 84 (61.8%) were male and 52 (38.2%) were female. We determined 80.55% of the non-naïve cases responded to ustekinumab. Conclusion Ustekinumab can be a suitable treatment option for non-naïve and resistant patients. Our data suggest the positive effect persists in cases with favorable responses to the first or second dose of ustekinumab. Also, we determined male cases gave more rapid and more robust responses than female cases, and patients were more willing about continuing the treatment

A case of nonhealing leg ulcer : Basal cell carcinoma

Yetmiş beş yaşında bayan hasta sol bacak ön yüzde üç yıldır iyileşmeyen ağrısız yara şikayetiyle polikliniğimize başvurdu. Daha önce kullanmış olduğu lokal yara tedavilerine yanıt almadığını ifade etmekteydi. Dermatolojik muayenede sol bacak ön yüzde, 2.7x3.7 cm çapında keskin sınırlı, çevresinde minimal eritem izlenen, yüzeyi sağlıklı parlak granülasyon dokusu ile kaplı ülserasyon alanı saptandı. Ülser zemininden ve kenarından alınan deri biyopsisi bazal hücreli karsinom ile uyumlu olarak değerlendirildi. Dermatolojik muayenede ve yapılan alt ekstremite venöz Doppler ultasonografisinde kronik venöz yetmezliğe ait bulgu saptanmadı. Bazal hücreli karsinomlar, nadiren uzun süreli ülserlerin zemininde ya da primer olarak ortaya çıkabilir. İyileşmeyen bacak ülseri olan hastalar bazal hücreli karsinom gelişme olasılığı açısından değerlendirilmelidir.A 75-year-old woman was admitted to our outpatient clinic with a three-year history of a painless, nonhealing ulcer located on the left lower leg. She had no response to previous therapy with local wound care. Skin examination revealed an ulcer 2.7 x 3.7 cm in size, and the surrounding skin showed minimal erythema. The surface of the ulcer demonstrated shiny granulation tissue. Biopsy of the ulcer edge and base showed basal cell carcinoma. Venous Doppler ultrasonography and dermatological examination did not reveal chronic venous insufficiency. Basal cell carcinomas rarely arise from previous long-term ulcers or developing de novo. We suggest that patients who develop non-healing leg ulcers, should be examined for basal cell carcinom

Serum high sensitivity c reactive protein and homocysteine levels in patients with mild to moderate psoriasis

Amaç: Psoriyazisin artmış kardiyovasküler risk profili ile ilişkisi bildirilmiştir. Yüksek sensitif C reaktif protein (hs-CRP) ve homosistein (Hcy) sonradan gelişebilecek kardiyovasküler olay riskini gösterebilen kanıtlanmış güncel biyolojik göstergelerdir. Bu çalışmanın amacı hafif ve orta şiddetli psoriyazis hastalarında hs-CRP, Hcy ve folik asit düzeylerini araştırmaktır. Gereç ve Yöntem: Elli bir ardışık hafif ya da orta şiddette psoriyazis vulgaris, yaş ve cinsiyet açısından eşleştirilmiş 32 sağlıklı kontrol çalışmaya alındı. Serum Hcy düzeylerini etkileyebilecek faktörler ekarte edildikten sonra hs-CRP, Hcy ve folik asit düzeylerini saptamak için kan örnekleri alındı. Ek olarak lipid düzeyleri de ölçüldü. Bulgular: Psoriyazis hastalarının ortalama Hcy değerleri kontrollerle karşılaştırıldığında anlamlı olarak yüksekti (p=0,001). Psoriyazisli hastalarla kontroller arasında hs-CRP ve folik asit düzeyleri açısından anlamlı farklılık yoktu (p>0,05). Total kolesterol (TC) yüksek dansiteli lipoprotein kolesterol (HDL C) oranı psoriyazisli hastalarda kontrollere göre anlamlı derecede yüksekti (p=0,044). Psoriyazis hastalarında Hcy düzeyleri ile cinsiyet arasında anlamlı ilişki mevcuttu. Psoriyazis hastalarında hs-CRP değerleri vücut kitle indeksi (BMI) ve TC ile anlamlı pozitif korelasyon gösterdi (p<0,05). Sonuç: Hafif ya da orta şiddetteki psoriyazis hastaları ile kontroller arasında serum hs-CRP ve folik asit düzeyleri açısından anlamlı farklılık gözlenmedi. Ancak psoriyazis hastalarında serum Hcy düzeylerinde artış ve folik asit düzeyleriyle ters korelasyon izlendi. Bu biyolojik göstergeler psoriyaziste aterosklerotik riskin değerlendirilmesinde ek bilgi sağlayabilir.Background and Design: Psoriasis has been reported to be associated with increased cardiovascular risk profile. High sensitivity C reactive protein (hs-CRP) and homocysteine (Hcy) have been demonstrated to be novel biomarkers for subsequent cardiovascular events. The aim of the present study was to examine hs-CRP, Hcy and folic acid levels in patients with mild to moderate psoriasis vulgaris. Material and Method: Fifty one consecutive patients with mild to moderate psoriasis vulgaris and thirty two sex- and age-matched healthy controls were included in this study. After excluding factors that may affect serum Hcy levels, blood samples were obtained for hs-CRP, Hcy and folic acid determination. Lipid levels were also evaluated. Results: The mean Hcy values of the psoriasis patients was significantly higher, compared with the controls (p=0.001). There were no significant difference in hs-CRP and folic acid levels between psoriasis patients and controls (p&gt;0.05). The total cholesterol (TC) high density lipoprotein cholesterol (HDL C) ratio was significantly higher in patients with psoriasis than in controls (p=0.044). There was a significant relationship between Hcy level and sex in psoriasis patients. The hs-CRP values had significant positive correlation with body mass index (BMI) and TC in psoriasis patients (p&lt;0.05). Conclusion: Serum hs-CRP and folic acid levels did not show any significant difference between patients with mild to moderate psoriasis and controls. However, serum Hcy levels increased and inversely correlated with folic acid levels in psoriasis patients. These biomarkers could provide additional information in the evaluation of the atherosclerotic risk in psoriasis

Behçet hastalarında katı mide boşalma zamanının değerlendirilmesi

Amaç: Behçet Hastalığı mukokutanöz sistem, göz, kardiyovasküler sistem, böbrek, akciğer, eklem ve merkezi sinir sistemi tutulumu ile seyredebilen multisistemik bir hastalıktır. Behçet Hastalığında gastrointestinal sistem tutulumu nadirdir. Bu çalışmada mide boşalma sintigrafisi ile Behçet Hastalarında mide boşalma oranlarının araştırılması amaçlandı. Gereç ve Yöntem: Solid mide boşalma oranlarının tesbiti amacıyla 14 Behçet Hastası ile 14 sağlıklı kontrol grubu sintigrafik olarak incelendi. Bir gece açlıktan sonra tüm olgular Tc-99m DTPA ile işaretli yumurta ve kızarmış beyaz ekmekten oluşan solid gıda aldı. Yemek yenilmesinden hemen sonra olgular gamma kamera altı- na sırt üstü yatırıldı ve 90 dakika boyunca sürekli görüntüler alındı. Mide yarı boşalma zamanı (T ½) ve 60. dakikada midede kalan radyoaktif madde oranı hesaplandı. Bulgular: Behçet Hastalarının ortalama yaşı 41.00±10.25, kontrol grubunun ise 40.57±10.05 idi. Behçet Hastalarının T ½ değeri 85± 61 dakika olarak bulunurken kontrol vakalarında 63±22 dakika olarak bulundu (p=0.122). 60. dakikada midede kalan radyoaktif madde oranı Behçet Hastalarında ve kontrol vakalarında sırasıyla % 69.3 ± 14.0 ve % 54.6± 22.0 idi (p=0.035). Tartışma: Mide yarı boşalma zamanları arasında belirgin bir farklılık olmamasına rağmen 60. dakikada midede kalan radyoaktif madde oranı Behçet Hastalarında kontrol grubuna göre belirgin yüksekti. Sonuç olarak gastrik staz Behçet Hastalarında multisistemik tutulum sonucu görülebilir.Aim: Behcet’s disease is a multisystemic disease that includes the mucocutaneous, ocular, cardiovascular, renal, pulmonary, joint and central nervous system involvement. Gastrointestinal system involvement is rare in Behcet’s disease. Current study was planned to investigate the rate of gastric emptying in patients with Behcet’s disease by using gastric emptying scintigraphy. Material and Method: In order to determine gastric emptying rate of solids, 14 patients with Behcet’s disease and 14 healthy controls were studied scintigraphically. After an overnight fast, all subjects ingested a Tc- 99m DTPA labeled solid meal consisted of an egg and toasted white bread. Immediately after ingestion of the meal, subjects were positioned supine under the gamma camera and serial images were recorded continuously for 90 minutes. Half empyting time (t 1/2) and percentage of radioactive material remaining in the stomach at 60 min. were calculated. Results: The mean ages of Behcet’s patients was 41.00&plusmn;10.25 years and 40.57&plusmn;10.05 years in control group. T &frac12; of Beh&ccedil;et’s patients was found 85&plusmn; 61 min. and 63&plusmn;22 min. in control cases (p=0.122). Percentage of radioactive material remaining in the stomach at 60 min. was 69.3&plusmn; 14.0 % and 54.6&plusmn; 22.0 % in Behcet’s patients and controls, respectively (p=0.035). Discussion: Although there was not a significant difference between half gastric emptying times, we determined that percentage of radioactive material remaining in the stomach at 60 min. was significantly greater in Behcet’s patients than that in controls. As a result, gastric stasis could be seen in Beh&ccedil;et’s patients due to multisystemic involvement

Postauricular rotation flap as a method to repair auricular conchal defects

Amaç: Kulak sayvanı yüzün estetik ünitelerinden biri olarak önemlidir. Bu çalışmada kulak konkasında görülen cilt tümörlerinin çıkartılması sonrasında oluşan defektin kapatılmasını sağlayan postaurikuler rotasyon flebi tekniğinin tanıtılması ve tartışılması hedeflenmiştir. Hastalar Ve Yöntemler: Çalışmaya kliniğimize kulak konkası malign cilt tümörü nedeniyle başvuran dört hasta alındı. Hastalardan üçü bazal hücreli karsinom, biri yassı epitel hücreli karsinom tanılıydı. Tüm hastalarda güvenli sınırla tümör rezeksiyonu sonrası oluşan defekt için postaurikuler rotasyon flebi uygulandı. Bulgular: Hiçbir hastada nüks gözlenmedi. Hastaların tamamında fleple rekonstrükte edilen bölge kozmetik olarak kabul edilebilir sınırlardaydı. Bir hastada flepte erken dönemde oluşan dolaşım bozukluğuna bağlı kısmi nekroz debridman ve eksizyonla sekonder iyileşti. Sonuç: Postaurikuler rotasyon flebi kulak konkasında oluşan cilt defektlerinin tamirinde uygulaması kolay ve güvenilir bir yöntemdir.Objectives: Auricula has an importance as an aesthetic subunit of the face. The aim of this study is to introduce and discuss the postauricular rotation flap as a reconstruction method after the removal of the maligncutaneous tumors. Patients And Methods: Four patients with malign cutaneous neoplasm of the auricular concha were included in the study. Three patients were diagnosed as basal cell carcinoma, while one had squamous cell carcinoma. All the patients were underwent a postauricular rotation flap reconstruction after the removal of the tumour with safe margins. Results: No patient had a recurrence of tumour. The reconstructed part of the ear had a considerable aesthetic appearance. Partial necrosis due to insufficient circulation of the flap was secondary healed with debridement and excision. Conclusion: Postauricular rotation flap is a simple and reliable method to reconstruct the conchal defects of the ear