Dermatolojik Açıdan Labial Füzyon: Prospektif Çalışma

Aim:Labial fusion is a common condition in prepubertal girls and has several complications. Some dermatological conditions were reported as etiologic factor for this disease. The aim of this study is to evaluate the etiological factors of labial fusion in children through a dermatologic view and to compare the socio-demographic, and environmental data of patients with healthy children.Materials and Methods:In this cross sectional prospective study,23 patients with labial fusion and 49 age-sex matched healthy subjects were questioned and examined from dermatological aspect and assessed by aquestionnaireResults:In the control group; 35 % of mothers graduated from university. In children with labial fusion 35% and 26% of mothers graduated from primary school and university, respectively. The atopic family history and history of atopic diseases of patients were higher in labial fusion group when compared with healthy controls. (p<0.001, p <0.001) There were complaints of pre-erythematous lesions with a mean of 1.26±1.32 (median: 1.00) weeks before labial fusion in 60.9% (n:14) of patients with labial fusion. The alcohol based baby wipes usage was higher in group with labial fusion (p = 0.035).Conclusion:Labial fusion can be diagnosed in children of mothers with lower grade education, with family and personal atopic history and diseases, and frequent usage of alcohol based baby wipes. Also erythema in genital area could need follow-up in first month of visit for prevention or early diagnosis of labial fusion.Amaç:Labial füzyon, prepubertal kızlarda sık görülen bir durumdur ve çeşitli komplikasyonları vardır. Bazı dermatolojik durumlar bu hastalık için etiyolojik faktör olarak bildirilmiştir. Bu çalışmanın amacı çocuklarda labial füzyonun etiyolojik faktörlerini dermatolojik olarak değerlendirmek; sosyodemografik ve çevresel verilerini sağlıklı çocuklarınkilerle karşılaştırmaktır. Materyal ve Metot:Bu kesitsel prospektif çalışmada, 23 tane labial füzyon olgusu ve 49 tane yaş cinsiyetine uygun sağlıklı denekler dermatolojik açıdan değerlendirildi ve tümüne bir anket uygulandı. Bulgular:Kontrol grubunda; annelerin %35’I üniversite mezunudur. Labial füzyonlu çocuklarda annelerin %35’'i ilkokuldan ve %26’sı üniversiteden mezun bulunmuştur. Atopik aile öyküsü ve hastaların atopic hastalık öyküsü, labial füzyon grubunda sağlıklı kontrollere gore daha yüksekti (p <0.001, p <0.001). Labial füzyon grubundaki olguların %60.9’unda (n:14) ortalama1.26 ± 1.32 (ortanca: 1.00) hafta öncesinde pre-eritematöz lezyon şikayeti mevcuttu. Alkol bazlı bebek mendillerinin kullanımı labial füzyonlu grupta daha yüksekti (p = 0.035). Sonuç:Annelerin eğitim düzeyi düşük olan; aile ve kişisel atopic öyküleri ve hastalıkları bulunan; alkol bazlı bebek mendilleri sık kullanılan çocuklarda labial füzyon saptanmaktadır. Ayrıca, genital bölgede eritemi olan çocuklar labial füzyonun erken tanısı ve önlenebilmesi için muayeneden sonraki ilk bir ay boyunca takip edilmelidir

Dermatological Aspect of Labial Fusion: A Prospective Study

Aim:Labial fusion is a common condition in prepubertal girls and has several complications. Some dermatological conditions were reported as etiologic factor for this disease. The aim of this study is to evaluate the etiological factors of labial fusion in children through a dermatologic view and to compare the socio-demographic, and environmental data of patients with healthy children.Materials and Methods:In this cross sectional prospective study, 23 patients with labial fusion and 49 age-sex matched healthy subjects were questioned and examined from dermatological aspect and assessed by a questionnaire.Results:In the control group; 35 % of mothers graduated from university. In children with labial fusion 35% and 26% of mothers graduated from primary school and university, respectively. The atopic family history and history of atopic diseases of patients were higher in labial fusion group when compared with healthy controls. (p<0.001, p <0.001) There were complaints of pre-erythematous lesions with a mean of 1.26±1.32 (median: 1.00) weeks before labial fusion in 60.9% (n:14) of patients with labial fusion. The alcohol based baby wipes usage was higher in group with labial fusion (p = 0.035).Conclusion:Labial fusion can be diagnosed in children of mothers with lower grade education, with family and personal atopic history and diseases, and frequent usage of alcohol based baby wipes. Also erythema in genital area could need follow-up in first month of visit for prevention or early diagnosis of labial fusion

The Psychiatric Aspects of Alopecia Areata

Alopecia areata (AA) refers to noncicatricial hair loss. It is defined as a secondary psychiatric disorder in the classification of psycho dermatological disorders. Its profound effect on a person’s physical appearance and the resulting emotional stress have led many researchers to investigate psychiatric aspects of AA in recent decades [1, 2]. This study presents a review of the literature and highlights psychiatric aspects of AA. The results showed that both pediatric and adult patients with AA have a high risk of depression and anxiety. Dermatologists should consider a psychiatric evaluation of female patients under 20 years with AA to detect potential depression and anxiety. As much as alexithymia also in association of AA and other psychiatric disorders, such as schizophrenia, obsessive-compulsive disorder (OCD), personality, manic, bipolar, attention deficit, phobic disorders, further investigations are needed. The evaluation of the psychological status of patients with AA is extremely important to aid the well-being of individuals suffering from this disease

Lichen nitidus presenting with trachyonychia

[No Abstract Available

The Effectiveness of Genital Wart Treatments

Human papillomaviruses (HPV) are a family of DNA viruses that infect the epithelium. They cause benign proliferative lesions called anogenital warts. HPV infection is common in men and women and is the most common sexually transmitted infection. HPV infection can cause cervical, penile, anal, vaginal, vulvar and oropharyngeal cancers. Genital warts adversely affect the quality of life. It may cause anxiety, guilt, anger, and loss of self-esteem and may cause anxiety about the cancer risk. For the diagnosis, generally, visual inspection is enough. Different kinds of treatments have been reported. Genital wart treatments are generally painful, prolonged, hard for the patient to apply, and unfortunately often with recurrence of the lesions seen after treatment. Although many treatment methods are used, their superiority to each other is unclear. In this review, we investigate self-application treatments, clinical-based treatments and alternative treatments

Alerjik kontakt dermatitli olgularda yama testi: Üç yillik retrospektif Tekirda? ili sonuçlari]

Background and Design: Allergic contact dermatitis (ACD) is a delayed-type hypersensitivity reaction to allergens in individuals who have been previously sensitized to an allergen. The causative allergens may change in time and may vary by geographic area and population. Materials and Methods: We retrospectively analyzed the patch test results and characteristics of 169 patients-107 (63.3%) male, 62 (36.7%) female-, who received the diagnosis of ACD between 2011 and 2014. Results: The mean age of the patients was 41.06 years and the mean disease duration was 19.5 months. The most common occupation was service sector/housewifery (26.6%). The most frequent localization of the disease was the hands (n=105, 73%) and 50.3% of patients were skin test positive to at least one allergen. The most frequent seven allergens were nickel sulfate (n=50, 29.6%), cobalt chloride (n=23, 13.6%), potassium dichromate (n=22, 13%), sesquiterpene lactone mix (n=18, 10.7%), thiuram (n=10, 5.9%), clioquinol mix (n=10, 5.9%), and 4-tert-butilfenol formaldehyde resin (n=10, 5.9%), respectively. On the other hand, no patient, had a positive reaction to N-Isopropyl-N-phenyl-4-phenylenediamine, epoxy resin, balsam of peru, formaldehyde, quaternium-15, primin, tixocortol-21-pivalate, and fragrance mix-2. Conclusion: In comparison of this study which is the first report of patch test results of patients in Tekirdag-a city in Thrace region-and other studies that report patch test results in different regions of our country; it was observed that the mean age of patients in the present study was higher than in other studies and there was no significant difference in terms of occupations of the patients and localization of the disease between the eastern region and Thrace region. We believe that further multicenter studies in a larger population performed in different cities of the country are needed to specify allergen characteristics of Thrace region

The Relationship Between Recurrent Aphtous Stomatitis and Macrophage Migration Inhibitory Factor Levels

AimRecurrent aphtous stomatitis (RAS) is the most common mucosal disease with unknown etiology. Macrophage migration inhibitory factor (MIF) is a proinflamatory cytokine which has a role in T cell activation. This study aimed to investigate importance of MIF in etiology of RAS.Materials and Methods70 patients who were above the age of 18, clinically diagnosed RAS and 72 healthy volunteers were included into the study. Patients and control subjects were examined for MIF seroprevalence by ELISA.ResultsThere were no significant difference between RAS and control groups in mean values of MIF. In comparison of RAS patients in two subgroups- with RAS score above 6 and with 5 and less than 5, there were also no significant difference between these subgroups in mean values of MIF. On the other hand the reccurrence of lesions and mean values of MIF showed no relevance.ConclusionEventhough proposed in the hypothesis of this study, there had been no statistically significant relationship between MIF and RAS etiology

Rekürrent aftöz stomatit hastalarında “makrofaj migrasyon inhibitör faktör” değerlerinin normal populasyon ile kıyaslanması

Rekürren aftöz stomatit(RAS) en sık rastlanılan ağız mukozası hastalıklarından biridir. Olası etyolojik faktörleri lokal ve sistemik koşullar ile genetik, immünolojik ve mikrobiyal faktörlerdir. Pek çok çalışmada hücresel immünitenin özellikle T hücre alt tiplerinin etyolojide yeri gösterilmiştir. Makrofaj migrasyon inhibitör faktör(MIF) ilk kez makrofajları inflamasyon alanına yoğunlaştıran bir lenfokin olarak tanımlanmış ve hücresel immünitede önemli rolü olduğu gösterilmiştir.Bu çalışmamızın amacı RAS hastalarında serum MIF konsantrasyonlarının normal populasyon arasındaki farkı kıyaslayarak MIF’in RAS oluşumundaki yerini araştırmaktır.Özet:Rekürren aftöz stomatit(RAS) en sık rastlanılan ağız mukozası hastalıklarından biridir. Olası etyolojik faktörleri lokal ve sistemik koşullar ile genetik, immünolojik ve mikrobiyal faktörlerdir. Pek çok çalışmada hücresel immünitenin özellikle T hücre alt tiplerinin etyolojide yeri gösterilmiştir. Makrofaj migrasyon inhibitör faktör(MIF) ilk kez makrofajları inflamasyon alanına yoğunlaştıran bir lenfokin olarak tanımlanmış ve hücresel immünitede önemli rolü olduğu gösterilmiştir.Bu çalışmamızın amacı RAS hastalarında serum MIF konsantrasyonlarının normal populasyon arasındaki farkı kıyaslayarak MIF’in RAS oluşumundaki yerini araştırmaktır.Özet:Rekürren aftöz stomatit(RAS) en sık rastlanılan ağız mukozası hastalıklarından biridir. Olası etyolojik faktörleri lokal ve sistemik koşullar ile genetik, immünolojik ve mikrobiyal faktörlerdir. Pek çok çalışmada hücresel immünitenin özellikle T hücre alt tiplerinin etyolojide yeri gösterilmiştir. Makrofaj migrasyon inhibitör faktör(MIF) ilk kez makrofajları inflamasyon alanına yoğunlaştıran bir lenfokin olarak tanımlanmış ve hücresel immünitede önemli rolü olduğu gösterilmiştir.Bu çalışmamızın amacı RAS hastalarında serum MIF konsantrasyonlarının normal populasyon arasındaki farkı kıyaslayarak MIF’in RAS oluşumundaki yerini araştırmaktır.Özet:Rekürren aftöz stomatit(RAS) en sık rastlanılan ağız mukozası hastalıklarından biridir. Olası etyolojik faktörleri lokal ve sistemik koşullar ile genetik, immünolojik ve mikrobiyal faktörlerdir. Pek çok çalışmada hücresel immünitenin özellikle T hücre alt tiplerinin etyolojide yeri gösterilmiştir. Makrofaj migrasyon inhibitör faktör(MIF) ilk kez makrofajları inflamasyon alanına yoğunlaştıran bir lenfokin olarak tanımlanmış ve hücresel immünitede önemli rolü olduğu gösterilmiştir.Bu çalışmamızın amacı RAS hastalarında serum MIF konsantrasyonlarının normal populasyon arasındaki farkı kıyaslayarak MIF’in RAS oluşumundaki yerini araştırmaktır.Introduction Recurrent aphtous stomatitis (RAS) is the most common mucosal disease with unknown etiology. Macrophage inhibition factor(MIF) is a proinflamatory cytokine which has a role in T cell activation. This study aimed to investigate importance of MIF in etiology of RAS. Material and Methods 70 patients who were above the age of 18, clinically diagnosed RAS and 72 healthy volunteers were included into the study. Patients and control subjects were examined for MIF seroprevalence by ELISA. Results There were no significant difference between RAS and control groups in mean values of MIF. In comparison of RAS patients in two subgroups- with RAS score above 6 and with 5 and less than 5, there were also no significant difference between these subgroups in mean values of MIF. On the other hand; the reccurrence of lesions and mean values of MIF showed no relevance. Conclusion Eventhough proposed in the hypothesis of this study, there had been no statistically significant relationship between MIF and RAS etiology

TEKİRDAĞ BÖLGESİ YÜZEYEL MANTAR ENFEKSİYON ETKENLERİNİN FARKLI YÖNTEMLERLE İDENTİFİKASYONU VE ANTİFUNGAL DUYARLILIĞI

Yüzeyel mikozlar, dünyanın her tarafında yaygın olarak görülmekte olup, ekolojik koşullara bağlı olarak değişen izolasyon sıklığı bildirilmektedir. Çalışmamızın amacı; Tekirdağ bölgesinde yüzeyel mikozlarda en sık etken olan dermatofit ve mayaların araştırılması ve izolatların sık kullanılan antifungal ajanlardan mikonazol, itrakonazol, terbinafin ve nistatin’ e karşı yanıtlarının antifungal duyarlılık testiyle belirlenmesidir. Çalışmamızda; 11.10.2011-08.04.2013 tarihleri arasında Namık Kemal Üniversitesi Sağlık Uygulama ve Araştırma Merkezi Deri ve Zührevi Hastalıklar Kliniğinden Mikrobiyoloji Laboratuvarına gönderilen 726 hastaya ait toplam 898 örnek geleneksel yöntemler ile incelenmiş ve yüzeyel mikoz etkeni olarak belirlenen 159 izolatın, identifikasyonu önce geleneksel daha sonra moleküler yöntemlerle yapılmıştır. Yüzeyel mikoz sıklığı %17,7 olarak saptanmıştır. Üreme saptanan örneklerin 100 (%62.9)’ ü dermatofit ve 59 (%37.1)’ u maya olarak tanımlanmıştır. Hastalardan alınan örneklerin enfeksiyon bölgelerine göre dağılımına bakıldığında; en sık karşılaşılan klinik tablo sırasıyla tinea pedis (n=476, %53) ve tinea unguium (n=321, %35.74) olmuştur. İzole edilen dermatofitler; T. rubrum (%66), T. mentagrophytes (%15), M. canis (%8), T. tonsurans (%4), T. verrucosum (%3), E. floccosum (%3) ve T. terrestre (%1)’ dir. Maya izolatlarının tanımlamalarına bakıldığında; %31’ si C. glabrata, %15.25’ si C. guillermondii, %11.86’ sı C. albicans, %6.77’ si C. tropicalis, %3.38’ i C. dubliniensis, %1.69’u C. keyfr, %1.69’u C. krusei, %1.69’u C. lusitaniae, %1.69’u C. parapsilosis, %1.69’u C. zeylanoides, %1.69’u Rhodotorula sp. olarak saptanmıştır. Antifungal duyarlılık düzeylerine bakıldığında; T. rubrum suşlarının T. mentagrophytes suşlarına göre minimal inhibisyon konsantrasyonlarının (MİK) daha yüksek olduğu görülmüştür. Türler arasında en düşük MİK değerleri T. verrucosum ve T.terrestre suşlarında görülmüştür. Mayaların çeşitli antifungallere karşı duyarlılıkları incelendiğinde izolatların mikonazol, itrakonazol ve terbinafin’ e direnç geliştirdiği görülmüştür. Nistatine karşı daha az direnç saptanmıştır.Superficial mycoses, a worldwide infection shows different isolation rates due to ecological factors.The aim of our study was to detect the common causes of superficial mycoses in Tekirdağ region and antifungal susceptibilities of the isolates to miconazole, itraconazole,terbinafin and nystatine. A total of 898 samples of 726 patients which were sent to Microbiology laboratory from the Clinics of Dermatology of Namık Kemal University Hospital, between 11.10.2011 and 08.04.2013 were primarly examined with classical mycological methods, followed by molecular and classical identification methods of 159 agents of superficial mycoses. The frequency of superficial mycoses was 17.7%. Of the isolates, 100(62.9%) were dermatophytes and 59(37.1%) were yeasts. The most common clinical appearence were; tinea pedis(n=476, 53%) and tinea unguium (n=321, 35.74 %). The dermatophyte isolates were; T. rubrum (66%), T. mentagrophytes (15%), M. canis (8%), T. tonsurans (4%), T. verrucosum (3%), E. floccosum (3%) and T. terrestre (1%).The yeasts isolates were; C. glabrata (31%), C. guillermondii (15.25%), C. albicans (11.86%), C. tropicalis (6.77%), C. dubliniensis (3.38%), C. keyfr (1.69%), C. krusei (1.69%), C. lusitaniae (1.69%), C. parapsilosis (1.69%), C. zeylanoides (1.69%), Rhodotorula spp. (1.69%) respectively. As a result of susceptibility tests; MIC of T.rubrum were found higher than T. mentagrophytes isolates. The lowest MIC values were detected with T. verrucosum and T.terrestre. Resistance to miconazole, itraconazole and terbinafin was higher, whereas low resistance rates were detected to nystatine

Role of GDF-15 as an inflammatory marker in patients with psoriasis vulgaris

Background and Design: Psoriasis is a chronic, inflammatory disease, and several biochemical markers play role in its inflammatory process. This study measured the levels of interleukin-12 (IL-12), IL-17a, IL-22 and IL-23, high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-alpha) and serum growth differentiation factor-15 (GDF-15) and aimed to detect the relationship of serum GDF-15 level with inflammation and disease severity. Materials and Methods: This study included 50 consecutive patients diagnosed with plaque-type psoriasis. For all patients, dermatological examinations were performed, and psoriasis area severity index (PASI) scores were recorded. Patients with PASI 20 severe (group 3) psoriasis. Results: No difference was observed between the patient and the control groups in terms of age, sex, IL-17a and IL-22. A statistically nonsignificant difference was detected in terms of IL-12 and IL-23. However, there was significant difference between two groups in terms of hs-CRP, TNF-alpha and GDF-15. GDF-15 was significantly different in all three groups (p1498.5 pg/mL (area under the curve: 0.813, p<0.001) in the receiver operating characteristic curve analysis. This study is mainly limited by the lack of follow-up and pre-and post-treatment assessment. Inflammatory markers were measured only in the serum, and their tissue levels are unknown. Conclusion: In addition to PASI score, GDF-15 levels can be a guide in monitoring treatment and systemic inflammation, determining the disease severity, and providing efficient treatment