A Case of Familial Lichen Amyloidosis

Familial lichen amyloidosis which is also referred to familial primary cutaneous amyloidosis is a rare clinical variant of cutaneous amyloidosis. Lichen amyloidosis is characterized by persistent, pruritic, small brown papules often located on anterior surfaces of legs which show tendency to form plaques. Amyloid deposits would be identified in papillary dermis in histopathological examination. In our clinic, a 42 year old woman with a widespread involvement describing that similar skin findings were present in her both daughters, elder brother and her nephew was evaluated with suspicion of lichen amyloidosis. In histopathological examination of the involved skin, because of determining amyloid deposits in papillary dermis the case was cited as lichen amyloidosis. Our case was searched for the accompanying diseases such as atopic dermatitis, chronic urticaria, lichen planus, multiple endocrine neoplasia and Kimura disease. The family history of our patient was consistent with autosomal dominant inheritance. Familial lichen amyloidosis has been reported as cases with autosomal dominant inheritance from Russia, Germany, United Kingdom and South America. The genetic researches over familial lichen amylodiosis are limited to the cases with multiple endocrine neoplasia. In this rarely reported cases, further genetical researches are necessary in order to determine the responsible gen locus. (Turkderm 2008; 42: 137-9

Birinci basamak sağlık kuruluşlarında çalışan hekimlerin deri ve zührevi hastalıklar ile ilgili deneyimleri ve mezuniyet öncesi eğitim hakkındaki görüşleri

Background and Design: Most patients with dermatological complaints first present to their general practitioners. In the present study, we aimed to investigate the experiences of primary care physicians on dermatological diseases and their opinions of undergraduate education. Materials and Methods: A questionnaire composed of 15 questions was prepared and was completed by practitioners working in family and community health centers. Results: We included 124 out of 142 practitioners working in family and community health centers in Denizli. Sixty-five practitioners responded the questionnaire. It was recorded that health screening in schools and/or public education were performed as preventive dermatology in 42.8% of the institutions that the practitioners were working in. The most frequent diseases encountered were eczema (37.1%), mycosis (22.7%), urticaria (10.3%), acne (7.2%) and psoriasis (6.9%), respectively. It was determined that practitioners were in need of dermatoscopy among the procedures that are not used routinely by practitioners and in need of education for potassium hydroxide and Wood lamp examination among the procedures that can be used by practitioners easily. It was found that the average dermatology training period for general practitioners was 3.5±2 weeks and most practitioners stated that this duration was insufficient. On-the-job training (median score 8.5), giving place to primary care institutions during education period (median score 8.1), giving place to dermatology during internship (median score 7.8) and case discussions (median score 7.8) were the education facilities that were reported to contribute mostly to postgraduate practical approach. Conclusion: The present study establishes very important data about practitioners' approach to patients with dermatological complaints. Practitioners' opinions of undergraduate education are also of importance because the suggestions were made according to postgraduate experiences

Mini clinical evaluation exercise in undergraduate dermatovenereology education: An experience of University of Pamukkale, Medical Faculty

Background and Design: Mini Clinical Evaluation Exercise (Mini-CEX) is being widely used in medical education and is a reliable and valid method for the assessment of residents' competency in medical interviewing, physical examination, humanistic qualities/professionalism, clinical judgment, counseling skills, organization, and efficiency. In order to enhance formative evaluation methods in our faculty, we planned to apply the method to students on dermatovenereology training. Materials and Methods: The Mini-CEX was performed by residents to 42 medical students. At first, 5 residents were evaluated by a faculty member with Mini-CEX and were informed about their application-oriented evaluator roles. The students were informed prior to conducting the assessment. Standard Mini-CEX form was used for the assessment. The participants were rated in 7 competencies and each was rated using a 9-point Likert scale. At the end of each encounter, students and evaluators rated their satisfaction with Mini-CEX using a 9-point Likert scale. Student's t-test and one-way ANOVA were used for statistical analysis. Student feedback was evaluated with "grounded theory". Results: A total of 50 assessments, 44 in outpatient and 6 in inpatient clinic, were performed. Satisfaction with the Mini-CEX was rated by the evaluators and the students as 7,16 and 7,98, respectively. There was no significant difference between the evaluators in terms of student satisfaction. Average time spent on observing the encounter and in giving feedback was 16.5 and 6.5 minutes, respectively. There was no significant difference between assessors in terms of time spent observing and giving feedback. Average scores of assessed clinical competencies were between 4,28 and 8,14. The highest scores were reported on humanistic qualities/ professionalism whereas the lowest were reported on clinical judgment skills. Discussion: According to our data, we believe that Mini-CEX may be used as an assessment tool in medical education. However, further researches should be carried out by different observers for Mini-CEX to be a part of medical education program

Tear film and ocular surface changes in patients receiving systemic isotretinoin

Purpose: Our aim in this study was to assess the ocular surface and tear film changes in acne vulgaris patients receiving systemic isotretinoin. Material and Method: Twenty-two eyes of 22 patients who received oral isotretinoin (roaccutane®, 0.7 mg/kg/day) for nodular acne vulgaris were enrolled in this prospective study. Tear film break-up time (BUT), Schirmer 1 test scores with anesthesia, ocular surface disease index (OSDI) scores and conjunctival impression cytology scores were recorded before treatment and at 3- and 6-month visits following the beginning of treatment. Results: BUT values decreased and OSDI scores significantly increased at 3 months after treatment (p=0.007 and p=0.018, paired samples test). Schirmer scores did not significantly change by isotretinoin treatment. Of 9 eyes with impression cytology specimens, 4 revealed normal conjunctival findings before treatment. At the 3rd month, there was an increase in the scores characterized by decrease of Goblet cells, and at 6 months of treatment, normal conjunctival findings did not exist in any of the patients (p=0.004, Friedman test). Discussion: Systemic isotretinoin treatment can cause alterations in the tear film and cause dry eye symptoms

Interpratation and adaptation of dermoscopic terminology to our language: Consensus report of the Turkish society of dermatology dermoscopy working group

"Dermoscopic Terminology Consensus Meeting" was held at Ege University Medical Faculty Dermatology Department on the 24th of February in 2012 with the aim of establishing a common language in the translation of the dermoscopic terminology in English literature into Turkish. In this article, the Turkish terminology in which the consensus was reached at that meeting is presented together with the definitions and representative images as a dictionary. © 2013 by Turkish Society of Dermatology

Dermoscopic evaluation of nodular melanoma

Importance: Nodular melanoma (NM) is a rapidly progressing potentially lethal skin tumor for which early diagnosis is critical

TÜRKDERM’de 1999-2007 yılları arasında yayınlanan yazılar ve atıflar: retrospektif değerlendirme

Background and Design: In this report, it has been aimed to investigate the citation rates of the online issues of the "Turkdem" which has been indexed in the Web of Science since 2008. It is aimed also to have a base to comparing with the results of the citations in the indexed years after 2008 in the future. Material and Method: It was searched the articles published in the "review, original article, case report, continious education, letter to editor, surgical prosedurs and what's your diagnosis" sections between 1999-2007 by Google scholar programme. The citations from Ulaknet national medical index, ISI and the other online peer-review journals were grouped according to years and article types. Results: Fourty-six % (n=165), 37% (n=131), 10% (n=35), 5% (n=17) and 1% (n=5) of the searched 356 articles were original articles, case reports, reviews, continous education and letters to editor, respectively. There were also three reports, two and one of which were what's your diagnosis and surgical procedures, respectively. Thirty seven, 30, 7, 5, and one of the cited 80 articles were in the sections of "original article, case report, continiuous education, review and letter to editor", respectively. The number of self made citations was 13 (13%). Although only five citations (5%) were determined in the journals with impact factors higher than 1.4 which have been indexed by the Web of Science, 44 citations (44%) were established in national dermatology journals. Conclusion: These results point out the low use rate of national references