Definition of videodermoscopic features of demodicosis

Background Diagnosis of demodicosis is usually confirmed by standardized skin surface biopsy. The skin of the patients with demodicosis is usually very sensitive. There is a need for new noninvasive tests. Videodermoscopic findings of demodicosis have not been validated yet. Our aim was to provide a noninvasive and easy method for diagnosis of demodicosis by using videodermoscopy. Materials and methods This study included 26 patients with demodicosis which were confirmed with microscopy and responded well to anti-Demodex therapy Twenty-six age- and sex-matched individuals without demodicosis constituted the control group. Dermatologic evaluation included clinical observation along with microscopy. All photographs of the clinical and dermoscopic findings were taken with videodermoscope. Results Demodex tails representing "Demodex mites" were a common feature in all patients. Gray dots were described as the second major videodermoscopic finding. Epidermal scale and red dots were also observed with higher prevalence than the other videodermoscopic features. We defined a new finding as follicular annular pigmentation corresponding to the facial pigmentation with demodicosis by videodermoscopy. Conclusions We concluded that it seems possible to confirm the clinical diagnosis of demodicosis by videodermoscopy, with similar results to handheld dermoscopy. Demodex tails should be considered as a sign of demodicosis, whereas detection of gray dots, epidermal scale, and red dots may raise the suspicion of demodicosis

Evaluation of Treatment Response by Using a Handheld Dermoscope in Patients with Alopecia Areata

Objective: Treatment response is variable in patients with alopecia areata, and may not be understood until significant hair growth is obtained. The aim of this study is to determine the potential benefit of handheld dermoscope in evaluating of treatment success in alopecia areata. Methods: Forty-nine patients who were diagnosed with alopecia areata were included in the study. Diagnosis was established clinically, and scalp biopsy was performed in doubtful cases. Dermoscopic examinations were performed by a polarized light and handheld dermoscope with 10-fold magnification. The images were taken by a digital camera with threefold optical zoom. Among 49 patients, 30 of them were followed-up during six months and concluded the study. Results: Of the 30 patients, 12 had a complete response to treatment (group 1), whereas 18 patients did not respond well to treatment or were remained completely responseless (group 2). When the trichoscopic findings were examined pretreatment, only thinning hairs were significantly more frequent in group 1 than group 2. The pre- and posttreatment findings of group 1 was shown that yellow dots, black dots, thinning hairs and broken hairs decreased or disappeared after the treatment, and this difference was statistically significant. In all of the patients in the first group, short terminal hairs were appeared at the end of treatment. Conclusion: According to our study, polarized light handheld dermoscope provides benefit for the evaluation of treatment success in patients with alopecia areata

A moderate response to plasmapheresis in nephrogenic systemic fibrosis

Nephrogenic systemic fibrosis (NSF) is a recently identified idiopathic cutaneous fibrosing disorder that occurs in the setting of renal failure. The disease initially called nephrogenic fibrosing dermopathy is closely linked to exposure to gadolinium-based contrast media used during magnetic resonance imaging in patients with renal insufficiency. Although little is known about the pathogenesis of this disease, the increased expression of transforming growth factor-beta has been demonstrated recently. Herein, we present a case of NSF was partially treated due to a moderate and temporary response to plasmapheresis with no recurrence for 6 months, but returned at the end of 6th month

The impact role of childhood traumas and life events in patients with alopecia aerate and psoriasis

© 2014, Ismail Volkan Şahiner et al.Background: Alopecia areata (AA) and psoriasis are common dermatological diseases which may be associated with psychosomatic origin. Close relationship with stressful life events has been shown both AA and psoriasis in previous studies. Dermatologic diseases which are thought to be psychosomatic origin are not examined about childhood traumas except AA. In the literature there is no study that investigates both stressful life events with childhood trauma in healthy indiviudals and dermatological diseases with psychosomatic origin such as AA and psoriasis. Objective: To determine whether stressful life events and childhood traumas play a role in AA is the first aim of this study. If it is, will this role specific for AA as a second aim? The patients with psoriasis and healthy individuals were also investigated too. Methods: Patients (range: 18-70 years of age) with a diagnosis of AA and psoriasis who admitted to Dermatology Outpatient Department of Baskent University Medical Faculty between August 2009 and July 2010 were recorded and analyzed for our study. Healthy individuals without past or present psychiatric symptoms proven by the Composite International Diagnostic Interview (CIDI) as control group were selected randomize. Forty patients with AA, 30 patients with psoriasis, and 50 healthy subjects as controls were stratified as three individual groups. The Childhood Trauma Questionnaire, the Life Events Checklist, The Beck Depression Inventory, and the Beck Anxiety Inventory and socio demographic data questionnaire were administered to the participants. Informed consent was obtained from all participants. Results: The rate of childhood traumatic events, the stressful life events, anxiety and depression scores were significantly higher in both AA and psoriasis group than healthy controls. Significant difference was not found between AA and psoriasis patients. Conclusion: Childhood traumas and stressful life events may play a role in the pathogenesis of AA. In addition, this role may also apply to other psychosomatic diseases as psoriasis. This result may let us understand the role of past and present psychological stressors in the etiology of dermatologic psychosomatic diseases. Psycho dermatologic new approaches are needed to evaluate stressful life events and childhood traumas

Awareness Of Hepatitis B Virus Reactivation Among Physicians Administering Immunosuppressive Treatment And Related Clinical Practices

Objective: This study aimed to evaluate the awareness and knowledge levels of all physicians administering immunosuppressive treatment concerning hepatitis B virus (HBV) reactivation, and draw attention to the importance of the subject through evaluation. Methods: The study was carried out by infectious diseases and clinical microbiology specialists in 37 health centers, and it was performed in Turkey between January and March 2017. All specialists providing a written consent and working in the departments of Medical Oncology, Hematology, Dermatology and Venereology, Physical Medicine and Rehabilitation, and Rheumatology of each study center were included in the study. Results: A total of 430 physicians participated in the study. Their mean age was 39.87 +/- 7.42 years, and 47.9% of them were males. During their career, 39.3% of these physicians had encountered patients developing HBV reactivation while receiving immunosuppressive treatment. The rate of encountering patients who died due to HBV reactivation was 6.5%. 97% of physicians who participated, considered the risk of HBV reactivation to be important. 70.2% of physicians stated that guidelines related to HBV reactivation and antiviral treatment for these patients were discussed in the congresses they participated, regarding their specialties. The rate of performing hepatitis screening among physicians whose patients developed HBV reactivation was statistically significantly higher than those physicians who had no patients with HBV reactivation (p<0.05). Physicians who used the guidelines related to HBV reactivation in their specialties performed screening for the HBV infection much more often than physicians who did not use the guidelines (p=0.002). Conclusions: According to the results obtained in our study, the rates of conducting screening and awareness of HBV reactivation among physicians administering immunosuppressive treatment were higher compared with similar studies; however, their awareness that HBV DNA and anti-HBc should be utilized much more frequently among the serological tests they use for screening of HBV infection, should be increased.WoSScopu