Co-infection of periorbital herpes zoster duplex bilateralis in COVID-19 re-infected patient

Amaç: Varicella-zoster virüsü (VZV) bir insan nörotrofik virüsüdür ve Herpes Zoster (HZ), önceden geçirilmiş bir suçiçeği enfeksiyonunu takiben VZV’nin dorsal kök gangliyonundaki latent durumundan yeniden aktive olduğunda ortaya çıkan bir enfeksiyondur. COVID-19 enfeksiyonunda yaygın ürtiker, suçiçeği benzeri papülo veziküler erüpsiyon, vaskülitik lezyonlar ve HZ gibi çeşitli deri bulgularına rastlandığı da gözlenmiştir. Bitişik olmayan iki dermatom tutulduğunda, tek taraflı etkilenirse herpes zoster duplex unilateralis; iki taraflı ise, bilateralis olarak adlandırılır. Olgu: 39 yaşında kadın hasta, yüksek ateş, halsizlik, öksürük, nefes darlığı ve her iki göz kapağında oluşan döküntüler nedeniyle kliniğimize başvurdu. Hastanın anamnezinden üç ay önce COVID-19 enfeksiyonu ve eşzamanlı olarak yüz felci geçirdiği öğrenildi. Dermatolojik muayenesi sonucunda iki taraflı üst göz kapağında yer alan eritemli zeminde grupe veziküler lezyonların HZ duplex bilateralis ile uyumlu olduğu düşünüldü. 14. Gün sonunda COVID-19 enfeksiyon bulgularının kaybolması ve deri lezyonlarının tamamen iyileşmesi üzerine hasta taburcu edildi. Sonuç: Olgumuz immunkompetan olmasına rağmen ikinci kez COVID-19 enfeksiyonu geçirirken üst göz kapaklarında HZ duplex bilateralis tanısı alması nedeniyle dikkat çekicidir. COVID-19 enfeksiyonu ile HZ dupleks bilateralis birlikteliği şimdiye kadar literatürde bildirilmemiştir. COVID -19 ile enfekte hastalarda HZ enfeksiyonunun sıradışı tutulumlar ile ortaya çıkabileceği göz ardı edilmemelidir.Aim: Varicella-zoster computer virus (VZV) is a human neurotrophic computer and Herpes Zoster (HZ) is a retargeted selection from potential target in the dorsal root ganglion of a bred varicella VZV. Urticaria, which becomes common when COVID-19 grows, has been observed where papule-vesicular eruptions such as chicken pox and days appearing as HZ are observed. Unilateral herpes zoster duplex unilateralis when in two non-adjacent dermatomes; If it is bilateral, it is called bilateral. Case: A 39-year-old female patient was admitted to our clinic with high fever, weakness, cough, shortness of breath and rash on both eyelids. It was learned from the patient’s anamnesis that he had COVID-19 infection and simultaneous facial paralysis three months ago. As a result of the dermatological examination, it was thought that grouped vesicular lesions on the erythematous background on the bilateral upper eyelid were compatible with HZ duplex bilateralis. At the end of the 14th day, the patient was discharged after the signs of COVID-19 infection disappeared and the skin lesions healed completely. Conclusion: Although our case was immunocompetent, it is noteworthy that she was diagnosed with HZ duplex bilateralis on the upper eyelids while she was infected with COVID 19 for the second time. The coexistence of COVID 19 infection and HZ duplex bilateralis has not been reported in the literature so far. It should not be ignored that HZ infection may occur with unusual involvements in patients infected with COVID-19

Vitiligo tanısı yeni konulan hastalarda koroid melanositleri koroid kalınlıklarını etkiler mi?

Aim: Vitiligo is a chronic skin disease and considered to be an autoimmune, neural, and autocytotoxic pathophysiology in which mainly the melanocytes in the epidermis are focused and destroyed. Therefore, alterations in the choroid and retinal pigment epithelium are expected, and there are very few publications using modern technology in research of this subject. This study aimed to examine the optic disc, retinal nerve fiber layer (RNFL), and choroidal thickness in patients with vitiligo by spectral-domain optical coherence tomography (SD-OCT) as a prospective observational study. Material and Methods: This single-center prospective cross-sectional study included 40 eyes of 40 patients with vitiligo and 42 eyes of 42 healthy individuals. The RNFL thickness, choroidal thickness, and optic disc parameters (rim area, disc area, and cup volume) were compared between the two groups. Results: The study consisted of 21 female and 19 male in the vitiligo group, and 21 female and 21 male in controls; no difference was found in gender distribution between two groups (p=0.836). Vitiligo and control groups had similar optic disc parameters, and RNFL and choroidal thicknesses; so the differences in the mentioned parameters did not differ statistically (p>0.05 for all). Conclusion: Vitiligo patients’ optic disc parameters, and RNFL and choroidal thicknesses did not differ from those in healthy individuals. Based on unknown pathogenesis, the melanocytes at the choroidal region may have compensatory mechanisms in vitiligo.Amaç: Vitiligo, kronik bir deri hastalığıdır ve esas olarak epidermisteki melanositlerin hedef alındığı ve yok edildiği otoimmün, nöral ve otositotoksik bir patofizyoloji olarak kabul edilir. Bu nedenle koroidde ve retina pigment epitelinde değişiklikler beklenir ve bu konuda modern teknolojiyi kullanan çok az yayın mevcuttur Gereç ve Yöntem: Bu çalışmada vitiligolu hastalarda optik disk, retina sinir lifi tabakası (RSLT) ve koroid kalınlığının spektral alan optik koherens tomografi (SD-OKT) ile incelenmesi prospektif gözlemsel bu çalışma amaçlandı. Bu tek merkezli prospektif kesitsel çalışmaya vitiligolu 40 hastanın 40 gözü ve 42 sağlıklı bireyin 42 gözü dahil edildi. RSLT kalınlığı, koroid kalınlığı ve optik disk parametreleri (rim alanı, disk alanı ve cup hacmi) iki grup arasında karşılaştırıldı. Bulgular: Çalışmaya vitiligo grubunda 21 kadın ve 19 erkek, kontrol grubunda 21 kadın ve 21 erkek; iki grup arasında cinsiyet dağılımı açısından fark bulunmadı (p=0,836). Vitiligo ve kontrol gruplarında benzer optik disk parametreleri, RSLT ve koroid kalınlıkları; yani bahsedilen parametrelerdeki farklılıklar istatistiksel olarak farklı değildi (tümü için p>0.05). Sonuç: Vitiligo hastalarının optik disk parametreleri, RSLT ve koroid kalınlıkları sağlıklı bireylerden farklı değildi. Bilinmeyen bir patogeneze bağlı olarak, koroid bölgesindeki melanositlerin vitiligoda kendini telafi edici mekanizmaları olabilir

The clinical characteristics and the frequency of metastatic cutaneous tumors among primary skin tumors

Background and Design: Our aim was to find out the ratio of cutaneous metastatic tumors among all cutaneous and skin appendage tumors and to establish their clinical characteriaMaterial-methods: We scanned the histopathological diagnoses of all the skin tumors records from the archives between 2006 to 2012 and recorded the age, gender, the diagnosis of internal malignancy, the type of cutenous lesion, the location and the period between the appearance of the primary malignancies and cutaneous metastases.Results: We found that 20 (0,48%) out of 4126 skin tumors were diagnosed as cutaneous metastatic tumors. Ten of the patients were men and ten of them were women ( median age of 51,3±18,34). When considered primary internal malignancies of these patients 6 patients with gastroenterologic malignancy, 4 patients with lung cancer, 4 patients with breast cancer, 3 patients with malignant melanoma, 1 patient with Ewing sarcoma, 1 with acute myeloblastic leukemia and 1 with prostatic cancer were diagnosed. The clinical appearance of the tumors were as follows; 14 nodule, 2 eczematized plaque, 2 papule, 1 papulonodule, 1 infitrated plaque. The localizations of the cutaneous metastatic tumors were as follows; 7 lesions on the anterior trunk, 5 lesions on the abdominal wall, 2 lesions on the back, 2 lesions on the thigh, 2 lesions on the scalp, 1 on the anterior arm, 1 on the inguinal site. We found that 3 patients (15 % ) attended with cutaneous metastatic tumors before the diagnosis of internal malignancies while 17 patients (85 %) attended 18,97±24,76 months (1,5 -109 months) after the diagnosis of internal malignancies.Conclusion: Cutaneous metastatic tumors are rarely seen skin lesions. We found that cutaneous metastatic tumors are mostly nodular and with trunk localization. It is important to recogniza these tumors, because they address primary internal tumo

Blastic Plasmacytoid Dendritic Cell Neoplasm: Skin and Bone Marrow Infiltration of Three Cases and the Review of the Literature

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a distinct and rare neoplastic entity and was classified as a subgroup of acute myeloblastic leukemia by the WHO in 2008. The median survival of patients was 15.2 months in a large case series. Allogeneic or autologous bone marrow transplantation has been recommended by some reports because of the disease's poor prognosis. We present three patients who presented with both skin and bone marrow infiltration. A 57-year-old man, a 62-year-old woman, a 64-year-old man were admitted to our outpatient clinic because of skin lesions. All of the patient's had bone marrow infiltration with positivity of the CD4, CD56, and CD123 staining. Survival of the patient's were 42, 6 and 12 months, respectively. Two of the patients who presented as blastic form didn't respond to any chemotherapy. BPDCN is a difficult disease to diagnosis and manage. CD4, CD56, CD123, CD303, and T cell leukemia/lymphoma 1. Cutaneous lesions can present as isolated nodules, macules, and disseminated macules and nodules. Positivities are crucial to the diagnosis of the disease in histological examination. Bone marrow infiltration or disease relapse at presentation were related to poor prognosis. Complete immunocytochemical staining must be performed for all patients who have cutaneous lesions with or without blood count abnormalities. Bone marrow (allogeneic or autologous) transplantation should be considered at the first remission

Has the COVID-19 pandemic changed attitudes and behaviors concerning cosmetic care and procedures among patients presenting to the dermatology outpatient clinic? A multicenter study with 1437 participants

Background The rate of cosmetic procedures and use of skincare products is considered to be affected during the pandemic period; however, this has not been investigated yet. Objective To determine whether the ongoing pandemic has changed people's habits related to skincare products and cosmetic procedures. Methods We conducted a multicenter survey study covering both private and public hospitals. Sociodemographic characteristics and clinical diagnoses of the patients were noted by dermatologists. A survey was used to determine the type and application areas of skincare products and cosmetic procedures before and during the pandemic, whether the patients were concerned about being infected, and any change in the make-up habits of female patients. Results Of the 1437 patients, 86.7% presented to the hospital due to dermatological complaints and 13.3% for cosmetic procedures. The rate of those that did not use skincare products was 0.05% before and 0.06% during the pandemic. Of the participants, 43.2% had undergone cosmetic procedures before and 38.1% during the pandemic. For both periods, the most frequent cosmetic procedure applied was laser epilation, followed by skincare treatment and chemical peeling. While undergoing these procedures, 34.9% of the patients were concerned about contracting coronavirus. Conclusion There was no significant difference in the use of skincare products and cosmetic procedures before and during the pandemic. The majority of the patients continued to undergo these procedures despite their fear of being infected. This shows that during the pandemic period, patients are concerned with their appearance and continue to undergo cosmetic procedures and pay attention to their skincare