Hand hygiene habits and hand eczema prevalence of healthcare workers during the COVID-19 pandemic

Aim: Hand hygiene has become an important building block in the prevention of the spread of coronavirus disease 2019 (COVID-19). The current study was conducted to determine the hand hygiene habits of healthcare workers and possible risk factors for hand eczema during the COVID-19 pandemic. Materials and Methods: The hand hygiene habits of healthcare personnel working at a university hospital since COVID-19 pandemic started were questioned between December 2020 and February 2021 and they were dermatologically examined to screen for hand eczema. Results: Of the 150 healthcare workers, 56 (37.3%) were doctors and 94 (62.7%) were nurses, and 40 (26.7%) were men and 110 (73.3%) were women. The rate of participants that reported washing their hands more frequently than 25 times daily was 46.0% (n=69), and the rate of disinfectant use was 59.3% (n=89). While 88 (58.7%) of the participants used a moisturizer daily, 62 (41.3%) did not use a moisturizer. Fifteen (10.0%) participants were diagnosed with hand eczema. Conclusion: There was an increase in the daily frequencies of hand washing and use of disinfectants during the COVID-19 pandemic, but our data did not reveal any statistically significant risk factor of hand eczema

Occupational facial dermatoses related to mask use in healthcare professionals

Background Mask use can lead to facial dermatoses due to factors, such as hyperhydration, seborrhea, high humidity caused by sweating, and the occlusive effect of the mask. Aim We investigated mask-related facial dermatoses in healthcare personnel who, since the beginning of the COVID-19 pandemic, had to wear a mask for long hours. Methods In this study, healthcare professionals working at Medipol Mega University Hospital since the beginning of the pandemic were screened for facial dermatoses between December 2020 and February 2021 with a dermatological examination and interview. Results Of the 101 healthcare professionals, 51 (50.5%) were doctors and 50 (49.5%) nurses, and 36 (35.6%) were male and 65 (64.4%) were female. All the participants had been actively working at the hospital for 35-46 weeks since the beginning of the pandemic and wearing N95 or surgical masks for an average of 6-13 h a day. During the dermatological examination, the most common facial dermatosis was acne, which was observed in 55.4% (n = 56) of the cases. Of the 56 acne cases, 41.1% (n = 23) had acne in their history, while 58.9% (n = 33) had new-onset acne. Being female, using a N95 surgical mask compared to surgical mask, and the daily average duration of mask use were determined as risk factors for acne development due to mask use. Conclusions The use of masks, more frequently N95, caused both an increase in existing acne and the development of new acne

Türkiye’de ulusal akne haftasında yapılan bilgilendirme seminerlerinin katılımcıların akne hakkındaki bilgi düzeylerine etkisi

Background and Design: To investigate the contribution of informative presentations about acne vulgaris and questionnaires administered before and after informative meetings on patients' awareness and consciousness. Materials and Methods: Participants were asked to fill out a 20-question survey before and after informative seminars in hospitals and secondary and high schools as part of National Acne Week. The level of statistical significance was set as p <= 0.05. Results: A total of 466 participants completed the survey before and after the seminar, and the mean age of the participants was 17.4 +/- 6.9. Before the seminar, 31.1% of participants thought that acne is originated from the liver, whereas this figure decreased to 16.7% after the seminar. In all, 47.6% of participants consulted doctors and 23.9% consulted social media to seek information about acne; however, after receiving training, 77% preferred to consult a doctor. Of the participants, 51.1% were expecting to see the results of acne treatment in 1 or 2 weeks, whereas 83.3% stated that the effects would be seen in 2 or 3 months after the seminar. When the participants' educational background was grouped as "secondary-high school-other," a statistically significant difference was obtained (p<0.05). Conclusion: Our study features both patients' misconceptions and their incorrect attitudes about acne, and their level of knowledge improved significantly as a result of educational seminars. The relative benefit derived from educational seminars was positively related to the participants' highest level of education.Amaç: Akne vulgaris ile ilgili bilgilendirme toplantısı öncesi ve sonrasında uygulanan anket formları ile bilgilendirici sunumların akne hakkındaki farkındalık ve bilinç düzeylerine katkısını incelemek amaçlanmaktadır. Gereç ve Yöntem: Ulusal Akne Haftası kapsamında hastane, ortaokul ve lise dengi okullarda verilen bilinçlendirme eğitimi öncesi ve sonrasında katılımcılardan 20 soruluk bir anket doldurmaları istendi. İstatistiksel anlamlılık düzeyi p≤0,05 olarak kabul edildi. Bulgular: Eğitim öncesi ve sonrasında anket formunu dolduran 466 kişinin yaş ortalaması 17,4±6,9 idi. Eğitim öncesi katılımcıların %31,1’i aknenin karaciğer kaynaklı olduğunu düşünürken, eğitim sonrası bu oran %16,7’ye indi. Akne hakkında bilgi almak için eğitim öncesi katılımcıların %47,6’sı doktora, %23,9’u sosyal medyaya başvururken, eğitim sonrası %77’si doktora başvurmayı tercih edeceğini belirtti. Katılımcıların %51,1’i akne tedavisinin 1-2 hafta içerisinde etkisini göstereceğini beklerken, eğitim sonrası %83,3’ü 2-3 ay kullandıktan sonra yanıt alınabileceğini belirtti. Kişilerin öğrenim durumları, “ortaokul-lise-diğer” olarak gruplandırıldığında, eğitim sonrası gruplar arasında öğrenim durumlarına göre istatistiksel olarak anlamlı bir farklılık saptandı (p=0,005). Sonuç: Çalışmamız bireylerin hem akne hakkındaki yanlış bilgi ve tutumlarını ön plana çıkarmakta, hem de hekimlerin vereceği eğitim seminerleri ve bilgilendirme toplantıları ile bilgi düzeylerinde kayda değer bir gelişme sağlanacağını göstermektedir

Adherence to systemic therapy in patients with psoriasis during the COVID-19 pandemic: A multicenter study

Background: Adherence to treatment is important in chronic dermatological diseases. There are limited data regarding the adherence to treatment in patients with psoriasis during the COVID-19 pandemic. Aims: We aimed to determine the rates of adherence to systemic treatments in patients with psoriasis and to identify the causes of non-adherence during the COVID-19 pandemic. Methods: We conducted a cross-sectional multicenter study from May 2021 to August 2021. A questionnaire including items regarding sociodemographic characteristics of the patients, disease-related characteristics, and treatment-related characteristics were filled out by the physicians. The Psoriasis Area Severity Index (PASI), Hospital Anxiety, and Depression Scale, and the Dermatology Life Quality Index were calculated. The rate of adherence and non-adherence to treatment and reasons for non-adherence to treatment were examined. Results: A total of 342 patients with psoriasis were included (182 male/160 female) in the study. The mean age of the patients was 45.9 ± 14.2 years. The average duration of psoriasis was 192 ± 134.7 months. While the rate of adherence to treatment was 57.6%, the rate of non-adherence to treatment was 42.4%. There were no significant differences with respect to adherence to treatment in comparison with oral and injection-therapy groups. The most frequent reasons for non-adherence to treatment were inability to go to the hospital (19.2%), concern about the COVID-19 infection (16.3%), discontinuation of the treatment by the doctor (13.7%), inability to reach the doctor (7.3%), and inability to have access to the medication (7.3%). Conclusion: Adherence to oral and injection therapies was fairly high among our patients with psoriasis during the COVID-19 pandemic. Psoriasis severity and duration of medication use had a negative impact on adherence to treatment

Clinical course of psoriasis patients that discontinued biologics during the COVID-19 pandemic

BackgroundSince psoriasis is a chronic disease, it is not recommended to discontinue the treatment agents used. However, in real life, the treatment of psoriasis patients may be interrupted for various reasons. During the pandemic period, the treatment of many patients was also interrupted. ObjectivesTo evaluate relapse and clinical worsening in psoriasis patients whose biological therapy was interrupted during the pandemic and reveal associated factors. MethodsThe study included patients aged >= 18 years, who were followed up with moderate and severe chronic psoriasis controlled by the last biological agent [Psoriasis Area Severity Index (PASI) 75 response achieved] but had to discontinue their treatment during the pandemic. The patients' demographic and clinical characteristics, clinical course after the discontinuation of these agents, presence of clinical worsening, and relapse were evaluated. Risk factors were analyzed with the logistic regression analysis. ResultsThe study included 169 patients, with a mean age of 47.3 +/- 14.5 (18-87) years. The mean biologics-free time was 18.2 +/- 12.3 (2-56) weeks. Clinical worsening was detected in 41.4% and relapse in 48.5% of the patients. The significant risk factors for clinical worsening and relapse in both univariate and multivariate analyses were alcohol use during the biologics-free period, total time off biologics, and the presence of an additional triggering factor. The use of secukinumab and ustekinumab was found to be a protective factor against clinical worsening in multivariate analyses. ConclusionAs the biologics-free period is prolonged, the likelihood of clinical worsening and relapse increases, therefore, we do not recommend discontinuing biological agents

Evaluation of the efficacy, safety, and side effects of secukinumab in patients with moderate-to-severe psoriasis: Real-world data from a retrospective multicenter study

Background: Clinical studies have demonstrated that IL-17A inhibition with secukinumab is effective for clearing the skin of patients with psoriasis and has a favorable safety profile. Objective: The authors aim to determine whether secukinumab is effective and safe for the treatment of moderate-to-severe chronic psoriasis based on clinical experience with this drug. Method: The authors conducted a multicenter retrospective study in nine referral centers and included patients with psoriasis who had received secukinumab between March 2018 to November 2020. Data on demographic characteristics, Psoriasis Area and Severity Index (PASI) scores, and previous treatments were collected from medical records. Patients were evaluated at 12, 24, and 52 weeks with respect to response to treatment and side effects. Results: In total, 229 patients were recruited for the study. A PASI score improvement of ≥90 points over the baseline was achieved by 79%, 69.8%, and 49.3% of patients at weeks 12, 24, and 52, respectively. The most common adverse events wereCandida infections and fatigue. In total, 74 (32%) patients discontinued treatment by week 52, including due to adverse events, or secondary ineffectiveness. Study limitations: Retrospective design. Conclusions: These findings suggest that secukinumab therapy is reasonably effective in patients with moderate-to-severe psoriasis. Comorbidities and time length of the disease can affect the response to treatment. The rates of adverse events were high in this patient population

Skin manifestations following anti-COVID-19 vaccination: A multicentricstudy from Turkey

Purpose: After the emergence of the pandemic caused by the COVID-19 virus, vaccination with various vaccines has started to be implemented across the world. To identify dermatological reactions developing after the COVID-19 vaccines administered in Turkey and determine their clinical features and risk factors that may play a role in their development. Materials and Methods: The study included patients aged ≥18 years, who presented to 13 different dermatology clinics in Turkey between July 2021 and September 2021 after developing dermatological reactions following the administration of the COVID-19 vaccine. After providing written consent, the patients were asked to complete a standard survey including questions related to age, gender, occupation, comorbidities, the regular medication used, the onset of cutaneous reactions after vaccination, and localization of reactions. Dermatological reactions were categorized according to whether they developed after the first or second dose of the vaccine or whether they occurred after the inactivated or messenger RNA (mRNA) vaccine. The relationship between dermatological reactions and some variables such as gender and comorbidities was also evaluated. Results: A total of 269 patients [116 women (43.1%), 153 men (56.9%)] were included in the study. It was observed that the dermatological diseases and reactions that most frequently developed after vaccination were urticaria (25.7%), herpes zoster (24.9%), maculopapular eruption (12.3%), and pityriasis rosea (4.5%). The rate of dermatological reactions was 60.6% after the administration of the mRNA vaccine and 39.4% after that of the inactivated vaccine. There was a statistically significantly higher number of reactions among the patients that received the mRNA vaccine (p = 0.001). Conclusion: The most common reactions in our sample were urticaria, herpes zoster, and maculopapular eruption. Physicians should know the dermatological side effects of COVID-19 vaccines and their clinical features

Patient use of complementary and alternative medicine for psoriasis vulgaris and factors believed to trigger the disease: A multicenter cross-sectional study with 1621 patients

Introduction: Due to the chronic recurrent nature of psoriasis vulgaris (PV) and lack of definitive treatment for the disease, patients often resort to alternative treatments. Physicians seem to have low awareness of this issue. Objectives: To elicit the perceptions of 1,621 PV patients on complementary and alternative medicine (CAM) and examine factors reported to worsen PV. Methods: The patients sociodemographic characteristics, Psoriasis Area Severity Index (PASI), Dermatology Life Quality Index (DLQI), disease duration, and severity were recorded, and the patients CAM use was questioned in detail. The patients were also asked about factors that worsened PV and their experiences with a gluten-free diet. Results: Of the patients, 56.51% had used CAM. The mean age, illness duration, PASI scores and DLQI of those using CAM were significantly higher. CAM use was significantly higher in those with facial, genital involvement, and arthralgia/arthritis. The patients mostly referred to CAM when PV became severe (46.4%). Of the CAM users, 45.52% used herbal topicals. The physicians of 67.03% did not inquire whether they used CAM. Of the participants, 37.73% considered that stress worsened their disease. Gluten-free diet did not affect PV symptoms in 52.22%. Conclusions: Patients CAM use is often overlooked by dermatologists. Our results showed that more than half the patients used CAM and did not share this information with their physicians. Therefore, the awareness of physicians should be increased and patients should be asked about the use of CAM and directed to the appropriate medical treatment options by physicians

Akne tedavisinde tamamlayıcı ve alternatif tedavi yöntemleri

Aknenin ataklarla giden kronik seyri nedeniyle, elimizdeki etkili pek çok tıbbi tedaviye rağmen, daha etkili olan ve yan etki potansiyeli daha az olan tedavi yöntemlerinin arayışı halen sürmektedir. Tamamlayıcı ve alternatif tedavi yöntemleri olarak adlandırılan bu tedavi yöntemlerinden akne tedavisinde özellikle bitkisel tedaviler (fitoterapi), arı venomu, akupunktur ve kupa tedavisi karşımıza çıkmaktadır. Çay ağacı yağı, aloe vera, yeşil çay ve resveratrol başta olmak üzere bitkisel tedavilerin, anti-enflamatuvar, antibakteriyel, antiandrojenik ve/veya sebosüpresif etkileri sayesinde, akne patogenezinde rol oynayan tüm basamaklarda etkili olduklarına dair çeşitli yayınlar mevcuttur. Arı venomunun, antienflamatuvar ve antibakteriyel etkileri nedeniyle, akupunkturun ise anti-enflamatuvar etkisi ile akne tedavisinde etkili olduğu öne sürülmektedir. Kupa tedavisinin, akne tedavisindeki etki mekanizması net olarak bilinmemekle birlikte enflamatuvar lezyonlar üzerine etkili olduğunu bildirilmiştir. Ancak bu tedavi yöntemlerin akne tedavisindeki yeri ve önemini ortaya koymak için kanıt düzeyi yüksek çalışmalara ihtiyaç vardır.Despite many effective medical treatments available for acne, search for more effective treatment methods having potentially less side effects is still continuing due to the chronic progression of acne with attacks. From these complementary and alternative treatment methods, particularly herbal therapies (phytotherapy), bee venom, acupuncture, and cupping stand out. There are various publications arguing that herbal therapies and particularly those involving tea tree oil, aloe vera, green tea, and resveratrol are effective in all the steps involved in acne pathogenesis owing to their anti-inflammatory, antibacterial, antiandrogenic and/or sebosuppressive activities. Bee venom is argued to be effective in acne treatment due to its anti-inflammatory and antibacterial properties and acupuncture due to its anti-inflammatory action. Although the mechanism of action of cupping in acne treatment is not fully known, it has been reported to be effective on inflammatory lesions. There is a need, however, for highly evidenced studies to demonstrate the place and significance of these treatment methods in resolving acne

Aknede diğer kozmetolojik yöntemler

Bu bölümde, aknede, nodülokistik lezyonların tedavisinde uzun yıllardır kullanılan ve kullanılmaya devam edilen intralezyonel kortikosteroid uygulamasına ve komedon ekstraksiyonu gibi basit girişimsel yöntemlere ek olarak skar tedavisinde yeri olan mikrodermabrazyona, püstüler ve yüzeyel kistik lezyonların tedavisinde kullanılan ve günümüzde akne tedavisinde pek tercih edilmeyen kriyoterapiye, komedon tedavisinde yeri olan elektrokoterizasyona ve özellikle atrofik akne skarlarında kullanılan cerrahi işlemlere kısaca değinilmiştir.This section briefly covers the intralesional corticosteroid practice, which has been used for many years in the treatment of nodulocystic lesions in acne, and some simple interventional methods such as pore extraction, as well as microdermabrasion used to treat scars, cryotherapy to treat pustular and superficial cystic lesions, which is not preferred today for acne treatment, electrocauterization used to treat plugged pores, and surgical procedures to treat atrophic acne scars in particular