254 research outputs found
Dermatoscopic Findings in Palmoplantar Dermatoses
Dermatoscopy is a useful, non-invasive method in the diagnosis of various dermatological diseases. Dermatoscopy of non-pigmented skin lesions shows additional morphologic features, such as cutaneous vascular pattern, scale color and scale distribution pattern, and background color. Dermatoscopy can be useful tool in differential diagnosis in palmoplantar dermatoses. The most specific dermatoscopic features of hand eczema include yellowish-orange globules, yellowish scales and yellowish crusts. Light red background color, regular vascular distribution pattern, dotted vessels and white scale color have been reported in previous studies as dermatoscopic features of palmoplantar psoriasis. Dotted vessels can be seen in various dermatoses, such as psoriasis, eczema, lichen planus, porokeratosis and keratodermas. The distribution pattern and color of the scales are also important in the differential diagnosis of palmoplantar dermatoses. Previous studies have shown that scales are mainly localized in skin furrows in patients with tinea manum. Patchy distributed, homogeneous, structureless, orange areas were reported in palmar keratoderma due to pityriasis rubra pilaris. Amber scales, white-to-pinkish background; sparse whitish scales were reported in palmar keratoderma due to mycosis fungoides. Dermatoscopical findings of palmoplantar area can help in the differential diagnosis of various dermatoses
Retrospective evaluation of patients with pityriasis rosea within last 5 years
Amaç: Pitiriyazis rozea tanısı alan hastalardaki olası etiopatogenik ve çevresel faktörler yanısıra klinik
özelliklerin değerlendirilmesi.
Yöntem: 1996-2001 yılları arasında Celal Bayar Üniversitesi Dermatoloji polikliniğine başvuran ve pitiriyazis
rozea tanısı alan 112 hasta çalışmaya alındı.
Bulgular: Hastaların yaşları 1 ile 65 arasında değişmekte olup yaş ortalaması 46.7 14.7 idi. Hastaların 76'sı
(%67.9) kadın, 36'sı (%32.1) erkekti. Hastalık süresi 1-90 gün arasında değişmekte olup, ortalama süre 18.4 19.1
gündü. Hastaların 89'unda (%79.5) öncesinde infeksiyon öyküsü yoktu. Seksenaltı olguda (%76.8) kaşıntı
yakınması mevcuttu. Beş hasta (%4.5) öncesinde stres öyküsü tanımlıyordu. Mevsimsel dağılıma baktığımızda
hastaların 43'üne (%38.4) kış mevsiminde, 22'sine (%19.6) yaz, 28'ine (%25.0) sonbaharda, 19'una (%17.0)
ilkbaharda tanı konmuştu. Hastaların 97'sinde (%86.6) madalyon plağı gözlendi. Lezyonların dağılımına
bakıldığında; 77 hastada (%68.8) gövde yerleşimli, 34'ünde (%30.3) generalize, 1'inde (% 0.9) alt ekstremite
yerleşimliydi.
Sonuç: Polikliniğimizde tanı alan pitiriyazis rozealı hastaların büyük çoğunluğunun kış mevsiminde ortaya
çıktığı, kaşıntılı seyrettiği ve daha çok gövde yerleşimli olduğu sonucuna varılmıştır.Objective: Theaimofthe study was to assess thepossible aetiopathogenic and environmental factors along with the clinical findings in patients with pityriasis rosea.
Material and Method: We performed a retrospective study of 112 patients with pityriasis rosea who attended our outpatient clinic (Celal Bayar University Dermatology Department) from 1996 to 2001.
Results: The mean age of patients was 46.7+14.7, range between 1 to 65 years. Seventy-six of the patients were female (67.9%) and 36 of them were male (32.1%). Duration pityriasis rosea period was ranging between 1 and 90 days (mean value: 18.4+19.1 days). Eighty-nine (79.5%) of the patients did not have a history of infection. Itching was present in 86 cases (76.8%). Five patients (4.5%) had previous history of stress. When seasonal distrubition was evaluated, the number of patients who were diagnosed in winter, summer, autumn and spring was 43 (38.4%), 22 (19.6%), 28 (25.0%), and 19 (17.0%) successively. Amedallion plaque was observed in 97 patients (86.6 %). Of 112 patients, 77 had lesions localized to trunk (68.8%), 34 had generalized lesions (30.3%) andone showedlesions inlowerextremities (0.9%).
Conclusion: Our results confirm that pityriasis rosea, in our population, is more prevalent in winter, has a predilectin for the trunk and is pruritic
Psychiatric disorders detected among dermatology inpatients who are in need of psychiatric consultation
Kliniığimizde çeşitli dermatolojik şikayetlerle yatan hastalardan psikiyatrik konsültasyon
gerektirenlerdeki ruhsal bozuklukları saptamak.
Ocak 1996 - Aralık 2001 tarihleri arasında Celal Bayar Üniversitesi Tıp Fakültesi Dermatoloji
kliniığinde çeşitli tanılarla yatarak tetkik ve tedavi edilen 394 hasta retrospektif olarak deığerlendirildi. Psikiyatri
kliniıği tarafından deığerlendirilen 66 hasta çalışma grubuna dahil edildi.
Çalışma grubuna alınan 66 yatan hastanın 42'si (% 63.6) kadın, 24'ü (% 36.4) erkekti.Yaşları 15 ile 79
arasında deığişen hastaların yaş ortalaması 43.74 14.34 idi. Hastaların servisimizde yatış süreleri 3 ile 150 gün
arasında deığişmekte olup, ortalama yatış süresi 22.57 26.71 gündü. Psikiyatri kliniığince deığerlendirilen
hastaların 10'unda (%15.2) herhangi bir patoloji saptanmadı. 27'si (%40.9) depresyon, 6'sı (%9.1) BTA (başka
türlü adlandırılamayan) anksiyete bozukluığu, 6'sı (%9.1) obsesif kompulsif bozukluk, 5'i (%7.6) karışık
anksiyete-depresif bozukluk, 3'ü (%4.5) distimik bozukluk, 2'si (%3.0) major depresyon, 1'i (%1.5) konversiyon
bozukluığu, 1'i (%1.5) obsesif kompulsif bozukluk ve depresyon, 1'i (%1.5) mikst anksiyete-depresyon ve obsesif
kompulsif bozukluk, 1'i (%1.5) konversiyon bozukluığu ve reaktif depresyon, 1'i (%1.5) atipik depresyon, 1'i
(%1.5) konversiyon bozukluığu ve distimik bozukluk, 1'i (%1.5) mental retardasyon tanısı aldı.
Dermatolojik hastalıklarla çeşitli psikiyatrik bozuklukların birlikteliığinin oldukça yüksek olduığu ve bu
konunun gözardı edilmemesi gerektiıği sonucuna varıldı.We aimed to determine psychiatric disorders detected among dermatology inpatients who are in need
of psychiatric consultation.
394 dermatology inpatients, who were treated between January 1996 and December 2001 in Celal
Bayar University Hospital, were evaluated retrospectively. 66 patients, examined by psychiatrists were included
in the study.
Of 66 patients 42 (63.6%) were female and 24 (36.4%) were male. Mean age of the patients was
43.74 14.34. Mean hospitalization period was 22.57 26.71 days, ranging from 3 to 150 days. According to the
psychiatric evaluations, no psychiatric abnormality was found in 10 (15.2%) patients. On the other hand, there
was depression in 27 patients (40.9%), anxiete disorder, that can not be named otherwise, in 6 (9.1%), obsessivecompulsive
disorder in 6 (9.1%), mixed anxiete and depressive disorder in 5 (7.6%), distimic disorder in 3
(4.5%), major depression in 2 (3.0%), conversion disorder in 1 (1.5%), obsessive-compulsive disorder and
depression in 1 (1.5%), mixed anxiete-depression and obsessive-compulsive disorder in 1 (1.5%), conversion
disorder and reactive depression in 1 (1.5%), atypic depression in 1 (1.5%), conversion disorder and distimic
disorder in 1 (1.5%), and mental retardation in 1 (1.5%) successively.
As dermatological diseases are associated with psychiatric disorders quite often, one should keep
this in mind while approaching to patients with dermatologic diseases
Post-adolescent acne in the spectrum of acne
Polikliniğimizde akne vulgaris tanısı alan hastalarda postadolesan akne sıklığını belirlemek ve bu
hastalarda lezyon tipi, lokalizasyonu, eşlik eden hirsutismus, menstruel düzensizlikler ve hormonal bozuklukları
değerlendirmektir.
1996- 2001 yılları arasında Celal Bayar Üniversitesi Dermatoloji polikliniğine başvuran 25 yaş
üstündeki akneli hastalar retrospektif olarak incelendi.
Toplam 1853 akneli hastadan 175'i (%9.4) postadolesan akne olarak değerlendirildi. 175 postadolesan
akneli hastanın 143'ünde (%81.7) aknenin 25 yaşından sonra başladığı, 32'sinde (%18.3) ise persistan olduğu
saptandı. Postadolesan akne tanısı alan hastaların yaşları 25 ile 48 arasında değişmekte olup, yaş ortalaması
29.71 5.08 idi. Hastalık süresi 1 ile 240 ay arasında değişmekteydi; ortalama süre 34.37 53.72 ay olarak
belirlendi. Hastaların 144'ü (%82.3) kadın, 31'i (%17.2) erkekti. Lezyon dağılımına baktığımızda 125'i (%71.4)
yüz yerleşimli, 11'i (% 6.3) gövde yerleşimli, 39'u (%22.2) yüz ve gövde yerleşimliydi. Hastaların 159'u (%90.9)
papülopüstüler, 16'sı (%9,1) nodülokistik akne olarak değerlendirildi. Hirsutismus hastaların 20'sinde (%11.4)
gözlendi. Menstruasyon düzensizliği tanımlayan ve/veya hirsutismus saptanan 28 hastadan istenen hormon
tetkikleri, 11 (%39.3) hastada anormal bulunurken; pelvik ultrasonografi tetkikini yaptıran 23 hastadan 7'sinde
(%30.4) polikistik over saptandı.
Hiperandrojenizm ile ilişkisi nedeniyle postadolesan akne tanısı alan hastaların hormonal bozukluklar
açısından araştırılması gerektiği sonucuna varıldı.Our aim was to determine the frequency of post-adolescent acne among acne patients, together with
the type and localization of their lesions, concurrent hirsutismus, menstrual irregularities and hormonal
abnormalities.
We performed a retrospective study of patients with acne over 25-year-old, who attended
our outpatient clinic from 1996 to 2001.
Of 1853 acne patients, 175 (9.4%) were diagnosed as post-adolescent acne. Among these 175 postadolescent
acne patients, 143 (81.7%) had history of acne after 25-years of age, while 32 (18.3%) had persistent
acne. The ages of patients with post-adolescent acne were ranging between 25 and 48 (mean value: 29.71 5.08).
The duration period of disease was ranging between 1 and 240 months (mean value: 34.37 53.72). 144 of the
postadolescent patients (82.3%) were female and 31 (17.2%) were male. When distribution of the lesions were
evaluated, there were facial lesions in 125 patients (71.4%), trunk lesions in 11 patients (6.35%), and both face
and trunk lesions in 39 patients (22.25%). Of 175 patients, 159 (90.9%) had papulopustular and 16 (9.1%) had
nodulocystic acne. Hirsutism was observed in 20 cases (11.4%). When hormones were evaluated in 28 patients
with hirsutism and/or irregular menstruation, abnormal levels were determined in 11 (39.3%) of them; while
pelvic ultrasonographic evaluations revealed polycystic ovary syndrome in 7 (30.4%) of 23 patients, who had
completed their ultrasonographic examinations.
Because of the close association with hyperandrogenetism, postadolescent acne patients have to be
investigated thoroughly in the aspect of hormonal irregularities
Comparison of dermoscopic and histopathologic diagnoses of naevus naevocellularis
Melanositik pigmente deri lezyonlarının birbirinden ayırımı, planlanacak tedavi yaklaşımı açısından
önemlidir. Bu amaçla yapılacak histopatolojik incelemeye alternatif olarak son zamanlarda preoperatif tanısal
doğruluğu belirgin arttıran dermoskopi yöntemi olarak ön plana çıkmıştır. Bu çalışmada, sıkça karşılaştığımız
melanositik pigmente lezyonlardan olan nevus nevosellularislerde dermoskopinin histopatolojik incelemenin
yerine geçip, geçemeyeceği araştırılmıştır.
Çalışmamızda, Eylül 1998- Haziran 1999 tarihleri arasında Celal Bayar Üniversitesi Tıp
Fakültesi Dermatoloji Anabilim Dalı Ben Takip Polikliniği' ne başvuran 22 hastadaki toplam 25 nevus
nevosellularis dermoskopik olarak incelendikten sonra alınan biyopsi materyallerinin histopatolojik tetkiki
yapılmış ve her iki yöntemle konulan tanılar karşılaştırılmıştır. Dermoskopik muayenede el dermatoskopu, slayt
çekimlerinde Dermaphot kullanılmıştır. Dermatoskopi ve histopatoloji yöntemlerinin tutarlılığını ölçmek için
Kappa analizi yapılmıştır.
Dermoskopik olarak 7 jonksiyonel nevus naevocellularis (NNC), 15 bileşik NNC, 3 intradermalNNC
tanısı konulurken, histopatolojik olarak 7 jonksiyonel NNC, 10 bileşik NNC, 8 intradermal NNC tanısı
konulmuştur. Dermoskopik olarak 25 lezyonun 20'si (%80), histopatolojik tanıyla aynı tanıyı almıştır. Kappa
istatistiğinde iki yöntemle konulan tanıların iyi derecede tutarlı olduğu bulunmuştur (K= 0.69).
Noninvaziv tanı yöntemi olarak son yıllarda ön plana çıkan dermoskopinin melanositik pigmente deri
lezyonlarından nevus nevosellularislerin tanısında ve ayrımında histopatolojik incelemenin yerine
geçemeyeceği sonucuna varılmıştır.Differential diagnosis in melanocytic skin lesions is important in determining the treatment modality.
In the past, histopathologic examination was mostly used for this aim. Recently, dermoscopy is widely used as an
alternative noninvasive diagnostic method, so that it increases preoperative diagnostic accuracy. In this study our
aim was to determine whether dermoscopy can substitute for histopathologic examination in the diagnosis of
naevus naevocellularis.
25 naevus naevocellularis of 22 patients, who had admitted to our nevus follow-up
clinic between September 1998-June 1999, were enrolled in this study. After dermoscopic and histopathologic
examinations of all the lesions were completed, the concordance between dermoscopic and histopathologic
diagnoses were evaluated. Manual dermoscope was used for routine dermoscopic examinations. Finally,
dermoscopic photographs of the lesions were taken by Dermaphot. Kappa value was interpreted to assesss the
agreement between dermoscopic and histopathologic methods.
Dermoscopic examination revealed 7 jonksiyonel nevus naevocellularis (NNC), 15 bileþik NNC, 3
intradermal NNC, where as histopathologic examination revealed 7 jonksiyonel NNC, 10 bileþik NNC, 8
intradermal NNC. Of the 25 lesions dermoscopically examined, the diagnoses of 20 (80%) were concordant with
the histopathologic diagnoses. The agreement between dermoscopic and histopathologic methods was good (K
value= 0.69).
Although dermoscopy is widely used as an alternative noninvasive diagnostic method in the
differential diagnosis of melanocytic skin lesions recently, our results have led us to conclude that this popular
method can not substitute for histopathologic examination in the diagnosis of naevus naevocellulari
Bullous pemphigoid associated with prostate adenocarcinoma
Bullous pemphigoid is a common autoimmune skin disease characterized by
the presence of subepidermal blisters. It has been associated with
underlying neoplasia in isolated reports. A 78-year-old man with
generalized blisters was diagnosed as bullous pemphigoid on clinical,
histopathological and direct immunofluorescence grounds. His free and
total prostate specific antigen (PSA) levels were high and
histopathological examination of a prostate specimen revealed prostate
adenocarcinoma. We present this rare case to discuss the possible
association between bullous pemphigoid and prostate adenocarcinoma
TOLL-LIKE RECEPTORS (TLR) 2 AND 4 EXPRESSION OF KERATINOCYTES FROM PATIENTS WITH LOCALIZED AND DISSEMINATED DERMATOPHYTOSIS
There are few studies on the role of innate immune response in dermatophytosis. An investigation was conducted to define the involvement of Toll-Like Receptors (TLRs) 2 and 4 in localized (LD) and disseminated (DD) dermatophytosis due to T. rubrum. Fifteen newly diagnosed patients, eight patients with LD and seven with DD, defined by involvement of at least three body segments were used in this study. Controls comprised twenty skin samples from healthy individuals undergoing plastic surgery. TLR2 and TLR4 were quantified in skin lesions by immunohistochemistry. A reduced expression of TLR4 in the lower and upper epidermis of both LD and DD patients was found compared to controls; TLR2 expression was preserved in the upper and lower epidermis of all three groups. As TLR4 signaling induces the production of inflammatory cytokines and neutrophils recruitment, its reduced expression likely contributed to the lack of resolution of the infection and the consequent chronic nature of the dermatophytosis. As TLR2 expression acts to limit the inflammatory process and preserves the epidermal structure, its preserved expression may also contribute to the persistent infection and limited inflammation that are characteristic of dermatophytic infections
Distribution pattern of psoriasis, anxiety and depression as possible causes of sexual dysfunction in patients with moderate to severe psoriasis
BACKGROUND:
Psoriasis may significantly impair sexual function. Depression and organic factors appear to play a key role in this relation. However, beyond genital psoriasis, the importance of the disease's distribution patterns has not been considered.
OBJECTIVES:
To research sexual function in psoriasis patients and investigate the roles of anxiety, depression and psoriasis' distribution patterns in sexual dysfunction.
METHODS:
A comparative study matched for sex and age was performed. Eighty patients with moderate to severe psoriasis and 80 healthy controls were included. The participants completed the Massachusetts General Hospital-Sexual Functioning Questionnaire, the Hospital Anxiety and Depression Scale, and the Self-Administered Psoriasis Area and Severity Index.
RESULTS:
Psoriasis was associated with sexual dysfunction, odds ratio=5.5 (CI 95% 2.6-11.3; p<0.001). Certain distribution patterns of psoriasis, involving specific body regions, were associated with an increase in sexual dysfunction in the group presenting the disease, odds ratio 7.9 (CI 95% 2.3-33.4; p<0.001). Multivariate logistic regression analysis identified anxiety and depression, and the involvement of these specific areas, as possible independent risk factors for sexual dysfunction in patients with moderate to severe psoriasis.
CONCLUSION:
This study identifies body areas potentially related to sexual dysfunction, independently of anxiety and depression, in psoriasis patients. The results suggest that the assessment of sexual dysfunction and the involvement of these body areas should be considered as disease severity criteria when choosing the treatment for psoriasis patients
Evaluation of the occurrence of sexual dysfunction and general quality of life in female patients with psoriasis
Background: Psoriasis has a significant impact on quality of life (QoL). Sexual life can also be affected, with sexual dysfunction being reported by 25-70% of patients. Objectives: To determine the occurrence of sexual dysfunction and evaluate QoL in women with psoriasis. Methods: This case-control study included women aged 18-69 years. The validated Brazilian Portuguese versions of the Female Sexual Function Index (FSFI) and of the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) were administered to all participants to assess sexual function and QoL, respectively. Patients with psoriasis underwent clinical evaluation for the presence of comorbidities, especially psoriatic arthritis and other rheumatic manifestations. Location of lesions and the extent of skin involvement were also assessed. Results: The sample consisted of 150 women, 75 with diagnosis of psoriasis and 75 healthy controls. Prevalence of sexual dysfunction was high in women with psoriasis (58.6% of the sample). Prevalence was statistically higher in women with psoriasis than in controls (P = 0.014). The SF-36 domain scores were also lower in women with psoriasis, with role limitations due to physical health, limitations due to emotional problems, and mental health being the most affected domains. Study limitations: Sample size was calculated to evaluate the association between the occurrence of sexual dysfunction and psoriasis, but it did not include the determination of the possible causes of this dysfunction. Conclusions: QoL and sexual function were altered in women with psoriasis and should be taken into consideration when assessing disease severity
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