Insulin resistance in women with hirsutism

Introduction: There are still not enough data showing whether patients with idiopathic hirsutism (IH) also have insulin resistance. The association between polycystic ovary syndrome (PCOS) and insulin resistance is well documented in the literature, but the Rotterdam Consensus has concluded that principally obese women with PCOS should be screened for the metabolic syndrome. We intended to investigate the presence/absence of insulin resistance in non-obese women with hirsutism

A generalized pustular psoriasis flare after CoronaVac COVID-19 vaccination: Case report

CoronoVac is a non-viable vaccine for severe acute respiratory syndrome coronavirus 2 (SARSCoV-2). Nowadays, there has been vaccination program for at-risk groups and older adults in Turkey. We here present 72-year-old male psoriasis patient who developed generalized pustular psoriasis flare after administration of CoronoVac. The COVID-PCR test was negative and investigations for flare etiology were all normal. He was first (to the best of our knowledge) psoriasis patient who developed an erythrodermic flare after the first dose of CoronaVac vaccine

Pitfalls of an Automated Dermoscopic Analysis System in the Differential Diagnosis of Melanocytic Lesions

Dermoscopy plays an important role in the diagnosis of pigmented lesions, particularly in the differential diagnosis of early-stage melanoma. Dermoscopy systems that aim to enable automatic “unmanned-without physician” diagnosis are becoming increasingly common. We aimed to investigate the reliability and weaknesses of diagnosis programs. Furthermore, we attempted to determine whether such programs are superior to diagnosis by a physician, compared to histopathological assessment. The images stored in the DermoGenius ultra-computerized dermoscopy system of the Dermoscopy Unit between January 2008 and December 2008 were surveyed retrospectively. Dermoscopic images made prior to excision of 77 lesions from 51 patients verified by histopathology were reviewed. Nineteen patients were men and 32 were women. Mean age was 35.5 years. Diagnosis by a clinician or automatic analysis revealed that 23 (30%) of the lesions were atypical (dysplastic) nevi, 22 (29%) were compound nevi, 10 (13%) were dermal nevi, 8 (10%) were malignant melanomas, 7 (9%) were common nevi, 6 (7%) were junctional nevi, and 1 (1%) was a blue nevus. Compared to histopathological diagnosis, considered the gold standard, the sensitivity of the automated analysis program was 96.6%, its specificity 14.9%, and its diagnostic accuracy 47%. For the clinician, the values were 100% for sensitivity, 66.7% for specificity, and 95% for diagnostic accuracy.Based on histopathological results, the diagnostic accuracy of the physician was higher than that of the automatic analysis program. Therefore, errors are inevitable when an inexperienced physician assesses patients according to automatic program results.</p

Demographic characteristics, aetiology, and assessment of treatment options in leukocytoclastic vasculitis

A b s t r a c t Introduction: Vasculitides are a heterogeneous group of diseases characterized by inflammation of the blood vessel walls. Etiological factors include infections, drugs, connective tissue diseases, and malignancies. Aim: To examine the demographic characteristics, etiological factors, and treatment options in 75 patients with leukocytoclastic vasculitis. Material and methods: The study included 75 patients diagnosed with leukocytoclastic vasculitis at our clinic. The patients&apos; medical records were reviewed to determine their age, sex, presence of systemic symptoms, possible etiological factors, laboratory results, types of cutaneous lesions, locations of the lesions, treatment options, and disease course. Results: There were 43 women and 32 men. Cutaneous lesions affected only the lower limbs in 60 of the 75 patients (80%) and usually presented as palpable purpura (64%, n = 48). Arthralgia (26.7%, n = 20) was the most frequent extracutaneous symptom. Of the patients with secondary vasculitis, the most common causes were infections and drugs. The mean age of the patients with Henoch-Schönlein purpura was 26.8 years. There was no significant association between age and renal, gastrointestinal, or joint involvement. Conclusions: The most common form of vasculitis in our study was cutaneous leukocytoclastic vasculitis. In most of the patients it appeared to be idiopathic. Among drugs, antibiotics were the most common etiological factor. In 4 patients, the cutaneous leukocytoclastic vasculitis behaved like the paraneoplastic syndrome

Epidemiology of pemphigus in Turkey: One-year prospective study of 220 cases

Pemphigus is a group of rare and life-threatening autoimmune blistering diseases of the skin and mucous membranes. Although they occur worldwide, their incidence shows wide geographical variation, and prospective data on the epidemiology of pemphigus are very limited. Objective of this work is to evaluate the incidence and epidemiological and clinical features of patients with pemphigus in Turkey. All patients newly diagnosed with pemphigus between June 2013 and June 2014 were prospectively enrolled in 33 dermatology departments in 20 different provinces from all seven regions of Turkey. Disease parameters including demography and clinical findings were recorded. A total of 220 patients were diagnosed with pemphigus during the 1-year period, with an annual incidence of 4.7 per million people in Turkey. Patients were predominantly women, with a male to female ratio of 1:1.41. The mean age at onset was 48.9 years. Pemphigus vulgaris (PV) was the commonest clinical subtype (n=192; 87.3%), followed by pemphigus foliaceus (n=21; 9.6%). The most common clinical subtype of PV was the mucocutaneous type (n=83; 43.2%). The mean Pemphigus Disease Area Index was 28.14±22.21 (mean ± Standard Deviation).  The incidence rate of pemphigus in Turkey is similar to the countries of South-East Europe, higher than those reported for the Central and Northern European countries and lower than the countries around the Mediterranean Sea and Iran. Pemphigus is more frequent in middle-aged people and is more common in women. The most frequent subtype was PV, with a 9-fold higher incidence than pemphigus foliaceus.   </p