Clinical practice guidelines for the diagnosis and treatment of scabies.

Scabies, caused by the Sarcoptes scabiei var hominis mite burrowing into the skin, is a highly contagious disease characterized by intense nocturnal itching. Its global impact is considerable, affecting more than 200 million individuals annually and posing significant challenges to healthcare systems worldwide. Transmission occurs primarily through direct skin-to-skin contact, contributing to its widespread prevalence and emergence as a substantial public health concern affecting large populations. This review presents consensus-based clinical practice guidelines for diagnosing and managing scabies, developed through the fuzzy Delphi method by dermatology, parasitology, pediatrics, pharmacology, and public health experts. The presence of burrows containing adult female mites, their eggs, and excreta is the diagnostic hallmark of scabies. Definitive diagnosis typically involves direct microscopic examination of skin scrapings obtained from these burrows, although dermoscopy has become a diagnostic tool in clinical practice. Treatment modalities encompass topical agents, such as permethrin, balsam of Peru, precipitated sulfur, and benzyl benzoate. In cases where topical therapy proves inadequate or in instances of crusted scabies, oral ivermectin is recommended as a systemic treatment option. This comprehensive approach addresses the diagnostic and therapeutic challenges associated with scabies, optimizing patient care, and management outcomes.

Assessment of Oxidative/Nitrosative Stress and Raftlin in Vitiligo.

Background: Vitiligo is a chronic skin disease characterized by white macules on the skin due to loss of melanocytes. Although there are many theories about the etiopathogenesis of the disease, oxidative stress is identified as an important determinant in the etiology of vitiligo. In recent years, Raftlin has been shown to play a role in many inflammatory diseases. Aims: The aim of this study was to compare the patients with vitiligo and the control group to determine both oxidative/nitrosative stress markers and Raftlin levels. Materials and Methods: This study was designed prospectively between September 2017 and April 2018. Twenty-two patients diagnosed with vitiligo and 15 healthy people as the control group were included in the study. Blood samples collected to determine oxidative/nitrosative stress, the antioxidant enzyme, and Raftlin levels were sent to the biochemistry laboratory. Results: In patients with vitiligo, the activities of catalase, superoxide dismutase, glutathione peroxidase, and glutathione S transferase were significantly lower than in the control group (P < 0.0001). In vitiligo patients, the levels of malondialdehyde, nitric oxide, nitrotyrosine (3-NTx), and Raftlin were significantly higher than in the control group (P < 0.0001). Conclusions: The results of the study support that oxidative stress and nitrosative stress may play a role in the pathogenesis of vitiligo. In addition, the Raftlin level, a new biomarker of inflammatory diseases, was found high in patients with vitiligo.

Clinical practice guidelines for the diagnosis and treatment of cutaneous leishmaniasis in Turkey.

BACKGROUND: Cutaneous leishmaniasis (CL) is a vector-born parasitic disease characterized by various skin lesions that cause disfiguration if healed spontaneously. Although CL has been endemic for many years in the southern regions of Turkey, an increasing incidence in nonendemic regions is being observed due to returning travelers and, more recently, due to Syrian refugees. Thus far, a limited number of national guidelines have been proposed, but no common Turkish consensus has emerged. OBJECTIVES: The aim of this study was to develop diagnostic and therapeutic guidelines for the management of CL in Turkey. METHODS: This guideline is a consensus text prepared by 18 experienced CL specialists who have been working for many years in areas where the disease is endemic. The Delphi method was used to determine expert group consensus. Initially, a comprehensive list of items about CL was identified, and consensus was built from feedback provided by expert participants from the preceding rounds. RESULTS: Evidence-based and expert-based recommendations through diagnostic and therapeutic algorithms according to local availability and conditions are outlined. CONCLUSION: Because CL can mimic many other skin diseases, early diagnosis and early treatment are very important to prevent complications and spread of the disease. The fastest and easiest diagnostic method is the leishmanial smear. The most common treatment is the use of local or systemic pentavalent antimony compounds.