Factors affecting onychomycosis in patients with psoriasis.

Prevalence of onychomycosis increases in patients with psoriasis and that psoriasis predisposes to onychomycosis. It was aimed to determine the frequency of onychomycosis and responsible pathogens in patients with psoriasis, to reveal their differences compared to the population without psoriasis, and to determine the factors in this study. The study included 81 patients with nail disorder diagnosed with psoriasis. Clinical findings, psoriasis area and severity index (PASI), nail psoriasis severity index (NAPSI) scores, body mass indexes (BMI) and laboratory characteristics were recorded. Mycological examination by direct microscopy and fungal culture was performed both on nails that were considered onychomycosis and on nails with any of the psoriatic nail findings. The prevalence of onychomycosis was 27.2% in psoriasis patients. Nail involvement of psoriasis was found in 31.3% of the patients using biologic agents, 5.9% of those receiving conventional treatment, and 31.3% of those receiving topical treatment and 68.8% of the patients who did not receive treatment at all. The difference between the patients who did not receive treatment and those who received conventional treatment was significant (p < 0.05). There was growth in the fungal culture in 23.5% of the patients with psoriasis. There was no statistically significant relationship between onychomycosis and PASI, NAPSI score, and BMI (p > 0.05). Since the prevalence of onychomycosis in psoriasis patients receiving conventional and anti-TNF-α therapy is higher than in patients not receiving treatment, nail changes in these patients should be evaluated in more detail for the presence of onychomycosis. In addition, since more than one fungal agent can grow and non-dermatophyte molds are seen more frequently in patients with psoriasis, it should be taken into account that native and fungal culture examinations should be performed together.

A multicentre prospective analysis of the incidence of pemphigoid diseases in Turkey.

BACKGROUND: The differentiation between the pemphigoid diseases is essential for treatment and prognosis. In Turkey, data on the incidence of these diseases are insufficient. Our aim in this study is to determine the incidence, demographics and clinical characteristics associated with diseases of the pemphigoid group. METHODS: We prospectively analysed 295 patients with pemphigoid who visited dermatology clinics of tertiary referral hospitals in 12 different regions of Turkey within a year. The diagnosis was based on clinical, histopathological, direct immunofluorescence (DIF) and serological (multivariant enzyme-linked immunosorbent assay [ELISA], indirect immunofluorescence and mosaic-based BIOCHIP) examinations. Clinical and demographic findings, aetiological factors and concomitant diseases observed in the patients were recorded. RESULTS: A total of 295 (female/male ratio: 1.7/1) patients with pemphigoid were diagnosed in 1-year period. The overall incidence rate of pemphigoid diseases was found to be 3.55 cases per million-years. The ratio of pemphigoid group diseases to pemphigus group diseases was 1.6. The most common pemphigoid type was bullous pemphigoid (BP, 93.2%). The others were epidermolysis bullosa acquisita (3.1%), pemphigoid gestationis (2.4%), linear IgA disease (1%) and mucous membrane pemphigoid (0.3%). The most common (26.8%) possible trigger of the bullous pemphigoid was gliptin derivative drugs. The most common concomitant diseases with pemphigoid were cardiovascular (27.8%) and neurological diseases (23.7%). CONCLUSIONS: This study showed that the increased frequency of bullous pemphigoid reversed the pemphigoid/pemphigus ratio in Turkey. Further studies are warranted regarding the reasons for this increase.

Multicenter study evaluating the impact of COVID-19 outbreak on dermatology outpatients in Turkey.

COVID-19 pandemic has a significant impact on public health, whether directly or indirectly. The first case was seen in Turkey on March 11, and the World Health Organization (WHO) declared a pandemic on March 12, 2020. The study aimed to document the effect of pandemic on dermatology outpatient clinics in Turkey. Fifteen tertiary hospitals from 13 provinces were included in the study, which was conducted between January 12 and May 12, 2020. The International Codes of Diseases (ICD-10) categories and patients' characteristics were evaluated before and after the pandemic. A total of 164 878 patients, 133 131 before and 31 747 after the pandemic, were evaluated. The daily hospital applications were found reduced by 77%. The three of the most frequent diagnoses; dermatitis, acne, and psoriasis remained unchanged after the pandemic. While the frequency of herpes zoster, scabies, urticaria, pityriasis rosea and sexually transmitted diseases increased significantly; allergic and irritant contact dermatitis decreased after the pandemic. The applications regarding cutaneous neoplasms were considerably reduced during the pandemic, and this effect was more pronounced in cities with higher COVID incidence. The pandemic caused a noteworthy reduction in the number of patients accessing dermatological care. The pandemic caused significant changes in the frequency of a wide range of dermatological diseases. The application of cutaneous neoplasms is considerably reduced after the pandemic, and this effect was more pronounced in cities where pandemics are frequent. Therefore, the pandemic has resulted on numerous impacts on many critical issues in dermatology and dermatological care.

Serum Preptin and Amylin Values in Psoriasis Vulgaris and Behçet's Patients.

BACKGROUND: Insulin resistance is found in both psoriasis and Behçet's disease. No study has yet explored whether preptin and amylin, two hormones associated with insulin resistance, are involved in the insulin resistance observed in patients with psoriasis and Behçet's disease. OBJECTIVES: We aimed to explore how the amounts of preptin and amylin change in psoriasis and Behçet's disease and whether they are involved in the etiopathology of these two diseases, by comparing hormone levels in patients and healthy controls. METHODS: The study registered 30 patients with psoriasis, 30 patients with Behçet's disease, and 30 healthy volunteers (as a control group). Fasting blood sugar, triglyceride, LDL, VLDL, HDL, total cholesterol, HbA1c, C-peptide, insulin, and serum preptin and amylin levels were measured in all subjects. RESULTS: Serum preptin and amylin levels were significantly lower in the patients with psoriasis and Behçet's disease than in the control group (P < 0.001, P = 0.004, and P = 0.008, respectively). A comparison of the serum preptin and amylin levels between the patients with psoriasis and Behçet's disease did not reveal a statistically significant difference. Serum insulin level and The homeostasis model assessment of insulin resistance (HOMA-IR) index were significantly lower in the psoriasis patient group relative to the control group (P = 0.02 and P = 0.03, respectively), while the values for the Behçet's disease group did not differ significantly from those for the control group CONCLUSIONS: Serum levels of preptin and amylin were significantly lower in patients with psoriasis and Behçet's disease, indicating that these hormones may be a factor for development of metabolic syndrome in these two diseases.

Serum ghrelin levels in patients with Behcet's disease.

INTRODUCTION: Behcet's disease (BD) is a chronic, relapsing, systemic vasculitis of unknown etiology. AIM: To measure serum ghrelin levels in BD patients and healthy controls and to investigate its association with metabolic syndrome (MetS). MATERIAL AND METHODS: Thirty BD patients and 30 healthy individuals were enrolled in the study. Ghrelin levels were measured in blood samples using ELISA. RESULTS: The mean serum ghrelin level in BD patients (28.57 ±14.04) was significantly lower compared to healthy controls (40.72 ±23.21) (p = 0.01). The mean serum ghrelin level in BD patients who had MetS (24.18 ±12.73) was lower compared to BD patients who did not have MetS (30.77 ±14.45), but this difference was not significant (p > 0.05). CONCLUSIONS: Ghrelin levels were lower in BD patients compared to healthy controls. There was no association between reduced ghrelin levels and MetS; however, there was a negative correlation between ghrelin levels and disease activity.

Evaluation of ovarian reserve and function in female patients treated with oral isotretinoin for severe acne: an exploratory study.

BACKGROUND: Isotretinoin affects the levels of female hormones and ovaries in patients with severe acne. OBJECTIVE: This study evaluated the effects of isotretinoin on the ovarian reserve and levels of female hormones in patients with severe acne. METHODS: Thirty-two female patients with severe acne were enrolled. All the patients were treated with oral isotretinoin 0.5-2 mg/kg/d. The total cumulative dose for a full course was 120-135 mg/kg. The treatment duration ranged from 5 to 8 months. The serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) levels and antral follicle count (AFC) and ovarian volume (OV) were evaluated before and after treatment. RESULTS: After treatment, the mean FSH, LH, and E2 levels were significantly lower than before treatment. In addition, the mean AFC and OV decreased after treatment, although the difference was not significant. CONCLUSION: The results of this exploratory study do not demonstrate that oral isotretinoin has an impact in ovarian function. In contrast, isotretinoin affects levels of female hormones in patients with severe acne.

Role of asprosin and meteorin-like peptide in progression of actinic keratosis to squamous cell carcinoma.

Squamous cell carcinoma (SCC) often develops from an underlying premalignant lesion. Factors that affect the progression of actinic keratosis (AK) to invasive SCC are not fully known. Asprosin (ASP) and meteorin-like peptide (METRNL) are adipokines that are involved primarily in glucose metabolism. We investigated the expression of ASP and METRNL in AK and SCC to evaluate the role of these adipokines in the development of SCC. We used 15 SCC specimens, 12 AK specimens and 12 healthy control skin specimens. ASP and METRNL protein expression in tumor and surrounding tissue was evaluated using immunohistochemistry. ASP expression in tumor tissue was significantly greater in the SCC group than in the control and AK groups, but it did not differ significantly between the AK and control groups. A positive correlation was observed for both ASP and METRNL expressions between tumor tissue and adjacent epidermis, hair follicles, sebaceous gland, eccrine gland, inflammatory cells and vascular structures. ASP and METRNL may exert pro-tumor effects toward development of invasive SCC. The expression intensity of ASP and METRNL can be used as a biomarker of risk of progression to SCC.

Garlic Exosomes Promote Hair Growth Through the Wnt/ß-catenin Pathway and Growth Factors.

Background Exosomes are membrane-derived nanovesicles produced by cells and play an important role in intercellular communication. Objectives This study aimed to investigate the effects of garlic exosome (GE) on hair growth. Methods Forty-two Sprague-Dawley/Wistar albino rats were randomly divided into six groups: non-shaved control, shaved control, topical control, GE 2 mg, GE 4 mg, and topical GE. At the end of the experiment, the number of hair follicles, follicle diameter, and subcutaneous tissue thicknesses were measured histopathologically. The Wnt-1, ß-catenin, platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), transforming growth factor-ß1 (TGF-ß1), and collagen I levels were measured by the Western Blot method. Results The anagen follicle counts of the GE 2 mg, 4 mg, and topical GE groups were 66.57±15.49, 105.71±25.06, and 55.29±6.72, and were significantly higher than the control groups (p<0.01, p<0.001 and p<0.05, respectively). The follicle diameter of the GE 4 mg group was higher than the others (p<0.05). The Wnt-1, PDGF, VEGF, TGF-ß1, and collagen I levels of all GE groups, and the ß-catenin levels of the GE 4 mg and topical GE groups were significantly higher than the control groups (p<0.05). Conclusion GE induces hair growth in rats via the Wnt-1, ß-catenin, VEGF, PDGF, and TGF-ß1 signaling pathways.

In chronic spontaneous urticaria, IgE and C-reactive protein are linked to distinct microRNAs and interleukin-31.

BACKGROUND: Chronic spontaneous urticaria (CSU) is a common and disabling disease. Assessments of IgE and C-reactive protein (CRP) are recommended in the diagnostic work-up, but the role and clinical relevance of these biomarkers are not well characterized. Moreover, it remains unknown if elevated levels of IgE or CRP are linked to CSU microRNA (miRNA) signatures or interleukin 31 (IL-31). METHODS: We measured IgE and CRP serum levels in 47 CSU patients (and 45 healthy controls) and determined CSU disease activity using the urticaria activity score (UAS7). Expression levels of miR-155 and miR-221 were assessed by RT-PCR, and IL-31 levels were determined by ELISA. RESULTS: Total IgE and CRP levels were independently increased in CSU patients. IgE and CRP levels were highest and lowest in patients with high and mild disease activity. IgE levels correlated with miR-155 levels, whereas CRP levels correlated with miR-221 levels. miR-155 and miR-221 were significantly overexpressed in CSU patients. ROC analyses linked miRNA-155 and CSU with a sensitivity of 79% and specificity of 87%, and miRNA-221 and CSU with a sensitivity of 75% and specificity of 91%. High CRP and miR-221 expression levels were linked to elevated levels of IgG anti-TPO and IL-31. CONCLUSION: IgE and CRP are useful biomarkers for disease activity in CSU, with distinct miRNA profiles. High CRP and miR-221 levels may point to autoimmune CSU and a role for IL-31.

Effects of a Combination of Arginine Silicate Inositol Complex and a Novel Form of Biotin on Hair and Nail Growth in a Rodent Model.

The purpose of this study was to examine the effects of a combination of inositol-stabilized arginine silicate complex (ASI) and magnesium biotinate (MgB) on hair and nail growth in an animal model. Twenty-eight female Sprague-Dawley rats (8 weeks old) were randomized into one of the following groups: (i) group (control), shaved; (ii) group (ASI), shaved + ASI (4.14 mg/rat/day); (iii) group (ASI + MgB I), shaved + ASI (4.14 mg/rat/day) + MgB (48.7 µg/rat/day); and (iv) group (ASI + MgB II), shaved + ASI (4.14 mg/rat/day) + MgB (325 µg/rat/day). On day 42, compared with the control group, while hair density (p < 0.05, p < 0.01, and p < 0.0001, respectively) and anagen ratio (p < 0.01, p < 0.01, and p < 0.001) increased in the ASI, ASI + MgB I, and ASI + MgB II groups, telogen ratio decreased (p < 0.01, p < 0.01, and p < 0.001, respectively). In the molecular analysis, VEGF, HGF, and KGF-2 increased in the ASI (p < 0.01, p < 0.01, and p < 0.05, respectively), ASI + MgB I (p < 0.0001 for all), and ASI + MgB II (p < 0.0001 for all) groups when compared to the control group. FGF-2 (p < 0.01) and IGF-1 (p < 0.001) were found to be increased in the ASI + MgB I and ASI + MgB II groups. SIRT-1 and ß-catenin increased in the ASI (p < 0.05 and p < 0.01), ASI + MgB I (p < 0.001 for both), and ASI + MgB II (p < 0.0001 for both) groups. Wnt-1 increased in the ASI + MgB I (p < 0.001) and ASI + MgB II (p < 0.0001) groups. In conclusion, the combination of ASI and MgB could promote hair growth by regulating IGF-1, FGF, KGF, HGF, VEGF, SIRT-1, Wnt, and ß-catenin signal pathways. It was also established that ASI did not affect nail growth, whereas the MgB combination was effective using a higher dose of biotin.

Coexistence of vitiligo and psoriasis: three case reports.

Vitiligo and psoriasis are both common diseases. However, coexistence of these two diseases is rare. The pathogenesis of the coexistence of vitiligo and psoriasis is still unknown. Herein, we report three children (11-year-old, 8-year-old, and 7-year-old females) who attended our Department of Dermatology with coexisting vitiligo and psoriasis.

Two Novel Biomarker Candidates for Differentiating Basal Cell Carcinoma from Trichoblastoma; Asprosin and Meteorine Like Peptide.

INTRODUCTION: BCC (Basal Cell Carcinoma) and trichoblastoma are skin tumors originating from the hair follicle. BCC is the most common non-melanoma skin cancer. Differential diagnosis of BCC from trichoblastoma, which is a common benign tumor in terms of histology, morphology, and immunohistochemistry, is not possible. The effects of adipokines on tumorigenesis have attracted attention. MATERIALS AND METHODS: By examining the effects of Asprosin and Meteorine like peptide (METRNL) on these tumors, it is aimed to reach new information in the differential diagnosis of BCC and trichoblastoma. Twenty normal healthy tissue, 17 basal cell carcinoma and 12 trichoblastoma samples were included in the study. RESULTS: Increased expression of Asprosin and METRNL was observed in tumor and stromal tissues in BCC. Although overexpression of METRNL was observed in the lesion area in trichoblastoma, no increase in Asprosin expression was observed. Asprosin and METRNL immunoreactivity were found to be statistically significantly higher in BCC samples compared to control and trichoblastoma. CONCLUSION: Asprosin and METRNL can be used in the diagnosis of BCC. METRNL can be used in the diagnosis of trichoblastoma. These biomarkers are helpful for differentiation between BCC and trichoblastoma.

Effect of boron element on photoaging in rats.

BACKGROUND: The present study further assessed the effects of oral and topical applications of boron, which is known to have antiinflammatory and wound healing effects, on photoaging. METHODS: A total of 49 eight-week-old female Wistar albino rats randomly divided into seven groups (control, shaved control, shaved+UVB, topical dermabor 2% (D2), and %5 (D5), systemic sodium perborate tetrahydrate (SPT) 2% (SPT2) and 4% (SPT4). To induce an experimental photoaging, the rats were exposed to UVB at an emission spectrum of 290-320 nm. Biochemical, molecular, skin, histological, and collagen content analyzes were made at the end of the study. RESULTS: Increased skin inflammatory parameters (COX-2, IL-8, NF-KB, IL-6, and TNF-α) levels in UVB-exposed groups were inhibited in all treatment groups. The tissue level of hydroxyproline and elastase was found to decrease in all UVB-exposed group. The level of hydroxyproline was significantly higher in the D2 and D5 groups than in the SPT2 and SPT4 groups. The level of elastase was significantly lower in the D2 and D5 groups than in the SPT2 and SPT4 groups. CONCLUSIONS: In future, boron may be developed as a functionally protective treatment against photoaging caused by UVB, and may be included in sun protection systems.

Sodium pentaborate pentahydrate promotes hair growth through the Wnt/ß-catenin pathway and growth factors.

BACKGROUND: Boron (B) is an element involved in many physiological processes in humans and accelerates wound healing and increases angiogenesis. This study aimed to evaluate the possible effects of sodium pentaborate pentahydrate (NaB) on hair growth and reveal its effects on Wnt-1, ß-catenin, vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), and transforming growth factor-ß1 (TGF-ß1) signaling pathways, which are important molecular mechanisms involved in hair growth. METHODS: Thirty-five Sprague-Dawley/Wistar albino rats were randomly divided into five groups: non-shaved control, shaved control, NaB 1 mg (shaved + NaB 1 mg elemental B/kg CA), NaB 2 mg (shaved + NaB 2 mg elemental B/kg CA), and NaB 4 mg (shaved + NaB 4 mg elemental B/kg CA). Hair density was measured using the trichoscopy method. Dorsal skin samples were examined histopathologically at the end of the 42nd day, and follicle count, follicle diameter, and subcutaneous tissue thickness were recorded. Wnt-1, ß-catenin, PDGF, VEGF, TGF-ß1, and collagen I levels were analyzed with the Western blot method. RESULTS: In trichoscopy measurements, hair density increased in the NaB 4 mg group (90.9%). In histopathological examination, anagen follicles were observed to increase in the NaB 1 mg and 2 mg groups (p < 0.05). Follicle diameter increased in all NaB groups (p < 0.05). The Wnt-1, ß-catenin, PDGF, VEGF, TGF-ß1, and collagen I level increased in the NaB 1 mg and 2 mg groups (p < 0.05), but they were similar in the NaB 4 mg group compared to the control groups (p > 0.05). CONCLUSION: NaB 1 and 2 mg B/kg supplementation induces the anagen phase in rats via Wnt-1, ß-catenin, VEGF, PDGF, and TGF-ß1 signaling pathways. NaB 4 mg B/kg suppresses these pathways and adversely affects hair growth.

The impact of COVID-19 pandemic on psoriasis patients, and their immunosuppressive treatment: a cross-sectional multicenter study from Turkey.

BACKGROUND: Immunosuppressive therapy has been a great concern during the pandemic. This study aimed to evaluate the pandemic's impact on psoriasis patients treated with immunosuppressive drugs. MATERIAL AND METHODS: The multicenter study was conducted in 14 tertiary dermatology centers. Demographic data, treatment status, disease course, and cases of COVID-19 were evaluated in patients with psoriasis using the immunosuppressive treatment. RESULTS: Of 1827 patients included, the drug adherence rate was 68.2%. Those receiving anti-interleukin (anti-IL) drugs were more likely to continue treatment than patients receiving conventional drugs (OR = 1.50, 95% CI, 1.181-1.895, p = .001). Disease worsening rate was 24.2% and drug dose reduction increased this rate 3.26 and drug withdrawal 8.71 times. Receiving anti-TNF or anti-IL drugs was associated with less disease worsening compared to conventional drugs (p = .038, p = .032; respectively). Drug withdrawal causes were 'unable to come' (39.6%), 'COVID concern' (25.3%), and 'physician's and patient's co-decision' (17.4%). Four patients had COVID-19 infection with mild symptoms. The incidence was 0.0022% while it was 0.0025% in the general population. CONCLUSION: Our study shows that psoriasis patients using systemic immunosuppressive do not have a higher, but even lower COVID-19 risk than the general population, and treatment compliance with biological drugs is higher.

Plasma osteopontin levels in patients with Behcet's disease and psoriasis.

BACKGROUND: Behcet's disease (BD) is a chronic and recurrent systemic vasculitis marked by macrophage chemotaxis. OBJECTIVE: The present study aimed to examine the relationship between the osteopontin molecule and BD. PATIENTS AND METHODS: The study registered 60 patients with BD, as well as 50 healthy individuals and 63 patients with psoriasis as the control group. Patients with BD in our study were divided into 2 groups, with regard to mucocutaneous involvement, as active and inactive patients. In addition, patients with BD were also divided into 3 groups with regard to vascular involvement: active, inactive, and no vascular involvement. RESULTS: Plasma osteopontin (OPN) levels in active patients with BD, inactive patients with BD and patients with psoriasis were found statistically significantly elevated, in comparison to those in the healthy control group (p < 0.001, p = 0.008, p < 0.001, respectively). When active and inactive patients with BD were compared to the healthy control group with regard to vascular involvement, mean plasma OPN levels were found to be statistically significantly higher (p = 0.01, p < 0.001, respectively). CONCLUSIONS: We found that plasma levels of OPN were higher in patients with Behcet's and psoriasis.

The Protective Effects of a Combination of an Arginine Silicate Complex and Magnesium Biotinate Against UV-Induced Skin Damage in Rats.

The purpose of this study was to observe the effects of a novel combination of inositol-stabilized arginine silicate complex (ASI) and magnesium biotinate (MgB) on the prevention of skin damage after UVB exposure in rats. Forty-nine Sprague-Dawley rats were randomized into one of the following groups: (1) NC, normal control, (2) SC, shaved control, (3) UVB (exposed to UVB radiation), (4) ASI+MgB-L (Low Dose), (5) ASI+MgB-H (High Dose), (6) ASI+MgB-L+MgB cream, (7) ASI+MgB-H+MgB cream. The results showed that ASI+MgB treatment alleviated the macroscopic and histopathological damages in the skin of rats caused by UVB exposure. Skin elasticity evaluation showed a similar trend. ASI+MgB increased serum Mg, Fe, Zn, Cu, Si, biotin, and arginine concentrations and skin hydroxyproline and biotinidase levels while decreasing skin elastase activity (p < 0.05) and malondialdehyde (MDA) concentration (p < 0.001). Moreover, ASI+MgB treatment increased skin levels of biotin-dependent carboxylases (ACC1, ACC2, PC, PCC, MCC) and decreased mammalian target of rapamycin (mTOR) pathways and matrix metalloproteinase protein levels by the regulation of the activator protein 1 (AP-1), and mitogen activated protein kinases (MAPKs) signaling pathways. In addition, ASI+MgB caused lower levels of inflammatory factors, including TNF-α, NFκB, IL-6, IL-8, and COX-2 in the skin samples (p < 0.05). The levels of Bax and caspase-3 were increased, while anti-apoptotic protein Bcl-2 was decreased by UVB exposure, which was reversed by ASI+MgB treatment. These results show that treatment with ASI and MgB protects against skin damage by improving skin appearance, elasticity, inflammation, apoptosis, and overall health.

Dermoscopy in differential diagnosis of inflammatory dermatoses and mycosis fungoides.

BACKGROUND: The use of dermoscopy for the evaluation of various inflammatory dermatoses has witnessed a gradual increase in recent years. The present study describes and highlights the importance of dermoscopic findings in the differential diagnosis of plaque psoriasis (PP), lichen planus (LP), mycosis fungoides (MF), pityriasis rosea (PR), and nummular dermatitis (ND) that mostly involve the trunk. METHODS: The study included 150 cases (PP:50, LP:30, MF:20, PR:30, ND:20). The lesions were inspected using a polarized dermoscope. The dermoscopic findings of each lesion were evaluated for background color, type, and distribution of vessels, color and distribution of scales, and other additional findings. RESULTS: When the patient groups were evaluated for background color, yellow color was prominent in PR, and light and dull red color was prominent in other groups. Dotted vessels were prominent in PP, PR, and ND, and dotted + linear vessels were significantly more prominent in MF and LP. In the evaluation of the distribution pattern of vessels, PP showed regular, LP showed peripheral, and PR, MF, and ND showed patchy distribution patterns. White scales were prominent in PP, PR, and MF, and yellow-white scales were prominent in LP and ND. Only PR had a predominant peripheral distribution of scales, while other groups had a patchy distribution. CONCLUSIONS: In conclusion, it was observed that PP, LP, MF, PR, and ND exhibited specific dermoscopic patterns that might be useful in clinical diagnosis.

Demographic and clinical properties of juvenile-onset Behçet's disease: A controlled multicenter study.

BACKGROUND: Behçet's disease (BD) is a multisystemic inflammatory disorder of unknown origin. The disease usually occurs between the second and the fourth decades, whereas it is uncommon in children. OBJECTIVE: In this multicenter study, we aimed to describe the demographic and clinical features along with severity in juvenile- versus adult-onset BD. METHODS: Patients with initial symptoms at age 16 years or younger were considered as having juvenile-onset BD. In all, 83 patients with juvenile-onset BD (38 male and 45 female; mean age 19.6 +/- 7.6 years) and 536 with adult-onset (>16 years) BD (293 male and 243 female; mean age 39.2 +/- 10.1 years) who fulfilled the classification criteria of the International Study Group for BD were involved in the study. RESULTS: Familial cases were more frequent in juvenile-onset compared with adult-onset BD (19% vs 10.3%; P = .017). The mean age of disease onset was 12.29 +/- 3.54 years in juvenile-onset BD and 31.66 +/- 8.71 years in adult-onset BD. Mucocutaneous lesions and articular symptoms were the most commonly observed manifestations in both groups. The frequency of disease manifestations was not different between juvenile- and adult-onset BD, except neurologic and gastrointestinal involvement, which were higher in juvenile-onset BD than adult-onset BD (P = .027 and P = .024, respectively). Oral ulcer was the most common onset manifestation of both juvenile-onset (86.74%) and adult-onset (89.55%) BD. The frequencies of onset manifestations of BD were similar, except genital ulcer, which was higher in adult-onset BD (P = .025). LIMITATIONS: Our study consisted of patients with BD mainly applying to dermatology and venerology departments. Therefore, it can be speculated that this study includes rather a milder spectrum of the disease. CONCLUSIONS: Although the clinical spectrum of juvenile-onset BD seems to be similar to adult-onset BD, the frequency of severe organ involvement was higher. Because of the higher prevalence of familial cases in juvenile-onset BD, it can be speculated that genetic factors may favor early expression of the disease with severe organ involvement.