Methyl(chloro)isothiazolinone contact allergy: a monocentric experience from Turkey.

INTRODUCTION: Due to their ubiquitous use, isothiazolinones caused allergic contact dermatitis epidemics and their use was restricted by legal regulations. OBJECTIVES: We aimed to evaluate demographic data, clinical findings, and patch test features of patients with methylisothiazolinone (MI) and/or methylchloroisothiazolinone(MCI) sensitivity in our study. METHODS: This study is a bidirectional and cross-sectional study, between July 2020 and September 2021. A total of 616 patients, including prospective and retrospective populations, demographic data, clinical findings, and patch test results were reviewed. Patients' demographics, patch test results, allergen sources, presence of occupational contact, and the characteristics of dermatitis attacks were recorded. RESULTS: A total of 50 patients with MI and MCI/MI sensitivity, 36 male (72%) and 14 female (28%), were included in our study. The overall prevalence of MI and MCI/MI between 2014 and 2021 was 8.4% (52/616) with two peak levels in 2015(21%) and 2021 (20%). A statistically significant relationship was found between shampoo use and facial involvement (p = 0.031), shower gel use and arm involvement (p = 0.027), wet wipe use and hand involvement (p = 0.049), detergent use and the pulps (p = 0.026) and the lateral aspects of fingers involvement (p = 0.048), water-based dye use and periungual involvement (p = 0.047). CONCLUSION: Although legal regulations related to MI and MCI/MI cause a decrease in the frequency of their sensitivities were still common causes of allergic contact dermatitis.

Evaluating the Effect of the Demographic, Trichoscopic and Laboratory Characteristics on The Recurrence of Alopecia Areata.

INTRODUCTION: Alopecia areata (AA) has diverse disease characteristics and multiple factors may interfere with the prognosis of the disease. OBJECTIVES: In this study, the factors affecting the AA recurrence were evaluated. METHODS: A total of a hundred patients diagnosed with AA between June 2022 and March 2023 were included in this retrospective, cross-sectional study. The patients were divided into two groups according to the presence of outbreaks. Both groups were compared in terms of age, gender, disease duration, number of outbreaks, family history of AA, previous medical treatment history for AA, clinical type, disease severity, presence of accompanying nail findings, and trichoscopic and laboratory characteristics. RESULTS: Among 100 patients, male dominance was found (N = 69). Most of the patients had patchy disease (90/100), mild disease severity (88/100), and a solitary outbreak (65/100). Male gender, longer disease duration, family history, presence of S2 severity of alopecia tool score, trachyonychia, short vellus hairs in trichoscopic examination, hypothyroidism, and folic acid deficiency were factors for AA outbreaks. Male gender and the presence of a family member with AA in the family were defined as the independent prognostic factors for disease recurrence. CONCLUSIONS: While demographic, laboratory, and clinical findings are factors for AA outbreaks in the follow-up, male gender and family history should be considered independent predictors.

Evaluation of Depression, Self-esteem, Anxiety, and Dermatological Quality of Life Index in Adolescent Acne Patients: A Case-Control Study.

Objectives: Acne vulgaris is a common skin condition that affects adolescents and can have a significant impact on their mental health. In this study, we aimed to evaluate the depression and anxiety symptoms, self-esteem and dermatological quality of life indexes of adolescent patients with acne vulgaris. Methods: A total of 160 patients aged between 10 and 19 years with acne vulgaris and 100 healthy controls were included in the study. All participants completed the Reynolds Adolescent Depression Scale (RADS), Beck Adolescent Anxiety Scale (BAAS), and Coopersmith Self-Esteem Survey Scale (CSES), alone and independently. The dermatologists evaluated the acne disease severity of the study group using the Global Acne Grading System, while the Children's Dermatological Quality of Life Index (CDLQI) was evaluated in the same group. Age, gender, and scale results of all participants were recorded on case report forms for further analysis. Results: The study group had significantly higher RADS (27.5% vs 12.5%, p=0.003) and BAAS scores (80% vs 64%, p=0.001) than the control group. The percentage of patients with CSES scores below 20 in the study group was significantly higher than the control group (p=0.001). Higher RADS and BAAS scores were associated with higher CDLQI scores (p=0.001, p=0.001, respectively), while higher CSES scores were associated with lower CDLQI scores (p=0.001). Conclusion: The study shows that acne vulgaris has a significant impact on the depression, anxiety, and self-esteem levels of adolescent patients. Dermatologists should pay attention to the psychological well-being of patients and provide psychiatric evaluation if necessary.

The Difference Between SARS-CoV-2 Associated Telogen Effluvium and Telogen Effluvium Due to Other Causes.

INTRODUCTION: Telogen effluvium (TE) is a common type of non-cicatricial alopecia, and it is reported frequently in patients with SARS-CoV-2 infection. OBJECTIVES: Herein, we aimed to examine the demographic, dermoscopic, and laboratory features of the patients with SARS-CoV-2 associated TE (CATE) and compare them with TE due to other causes (TEDOC) according to these features. METHODS: In this retrospective case-control study we evaluated the patients who were diagnosed with TE and were above 18 years of age between April and June 2022. The patients were divided into two groups based on their medical history and SARS-CoV-2 PCR positivity. The first group included patients with CATE and positive SARS-CoV-2 PCR test results in the last 3 months. The second group consisted of patients with TEDOC. Patients gender, age, disease duration, additional systemic disease, dermoscopic findings, and laboratory results were recorded. RESULTS: A total of 92 patients, 86 (93.5%) females, and 6 (6.5%) males, were included in the study. CATE was detected in 52 (56.5%) patients whereas 40 (44.5%) patients had TEDOC. The mean time between the onset of SARS-CoV-2 infection and hair loss complaint was calculated as 64.8 + 25.6 days, and this time was significantly shorter than patients with TEDOC (P = 0.003). The dermoscopic evaluation showed that empty follicular openings and yellow dots were statistically higher in patients with CATE, whereas short regrowing hair were markedly higher in patients with TEDOC (P = 0.001, P = 0.001,and P = 0.001, respectively) CONCLUSIONS: CATE is characterized by excessive hair-shedding that begins sooner after infection than classic TE. Dermoscopic findings can assist clinicians in diagnosis.

A cross sectional study evaluating the relationship of acne to androgenetic alopecia subtype and severity.

The circulating androgens have a role in the pathogenesis of both acne vulgaris and androgenetic alopecia; an association between these two have been found previously. The aim of this study is to investigate the relationship of the severity of acne vulgaris lesions to the subtype of AGA; and to validate the relationship between severities of acne vulgaris and AGA. This study was conducted cross-sectionally at five different dermatology clinics. Male and female androgenetic alopecia patients with comorbid acne vulgaris have been included. The age, gender, severity of acne lesions, subtype of androgenetic alopecia and the severity of androgenetic alopecia were noted. The severity of acne lesions were graded according to the Global Acne Severity Scale and androgenetic alopecia was graded according to the Hamilton and Ludwig Scales. SPSS v 21 was used for the statistical analysis. A total of 101 patients have been included (12 male and 89 female). The mean age of the patients with severe acne was statistically significantly lower (p = 0.020). The difference in terms of gender was statistically insignificant (p = 0.388). The severity of acne vulgaris was found to be independent of the severity and of the subtype of AGA; p = 0.623 and 0.870 respectively. Neither a relationship between the severity of androgenetic alopecia and severity of acne; nor a relationship between acne severity and androgenetic alopecia subtype were found in this study. Thus we report that, acne severity is independent of the subtype and stage of the co-existing androgenetic alopecia.

Evaluation of demographic and clinical characteristics of 728 patients with mycosis fungoides and their relationship with systemic comorbidities: multicenter, registry-based (MF-TR) study from Türkiye.

BACKGROUND: Mycosis fungoides (MF) is the most common cutaneous lymphoma with a chronic disease course. MF patients may also suffer from systemic comorbidities such as cardiovascular and metabolic diseases. METHODS: In this study, we aimed to evaluate the demographic and clinical features of MF patients registered in the MF-TR registry system and to examine the relationship of these features with systemic comorbidities. We collected the data from the medical files of the patients via the MF-TR registry system. RESULTS: Our study included 728 patients with MF, of which 396 (54.40%) were male and 332 (45.60%) were female. The most common additional systemic disease observed was hypertension, affecting 124 (17.03%) patients. This was followed by multinodular goiter in 66 (9.06%) patients, and diabetes mellitus type 2 in 61 (8.37%) patients. Twenty-two (3.02%) patients had a history of another secondary malignancy, with lung cancer being the most common type, affecting 5 (0.68%) patients. Female gender and high BMI were statistically higher in MF patients with asthma (P=0.019 and P=0.031, respectively). In patients with hypertension and hypercholesterolemia, the duration of diagnosis was significantly longer (P=0.013 and P=0.047, respectively). CONCLUSIONS: Dermatologists should be aware of these accompanying comorbidities in patients with MF. Multidisciplinary evaluation should be performed in the follow-up, if necessary.

Evaluation of Patch Test Results in Paediatric Patients in a Tertiary Dermatology Clinic.

Background and Objectives: Allergic contact dermatitis is common in childhood as well as in adulthood. Children could be affected by numerous allergens. Allergen sources could change by region. In this study, we aimed to identify the most common allergens that cause contact sensitivity in paediatric patients in our region to make a standardized patch test series and define the ways of exposure to these allergens. Materials and Methods: Between June 2013 and January 2021, a total of 61 patients' European baseline series patch test results were evaluated. Results: Among 61 patients, 36 (%59) were female and 25 (%41) were male. The mean age was 10.4 years. Positivity with at least one allergen was present in 39 (64%) cases. The most common allergens with positive reactions were balsam of Peru (BOP) in 11 (18%) patients, nickel in eight (13.1%) patients, and fragrance mix-1 in seven (11.4%) patients. No statically significant difference was found between patch test results and gender (P = 0.109), atopy (P = 0.774), atopic dermatitis (P = 0.662), hobby (P = 0.377) and side of lesions (P = 0.826). However, there was a significant relationship between the duration of complaints and patch test results (P = 0.007). Conclusion: The responsible allergen in paediatric patients may vary especially by region, thus this could be challenging for diagnosis. Therefore, each region should create its own specific standardized paediatric patch tests.

Factors Affecting Topical Treatment Success in Pediatric Scabies Cases: A Cross-Sectional Study.

INTRODUCTION: Scabies is a common disease that affects the pediatric population. Treatment failure and relapse occur frequently in children. OBJECTIVES: We aimed to identify the factors that affect topical treatment success in pediatric scabies patients. METHODS: A multicenter cross-sectional study was conducted from April 2022 to December 2022. Pediatric scabies cases were classified as belonging to either the treatment failure (TF) group or the treatment success (TS) group. RESULTS: We enrolled 170 patients for the study. In the TF group, the presence of symptomatic household members and referrals from physicians other than dermatologists were more common (both P < 0.001), and relapse rates and total symptom duration were higher (P = 0.007, P < 0.001, respectively). Regarding treatment agents, 5% permethrin was more commonly used in the TF group (71.1% versus 25%; P < 0.001). The proportion of patients treated with sulfur preparations was significantly higher in the TS group (60.7% versus 16.9%; P < 0.001). Misapplication of topical therapy was significantly more common in the TF group (P < 0.001), with statistically significant errors being (i) lack of treatment of close contacts (p<0,001), (ii) single application (P < 0.001), and (iii) local application (P = 0.027). A multivariate analysis revealed that TS was mainly associated with (i) the presence of atopy (odds ratio [OR] 6.12, 95% CI: 1.39-27.04), (ii) the absence of symptomatic household members (OR 6.31, 95% CI: 2.14-18.63), and (iii) presentation to a dermatologist rather than another specialist (OR 6.51, 95% CI: 2.11-20.13). The use of permethrin negatively affected treatment success (OR 0.22, 95% CI: 0.07-0.71). CONCLUSIONS: Pediatric scabies patients should be treated before other family members become infested and with topicals other than permethrin. In addition, awareness of scabies needs to be increased among non-dermatologists.