Sexual quality of life in female patients with acne.

Acne is a common skin disease which can have a negative psychosocial impact on quality of life. Sexual health is an important part of overall health and little is known about the effects of acne on individual sexuality. We aimed to assess the sexual quality of life and general quality of life in female patients with acne and compare to those without acne. Sixty female participants with acne and age-matched 40 female controls were enrolled in the study and asked to complete the Sexual Quality of Life-Female Questionnaire and the Short Form-36 Health Survey. Acne severity was evaluated objectively by the Global Acne Grading System and subjectively by the Visual Analogue Scale. Participants reported a significantly worse sexual quality of life and had significantly decreased scores on the quality of life scales of Bodily Pain, General Perception of Health and the Physical Component Summary when compared to controls. Neither the sexual quality of life nor the quality of life was correlated with objective and subjective acne severity and duration of acne. Acne can negatively affect sexual quality of life in female patients as well as differentdimensions of quality of life. The sexual quality of life should be considered while evaluating acne in women irrespective of its severity.

Dermatological aspects of synthetic cannabinoid addiction.

CONTEXT: Synthetic cannabinoids (SCs) have recently become one of the most abused substances among young population and have caused severe health consequences in our country and worldwide. OBJECTIVE: The aim of this study was to investigate sociodemographic and dermatological findings in SC addicts. MATERIALS AND METHODS: A total of 136 SC users who applied to our hospital's Substance Dependence Center outpatient clinic and diagnosed with drug addiction according to DSM-4 criteria between September 2014 and September 2015 were enrolled to our study. Patients were evaluated by dermatologist and psychiatrist with sociodemographic and clinical data sheets. Data were obtained by direct conversation with patients, clinical examination findings, and laboratory tests, if necessary. RESULTS: Of 136 patients, 12 (8.8%) were female and 124 (91.2%) were male, aged between 17 and 53 with mean age of 25.8 ± 9.2. Most common use way of SC was smoking and patients majorly used opiates before SC. The majority of the patients enrolled to our study were low-educated and almost 50% did not have a regular job. The most frequent dermatologic complaints were periorbital darkening, hallowed-cheeks and premature aging, hair loss and gray hair, and acnes, whereas most frequent dermatologic examination findings were artifact lesions such as blade scars and tobacco scars-stains, tattoos, and acnes. DISCUSSION AND CONCLUSIONS: Given the increased prevalence of SC use in our country and around the world, dermatologists should continue to familiarize themselves with the common mucocutaneous markers of this substance use. Awareness of signs of SCs use will facilitate earlier diagnose, intervention, and directed treatment.

The Impact of Inflammatory and Infectious Diseases of Vulvar on Quality of Life.

OBJECTIVES: This study aimed to evaluate the effects of vulvar dermatoses (VD) and vulvar infections (VE) on anxiety, depression scores, general, and dermatological quality of life (QOL) of women. METHODS: We conducted a cross-sectional survey on patients diagnosed with VD and VE. All patients were assessed using a sociodemographic form, Skindex-29 scale, World Health Organization QOL (WHOQOL) BREF scale, Hamilton anxiety rating scale (HAM-A), Hamilton depression rating scale (HAM-D). RESULTS: HAM-A score was significantly higher in the VD group than in the control group. Based on age groups, all subscales of Skindex-29 were found to be higher in women > 50 years. For women with severe pruritus, the symptom subscale was higher in patients with skin involvement and the function and emotion subscales were higher in patients with and emotion subscales were higher in patients with mucosal involvement. CONCLUSIONS: We found that VD was particularly significantly associated with decreased QOL.

Frequency of body dysmorphic disorder among patients with complaints of hair loss.

BACKGROUND: Body dysmorphic disorder (BDD) is a psychiatric condition in which a disabling preoccupation with a non-existent or slight defect in appearance is the main symptom. Hair concerns are frequent in patients with BDD. OBJECTIVES: The purpose of this study was to determine the prevalence of BDD among patients with complaints of hair loss. METHODS: A validated BDD questionnaire (BDDQ) was administered to 150 patients with complaints of hair loss and 150 control subjects who were selected from among general dermatology (GD) patients. Standard statistical tests were performed (descriptive analysis, chi-squared tests, non-parametric tests). Differences that achieved a P-value of <0.05 were considered statistically significant. RESULTS: Among patients with complaints of hair loss, 42 of 142 subjects retained in the study (29.6%; 31 females and 11 males) were diagnosed with BDD. Furthermore, 25.6% of female patients and 52.4% of male patients were diagnosed with BDD (P = 0.013). Hair concerns were more common in males than in females (P < 0.05). In the GD group, four control subjects (2.7%, all female) were diagnosed with BDD; all of their concerns focused on the body and acne. CONCLUSIONS: The incidence of BDD is about 10 times higher in patients with complaints of hair loss than it is in GD patients and is higher in males. Awareness of the condition and the referral of selected patients to mental health professionals is crucial.

Scabies Incognito Presenting as a Subcorneal Pustular Dermatosis-like Eruption.

Scabies is a common parasitosis of the skin caused by Sarcoptes scabiei hominis. This infestation occurs in all geographic areas and across all age groups, races, and social classes. Poor economic conditions and lack of proper hygiene are risk factors for the disease. Subcorneal pustular dermatosis is characterized by numerous relapsing pustular eruptions on normal or mildly erythematous skin. The pustular eruption typically involves the flexural sites of the trunk and proximal extremities with pruritus and irritation symptoms. The pustules are superficial and rupture easily, resulting in a superficial crust, and they form annular, circinate, or serpiginous patterns. Here we reported a case of scabies incognito in an elderly woman that presented as subcorneal pustular dermatosis-like eruption. We assumed that this case could be reported because it is an unusual event among the general population. In conclusion, the differential diagnoses of skin diseases should be considered when diagnosing scabies. Thus, unnecessary therapy and contamination among people can be prevented.

[An alternative biphasic nutrient medium for the diagnosis of cutaneous leishmaniasis]. / Kutanöz leysmanyazis tanisinda alternatif bifazik nutrient besiyeri.

Cutaneous leishmaniasis (CL) caused by the Leishmania spp. parasites, is a disease characterized by nodulo-ulcerative lesions in the skin. CL is transmitted to humans by infected sandflies during blood sucking, and is endemic in about 98 countries over the world. The demonstration of amastigotes via microscopic examination, and the growth of promastigotes in NNN (Novy-MacNeal-Nicolle) medium are gold standard methods for laboratory diagnosis. The aim of this study was to compare the biphasic NNN medium that is frequently used in routine laboratories with the biphasic nutrient medium that can be prepared easily in microbiology laboratories, for the growth of promastigotes. In the study, the aspiration fluid sample was used as clinical sample which was obtained from the skin lesion of a 47-year-old female patient admitted to Izmir Katip Celebi Ataturk Education and Research Hospital dermatology outpatient clinic and pre-diagnosed as CL. The aspirate sample taken from the lesion was evaluated with microscopy, cultivation in two different media and real-time polymerase chain reaction (Rt-PCR) methods. In microscopic examination Leishmania amastigotes were observed in Giemsa-stained smears prepared from the aspiration fluid. In Rt-PCR performed by using specific primers and probes targeting ITS1 region of Leishmania parasite, a melting-curve compatible with L.tropica was detected. For cultivation, triple inoculations of the aspirate sample into NNN (NNN + RPMI 1640 + 10% fetal calf serum) and nutrient media (nutrient agar + nutrient broth + 10% fetal calf serum) were used. The cultures were incubated at 27°C for 10 days, and the number of propagated promastigotes were counted on the third, seventh and tenth days. The growth of Leishmania promastigotes was detected in both media on the third day. The number of promastigotes grown in NNN medium on the third, seventh and tenth days were 105/ml, 106/ml and 108/ml, respectively. Those values in nutrient medium were 106/ml, 107/ml and 108/ml on the third, seventh and tenth days, respectively. Although the number of promastigotes on the third and seventh days were higher in nutrient medium than NNN medium, the number of cultivated promastigotes were equal on the tenth day. As a result, nutrient medium is considered to have an impact in the diagnosis of CL, by providing an alternative to the routine medium used and can readily be available in microbiology and parasitology laboratories with long shelf-life. It was concluded that biphasic nutrient medium could be used as a supplementary medium for diagnosis in laboratories in the absence of NNN medium or can not be provided.

Clinical practice trends in cryosurgery: a retrospective study of cutaneous lesions.

INTRODUCTION: Cryosurgery is an alternative treatment for many benign, premalignant, and malignant lesions of the skin. AIM: To review the indications of cryosurgery for cutaneous lesions. MATERIAL AND METHODS: The retrospective study was based on the assessment of medical records of 1031 dermatology patients who had cryosurgery. RESULTS: One thousand two hundred and forty-four sessions of cryosurgery were applied to the total of 1031 patients. Of the 1031 patients, the most frequent indication for cryosurgery was common warts which were present in 535 (61.59%) patients, followed by anogenital warts in 119 (11.54%) patients, callosity in 81 (7.85%) patients, actinic keratosis in 77 (7.46%) patients, molluscum contagiosum in 35 (3.39%) patients, and other benign or malignant skin lesions. CONCLUSIONS: Cryosurgery is still a valuable treatment of choice in various benign, premalignant, and malignant skin diseases but seems to be underused for indications other than viral warts.

Genital Ulcerative Pyoderma Gangrenosum in Behçet's Disease: A Case Report and Review of the Literature.

Behçet's disease (BD), first described by Hulusi Behcet, is a multisystemic disease characterized by recurrent oral and genital ulcerations, ocular and cutaneous lesions, arthritis and vascular disease. Pyoderma gangrenosum (PG) is a rare, chronic, sterile pustular and progressive ulcerative process of unknown cause; sometimes can participate in the differential diagnosis of Behcet's ulceration. A 33-year-old woman complained a severe genital ulcer. She had a purulent oozing and stinky ulceration on the right side of labium minor measuring 5-8 cm. A punch biopsy at ulcer margin showed that the lymphocytic panniculitis was extending to the subcutaneous fat tissue without fibrin deposition or necrotic changes in the vessel wall. Based on the clinical and histological findings, she was diagnosed as genital ulcerative PG, which occurred during the exacerbation of BD.

Treatment of various types of basal cell carcinoma with topical 5% imiquimod in the elderly who refused surgical intervention: a case series.

Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer in the elderly population, causing significant local destruction and image deformities. Although surgical excision is the primary treatment modality, preservation of functions, cosmetic concerns and patient's age, as well as tumor prognostic factors, aid in treatment selection. Topical imiquimod provides immunomodulatory effects by increasing the release of proinflammatory cytokines, and is currently approved and funded for pathologically diagnosed superficial BCC. We report herein the successful results of topical imiquimod in four cases of BCC, nodular and large superficial types, all of whom refused surgical intervention. The lesions regressed in all except one in whom more than one BCC of superficial type was present. She is still on follow-up for intermittent cryotherapy sessions. Imiquimod is a good alternative to surgery in elderly patients who have unwillingness to surgery and are often poor candidates for surgery.

Insulin resistance in patients with post-adolescent acne.

BACKGROUND: Post-adolescent acne has been defined as acne in a patient aged >25 years. Acne vulgaris first develops at the onset of puberty as a result of hormonal changes. During puberty, there is a transient decline in insulin sensitivity. We hypothesized that insulin resistance might persist after puberty in patients with post-adolescent acne. OBJECTIVES: This study was conducted in order to investigate the relationship between post-adolescent acne and insulin resistance. METHODS: The study population comprised 35 patients with post-adolescent acne and 35 healthy control subjects. The parameters measured were fasting blood glucose, insulin, aspartate aminotransferase (AST) and alanine aminotransferase (ALT), total cholesterol (TC), triglycerides, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). The homeostasis model assessment of insulin resistance (HOMA-IR) index was calculated for each individual. RESULTS: No significant differences were observed between patients with post-adolescent acne and control subjects in fasting blood glucose, fasting insulin, AST, ALT, triglyceride and HDL-C levels, and HOMA-IR index. There were also no correlations between these parameters and the severity of acne. CONCLUSIONS: This study suggests that insulin resistance may not play a major role in the pathogenesis of post-adolescent acne. Hormonal changes, genetic susceptibility, stress, the use of cosmetics, drugs, and environmental factors should be considered in the development of post-adolescent acne.

Epidemiología de dermatosis pediátricas en la región centro-occidental de Anatolia en Turquía / Epidemiology of pediatric skin diseases in the mid-western anatolian region of Turkey

Antecedentes. El campo de la dermatología pediátrica ha ganado relevancia con el aumento de la cantidad de pacientes pediátricos y la discrepancia de las dermatosis respecto de las presentaciones en adultos. Nuestro objetivo fue describir la frecuencia y la distribución de las dermatosis pediátricas, los procedimientos de diagnóstico y los tratamientos indicados. Métodos. Estudio epidemiológico transversal. Se recolectaron datos acerca de los patrones diagnósticos, los métodos diagnósticos y las modalidades de tratamiento en las consultas ambulatorias de dermatología pediátrica a lo largo de 18 meses. Resultados. Los diagnósticos más prevalentes fueron las enfermedades infecciosas (27,9%), incluidas las verrugas virales (17,5%), seguidas de acné o enfermedades acneiformes (19,9%) y alergias (14,5%). Entre las pruebas diagnósticas, fue necesario realizar exámenes histopatológicos en el 5,2% de los casos, en general para diagnosticar lesiones inflamatorias y tumorales. En la mayoría de los casos, se emplearon tratamientos tópicos (49,3%), seguidos por tratamientos sistémicos (32,4%). Conclusiones. Las verrugas virales representaron las dermatosis más frecuentes, y es importante que la salud pública incorpore medidas preventivas contra la transmisión del VPH en los niños.

Background: The field of pediatric dermatology has gained importance with the increment of pediatric patients and the discrepancy of their skin diseases with the adult versions. We aimed to describe frequency and distribution of pediatric skin diseases, and the diagnostic procedures and treatments prescribed. Methods: Cross-sectional epidemiological study. We collected data about diagnostic patterns, diagnostic methods and treatment modalities in pediatric dermatology outpatient clinic visits over 18 months. Results: Infectious diseases (27.9%) and among them viral warts (17.5%) were the most prevalent diagnoses, followed by acne-acneiform diseases (19.9%) and allergic diseases (14.5%). Among the diagnostic tests histopathology was required in 5.2%, usually to diagnose inflammatory and tumoral lesions. Topical treatments (49.3%) were followed by systemic treatments (32.4%) in majority of cases. Conclusions: Viral warts were among the most common dermatoses, and preventive measures for HPV transmission should become important part of public health efforts in children.

Epidemiología de dermatosis pediátricas en la región centro-occidental de Anatolia en Turquía / Epidemiology of pediatric skin diseases in the mid-western anatolian region of Turkey

Antecedentes. El campo de la dermatología pediátrica ha ganado relevancia con el aumento de la cantidad de pacientes pediátricos y la discrepancia de las dermatosis respecto de las presentaciones en adultos. Nuestro objetivo fue describir la frecuencia y la distribución de las dermatosis pediátricas, los procedimientos de diagnóstico y los tratamientos indicados. Métodos. Estudio epidemiológico transversal. Se recolectaron datos acerca de los patrones diagnósticos, los métodos diagnósticos y las modalidades de tratamiento en las consultas ambulatorias de dermatología pediátrica a lo largo de 18 meses. Resultados. Los diagnósticos más prevalentes fueron las enfermedades infecciosas (27,9%), incluidas las verrugas virales (17,5%), seguidas de acné o enfermedades acneiformes (19,9%) y alergias (14,5%). Entre las pruebas diagnósticas, fue necesario realizar exámenes histopatológicos en el 5,2% de los casos, en general para diagnosticar lesiones inflamatorias y tumorales. En la mayoría de los casos, se emplearon tratamientos tópicos (49,3%), seguidos por tratamientos sistémicos (32,4%). Conclusiones. Las verrugas virales representaron las dermatosis más frecuentes, y es importante que la salud pública incorpore medidas preventivas contra la transmisión del VPH en los niños.(AU)

Background: The field of pediatric dermatology has gained importance with the increment of pediatric patients and the discrepancy of their skin diseases with the adult versions. We aimed to describe frequency and distribution of pediatric skin diseases, and the diagnostic procedures and treatments prescribed. Methods: Cross-sectional epidemiological study. We collected data about diagnostic patterns, diagnostic methods and treatment modalities in pediatric dermatology outpatient clinic visits over 18 months. Results: Infectious diseases (27.9%) and among them viral warts (17.5%) were the most prevalent diagnoses, followed by acne-acneiform diseases (19.9%) and allergic diseases (14.5%). Among the diagnostic tests histopathology was required in 5.2%, usually to diagnose inflammatory and tumoral lesions. Topical treatments (49.3%) were followed by systemic treatments (32.4%) in majority of cases. Conclusions: Viral warts were among the most common dermatoses, and preventive measures for HPV transmission should become important part of public health efforts in children.(AU)

Epidemiology of pediatric skin diseases in the mid-western Anatolian region of Turkey.

BACKGROUND: The field of pediatric dermatology has gained importance with the increment of pediatric patients and the discrepancy of their skin diseases with the adult versions. We aimed to describe frequency and distribution of pediatric skin diseases, and the diagnostic procedures and treatments prescribed. METHODS: Cross-sectional epidemiological study. We collected data about diagnostic patterns, diagnostic methods and treatment modalities in pediatric dermatology outpatient clinic visits over 18 months. RESULTS: Infectious diseases (27.9%) and among them viral warts (17.5%) were the most prevalent diagnoses, followed by acne-acneiform diseases (19.9%) and allergic diseases (14.5%). Among the diagnostic tests histopathology was required in 5.2%, usually to diagnose inflammatory and tumoral lesions. Topical treatments (49.3%) were followed by systemic treatments (32.4%) in majority of cases. CONCLUSIONS: Viral warts were among the most common dermatoses, and preventive measures for HPV transmission should become important part of public health efforts in children.

Evaluation of nasal and oropharyngeal flora in patients with acne vulgaris according to treatment options.

The aim of this study was to evaluate changes in nasal and oropharyngeal flora in patients with acne during treatments with tetracycline and isotretinoin. Swab specimens were taken from the right and left nasal cavities and oropharynx of 55 patients with acne and 20 healthy volunteers who were admitted to the dermatology department (Etlik Educational and Research Hospital, Ankara, Turkey) before the administration of treatment and in the third month of treatment. Study participants were divided into four groups as follows: patients with acne on topical treatment only, systemic isotretinoin, and systemic tetracycline, and the control group. Of 55 patients with acne, 18 were male and 37 were female. The mean age of the patients and the control group was 22.21 ± 4.22 and 21.95 ± 7.64, respectively. Staphylococcus aureus was isolated from the nasal flora of five patients, normal flora was suppressed in the oropharyngeal cultures of seven patients, and normal flora grew in the cultures of the other 20 patients who were on tetracycline treatment. On the other hand, normal flora grew in the nasal and oropharyngeal cultures of all the patients who were on isotretinoin treatment. Treatment options and follow-up procedures for acne vulgaris may lead to the development of bacterial resistance and damage to flora. In particular, systemic tetracycline treatment leads to changes in flora of the nose and throat in patients with acne with an increased carriage of S. aureus. Therefore, careful attention should be paid to the duration of tetracycline treatment in order to not increase the risk of disturbance of microbial flora.

Does pernio cause nail dystrophy?

Pernio is an abnormal inflammatory response to moisture and cold. It is characterized with inflammatory, erythema or violet, painful or itchy cutaneous lesions affecting distal extremities, particularly the fingers and toes. It is more common in women. A literature search showed no reports of nail deformities due to pernio. Here, we present a pernio case who developed nail deformities after extended exposure to cold, if combined with other facilitating factors.

Erythroderma secondary to gliclazide: a case report.

Erythroderma is generalized exfoliative dermatitis, which involves more than 90% of the patient's skin. The most common cause of erythroderma is exacerbation of an underlying skin disease, malignancies or drug reaction. There is a long list of drugs responsible for erythroderma such as antiepileptics, sulfonamides, antibiotics, and angiotensin converting enzyme (ACE) inhibitors. We herein report a case of erythroderma due to gliclazide usage which is also proved by histopathologic examination and patch test. We could not find any case report of gliclazide, an oral antidiabetic, as a cause erythroderma in the literature.

A case of septal panniculitis secondary to interferon treatment.

The most common side effects of interferon-beta therapy following subcutaneous administration include pain, inflammation and induration at the injection site, which occur in approximately 20-60% of patients. Besides, transient injection-site erythema is frequently seen in beta-interferon therapy. Less frequent reactions at injection sites include vascular thrombosis, mucinosis, dermal and systemic sclerosis, necrosis, and ulceration. Here, we report a 44-year-old case diagnosed with multiple sclerosis, who developed pain and swelling following interferon-beta 1a treatment after an improperly administered intramuscular injection; and with this case report, we would like to draw attention to septal panniculitis, a serious drug complication, that develops following interferon-beta 1a treatment after an improperly administered intramuscular injection.

An uncommon cause of laser burns: the problem may be the use of gel.

Laser hair removal is the most common procedure which is usually performed on patient's demands. Even though they are usually safe and well tolerated, with the widespread use both expected and unexpected side effects can be seen. Recognizing the source of side effects is an important issue for the laser operator. In recent years, a new laser technology has been introduced to aid in pain and other side effects in laser applications. Diode laser systems are produced for this technology. The major disadvantage with this laser is the gel application during procedure. We herein report a women while on her second session for laser hair-removal procedure with a 808-nm diode laser, complicated with an epidermal burn reaction due to accumulated debris on the guide.

Treatment of primary hyperhidrosis with tap water iontophoresis in paediatric patients: a retrospective analysis.

OBJECTIVES: Primary hyperhidrosis is an under-recognized condition in children and adolescents. Iontophoresis is the second line of treatment for palmoplantar hyperhidrosis following topical treatment. The studies evaluating the efficacy of iontophoresis in children are limited. We aimed to investigate the efficacy and reliability of tap water iontophoresis in children with primary hyperhidrosis. METHODS: Twenty-one patients aged under 18 years, who received iontophoresis for primary palmoplantar hyperhidrosis, were included in the study. In our clinic, tap water iontophoresis was administered at regular intervals, starting with five times per week and decreased to once a week on fifth week. Then maintenance sessions once a week for 6 weeks are recommended. The presence of excessive sweating was scored by visual analogue scale (VAS): "0" as continuation of excessive sweating and "10" as the absence of excessive sweating. The demographic and clinical data were collected from files. Also, patients fulfilled a questionnaire for efficacy on follow-up visit. RESULTS: Nineteen patients completed the whole 21 sessions. The mean VAS score was 5.89 ± 1.49 at the end of the 15th session and 6.36 ± 2.06 at the end of the treatment. Side effects were well tolerated. Only seven patients were still free of excessive sweating on third months after treatment. The mean satisfaction score was 4.95 ± 2.38, as measured by VAS where 0 indicated dissatisfaction and 10 indicated high satisfaction. CONCLUSION: Tap water iontophoresis is an effective method of treatment for primary palmoplantar and axillary hyperhidrosis in paediatric patients. But there are still unanswered questions about the mechanism of action, ideal session intervals and protocols for maximum efficacy.

Tumoral melanosis in an adolescent after trauma: a clinicopathological dilemma.

Tumoral melanosis (TM) is a histologic term used to indicate a nodular accumulation of melanophages in the dermis clinically presenting as a pigmented lesion. It is usually associated with regression of melanoma and nonmelanoma melanocytic pigmented lesions. We present the case of a 16-year-old girl with a suspicious pigmented macule on her right knee that appeared after trauma. The lesion was completely excised and diagnosed as TM.