Social Media Use in Dermatology in Turkey: Challenges and Tips for Patient Health.

Social media has established its place in our daily lives, especially with the advent of the COVID-19 pandemic. It has become the leading source of information for dermatological literacy on various topics, ranging from skin diseases to everyday skincare and cosmetic purposes in the present digital era. Accumulated evidence indicates that accurate medical content constitutes only a tiny fraction of the exponentially growing dermatological information on digital platforms, highlighting an unmet patient need for access to evidence-based information on social media. However, there have been no recent local publications from Turkey analyzing and assessing the key elements in raising dermatological literacy and awareness in digital communication for patients. To the best of our knowledge, this study is the first collaborative work between health care professionals and a social media specialist in the medical literature. Furthermore, it represents the first author-initiated implementation science attempt focusing on the use of social media in addressing dermatological problems, with the primary end point of increasing health literacy and patient benefits. The multidisciplinary expert panel was formed by 4 dermatologists with academic credentials and significant influence in public health and among patients on digital platforms. A social media specialist, who serves as a guest lecturer on "How social media works" at Istanbul Technical University, Turkey, was invited to the panel as an expert on digital communication. The panel members had a kickoff meeting to establish the context for the discussion points. The context of the advisory board meeting was outlined under 5 headlines. Two weeks later, the panel members presented their social media account statistics, defined the main characteristics of dermatology patients on social media, and discussed their experiences with patients on digital platforms. These discussions were organized under the predefined headlines and in line with the current literature. We aimed to collect expert opinions on identifying the main characteristics of individuals interested in dermatological topics and to provide recommendations to help dermatologists increase evidence-based dermatological content on social media. Additionally, experts discussed paradigms for dermatological outreach and the role of dermatologists in reducing misleading information on digital platforms in Turkey. The main concluding remark of this study is that dermatologists should enhance their social media presence to increase evidence-based knowledge by applying the principles of patient-physician communication on digital platforms while maintaining a professional stance. To achieve this goal, dermatologists should share targeted scientific content after increasing their knowledge about the operational rules of digital channels. This includes correctly identifying the needs of those seeking information on social media and preparing a sustainable social media communication plan. This viewpoint reflects Turkish dermatologists' experiences with individuals searching for dermatological information on local digital platforms; therefore, the applicability of recommendations may be limited and should be carefully considered.

The investigation of the possible relationship between Coxsackie viruses and pemphigus.

BACKGROUND: Pemphigus is a group of autoimmune bullous diseases on which the etiopathogenesis of several viruses has been blamed. Coxsackie viruses (CVs) are the causative agents of hand, foot, and mouth disease, and herpangina, which have been strongly associated with several autoimmune diseases. The onset of pemphigus after CV infection and cephalosporin use has been reported. OBJECTIVE: To detect the presence of CV in patients with pemphigus. MATERIALS AND METHODS: Reverse transcriptase-polymerase chain reaction analysis for CV RNA sequences and immunohistochemical staining for the CV and adenovirus receptor expression were performed on patient skin samples. CV-IgM and -IgG serum levels were analyzed. RESULTS: Thirty-two patients and 40 controls were investigated. Neither the CV and adenovirus receptor expression nor CV RNA sequences was established in the skin samples of patients. The ratio of CV-IgG positivity was higher in patients (12.5%) than in the controls (5%; P > 0.05). CONCLUSION: Our preliminary results indicate that the viral genome of CV does not become persistent in the skin. Further studies with a larger number of cases are needed to clarify the place of CVs in the etiopathogenesis of pemphigus.

Influence of narrowband UVB irradiation of serum on autologous serum skin test results.

BACKGROUND: Autologous serum skin test (ASST) is an in vivo test to demonstrate circulating endogenous proinflammatory or wheal-inducing factors in urticaria patients. While ASST was negative in a patient with solar urticaria and in a patient with localized heat urticaria, test results turned to positive when performed with visible light-irradiated and heated serums, respectively. These data suggest that some factors and/or antibodies in serum may be activated or inhibited with different factors. We aimed to investigate whether or not ASST results change when performed with narrowband ultraviolet B (UVB)-irradiated serum. MATERIALS AND METHODS: Seventy-seven patients with chronic idiopathic urticaria underwent ASST twice in consecutive days. The second ASST was performed with narrowband UVB-irradiated serum. The results of the first and second ASSTs were compared. RESULTS: The first ASST results were positive in 46 (59.7%) patients. ASST results reversed oppositely in 36 (46.8%) patients, turned from negative to positive in 19 patients, and turned from positive to negative in 17 patients when performed with narrowband UVB-irradiated serum. CONCLUSION: Our results suggest that narrowband UVB may have modifying effects on some wheal-inducing factors and/or antibodies. On which factors in serum narrowband UVB has effects may be investigated.

Vitamin D receptor gene polymorphisms and haplotypes (Apa I, Bsm I, Fok I, Taq I) in Turkish psoriasis patients.

BACKGROUND: Psoriasis is an inflammatory disease characterized by increased squamous cell proliferation and impaired differentiation. Vitamin D, Calcitriol, and its analogues are successfully used for psoriasis therapy. However, it is unknown why some psoriasis patients are resistant to Vitamin D therapy. Vitamin D mediates its activity by a nuclear receptor. It is suggested that polymorphisms and haplotypes in the VDR gene may explain the differences in response to vitamin D therapy. MATERIAL/METHODS: In this study, 102 psoriasis patients and 102 healthy controls were studied for VDR gene polymorphisms. The Fok I, Bsm I, Apa I and Taq I polymorphisms were examined by PCR-RFLP, and 50 subjects received vitamin D therapy to evaluate the association between VDR gene polymorphisms and response to vitamin D therapy. Existence of cutting site is shown by capital letters, and lack was shown by lower case. The haplotypes were analysed by CHAPLIN. RESULTS: There was significant difference in allele frequency of T and genotype frequency of Tt between cases and controls (p values 0.038 and 0.04, respectively). The Aa and bb genotypes were significantly higher in early onset than late onset psoriasis (p values 0.008 and 0.04, respectively). The genotypes Ff, ff and TT are significantly different between vitamin D3 therapy responders and non-responders (p values 0.04, 0.0001, 0.009, respectively). To the best of our knowledge, this is the first report showing importance of VDR gene haplotypes in psoriasis, the significance of the Wald and LR (Likelihood Ratio) statistics (p=0,0042) suggest that FfBbAatt is a disease-susceptibility haplotype. CONCLUSIONS: Haplotype analysis is a recent and commonly used method in genetic association studies. Our results reveal a previously unidentified susceptibility haplotype and indicate that certain haplotypes are important in the resistance to vitamin D3 therapy and the onset of psoriasis. The haplotypes can give valuable data where genotypes unable to do.