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.

Pitfalls of an automated dermoscopic analysis system in the differential diagnosis of melanocytic lesions.

Dermoscopy plays an important role in the diagnosis of pigmented lesions, particularly in the differential diagnosis of early-stage melanoma. Dermoscopy systems that aim to enable automatic "unmanned-without physician" diagnosis are becoming increasingly common. We aimed to investigate the reliability and weaknesses of diagnosis programs. Furthermore, we attempted to determine whether such programs are superior to diagnosis by a physician, compared to histopathological assessment. The images stored in the DermoGenius ultra-computerized dermoscopy system of the Dermoscopy Unit between January 2008 and December 2008 were surveyed retrospectively. Dermoscopic images made prior to excision of 77 lesions from 51 patients verified by histopathology were reviewed. Nineteen patients were men and 32 were women. Mean age was 35.5 years. Diagnosis by a clinician or automatic analysis revealed that 23 (30%) of the lesions were atypical (dysplastic) nevi, 22 (29%) were compound nevi, 10 (13%) were dermal nevi, 8 (10%) were malignant melanomas, 7 (9%) were common nevi, 6 (7%) were junctional nevi, and 1 (1%) was a blue nevus. Compared to histopathological diagnosis, considered the gold standard, the sensitivity of the automated analysis program was 96.6%, its specificity 14.9%, and its diagnostic accuracy 47%. For the clinician, the values were 100% for sensitivity, 66.7% for specificity, and 95% for diagnostic accuracy. Based on histopathological results, the diagnostic accuracy of the physician was higher than that of the automatic analysis program. Therefore, errors are inevitable when an inexperienced physician assesses patients according to automatic program results.

Non-healing ulcer on the foot: early onset unilateral Mali-type acroangiodermatitis.

Acroangiodermatitis (pseudo-Kaposi's sarcoma, AAD) is a benign vascular dermatosis that resembles Kaposi's sarcoma clinically and histopathologically (1). Four types have been defined: the Stewart-Bluefarb type accompanying chronic arteriovenous malformations, the Mali type accompanying stasis dermatitis, a type accompanying the first gestation, and a type accompanying arteriovenous shunts in patients with chronic kidney failure (3). Although AAD development is associated with chronic venous failure, less frequently AAD can develop as a complication of extremity paralysis, hemodialysis, post-traumatic arteriovenous fistula, amputated extremities, and vascular malformations (e.g., Klippel-Trénaunay syndrome). Pseudo-Kaposi's sarcoma can be histopathologically and clinically confused with malignant diseases such as Kaposi's sarcoma (1, 4). A 22-year-old male was referred to our outpatient clinic with a complaint of a non-healing wound on the distal phalanx of the left first toe. The patient was referred to various centers for 2 years and stated that he had received infection treatments but that his complaints did not disappear. An AAD diagnosis was established for the patient based on clinical and histopathologic evidence. Because he had early-onset disease and it was unilateral, the diagnosis was delayed. In addition, due to the rare occurrence of the disease, we histopathologically diagnosed this patient as having acroangiodermatitis.

Impact of Helicobacter pylori infection on severity of psoriasis and response to treatment.

The aims of this study were to determine the prevalence of H. pylori seropositivity in patients with psoriasis, to evaluate the relationship between PASI (Psoriasis Area and Severity Index) scores and H. pylori infection, and to assess the impact of H. pylori infection on the response to treatment. A total of 300 patients with psoriasis and 150 non-psoriatic healthy controls were enrolled in the study. Patient PASI scores were recorded and H. pylori stool antigen tests performed in both patients and controls. Fifty patients with H. pylori infections were randomly assigned to one of two groups, one of which received acitretin with H. pylori treatment and the other acitretin alone. Statistical analyses were performed using chi-square and logistic regression tests. PASI scores were significantly higher in patients with H. pylori infections. Treatment aimed at eradicating H. pylori infection enhanced the effectiveness of acitretin therapy and shortened response times. Our results suggest that H. pylori infection plays a role in the severity of psoriasis, and that eradicating such infections enhances the effectiveness of psoriasis treatment.