Evaluation of the frequency and intensity of favipiravir-associated yellow-green fluorescence in lunulae, hair, and face.

BACKGROUND: We detected yellow-green fluorescence in the face, hair and lunulae of patients using favipiravir. AIM: We evaluated the frequency and intensity of favipiravir-associated fluorescence. PATIENTS/METHODS: The participants comprised patients who had taken at least a single dose of favipiravir and been examined no later than 30 days after the last dose. The gender, age, body mass index (BMI), Fitzpatrick's skin-type, hair color, N-acetylcysteine use, presence and the intensity of fluorescent reflection under Wood's light in the lunulae of the fingernails, hair, and the face were recorded. RESULTS: There were 275 patients, 144 (52.4%) of whom were women. 165 (57.9%) had used treatment for a maximum of 5 days, 99 (34.7%) for 6-10 days, and 21 (7.4%) for more than ten days. Using more than 22 tablets of favipiravir increased the probability of detecting fluorescence in the lunulae by 6.72 (2.61-17.23) times. Using more than 28 tablets increased the risk of fluorescence in hair and the T-zone by 5.92 (2.43-14.71) and 2.88 (1.11-7.47) times, respectively. No relationship was found between the fluorescence intensity in any localization and the total dose. However, we determined a negative correlation between the elapsed time after the last dose and the fluorescence intensity in the lunulae and the T-zone (p=0.036; p=0.031; respectively). It was noted that BMI negatively correlated with the fluorescence intensity in the lunulae (p=0.001). Skin type was related to intensity for all localizations (p<0.001). Fluorescence was found in the lunulae with significantly less frequency in patients using N-acetylcysteine (p=0.040). CONCLUSIONS: We must be aware of favipiravir-induced phototoxicity.

Mean platelet volume as a predictor in the differentiation of Behçet's disease from recurrent aphthous stomatitis - A single centre, prospective, case-control study.

INTRODUCTION: Recurrent oral ulcers (ROUs) are the most common disorder of the oral cavity in the community. The most challenging issue for the clinician to deal with in the diagnosis is to distinguish whether ROUs are associated with primarily Behçet's disease (BD). We aimed to investigate whether hemogram parameters contribute to reinforce BD suspicion in the differential diagnosis of recurrent aphthous stomatitis (RAS) and BD. METHODS: A total of 260 participants were recruited from the dermatology department in this single-centre, prospective, case-control study. Participants meeting eligibility criteria were divided into three groups as healthy control (n = 90), RAS (n = 97) and mucocutaneous BD (n = 73). The mean platelet volume (MPV), red cell distribution width (RDW), haemoglobin, neutrophils, monocyte, lymphocytes and platelet counts were evaluated with the complete blood count. Furthermore, the neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio and platelet/lymphocyte ratio were calculated. Erythrocyte sedimentation rate (ESR) and C-reactive protein were recorded. The contribution of hemogram parameters to the differentiation of BD from RAS was analysed. RESULTS: The healthy control, RAS and BD groups were matched in terms of mean age (29.3 ± 5.8, 28.7 ± 5.6 and 29.9 ± 6.8 years; respectively) and sex distribution (women/men rate: 1.4, 1.6 and 1.7; respectively). ESR, neutrophil count and NLR were significantly higher in BD patients. (P = .032, P = .010, P = .019; respectively). MPV is significantly decreased in BD patients than in healthy control and RAS patients (P < .001). Decreased MPV (≤10 fL) and increased RDW (≥13.0%) were useful in predicting BD in patients evaluated with complaints of ROUs (OR = 9.98, 95% CI: [4.65-21.42], P < .001 and OR = 2.23, 95% CI: [1.14-3.36], P = .019, respectively). CONCLUSIONS: Decreased MPV may be predictive for BD in selected patients with ROUs. We consider that more attention is required in terms of BD especially if MPV ≤10.0 fL.

Investigating the factors enabling the accurate implementation of the patient-assisted teledermatology model during the pandemic in Turkey: A pilot study.

We aim to investigate the factors enabling the accurate implementation of the patient-assisted teledermatology model during the pandemic in our country. This single-center, a prospective-survey study was enrolled consecutively 468 patients aged 13 years and older. The patients were asked about their attitudes towards teledermatology. After the dermatological examinations, the diagnosis and management of the diseases, and classification of diseases according to lesion locations were recorded. The physician's and the patient's opinions on whether it was possible to manage properly the current medical condition through teledermatology were recorded. The patients stated that 81.2% have been keen to use teledermatology for any complaints during the pandemic. 53.7% of the patients who are positive to use teledermatology expressed that they would never use this method unless it is fully reimbursed. Although it was thought that 49.8% of the current complaints according to the patients and 56.6% to the dermatologists could be resolved appropriately by teledermatology, for 24.8% either the patient's or the physician's opinion was contrary. Being woman, high-income level, and the presence of facial dermatosis favorably affected the patients' and physicians' evaluations regarding the suitability of the complaint to teledermatology. Factors such as low education level, insufficient technical skills to be examined alone, and the necessity of undressing for examination caused patients to consider teledermatology unsuitable for their current complaints. Priority should be given to the development of an appropriate reimbursement system and reducing potential medicolegal risks to encourage patients to participate in high-quality teledermatology.

Evaluation of cutaneous side-effects associated with chemotherapeutic use in oncological patients.

INTRODUCTION: Side-effects are frequently encountered in classic chemotherapy. However, the recent development of targeted treatments has resulted in a diminution of these. The most common side-effects are dermatological. AIM: To investigate cutaneous changes occurring in patients using classic and targeted chemotherapeutic agents, and the prevalence of these changes in the two groups. MATERIAL AND METHODS: One hundred twenty-eight volunteer oncological patients using chemotherapeutic agents were included in this prospective study. Two subgroups were established, patients using classic and those using targeted chemotherapeutic agents. RESULTS: Xerosis was the most common side-effect, being seen in 93 (72.7%) of the 128 patients. Other common side-effects included alopecia, pruritus, mucositis, skin pigmentation, and palmar-plantar erythema. The most common side-effects in the classic chemotherapeutic group were xerosis seen in 71 (75.5%) patients, pruritus in 50 (53.2%), alopecia in 49 (52.1%), and nail changes in 43 (45.7%). The most common side-effects in the targeted chemotherapeutic group were xerosis seen in 22 (64.7%) patients, nail changes in 17 (50%), alopecia in 15 (44.1%), and pruritus in 13 (38.2%). CONCLUSIONS: The most common cutaneous side-effects were less prevalent in the patient group using targeted chemotherapeutic agents than in the classic group. Various side-effects associated with chemotherapeutic use which had not been previously reported were also identified in this study. Classic chemotherapeutic agents caused more serious side-effects requiring discontinuation of treatment than targeted chemotherapeutic agents.

Changes in dermatological complaints among healthcare professionals during the COVID-19 outbreak in Turkey.

INTRODUCTION: This questionnaire study evaluates dermatological complaints that may arise due to hygiene measures and anxiety among healthcare professionals (HCPs) during the COVID-19 outbreak. METHODS: A total of 526 volunteers, consisting of doctors and nurses, participated. Demographic features, personal hygiene behavior, personal protective equipment (PPE) use, Hospital Anxiety and Depression Scale-Anxiety (HADS-A) parameters, and symptoms of various dermatological diseases (xerosis, eczema, acne, hair loss, palmar hyperhidrosis, xeromycteria, urticaria, aphthous stomatitis, and seborrheic dermatitis) were investigated. RESULTS: Although the frequency and severity of many dermatological complaints increased during the pandemic period, the most frequent increase was observed in the frequency of complaints suggesting xerosis and eczema. We found that complaints suggesting xerosis and eczema were seen on the hands 2.44 and 3.57 times, respectively, as a result of washing hands 10 times/day, and that handwashing times of 10 seconds or more significantly increased the risk of eczema (5.44 times). Another remarkable result was a fivefold increase in acne complaints among those using any mask. The severity of all complaints except hair loss and seborrheic dermatitis correlated significantly with HADS-A. CONCLUSIONS: Our study showed that the frequency and severity of some dermatological complaints increased in HCPs.

Epidemiological Evaluation of Scabies Cases Encountered in the Last Three Years as a Tertiary Health Center.

OBJECTIVES: We aimed to reveal the change in the demographic characteristics of patients with scabies in the last three years and the increase in frequency of patients with scabies observed in our region. METHODS: All patients diagnosed as having scabies in Erzurum Regional Training and Research Hospital and Palandöken State Hospital, Clinic of Dermatology between January 2017 and December 2019 were retrospectively evaluated. Data such as age, gender, citizenship, presentation dates were recorded from the hospital database by anonymizing. RESULTS: The disease was significantly more common in men than women (p<0.001). Of female patients, 40.9% and of male patients, 51.9% were young adults (15-44 years of age). Of 252.261 patients who were admitted to the dermatology outpatient clinic in the past three years, 1.952 (0.77%) were diagnosed as having scabies. It was observed that the frequency of scabies gradually increased in the last three years (0.55%, 0.80% and 0.94%, respectively). The case frequency was significantly higher in 2019 compared to 2017 (p<0.001). Considering the quarters of the year, the lowest rate was observed in the first quarter of 2017, while the highest was in the last quarter of 2019 (0.42% and 1.54%, respectively). It was determined that the frequency of scabies between the quarters of the year increased significantly in the last quarters (p<0.001). One hundred and twenty six (6.5%) patients had a recurrent presentation. It was remarkable that suspicion of treatment failure gradually increased from 3.2% to 6.2% in the past three years. CONCLUSION: The frequency of scabies in our region was indeed increased significantly in 2019 and especially in the 3rd and 4th quarters.

Change of the diagnostic distribution in applicants to dermatology after COVID-19 pandemic: What it whispers to us?

We aim to evaluate the change in the diagnostic spectrum in dermatology outpatient applications compared to before COVID-19. All patients were enrolled from the Department of Dermatology between February 12 and May 8, 2020, the duration of 4 weeks before COVID-19 and 8 weeks after were analyzed in three parts consisting of 4 weeks. Data obtained from the database such as age, gender, diagnoses were anonymized. Repeated applications with the same diagnosis in 10 days after the first presentation were ignored. Compared to the pre-outbreak, there was a 3.5-fold decrease in dermatology applications in the first month after COVID-19 and an 8.8-fold in the second month. We found a significant increase in the frequency of diagnoses such as generalized pruritus, pityriasis rosea, alopecia areata, bacterial skin/mucosa diseases, and zona zoster after COVID-19. The frequency declined in diseases such as verruca vulgaris, hyperpigmentation, skin tag, melanocytic nevus, and seborrheic keratosis/solar lentigo. It has been found that the frequencies of most diseases, including acne (⁓25% of patients), did not change. We think that many factors, such as affecting the quality of life, risk perception, increased stress burden may cause a change in the diagnostic distribution of the dermatology applications.