Skin manifestations following anti-COVID-19 vaccination: A multicentricstudy from Turkey.

PURPOSE: After the emergence of the pandemic caused by the COVID-19 virus, vaccination with various vaccines has started to be implemented across the world. To identify dermatological reactions developing after the COVID-19 vaccines administered in Turkey and determine their clinical features and risk factors that may play a role in their development. MATERIALS AND METHODS: The study included patients aged ≥18 years, who presented to 13 different dermatology clinics in Turkey between July 2021 and September 2021 after developing dermatological reactions following the administration of the COVID-19 vaccine. After providing written consent, the patients were asked to complete a standard survey including questions related to age, gender, occupation, comorbidities, the regular medication used, the onset of cutaneous reactions after vaccination, and localization of reactions. Dermatological reactions were categorized according to whether they developed after the first or second dose of the vaccine or whether they occurred after the inactivated or messenger RNA (mRNA) vaccine. The relationship between dermatological reactions and some variables such as gender and comorbidities was also evaluated. RESULTS: A total of 269 patients [116 women (43.1%), 153 men (56.9%)] were included in the study. It was observed that the dermatological diseases and reactions that most frequently developed after vaccination were urticaria (25.7%), herpes zoster (24.9%), maculopapular eruption (12.3%), and pityriasis rosea (4.5%). The rate of dermatological reactions was 60.6% after the administration of the mRNA vaccine and 39.4% after that of the inactivated vaccine. There was a statistically significantly higher number of reactions among the patients that received the mRNA vaccine (p = 0.001). CONCLUSION: The most common reactions in our sample were urticaria, herpes zoster, and maculopapular eruption. Physicians should know the dermatological side effects of COVID-19 vaccines and their clinical features.

Telogen effluvium in daily practice: Patient characteristics, laboratory parameters, and treatment modalities of 3028 patients with telogen effluvium.

BACKGROUND: Telogen effluvium (TE) is a common form of non-scarring alopecia, characterized by excessive shedding of telogen club hairs. OBJECTIVES: The aim of the present study was to investigate patient characteristics, laboratory parameters, and treatment strategies in TE. METHODS: Electronic records of 3028 patients were retrospectively analyzed. Demographic and clinical data, as well as serum parameters screening for iron, vitamin B12, vitamin D, folate and zinc deficiencies, thyroid function, and ANA titers, were evaluated. RESULTS: In the study group, the most frequently performed test type was serum ferritin level (82.3%), followed by complete blood count (81%), both of which revealed that 6.2% of the patients had iron deficiency anemia. 4.6% of the patients had thyroid dysfunction. In screened patients, vitamin and mineral deficiencies were as follows: vitamin D (72.2%), vitamin B12 (30.7%), folate (4.4%), and zinc (2.1%). Women were more likely to be prescribed vitamin D replacement therapy. Iron replacement was the most frequently ordered treatment, comprising 37.5% of total prescriptions. CONCLUSION: To the best of our knowledge, this is the most comprehensive retrospective study having the largest number of patients with TE. Our results will not only help to augment knowledge about TE, but also provide a diagnostic algorithm for the laboratory and clinical workup of patients with TE.

Serum levels of survivin in patients with psoriasis and their relation to disease characteristics.

BACKGROUND: Psoriasis is a chronic inflammatory disease in which T helper 1 (Th1) and Th17 cells play a major role in its pathogenesis. Studies have shown that keratinocytes in psoriatic tissue are resistant to apoptosis and have a high proliferation rate. Survivin is a multifunctional protein belonging to an apoptosis inhibitor family, which has significant effects on the immune system, such as activation of dendritic cells and T cells and immunomodulation. OBJECTIVES: To investigate a possible relationship between serum survivin levels and psoriasis disease characteristics and severity. MATERIALS AND METHODS: The present study included 84 patients with psoriasis who did not receive any systemic treatment for psoriasis in the last three months and 84 volunteers without psoriasis. Demographic data, smoking status, and alcohol consumption of the participants were questioned, and body mass index (BMI) was calculated. In the patient group, disease duration, family history, accompanying arthritis, and nail involvement were questioned and psoriasis area severity index (PASI) scores were calculated. Serum survivin levels were measured in all subjects. RESULTS: Serum survivin level was significantly higher in the patients compared to the controls (p = 0.008). There was no relationship between serum survivin level and disease duration, family history, joint involvement, nail involvement, BMI, and PASI score (all p-values > 0.05). Serum survivin levels were significantly higher in smokers than non-smokers and in alcohol consumers than patients that did not drink alcohol in the psoriasis group (p = 0.034 and p = 0.006, respectively). CONCLUSION: Serum survivin levels were higher in psoriasis patients than the control group. This finding suggests that this molecule, which is both immunomodulatory and an apoptosis inhibitor, may play a role in the pathogenesis of psoriasis. Significantly high serum survivin level in psoriasis patients who smoke suggests that smoking may act through survivin. More comprehensive studies are needed to evaluate the role of survivin in the pathogenesis of psoriasis and its relationship with smoking.

Evaluation of HLA class I and HLA class II allele profile and its relationship with clinical features in patients with alopecia areata: a case-control study.

BACKGROUND: Alopecia areata (AA) is an autoimmune disease where autoimmune dysregulations along with genetic susceptibility are hypothesized to play a role in pathogenesis. OBJECTIVE: The aim of this study in to evaluate HLA-A, HLA-B, HLA-C, HLA-DQB1, and HLA-DRB1 profile and its relationship with clinical features in AA patients. MATERIALS AND METHODS: Ninety-eight patients with AA and 100 healthy controls were included in the study. HLA-A, HLA-B, HLA-C, HLA-DQB1, and HLA-DRB1 frequencies were analyzed using polymerase chain reaction-sequence specific primers (PCR-SSP). RESULTS: HLA-B*39 and HLA-HLA-DRB1*15 allele frequencies were increased (p = .022 and p = .023, respectively), HLA-A*11 and HLA-B*35 frequencies were decreased (p = .006 and p = .014, respectively) in AA patients. HLA-B*13 and HLA-DRB1*11 were associated with poor prognostic factors. A class I allele, HLA-B*13 was associated with recurrence (p = .023) and presence of nevus flammeus (p = .022), while the class II allele HLA-DRB1*11 was associated with widespread hair loss (diffuse or universal alopecia) (p = .026), presence of ophiasis (p = .049) and juvenile onset (p = .018). CONCLUSION: Belonging to two different classes of HLA family, HLA-B*13 and HLA-DRB1*11 alleles identified separate set of risk factors. In addition to increasing the risk of AA, HLA alleles may affect the prognosis of the disease.

No Additional Benefit of Combining Fractional Carbon Dioxide Laser With Narrow-Band Ultraviolet B Phototherapy for Vitiligo: A Randomized Prospective Study With Half-Body Side Comparison.

BACKGROUND: Narrow-band ultraviolet B (nb-UVB) phototherapy constitutes the gold standard treatment for vitiligo. Whether carbon dioxide (CO2) laser might increase the efficacy of nb-UVB is still a topic of debate. OBJECTIVE: To test the hypothesis that the addition of fractional CO2 laser to nb-UVB may enhance repigmentation. PATIENTS AND METHODS: Fractional CO2 laser was applied with an interval of 2 weeks for 7 sessions, only to 1 of the 2 symmetrical vitiligo patches located on 2 different half-body sides. Patients received whole-body nb-UVB phototherapy 3 times a week, for at least 4 months. Repigmentation was scored with a quartile grading scale, with the help of a computer program using the photographs taken by the digital dermatoscope. RESULTS: Fifty-one symmetrical vitiligo patches of 30 patients were included. No statistically significant difference was found between the mean repigmentation scores for the laser and nonlaser sides (p = .11). CONCLUSION: Results of this study suggest that combining fractional CO2 laser with nb-UVB phototherapy with the regimen used in this study does not increase the repigmentation scores for vitiligo.

A Case of Plasma Cell Granuloma Located on the Gingiva.

Plasma cell granuloma (PCG) is an uncommon benign tumor of unknown etiology, primarily located in the lungs. We report a case of PCG on the gingiva mimicking benign and malignant tumors in a 56-year-old woman. Histopathological examination revealed a relatively sharp circumscribed inflammatory cell infiltration under the mucosa-containing plasma cells, predominantly those including Russell bodies. Plasma cells are stained by CD138 immunohistochemistry. Polyclonal status of the lesion was confirmed by kappa and lambda light chaining. The typical histopathological and immunohistochemical findings in combination with the clinical features were consistent with PCG, about which the literature reports very few cases.