Assessing Public Awareness and Perception of Teledermatology Via Survey.

INTRODUCTION: Teledermatology represents an alternative medical approach allowing for the remote assessment of a patient's clinical information without the need for face-to-face consultations. OBJECTIVES: This study aims to gauge the public's awareness and perception of teledermatology. METHODS: This research employed a cross-sectional observational design. Data collection was executed using an online survey. Sociodemographic attributes of all participants, such as age, gender, and occupation, were recorded. The survey, designed using Google Forms, comprised two sections: demographic information (5 questions) and queries related to teledermatology (10 questions). Questions and options in the survey were reviewed and revised by two dermatologists to eliminate potential misunderstandings, grammar, and other errors. Power analysis indicated a requirement of a minimum of 527 participants, given a 0.05 margin of error, 98% confidence level, and 0.50 response distribution. RESULTS: A total of 873 individuals completed the survey- 47.7% were male and 52.3% were female. Students made up 48.1% of the participants, while 22.6% were civil servants. The Marmara Region had the highest participation rate at 47.7%. Remarkably, 41.9% of participants were unfamiliar with the term "teledermatology". However, 57.2% expressed a preference for consultations via teledermatology. Furthermore, 63.7% mentioned facing challenges when attempting to communicate with dermatologists for skin-related concerns. A notable 71.6% supported the formal implementation of teledermatology in our country. CONCLUSIONS: Our survey highlighted a limited awareness of teledermatology among participants, yet a majority showed a preference for teledermatology consultations. For a comprehensive understanding of public knowledge and perception towards teledermatology, more extensive, multicentric studies are necessary.

The relationship between seborrheic dermatitis and body composition parameters.

OBJECTIVE: Seborrheic dermatitis (SD) is a chronic, recurrent inflammatory skin disease characterized by clinically scaly patches. It is known that skin diseases with chronic inflammation are associated with comorbid conditions such as metabolic syndrome, obesity, cardiovascular diseases (CVD) and diabetes. In recent years, there are studies investigating the relationship of SD with metabolic syndrome, hypertension, obesity and nutritional factors. However, there is no study evaluating body composition parameters in SD patients. In the light of this information, it was aimed to evaluate the relationship between SD and body composition parameters. METHODS: The study was conducted on a total of 78 participants, including 39 SD patients over the age of 18 and 39 age- and gender-matched control patients, who applied to the University Faculty of Medicine Dermatology outpatient clinic. Body composition parameters were measured for each participant with the Tanita MC 580 Body Analyzer. In addition, SD area severity index (SDASI) was calculated in the SD patient group. These parameters were compared between the case and control groups. RESULTS: There was no significant difference concerning height (p=0.208), weight (p=0.309), body mass index (p=0.762), fat mass (p=0.092), metabolic age (p=0.916), body density (p=0.180), mineral (p=0.699), visceral adiposity (p=0.401), protein (p=0.665), and other body composition parameters, between the case and control groups. There was only positive correlation between SDASI and height (p=0.026) and protein (0.016) value. CONCLUSION: SD may be associated with obesity, metabolic syndrome, insulin resistance, and CVD, but the results are unclear and further studies are needed.

The role of childhood trauma in patients with chronic urticaria.

OBJECTIVE: Chronic urticaria (CU) is a common skin disease in which the etiology involves immunological and psychological factors. Childhood traumas may disrupt the development of the neuro-immuno-cutaneous-endocrine system and start a complex pathophysiological process with inflammatory abnormalities, potentially leading to the development of skin disease. In light of this information, we believe that childhood trauma may play a role in the onset and severity of disease in CU patients. Our study aimed to discover a potential relationship between CU and childhood traumatic experiences. METHODS: This study was conducted with 53 controls and 50 CU patients. The participants were given a questionnaire form that included sociodemographic information, Beck Anxiety Scale, Beck Depression Scale, and Childhood Trauma Questionnaire (CTQ-28). RESULTS: The rates of childhood trauma were found to be 68% in the patient group, and 54.7% in the control group. The patient group demonstrated higher scores for moderate to severe anxiety and depression. The mean emotional abuse score was significantly higher in early onset (<35 ages) urticaria patients in comparison to late onset urticarial (≥35 ages) and the control group. It was found that depression scores were positively correlated with all abuse sub-types, excluding sexual abuse, and total CTQ-28 scores. Anxiety scores were positively correlated with emotional abuse, physical neglect, emotional neglect, and total CTQ-28 scores. CONCLUSION: Childhood traumas are associated with the early onset and severity of disease in CU patients as well as the accompanying depression and anxiety.

The effect of COVID-19 on development of hair and nail disorders: a Turkish multicenter, controlled study.

BACKGROUND: A broad spectrum of skin diseases, including hair and nails, can be directly or indirectly triggered by COVID-19. It is aimed to examine the type and frequency of hair and nail disorders after COVID-19 infection. METHODS: This is a multicenter study conducted on consecutive 2171 post-COVID-19 patients. Patients who developed hair and nail disorders and did not develop hair and nail disorders were recruited as subject and control groups. The type and frequency of hair and nail disorders were examined. RESULTS: The rate of the previous admission in hospital due to COVID-19 was statistically significantly more common in patients who developed hair loss after getting infected with COVID-19 (P < 0.001). Telogen effluvium (85%) was the most common hair loss type followed by worsening of androgenetic alopecia (7%) after COVID-19 infection. The mean stress scores during and after getting infected with COVID-19 were 6.88 ± 2.77 and 3.64 ± 3.04, respectively, in the hair loss group and were 5.77 ± 3.18 and 2.81 ± 2.84, respectively, in the control group (P < 0.001, P < 0.001). The frequency of recurrent COVID-19 was statistically significantly higher in men with severe androgenetic alopecia (Grades 4-7 HNS) (P = 0.012; Odds ratio: 2.931 [1.222-7.027]). The most common nail disorders were leukonychia, onycholysis, Beau's lines, onychomadesis, and onychoschisis, respectively. The symptoms of COVID-19 were statistically significantly more common in patients having nail disorders after getting infected with COVID-19 when compared to the control group (P < 0.05). CONCLUSION: The development of both nail and hair disorders after COVID-19 seems to be related to a history of severe COVID-19.

Evaluation of plasma zonulin level and its relationship with inflammatory cytokines in patients with vitiligo.

BACKGROUND: It has been proven that there is an increase in intestinal permeability in some autoimmune diseases. In our study, we purposed to assess intestinal permeability in vitiligo disease by looking at zonulin levels. At the same time, we aimed to examine the correlation of inflammatory cytokines and lipopolysaccharide (LPS) levels with zonulin. METHODS: Forty-one patients and 41 healthy participants were involved in our study. Blood samples were taken from all patients and controls, and the levels of zonulin, tumor necrosis factor (TNF)-α, interleukin (IL)-6 and LPS were examined. RESULTS: The mean of zonulin in the patient group was found to be statistically higher than the control group (p < 0.05). A positive correlation was found between zonulin level and IL-6, TNF-α, and LPS levels (p < 0.05). TNF-α and LPS levels in the vitiligo group were significantly higher than in the control group, but there was no such significance in terms of IL-6 levels. CONCLUSION: We think that serum zonulin level increases and intestinal permeability increases in vitiligo disease.

Evaluation of serum TWEAK, TRAIL, and oxidative stress markers in rosacea patients.

BACKGROUND: Rosacea is a chronic inflammatory skin disease of unknown pathogenesis. TWEAK and TRAIL are two cytokines thought to have a role in the pathogenesis of some inflammatory and autoimmune diseases. AIMS: The purpose of this study was to examine TWEAK and TRAIL serum levels and oxidative stress markers in patients with rosacea. MATERIAL AND METHOD: Forty rosacea patients and 40 sex- and age-matched healthy controls were involved in the study. Serum TWEAK and TRAIL levels were evaluated with ELISA kits. Serum total antioxidant status, total oxidant status, total thiol, native thiol, disulfide levels were evaluated, and oxidative stress index was computed. RESULTS: Serum levels of TWEAK, TRAIL, and oxidative stress markers did not differ statistically in the patients and controls. Both TWEAK and TRAIL levels in the patients were detected to be statistically higher in male than in female. CONCLUSION: TWEAK and TRAIL may not have a systemic effect in rosacea, unlike other inflammatory diseases. More studies are needed to investigate the role of TWEAK and TRAIL in rosacea.

Cutaneous reactions after COVID-19 vaccination in Turkey: A multicenter study.

OBJECTIVES: In this study covering all of Turkey, we aimed to define cutaneous and systemic adverse reactions in our patient population after COVID-19 vaccination with the Sinovac/CoronaVac (inactivated SARS-CoV-2) and Pfizer/BioNTech (BNT162b2) vaccines. METHODS: This prospective, cross-sectional study included individuals presenting to the dermatology or emergency outpatient clinics of a total of 19 centers after having been vaccinated with the COVID-19 vaccines. Systemic, local injection site, and non-local cutaneous reactions after vaccination were identified, and their rates were determined. RESULTS: Of the 2290 individuals vaccinated between April 15 and July 15, 2021, 2097 (91.6%) received the CoronaVac vaccine and 183 (8%) BioNTech. Systemic reactions were observed at a rate of 31.0% after the first CoronaVac dose, 31.1% after the second CoronaVac dose, 46.4% after the first BioNTech dose, and 46.2% after the second BioNTech dose. Local injection site reactions were detected at a rate of 35.6% after the first CoronaVac dose, 35.7% after the second CoronaVac dose, 86.9% after the first BioNTech dose, and 94.1% after the second BioNTech dose. A total of 133 non-local cutaneous reactions were identified after the CoronaVac vaccine (2.9% after the first dose and 3.5% after the second dose), with the most common being urticaria/angioedema, pityriasis rosea, herpes zoster, and maculopapular rash. After BioNTech, 39 non-local cutaneous reactions were observed to have developed (24.8% after the first dose and 5% after the second dose), and the most common were herpes zoster, delayed large local reaction, pityriasis rosea, and urticaria/angioedema in order of frequency. Existing autoimmune diseases were triggered in 2.1% of the patients vaccinated with CoronaVac and 8.2% of those vaccinated with BioNTech. CONCLUSIONS: There are no comprehensive data on cutaneous adverse reactions specific to the CoronaVac vaccine. We determined the frequency of adverse reactions from the dermatologist's point of view after CoronaVac and BioNTech vaccination and identified a wide spectrum of non-local cutaneous reactions. Our data show that CoronaVac is associated with less harmful reactions while BioNTech may result in more serious reactions, such as herpes zoster, anaphylaxis, and triggering of autoimmunity. However, most of these reactions were self-limiting or required little therapeutic intervention.

Psychiatric basics of alopecia areata in pediatric patients: Evaluation of emotion dysregulation, somatization, depression, and anxiety levels.

BACKGROUND/OBJECTIVE: Alopecia areata (AA) is a skin disease characterized by sudden-onset hair loss. The relationship between psychiatric status and AA has not been fully elucidated. The aim of this study was to evaluate emotion dysregulation, somatization, depression, and anxiety levels in children and adolescents with AA. METHODS: The study included 27 patients aged 8-18 years diagnosed with AA, and an age and gender-matched control group consisting of 30 cases without a known chronic medical disease. All individuals were screened for existing psychiatric illnesses by a pediatric psychiatrist through the Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime Version (K-SADS-PL). The patients were then evaluated using the Children's Depression Inventory (CDI), Screen for Child Anxiety-Related Emotional Disorders (SCARED), State-Trait Anxiety Inventory for Children (STAI-C), and Children Somatization Inventory (CSI-24). In addition, the patients' parents were asked to complete the Emotion Regulation Checklist-Family Form (ERC). RESULTS: When comparing the scale scores of the AA and control group, there was a statistically significant difference between the groups in terms of the Emotional Lability/Negativity subscale scores on ERC. K-SADSPL ratios denoted features of at least one psychiatric condition in 62.9% and 16.6% of the AA group and control group, respectively. CONCLUSIONS: Our results emphasize the importance of psychiatric evaluation in patients with AA. Our study also reveals the need for further studies with a larger sample of AA patients being evaluated in terms of emotion regulation.

Platelet rich plasma application by dermapen microneedling and intradermal point-by-point injection methods, and their comparison with clinical findings and trichoscan in patients with androgenetic alopecia.

Androgenetic alopecia (AGA) is a progressive hair loss disease that occurs with the effect of androgens and genetic predisposition. Hair thinning and hair loss affect people's self-confidence and self-image more than is thought. In these patients, platelet rich plasma (PRP) treatment is used in addition to the limited medical treatments available. However, there is a lack of standardization for the application method of PRP treatment in the literature. The number of studies in which objective data and hair analysis parameters were revealed to demonstrate the effectiveness of PRP treatment is also very limited. In this study, it was aimed to show the efficacy of PRP treatment with trichoscan data in AGA patients and to compare dermapen-mediated microneedling and point-by-point technique injection application methods. The study was conducted with 62 male AGA patients, aged between 18 and 55 years, who applied to the University Faculty of Medicine, Department of Dermatology, and ranged from Norwood-Hamilton Stage II-V. The patients were randomly divided into two groups and one group was given microneedling with a dermapen, an electrical device that makes automatic needling, and the other group was given manual injection with point-by-point technique with a 30-gauge needle. Before the first treatment, each patient underwent a trichoscan hair analysis evaluation. A total of four sessions of PRP treatment were performed, as three sessions at 2-week intervals and the fourth session 1 month after the last session. The mean age of the cases was 33.13 ± 6.36. According to Norwood-Hamilton staging, stage III was detected with the highest rate of 46% (29). Hair pulling test became significantly negative after treatment (p < 0.05). Statistically significant differences were found in trichoscan analysis parameters for hair count, hair density, terminal hair count, and terminal hair density in both groups compared to pretreatment (p < 0.05). Between the groups, a statistically significant difference was found between the averages of anagen hair, telogen hair, and hair length in the dermapen treated group compared to the group treated with the point-by-point technique. In our study, the efficacy of PRP treatment for AGA patients was demonstrated by trichoscan parameters. Among the PRP application methods, dermapen-mediated application was found to be superior to the point-by-point technique in terms of anagen, telogen, and average hair length parameters.