Sorbitan sesquioleate: a rare contact allergen that is also an important indicator of allergic contact dermatitis from crossreacting compounds as well as for false-positive fragrance allergy.

BACKGROUND: Controversy exists about the addition of sorbitan sesquioleate (SSO) to the European baseline series for concomitant patch testing, particularly with fragrance mix (FM) I and Myroxylone pereirae (MP), which both contain SSO as an emulsifier. AIM: To investigate SSO contact sensitization and concomitant positive patch test reactions to FM I or MP in Turkey. METHODS: This was a retrospective analysis of 840 patients consecutively patch tested with SSO 20% petrolatum between 1996 and 2020. RESULTS: The prevalence of SSO sensitization was 0.6% (5 of 840). In four of the five patients, clinical relevance could be established from SSO crossreactants, mainly in moisturizers and topical pharmaceuticals other than corticosteroids. Positive patch test reactions with unknown clinical relevance were observed to FM I or MP (both containing 5% SSO) in 71.4% of patients with a positive/questionable positive reaction to SSO (P < 0.001) and to other patch test allergens containing 1-5% SSO. CONCLUSIONS: SSO was a very good indicator for positive patch test reaction with unknown clinical relevance to fragrances and other allergens containing 1-5% SSO. We suggest that SSO should be tested as a negative control with any commercially available patch test allergen containing SSO at any concentration. Moreover, clinicians should be alert for SSO synonyms and for other sorbitan derivatives in product labels, as SSO itself might not be the culprit but an indicator for crossreacting allergens.

Methylchloroisothiazolinone/methylisothiazolinone and methylisothiazolinone contact allergy: A 24-year, single-center, retrospective cohort study from Turkey.

BACKGROUND: Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) and MI allergy caused a global epidemic during the period 2010 to 2015, reaching its peak in 2013/14. OBJECTIVE: To investigate the characteristics of MCI/MI and MI allergy in Turkey over 24 years. METHODS: A total of 2310 patients patch tested between 1996 and 2019 with MCI/MI 0.01% aq. or MCI/MI 0.02% aq., with or without MI 0.2% aq., were analyzed. RESULTS: The overall prevalence of contact sensitization was 3.3% (n = 77) with a peak level of 16.4% in 2015. The prevalence gradually decreased thereafter, but was still high (6.5%) in 2019. Seventy-three patients had clinically relevant sensitizations. MI could detect clinically relevant sensitizations in all seven patients with a negative patch test reaction to MCI/MI 0.02%. Non-occupational allergic contact dermatitis (ACD) was most frequently seen, mainly in women, with hand/face eczema from rinse-off or leave-on cosmetics, such as wet wipes. Occupational ACD was mainly seen among men with airborne eczema from wall paints in house painters, or with hand eczema from hair gel/wax in men's barbers. CONCLUSIONS: The prevalence of MCI/MI and MI sensitization in Turkey following the peak in 2015 is still high. This is probably due to the currently allowed level of 100 ppm for MI in rinse-off cosmetics. This needs to be urgently reduced.

Surveillance of psoriatic patients on biologic treatment during the COVID-19 pandemic: A single-center experience.

There are few studies on how patients with psoriasis who are on biologic therapy are affected by the COVID-19 pandemic. We analyzed the impact of the COVID-19 pandemic on patients with psoriasis receiving biologic therapy, patients' current status at a single center in Turkey. A total of 133 patients (mean age; 44.6 ± 13.5 years) were on maintenance biological treatment for moderate-to-severe psoriasis during the pandemic. A standardized questionnaire was administered by phone interviews to determine patients' perceptions, attitudes, and adherence to therapy and identify the frequency of COVID-19 infection, psoriasis status, and new comorbidities during the pandemic. All patients had been receiving a biological agent including ustekinumab, etanercept, adalimumab, secukinumab, infliximab, ixekizumab, or certolizumab pegol. Ninety-one patients (68.4%) had at least one comorbid condition, including psoriatic arthritis (35.3%), hypertension (19.5%), diabetes mellitus (16.5%), obesity, coronary artery disease, and dyslipidemia. During the first 3 months of the pandemic, 52 patients (39%) suspended their biological therapies for short (n = 33) or long (n = 19) periods without medical advice for reasons of fear, worry, and anxiety. All but one patient restarted their medications as a result of therapeutic counseling. Five patients reported suspicious symptoms, but only one had PCR-confirmed COVID-19. Our findings suggest that biologic treatment for moderate-to-severe psoriasis would not pose an additional risk for COVID-19 infection and its life-threatening complications, even in the presence of a high frequency of cardiometabolic comorbidities, provided that all patients are informed and necessary pandemic-directed precautions are well adopted by the patients.

The impact of COVID-19 pandemic on the management of patients with chronic urticaria: An observational two-center study from Turkey.

The Coronavirus Disease 2019 (COVID-19) outbreak significantly affected the clinical practice in hospitals and the management of many diseases. The aim of this study was to evaluate the effect of pandemic-related factors on the severity and course of chronic urticaria (CU). A total of 194 CU patients who were on regular follow-up, were enrolled in the study. The disease activity was assessed by means of the weekly urticaria activity score (UAS7) and urticaria control test (UCT). Patients were divided into two subgroups according to their disease aggravation as "aggravated" and "non-aggravated". Two groups were compared in terms of demographic, clinical, COVID-19-associated parameters, and parameters related with the effect of COVID-19 pandemic on CU management. The omalizumab use was statistically higher (P = .017), and the systemic corticosteroid use was statistically lower (P = .025) in the "aggravated" group. Adherence to quarantine was significantly lower in the "aggravated" group (P = .027). 173 patients (89.2%) were unable to contact a dermatologist during the pandemic. Among 186 patients who received treatment for CU before the pandemic, 48 (25.8%) did not continue the existing treatment during the pandemic. CU aggravated in one patient with COVID-19 and remained stable in the other. This study showed that CU patients, especially those on omalizumab therapy, had difficulties in attending medical care and even in the maintenance of their existing therapies during the pandemic. Creating novel follow-up and treatment models as well as the increased use of teledermatology might be beneficial in the management of this life-disturbing condition.

Impact of The Method of Diagnosis on The Stage of Breast Carcinoma.

OBJECTIVE: Screening mammography is recommended to women at a certain age to achieve an early diagnosis. The purpose of this study is to find out how breast carcinoma was diagnosed and the impact of the method of diagnosis on the stage of the tumor. MATERIALS AND METHODS: In this study, 903 operated breast cancer patients, between 2010-2016, in a large volume Marmara University Istanbul Pendik Education and Research Hospital were analyzed retrospectively. Patients presenting with clinical symptoms and those diagnosed with screening were investigated separately. The percentage of the patients diagnosed with symptoms and the impact of the method of diagnosis on the stage of the tumor was the primary outcome of the study. RESULTS: 738 patients fulfilling inclusion criteria with complete clinical records were analyzed. 126 patients (17%) were in the age range of 19-39 years, while 32% (236 patients) were 40-50 and 51% (376 patients) were older than 50 years.485 patients (65.7%) were diagnosed with a mass in the breast, while 241 (32.6%) patients were diagnosed with screening with mammography. Twelve patients (1.7%) presented with nipple discharge. Median tumor sizes measured in the resected specimen were 22 mm, 21 mm, and 21 mm in patients diagnosed with a mass, screening, and nipple discharge respectively. The difference among the groups were not significant (p=0.460).Axillary lymph nodes were positive in 210 (43.3%) of patients presenting with a mass in the breast while 85 patients (35.3%) diagnosed with screening had metastatic lymph nodes in the axilla. Three patients presenting with nipple discharge had positive axillary lymph nodes (p=0.137). CONCLUSION: This study demonstrated that breast cancer screening programs in Turkey needs improvement and at the same time shows that screening with mammography after 40 years of age should be done annually despite Ministry of Health recommendations.