The Possible Relation of Demodex and Facial Erythema in Connective Tissue Diseases.

Background: We aimed to investigate the frequency of Demodex infestation and clinical implications in connective tissue disease patients with facial erythema. Methods: Patients diagnosed with a connective tissue disease and had facial erythema were consecutively enrolled in the study from 2019-2020. An age and gender matched control group was formed from healthy volunteers. Presence of Demodex was investigated by standardized skin surface biopsy. Number of Demodex mites over 5 per centimeter square was considered meaningful for infestation. Topical or systemic metronidazole treatment was given to the connective tissue disease patients with Demodex infestation. Facial erythema visual analog scale was questioned in patients at treatment onset and one month after. Results: A total of 31 connective tissue disease patients with facial erythema were enrolled. Control group included 31 healthy volunteers. Demographics and comorbidities were similar between groups. Demodex infestation was present in 58.1% of the disease group and in 25.8% of the control group (P=0.01). Pruritus was the most common symptom in patients with infestation. Median (IQR) facial erythema visual analog scale score was 6 (3) at treatment onset and was 2 (2.5) one month later (P<0.001). Conclusion: When evaluating facial cutaneous lesions, Demodex infestation should not be overlooked in a patient group like connective tissue diseases with dysfunctional immune system.

Differences in skin lesions of endogenous and exogenous Cushing's patients.

INTRODUCTION: Cushing's syndrome is a rare condition characterized by increased glucocorticoid levels. Dermatologically, it causes a variety of skin conditions such as atrophy, striae, acne, plethora, hypertrichosis, hirsutism, acanthosis nigricans, hyperpigmentation, alopecia, purpura and fragile skin. Although skin lesions of Cushing's syndrome have been described, exogenous and endogenous types have not been studied in detail. AIM: To determine differences in possible skin lesions depending on the cause of Cushing's syndrome. MATERIAL AND METHODS: A total of 35 patients - 16 iatrogenic Cushing's syndrome patients and 19 endogenous Cushing's syndrome patients - who were diagnosed in Erciyes University and 15 healthy individuals were included in this study. RESULTS: There was at least one skin finding in 34 (97.1%) of the patients with Cushing's syndrome and 9 (60%) in the control group (p = 0.001). Comparison regarding skin findings in patient and control groups revealed that hypertrichosis, hyperpigmentation, and fungal infections were significantly more frequent in the patient group than the control group. Hirsutism was found more frequently in the endogenous group whereas stria, hypertrichosis and fungal infections were more frequent in the exogenous group. CONCLUSIONS: Since Cushing's syndrome is a rare disease and it is often diagnosed later in life, data on the frequency of skin findings are limited and sparse in the literature. In the comparison of endogenous Cushing's and exogenous Cushing's groups, acne, hypertrichosis, and fungal infections were found more frequently in the exogenous Cushing's group and hirsutism more frequently in the endogenous Cushing's group.

Fixed drug eruption due To 2,3-dimercapto-1-propanesulfonic acid (DMPS) treatment for mercury poisoning: a rare adverse effect.

BACKGROUND: Fixed drug eruptions (FDE) are characterized by recurrent, usually solitary erythematous or dark red macular, plaque or bullous lesions, all at the same site. Among the first choices for antidotal treatment in mercury exposure, 2,3-dimercapto-1-propanesulfonic acid (DMPS) is generally a drug with a low incidence of side effects. FDE due to DMPS was not detected in our literature research and so we aimed to present this rare case. CASE REPORT: Forty-eight-year-old male patient, gunpowder and explosives factory worker, was admitted to our hospital because of mercury exposure and we started DMPS treatment. On the second day of chelation treatment, swelling and felting on lips and complaints of wound formation in genital areas started. Annular, purple color plaque on penis with no angioedema was observed. Case was regarded as FDE. Systemic and topical steroid therapy was started after termination of chelation therapy and lesions regressed with steroids. DISCUSSION: Drug eruptions are substantially common dermatological problems and can be seen in about 2.2% of inpatients. The most common unexpected effects of DMPS are allergic skin reactions. The clinical state regress rapidly after the cessation of chelation therapy.

Can we use the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and mean platelet volume values for the diagnosis of anterior uveitis in patients with Behcet's disease?

INTRODUCTION: The purpose of this study was to compare the value of hematological parameters, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV), as indicators of anterior uveal segment involvement in patients with Behcet's disease (BD). PATIENTS AND METHODS: Hospital-based records of a total of 912 patients with BD from the dermatology clinic and healthy volunteers from the checkup clinic were assessed retrospectively. After applying the exclusion criteria of the study, 71 of the BD patients with anterior uveitis, 69 of the BD patients without ophthalmological pathology and 151 healthy volunteers were included in the study. MPV, PLR, and NLR values of patients and healthy volunteers were compared. RESULTS: All MPV, PLR, and NLR values of patients who had anterior uveitis were significantly higher than those of other patients and healthy volunteers. Statistically, considering area under curves (ratio): NLR was 0.725 (0.653-0.797), P<0.001; PLR was 0.600 (0.523-0.676), P=0.012, and MPV was 0.358 (0.279-0.437), P<0.001. CONCLUSION: MPV, PLR, and NLR are all valuable for assessment of anterior uveal segment involvement in patients with BD. However, the NLR seems to be better than the PLR and MPV for indicating anterior uveitis due to BD.