Factors Affecting Topical Treatment Success in Pediatric Scabies Cases: A Cross-Sectional Study.

INTRODUCTION: Scabies is a common disease that affects the pediatric population. Treatment failure and relapse occur frequently in children. OBJECTIVES: We aimed to identify the factors that affect topical treatment success in pediatric scabies patients. METHODS: A multicenter cross-sectional study was conducted from April 2022 to December 2022. Pediatric scabies cases were classified as belonging to either the treatment failure (TF) group or the treatment success (TS) group. RESULTS: We enrolled 170 patients for the study. In the TF group, the presence of symptomatic household members and referrals from physicians other than dermatologists were more common (both P < 0.001), and relapse rates and total symptom duration were higher (P = 0.007, P < 0.001, respectively). Regarding treatment agents, 5% permethrin was more commonly used in the TF group (71.1% versus 25%; P < 0.001). The proportion of patients treated with sulfur preparations was significantly higher in the TS group (60.7% versus 16.9%; P < 0.001). Misapplication of topical therapy was significantly more common in the TF group (P < 0.001), with statistically significant errors being (i) lack of treatment of close contacts (p<0,001), (ii) single application (P < 0.001), and (iii) local application (P = 0.027). A multivariate analysis revealed that TS was mainly associated with (i) the presence of atopy (odds ratio [OR] 6.12, 95% CI: 1.39-27.04), (ii) the absence of symptomatic household members (OR 6.31, 95% CI: 2.14-18.63), and (iii) presentation to a dermatologist rather than another specialist (OR 6.51, 95% CI: 2.11-20.13). The use of permethrin negatively affected treatment success (OR 0.22, 95% CI: 0.07-0.71). CONCLUSIONS: Pediatric scabies patients should be treated before other family members become infested and with topicals other than permethrin. In addition, awareness of scabies needs to be increased among non-dermatologists.

Evaluation of the Demographic and Clinical Features of Patients With Digital Myxoid Pseudocysts and Their Response to Treatment.

BACKGROUND: Digital myxoid pseudocysts (DMPs) are the most common benign degenerative lesions of the nail unit. There is currently no consensus regarding first-line treatments for DMPs. OBJECTIVE: To evaluate demographic and clinical features and treatment methods of DMP and examine recurrence rates and factors that may affect recurrence. METHODS AND MATERIALS: All patients in the authors' clinic who were diagnosed with DMP between 2013 and 2020 were included. Treatment methods were categorized as surgical excision (SE), drainage and compression (DC), simple drainage (SD), and no treatment. Responses and recurrence rates after different treatment methods were investigated. RESULTS: Fifty-one lesions from 48 patients were included. Thirty-two lesions were treated with SE, 11 with DC, and 1 with SD, while 7 lesions were left untreated. The initial complete response rate after SE was significantly higher than that after DC. No statistically significant difference was found between the recurrence rates of the 2 treatment methods. Using intra-articular methylene blue during SE did not seem to affect recurrence rates. CONCLUSION: Drainage and compression seems to be a safe and effective first-line treatment option for DMPs located on the proximal nail fold and distal interphalangeal joint. SE is more favorable as a second-line treatment.

The role of dermoscopy in the diagnosis of subungual glomus tumors.

BACKGROUND AND OBJECTIVES: The dermoscopic features of glomus tumors have only been described in a few case reports. The aim of this research was to define the clinical and dermoscopic features of subungual glomus tumors. METHODS: Thirty-two patients with subungual glomus tumors were evaluated retrospectively. RESULTS: On the photographs, longitudinal erythronychia, longitudinal leukonychia, punctate leukonychia, splinter hemorrhage, isolated capillaries, distal notching, distal subungual hyperkeratosis, onycholysis, and onychoschizia were found. There was no statistical difference between the rates of detection of these findings by evaluation from clinical photographs alone and from both clinical and dermoscopic photographs. While ramified vessels with bluish spots could be detected in only five of 26 cases with bluish spots in their clinical photographs, these ramified vessels were seen in 14 cases in bluish spots in dermoscopic photographs (P = 0.004). Compared to clinical examination, dermoscopy was able to detect blue spots in three more cases. Lesion duration was higher in the cases with ramified vessels (P = 0.018). CONCLUSIONS: Dermoscopy seems to contribute to the clinical examination in displaying only ramified vessels located in bluish spots and in determining the localization of the subungual tumors. The presence of ramified vessel in the bluish spots is strongly related to lesion duration.

Is There a Pathogenetic Relationship Between Alopecia Areata and Familial Mediterranean Fever?

Alopecia areata (AA) is type of autoimmune, T-cell-mediated disease with abnormal expression of MHC Class I, a common reason for non-scarring hair loss. Familial Mediterranean fever (FMF) is a hereditary autoinflammatory disease characterized by periodic fever and serositis. Various diseases and conditions that may be related to FMF have been reported. It has been known that patients with FMF are vulnerable to MHC Class I-related diseases. The co-existence of the two MHC Class I group-associated entities, FMF and AA, has not been reported in the literature. Here, we present three cases with AA and FMF and discuss the possible common pathway in their pathogenesis.