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2.
Dermatol Ther ; : e14834, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33527603

RESUMO

Acitretin is a nonimmunosuppresive systemic agent used in the treatment of psoriasis. Despite its frequent use, research on drug survival and adverse effects is limited. This study aims to evaluate drug survival, factors associated with survival, and adverse effects. Database of the six tertiary referral center for psoriasis patients treated with acitretin between November 2014 and April 2020 were retrospectively analyzed. Demographics of patients, adverse effects, and also drug survival were analyzed. Of 412 patients, 61.2% were male, and 38.8% were female. Common clinical adverse effects were cheilitis (71.4%), dry skin (62.5%), and palmoplantar skin peeling (37.2%). High triglyceride and high total cholesterol levels were observed in 50.0% and 49.5% of patients, respectively. Median survival time (95% confidence interval [CI]) was 18 (13.6-22.4) months. Statistically significant risk factors affecting drug discontinuation were having psoriatic arthritis, age under 65, and receiving previous systemic treatment. Drug survival rates were 56.6%, 25.9%, and 19.8% at 1, 5, and 8 years, respectively. Although mucocutaneous adverse effects of the acitretin were quite frequent, severe, life-treatining ones were infrequent. This old, relatively inexpensive and safe treatment remains a good alternative for the treatment of psoriasis.

3.
Dermatol Ther ; 34(1): e14733, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33389789

RESUMO

There is a growing body of evidence linking rosacea to various systemic disorders, even though data regarding the association between rosacea and cardiovascular diseases are presently controversial. We sought to investigate the potential association of rosacea with subclinical atherosclerosis and serum proinflammatory/proatherogenic markers. This study included 44 patients with rosacea and 44 age-matched and sex-matched healthy control subjects. Patients with traditional cardiovascular risk factors or a history of cardiovascular events were excluded. Demographic, clinical, and laboratory data, including serum interleukin-1 beta (IL-1ß), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and high-sensitivity C-reactive protein (hs-CRP) levels were assessed. Carotid intima-media thickness (CIMT) and carotid plaques were measured by carotid ultrasonography. Serum IL-1ß (P < .001), IL-6 (P < .001), TNF-α (P < .001), and hs-CRP (P < .001) levels were significantly higher in the patient group compared with the control group. Mean CIMT values did not differ significantly between the patient group and control group (P > .05). Patients with moderate to severe rosacea had a significantly greater CIMT than those with mild rosacea (P = .047). Rosacea patients with eye involvement had a significantly greater CIMT than those without eye involvement (P = .008). There was no significant correlation between CIMT values and inflammation parameters. As conclusion, in the absence of other traditional cardiovascular risk factors, rosacea does not seem to affect mean CIMT value. However, specific subgroups such as patients with moderate to severe disease or with eye involvement are associated with increased subclinical atherosclerosis and may require additional attention for cardiovascular disease prevention.

4.
Dermatol Ther ; 34(1): e14691, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33351215

RESUMO

There is widespread concern about treatment of psoriasis in COVID-19 pandemic. We aimed to evaluate the epidemiological data, clinical characteristics, treatment features of the psoriasis patients during the pandemic period. We conducted a study in dermatology clinics of seven different tertiary centers. All adult psoriasis patients who were followed up between 11 March 2020 and 28 June 2020, were phone called or questioned in their visit to their follow-up clinics. A semistructured questionnaire was applied and patients' demographics and disease characteristics were recorded. Of 1322 patients, 52.4% were male, and 47.6% were female. According to the questionnaire responses, 964 (72.9%) of these patients could not communicate with their physician during this period, remained 358 (27.1%) patients contacted the physician by phone, email, or hospital visit. From the patients diagnosed as probable/confirmed COVID-19, 14 were female, and 9 were male. Nine of 23 (39.1%) patients were using biologic treatment. There was no statistically significant difference in terms of hospitalization from COVID-19 between the patients using biologics (n = 9) and those who did not (n = 14) (P = 1.00). No mortality was observed among them. Obesity, smoking, age, and accompanying psoriatic arthritis were not among the risk factors affecting the frequency of COVID-19. We only encountered an increased risk in diabetic patients. Also, an exacerbation of psoriasis was observed with the infection. No difference was found in patients with psoriasis in terms of COVID-19 infection in patients who use biologics and those who don't.

5.
Dermatol Ther ; : e14465, 2020 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-33112028

RESUMO

Acquired perforating dermatosis (APD) is a group of a rare dermatological disorder characterized by elimination of dermal connective tissue through epidermis. We aimed to evaluate the characteristics of patients diagnosed with APD and to determine the differences in comorbidities according to subtypes of APD. A retrospective, observational, cross-sectional study was designed. Patients diagnosed with APD between January 2008 and January 2019 were reviewed. Eighty patients were included in the study. 61.2% (n = 49) of the patients were female and 38.8% (n = 31) were male with a mean age of 58.4 ± 12.5 years. 82.5% (n = 66) of the patients were diagnosed with reactive perforating collagenosis (RPC) and 17.5% (n = 14) of perforating folliculitis (PF). The most common concomitant disease was diabetes mellitus (82.5%). 5.0% of the patients had malignancy. The comorbidity rate in RPC group was higher than PF (P < .05). Topical steroid was the most frequently (90.0%) used treatment. Complete response was obtained 55.0% of patients. Exitus was observed in 23.8% (n = 19) of patients in a mean 17.6 ± 25.7 months follow-up period. APD may be associated with many diseases. Comorbidities are more frequent in RPC group. This situation warns us to evaluate patients with RPC in more detail for underlying diseases. High mortality rate related to the underlying systemic diseases suggests being careful in terms of mortality in patients diagnosed with APD.

6.
Clin Nucl Med ; 45(9): 681-682, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32657869

RESUMO

A 64-year-old woman who had yellowish orange-colored, sharp-edged, and flat skin plaques and back pain for about a year was referred for F-FDG PET/CT imaging and her bone marrow biopsy revealed 10% to 20% atypical plasma cells suggestive of monoclonal gammopathy. PET/CT showed linear F-FDG uptake on the surface of the skin on the neck, axillary, chest, inframammary, and inguinal regions. Punch biopsy revealed numerous histiocyte infiltrates with large vacuoles, xanthomized cytoplasm in the dermis, and midsection, and there are several Touton-type giant cells supporting the preliminary diagnosis of xanthoma disseminatum.


Assuntos
Fluordesoxiglucose F18 , Histiocitose de Células não Langerhans/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Biópsia , Medula Óssea/patologia , Feminino , Histiócitos/patologia , Histiocitose de Células não Langerhans/patologia , Humanos , Pessoa de Meia-Idade , Plasmócitos/patologia , Baço/patologia
7.
Dermatol Ther ; : e14041, 2020 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-32691920

RESUMO

Tinea pedis affects the life quality distinctly and patients those with a prolonged disease often resort to non-medical methods. We sought to evaluate patients' knowledge about tinea pedis and approaches to the non-pharmacological agents. A cross-sectional study was conducted on 152 patients with tinea pedis who answered the survey between July and November 2019. Demographic and clinical features, patients' attitudes, behaviors, and opinions about non-pharmacological treatments related to tinea pedis were evaluated. Of 152 patients, 65 (42.8%) were female and 87 (57.2%) were male. The frequency of at least one non-pharmacological agent use for tinea pedis was 55.9%. The most common non-pharmacological agent was cologne (27.0%), followed by saltwater, vinegar, and henna. The rate of non-pharmacological agent use was not significantly different between genders and patients with different education levels. Information sources for tinea pedis were dermatologists in only 42 patients (27.8%). The opinion that the disease will improve spontaneously was not significantly different between the groups according to the education level (P = .154). Tinea pedis needs awareness as a health problem particularly in Muslim populations. Patients should be prevented from applying wrong practices and informed about the risk factors, contagiousness, and treatment options by physicians.

8.
Dermatol Ther ; 33(4): e13669, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32459383

RESUMO

Oral isotretinoin is frequently used in the treatment of young acne patients. However, knowledge levels and attitudes about this treatment have not been studied in the parents previously. We aimed to investigate the knowledge levels and concerns about oral isotretinoin in the parents of adolescent acne patients. We conducted a cross-sectional study on 136 parents of adolescent patients with moderate to very severe acne vulgaris who answered the questionnaire about oral isotretinoin treatment. Demographic data and acne characteristics were recorded. The parents' knowledge levels and concerns about the treatment process were asked by the questionnaire. Since 32 parents have never heard oral isotretinoin before, they were excluded from the study. Of the remaining 104 parents, 80.8% were female and 19.2% were male. Of the parents, 62.5% had some concerns about oral isotretinoin treatment and 34.6% had no idea whether the drug is suitable for the use of <18 years. 52.9% stated that they think the drug will damage the liver. The most known and worrying side effects were dry lips and vision problems, respectively. The knowledge levels about oral isotretinoin treatment and its side effects were low in the parents of adolescent acne patients, leading to prejudice to the drug.

9.
Acta Dermatovenerol Croat ; 27(2): 75-80, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31351500

RESUMO

Actinic keratoses have variants that differ clinically and pathologically. Proliferative actinic keratoses (PAK) are known to be resistant against standard therapies and to create a tendency for the development of invasive squamous cell carcinoma (SCC). This study retrospectively reviewed the medical records of 50 patients with 51 PAK lesions. Fifty patients (40 male, 10 female) with a mean age of 68.5 were included in the study. Thirty-two (63%) PAK lesions were clinically selected for total excision but only 27 of them could be totally excised. Among the excised lesions, 13 were reported to be PAK, 13 were SCC, and 1 was keratoacanthoma. There was no significant difference between the PAK and SCC groups. Overall, the groups with excised and unexcised lesions were statistically similar with respect to age, sex, lesion duration, localization, size, and surface features, but induration was more common in the SCC group. The mean follow-up time was 19.7 and 17.0 months in the PAK and SCC group, respectively. In conclusion, 25% (13/51) of lesions diagnosed as PAK were invasive SCC, which is of clinical and histopathological significance. Our results suggest that the definition of PAK should be histopathologically revised and that total excisional biopsy instead of punch biopsy should be considered, especially for lesions with a proliferative appearance.


Assuntos
Carcinoma de Células Escamosas/patologia , Ceratose Actínica/patologia , Neoplasias Cutâneas/patologia , Idoso , Carcinoma de Células Escamosas/cirurgia , Feminino , Humanos , Ceratose Actínica/cirurgia , Masculino , Invasividade Neoplásica , Estudos Retrospectivos , Neoplasias Cutâneas/cirurgia
10.
Mol Imaging Radionucl Ther ; 28(2): 79-82, 2019 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-31237139

RESUMO

Dystrophic epidermolysis bullosa (DEB) is a rare, inherited skin fragility disorder characterized by blister formation in the sublamina densa. DEB is associated with aggressive squamous cell carcinoma (SCC) that has increased risk of metastases and poor prognosis. A 41-year-old woman with DEB underwent 18F-fluoro-2-deoxy-glucose positron emission tomography/computed tomography (18F-FDG PET/BT). PET/CT showed increased 18F-FDG uptakes in multifocal cutaneous lesions in both lower extremities. The patient was diagnosed with SCC via skin biopsy from the left lateral lower thigh. Ten months later, PET/CT showed increased FDG uptakes in the primary tumor area as well as the left inguinal and left supraclavicular lymph node regions. 18F-FDG PET/CT seems to be useful for re-staging and planning appropriate therapeutic strategy in DEB-patients with SCC.

11.
Dermatol Online J ; 25(2)2019 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-30865409

RESUMO

Angiolipoma, a subtype of lipoma, is a benign adypocytic soft tissue tumor composed of mature adipose tissue and small vascular proliferations. This entity makes up 5-17% of all lipomas. The diagnosis is made by clinical and pathological examination, ultrasonography, and/or magnetic resonance imaging (MRI). It is generally an encapsulated tumor (noninfiltrative), but rarely has an infiltrative form. Angiolipoma mostly occurs on the trunk and extremities with male predominance. The forearm is the most frequent location for angiolipomas. It is very rarely seen on the fingers. Herein, we report a patient with solitary noninfiltrating angiolipoma on a finger. The patient was treated with surgical excision and no recurrence has been noted over one year of observation.


Assuntos
Angiolipoma/diagnóstico por imagem , Angiolipoma/patologia , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/patologia , Dedos , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Ultrassonografia
12.
Anatol J Cardiol ; 17(1): 66-72, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27271475

RESUMO

OBJECTIVE: Psoriasis is associated with an increased frequency of cardiovascular risk factors. Metabolic syndrome (MS) and the Framingham risk score (FRS) are two different algorithms for evaluating cardiovascular risk. They include different features: waist circumference measurement is included in the MS criteria, whereas smoking, age, and gender are questioned in FRS. This study aimed to evaluate the frequency of MS and FRS in psoriasis patients compared with a control group and investigate the differences between MS and FRS. METHODS: This was a cross-sectional study involving 300 psoriasis patients and 177 controls. MS, FRS, and disease severity were evaluated. RESULTS: The frequency of MS was higher in females with psoriasis than in those in the control group (p=0.019). Females in the psoriasis group were more obese than those in the control group (p=0.036). FRS significantly differed between the patients and controls of age >60 years (p=0.006). The risk of hypertension in current and past smokers was higher in the psoriasis patients (OR=2.07 and 2.32-2.48, respectively) than in the control group. There was no statistically significant relationship among MS, FRS, and psoriasis severity (p>0.05). CONCLUSION: The results of this study support the evaluation of cardiovascular risk assessment in female psoriasis patients with MS and in male and elderly psoriasis patients with FRS.


Assuntos
Algoritmos , Síndrome Metabólica/epidemiologia , Psoríase , Adulto , Fatores Etários , Antropometria , Estudos de Casos e Controles , HDL-Colesterol/sangue , Estudos Transversais , Feminino , Humanos , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/etiologia , Pessoa de Meia-Idade , Obesidade Abdominal , Fatores de Risco , Fatores Sexuais , Triglicerídeos/sangue , Turquia/epidemiologia
13.
Australas J Dermatol ; 58(2): e26-e30, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-26969834

RESUMO

BACKGROUND/OBJECTIVES: Demodex mite density is emphasised in the aetiopathogenesis of acne rosacea. Reflectance confocal microscopy (RCM) has been shown to be a good method for determining demodex mite density. The objective was to determine demodex mite density using RCM in acne rosacea patients and compare them with controls. METHODS: In all, 30 papulopustular rosacea (PPR) and 30 erythematotelangiectatic rosacea (ETR) totally 60 acne rosacea patients and 40 controls, were enrolled in the study. The right cheek was selected for imaging and RCM was used for scanning. Ten images of 1000 × 1000 µm (total 10 mm2 ) area were scanned from adjacent areas. The numbers of follicles, infested follicles and mites were counted. The mean numbers of mites per follicle and infested follicles were calculated and compared in the patients and control groups. RESULTS: The mean number of mites was 44.30 ± 23.22 in PPR, 14.57 ± 15.86 in ETR and 3.55 ± 6.48 in the control group (P < 0.001). The mean number of mites per follicle was 1.77 ± 0.90 in PPR, 0.57 ± 0.63 in ETR and 0.13 ± 0.23 in the control group (P < 0.001). The cut-off for the mean number of mites for determining mite infestation was 0.17 and above. CONCLUSIONS: Demodex mite density was markedly increased in both ETR and PPR patients. It is believed that the presence of demodex mites plays an important role in rosacea aetiopathogenesis. Demodex mite treatment may reduce the severity of the disease and slow its progressive nature.


Assuntos
Folículo Piloso/diagnóstico por imagem , Folículo Piloso/parasitologia , Infestações por Ácaros/diagnóstico por imagem , Ácaros , Rosácea/diagnóstico por imagem , Rosácea/parasitologia , Adulto , Animais , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Microscopia Confocal , Pessoa de Meia-Idade , Infestações por Ácaros/complicações
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