Asena Çiğdem Doğramacı

Validation of a melasma quality of life questionnaire for the Turkish language: The MelasQoL-TR study

Objectives: In this study, the objective was to evaluate the validity and reliability of the Turkish version of the melasma quality of life questionnaire (MelasQoL-Tr) for melasma patients. Methods: The study included 114 melasma patients. The melasma area and severity index (MASI), MelasQoL-Tr and the Turkish short version of the QoL assessment instrument from the World Health Organization (WHOQOL-BREF) were used to assess melasma severity and QoL at baseline. The reliability and validity of MelasQoL-Tr were computed. Results: The mean age of the patients in the study was 31.8 ± 7.3 years. The internal consistency of the scale (Cronbachs alpha coefficient) was 0.88. The MelasQoL-Tr score was 29.9 ± 14.6 (range 10-66). The total WHOQOL-BREF score was 54.8 ± 9.8. The comparison of MelasQoL-Tr and WHOQOL-BREF questionnaires showed an inverse significant correlation on total scores, which indicated a sufficient convergent validity. According to the subscale of WHOQOL-BREF, the inverse correlation was most significant between the MelasQoL-Tr score and psychological domain and less significant between the MelasQoL-Tr score and environmental domain. The MelasQoL-Tr score and MASI were significantly correlated. Conclusion: The Turkish version of the MelasQoL was valid and reliable for evaluating the quality of life of Turkish melasma patients.

Skin diseases in patients with β‐thalassemia major

Background  β‐Thalassemia major affects multiple organs and is associated with considerable morbidity and mortality. The goal of this analysis was to document the frequency of skin diseases among patients with β‐thalassemia major.

Lipoid proteinosis in the eastern Mediterranean region of Turkey

BACKGROUND Lipoid proteinosis (LP), also known as hyalinosis cutis et mucosae or Urbach-Wiethe disease, is a rare autosomal recessive genodermatosis. Hyalin-like material is deposited in multiple organs, including the skin, oral mucosa, larynx, and brain. Only about 300 cases have been reported in the literature so far. Occurrence of LP in siblings is also rare. The reasons for relatively large number of cases, the clinical features of the patients, and the association of LP with other clinical conditions are described in this article. AIMS The aim of this study is to show that LP is not rare in Turkey and consanguineous marriage is still a social problem. METHODS We included patients between the years of 2008-2011 with lesions resembling LP. Based on the findings of clinical and histological examination of all cases, a diagnosis of LP was made. RESULTS We presented six different families with multiple family members suffered from LP. In total, we determined eight children and six adult patients. Three of eight children were from the same family (sisters), the other three children belonged to another family (brothers), two children were from another family (brother and sister), and the adult patients were from three different families. CONCLUSIONS Patients with LP are likely to present first to a dermatologist because of the appearance of their skin; therefore, it is important that the dermatologic diagnosis is not to be missed. We described patients with LP and discuss the salient features of this disease.

Mean platelet volume and eosinophilia relationship in patients with bullous pemphigoid

Abstract Introduction: Bullous pemphigoid (BP) is an autoimmune skin disease that is characterized by the formation of blisters on normal or erythematous skin. In patients with BP, eosinophils are highly represented in the inflammatory infiltrate of the lesional skin and their levels are often increased in peripheral blood. It is known that eosinophils are the major intravascular source of tissue factor (TF), an initiator of the extrinsic coagulation pathway. Patients with BP are also three times more likely to develop pneumonia and pulmonary embolism than the matched controls. We hypothesized that there might be an association between the eosinophil level and mean platelet volume (MPV) in these patients. Patient and method: A total of 19 patients with BP and age–sex match 22 healthy controls were included in this study retrospectively. MPV before treatment, MPV after treatment, platelet, eosinophil count before treatment, eosinophil count after treatment, white blood cell, glucose, C reactive protein and sedimentation rate were evaluated in BP patients and the control group. Results: The MPV value (8.32 fl ± 1.8) and eosinophil count (1.03 × 103 μL−1 ± 0.36) in patients with BP was significantly higher than that of control subjects (p = 0.036) and (0.22 ×103 μL−1 ± 0.29) (p = 0.002) (p < 0.05, Mann–Whitney U-test). Conclusion: In this study high levels of MPV and eosinophil levels have been detected. MPV may be a useful indicator of the risk of vascular events. Prospective studies are needed to compare disease activity, thromboembolic events and MPV in BP patients.

Dermanyssus gallinae infestation: an unusual cause of scalp pruritus treated with permethrin shampoo.

Abstract Dermanyssus gallinae is a blood parasite of wild birds, but it is also a pest in the poultry industry. It occasionally bites mammals and thus rarely creates skin problems such as itching, papules, vesicles, and dermatitis. A 92-year-old man presented with severe itch on his head, particularly at night. He had been misdiagnosed with senile pruritus and treated with antihistamines and topical corticosteroids with temporary relief of the symptoms. On the basis of clinical and parasitological findings, D. gallinae dermatitis was diagnosed. Decontamination of the patients immediate environment was not helpful. The patient was successfully treated using a 1% permethrin shampoo once a week for 2 weeks. During 3 months of follow-up he was free of symptoms. The case is of significance because most dermatologists have difficulty identifying ectoparasitoses, such as those that arise within new or atypical conditions.

Narrow-band ultraviolet B phototherapy in childhood.

Abstract Background: Narrow-band ultraviolet B (UVB) has been used for skin diseases in children. However, the use of phototherapy in childhood has limited due to the possible risk of skin cancer. The aim of this study is to evaluate the efficacy and safety of the narrow-band UVB phototherapy in children for the treatment of various skin diseases. Methods: The data of the children aged 16 years or under who were treated with narrow-band UVB in our clinic’s phototherapy unit were analyzed, retrospectively. Results: The study included 77 children (42 girls, 35 boys) aged 5–16 years (mean 12.18 ± 3.53) who were treated with a total of 81 courses of narrow-band UVB phototherapy in the last 4.5 years. The majority of patients had vitiligo (47%) and psoriasis (39%). Thirty-four (44.2%) patients showed complete response, 15 (19.5%) good response, 12 (15.6%) partial response, 5 (6.5%) poor response and 11(14.3%) no response. Acute side effects of phototherapy were observed only in 11 (14.3%) patients. Conclusions: Narrow-band UVB phototherapy is an effective and well-tolerated treatment in childhood.

Localized bullous pemphigoid occurring on surgical scars.

A 39-year-old woman presented with blisters on the old surgical scars for a month. Fifteen years ago she had undergone surgical operation due to a traffic accident. In dermatological examination, there were intact, tense bullae, located linearly along the scars on her legs [Figure 1]. Nikolsky phenomenon was negative. There were no bullae in any other mucocutaneous site. No milia were seen. Histopathological examination of the biopsy revealed subepidermal separation and bullous formation. There were abundant neutrophils and eosinophils in bullae [Figure 2]. In dermis, dilated vessels and perivascular chronic inflammatory cell infiltration and less neutrophils and eosinophils were seen. Direct immunofluorescence showed linear complement C3 deposition at the epidermal basement membrane [Figure 3]. IgG, IgA, IgM, and fibrinogen were negative. According to these signs, bullous pemphigoid (BP) was diagnosed. The patient was treated with 0.05% clobetasol propionate cream and her lesions disappeared and no new lesions were observed.

Scleredema Diabeticorum Partially Treated with Low-Dose Methotrexate: a Report of Five Cases

Scleredema is a rare connective tissue disorder that belongs to a group of scleroderma-like disorders. Although no known curative therapy exists, various specific treatments have been proposed in the literature. In this report, we describe five cases of scleredema partially treated with low-dose methotrexate therapy. All patients have diabetes mellitus type II. All patients were started on methotrexate 15 mg subcutaneously once weekly for 3 months. Biopsy specimens were taken from all patients and were examinated histologically before the treatment and after 3 months of treatment. All cases partially responded to low-dose methotrexate therapy. We believe that methotrexate therapy may be an alternative therapeutic options in scleredema in view of its efficacy.

Assessment of thyroid function and lipid profile in patients with postadolescent acne in a Mediterranean population from Turkey.

Postadolescent acne is defined as acne that is seen even after the age of 25 years, regardless of the age at onset. The causes of postadolescent acne have not been completely clarified up to now. Androgens are considered to be the major factor involved in pathogenesis.

Leishmaniasis recidiva cutis of the lips mimicking granulomatous cheilitis

Leishmaniasis recidiva cutis (LRC) is an unusual form of acute cutaneous leishmaniasis. Herein, we present a case of LRC of the lips mimicking granulomatous cheilitis. An 8-year-old, Syrian child admitted with a swelling and disfigurement of his lips for 4 years. Abundant intra and extracellular Leishmania amastigotes were determined in the smear prepared from the lesion with Giemsa stain. Histopathology showed foamy histiocytes and leishmania parasites within the cytoplasm of macrophages in the epidermis and a dense dermal mixed type inflammatory cell infiltrate composed of lymphocytes, foamy histiocytes with multinucleated giant cells. On the basis of anamnestic data, the skin smears results, clinical and histopathologic findings, LRC was diagnosed. The patient was treated with meglumine antimoniate intramuscularly and fluconazole orally. Cryotherapy was applied to the residual papular lesions. The lesion improved markedly at the first month of the treatment.