Gürkan Yardimci

Precancerous lesions of oral mucosa

Precancerous lesions of oral mucosa, known as potentially malignant disorders in recent years, are consists of a group of diseases, which should be diagnosed in the early stage. Oral leukoplakia, oral submucous fibrosis, and oral erythroplakia are the most common oral mucosal diseases that have a very high malignant transformation rate. Oral lichen planus is one of the potentially malignant disorders that may be seen in six different subtypes including papular, reticular, plaque-like, atrophic, erosive, and bullous type, clinically. Atrophic and erosive subtypes have the greater increased malignant transformation risk compared to another subtypes. Although there are various etiological studies, the etiology of almost all these diseases is not fully understood. Geographically, etiologic factors may vary. The most frequently reported possible factors are tobacco use, alcohol drinking, chewing of betel quid containing areca nut, and solar rays. Early diagnosis is very important and can be lifesaving, because in late stages, they may be progressed to severe dysplasia and even carcinoma in situ and/or squamous cell carcinoma. For most diseases, treatment results are not satisfactory in spite of miscellaneous therapies. While at the forefront of surgical intervention, topical and systemic treatment alternatives such as corticosteroids, calcineurin inhibitors, and retinoids are widely used.

Evaluation of body composition parameters in patients with psoriasis

Body composition parameters, such as weight, body mass index (BMI), and visceral fat rating, have been found to be associated with psoriasis. However, the associations of these parameters with psoriasis have not been demonstrated clearly.

Comparison of Effectiveness of Electrocautery and Cryotherapy in Partial Matrixectomy After Partial Nail Extraction in the Treatment of Ingrown Nails

OBJECTIVE To determine an effective mode of therapy of ingrown nail using two different methods. METHODS Patients with the diagnosis of stage 2 or 3 ingrown nails were included and divided into two groups. In the first group, partial matrixectomy was performed using electrocautery after partial nail extraction; in the second group, partial matrixectomy using cryotherapy was performed after partial nail extraction. RESULTS The study included 53 patients with ingrown nails. Patient ages ranged from 11 to 79 years (median 31.8 ± 16.9). No relapse was observed in 96.2% of the patients after a follow‐up period of 3–12 months (n = 51). Matrixectomy in 71.7% (n = 38) of patients was successful. Matrixectomy using electrocautery was successful in 18 of 29 patients. Matrixectomy using cryotherapy was successful in 20 of 24 patients. CONCLUSIONS Matrixectomy should be added to the treatment of ingrown nails. There was no significant difference between electrocautery and cryotherapy in terms of relapse. In patients with advanced stages of ingrown nails, partial nail extraction combined with matrixectomy using cryotherapy is an effective method of treatment.

Evaluation of Effectiveness of Cryotherapy on the Treatment of Cutaneous Kaposi's Sarcoma

OBJECTIVE Kaposis sarcoma (KS) is a vascular tumor that affects the skin and other organs. Several therapeutic options are available, but the optimal therapy is unclear. The aim of this study was to determine the effectiveness and safety of cryotherapy in the treatment of KS. MATERIALS AND METHODS Thirty patients were evaluated. Cryotherapy was applied using liquid nitrogen. Each treatment consisted of two freeze–thaw cycles, with freezing times ranging from 15 to 40 seconds per cycle. RESULTS One hundred twenty‐five lesions were treated in an average of 3.2 sessions. Complete response was observed in 19 (63%) of the 30 patients after cryotherapy treatment with no recurrence. The subjects tolerated cryotherapy well. Blistering occurred frequently, but local pain was limited. There were no secondary infections. CONCLUSION Liquid nitrogen cryotherapy is safe and cost‐efficient and can be readily adopted as an effective primary therapy for cutaneous KS lesions that respond slowly or show incomplete cosmetic improvement after systemic therapies.

A dystrophic calcinosis cutis case treated with CO2 laser.

Abstract Calcinosis cutis is the deposition of insoluble calcium salts within cutaneous tissue. It may be divided into four major subtypes: dystrophic, metastatic, idiopathic, and iatrogenic. The most common subtype is dystrophic calcinosis cutis. It can occur as a result of local tissue injury. We herein present a child with dystrophic calcinosis cutis developed following trauma and successfully treated with CO2 laser.

Evaluation of effectiveness of erbium:yttrium–aluminum–garnet laser on atrophic facial acne scars with 22‐MHz digital ultrasonography in a Turkish population

Scar formation due to acne is a common problem among the young population and significantly affects their quality of life. The aim of this study was to evaluate the efficacy of erbium:yttrium–aluminum–garnet (Er:YAG) laser resurfacing for acne scars and to objectively demonstrate the altering of collagen density in the dermis by 22‐MHz digital ultrasonography. Twenty‐one patients, aged 19–55 years, with facial acne scars were treated with Er:YAG laser. The results of the laser resurfacing were evaluated for the degree of clinical improvement, alteration of the collagen density by 22‐MHz digital ultrasonography and any adverse effects at 3 months. At 3 months after the treatment, good (in 12 patients) and near total (in four patients) clinical improvement was noted in most of the patients compared to baseline. Overall treatment results were 76% (both near total and good) in 16 patients. By ultrasonographic evaluation, the average density of dermal collagen (total density/number of patients) of 21 patients was 32.714 (right cheek) and 32.142 (left cheek) before laser facial resurfacing. At the third month after treatment, the average density of dermal collagen of 21 patients was 36.380 (right cheek) and 38.809 (left cheek). In conclusion, Er:YAG laser skin resurfacing was found to be a safe and effective treatment modality for treatment of atrophic facial acne scars. As public demand grows for less invasive modalities to approach clinical diagnosis and evaluation, digital ultrasonography seems to provide an easy and confidential method for collagen density evaluation.

Acral manifestations of fungal infections

Fungal infections, which are named according to the body site involved, can affect any skin area, the fingernails, or the toenails. Numerous fungal agents are responsible for both superficial and deep fungal diseases. Dermatophytes and Candida spp are the most common causative organisms on the surface of the hands, feet, and nails of patients with superficial fungal diseases; however, although deep fungal infections of the skin are less common compared with superficial fungal diseases, their incidence is increasing worldwide due to cross-border travel. Most superficial fungal diseases are diagnosed clinically, but sometimes direct microscopic examination with potassium hydroxide and fungal culture may be necessary for diagnosis, especially in patients suspected of having tinea incognito. In cases of superficial fungal infections except for onychomycosis and tinea incognito, topical treatments are usually sufficient and effective, but systemic treatments may be required in recalcitrant cases. Deep fungal diseases may resemble each other clinically; therefore, the organism must be identified with laboratory methods and should be treated for a long period. We review the most important clinical, diagnostic, and therapeutic aspects of fungal diseases. This paper covers fungal problems encountered both in hospitals and in general practice.