Işıl Bulur

Symmetrical drug-related intertriginous and flexural exanthema (Baboon syndrome) associated with infliximab

BACKGROUND Symmetrical drug related intertriginous and flexural exanthema (SDRIFE or Baboon syndrome) is a symmetrical contact dermatitis on inverse regions of the body. The disorder is easily differentiated from other drug eruptions by its typical appearance and lack of other concurrent findings. OBSERVATION A 50-year-old male patient presented to our clinic complaining of a rash that had developed two days after the tenth infliximab infusion for psoriasis and reoccurred after consecutive infusions. The physical examination revealed a bilateral intergluteal, inguinal, abdominal, axillary, antecubital and neck region macular erythematous rash. There were no other systemic findings. The laboratory values were within normal range. The patient was diagnosed with symmetrical drug-related intertriginous and flexural exanthema associated with infliximab treatment based on dermatological findings, histopathology and the results of the provocation test. The lesions resolved permanently after the patient was swiched from infliximab to adalimumab. CONCLUSION Various cutaneous adverse events of anti-tumor necrosis factor alpha treatment have already been reported. The increased use of these agents can lead to a wider variety of drug-induced skin lesions, such as the reported Baboon syndrome.

Clinical Effects of Topical Tacrolimus on Fox-Fordyce Disease

Fox-Fordyce Disease (FFD) is a rare, chronic, pruritic, inflammatory disorder of apocrine glands. It is characterized by dome-shaped, firm, discrete, skin-colored, and monomorphic perifollicular papules. The most common sites of involvement are axillae and anogenital and periareolar regions which are rich in apocrine sweat glands. Treatment is difficult. Topical, intralesional steroids, topical tretinoin, adapalene, clindamycin, benzoyl peroxide, oral contraceptives, isotretinoin, phototherapy, electrocauterisation, excision-liposuction and curettage, and fractional carbon dioxide laser are among the treatment options. In the literature, there are articles reporting beneficial effects of pimecrolimus in FFD. Nevertheless, there have not been any reports about the use of tacrolimus in FFD. We report two patients diagnosed with FFD by clinical and histopathologic examination and discussed therapeutic effects of topical tacrolimus on FFD in the light of literature.

Perianal Basal Cell Carcinoma

Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer. Exposure to ultraviolet light is an important risk factor for BCC development and the disorder therefore develops commonly on body areas that are more exposed to sunlight, such as the face and neck. It is uncommon in the closed area of the body and quite rare in the perianal and genital regions. Herein, we report a 34-year-old patient with perianal BCC who had no additional risk factors.

The role of oxidative stress in early‐onset androgenetic alopecia

Androgenetic alopecia (AGA) is the most common cause of alopecia in men. In the literature, although there are in vitro studies investigating the relationship between oxidative stress and AGA, any in vivo study does not exist.

Superimposed segmental manifestation of juvenile amyopathic dermatomyositis in a 9-year-old boy

Dermatomyositis is a well-known autoimmune disorder. On the other hand, juvenile amyopathic dermatomyositis (JADM) occurs rather rarely. Here, we report an unusual case in a 9-year-old Turkish boy showing a unilateral linear inflammatory skin lesion that was followed, after 16 months, by the appearance of bilateral disseminated features JADM.

Do dermatologists have cosmetic procedures

Current approach and ideas of dermatologists about undergoing MICPs themselves are unknown.

The Evaluation of Contact Sensitivity with Standard and Cosmetic Patch Test Series in Rosacea Patients

Background Rosacea is a common dermatosis characterized by erythema, telangiectasia, papules and pustules. Objective We aimed to evaluate contact sensitivity in the rosacea patients. Methods We included 65 rosacea patients and 60 healthy volunteers in the study. The patient and control groups were patch tested with European baseline series and cosmetic series. Results A positive reaction to at least 1 allergen in the European standard series was found in 32.3% of rosacea patients and 20.0% of subjects in the control group while the relevant numbers were 30.8% of rosacea patients and 10% of controls with the cosmetic series (p=0.08). In total, we found a positive reaction to at least 1 allergen in 38.5% of patients and 25.0% of controls (p=0.15). We did not find a statistically significant relationship between a positive reaction to 1 allergen in total and the gender, skin type, rosacea type, ocular involvement, age and disease duration. There were more symptoms in patients with a positive reaction to allergens (p<0.001). Conclusion Contact sensitivity was detected more common in rosacea patients. Patch testing may be useful in the treatment and follow up of rosacea patients especially if symptoms such as itching, burning and stinging are present.

The efficacy and safety of phototherapy in geriatric patients: a retrospective study

BACKGROUND While phototherapy is a well-established treatment for many dermatoses, data from the literature regarding its use in elderly patients are quite limited. OBJECTIVE In this study, we aimed to determine the phototherapy indications in geriatric patients and to evaluate the effectiveness and reliability of phototherapy in this group. METHODS This study included 95 patients of 65 years of age and older who were treated in our phototherapy unit between 2006 and 2015. The data for this study were collected retrospectively from patient follow-up forms in the phototherapy unit. RESULTS Phototherapy was administered to 28 (29.5%) patients for mycosis fungoides, 25 (26.3%) patients foplaque type psoriasis, 12 (12.6%) patients for palmoplantar psoriasis, 12 (12.6%) patients for generalized pruritus, and 18 (19%) for other dermatoses. Of the patients, 64.2% had received a narrowband UVB (NB-UVB), 21.1% oral psoralen UVA (PUVA), and 14.7% local PUVA treatment. A complete response was achieved in 76.9-85.7% of the mycosis fungoides and in 73.71-100% of the psoriasis vulgaris patients treated with NB-UVB and PUVA, respectively. All the patients with generalized pruritus were treated with NB-UVB, and 80% of these patients achieved significant improvement. The erythema rate was found to be 0.43% per session for NB-UVB treatment and 0.46% per session for PUVA treatment as a side effect. STUDY LIMITATIONS The limitations of our study are that it was retrospective and the remission durations of the patients are not known. CONCLUSION This study showed that phototherapy is effective and reliable in the elderly population with proper dose increases and close follow-up.Background While phototherapy is a well-established treatment for many dermatoses, data from the literature regarding its use in elderly patients are quite limited. Objective In this study, we aimed to determine the phototherapy indications in geriatric patients and to evaluate the effectiveness and reliability of phototherapy in this group. Methods This study included 95 patients of 65 years of age and older who were treated in our phototherapy unit between 2006 and 2015. The data for this study were collected retrospectively from patient follow-up forms in the phototherapy unit. Results Phototherapy was administered to 28 (29.5%) patients for mycosis fungoides, 25 (26.3%) patients foplaque type psoriasis, 12 (12.6%) patients for palmoplantar psoriasis, 12 (12.6%) patients for generalized pruritus, and 18 (19%) for other dermatoses. Of the patients, 64.2% had received a narrowband UVB (NB-UVB), 21.1% oral psoralen UVA (PUVA), and 14.7% local PUVA treatment. A complete response was achieved in 76.9-85.7% of the mycosis fungoides and in 73.71-100% of the psoriasis vulgaris patients treated with NB-UVB and PUVA, respectively. All the patients with generalized pruritus were treated with NB-UVB, and 80% of these patients achieved significant improvement. The erythema rate was found to be 0.43% per session for NB-UVB treatment and 0.46% per session for PUVA treatment as a side effect. Study limitations The limitations of our study are that it was retrospective and the remission durations of the patients are not known. Conclusion This study showed that phototherapy is effective and reliable in the elderly population with proper dose increases and close follow-up.

Advanced oxidation protein products and serum total oxidant/antioxidant status levels in rosacea

Introduction Rosacea is a chronic, inflammatory dermatosis which develops due to the effect of genetic and environmental factors. Aim To evaluate the oxidative stress in rosacea patients by measuring serum total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI) and advanced oxidation protein products (AOPP) levels in our study. Material and methods Our study included rosacea patients and healthy volunteers aged between 18 and 65 years. Total antioxidant status, TOS and AOPP levels were measured and OSI was calculated. Results The study included 70 rosacea patients and 30 healthy volunteers as a control group. When TAS, TOS, OSI and AOPP levels were compared between rosacea and control groups, there was no difference for OSI levels; while TAS, TOS and AOPP levels were significantly higher in the rosacea group (p = 0.151, p = 0.013, p = 0.034, p = 0.017, respectively). In the rosacea group, there was no correlation between TAS, TOS, OSI and AOPP levels and disease duration. Besides there was no difference between family history, rosacea type, symptom frequency and ocular involvement and TAS, TOS, OSI and AOPP levels in the rosacea group. Conclusions We observed that serum TAS, TOS and AOPP levels were significantly higher in rosacea patients, but there was no significant difference among the disease activity parameters. These results can support the role of oxidative stress in the pathogenesis of rosacea.

Evaluation of Serum Resistin Levels and Metabolic Syndrome Related Parameters in Chronic Spontaneous Urticaria

Amaç: Kronik spontan ürtiker (KSÜ) hastalarında serum resistin düzeyi ve metabolik sendrom (MetS) ilişkisini değerlendirmek. Yöntemler: Çalışmaya 42 KSÜ hastası ve 42 sağlıklı gönüllü dahil edildi. Boy, kilo, bel çevresi ve kan basıncı ölçümleri her iki grupta da değerlendirildi. Açlık kan şekeri, serum lipid düzeyleri, resistin ve tümör nekroz faktörü-alpha (TNF-α) düzeyleri venöz kan örneklerinde değerlendirildi. MetS tanısı National Cholesterol Education Program Adult Treatment Panell III tanı kriterleri ile belirlendi. Bulgular: KSÜ hastalarının 14’ünde (%33,3) ve kontrol grubunun 5’inde (%11,9) MetS saptandı. İki grup arasında MetS varlığı açısından istatistiksel olarak anlamlı fark bulundu, p=0,037. KSÜ hastalarının serum resistin düzeyleri ortalaması 1928,31±212,85 pg/mL ve kontrol grubunun serum resistin düzeyleri ortalaması 2107,60±156,71 pg/mL olarak saptandı. Her iki grup arasında serum resistin düzeyi açısından istatistiksel anlamlı fark görülmedi. KSÜ hastalarında MetS tanısı olan hastalar ile MetS tanısı olmayan hastalar arasında ürtiker aktivite skoru, hastalık süresi, otolog serum deri testi pozitifliği, serum immünoglobulin E düzeyi, otoimmünite varlığı, serum resistin ve TNF-α düzeyi açısından farklılık görülmedi. Sonuç: Çalışmamızda KSÜ hasta grubunda MetS görülme sıklığında artış olduğu saptanmıştır. Diğer taraftan KSÜ hastaları içinde MetS’yi olan ve olmayan iki grup arasında hastalık ilişkili parametreler ile serum resistin ve TNF-α düzeyi farklılık göstermemiştir. Anahtar kelimeler: Kronik spontan ürtiker, metabolik sendrom, resistin, tümör nekroz faktörü-alfa, ürtiker aktivite skoru, otolog serum deri testi Öz Abstract