Müzeyyen Gönül

Clinical aspects of epidermodysplasia verruciformis and review of the literature

Background  Epidermodysplasia verruciformis (EV), is an unusual genodermatosis characterized by persistent human papilloma virus infection with an autosomal recessive inheritance pattern. Clinically, it is characterized by flat wart‐like lesions, scaly hypo‐ and hyperpigmented macules and/or patches, which resemble pityriasis versicolor, and development of early beginning nonmelanoma cutaneous carcinomas.

Homocysteine, vitamin B12 and folic acid levels in psoriasis patients

Background  Hyperhomocysteinaemia is a risk factor for atherosclerotic cardiovascular disease, stroke, peripheral arterial occlusive disease and venous thrombosis. An association between psoriasis and cardiovascular diseases has been reported.

A case of generalized discoid lupus erythematosus: Successful treatment with Imiquimod cream 5%

Discoid lupus erythematosus (DLE) is the most common form of chronic cutaneous lupus erythematosus. Classic DLE lesions begin as red-purple macules, papules, or small plaques and rapidly develop a hyperkeratotic surface. Most patients with untreated classic DLE lesions suffer indolent progression to large areas of cutaneous dystrophy and scarring alopecia that can be psychosocially devastating. A 44-year-old male patient presented to the clinic with erythematous scaly patches that began on his nose 1 y before. His face was most affected, however, lesions were also noted on his scalp, ears, and limbs. Histopathologic examination verified a diagnosis of DLE. Laboratory examinations and consultations revealed no signs of systemic involvement. Imiquimod cream 5% was applied to the lesions once a day 3 times a week. After 20 applications, entire lesions regressed significantly. Imiquimod cream 5% may represent an alternative treatment method for patients with DLE.

Detection of contact hypersensitivity to corticosteroids in allergic contact dermatitis patients who do not respond to topical corticosteroids

The delayed hypersensitivity development against topical corticosteroids which are used in allergic contact dermatitis (ACD) treatment is an important clinical problem. In our study, 41 ACD patients who did not show any response to topical corticosteroid treatment were patch tested with corticosteroid series and the commercial preparations of corticosteroids and their vehicles. In corticosteroid series, there were budesonide, bethametasone‐17‐valerate, triamcinolone acetonide, tixocortol pivalate, alclomethasone‐17‐21‐dipropionate, clobetasole‐17‐propionate, dexamethasone‐21‐phosphate disodium and hydrocortisone‐17‐butyrate. We detected positive reaction to corticosteroids in 9 of our cases (22%) (5 single and 4 multiple). The sensitivity was mostly produced by tixocortol pivalate (6 patients). This was followed by triamcinolone acetonide (2 patients) budesonide (2 patients), alclomethasone dipropionate (2 patients), dexamethasone 21 phosphate disodium (2 patients) and betamethasone‐17‐valerate (1 patient). As a result, it should not be forgotten that the corticosteroids used to treat ACD patients may cause ACD themselves. In ACD patients who did not respond to corticosteroid treatment, routinely applying patch test with corticosteroids should be helpful in directing the treatment.

Unconventional medicine in dermatology outpatients in Turkey

Background  Many people use unconventional therapies for health problems, but the extent and pattern of this use in dermatology have not been studied in detail. This article reports the first investigation on the use of unconventional therapies in dermatology in Turkey.

Autoimmune thyroid disorders in patients with psoriasis

A few studies have shown a high prevalence of thyroid autoimmunity in patients with psoriatic arthritis. However, thyroid autoimmunity has not been investigated in patients with psoriasis who do not have psoriatic arthritis. We aimed to investigate thyroid autoimmunity in patients with psoriasis. The study included 105 consecutive patients with psoriasis who did not have psoriatic arthritis and a sex and age matching control group consisting of 96 patients with tinea pedis. All of the patients with psoriasis were examined dermatologically and PASI scores were calculated for each patient. Free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH), antithyroglobulin (AbTG), and antithyroidperoxidase antibody (AbTPO) levels were measured in all of the subjects. The levels of TSH, FT3, FT4, AbTG and AbTPO and ultrasonographic findings of thyroid gland were compared statistically between psoriasis and control groups. Also, the levels of TSH, FT3, FT4, AbTG and AbTPO of psoriasis patients were compared with PASI scores. Mann-Whitney U test was used as statistical method. The mean age of patients with psoriasis was 40.54 +/- 16.91 years. 56 patients were female, 49 were male. The levels FT4 were found to be significantly increased in the patient group. But levels of AbTPO and AbTG were not statistically different between the two groups. The patients who had thyroiditis plus nodules in thyroid ultrasonography had statistically longer disease periods. This is the first study that investigated autoimmune thyroid disorders in patients with psoriasis who did not have arthritis. We believed that thyroid autoimmunity in patients with psoriasis was no different from that found in healthy individuals.

Skin findings in newborns and their relationship with maternal factors: observational research.

Background Cutaneous lesions are commonly seen in the newborn period and exhibit inconsistency from the skin lesions of an adult. Objective The present study was carried out with an aim to determine the frequency of physiologic and pathologic cutaneous findings in newborns. Methods Typically, 1234 newborns were included in this study. A questionnaire about maternal gestational history, maternal and family history was issued to the parents of each newborn. The presence of cutaneous lesions was recorded. Results Overall, 642 (52%) of the newborns were male and 592 (48%) were female. Typically, 831 newborns (67.3%) had at least one cutaneous lesion. The prevalence of genital hyperpigmentation and milia was significantly higher in males. In premature newborns, the pervasiveness of cutis marmorata and genital hyperpigmentation was found to be significantly higher. Caput succedaneum, transient neonatal pustular melanosis and cyanosis appeared predominantly in vaginally born infants. Erythema toxicum neonatorum was seen in infants, who were born by cesarean section. The predominance of Mongolian spots and erythema toxicum neonatorum were significantly higher in the newborns of the multiparous mothers; however, caput succedaneum was significantly higher in newborns of the primiparous mothers. Conclusion A number of studies about neonatal dermatoses have been carried out involving different methods in various countries. We consider that our study may be useful in literature, as it has been carried out involving large number of maternal parameters.

Pediatric Skin Disorders Encountered in a Dermatology Outpatient Clinic in Turkey

Abstract:  This study documents the spectrum and frequency of skin disorders in a total of 2370 children encountered in a dermatology outpatient clinic in Turkey. Infectious skin diseases were most frequently observed (27.6%) followed by, eczemas (17.9%), acne (14,5%), papulosquamous diseases (6.9%), hair diseases (4.1%), pigmentation disorders (3.8%), generalized pruritus (2.8%), urticaria (2.7%), and insect bite (2.3%). Epidemiologic data are useful in planning of the health care and taking preventive measures to decrease the prevalence of skin disorders in children.

Smoking, alcohol consumption and denture use in patients with oral mucosal lesions.

BACKGROUND Epidemiologic researches about oral mucosal lesions have been performed in different populations. But, in dermatology outpatients, oral mucosal lesions have not been investigated previously. OBJECTIVE We aimed to determine the prevalence of oral mucosal lesions among dermatology outpatients and the relationship between OML and smoking, alcohol intake, denture and dental filling use and skin diseases. METHODS Randomly selected 1041 dermatology outpatients were examined for dermatological diseases and oral mucosal lesions. All of the patients were questioned about smoking, alcohol intake, denture and dental filling use. RESULTS In 235 patients, oral mucosal lesions were recorded. 268 (25.7%) of the patients had history of smoking, 42 (4%) drinking alcohol and 180 (17.3%) denture and dental filling. 32 (64%) of the smokers, 54 (30%) of denture users and 10 (23.8%) alcohol consumers had at least one OML. Age and smoking were found as significant risk factors for oral mucosal lesions. Fissured tongue was the most common oral lesion and it was seen significantly higher in patients with denture. Smoking was risk factor for coated tongue and linea alba. CONCLUSIONS Oral mucosa should be examined carefully even if the patients do not attend with the complaint of oral lesions, especially in elderly patients, smokers and denture users.

Serum vitamin B12, folate, ferritin and iron levels in Turkish patients with vitiligo.

Oxidative stress, characterized by an increase in free-radical production exceeding the intracellular antioxidant defence, has been proposed as a possible pathogenetic mechanism for vitiligo.[1] Iron is involved in antioxidative system and large amounts of iron is sequestered by ferritin. Ferritin is an important acute phase reactant and its serum level is increased in some autoimmune disorders.[2] There is only one report investigating serum ferritin levels in vitiligo.[3] We retrospectively investigated the levels of serum vitamin B12, folate, ferritin and iron levels in vitiligo patients.