Neslihan Şendur

Acne: prevalence, perceptions and effects on psychological health among adolescents in Aydin, Turkey.

Background  Acne vulgaris is a common disease among adolescents and known to have adverse effects on psychological status.

Paederus Dermatitis: A Report of 46 Cases in Aydın, Turkey

Paederus dermatitis is a specific form of acute irritant contact dermatitis caused by pederin, a secretion of insects of the genus Paederus. The disease is characterized by vesicles, bullae and sometimes small pustules on an erythematous base with sudden onset of a stinging, burning sensation. The dermatitis is most frequently seen in regions with a hot, tropical climate. We present 46 cases from Aydın, Turkey, a province well known for its long hot summers. These are the first cases reported from this region. We would like to point out the possibility of Paederus dermatitis in regions with a similar climate and suggest that ‘night burn’ be included among other differential diagnoses of a grouped vesicular and/or pustular lesion on an erythematous base.

Immunohistochemical Findings in Notalgia paresthetica

Background: Notalgia paresthetica (NP) is a sensory neuropathy the pathogenesis of which is not yet completely elucidated. Objective: The aim of this study was to investigate the histopathological changes in NP with special emphasis on cutaneous innervation. Methods: Along with site-matched biopsies from 5 healthy individuals, lesional skin biopsies from 14 cases of NP and biopsies from contralateral nonlesional skin in 9 of these cases were stained with hematoxylin-eosin and Congo red. For immunohistochemical analysis, all samples were stained with two general neural markers (S-100 protein and protein gene product 9.5) and two neuropeptides (vasoactive intestinal polypeptide and substance P). Results: Light microscopy was compatible with postinflammatory hyperpigmentation. Immunohistochemistry did not reveal a significant difference in the staining pattern of lesional skin and control tissue (p > 0.05). Although not reaching statistical significance, the percentage of cases which showed no staining was higher in the group of patients with more chronic NP. Conclusion: The finding of less immunohistochemical staining in cases with more chronicity could be of clinical importance and is worth investigating further.

Rosacea treatment with intermediate-dose isotretinoin: follow-up with erythema and sebum measurements.

Isotretinoin is one of the therapeutic options for rosacea. However, the response of erythema to treatment with isotretinoin is usually slow and incomplete with common (0.5-1 mg/kg/day) or low (10 mg/day) doses. This study investigated the efficacy of, and relapse on, 20 mg/day isotretinoin treatment in rosacea, with the aid of instrumental measurement of facial erythema and sebum levels. A 20 mg/day dose of isotretinoin was given for 4 months, and then the dose was tapered off within the following 6 months. A total of 25 patients were included in the study. Papule and pustule counts, erythema index, sebum level, dermatologists and patients erythema scores, and dermatologists sebum scores were significantly lower in the first month of therapy compared with pre-treatment values (p < 0.05). Within a median follow-up of 11 months (95% confidence interval: 8.4-13.5 months) 45% of patients had a relapse. In conclusion, 20 mg/day isotretinoin was rapidly efficient for reducing both inflammatory lesions and erythema in rosacea.

Adiponectin levels, insulin resistance and their relationship with serum levels of inflammatory cytokines in patients with Behçet’s disease

Aim  Increased frequency of cardiovascular disease and its possible relations with insulin resistance have been reported in patients with inflammatory diseases. The aim of our study was to investigate insulin resistance and serum adiponectin levels as cardiovascular risk markers in patients with Behçet’s disease.

Resistant oral mucosal lesions in pemphigus vulgaris responsive to double filtration plasmapheresis: First case report from Turkey

BACKGROUND Adjuvant therapeutic methods are employed when pemphigus vulgaris (PV) fails to be controlled by conventional corticosteroid treatment. OBJECTIVE The efficacy of double filtration plasmapheresis (DFPP) was investigated in a PV patient with severe, refractory mucosal disease. METHODS A total of 3 DFPP cycles, each cycle consisting of 5 double filtration sessions conducted on alternate days was completed. RESULTS DFPP provided immediate clinical relief of symptoms as well as a significant decrease in anti-desmoglein antibody levels and allowed for a much lower corticosteroid dose. CONCLUSION DFPP was an effective and safe adjuvant therapy in our patient with PV and it offers a valid treatment option in PV patients with recalcitrant disease.

Interobserver Agreement in the Use of the ABCD Rule for Dermoscopy

To the Editor: Dermoscopic algorithms, which are the methods of analysis of dermoscopic data, include pattern analysis, the ABCD rule, the seven features of melanoma (7FFM), the eleven surface microscopic features method of diagnosis of invasive melanoma, and the new 7 point checklist based on pattern analysis (1–3). The main goal in the development of all of these algorithms is to help dermoscopical examination become an easily reproducible, sensitive, and specific diagnostic technique (4, 5). The most limiting factor in the use of dermoscopy remains its inability to be totally objective because it is a direct result of assessment by individuals. We aimed to investigate interobserver agreement in the commonly used ABCD rule of dermoscopy with special emphasis on the effect of its various (A, B, C and D) components and to discuss the possible contributory factors. One hundred fifteen melanocytic lesions were independently examined dermoscopically by four observers two of whom had completed a dermoscopy course and had more than 10 years of dermatology experience. Of the total 460 clinical diagnoses 450 were melanocytic nevi, 3 were melanoma and the remaining 7 were various benign disorders including seborrheic keratoses and lentigo simplex. None of the lesions was greater than 1 cm in diameter. Mean TDS (total dermoscopy score) values were between 3.11 ± 0.94 and 3.42 ± 1.17, and the differences in TDS scores among the observers were statistically significant (p=0.002, Friedman test). Table 1 shows the κ values referring to interobserver agreement in parameters A (asymmetry), B (abrupt cutoff of pigment pattern), C (difThe Journal of Dermatology Vol. 31: 1041–1043, 2004