Zeynep Nurhan Saraçoğlu

Turkish version of Skindex-29

Background  There is a clear need for a useable measure of health‐related quality‐of‐life (HRQoL) for dermatology patients. Most of the existing dermatology‐specific measures were developed for the English language, and these measures should be adapted for use in other cultures.

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.

Purpuric Pityriasis Rosea

A 17‐year‐old young man presented with a 2‐week history of an asymptomatic widespread eruption affecting the trunk and arms.

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.

Age and gender differences in Framingham risk score and metabolic syndrome in psoriasis patients: A cross-sectional study in the Turkish population.

Objective: Psoriasis is associated with an increased frequency of cardiovascular risk factors. Metabolic syndrome (MS) and the Framingham risk score (FRS) are two different algorithms for evaluating cardiovascular risk. They include different features: waist circumference measurement is included in the MS criteria, whereas smoking, age, and gender are questioned in FRS. This study aimed to evaluate the frequency of MS and FRS in psoriasis patients compared with a control group and investigate the differences between MS and FRS. Methods: This was a cross-sectional study involving 300 psoriasis patients and 177 controls. MS, FRS, and disease severity were evaluated. Results: The frequency of MS was higher in females with psoriasis than in those in the control group (p=0.019). Females in the psoriasis group were more obese than those in the control group (p=0.036). FRS significantly differed between the patients and controls of age >60 years (p=0.006). The risk of hypertension in current and past smokers was higher in the psoriasis patients (OR=2.07 and 2.32–2.48, respectively) than in the control group. There was no statistically significant relationship among MS, FRS, and psoriasis severity (p>0.05). Conclusion: The results of this study support the evaluation of cardiovascular risk assessment in female psoriasis patients with MS and in male and elderly psoriasis patients with FRS.

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

Morphea in Middle Anatolia, Turkey: a 5-year single-center experience

Introduction Morphea, also referred to as localized scleroderma, is a rare fibrosing skin disorder of undetermined cause. Aim We report our single-center experience with morphea. Material and methods The study included 53 patients who were diagnosed with morphea by histopathology in our department between 2010 and 2015. Study data were collected retrospectively from the records of morphea patients. Results The study included 53 patients (38 women, 15 men), and median age at onset was 39.0 (range: 8–85) years. Thirty (56.6%) patients had circumscribed morphea, 15 (28.3%) had generalized morphea, and 7 (13.2%) had linear morphea. One patient had mixed variant morphea (generalized, pansclerotic and linear morphea). ANA positivity was detected in 12 (22.6%) patients, but analysis for an association between the presence of ANA and morphea types, patients’ characteristics did not reveal any significant associations. We did not observe any extracutaneous manifestations in patients during follow-up period. There were 2 of 53 patients who had concomitant autoimmune disorder including vitiligo and spondyloarthritis. Thirty (56.6%) patients received only topical treatment. The patients with clinical improvement who were treated with systemic therapy received methotrexate (26.4%), colchicine (9.4%), mycophenolate mofetil (5.7%) and prednisolone (1.9%). Conclusions Our results related to the demographic data of the patients and morphea types were consistent with the literature. On the other hand we observed that methotrexate was mostly used as an effective treatment option for generalized morphea.

Methotrexate Treatment in Children with Febrile Ulceronecrotic Mucha-Habermann Disease: Case Report and Literature Review

Febrile Ulceronecrotic Mucha-Habermann disease is a rare and potentially fatal variant of pityriasis lichenoides et varioliformis acuta and is characterized by high fever, constitutional symptoms, and acute oncet of ulceronecrotic lesions. We present an 11-year-old male with Febrile Ulceronecrotic Mucha-Habermann disease who was cured with methotrexate and review the use of methotrexate for this disorder in the pediatric age group with the relevant literature.