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Background and Design: Albeit an easily recognized disease, urticaria features many diverse approaches which rationalize the need for an algorithm for the diagnosis, classification, etiopathogenesis, diagnostic evaluation and therapeutic approach. Therefore, authors from Dermatoallergy Working Group of the Turkish Society of Dermatology and the Turkish Dermatoimmunology and Allergy Association aimed to create an urticaria guideline for the diagnosis, treatment and followup of urticaria. Materials and Methods: Each section of the guideline has been written by a different author. The prepared sections were evaluated in part by e-mail correspondence and have taken its final form after revision in the last meeting held by the participation of all authors. Results: The guideline includes the description, classification, pathophysiology as well as diagnosis and treatment of urticaria. Urticaria is classified into two main types: acute urticaria and chronic urticaria while chronic urticaria is further subdivided into spontaneous urticaria and inducible urticaria. The first step of treatment includes standard doses of H1-blockers. In patients who do not respond to the first step, antihistamine dose is increased up to four times; if unsuccessful, another second-generation antihistamine is given in the same dose. In antihistamine-resistant cases, introduction of omalizumab is required. Omalizumab dose may be increased in patients failing to respond to the standard dose. In patients unresponsive to omalizumab, cyclosporine-A may be given. Routine diagnostic tests are not recommended in acute urticaria. In chronic urticaria, erythrocyte sedimentation rate, differential blood count and C-reactive protein testing are the only investigations that are needed routinely. Conclusion: Chronic urticaria is a disease that can be challenging for the physician in terms of treatment and follow-up. Depending on evidence-based data (and individual experiences), this guideline will have a leading role in the diagnosis and treatment of urticaria and help the physician to overcome the challenges in the management.

Background and Design: Albeit an easily recognized disease, urticaria features many diverse approaches which rationalize the need for an algorithm for the diagnosis, classification, etiopathogenesis, diagnostic evaluation and therapeutic approach. Therefore, authors from Dermatoallergy Working Group of the Turkish Society of Dermatology and the Turkish Dermatoimmunology and Allergy Association aimed to create an urticaria guideline for the diagnosis, treatment and followup of urticaria. Materials and Methods: Each section of the guideline has been written by a different author. The prepared sections were evaluated in part by e-mail correspondence and have taken its final form after revision in the last meeting held by the participation of all authors. Results: The guideline includes the description, classification, pathophysiology as well as diagnosis and treatment of urticaria. Urticaria is classified into two main types: acute urticaria and chronic urticaria while chronic urticaria is further subdivided into spontaneous urticaria and inducible urticaria. The first step of treatment includes standard doses of H1-blockers. In patients who do not respond to the first step, antihistamine dose is increased up to four times; if unsuccessful, another second-generation antihistamine is given in the same dose. In antihistamine-resistant cases, introduction of omalizumab is required. Omalizumab dose may be increased in patients failing to respond to the standard dose. In patients unresponsive to omalizumab, cyclosporine-A may be given. Routine diagnostic tests are not recommended in acute urticaria. In chronic urticaria, erythrocyte sedimentation rate, differential blood count and C-reactive protein testing are the only investigations that are needed routinely. Conclusion: Chronic urticaria is a disease that can be challenging for the physician in terms of treatment and follow-up. Depending on evidence-based data (and individual experiences), this guideline will have a leading role in the diagnosis and treatment of urticaria and help the physician to overcome the challenges in the management.

Toplumda oldukça yaygın olarak görülen verrukalar özellikle ağrı, fonksiyonel bozukluk ve kozmetik rahatsızlık oluşturduğunda veya tedaviye direnç gösterdiğinde hem hastalar hem de hekimler açısından ciddi bir sıkıntı kaynağı oluşturabilmektedir. Literatürde bildirilmiş farklı tedavi seçeneklerine rağmen henüz optimal tedavi açısından bir görüş birliği bulunmamaktadır. Genellikle topikal tedaviler ve/veya destrüktif yöntemler kullanılmakla birlikte, bu tedavilerin insan papilloma virüsü infeksiyonuna karşı spesifik antiviral etki göstermemesi nedeniyle her zaman başarılı sonuçlar alınamamaktadır. Burada ellerinde ve ayaklarında klasik tedavilere dirençli çok sayıda verrukası olan ve dört ay süreyle kullanılan 30 mg/gün asitretin tedavisine büyük oranda yanıt veren 63 yaşında bir kadın olgu sunulmaktadır

Background and Objective: Paederus dermatitis is a self-limited skin disorder characterized with lineer and vesicular, bullous and/or pustular lesions on erythematous bases caused by Paederus species belonging to Staphlinidae (Coleoptera) family. The lesions which are seen in warm and moist climates especially in summer months occur within 24 hours after the crushing of the beetle over the skin and heal with slight hyperpigmentation within 7-8 days. In our study we aimed to evaluate the history and clinical features of cases with Paederus dermatitis. Materials and Methods: Sixteen patients (9 female, 7 male, mean age: 31.75 ± 15.72) were diagnosed as Paederus dermatitis on history and clinical findings. Detailed history and clinical features of the patients were recorded. Results: Most of the patients live in central part of Denizli and have a history of spending time in a garden or on a balcony. Mostly painfull lesions were commonly located on the neck and V region of the neck, upper arm, shoulder and scapular regions with lineer or nummular pattern. Conclusion: The cases from Çukurova and Aydin region have been reported previously. In this report, we stress that Paederus dermatitis may be a common dermatosis in other regions with similar climates in Turkey and should be considered in differential diagnosis of phytophotodermatitis, impetigo, herpes zoster, etc.