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Children who have lymphatic malformations frequently experience functional limitations and aesthetic abnormalities that have a significant impact on their quality of life and may pose a threat to their lives. Conventional treatments such as surgery or sclerotherapy are rarely curative, demonstrating the great need for new treatment modalities. Recently, oral or topical administration of sirolimus has successfully treated lymphatic malformations. We report the 6-month treatment outcome of a 7-year-old boy with lesions consistent with lymphangioma circumscriptum on the left side of the neck since birth who was successfully treated with topical sirolimus.

Background and Design: The onset chronology of disease symptoms in patients with hidradenitis suppurativa (HS) and their gender differences have not yet been fully elucidated. We aimed to define the onset chronology of the disease symptoms and the socio-demographic and clinical characteristics. Materials and Methods: This single-center case series study included 100 consecutive patients. The disease symptoms for each patient were recorded in the time order of manifestations. Results: HS was more common in males (72%); 70% of the patients were overweight or obese. Smoking and alcohol consumption was significantly higher in males. The axilla was the most common onset area, followed by the inguinal and gluteal regions. The incidence of disease onset in the axilla in male and disease onset in the gluteus in female patients was significantly higher. Also, involvement of the pubis, perianal region, neck, back, and behind the ear was more common in males. The disease followed a more severe course in patients with the involvement of axilla, perianal, and inframammary areas (p

Background and Design: The human papillomavirus (HPV) is a non-enveloped DNA virus infecting skin and mucosal surfaces and causes one of the most common sexually transmitted infections worldwide. Thus, physicians must know about HPV infections, associated cancers, and immunization for public health. This study aimed to determine the knowledge of medical faculty students about HPV infections, related cancers, and vaccines and examine related variables. Materials and Methods: This descriptive study included all students in the first to fifth grades of the faculty of medicine. Data were collected with a two-part questionnaire consisting of 37 questions. Questionnaires were filled voluntarily. Data were analyzed with SPSS version 18.0. Results: The study included 250 medical students, and 52.4% (n=131) were men. While 95.6% (n=239) stated that they were aware of HPV, only 39.2% thought that they had sufficient knowledge. The most important sources of information were lectures and the Internet. Only 3.6% (n=9) of the students had been vaccinated against HPV. The most important reason (58%) for not being vaccinated was not having heard of the HPV vaccine before or not knowing someone who had it, and the other important reason was economics. Nearly 80% of the students thought that HPV vaccines should be included in routine vaccination. While 60% of the students stated that they would get an HPV vaccine if a free vaccine is provided, the lack of sufficient information was cited as the most important reason (45%) against the widespread use. Conclusion: The knowledge of medical school students about HPV infection and vaccines was not very sufficient, and the vaccination rate was low. Our results suggest that HPV-related courses in medical education and reimbursement of vaccines by health authorities require some adjustments in the core education curriculum and national health policies.

Morphea is an inflammatory immune-mediated disease associated with many factors such as genetic predisposition, environmental triggers such as bacterial and viral infections, as well as intrinsic factors such as hormonal and immunological dysregulation, although its pathogenesis is largely unknown. Here, we report the first case of morphea relapse after the mRNA coronavirus disease-2019 (COVID-19) vaccine. Our case along with recent reports suggest that new associations might appear due to COVID-19 infection and vaccines.

Dermatofibromas are common skin tumors although there are some different clinical forms, which are seen rarely. Giant dermatofibromas are benign, pedunculated lesions that are larger than 5 cm with typical dermatofibroma histopathologic features. Typically, plaque-like dermatofibromas are considered a subtype of giant dermatofibromas without a pedicule. Here, we aimed to report a case of plaque-like dermatofibroma seen in a 5-year-old girl due to its rarity and to review this clinical picture together with all the cases in the literature.

Coronavirus disease-2019 (COVID-19) is a serious cause of respiratory tract infection, and its severe course has been associated with some risk factors, including malignancies and immunosuppressive treatments. Primary cutaneous lymphomas (PCL) are a heterogeneous group of immune system neoplasms, which are subclassified as indolent and aggressive types according to their survival rates. PCL treatment ranges from skin-based therapies to systemic treatments, of which immunosuppressive effects occur in some. During the COVID-19 pandemic, patients with PCL should be protected from possible COVID-19 complications, and the optimal treatment should be provided to control the disease taking into account the treatment-related risks. Therefore, recommendations about the management of patients with PCL during the COVID-19 pandemic were overviewed in light of the literature. Topical treatments can generally be considered low-risk therapies and can be continued without interruption. Phototherapy, skin radiotherapy, and total skin electron beam therapy increase the risk of COVID-19 exposure due to hospital visits. Moderate-risk therapies like interferons, systemic retinoids, methotrexate, and systemic corticosteroids might be used with caution. Advanced-stage patients with COVID-19 related comorbidity and who previously received immunosuppressive therapy should be carefully evaluated. Biological agents and systemic chemotherapeutics, which are considered high-risk, should not be delayed when needed. However, increasing intervals between treatments or switching to alternative therapies may be preferable in stable diseases. Most importantly, all patients with PCL should be ensured to comply with general protection measures as long as the pandemic continues.

Background and Design: Atopic dermatitis (AD) is a common chronic, recurrent, and itchy inflammatory skin disease. Various therapeutic agents are available, but severe side effects may limit their usage. Recently, dupilumab, a human monoclonal antibody that targets the interleukin-4 (IL-4) receptor alpha subunit of heterodimeric IL-4 and IL-13 receptors, is approved and might be used in patients with resistant AD, with the permission of the Ministry of Health. Materials and Methods: This study aimed to retrospectively evaluate the clinical characteristics of patients and dupilumab treatment responses in our center. This study included patients with AD who were unresponsive to conventional treatments and treated with dupilumab. Sociodemographic, laboratory data, previous treatments, and responses along with disease severity scores [eczema area and severity index (EASI)] before and after dupilumab were evaluated through the electronic files of patients. Results: A total of 21 patients (13 males and 8 females) between June 2019 and March 2021 were identified. The mean age of patients was 40.57±15.21 years. The mean duration of dupilumab treatment was 6.59±5.88 months. The mean EASI score at the beginning of dupilumab was 15.35±8.03, whereas 4.6±2.9 after treatment. A 70-100% improvement was found in approximately 75% of the patients. No side effects were observed that required treatment discontinuation or dose changes. Conclusion: Our study has the highest number of reported patients in our country, which revealed that dupilumab is highly effective and safe for conventional treatment-resistant AD.

Background and Design: Drug reaction with eosinophilia and systemic symptoms (DRESS) is an uncommon, but potentially fatal, adverse drug reaction. Despite the alarming statistics regarding morbidity, mortality, and hospitalizations, epidemiological data on DRESS are insufficient. In this investigation, we sought to determine the etiology, clinicopathological characteristics, and prognosis of DRESS cases at our institution. Materials and Methods: In this retrospective, single-center study, 23 patients with DRESS examined between January 2014 and September 2020 were included according to the European Registry of Severe Cutaneous Adverse Reactions (RegiSCAR) scoring system. Patients were examined between January 2014 and September 2020. Descriptive statistics, Shapiro-Wilk test, Kolmogorov-Smirnov test, Mann-Whitney U test, Pearson chi-square test, and Fisher's exact test were performed. Results: The most frequently detected culprit drug category was anticonvulsants. Maculopapular eruption (100%) and elevated liver function tests (82%) were the most prevalent cutaneous and laboratory findings, respectively. Patients with elevated liver enzymes were more likely to exhibit facial erythema/edema and lymph node enlargement than those without (p=0.021 and p=0.103, respectively). The predominant pathological features were sparse vacuolization of the dermal-epidermal junction and superficial perivascular lymphohistiocytic inflammation with eosinophils. Two patients died during the period of follow-up, three patients were lost to follow-up, and eighteen patients recovered completely. Conclusion: Our research demonstrated that facial erythema/edema and lymph node enlargement are more prevalent in patients with elevated liver enzymes. Cyclosporine may be a treatment option in the fragile age group to prevent systemic corticosteroid complications. Early diagnosis and treatment that balances benefits and risks remain the most important determinants of prognosis

Copyright of Turkish Journal of Dermatology / Turk Dermatoloji Dergisis is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Design: Pemphigus vulgaris (PV) is a severe, chronic, potentially life-threatening autoimmune blistering disease that affects the skin and mucous membranes, associated with the loss of cell-cell adhesion and blister formation. Systemic steroids in combination with immunosuppressive agents are the mainstay of therapy in pemphigus. Rituximab, a chimeric monoclonal anti-CD20 antibody, has been tried increasingly for the treatment of PV. Materials and Methods: We sought to test the efficacy and safety of rituximab as an adjuvant therapy by retrospective analysis of clinical and immunological data of patients. We performed a retrospective analysis of 13 patients with refractory pemphigus vulgaris who were treated with rituximab at Akdeniz University Hospital, Clinic of Dermatology and Venereology, Bullous Disease Unit. We evaluated clinical and immunological data with last treatments. Results: The patients were treated with one cycle of two biweekly infusions of rituximab at a dose of 1000 mg on days 1 and 15, except one received four doses of 375 mg/m2 weekly. The mean follow-up time was 18.5 months. All patients had a decrease in antibody titers or antibodies were completely undetected after treatment. Rituximab use resulted in a significant reduction in steroid dosage during follow-up. At the end of the follow-up period, 7 patients achieved complete disease remission without therapy, 1 patient achieved partial disease remission without therapy, 2 patients achieved complete remission on minimal therapy, 1 patient achieved complete remission on therapy, 1 patient achieved partial remission on minimal therapy, and one patient was lost to follow-up. Rituximab was well tolerated by all patients. Clinical relapse was seen in 7 patients (53.8%) in the mean period of 13.8 months. Relapses have been managed with additional infusions of rituximab. Conclusion: Rituximab is beneficial in the management of refractory PV, induces prolonged clinical remission and has a steroid-sparing effect. (Turkderm 2015; 49: 117-24) [ABSTRACT FROM AUTHOR]

Copyright of Archives of the Turkish Dermatology & Venerology / Turkderm is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)