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Background: Due to the chronic, recurrent nature of Psoriasis vulgaris (PV) and lack of definitive treatment for the disease, patients often resort to alternative treatments. Physicians seem to have low awareness of this issue. Objectives: To elicit the perceptions of 1,621 PV patients on complementary and alternative medicine (CAM) and examine factors reported to worsen PV. Methods: The patients’ sociodemographic characteristics, Psoriasis Area Severity Index (PASI), Dermatology Life Quality Index (DLQI), disease duration, and severity were recorded, and the patients’ CAM use was questioned in detail. The patients were also asked about factors that worsened PV and their experiences with a gluten-free diet. Results: Of the patients, 56.51% had used CAM. The mean age, illness duration, PASI score,s and DLQI of those using CAM were significantly higher. CAM use were significantly higher in those with facial, genital involvement, and arthralgia/arthritis. The patients mostly referred to CAM when PV became severe (46.4%). Of the CAM users, 45.52% used herbal topicals. The physicians of 67.03% did not inquire whether they used CAM. Of the participants, 37.73% considered that stress worsened their disease. Gluten-free diet did not affect PV symptoms in 52.22%. Conclusions: Patients’ CAM use is often overlooked by dermatologists. Our results showed that more than half the patients used CAM and did not share this information with their physicians. Therefore, the awareness of physicians should be increased and patients should be asked about the use of CAM and directed to the appropriate medical treatment options by physicians.

Background: Hidradenitis suppurativa (HS) is a chronic, relapsing and debilitating inflammatory disease associated with profound morbidity. Aim: In this multicentre study, we investigated the demographic and clinical features of HS, and determined risk factors of disease severity. Methods: In total, 1221 patients diagnosed with HS from 29 centres were enrolled, and the medical records of each patient were reviewed. Results: The mean age of disease onset was 26.2 ± 10.4 years, and almost 70% (n = 849) of patients were current or former smokers. Mean disease duration was 8.9 ± 8.4 years with a delay in diagnosis of 5.8 ± 3.91 years. Just over a fifth (21%; n = 256) of patients had a family history of HS. The axillary, genital and neck regions were more frequently affected in men than in women, and the inframammary region was more frequently affected in women than in men (P

Amaç: Son yıllarda nötrofil/lenfosit oranı (NLO), trombosit/lenfosit oranı (TLO),ortalama trombosit hacmi(OTH) ve C reaktif protein(CRP)’nin sistemik inflamasyonun önemli göstergeleri olduğu gösterilmiştir. Yapılan çalışmalarda psöriazis vulgaris hastalarında NLO, TLO, OTH ve CRP ’nin kontrol gurubuna göre daha yüksek olduğu gösterilmiştir. Çalışmamızda psöriazisli hastaların NLO, TLO, OTH ve CRP düzeyleri ölçüldü ve bu parametrelerin tırnak tutulumu, artrit varlığı, hastalık süresi ve PAŞİ skoru ile ilişkili olup olmadığı araştırıldı. Yöntemler: Herhangi bir sistemik hastalığı, infeksiyöz hastalığı ve otoimmun hastalığı olmayan 133 psöriazis vulgaris hastası ve 107 sağlıklı kontrol çalışmaya dahil edildi. Hastalar PAŞİ skoruna göre hafif (PAŞİ0.05) NLO ve TLO değerleri ile PAŞİ skoru, artrit varlığı, tırnak tutulumu ve hastalık süresi arasında istatistiksel olarak anlamlı bir ilişki saptanmadı. (p>0.05) Sonuç: NLO ve CRP’ nin psöriazis hastalarında inflamasyonu göstermede uygun bir parametre olduğu söylenebilir bununla birlikte NLO’ nun hastalık şiddetiyle korele olmaması klinik kullanımını kısıtlayabilir. OTH’ nın psöriazis hastalarında kontrollere göre daha yüksek olması ve PAŞİ skoru ile ilişkili olması inflamasyon belirteci olarak kullanılmasının TLO ve NLO’ ya kıyasla daha yararlı bir belirteç olduğunu göstermektedir. Objective: Recent reports indicate that neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), and C-reactive protein (CRP) are key markers of systemic inflammation. These markers have also been shown to be significantly increased in patients with psoriasis vulgaris compared to control subjects. In this study, we aimed to evaluate the relationship between serum levels of NLR, PLR, MPV, and CRP and nail involvement, presence of arthritis, duration of disease, and Psoriasis Area and Severity Index (PASI) scores in patients with psoriasis vulgaris. Methods: The study included 133 patients with psoriasis vulgaris that had no systemic, infectious, or autoimmune diseases and a control group of 107 healthy volunteers. The patients were divided into two groups based on their PASI scores: (I) mild (PASI0.05). Similarly, no significant relationship was found between the NLR and PLR values and PASI score, presence of arthritis, nail involvement, and duration of disease (p>0.05). Conclusion: NLR and CRP can be useful markers of inflammation in patients with psoriasis vulgaris; however, the absence of a correlation between NLR and the severity of disease may lead to a limitation in the clinical use of NLR. MPV can be a better marker of inflammation compared to PLR and NLR since it was significantly higher in the patients with psoriasis vulgaris compared to the healthy subjects and also correlated with the PASI score

Turkey is a country which acquired a significant part of their income from farming and animal husbandry. Orf is a frequent disease all over the world, in areas where sheep and goat are raising. Complications due to orf are rare. Erythema multiforme is one of the complications of orf. A total of ten patients with lesions of erythema multiforme following orf were existed. Eight of the patients were female and two were male. All of the patients were living in rural areas and occupied with animal husbandry. The mean age of the patients was 34.3 years and ages of the patients ranged from 17 to 63. The mean time for the formation of orf lesions was 11.4 (range 7-20) days, while the mean time passed for erythema multiforme development was 6.7 (range 5-9) days. In terms of orf position; in two of our patients there was localization on the left side whereas in the remaining patients, localization was found on the right side. Topical corticosteroids, systemic antibiotherapy and systemic corticosteroid therapy were planned to patients as a treatment. The results of this study show that orf-related erythema multiforme occurs more frequently than we thought. Patients referred to us with a complaint of erythema multiforme following orf infection. Awareness of the public and physicians will provide a better understanding of the relationship between orf and erythema multiforme. Türkiye gelirinin önemli bir kısmını çiftçilik ve hayvancılıkla elde eden bir ülkedir. Orf, tüm dünyada, koyun ve keçi yetiştirilen yerlerde sık görülen bir hastalıktır. Orfa bağlı komplikasyonlar nadirdir. Eritema multiforme orfun komplikasyonlarından biridir. Orfu takiben eritema multiformeleri olan toplam on hastamız mevcuttu. Hastaların sekizi kadın, ikisi erkek hastalardan oluşmaktaydı. Tüm hastalar kırsal kesimde yaşıyordu ve hayvancılıkla uğraşıyordu. Hastaların yaşları 17 ile 63 arasında değişmekle beraber ortalama yaşları 34,3’tü. Orf lezyonlarının oluşumunda ortalama süre 11,4 (7-20 gün) iken, eritema multiforme gelişimi için geçen süre ortalama 6,7 (ortalama 5-9) gündü. Orf lokalizasyonu açısından bakıldığında iki hastamızda sol tarafta yerleşim mevcutken geri kalan hastalarımızda sağ tarafta yerleşim mevcuttu. Tedavi olarak hastalara topikal steroid, sistemik antibiyotik tedavisi ve sistemik steroid tedavisi planlanmıştı. Bu çalışmanın sonuçları göstermiştir ki; orfa bağlı eritema multiforme düşündüğümüzden daha sıktı. Bize başvuran hastalar orf enfeksiyonunu takiben ortaya çıkan eritema multiforme şikayetiyle başvurmuşlardı. Halkın ve hekimlerin bilinçlenmesi orf ve eritema multiforme ilişkisinin daha iyi anlaşılmasını sağlayacaktır

Dermatofibroma is a benign fibrohistiocytic neoplasia. The etiology of dermatofibroma remains uncertain but it is considered to have a traumatic origin such as an insect bite or follicular rupture. Dermatofibroma clinically presents as smooth-surface nodular lesions. We report a patient with a plaque with asymptomatic verrucous surface on the right leg.

Bullous pemphigoid (BP) is an autoimmune bullous disease commonly seen in adult population but rarely encountered in the pediatric population. Although the exact etiology of BP remains unclear, various vaccines, infectious agents, and drug use have been blamed in the etiology of BP. Here, we present a 14-year-old patient who developed BP after using metamizole and whose diagnosis was clinically and histopathologically confirmed.

Öztürk, Savaş (Balikesir Author), BACKGROUND: There are only a few studies about epidemiological features of acne vulgaris in the literature. The aim of this study was to analyze demographic, clinical, familial and environmental characteristics of acne, the role of diet and aggravating factors and association of these factors with acne severity. METHODS: Patients with a diagnosis of mild-moderate to severe acne were consecutively interviewed at the participating centers during the study period. RESULTS: A total of 3826 patients and 759 control patients were involved in this study. Mild acne was the most common type of acne, and most of the lesions were localized on face followed by the trunk. The severity of acne was worse in patients who had a positive family history of acne. The most common triggering factor was psychological stress. We found a positive correlation with chocolate, bread, green tea, milk, white sugar, ripe banana, ice cream, apple, orange, and red meat consumption. As we compare the acne severity according to geographical features we detected mild-moderate acne was more common in Mediterranean region and severe acne was more common in East Anatolian region. Family history positivity was more common in Aegean region and least common in Central Anatolian region. There was statistically significant relationship as we compare acne severity and dietary factors such as chocolate, dairy products such as milk, sunflower seed consumption within the geographical regions. CONCLUSIONS: This study presents the demographic and clinical characteristics of acne patients in Asian and the European parts of Turkey. We believe that this study will provide a useful overview of acne in Turkey.

Introduction In recent years, the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), mean platelet volume (MPV) and C reactive protein (CRP) have been shown to be important indicators of systemic inflammation. Studies have shown that NLR, PLR, MPV and CRP are higher in psoriasis patients than in the control group. Aim To investigate the NLR, PLR, MPV and serum CRP levels in patients who were treated with biological agents for psoriasis. Material and methods In our study, 75 patients who were followed up and had a diagnosis of psoriasis vulgaris and took a biological agent therapy between January 2014 and December 2017 in the Dermatology Clinic of the Dicle University Medical Faculty Hospital were evaluated before treatment, and 3 and 6 months after treatment. Results Neutrophil count, lymphocyte count, thrombocyte count, NLR, PLR, MPV and CRP values before the biological agent treatment were statistically higher than the values at 3 and 6 months of treatment. There was no statistically significant difference between pre-treatment neutrophil, lymphocyte, leukocyte, platelet, NLR, PLR, MPV, CRP values and values at 3 and 6 months after treatment when we compared four different biological agents. Conclusions It was seen that NLR, PLR, MPV and CRP values decreased independently of the type of the biological agent used in our study. Therefore, we think that these parameters can be used to evaluate the effects of biological agent treatment on systemic inflammation in psoriasis patients and to monitor the course of the disease.

Prurigo pigmentosa (PP) is a rare inflammatory skin disease. Neutrophil-mediated inflammation is considered to be responsible for the etiopathogenesis of PP. We consider that colchicine may be an effective agent in the treatment of PP since it exerts an antiinflammatory effect by inhibiting neutrophil chemotaxis. Further studies are required to verify whether colchicine is an effective treatment option for PP.

The purpose of this study was to evaluate choroidal thickness (CT) in patients with psoriasis using enhanced depth imaging optical coherence tomography (EDI-OCT) and to determine its relationship with psoriasis activity indices. In this prospective study, EDI-OCT images were obtained in consecutive patients with psoriasis and in age–gender-matched healthy individuals. Comprehensive ophthalmic examination and EDI-OCT evaluation were performed. CT was measured in the subfoveal area. Correlation analyses were performed to identify the relationship of the CT with disease duration and clinical disease activity score. In total, 65 individuals were evaluated in this study, 35 with psoriasis and 30 controls. The mean disease duration of the patients with psoriasis was 15.7 ± 8.8 years (0.3–34 years). There was no difference between groups with respect to age and gender (p = 0.695 and p = 0.628, respectively). Five of the 35 patients with psoriasis had anterior uveitis. None of the patients with psoriasis had signs of posterior uveitis. CT was significantly higher in the psoriasis group than that of control subjects (p < 0.001). The mean central foveal thickness was comparable between groups (p = 0.672). There was also no significant correlation between EDI-OCT, disease activity score, and disease duration (p < 0.05). Choroidal thickness is increased in psoriasis patients. Large serial and comparative studies are necessary to evaluate EDI-OCT, an examination that may be helpful in understanding the effects of psoriasis on the eye and its pathophysiology.

Introduction: The purpose of this study was to evaluate sexual dysfunction in male patients with Behçet’s Disease in comparison to healthy control subjects. Material and Methods: Seventy-two sexually active male patients with Behçet’s Disease and 62 healthy control subjects were included in this study. Patients’ demographic and clinical characteristics were noted. Sexual function was assessed by means of the International Index of Erectile Function scoring system. In addition, disease-related quality of life was measured by means of the Nottingham Health Profile, and anxiety and depression levels were assessed by means of the Hospital Anxiety and Depression Scale. Results: Patients with Behçet’s Disease scored significantly lower in each of the 5 parameters of International Index of Erectile Function (p < 0.001) and significantly higher in Hospital Anxiety and Depression Scale compared to healthy control subjects (p < 0.001). International Index of Erectile Function scores correlated with age, duration of disease and Hospital Anxiety and Depression Scale and Nottingham Health Profile scores in patients with Behçet’s Disease (p < 0.05). Conclusion: Sexual function is impaired in male patients with Behçet’s Disease, which might be associated by age, duration of disease, psychological status and quality of life.

Ranunculus arvensis (R. arvensis) is a member of the Ranunculaceae family and is often used by advanced age women living in rural areas for the topical treatment of arthralgia, myalgia, hemorrhoid, and warts. Protoanemonin is a substance found in the fresh leaves of the plants from the Ranunculaceae family and leads to contact dermatitis. In this report, we present three cases that developed phytocontact dermatitis caused by the topical use of R. arvensis as an alternative treatment method for arthralgia and palmoplantar psoriasis.

Background and Design: Pemphigus vulgaris is an autoimmune blistering skin disease. The aim of this study was to compare levels of T helper 1 (Th1), T helper 2 (Th2) and T helper 17 (Th17) type cytokines in pemphigus vulgaris patients and healthy controls. Materials and Methods: The study population included 37 patients with PV and 35 healthy individuals. The patients were grouped into mild, moderate and severe disease groups according to the severity of skin and mucosal involvement. Serum interleukin(IL)-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-17A and interferon(IFN)-γ levels were assessed using the enzyme-linked immunosorbent assay method. Serum cytokine levels of patients versus controls and between patient subgroups were compared. Analysis of data was done using SPSS 15.0. Results: Serum IL-2, IL-4, IL-6 levels were significantly higher in the patient group compared to the control group (p

Background and Design: Practical training of medical students, especially in specialties such as dermatology, is performed in outpatient clinics where mostly outpatients are encountered. The aim of this study was to compare patients’ perspectives on medical students in two university hospitals (X–Y) situated in different regions of Turkey. Materials and Methods: A total of 250 patients, who visited outpatient clinics of X (group 1) and Y (group 2) university hospitals during practical training for fifth year medical students, were included in this study. A questionnaire composed of 16 items was filled by all patients. The first eight questions were about patients’ consent and preferences on the presence of medical students during their interview and the remaining eight questions inquired patients’ overall thoughts on medical students. Results: The patients in both groups were willing to be a part of the educational programme of medical students (39.8%, 53.5%, respectively). The patients were aware that they had the right to refuse the presence of medical students (61.0%, 62.3%) and majority wanted to be informed on the presence of medical students during the interview (72.4%, 80.7%). While patients in group 1 evaluated being with medical students as pleasurable (43.1%), patients in group 2 did not agree (44.7%). In addition, both groups were not bothered to share personal information with medical students (50.4%, 44.7%) and stated that they would recommend their friends and relatives to have a physical examination done by medical students (51.2%, 41.2%). Conclusion: The active role of medical students during dermatology training is positively viewed by patients in both western and eastern parts of our country. The patients’ request on being informed for the presence of medical students during clinical examination reveals the requirement of oral and written informed consent.

Background Dermoscopy is a method to aid in the visualization of the epidermis and dermis. In recent years, the use of dermoscopy in the diagnosis of non-melanocytic lesions such as those of leishmania cutis has increased. Objectives This study was intended to establish whether dermoscopic investigation has any diagnostic value in cutaneous leishmaniasis (CL). Methods Fifty-five patients diagnosed with CL at the Department of Dermatology, Faculty of Medicine, Dicle University, between February and October 2012, were included in the study. Collectively, the patients exhibited a total of 127 lesions. Results The mean ± standard deviation age of the patients was 25.7 ± 21.3 years (range: 4–86 years). Twenty-three (41.8%) patients were male, and 32 (58.2%) were female. In dermoscopy, teardrop-like structures were observed in 42.5% of the lesions. Vascular structures were detected in 115 (90.6%) lesions; no vascular structures were observed in 12 (9.4%) lesions. Branching, linear, comma-like, and polymorphic vessels were seen more commonly in lesions on the face; pin-point and hairpin-like vessels were seen more commonly in lesions on the upper extremities. Conclusions When the findings obtained in this study were evaluated along with those reported in the literature, it became apparent that follicular plugs, also called “teardrop-like structures”, seen on the face and neck may be a dermoscopic feature specific to CL. As hairpin-like vessels seen in an asymmetric radial arrangement were often observed on parts of the body other than the face, further dermoscopic studies comparing the lesions of CL with other ulcerating lesions are necessary.

Aim: The aim of this study was to evaluate sleep quality and the related variables in patients with Behcet’s disease (BD). Method: One hundred and twelve patients diagnosed with BD and 67 age- and gender-matched healthy controls were enrolled in the study. The Pittsburgh Sleep Quality Index (PSQI) was used for the evaluation of sleep disturbance in all participants. The quality of life (QoL) of all patients were evaluated by Nottingham Health Profile (NHP), and anxiety and depression which were assessed by Hospital Anxiety and Depression Scale (HADS). Results: The patients with BD had significantly higher scores in subjective sleep quality, sleep latency, sleep efficiency, sleep disorder, functional disorder in the morning and total PSQI score compared to the healthy control group. According to Pearson’s analysis, there was a significantly higher correlation between the anxiety, depression and all components of NHP scores and the total PSQI score. Logistic regression analyses indicated that genital ulcer and arthritis were predictors for poor sleep quality. Conclusion: Sleep quality is disturbed in patients with BD. The lower quality of sleep is greatly associated with anxiety, depression, QoL, genital ulcers and arthritis.

Background: We aimed to determine the demographic and clinical features of patients with Beh cet’s disease (BD) in Southeastern Turkey. Methods: In this study, files of 132 patients with BD (76 females and 56 males) who were diagnosed with BD according to the International Study Group criteria at the Department of Dermatology of Dicle University Faculty of Medicine from 2005 to 2009 were evaluated retrospectively. Demographical and clinical characteristics of the cases were recorded . Results: Mean age of the cases was 32.40 ± 9.4 years (range 15 - 59 years) and male/female ratio was 0.73. The mean age at diagnosis was 28.71 ± 9.1 years. Six cases were diagnosed as juvenile BD (4.45%). Oral aphthous lesions (100%) and genital ulcers (94%) were found to be the most common findings of the disease, followed by pathergy positivity (75%), papulopustular lesions (74.2%), erythema nodosum (43.2%), thrombophlebitis (6.8%) and extragenital ulcers (6.1%). Systemic involvement was noted as joint involvement in 79.5%, ocular involvement in 28.8%, vascular involvement in 9.8%, pulmonary involvement in 2.3%, neurologic involvement in 2.3% and genitourinary system involvement in 0.8%. There was no significant difference between mucocutaneous findings and systemic involvement ratios of male and female cases. Conclusion: D emographic and clinical features of BD may vary according to geographical region, gender and ethnicity. We hope that this study will contribute to the epidemiologic data of BD which may exhibit different clinical and demographic features in different parts of the world. J Clin Med Res. 2014;6(6):476-481 doi: http://dx.doi.org/10.14740/jocmr1952w

Background The aim of this study is to investigate and compare the serum levels of various cytokines in patients with Behcet's Disease and healthy controls. Methods Thirty-five patients with Behcet's disease and 29 age and sex-matched healthy controls were included in the study. The patients were separated into groups with active and inactive disease. Serum IL-2, IL-6, IL-8, IL-10, IL-17A, and IFN-γ levels were determined using the enzyme-linked immunosorbent assay method. Cytokine levels of the two patient groups and healthy controls were compared using SPSS 15.0. Results Ten patients with active disease and 25 patients with inactive disease were present. Serum IL-8 levels of active BD patients were higher compared to inactive patients (P = 0.048) and healthy controls (P = 0.02). IL-8 levels were correlated with the duration of symptoms (r = 0.490, P = 0.003) and time passed since diagnosis (r = 0.579, P ˂ 0.001). Conclusion Behcet's disease involves complex interactions of cells of the immune system, mainly T lymphocytes and neutrophils. Further studies on the cytokine profile in Behcet's disease will aid in elucidation of its pathogenesis.

Objectives: Chronic urticaria (CU) and fibromyalgia (FM) are different types of diseases with unclear etiopathogeneses but share many clinical and histochemical features. This study aims to make a recognization on these features and examines whether patients with CU are also affected by FM. Patients and methods: Forty patients with CU and 38 healthy controls were enrolled to this study. All of the participants were assessed according to the 1990 American College of Rheumatology (ACR) classification criteria for FM and asked questions regarding the clinical features of FM. The quality of life was assessed by the Nottingham Health Profile (NHP), while the psychological status was evaluated using the Hospital Anxiety and Depression Scale (HADS). Results: The incidence of FM was higher among the patients with CU (32.5%) than the controls (10.5%) (p=0.019). We indicated that the patients with CU suffered restrictions regarding to quality of life as assessed by the NHP. NHP-sleep (p=0.035), NHP-social isolation (p=0.032) and NHP-emotional reaction (p=0.027) scores were significantly higher compared to HCs. The HADS-depression scores were also significantly higher in the patients with CU (p=0.006). The patients with CU and concomitant FM had higher total NHP scores than those without FM (p

Anthrax is a rare disease cause by Bacillus anthracis, a Gram-positive, rod-shaped endospore-forming capsuled bacterium. Anthrax is manifest in three primary forms: cutaneous, respiratory, and gastrointestinal. Cutaneous anthrax accounts for approximately 95% of all cases of anthrax in humans.In the present study, we evaluated the clinical diagnosis and treatment of cutaneous anthrax, a rare disease that nonetheless remains a serious healthcare problem in developing countries.The complete medical records of patients diagnosed with cutaneous anthrax between January 2001 and December 2012 were examined in a retrospective manner. Cutaneous anthrax was diagnosed by the identification of typical anthrax lesions and/or the presence of Gram-positive-capsuled bacillus after staining with Gram stain and methylen blue in pathology samples obtained from these lesions and the presence of characteristic scarring with a history of severe swelling, black eschar, and positive response to treatment form the basis of diagnosis in cases where cultures were negative for the presence of bacillus.A total of 58 patients were admitted to the hospital with cutaneous anthrax between January 2001 and December 2012. This included 32 (55.2%) males and 26 (44.8%) females, with an age range of 15-82 years and a mean age of 38 ± 13.8 years. The incubation period for the infection ranged between 1 and 20 d (mean 3.7 ± 1.4 d). The most common symptoms at the time of hospital referral were swelling, redness, and black eschar of the skin. The most common lesion site was the hand and fingers (41.3%). Isolated of bacteria was used to diagnose the disease in six cases (23.8%), detection of Gram-positive bacillus in samples of characteristic lesion material was used in seven (28.5%) cases, and the presence of a characteristic lesion was the sole diagnostic criteria in 45 (77.6%) cases. Treatment consisted of penicillin G (12 cases), ampicillin-sulbactam (30 cases), Cefazolin (12 cases), or ciprofloxacin (4 cases).Although the prevalence of anthrax is a decreasing worldwide, it remains a significant problem in developing countries. Rapid identification of the signs and symptoms of cutaneous anthrax is essential for effective treatment. Early supportive treatment and appropriate antimicrobial measures are necessary to address this potentially life-threatening disease.

Introduction: the purpose of this study was to investigate levels of inflammatory cytokines such as interleukin 6 (il-6), tumor necrosis factor α (tnf-α ) and neopterin and oxidative stress status in patients with intrahepatic cholestasis of pregnancy (iCp) as well as their potential role in the pathophysiology. Material and methods: thirty patients with iCp (Group 1) and 30 healthy pregnant women (Group 2) were included in this prospective case-control study. levels of il-6, tnf-α and neopterin were determined in both of the groups. total anti-oxidant status (tAS) and total oxidative stress (tOS) levels were determined by means of a fully automated erel method. Oxidative stress index (OSi) was calculated as the ratio of tOS to tAS. Results: t here was no significant difference between the groups in il -6 and tnf -α levels (p = = 0.105 and p = 0.722, respectively). the mean neopterin level was significantly higher in Group 1 compared to Group 2 (2.34 ±0.77 and 1.57 ±0.38, respectively, p = 0.001). in addition, tAS, tOS and OSi levels were significantly higher in Group 1 (p = 0.004, p = 0.001 and p = 0.001, respectively) compared to Group 2. Discussion: intrahepatic cholestasis of pregnancy is an inflammatory disorder in which maternal immune reaction may play a role. interleukin 6 and tnf-α, which are some of the markers of humoral reaction, act as an indicator of abnormal reaction rather than acute-phase reaction in iCp. further clinical trials and supportive placental findings are needed on the role of cytokines in cellular and humoral immune reactions during the symptomatic period and delivery to better understand the role of immune mechanisms in the aetiology of iCp.

Introduction: t he aim of this study was to evaluate levels of interleukin ( il)-2, il-6, il-8, il-10, il-17A and interferon γ (ifN-γ) in the serum of patients with erythema multiforme (eM) and to search for the presence of il-17-expressing cells in lesional samples of eM. Material and methods: A total of 32 patients (22 females and 10 males) diagnosed with eM of the minor or major type were included in the study. levels of il-2, il-6, il-8, il-10, il-17a and ifN-γ in the serum were determined and compared with healthy controls. Biopsy specimens were stained with haematoxylin and eosin (He) and monoclonal antibodies to Cd4, Cd8 and il-17 for immunohistochemical examination. Results: il-2, 6, 8 and 17A were significantly higher in the patient group (p = 0.016, p = 0.001, p = 0.004, p = 0.006, respectively) and levels of il-10 were significantly lower than in the control group (p = 0.046). the cellular infiltrate in lesions of eM was composed mainly of Cd4+ t lymphocytes. the presence of il-17-expressing cells, at proportion of 5 to 50%, was observed in the infiltrate. Conclusions: the demonstration of il-17-expressing cells in lesions of eM in this study has brought forth the assumption that th17 cells may be involved in the pathogenesis of eM.

Objective: The aim of this study was to evaluate the demographiccharacteristics of Behcet’s disease (BD) patientswith and without ocular involvement.Methods: In this retrospective study BD patients followedup between 2009 and 2013 years in ophthalmology anddermatology clinics were reviewed. Patients were dividedinto 2 groups according to the ocular involvement asocular or non-ocular BD. For each patient, age of onset,gender, family history, and systemic involvement were examined.The frequency of these data was analyzed.Results: Of the 295 patients 177 were ocular BD and 118were non-ocular BD. Ocular involvement were seen morefrequently in male patients than in females. There wasno change between the groups in terms of age at onsetof the disease, a history of thrombophlebitis or gastrointestinal,pulmonary and joint involvement. Pathergy testpositivity and the presence of genital ulcers had more frequentin non-ocular BD.Conclusion: In this study clinical and demographic characteristicsof ocular and non-ocular BD patients in theSoutheast Anatolian Region of Turkey were presented. Asimilar study was not performed previously in our regiontherefore we believe that those data will be useful for diagnosisand follow-up of BD patients. J Clin Exp Invest2013; 4 (3): 339-342Key words: Behçet disease, eye involvement, demographic characteristics

Molluscum contagiosum (MC) is a pediatric viral infection that is fairly contagious. Although various treatment methods are available, the presence of facial lesions limits options of therapy.We aimed to test an alternative treatment consisting of application of two different concentrations of potassium hydroxide (of KOH 5% solution and of KOH 2.5% solution) aqueous solution.In this study we evaluated the effectiveness and side-effects of daily applications of potassium hydroxide (KOH) aqueous solution at 2.5% and 5% concentrations, twice daily in 29 children with MC. Out of a total of 29 patients with molluscum contagiosum included in the study, 13 patients in the 2.5% KOH group and 12 patients in the KOH 5% group completed the study. Families were instructed to apply potassium hydroxide twice a day. The assessment of response and side-effects were performed on days 0, 15, 30, 45 and 60 (visits were numbered 1, 2, 3, 4 and 5, respectively) and one month after.We had a total of 11 (44%) patients who completely recovered after the fifth visit. While eight (66.7%) of these 11 patients were in the 5% treatment group, three (23.1%) patients were in the 2.5% treatment group, and there was a statistically meaningful difference (p 0.047). Patients with fewer lesions remitted better (p 0.05). When number of lesions were taken into consideration, difference between the two treatment groups appeared after the fourth visit (p 0.001). There were no statistical differences between the two groups with respect to side-effects (p = 0.682).Potassium hydroxide solution at a concentration of 5% was more effective than 2.5% in our patients. The treatment was well-tolerated on the face with the advantage of administration of lower concentrations. This study suggests potassium hydroxide may be a more preferable mode of treatment for molluscum contagiosum lesions on the face.

Background: Pemphigus vulgaris was almost fatal before the advent of glucocorticoids. Unfortunately, the high doses and prolonged administration of glucocorticoids, which often needed to control the disease, result in numerous adverse effects many of which are serious. Aims: To evaluate the patients with pemphigus vulgaris on treatment in respect of osteoporosis and to compare the frequency of osteoporosis in these patients with the healthy ones. Methods: The study consisted of 40 patients with pemphigus vulgaris and 34 healthy controls. Bone mineral density measurements were obtained by dual- energy X-ray absorptiometry. Blood serum, bone parameters, and biochemical hormonal measurements were examined in both groups. Results: When the bone mineral density values of patients with pemphigus vulgaris were compared with those of the control group, there was no significant difference between hip bone mineral density values, while lumbar region T and Z scores were found significantly low in the patient group (p = 0.034 and p = 0.006, respectively). Osteoporosis, osteopenia, and normal dual-energy X-ray absorptiometry rates in the patient group were found to be 32.5%, 32.5%, and 35%, respectively. These rates were found to be 18%, 23%, and 59% in control group, respectively. There were more fractures in the patient group and the difference was statistically significant (p = 0.004). Conclusion: An increase in osteoporosis frequency and secondary fracture to osteoporosis in the patients with pemphigus vulgaris was detected.

Vitiligo is a common disorder that results in depigmented areas of the skin. The pathogenesis of the disease remains unclear, but oxidative stress is one suggested cause. Oxidative stress may be induced by increasing the generation of reactive oxygen species and other free radicals. The generation of reactive oxygen species is known to be associated with a decrease in antioxidant levels. This study examined oxidative stress index in active lesions of generalized vitiligo patients. We analysed serum levels of paraoxonase 1, arylesterase, catalase, ceruloplasmin, total antioxidant capacity, and oxidative stress index in patients with active lesions of generalized vitiligo, as well as in matched, healthy controls. Serum oxidants and oxidative stress indexes were higher, and serum antioxidants were lower, in vitiligo patients compared with healthy controls. Our findings suggest that oxidative stress may play an important role in the pathogenesis of vitiligo. Paraoxonase 1 can be used as an indicator in determining oxidative stress existent in the pathogenesis of vitiligo diseases.

Pemphigus is an uncommon autoimmune mucocutaneousblistering disease, mediated by antibodies directedagainst proteins present on the surface of keratinocytesthat provide mechanical structure to the epidermis. Incidencesof the various forms of pemphigus vary fromcountry to country. Pemphigus vulgaris consists of the80% of pemphigus cases and it occurs 10 times morethan pemphigus foliaceus. There have been several recentadvances in the management of pemphigus. Treatmentof with systemic steroids and cytotoxic immunosuppressantscan be highly effective. This article will discussits epidemiology, pathogenesis, clinical variants and approachesto treatment. J Clin Exp Invest 2011; 2 (4): 468-473

Objective: The aim of this study was to evaluate the clinicopathologic correlation of skin biopsies in pediatric patients who consulted to Dicle University Medicine Faculty Hospital Department of Dermatology. Methods: 15337 patients under 16 years old who consulted to Dermatology polyclinic of Dicle University Hospital between January 2008- December 2013 were included in the study. The files of these patients were retrospectively reviewed and performed skin biopsies in 121 patients for diagnosis was detected. The data obtained from these 68 patients were evaluated. The obtained results were evaluated according to preliminary diagnosis and diagnosis correlation. Correlation was considered positive if there is an overlap between clinician\'s preliminary diagnosis and diagnosis. Results: 39 patients (57.3%) were female and 29 patients (42.7%) were male. There was a correlation between preliminary diagnosis and pathological diagnosis in 57 patients (83.8%). First preliminary diagnosis and pathology correlation was positive in 42 (61.7%) patients, positive in 8 (11.7%) patients for second preliminary diagnosis and was positive in 4 (5.8%) patients for third diagnosis. Biopsy did not provide a contribution in 10 (14.7%) patients for diagnosis. 1 (1.47%) patient had a diagnosis with outside of the preliminary diagnosis. Conclusion: Skin biopsy is a diagnostic technique, which is used to promote and strengthen the hands of clinicians in childhood as well as in adulthood patients particularly in patients with atypical clinical forms. However, it is seen that the way of using this diagnostic technique more efficiently is sharing better information by clinicians and if needed to support visual materials with the pathologist., Amaç: Bu çalışmada, Dicle Üniversitesi Tıp Fakültesi Hastanesi Dermatoloji Polikliniği\'ne başvuran çocuk hastalardan alınan deri biyopsilerinde klinikopatolojik korelasyonun değerlendirilmesi amaçlandı. Yöntemler: Çalışmaya Ocak 2008- Aralık 2013 yılları arasında Dicle Üniversitesi Hastanesi Dermatoloji Polikliniği\'ne başvuran 16 yaş ve öncesi 15337 hasta dahil edildi. Bu hastaların dosyaları retrospektif olarak tarandı ve 121 hastada tanı amaçlı deri biyopsisi yapıldığı saptandı. Bu hastaların 68\'inden elde edilen veriler değerlendirildi. Elde edilen sonuçlar, ön tanı ve tanı korelasyonu açısından değerlendirildi. Klinisyen tarafından belirtilen ön tanılar ile elde edilen tanı arasında örtüşme mevcutsa korelasyon pozitif olarak kabul edildi. Bulgular: Hastaların 39\'u (%57,3) kız, 29\'u (%42,7) ise erkekti. Patoloji incelemesinde 57 (%83,8) hastada ön tanılar ile patolojik tanı arasında korelasyon vardı. Birinci ön tanı ile patoloji korelasyonu 42 (%61,7) hastada, ikinci ön tanı ile patoloji korelasyonu 8 (%11,7) hastada, üçüncü ön tanı ile patoloji korelasyonu ise 4 (%5,8) hastada saptandı. 10 (%14,7) hastada biyopsi tanı koymada bir katkı sağlamamıştı. 1 (%1,47) hastada ise ön tanıların dışında bir tanı konmuştu. Sonuç: Erişkin dönem hastalarda olduğu gibi çocukluk çağındaki hastalarda da özellikle atipik seyirli klinik tablolarda deri biyopsisi, tanıda kullanılan ve klinisyenin elini güçlendiren bir tanı tekniği olarak karşımıza çıkmaktadır. Ancak bu tanı tekniğinin daha verimli bir şekilde kullanılabilmesinin yolunun, klinisyen tarafından iyi bir bilgi paylaşımı ve gerektiğinde görsel malzemelerle patoloğun desteklenmesi olduğu görülmektedir.

Background: Netherton syndrome is a rare autosomal recessive disease demonstrating ichthyosis linearis circumflexa, atopic findings, and hair shaft anomalies. Trichorrhexis invaginata is the pathognomonic hair shaft anomaly seen in this syndrome. Objective: In recent years, hair shaft anomalies have been described as “matchstick” and “golf tee” signs. We present a patient with Netherton syndrome diagnosed by the presence of matchstick and golf tee hairs in addition to trichorrhexis invaginata.

Ecthyma gangrenosum is a skin lesion associated with Pseudomonas aeruginosa. A previously healthy one-year-old boy who had been diagnosed with varicella 10 days ago was admitted to our hospital with complaints of diarrhea, green ear discharge and new lesions in the diaper area. Intravenous meropenem and amikacin had been previously initiated. Physical examination revealed greenish, well bordered necrotic ulcers on both gluteal areas and the perianal area. Pseudomonas aeruginosa grew in wound culture. A colostomy was opened due to recalcitrant diarrhea and ulcers. The patient remitted in one month and was discharged. T lymphocyte subgroups and immunoglobulins were found to be normal on immunologic evaluation. We presented this case to draw attention to the fact that ecthyma gangrenosum due to Pseudomonas aeruginosa may occur in the diaper area and that sepsis due to Pseudomonas should be investigated.

Aim Psoriatic arthritis (PsA) is a chronic, inflammatory disease. The purpose of this study was to examine the association between PsA and comorbid conditions. This is the first study to investigate comorbid diseases in PsA in Turkey. Methods This study was performed under the auspices of the Anatolian Group for the Assessment in Rheumatic Diseases (ANGARD) and involved participation by six university research hospitals. Patients diagnosed with and treated for PsA on the basis of clinical, radiological and laboratory findings and expert opinion were monitored using standardized examination methods and jointly prepared forms. Clinical status, accompanying systemic diseases and surgical history were recorded. Results One hundred and seventy-three patients with PsA (75 male, 98 female, mean age 41.8) and 138 patients with rheumatoid arthritis (RA) (17 male, 121 female, mean age 48.6) and 67 with psoriasis (PsO) (43 male, 24 female, mean age 36.1) were included in the study. No accompanying disease was determined in 72.8% of PsA, 50.0% of RA and 80.6% of PsO groups. In regression analysis, patients with PsA had higher risk for cataract/glaucoma surgery (odds ratio [OR] = 11.99; 95% CI 1.36–105.4, P = 0.025) compared to patients with RA, and higher risk for hypertension (HT) (OR = 4.26; 95% CI 1.27–14.23, P = 0.018) compared to the patients with PsO. Conclusion Patients with PsA have relatively lower frequency of comorbidities like diabetes mellitus, HT and cataract/glaucoma surgery compared to the patients with RA. The increased risk for having cataract/glaucoma surgery in RA compared to PsA may be particularly attributed to the more prevalent glucocorticoid use in RA.

Dermoscopy is an aiding method in the visualization of the epidermis and dermis. It is usually used to diagnose melanocytic lesions. In recent years, dermoscopy has increasingly been used to diagnose non-melanocytic lesions. Certain vascular structures, their patterns of arrangement and additional criteria may demonstrate lesion-specific characteristics. In this review, vascular structures and their arrangements are discussed separately in the light of conflicting views and an overview of recent literature.

A 25-year-old female presented with burning and pain in her mouth. A few erythematous patches with slightly raised keratotic band-shaped borders were present on the dorsum of her tongue. Fissures were also observed. History taking revealed good nutritional status, no systemi c diseases and no personal or familial history of psoriasis. Geographic tongue is a benign recurrent condition in which depapillated migratory areas are seen on the tongue. Fissured tongue is characterized by grooves of variable depth on the dorsum of the tongue. These two conditions are discussed in this article

Dermatofibrosarcoma protuberans (DFSP) is a slow-growing dermal spindle cell tumor. Its rare myxoid variant is characterized by extensive myxoid degeneration. We report a case of myxoid DFSP of the lower abdomen in a 35-year-old man. Histopathologically, the tumor consisted of spindle-shaped cells that were strongly positive for CD34 with a typical storiform pattern and myxoid stromal changes.

A 12-year-old girl was seen with widespread millimetric papules which resolved leaving varioliform scars. Tuberculin test was strongly reactive. Underlying pulmonary tuberculosis was diagnosed. The patient responded to antituberculous treatment. Papulonecrotic tuberculid is a skin eruption thought to be due to hypersensitivity to an underlying focus of tuberculosis and is an indicator of good immunologic status.

Aim: In recent years, neutrophil / lymphocyte ratio (NLR), platelet / lymphocyte ratio (PLR) and mean platelet volume (MPV) has been shown to be important indicators of systemicinflammation. Studies have shown that NLR and PLR are higher and that MPV is lower in lichen planus patients compared to the control group. In this study, NLR, PLR and MPV values of lichen planus patients were calculated and investigated whether these parameters were related to nail and oral mucosal involvement. Material and Methods: Eighty one patients with lichen planus without any systemic, infectious and autoimmune disease were included in this study while 81 patients who were admitted to the outpatient clinic for any non-inflammatory condition and whom had blood picture were included in the study as control group. Results: There was no statistically significant difference between neutrophil count, lymphocyte count, leukocyte count, platelet count, NLR and PLR values in LP patients and control group (p> 0.05). MPV value of LP patients had a mean of 8.10 ± 1.40 , and controls had a mean of 7.21 ± 1.45, and the difference was statistically significant (p 0.05). Conclusion: It can be concluded that NLR and PLR were not suitable parameters to show inflammation in LP. The significant higher values of MPV in LP patients suggests that it may be used as a better marker of inflammation in LP patients than NLR and PLR. Nevertheless, the lack of significant association of MPV with nail involvement and oral mucosal involvement may restrict clinical use of it in LP.

Objectives: Lichen planus is an immunologic diseasemediated by lymphocytes in which T lymphocytes targetat basal cells. It is believed that TNF-α that is releasedfrom T lymphocytes and keratinocytes plays a key role inthe starting and progression of lichen planus by inducingapoptosis. MHC Class-I antigens on basal keratinocytesand interleukin-2 (IL-2) and IFN-gamma (γ) that are producedfrom CD4+ T cells stimulate the apoptosis of keratinocytesin lichen planus. The aim of this study was tomeasured the IL-2 and TNF-α levels in peripheral bloodfrom patients with Lichen planus.Materials and methods: A total of 26 lichen planus patients(18 females, 8 males) that applied to the dermatologypoliclinics in Dicle University Hosspital between 2004and 2006 and a healthy control group were included inthe study. Serum IL-2 and TNF-α levels were measuredby using Immulate 1000 solid phase and two-site chemiluminescentimmunometric assay method. The results ofpatients and control group were compared.Results: Level of IL-2 (1172.615 ± 774.967) and TNF-α(13.361 ± 5.638) were higher in lichen planus to comparedcontrols. IL-2 and TNF-α levels in the patient group werefound to be significantly high statistically compared tohealth control group, respectively p=0.004 and p