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Scabies, caused by the Sarcoptes scabiei var hominis mite burrowing into the skin, is a highly contagious disease characterized by intense nocturnal itching. Its global impact is considerable, affecting more than 200 million individuals annually and posing significant challenges to healthcare systems worldwide. Transmission occurs primarily through direct skin-to-skin contact, contributing to its widespread prevalence and emergence as a substantial public health concern affecting large populations. This review presents consensus-based clinical practice guidelines for diagnosing and managing scabies, developed through the fuzzy Delphi method by dermatology, parasitology, pediatrics, pharmacology, and public health experts. The presence of burrows containing adult female mites, their eggs, and excreta is the diagnostic hallmark of scabies. Definitive diagnosis typically involves direct microscopic examination of skin scrapings obtained from these burrows, although dermoscopy has become a diagnostic tool in clinical practice. Treatment modalities encompass topical agents, such as permethrin, balsam of Peru, precipitated sulfur, and benzyl benzoate. In cases where topical therapy proves inadequate or in instances of crusted scabies, oral ivermectin is recommended as a systemic treatment option. This comprehensive approach addresses the diagnostic and therapeutic challenges associated with scabies, optimizing patient care, and management outcomes., (© 2024 The Author(s). International Journal of Dermatology published by Wiley Periodicals LLC on behalf of the International Society of Dermatology.)

Psoriasis is a common multisystem inflammatory disease, and arthritis is an essential component of the disorder, requiring early diagnosis and prompt treatment for successful management. In this study, we aimed to investigate the relationship between nail and scalp involvement and other covariates with psoriatic arthritis (PsA). This cross-sectional study, conducted from June 2021 through December 2021, included 763 patients from 11 different centers in Turkey. The severity of involvement was evaluated using psoriasis area severity index (PASI), nail psoriasis severity index (NAPSI), and psoriasis scalp severity index (PSSI) scores. Predictors for PsA were evaluated using univariate and multivariate logistic regression models. PsA (n = 155, 21.5%) was significantly more common in patients having a family history of psoriasis (43.2% vs 30.9%, P = .004), nail involvement (68.4% vs 52.3%, P < .001), and coexistence of nail and scalp involvement (53.7% vs 39.6%, P = .002). Furthermore, patients with PsA had considerably higher PASI (7 vs 5.6, P = .006), NAPSI (5 vs 2, P < .001), and PSSI scores (7 vs 4, P = .002) and longer disease duration (months) (126 vs 108, P = .009). In multivariate analysis, female gender [OR: 3.01, 95% CI (1.861-4.880), P < .001], nail involvement [OR: 2.06, 95% CI (1.293-3.302), P = .002)], and body mass index (BMI) [OR: 1.06, 95% CI (1.017-1.100), P = .005] were identified as independent predictors for PsA. Female gender, nail involvement, and high BMI are significant predictors for PsA and warrant detailed rheumatological assessment. Notably, being female is the strongest predictor of increased risk of PsA in our survey. Scalp involvement appears not to be associated with PsA. Also, the presence of PsA seems related to a more severe skin involvement phenotype., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Extubation of patients in supine position after prone operations may lead to unwanted effects on hemodynamic and respiratory parameters during emergence and recovery period. We aimed to observe the effects of prone position on emergence and recovery periods after prone surgery., Methods: This randomized controlled trial was studied with sixty patients extubated either in prone position (30 patients) or in supine position (30 patients) after lumbar spinal surgery in tertiary educational hospitals. Heart rate, non-invasive arterial blood pressure, peripheral oxygen saturation and Bispectral Index values were measured, and recorded in all patients during operation, at the time an anesthetic agent was discontinued, before and after extubation. The number of the mouth suctioning, Aldrete recovery score, and Ricker agitation score were recorded together with the severity of cough during emergence and recovery. Incidents such as nausea, vomiting, respiratory failure, uncontrolled airway, and decreased saturation were also recorded., Results: Heart rate and mean arterial pressure values were significantly lower in the prone group during emergence and recovery period compared with the supine group (P<0.05). Aldrete Recovery Scores were higher in the prone group (P<0.001). The number of the mouth suctioning and the cough severity were lower in the prone group (P<0.001)., Conclusions: Extubation in the prone position provides a more comfortable emergence and recovery periods by less altering the hemodynamic and respiratory status with better recovery profile.

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 < 0.05 for all). Acne (40.8%), pilonidal sinus (23.6%) and diabetes mellitus (12.6%) were the most prevalent associated diseases. Of the various therapies used, antibiotics (76.4%) were most common followed by retinoids (41.7%), surgical interventions (32.0%) and biologic agents (15.4%). Logistic regression analysis revealed that the most important determinants of disease severity were male sex (OR = 2.21) and involvement of the genitals (OR = 3.39) and inguinal region (OR = 2.25). More severe disease was associated with comorbidity, longer disease duration, longer diagnosis delay and a higher number of smoking pack-years., Conclusions: Our nationwide cohort study found demographic and clinical variation in HS, which may help broaden the understanding of HS and factors associated with disease severity., (© 2020 British Association of Dermatologists.)

We report a retrospective analysis the efficacy of high-dose intravenous immunoglobulins on 9 patients with Livedoid vasculopathy for whom resistant to immunosuppressants plus anticoagulants or could not be prescribed. Intravenous immunoglobulins were used 2 g/kg per month in these patients. The treatment induced stabilization of the disease and all patients demonstrated improvement with IVIg. Complete and partial clinical response was achieved in 6 and 3 patients respectively., (© 2020 Wiley Periodicals, Inc.)

Background: Nailfold capillaroscopy is used for the identification of microvascular involvement in many rheumatic and extrarheumatic diseases., Aim: To determine the nailfold capillary changes in patients with Behçet disease (BD) by videodermoscopy, i.e. nailfold videocapillaroscopy (NVC)., Methods: We used a videodermatoscope (Molemax II, × 30 magnification) to perform nailfold capillaroscopy on 40 patients with BD and 40 healthy controls (HC). All nailfold images were evaluated for capillary density, distribution and morphology, assessing features such as enlargement or tortuosity of the capillaries, microhaemorrhages and avascular areas., Results: Enlarged capillaries were detected in 14 patients, microhaemorrhages in 6 patients, and avascular area in 3 patients. There was a statistically significant difference between patients with BD and healthy controls for capillary dilatation and microhaemorrhages (P < 0.05). Capillaroscopic changes were not associated with sex or clinical characteristics., Conclusions: Using NVC, nailfold capillary changes were apparent in patients with BD, but not in HC. NVC could be a useful technique for evaluating microvascular damage in BD., (© 2014 British Association of Dermatologists.)

Background: Light-based therapies and lasers have been proposed for the treatment of acne vulgaris but the efficacy and application periods of 532-nm KTP laser treatment are not clear., Objective: To evaluate the efficacy and safety of 532-nm KTP laser and compare the effects of once and twice weekly applications in the treatment of mild to moderate acne vulgaris., Methods: Totally 38 patients were treated once weekly and twice weekly in group I and in group II respectively. One half of the face of each patient was treated with 532-nm KTP and the other half was remained as untreated. Patients were evaluated at the beginning, one and four weeks after the last treatment session with Michaëlsson acne severity grading score (MASS)., Results: Statistically significant improvement was found at second control (p = 0.005) in group I, and at the first (p = 0.004), and second (p < 0.001) controls in group II for treated sides. For both groups, changes of MASS were insignificant for untreated sites. Improvement of MASS of treated sides was not statistically significant between two treatment groups for both controls., Conclusion: 532-nm KTP laser treatment may be an alternative method in selected acne vulgaris patients. No significant difference was noted between once and twice weekly applications.

Background: Melasma is a pigmentary disorder often recalcitrant to treatment. Few studies have objectively evaluated the efficacy of treatment colorimetrically., Aim: To evaluate the safety and efficacy of a depigmentation cream, including mainly glycolic acid and Rumex occidentalis., Method: Twenty-seven patients applied the cream twice daily for the first 3 months and twice weekly for the following 3 months. L*, C* and h* values of the target lesions and the perilesional area were analyzed at baseline, 12 and 24 weeks colorimetrically. The physician and patient evaluated the clinical response rate. These results were compared statistically between the lesional and perilesional area., Results: There was a significant difference between 0-12, 0-24 (L*, C* and h* values) and 12-24 weeks (L* value) (p <0.001). For C* and h* values, the difference was not significant between 12 and 24 weeks (p = 0.464 and 0.151, respectively). Statistical significance was detected only between 3 and 6 months for C* value (p < 0.05) for the lesional and the perilesional areas. Clinical response rate was significant (p < 0.05)., Conclusion: Our depigmentation cream is a moderate effective agent, well tolerated and can be considered as an alternative treatment of melasma. Twice-daily application may enhance the efficacy of treatment instead of twice-weekly application in the maintenance period.

Background: The Nd:YAG laser has been considered the gold standard of treatment for leg veins, but pain and side effects have fueled physicians to use treatment alternatives., Objective: To compare the clinical efficacy of the long-pulsed 1064-nm Nd:YAG laser with KTP laser irradiation in the treatment of leg telangiectasia., Methods: A series of 16 patients with size-matched superficial telangiectases of the lower extremities were randomly assigned to receive three consecutive monthly treatments with the long-pulsed 1064-nm Nd:YAG on one leg and 532-nm KTP laser irradiation on the other., Results: For the 16 patients who completed the study, 64 leg vein sites were treated. Average clinical improvement scores were 1.94 and 1.25 for the KTP laser-treated leg and 3.38 and 3.50 for the Nd:YAG laser-treated leg with thin (≤ 1 mm) and large (1-3 mm) vessels, respectively. After the third treatment session, average improvement scores of 2.44, 1.31 and 3.75, 3.23 were given for the KTP and Nd:YAG laser-treated sides, respectively., Conclusion: Both the 1064-nm Nd:YAG and KTP lasers are effective in the treatment of lower extremity telangiectases. However, the KTP laser has very low efficacy with vessels larger than 1 mm and should not be elected when treating such vessels.

To analyze the effect of possible risk factors, including breastfeeding, on the development of childhood-onset psoriasis, a multicenter case-control study with prospective collection of data was performed. Using a standard questionnaire, personal and specific variables including family history of psoriasis, maternal and environmental tobacco smoke exposure, body mass index (BMI), exclusive and partial breastfeeding for at least 3 and 12 months, cow's milk intake before 1 year, birth delivery method, and stressful life events were collected during 2009 from 537 patients with psoriasis and 511 controls younger than 18. Overall, patients more frequently reported exposure to environmental tobacco smoke at home and stressful life events in the year preceding the diagnosis than controls. The odds ratios (OR) for smoking and stressful life events were 2.90 (95% confidence interval [CI]=2.27-3.78) and 2.94 (95% CI=2.28-3.79), respectively. In addition, children with psoriasis were more likely to have a higher BMI (>26) than controls (OR=2.52; 95% CI=1.42-4.49). High BMI, environmental tobacco smoke exposure at home, and stressful life events may influence the development of pediatric psoriasis., (© 2011 Wiley Periodicals, Inc.)

Narrow-band ultraviolet therapy has been used successfully for the treatment of inflammatory skin disorders and generalized pruritus. We have prospectively evaluated seven consecutive patients with resistant psychogenic excoriation (PE) treated with narrow-band ultraviolet B (NB-UVB). Approximately 70% of all patients showed improvement in their condition. NB-UVB therapy was well tolerated, with no serious side effects. We may conclude that, when treating a patient with PE, NB-UVB in combination with other approaches may provide extra benefit in resistant cases.

Background: Treatment options for seborrheic dermatitis are numerous, including both topical and systemic agents (e.g. topical corticosteroids, oral antifungals, and psoralen plus UVA). However, long-term use of topical corticosteroids may lead to adverse effects. Pimecrolimus 1% cream is an effective and well tolerated treatment for seborrheic dermatitis., Objective: To explore the efficacy of pimecrolimus 1% cream for the treatment of seborrheic dermatitis lesions resistant to conventional treatments., Methods: Sixteen patients with resistant seborrheic dermatitis of the face applied pimecrolimus 1% cream twice daily for 2 weeks. The lesions were assessed clinically and the severity of the signs were assessed using a 4-point score. Additionally, the scores of all affected regions (paranasal, forehead, and eyebrows) were evaluated separately to assess whether different results would be obtained in different regions of the face. Also, patients completed self-assessments on a 100 mm Visual Analogue Scale (VAS) at each visit., Results: Statistically significant reductions in the scores of all parameters were observed at day 7 and day 14 of the study. There were no significant differences between the responses on the three regions of the face. No adverse effects were reported except for temporary pruritus immediately after the application of pimecrolimus 1% cream in one patient., Conclusion: Although the interpretation of efficacy was limited by the open-label, non-controlled study design and the small number of patients, this trial suggests that pimecrolimus 1% cream may be a successful treatment choice for patients with resistant seborrheic dermatitis of the face.

Adverse effects of desensitization injections mostly consist of local transient reactions. Rarely, persistent subcutaneous nodular lesions may also develop at the site of injection. These reactions have been attributed to the vaccines containing aluminium hydroxide. Aluminium hydroxide is used as an adjuvant in vaccines and hyposensitization solutions. We describe a patient who presented persistent, itchy subcutaneous nodules as a local reaction to allergen immunotherapy for the treatment of allergic asthma., ((c) 2009 John Wiley & Sons A/S.)

Background: Interferons are molecules with antiviral effects, which have been used for the treatment of verruca for many years., Aims: To determine if sublesional interferon (IFN)-alpha injection offers an effective alternative treatment for common warts., Methods: We compared the results of single-dose sublesional IFN application in different types of verruca and with placebo for the treatment of single verruca plantaris lesions. In total, 53 patients (mean age 22.6 years) were enrolled in the study. Of these, 45 patients received a single sublesional injection of 4.5 MU IFN-alpha2a (three study groups), and eight patients with single verruca plantaris lesions were injected with physiological saline as placebo (control group). As local anaesthesia, liquid nitrogen was sprayed only on to the injection site for 3-4 s. The injection was made directly under the lesion through the border of the lesion, at with approximately a 45 degrees angle from healthy skin., Results: At the 12-month follow-up in the group of patients with single verruca plantaris, there were 19 complete cures (7.2%) and 2 partial responses (8.3%), and 3 patients (12.5%) had no response. In the control group, only 2 patients (25%) had a partial response to treatment., Conclusions: These results suggest that a single sublesional dose of 4.5 MU IFN-alpha may be of value in the treatment of patients with verruca, especially in those with single verruca plantaris lesions.

Insulin-like growth factor (IGF) and its binding proteins (BPs) are candidates to play a role in the pathogenesis of psoriasis. IGF-I and -II and their binding proteins (IGFBPs) have both growth inhibitory and mitogenic effects on a multitude of cell types. Current studies have explored the potential role of IGFBP-3 in keratinocyte growth and differentiation. To gain more insight into the role of IGFBP-3 in the pathogenesis of psoriasis, we investigated the changes in IGFBP-3 expression levels in psoriatic plaque and compared these expressions with levels in other inflammatory skin diseases. In particular, we investigated whether or not the changes in IGFBP-3 were affected by systemic treatment with cyclosporine A (CsA) or methotrexate (Mtx). We found significantly increased IGFBP-3 expression levels in the psoriatic group compared with levels in patients with other, nonproliferative inflammatory skin diseases, and we demonstrated differences in distribution pattern before and after systemic treatment with Mtx or CsA. Mtx and CsA had no effect on tissue IGFBP-3 expression levels. Before treatment with Mtx or CsA, IGFBP-3 expression was limited to the basal layer and suprapapillary region. Unlike with Mtx, CsA significantly changed the IGFBP-3 distribution pattern.

Psoriasis is a chronic, recurrent, inflammatory, and hyperproliferative disease. Recently there have been studies regarding increases in the levels of NO in inflammatory dermatoses including psoriasis. In this study, 22 patients with psoriasis were scored with PASI (psoriasis area and severity index) and the levels of serum nitrite-nitrate were evaluated before and after therapy with methotrexate (Mtx). The results were compared with age- and sex-matched healthy volunteers. The relation of the results with the clinical severity and the cumulative Mtx dose were also evaluated. The serum levels of nitrite-nitrate of the psoriatic patients with active lesions were found to be significantly higher than the levels of the healthy volunteers and the patients after therapy. The elevated nitrite-nitrate serum levels in the inflammatory period may suggest the possible role of this mediator in the etiopathogenesis of psoriasis and the potential future use of NO inhibitors in the treatment of psoriasis.