Dermatology consultations in patients with hematological and solid organ malignancies

Aims: Patients with hematological or solid organ malignancies are susceptible to various skin disorders. This study described the cutaneous problems related to the underlying diseases or their management in hematology and oncology inpatients. Methods: In this retrospective study with a cross-sectional analysis, we examined the medical records of inpatients with hematologic or solid organ malignancy who consulted the dermatology department from January 2018 through March 2021. Sociodemographic characteristics, medical history and comorbidities, cancer type, and dermatological findings and diagnoses were noted. Patients who have consulted the outpatient clinic and those with inadequate medical records were excluded. Results: The study included 200 patients (age, mean±standard deviation, minimum-maximum: 51.4±18.2, 18-89 years;female 51%). Most of the consultations were from the internal medicine clinic (26.4%), followed by the hematology and oncology clinics (12.5%). A quarter of the patients had acute myeloid leukemia, the most frequent disease among hematological malignancies. Breast cancer (7%) and testis cancer (7%) were the most common solid organ malignancies. The most common dermatological diagnoses were cutaneous infections (33.5%) and drug reactions (13.5%). Skin biopsies were performed in 19.5% (n=39) of the patients. The evaluation of the patient by a dermatologist for a cutaneous symptom or finding led to modifications of disease management in 67 patients (33.7%). Conclusions: Dermatology consultations are frequently required in hematological or solid organ malignancies. A successful evaluation of skin manifestations in these patients may improve the quality of care in this vulnerable population.

Pemphigus vulgaris after SARS-CoV-2 vaccination: A case with new-onset and two cases with severe aggravation.

Pemphigus may be induced or aggravated by certain drugs and vaccines. People worldwide are currently vaccinated with several SARS-CoV-2 vaccines which may be associated with increased number of aggravated or triggered autoimmune bullous diseases in subjects with an underlying genetic predisposition. Herein, a case of new-onset pemphigus vulgaris (PV) and two cases with aggravation of PV after vaccinations for SARS-CoV-2 are reported.

Rapid Response to Certolizumab Pegol in Hidradenitis Suppurativa: A Case Report.

INTRODUCTION: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease of hair follicles which usually affects patients' quality of life negatively. Although there are various therapeutic approaches including topical and systemic antibiotics, retinoids, biological agents, and also surgical modalities, there is no curative treatment option and clinical management of HS is still challenging. CASE PRESENTATION: Herein, we present a 43 year-old man with HS who had used different treatments in 15 years. The patient showed improvement initially with adalimumab, then exhibited secondary unresponsiveness after 18 months. While worsening of HS was recorded due to increased discharge under secukinumab, no additional benefit was observed with methotrexate. He was not willing to undergo surgical procedures due to previous surgical experience. Finally, certolizumab pegol has been started to patient with similar dosing to psoriasis patients. Sartorius, 10-point visual analogue scale (VAS), and dermatological life quality index (DLQI) scores regressed from 171 to 105, 9/10 to 3/10, and 27 to 19 after 3 months with certolizumab pegol treatment. DISCUSSION/CONCLUSION: Certolizumab pegol is a humanized antigen-binding fragment of a monoclonal antibody which binds to TNF-alpha. However, certolizumab pegol is only approved for plaque psoriasis in dermatology; it is likely to be a promising effective agent for HS, especially in challenging cases.

Medical and socioeconomic challenges of private dermatocosmetology clinics during COVID-19 pandemic: A survey from Turkey.

BACKGROUND: Coronavirus 2019 (COVID-19) disease has rapidly spread worldwide with a multitude effects on daily life. Since the transmission risk increases with close contact, some cosmetic procedures are considered high risk and majority of them had to be postponed or canceled in private dermatocosmetology clinics especially during the heavy period of the outbreak. AIMS: We aimed to document the medical and socioeconomic problems emerged in dermatocosmetology clinics in Turkey caused by COVID-19 pandemic and to discuss the management strategies taken by dermatologists. PATIENTS/METHODS: This survey research was conducted with 100 dermatologists who work in private dermatocosmetology clinics. The survey included 38 questions about office re-arrangements including patient admission and office environment, safety precautions taken for cosmetic procedures, management of clinic staff, and financial impact of the pandemic. RESULTS: A remarkable decrease in major cosmetic interest was reported in private clinics; meanwhile, there was an increase in applicants for noncosmetic dermatological complaints. The most avoided cosmetic procedures were application of skin care devices, lasers, chemical peeling, and thread lifting, while botulinum toxin injection was the most performed procedure. Nearly half of the participants had severe financial damage. Of the participants, 55% reported that they worked anxiously during this period and 60% believed that they managed the early period of the pandemic successfully. CONCLUSION: Private dermatocosmetology clinics have to work in a totally different period that they have never experienced before. The pandemic has had serious impacts on both medical and socioeconomic issues which had to be managed carefully.