Retrospective Analysis of Dermatological Diseases in Geriatric Patients During Dermatology Outpatient Department Visits.

Introduction: The elderly population is vulnerable to experience a great number of dermatological diseases thanks to the intrinsic and extrinsic process of aging. Objectives: The aim of this study is to retrospectively investigate the prevalence of dermatological diseases in geriatric patients, their distribution by age and gender, and to provide a reference for studies on aging and skin problems. Methods: In the present study, patients who reported to the dermatology outpatient clinic between January 1 2019, and January 1 2021, were evaluated retrospectively. As a result of examining the records of patients, 887 patients over the age of 65 who met the study protocol were included. Results: The three most common diseases in all geriatric patients were fungal infections, eczematous dermatitis, and pruritus. Fungal infections were frequent in males and the 65-74 age group. In the males, the more frequent were precancerous lesions and malignant neoplasms, whereas in the females it was urticaria and adverse drug reactions. In the logistic regression model, the risk of fungal infection in geriatric patients was increased by being male (odds ratio 1.55, P = 0.006) and being in the range of 65-74 years old (odds ratio 1.46, P = 0.025). Male patients were at significantly higher risk for precancerous and malignant lesions (OR:2.81 P < 0.001) and actinic keratosis (odds ratio 3.26, P < 0.001) in this disease group. Conclusions: Men are more vulnerable to life-threatening skin diseases. It is important to determine risk factors for individuals who are more sensitive to environmental factors in terms of increasing the quality of life and protection from diseases.

Perspectives of dermatology specialists and residents on COVID-19 vaccines: A questionnaire-based survey.

BACKGROUND: To evaluate the perspectives of dermatology specialists and residents on coronavirus disease 2019 (COVID-19) vaccines. METHODS: Present questionnaire-based study was conducted on dermatology residents and specialists between January 5 and 20. A non-validated online questionary evaluating the attitude of the participants about the COVID-19 vaccine was performed. In the first step of the study, data related to the demographic features, all participants' clinical characteristics, and working conditions were recorded. Thereafter answers given to 12 specific questions were recorded. The study population was divided into two groups: dermatology residents (n = 138) and specialists (n = 159). Mentioned variables were compared between the two defined groups. Furthermore, a correlation analysis was performed to assess the relationship between vaccination acceptance and various study parameters. RESULTS: Majority of the cases had positive attitudes against COVID-19 vaccines. However, there were significant differences between the resident and specialist groups related to the source of information, working conditions, degree of concern, and type of vaccines. Statistically significant negative, weak correlations were observed for age and duration of medical practice (r = -.128, P = .028; r = -.132, P = .041 respectively). Statistically significant positive weak correlations were observed for chronic diseases, level of knowledge about COVID-19 vaccines, number of information sources about COVID-19, and previous COVID-19 infection (r = .133, P = .021; r = .207, P < .001; r = .335, P < .001; r = .176, P = .002 respectively). CONCLUSION: The acceptance of COVID-19 vaccination may be affected by working conditions, medical experience, level of knowledge and the presence of risk factors for severe disease among dermatology residents and specialists.

Experience with oral tofacitinib in severe alopecia areata with different clinical responses.

BACKGROUND: Alopecia areata (AA) and generalized form, universalis (AU) are common causes of noncicatricial alopecia, targeting anagen hair follicles. A dominant interferon-gamma transcriptional signaling and cytotoxic T lymphocytes were accused as the main drivers of disease pathogenesis. Tofacitinib is a Janus kinase inhibitor that has been proven to interfere with the positive feedback loop between the follicular cell and the cytotoxic T lymphocytes in AA. There is an increasing number of studies reporting success with tofacitinib in AA. AIMS: We aimed to assess oral tofacitinib's safety and efficacy in 13 recalcitrant AA and AU patients. METHODS: This is a retrospective pilot study performed between 2017 and 2020. The demographic features and the treatment responses were evaluated with Severity of Alopecia Tool score changes. RESULTS: Thirteen recalcitrant alopecia areata patients (3 AA, 10 AU), aged between 17 and 49, were included in the study. The treatment duration was 3-15 months. All three AA patients responded well; however, the therapy was unsuccessful in five of ten AU patients. Relapse was observed in one of the AA and three of the AU responders. Acneiform lesions and elevation of transaminases were the major side effects. CONCLUSION: Tofacitinib seems to be more promising and thriving in the treatment of AA than AU. Starting the therapy earlier can bring more successful results. Unfortunately, even in the cases that fully respond to treatment, relapse can be observed after discontinuation of the treatment. It is essential to inform patients about this situation in reducing the frustrations that may occur later.

Changing trends in dermatology practice during COVID-19 pandemic: A single tertiary center experience.

The aim of this study was to evaluate the changing trends in dermatology clinical practice at a tertiary center during the coronavirus disease 2019 (COVID-19) pandemic. This retrospective cohort study was conducted on patients who were admitted to Ufuk University Hospital with dermatologic complaints/diseases before and during the pandemic. The patients were divided into two groups: (a) the pre-pandemic period (March-May 2019) and (b) the Pandemic period (March-May 2020). Demographic features, clinical characteristics, dermatologic diseases/complaints, dermatologic procedures/interventions, hospitalization rate, and use of biologic agents were compared between the two groups. Total number of hospital admissions have decreased from 1165 to 717. Admission rates for acne, dermatophytosis, and benign neoplasm of the skin significantly lower during the pandemic period (P values were .02, .04, and .006, respectively). Contact dermatitis, acne accompanying dermatitis, cicatricial hair loss, lichen planus, and zona zoster infection rates were significantly higher (P values were .007, <.001, .009, .04, and .03, respectively). Rates of biopsy and electrocautery procedures were decreased significantly (P values were <.001 and .002, respectively). The hospitalization rate was similar between the groups (P = .51). However, the use of biologic agents significantly decreased during the pandemic period (P = .01). Updated clinical protocols should be established for the new normal period in accordance with these findings.