The Relationship Between Disease Activity and Platelet Indices in Pemphigus: An Observational Preliminary Study.

Tests which have proven their efficacy and reliability in the follow-up of pemphigus patients are used only on a limited scale or take time to complete due to a lack of technical facilities in several centers. Therefore, more accessible methods are being considered for monitoring disease activity. We aimed to investigate the relationship between platelet function and disease activity based on the change in proinflammatory cytokine profile in pemphigus pathogenesis. The size of platelets correlates positively with their activity. Platelet sizes can be evaluated by the platelet volume index consisting of mean platelet volume (MPV), platelet-crit (PCT), and platelet distribution width (PDW). These indicators can be easily measured in complete blood count (CBC) with automatic blood counting devices, which do not require additional costs and are readily available. Patients diagnosed with pemphigus between April 2010 and February 2016 (n=18) in our center were retrospectively included in the study. Demographic data, follow-up period, clinical variants of the patients, platelet parameters (MPV, PDW, PCT), and platelet count (PLT) in CBC analysis with concurrent clinical activity, as well as indirect immunofluorescence (IIF) findings (positive highest titer) at the 6th and 12th month were recorded for each patient. MPV changes were consistent with the course of the disease. A statistically significant decrease in PCT levels was observed at the 12th month compared with the baseline levels (P<0.05). According to the baseline measurement, a statistically significant positive correlation (58.9%) was found between the 12-month difference measurements of IIF and PCT. Our data demonstrated that PCT decrease is correlated with IIF values. The significant correlation between PCT and IIF values in our study is important in showing the possible role of platelet index in the measurement of disease activity.

The impact of refugees on leishmaniasis in Turkey: a new Syrian/Turkish Leishmania tropica population structure described by multilocus microsatellite typing (MLMT).

Turkey is one of the leishmaniasis endemic countries, and according to the recent reports, more than 45% of the cases were reported from the Southeastern part of Turkey. The disease is endemic in Syria with annually 25,000 cases, and it is emphasized by WHO that the actual number was estimated to be 2-5-fold higher than the reported numbers. Due to the civil war in Syria, more than seven million people were displaced and migrate to neighboring countries. The population structure of Leishmania tropica was investigated in the present study using clinical samples, which were obtained from Syrian patients residing in Turkey. Previously reported database was used to compare the results obtained in the present study. According to the multilocus microsatellite typing profiles, three populations (Sanliurfa, Mediterranean, and Syrian/Turkish) were identified. Syrian/Turkish population, which is a new structure and identified for the first time in the present study, was comprised of clinical samples obtained from Syrian patients. The newly described population structure was homogeneous and solid comparing to previously identified population structures in Turkey. Further analyses revealed two sub-populations under the main Syrian/Turkish population structure. The findings of the present study revealed that the epidemiological status of leishmaniasis is more complicated than it is estimated. We believe that the data presented here will provide valuable information on the leishmaniasis epidemiology.

Leishmaniasis in Istanbul; A new epidemiological data about refugee leishmaniasis.

Leishmania is an intracellular parasite, which is transmitted by the bite of infected female Phlebotominae sand flies. Turkey is a crossroad between Europe and Asia that makes it important in terms of epidemiology. In the present study, we aimed to evaluate Leishmania infection among non-autochthonous patients admitted to Health Sciences University, Dr. Sadi Konuk Research and Training hospital between 2014-2018. Slides were prepared by sampling the edge of the lesions for each patient. Microscopical examination was performed after staining procedures. After microscopical examination slides were washed and DNA extraction was performed. ITS-1 real-time PCR was performed to identify the species of the causative agents. Demographic data were recorded for each patient. Also number, type and location of the lesions were recorded. Totally 13 patients were included in this. Majority (12/13) of them were found to be infected with L. tropica, while one patient was infected with L. infantum. Two of the lesions were wet type and 11 of them were dry type lesions. Several papers were published recently about leishmaniasis in Turkey but to best of our knowledge, this is the first study reporting refugee leishmaniasis in Istanbul.

Pediatric patients with psoriasis and psychiatric disorders: premorbidity and comorbidity in a case-control study.

BACKGROUND: Psychiatric disorders are thought to play an important role in the onset, exacerbation and course of several chronic dermatological diseases. We aimed to investigate psychiatric diagnoses in children with psoriasis before and during the disease and to examine potentially related factors. METHODS: A total of 108 children aged 8-16 years, 54 with a diagnosis of psoriasis and 54 healthy individuals, were included in the study. Participants were evaluated using The Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime Version (K-SADS PL), Children's Dermatology Life Quality Index (CDLQI), Screen for Child Anxiety Related Emotional Disorders (SCARED) and Children's Depression Inventory (CDI), and the results were compared using statistical techniques. RESULTS: At least one psychiatric diagnosis was present in 70.3% of children with psoriasis and in 27.7% of the control group, the difference being significant (p = .0001). It was seen that 73.6% of children with a psychiatric diagnosis were psychiatric diagnoses in the premorbid period. Children with psoriasis were determined to have 9.21-fold greater risk of anxiety (p = .0001) and a 6.65-fold greater risk of depression (p = .0019) compared with the control group. CONCLUSIONS: A statistically significant increase in psychiatric disorders occurs in disease periods in cases of pediatric psoriasis. Moreover, a high prevalence of psychiatric disorders was detected in the premorbid process. We think that it is important for these to be considered in the management of the disease and in controlling exacerbation, and for the mechanisms involved to be elucidated.

Assessment of quality of life in Turkish children with psoriasis and their caregivers.

BACKGROUND/OBJECTIVES: The effect of pediatric psoriasis on quality of life has been demonstrated, but data regarding its influence on caregiver quality of life are scarce. The objective was to investigate how psoriasis affects quality of life of children and their caregivers. METHODS: This multicenter study included 129 children with psoriasis and their caregivers, who were family members accompanying patients to the clinic. Patient quality of life was measured using the Child Dermatology Life Quality Index. Caregiver quality of life was assessed using Dermatological Family Impact Scale, a 15-item questionnaire validated for use in the Turkish language. RESULTS: Mean Child Dermatology Life Quality Index score was 7.6, indicating a moderate effect on patient quality of life. Symptoms and feelings were the most severely impaired domains of patient quality of life, and emotions was the most severely impaired domain of caregiver quality of life. Dermatological Family Impact Scale score was significantly correlated with Child Dermatology Life Quality Index (correlation coefficient [r] = .554, P < .001) and Psoriasis Area and Severity Index (r = .350, P < .001). Caregivers of patients receiving systemic agents or phototherapy had relative impairment of multiple domains of quality of life compared to caregivers of patients receiving topical treatment only. CONCLUSION: Psychosocial effect of pediatric psoriasis was shown to extend beyond the individual, highlighting the importance of addressing patient and caregiver quality of life concerns in an integrated approach.

Vulvar syringomas as a part of nonfamilial generalized eruptive form: Unusual lesions leading to pseudohyper-trophy of the labia majora.

We present a case of eruptive generalized syringoma with vulvar involvement. This case is unique in terms of being a nonfamilial, linear variant, leading to pseudohypertrophy of the labia majora.

Bullous lichen sclerosus: isolated vulvar involvement.

We present a patient with the bullous form of lichen sclerosus of the vulva. She had no lesions in other cutaneous and mucosal areas. We used topical tacrolimus and topical clobetasol propionate. The patient was lesion free at the first-year follow-up.

Does Pediatric Obstructive Sleep Apnea Syndrome Cause Systemic Microvascular Dysfunction?

The aim of this study was to evaluate whether pediatric obstructive sleep apnea syndrome (OSAS) secondary to adenoid hypertrophy causes systemic microvascular dysfunction. This is a prospective single-blinded case-control study. As the patient group, 81 patients diagnosed to have OSAS secondary to adenoid hypertrophy at our hospital between January 2016 and May 2016; as the control group, 26 healthy pediatric volunteers who presented to the hospital for health screening were included in this study. Three groups of OSAS patients were defined as mild, moderate, and severe respectively, according to the lateral nasopharynx x-ray. Patients with comorbid diseases were excluded from the study. For microvascular dysfunction, videocapillaroscopic evaluation was performed at the nailfold and capillary density (CD) and postocclusive reactive hyperemia (PORH) values were measured and statistical analysis between the groups was performed. The duration of complaints in all patients with OSAS was at least 6 months and <1 year. CD measurement in the control group and mild, moderate, and severe OSAS group was 94.1 ±â€Š7.9, 96.9 ±â€Š11, 94.7 ±â€Š8.4, and 93.7 ±â€Š9.4, respectively, with no significant difference between the groups (P > 0.05). PORH measurement in the control group and mild, moderate, and severe OSAS group was 95.6 ±â€Š8.6, 97.9 ±â€Š10.1, 96 ±â€Š8.7, and 93.9 ±â€Š9.3, respectively, with no significant difference between the groups (P > 0.05). OSAS secondary to adenoid hypertrophy in pediatric patients was demonstrated to cause no dysfunction in microvascular circulation and carried no cardiovascular risk in the early period.

Comparative cosmetic outcome of surgical incisions created by the PEAK Plasma Blade and a scalpel after cesarean section by Patient and Observer Assessment Scale (POSAS): A randomized double blind study.

OBJECTIVE: To compare the cosmetic result of the PEAK Plasma Blade with traditional scalpel in patients who had primary cesarean delivery by using POSAS (Patient and Observer Assessment Scale). MATERIAL AND METHODS: Fourty women between 20 and 40 years, who were planning to have primary cesarean delivery, were randomized for skin incision with PEAK Plasma Blade (n:20) and with scalpel (n:20) were blinded to their group allocation. At six months, the cosmetic outcome of the cesarean scar was assessed using the POSAS. Subjective scar rating was performed using the patient component of the POSAS. Objective scar assessment was performed by an observer dermatologist blinded to the patient's group allocation. RESULTS: The observer scores (p = 0,003), patient scores (p = 0,001) and the total scores (p = 0,001) of the POSAS scale were significantly lower in favor of the Peak Plasma Blade group with respect to the scalpel group. CONCLUSION: The PEAK Plasma Blade has superior cosmetic outcome compared to traditional scalpel skin incision at cesarean section.