Depression and anxiety levels in mothers of children with cerebral palsy: a controlled study.

BACKGROUND: Studies investigating depression and anxiety levels in mothers of children with CP and related factors are limited, and controversial findings are reported in these studies. AIM: The study was aimed to determine depression and anxiety levels in mothers of children with cerebral palsy (CP) and to define factors related to depression and anxiety levels. DESIGN: A descriptive study. SETTING: Outpatient physical medicine and rehabilitation clinic of an education and research hospital. POPULATION: The study was composed of two groups: group 1, 116 mothers of children with CP and group 2, 114 mothers of healthy children. METHODS: Mothers of children with spastic-type CP were included into group 1. Functional levels in children with CP were investigated with The Gross Motor Function Classification System (GMFCS). Depression levels of mothers in both groups were assessed with Beck Depression Inventory (BDI), and anxiety levels with Beck Anxiety Inventory (BAI). RESULTS: BDI and BAI scores were statistically and significantly higher in group 1, compared to group 2. Among mothers in group 1, a positive correlation was determined between GMFCS score, and depression and anxiety levels. However, no correlation was detected between depression and anxiety levels, and body involvement of CP, education status, age and economic level among patients. In logistic regression analysis, the most significant risk factors of depressive symptoms were detected to be GMFCS score and speech defects. CONCLUSION: Our findings indicate that depression and anxiety levels of mothers with CP children are higher than those with healthy children and associated with speech defects and functional disability levels in children with CP. Healthcare professionals should take into account that depression and anxiety levels may be higher in mothers of children with CP. CLINICAL REHABILITATION IMPACT: For an effective rehabilitation program related to children with CP, depression and anxiety levels in mothers of such children should be taken into account, and mothers should closely be followed and if necessary, psychologically supported.

Correlation between the dermatoscopic and histopathological features of pigmented basal cell carcinoma.

BACKGROUND: Dermatoscopy has a great value in the diagnosis of pigmented basal cell carcinoma (BCC), which is a clinical variant of BCC. The precise definitions of histopathological correlates of dermatoscopic features observed in pigmented BCC have not been established yet. OBJECTIVE: The present study aimed to investigate the correlation between the dermatoscopic features of pigmented BCC and their histopathological counterparts to provide clear histopathological definitions of each dermatoscopic feature. METHODS: In this case series that comprised a methodological component, after the orientation of dermatoscopic features was determined by placing sutures in the lesions, the histopathological counterparts of each were examined and definitions were made accordingly. RESULTS: Although the most common histopathological subtype of BCC is the solid type, the most common histopathological subtype observed in the pigmented BCC lesions in the present study was the superficial multifocal type (72.5%). Blue-whitish veil was observed in 57.5% (n=23) of the lesions, a percentage higher than that reported in the literature. In addition to confirming the previously histopathologically defined dermatoscopic features of pigmented BCC, we identified three histopathologically undefined features of pigmented BCC that are spoke-wheel areas, large blue-grey ovoid nests and multiple blue-grey globules. CONCLUSION: Dermatoscopy facilitates prediction of the corresponding histopathological findings in pigmented BCC, based on specific dermatoscopic features.

Multidrug-induced erythema multiforme.

Adverse skin reactions to drugs are frequent, with rates of reaction to many commonly used drugs exceeding 1%. We describe a 29-year-old woman admitted with a history of itching, rash, vesicles on her hands and soles, and edema on her tongue and oropharynx after trimethoprim-sulfamethoxazole, ciprofloxacin, methenamine anhydromethylene citrate, piroxicam, azithromycin, and ceftriaxone intake. Erythema multiforme (EM) was diagnosed by skin biopsy after oral challenge with piroxicam. EM lesions reappeared after oral challenge with levofloxacin. Although EM is quite common with trimethoprim-sulfamethoxazole and there are some reports of EM appearing after intake of ciprofloxacin, it has rarely been attributed to piroxicam and no reports have identified levofloxacin as a cause.

Cutaneous mastocytosis: demographic aspects and clinical features of 55 patients.

BACKGROUND: Mastocytosis is a rare, heterogeneous group of disorder with abnormal increase of mast cells in one or more organ systems. OBJECTIVE: To evaluate the demographic and clinical features of cutaneous mastocytosis (CM). METHODS: Records of 55 patients with cutaneous mastocytosis were retrospectively analysed. RESULTS: Of the 22 females and 33 males, 80% had urticaria pigmentosa/maculopapular CM and 20% had mastocytoma. Of all cases, 81.8% had first lesions in childhood. The most common presentation was involvement of trunk together with extremities. Thirteen (23.6%) patients had history of bulla; Darier's sign was positive in 34 of 38 patients. Itching was the most common complaint, provocated by hot weather/bath. CONCLUSION: Clinical presentations of urticaria pigmentosa/maculopapular CM and mastocytoma are similar regarding gender, age of onset, age of diagnosis, and presence of Darier's sign and history of bulla. In contrast to mastocytoma, urticaria pigmentosa/maculopapular CM lesions were frequently located on trunk together with extremities.

The assessment of functional status in Turkish children with cerebral palsy (a preliminary study).

INTRODUCTION: Cerebral palsy (CP) is one of the most common causes of disability in childhood leading to functional limitations. Assessment of the functional limitations is important to determine the severity of the disability in CP and to evaluate the benefit of the rehabilitation programme. However, the results of the measurements show variations according to different sociocultural characteristics. The Functional Independence Measure of Children (WeeFIM) had not been studied in Turkish children previously. The aims of this study were to evaluate the functional disability of Turkish children with CP by using WeeFIM and to compare the results with those of healthy counterparts. METHODS: A total of 86 children aged 24 months to 120 months were included in the study. Forty-five children with CP and 41 healthy children representing the controls were evaluated with WeeFIM. Both children with CP and healthy controls were categorized into four groups according to their chronological age. The variations in the WeeFIM subsets scores (self-care, sphincter control, transfers and locomotion, communication and social cognition) and total WeeFIM scores in children with CP and healthy controls were analysed. RESULTS: The children with CP had lower WeeFIM scores than healthy controls. The sphincter control subset scores of children with CP increased as they grew up. There was no statistically significant difference in all WeeFIM subset scores and the total WeeFIM scores among the four age groups of children with CP. CONCLUSION: The WeeFIM appears to be a useful instrument for measuring the disability of Turkish children with CP. However, studies with wider series are needed to generalize our results.

Acute generalized exanthematous pustulosis induced by bleomycin and confirmed by patch testing.

Acute generalized exanthematous pustulosis is a potentially severe disease caused by drugs in about 90% of cases. To the best of our knowledge, acute generalized exanthematous pustulosis following use of bleomycin has not been previously reported. Here we report a case of acute generalized exanthematous pustulosis induced by bleomycin, which was confirmed by patch testing.