Lip mesotherapy with dexpanthenol in the treatment of isotretinoin-induced cheilitis.

INTRODUCTION: Cheilitis is the most common mucocutaneous side effect of isotretinoin (ISO). Dexpanthenol (DXP) increases fibroblast proliferation and re-epithelialization in wound healing. We aimed to investigate the effect of DXP-mesotherapy in ISO-induced cheilitis in this study. METHODS: This study was conducted on patients who had been using ISO (0.5-1 mg/kg/day) for at least 2 months. Twenty-five patients who administered DXP-mesotherapy (mesotherapy group) and 33 patients without the procedure (control group, only ointment) participated in this study. All patients were prescribed only hamamelis virginiana distillate in ointment form as a lip balm. The efficacy of the treatment was interpreted by the change in lip balm use frequency, quality of life, and Isotretinoin Cheilitis Grading Scale (ICGS). RESULTS: There was a statistically significant decrease in all ICGS-subgroups scores in the mesotherapy group after 1 month compared with the baseline (p = <0.001), although in the controls, erythema, crust, and fissure scores significantly increased (p = 0.001, p = 0.002).While there was no difference between the groups in terms of ICGS total scores at baseline, there was a significant difference after 1 month in favor of the mesotherapy group (p < 0.001). In the mesotherapy group, lip balms were needed significantly less frequently and there was a significant improvement in quality of life compared with both the control group and at baseline after 1 month (both; p < 0.001). On the other hand, the control patients suffered more from cheilitis and dryness than at baseline (p < 0.001). CONCLUSION: Dexpanthenol-mesotherapy seems to be a safe, and so effective method in management of ISO-related cheilitis.

Evaluation of subclinical atherosclerosis in Turkish patients with acne vulgaris receiving systemic isotretinoin.

Studies conducted on isotretinoin have shown that it may indirectly lead to atherosclerosis. The objective of this study was to determine the effect of systemic isotretinoin on subclinical atherosclerosis. The present study included 63 patients with acne vulgaris who had used isotretinoin for 6 months. Glucose, insulin, and homeostatic model assessment of insulin resistance levels; body mass index; waist circumference; blood pressure; lipid profile; and lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1), high-sensitivity C-reactive protein, and oxidized low-density lipoprotein (Ox-LDL) levels were compared in the patients at the initiation and discontinuation of the treatment. At the discontinuation of the treatment, LOX-1 and Ox-LDL levels showed a significant increase (P < .001 and P = .040, respectively). Differences in waist circumference were positively correlated with an increase in LOX-1 levels (r = .274; P = .030). Isotretinoin causes an increase in the levels of subclinical atherosclerosis markers. Although the present study sample size was small, we believe that caution should be exercised considering the risk of atherosclerosis during isotretinoin use in men with high waist circumference and cardiovascular risk factors; further studies are warranted in this regard.

The efficacy and safety of phototherapy in geriatric patients: a retrospective study.

BACKGROUND: While phototherapy is a well-established treatment for many dermatoses, data from the literature regarding its use in elderly patients are quite limited. OBJECTIVE: In this study, we aimed to determine the phototherapy indications in geriatric patients and to evaluate the effectiveness and reliability of phototherapy in this group. METHODS: This study included 95 patients of 65 years of age and older who were treated in our phototherapy unit between 2006 and 2015. The data for this study were collected retrospectively from patient follow-up forms in the phototherapy unit. RESULTS: Phototherapy was administered to 28 (29.5%) patients for mycosis fungoides, 25 (26.3%) patients foplaque type psoriasis, 12 (12.6%) patients for palmoplantar psoriasis, 12 (12.6%) patients for generalized pruritus, and 18 (19%) for other dermatoses. Of the patients, 64.2% had received a narrowband UVB (NB-UVB), 21.1% oral psoralen UVA (PUVA), and 14.7% local PUVA treatment. A complete response was achieved in 76.9-85.7% of the mycosis fungoides and in 73.71-100% of the psoriasis vulgaris patients treated with NB-UVB and PUVA, respectively. All the patients with generalized pruritus were treated with NB-UVB, and 80% of these patients achieved significant improvement. The erythema rate was found to be 0.43% per session for NB-UVB treatment and 0.46% per session for PUVA treatment as a side effect. STUDY LIMITATIONS: The limitations of our study are that it was retrospective and the remission durations of the patients are not known. CONCLUSION: This study showed that phototherapy is effective and reliable in the elderly population with proper dose increases and close follow-up.

Evaluation of the effects of acne vulgaris on quality of life in Turkey by using TAQLI.

BACKGROUND: Acne vulgaris (AV) is a chronic, inflammatory skin disease that may cause various psychiatric and/or psychological problems. OBJECTIVE: In this study, we aimed to determine the effect of AV on the quality of life in the Turkish population using the Turkish Acne Quality of Life Index (TAQLI). METHODS: A total of 960 patients with AV who attended the dermatology department were included in the study. Acne severity was determined using the global acne classification system. TAQLI was used to evaluate the effect of acne on quality of life. RESULTS: The 960 patients consisted of 673 (70.1%) females and 287 (29.9%) males. There were 536 (55.8%) patients under the age of 20, 386 (40.2%) aged 20-30, and 38 (4.0%) over 30. Acne duration varied between 1 and 20 years, and the mean duration was 2.95 ± 2.53 years. The mean TAQLI value of all patients was 20.8 ± 9.5. The mean TAQLI value was statistically significantly higher in female patients, in patients with an acne duration of more than 2 years, and in those with very severe acne. However, no statistically significant difference was found between the age groups. CONCLUSION: We observed that the quality of life in patients with AV was affected, and this effect was more significant in female patients, patients with severe acne and longer acne duration. We believe that the psychiatric/psychological effects should be followed up closely in this group of patients.

Kaposi's sarcoma concealed by stasis dermatitis in a patient with psoriasis.

Kaposi's sarcoma (KS) is a multifocal and angioproliferative neoplasm. KS may be accompanied by psoriasis; however, in most of these cases the main mechanism involves iatrogenic KS associated with the immunosuppressive drugs that are used in psoriasis treatment. In angioproliferative lesions as a result of venous insufficiency and stasis dermatitis, acroangiodermatitis (pseudo-KS) is initially considered. However, the concurrent occurrence of psoriasis, stasis dermatitis, and KS has not been previously reported. We report a case of classic-type KS in an 83-year-old man that was concealed by stasis dermatitis and accompanied by psoriasis.

Morphea in Middle Anatolia, Turkey: a 5-year single-center experience.

INTRODUCTION: Morphea, also referred to as localized scleroderma, is a rare fibrosing skin disorder of undetermined cause. AIM: We report our single-center experience with morphea. MATERIAL AND METHODS: The study included 53 patients who were diagnosed with morphea by histopathology in our department between 2010 and 2015. Study data were collected retrospectively from the records of morphea patients. RESULTS: The study included 53 patients (38 women, 15 men), and median age at onset was 39.0 (range: 8-85) years. Thirty (56.6%) patients had circumscribed morphea, 15 (28.3%) had generalized morphea, and 7 (13.2%) had linear morphea. One patient had mixed variant morphea (generalized, pansclerotic and linear morphea). ANA positivity was detected in 12 (22.6%) patients, but analysis for an association between the presence of ANA and morphea types, patients' characteristics did not reveal any significant associations. We did not observe any extracutaneous manifestations in patients during follow-up period. There were 2 of 53 patients who had concomitant autoimmune disorder including vitiligo and spondyloarthritis. Thirty (56.6%) patients received only topical treatment. The patients with clinical improvement who were treated with systemic therapy received methotrexate (26.4%), colchicine (9.4%), mycophenolate mofetil (5.7%) and prednisolone (1.9%). CONCLUSIONS: Our results related to the demographic data of the patients and morphea types were consistent with the literature. On the other hand we observed that methotrexate was mostly used as an effective treatment option for generalized morphea.

Disseminated eruptive granuloma annulare induced by levetiracetam.

Granuloma annulare (GA) is a benign, granulomatous cutaneous disease without clear etiology. Disseminated and drug induced granuloma annulare is a rare presentation. We present a 47-year-old woman with diffuse circular erythematous eruptions following treatment with levetiracetam. Her clinical and histopathological findings were compatible with the diagnosis of granuloma annulare. To the best of our knowledge, there is no previous report of this skin disease as a result of levetiracetam use. We report this case to highlight this antiepileptic drug as a possible etiologic agent in disseminated granuloma annulare.

Evaluation of Cutaneous Findings in Children and Adolescents with Attention Deficit Hyperactivity Disorder: A Preliminary Study.

Attention deficit hyperactivity disorder (ADHD) is characterized by attention, concentration, mobility, and impulse control problems and is among the most frequently seen psychiatric disorders during childhood. Our aim was to evaluate cutaneous findings in children and adolescents with ADHD. In our study we found that onychophagy, traumatic skin changes, atopy and related symptoms, certain birthmarks, and acne were frequent cutaneous findings in children with ADHD. Although a limitation is the lack of a control group, ADHD is very common, and our study suggests that further studies of cutaneous findings and ADHD are warranted.