The Relationship Between Adolescents' Perception of Family Emotional Atmosphere and Acne Severity, Self-Esteem, and Quality of Life in Adolescents Diagnosed with Acne Vulgaris.

OBJECTIVE: Acne vulgaris, a prevalent chronic condition among adolescents, significantly impacts patients' quality of life and self-esteem. Our aim was to investigate whether how adolescents perceive their family emotional atmosphere has an impact on their acne severity, quality of life, and self-esteem. MATERIALS AND METHODS: This study included 118 patients with acne vulgaris who completed various assessments, including a sociodemographic data form, the Acne Quality of Life Scale, the Hospital Anxiety and Depression Scale, the Shortened Level of Expressed Emotion Scale (SLEES) and, the Rosenberg Self-Esteem Scale. The Global Acne Grading System is performed by an experienced dermatologist to determine the severity of acne. RESULTS: Out of 118 patients, 78 (66.1%) were female and 40 (33.9%) were male. The mean age of patients was 15.2 ± 1.3 years. There was a positive correlation between the severity of acne and the levels of perceived intrusiveness subscores of SLEES (P = .021, r = 0.212). Significant correlations were also observed among quality of life scores, anxiety and depression levels, lack of emotional support (LES) scores, and self-esteem levels. The initial linear regression analysis demonstrated that the level of LES subscores of SLEES and levels of anxiety and depression were predictors of self-esteem. In the second regression analysis, anxiety and depression levels were identified as significant predictors of quality of life. CONCLUSION: The perceived family emotional atmosphere may be an important factor in evaluating the severity of acne as well as the self-esteem and quality of life of adolescent patients with acne vulgaris.

Scabies Affects Quality of Life in Correlation with Depression and Anxiety.

INTRODUCTION: Scabies is a highly contagious disease affects many people worldwide each year and a major public health problem. A small number of studies have shown that scabies causes impairment in the quality of life in adult patients. OBJECTIVES: The aims of this study are to assess the impact of scabies on adult patients quality of life (QoL) and evaluate the relationship between depression and anxiety levels and impairment in life quality. METHODS: This cross-sectional study included adult patients diagnosed with scabies in our dermatology outpatient clinic. The effect of scabies on QoL was evaluated by Dermatology Life Quality Index (DLQI), and the levels of depression and anxiety were evaluated by Beck Depression Scale (BDS) and Beck Anxiety Scale (BAS). RESULTS: Totally, 85 patients included to the study. QoL of 72.2% of the patients was moderate to extremely large affected. There was a positive correlation between the duration of the disease, the total DLQI score and the severity of the disease impact on QoL (rs= 0.287, P = 0.01 and rs=0.280, P = 0.008, respectively). A positive correlation was found between the number of treatments received and the total DLQI (rs= 0.223, P = 0.042). There was a positive correlation between BDS and BAS, and total DLQI score (rs=0.448 and P = 0.000; rs=0.456 and P = 0.000, respectively). CONCLUSIONS: Scabies has a moderate to severe effect on QoL. There was a positive correlation between impairment QoL and anxiety and depression scores.

Serum vitamin D levels and vitamin D receptor gene ApaI and TaqI polymorphisms in patients with morphea: a case-control study.

A uncommon inflammatory condition called morphea causes fibrosis in the skin and subcutaneous tissue. The key stages in the pathophysiology are vascular damage, immunological response, and fibrosis. Numerous research have examined the relationships between the immune system, fibrosis, and vitamin D, but the exact pathogenetic pathways of morphea remain poorly understood. The purpose of this study was to investigate serum 25(OH)D levels and the ApaI (rs7975232) and TaqI (rs731236) polymorphisms of the vitamin D receptor (VDR) in morphea patients. There were 48 age- and sex-matched controls and 41 morphea patients total. VDR polymorphisms were found using PCR tests and gel electrophoresis, and serum 25(OH)D levels were determined using liquid chromatography combined with tandem mass spectrometry (LC-MS/MS). The patient group consisted of 37 females (90.2%) and 4 males (9.8%). The patients' mean age was 38.68 ± 17.54 years. In terms of VDR ApaI and TaqI polymorphisms, there was no discernible difference between the patient and control groups. TaqI polymorphism heterozygosity was discovered in all patients with progressive disease, and this finding was statistically significant (p = 0.012). Patients' mean serum 25(OH)D levels were 16.98 ± 11.55 ng/mL, while those in the control group were 18.02 ± 14.30 ng/mL. VDR polymorphisms, vitamin D levels, disease subtype, age of onset, and responsiveness to treatment did not significantly correlate. In our research, we discovered that TaqI polymorphism may be related to the severity of the disease and that the polymorphisms of the VDR ApaI and TaqI were not associated with morphea susceptibility.

Omalizumab treatment in combination with any other biologics: Is it really a safe duo?

BACKGROUND: Chronic spontaneous urticaria (CSU) is a mast cell-mediated disease, which is sometimes associated with various inflammatory disorders. Omalizumab is a commonly used biological agent, which is a recombinant, humanized, monoclonal antibody against human immunoglobulin E. However, there are only few reports about the combination of omalizumab for CSU with any other biologics for accompanying inflammatory diseases in the literature. The aim of this study was to evaluate the patients whose treatment of omalizumab for CSU were combined with any other biologics for associated inflammatory disorders and to describe whether these combinations might have any safety concerns. METHODS: We conducted a retrospective cohort study of adult patients with CSU treated with omalizumab concurrently using another biological agent for their other dermatological conditions. RESULTS: Thirty-one patients, 19 women and 12 men, were evaluated. The mean age was 45.13 years. The median duration of omalizumab was 11 months. Biological agents which patients were treated other than omalizumab were as follows: adalimumab biosimilar (n = 3), ustekinumab (n = 4), secukinumab (n = 17) and ixekizumab (n = 7). The median duration of concurrent use of omalizumab and other biologics was 8 months. None of the drug combinations was stopped because of side effects. CONCLUSION: This observational study demonstrated that omalizumab treatment for CSU in combination with any other biological agents for dermatological disorders appeared to be well tolerated without any major safety concerns.

Ixekizumab treatment in patients with moderate-to-severe plaque psoriasis in a real-world clinical setting.

BACKGROUND: The efficacy and safety reports of ixekizumab for moderate-to-severe plaque psoriasis may vary between clinical trials and real-world studies. AIM: To analyze the real-world data of ixekizumab therapy to evaluate its efficacy and safety and highlight the factors influencing the treatment response in the real-world scenario. PATIENTS/METHODS: Data of 82 adult patients with moderate-to-severe chronic plaque psoriasis are included in this study. Psoriasis area severity index (PASI) 75/90/100 responses at 4, 16, 24, and 48 weeks were analyzed retrospectively from patient charts by examining demographic and clinical characteristics of the patients, especially their previous biologic experience, obesity, and involvement of hard-to-treat areas. RESULTS: PASI75, PASI90, and PASI100 responses were achieved in 92.4%, 86.1%, and 26.6% patients at week 16 and maintained till week 48 in 92.3%, 86.5%, and 17.3% patients. PASI90 responses in obese patients were significantly lower than non-obese patients at week 4 (33.3% vs. 69.6%, p = 0.042), but this difference was minimized by week 16 (82.4% vs. 90%, p = 0.405). PASI90 responses in biologic-naive patients were significantly higher than biologic-experienced patients at week 16 (p = 0.015). Involvement of hard-to-treat areas was negatively associated with PASI90 responses at week 16 (OR: 1591805.842; 95% CI: 1.223-2071404486740.201; p = 0.047). CONCLUSION: Ixekizumab provides an effective and safe biologic treatment option to patients with moderate-to-severe plaque psoriasis. Obesity, though it affects the early treatment response (till week 4), does not upset the overall treatment response beyond week 16. Previous biologic exposure and involvement of hard-to-treat areas are important prognostic factors for achieving high PASI responses in psoriatic patients.

A real life experience with ustekinumab: The effectiveness of 45 mg on patients greater than 80 kg but lower than 100 kg.

Ustekinumab is a fully human monoclonal antibody has been demonstrated efficacious and safe in clinical trials. However, there are few real-life data evaluating the efficacy of ustekinumab. The aim of this retrospective follow up study was showing the efficacy in 58 adult patients with moderate to severe psoriasis treated at least 24 weeks with ustekinumab. The efficacy was evaluated as PASI75, PASI90, and PASI100 response rates at week 4, 12, 24, and 36 in patient groups according to the treatment dose, weight, biologic treatment naivety, and obesity. PASI75, PASI90, and PASI100 response rates were 79.3%, 62.1%, and 8.6% respectively, at week 12 and, 92.5%, 71.7% and 9.4%, respectively, at week 36. PASI75, PASI90, and PASI100 responses were generally higher in naive patients to the biologic therapy. Also, the responses were generally higher in non-obese patients at 4 and 12 weeks. According to the weight categories, PASI100 response rates were higher in the 81-99 kg group at week 12. In conclusion, ustekinumab is an effective and safe treatment option for moderate to severe psoriasis patients. It seems to be more effective in biologic treatment naive patients and non-obese patients. A 45 mg dose of ustekinumab seems to be effective in patients weighing 99 kg or less.

Evaluation of patients with telogen effluvium during the pandemic: May the monocytes be responsible for post COVID-19 telogen effluvium?

INTRODUCTION: Telogen effluvium (TE) is one of the causes of non-scarring hair loss that occurred commonly 2-3 months after a triggering factor. It was reported that the incidence of TE increased during the COVID-19 (coronavirus disease 2019) pandemic. However, to date, there is no study evaluating the status of COVID-19 before the onset of hair loss in patients with TE. The aim of this study is to evaluate the patients with TE whether they had COVID-19 or not before the onset of their hair loss and to compare the demographic and clinical characteristics and laboratory parameters of those with and without a history of COVID-19. METHOD: We conducted an observational cohort study of TE patients. The diagnosis of TE depended on anamnesis and physical examination of the patients. Also, hair pull test was performed. Demographic data and the results of COVID-19 real-time polymerase chain reaction (RT-PCR) were recorded from the electronic medical records. RESULTS: Totally, 181 patients with TE were included in the study. Sixty-four of patients (35.4%) had been diagnosed with COVID-19 before the hair loss started. The median duration of development of hair loss was 2 months (range 1-11 months, IQR 3) after COVID-19 diagnosis. In this group, 87.5% of patients (n = 56) had acute TE and 12.5% of patients (n = 8) had chronic TE. The rate of acute TE and the use of vitamin supplements were ignificantly higher (p < 0.001 and p = 0.027, respectively) and the monocyte count in peripheral blood was lower (p = 0.041) in the group diagnosed with COVID-19. DISCUSSION AND CONCLUSION: It was stated that monocytes and macrophages infected by SARS-CoV-2 can produce pro-inflammatory cytokines that play a crucial role in the development of COVID-19-related complications. Also, it was suggested that the number of monocytes tends to be lower in the late recovery stage. The lower monocyte count in patients with a history of COVID-19 in our study may be related to evaluating the patients in the late period of recovery and the migration of circulating monocytes to hair follicles. The history of COVID-19 must be questioned in patients with TE. It should be kept in mind that hair loss that develops after COVID-19 may be presented as chronic TE form too. The exact mechanisms of hair loss induced by COVID-19 are not fully explained; the roles of monocytes on the hair follicles may be one of the responsible mechanisms.

Is dupilumab effective in adult-onset atopic dermatitis: Real-life experience of 16 patients.

BACKGROUND: Dupilumab is approved for the treatment of atopic dermatitis (AD). However, there are few studies demonstrating its efficacy and safety, particularly in the treatment of adult-onset AD. OBJECTIVE: The aim of this study is to evaluate the real-life experience regarding the efficacy and safety of dupilumab in the treatment of adult-onset AD. METHODS: This study is a case series in retrospective design. Patients with the diagnosis of adult-onset AD, using dupilumab at a standard dose for at least 3 months, were included in the study. Demographic and laboratory data of the cases, data regarding to dupilumab treatment, were recorded. The eczema area severity index (EASI) and the visual analog scale (VAS) for itch were used to evaluate treatment efficacy. RESULTS: A total of 16 patients, 6 female and 10 male, were included. The median age was 41 years, the median age of the disease onset was 37.5 years, and the median duration of the disease was 90 months. The median duration of the dupilumab treatment was 10.5 months. The mean percent reduction from baseline in EASI score was 85.8 ± 12.2 at 3 months, 90.7 ± 9.3 at 6 months, and 93.1 ± 5 at 12 months. The mean percent reduction from baseline in VAS itch score was 82.2 ± 8.6 at 3 months. Acute vestibular neuritis was developed in one patient during the dupilumab therapy and resolved with anti-inflammatory therapy. CONCLUSION: Dupilumab seems to be highly effective and safe in the treatment of adult-onset AD. The present study is important as it is the first study to evaluate this patient group specifically.

Retrospective evaluation of patients with chronic spontaneous urticaria using omalizumab during the COVID-19 pandemic.

INTRODUCTION: Omalizumab (OMZ) is a monoclonal anti-immunoglobulin E antibody used in patients with chronic spontaneous urticaria (CSU). The data about using OMZ during the coronavirus disease 19 (COVID-19) pandemic are limited. The aim of this study was to evaluate the status of having COVID-19 and relationships between COVID-19, vaccination, and urticaria symptoms of CSU patients on OMZ. METHOD: We conducted a retrospective cohort study of 36 adult CSU patients treated with OMZ. Demographic data, the results of COVID-19 real-time polymerase chain reaction (RT-PCR), and vaccination status were recorded from the electronic medical records. RESULTS: Thirty-six patients, 23 women, and 13 men were evaluated. The mean age was 45.81 years. Two patients were diagnosed with COVID-19 while using OMZ. Four patients interrupted their OMZ treatment during the pandemic, and OMZ treatments were restarted in all patients. There were 28 patients who had at least one dose of vaccine (inactive and/or mRNA vaccine). Only one patient had an urticaria exacerbation after the first dose of mRNA vaccine. CONCLUSION: As a result, our findings have shown that omalizumab treatment in CSU patients during the COVID-19 pandemic does not increase the risk of COVID-19 infection and omalizumab can be used safely.