Evaluation of androgen-dependent skin findings of polycystic ovary syndrome (PCOS).

AIM: The purpose of the study was to investigate the biochemical and metabolic abnormalities related to the cutaneous characteristics of PCOS. MATERIAL­METHODS: Patients diagnosed with PCOS were included in the study. Demographic data and accompanying androgen-dependent skin findings (acne, seborrhea, androgenic alopecia, acanthosis nigricans, skin tag, and hirsutism) were recorded. The free testosterone, total testosterone, dehydroepiandrosterone sulfate, androstenedione,17-Hidroksi progesterone, sex hormone binding globulin, prolactin, fasting glucose, fasting insulin, HbA1C, HDL, and triglycerides, follicle-stimulating hormone, luteinized hormone, free androgen index, and HOMA-IR levels of the patients were measured. The hormonal values of the patients with PCOS with and without skin findings were compared. RESULTS: The HOMA-IR values of the acanthosis nigricans (+) PCOS group were significantly higher than the acanthosis nigricans (-) PCOS group (p < .001). The DHEA-SO4, FAI, and FI values of patients with hirsutism (HR) (+) PCOS were found to be statistically higher than patients with HR (-) PCOS (p = .006, p = .015, p = .004). CONCLUSION: PCOS is among the most common endocrine disorders of women of reproductive age and was associated with some hormonal, metabolic, and skin findings. Certain androgenic and metabolic variables developing in PCOS might correlate with cutaneous symptoms.

How to Predict the Diagnosis of Cutaneous Leishmaniasis in a Non-Endemic Region.

Background: Cutaneous leishmaniasis (CL) is a parasitic infection transmitted by the female sandfly, which has limited knowledge in non-endemic areas. Aims: To predict the epidemiological and clinical characteristics of CL cases on treatment during the period of Syrian refugees' settlement. Methods and Material: The epidemiological and clinical data of 81 patients with CL who were admitted to the Istanbul Bagcilar Research and Training Hospital between March 2010 and April 2017 were conducted as a retrospective cohort study. A logistic regression analysis was performed. Results: Most detected demographics were Syrians (n = 56, 69.1%), ages <= 18 (n = 37, 45.7%), males (n = 49, 60.5%), elementary-school graduates (n = 35, 43.2%), and $500-750 income (n = 42, 51.9%). Most detected clinical characteristics were head/neck location (n = 38, 46.9%), acute-dry localized type (n = 71, 88%), crusted-papule (n = 79, 97.5%), and two lesions (n = 29, 35.8%). Means for age, family population, and session were 25.28 ± 20.90, 7.04 ± 2.03, and 11.27 ± 3.52, respectively. Majority of patients were admitted in 2014 and June. Significant factors by age were location, lesion type/number, and disease-duration. Lesion number ≥10, ages ≥41, crusted-nodule, cicatrix, and dissemination increased in session numbers, whereas crusted-nodule showed significant predictivity (P = 0.01). Conclusion: Location, lesion type/number, and disease duration may change by age in CL cases, whereas the presence of a crusted nodule may have a predictive effect on the number of treatment sessions.

Silhouette Lymphangioma: An Unknown Macular Form of Cutaneous Lymphangioma.

Unusual angiomatous or lymphangiomatous vascular malformations are rarely seen. One of them is lymphangioma (LA), which is a rare benign lymphovascular abnormality. LA is usually seen in the types of circumscriptum (or capillary), cavernous and cystic. Here, we report a unique case of LA with a patchy appearance. The patient presented due to unusual symptoms and eccentric clinical manifestation of the lesion. Here, we present a new lymphatic entity which was diagnosed as LA with its clinical, radiological and pathological findings. Written informed consent of the patient was obtained for this report. To the best of our knowledge this macular form of cutaneous LA has not been previously reported in literature. Macular LA should be kept in mind when faced with a colored long-term macular lesion on the skin.

Amelanotic nodular appearance within superficial spreading melanoma.

Usual clinical types of malignant melanoma (MM) are lentigo maligna, superficial spreading, nodular, and acral lentiginous MMs. Rarer variants of MM are amelanotic, neurotropic, desmoplastic, metastatic, invisible, pedunculatedmelanoma (PM), or nodal melanoma (NM), which constitute less than 5% of cases. Recognition and discrimination of these variants are important to avoid misdiagnosis of MM. We report a 42-year-old Caucasian woman presented with a superficial spreading malignant melanoma (SSM) with an amelanotic nodular center. The lesion simulated a NM or PM clinically, but its histopathology showed an SSM. This misleading appearance of SSM has not been reported previously.

Mental health and psychological resilience among acne vulgaris patients during the pandemic: A cross-sectional controlled study.

Background The current literature has not yet addressed mental health among acne vulgaris (AV) patients during the COVID-19 pandemic. OBJECTIVE: We aimed to investigate the psychological status of AV patients and analyze the influencing factors on psychological symptoms, during the pandemic. METHODS: This cross-sectional study included consecutively selected 220 eligible AV patients and 190 age/sex-matched healthy subjects. The Post-traumatic stress disorder (PTSD) checklist for DSM-5, Depression, Anxiety and Stress Scale-21, Brief Resilience Scale, and the Stressful Life Events List resulting from the pandemic were administered to the participants. RESULTS: There were not significantly differences between the AV patients and the control group in terms of depression, anxiety, stress, psychological resilience levels, and experienced stressful life events. Probable PTSD rate was significantly higher for AV patients (16.4%) than the control groups (9.5%) (p = 0.040). High levels of depression and anxiety, low psychological resilience, and high levels in experienced traumatic life events predicted high severity in PTSD symptoms, whereas low psychological resilience predicted high levels of depression, anxiety, and stress in AV patients. CONCLUSIONS: AV patients are at high risk of developing PTSD during the COVID-19 pandemic. The obtained results highlight the need to assess their psychological state, in particular those with low psychological resilience.

Has the COVID-19 pandemic changed attitudes and behaviors concerning cosmetic care and procedures among patients presenting to the dermatology outpatient clinic? A multicenter study with 1437 participants.

BACKGROUND: The rate of cosmetic procedures and use of skincare products is considered to be affected during the pandemic period; however, this has not been investigated yet. OBJECTIVE: To determine whether the ongoing pandemic has changed people's habits related to skincare products and cosmetic procedures. METHODS: We conducted a multicenter survey study covering both private and public hospitals. Sociodemographic characteristics and clinical diagnoses of the patients were noted by dermatologists. A survey was used to determine the type and application areas of skincare products and cosmetic procedures before and during the pandemic, whether the patients were concerned about being infected, and any change in the make-up habits of female patients. RESULTS: Of the 1437 patients, 86.7% presented to the hospital due to dermatological complaints and 13.3% for cosmetic procedures. The rate of those that did not use skincare products was 0.05% before and 0.06% during the pandemic. Of the participants, 43.2% had undergone cosmetic procedures before and 38.1% during the pandemic. For both periods, the most frequent cosmetic procedure applied was laser epilation, followed by skincare treatment and chemical peeling. While undergoing these procedures, 34.9% of the patients were concerned about contracting coronavirus. CONCLUSION: There was no significant difference in the use of skincare products and cosmetic procedures before and during the pandemic. The majority of the patients continued to undergo these procedures despite their fear of being infected. This shows that during the pandemic period, patients are concerned with their appearance and continue to undergo cosmetic procedures and pay attention to their skincare.

Prevalence of Metabolic Syndrome and Its Parameters and Their Correlations With Psoriasis Duration, Severity, and Sleep Quality In Psoriasis Patients: A Cross-Sectional Study.

BACKGROUND: Psoriasis is an inflammatory skin disease that may lead to comorbidities, including metabolic syndrome (MS). OBJECTIVE: We determined the prevalence of MS and its correlation with psoriasis duration, severity, and sleep quality in psoriasis patients. METHODS: A total of 112 subjects with chronic plaque psoriasis were studied. Demographics, MS parameters, disease duration, severity, and sleep quality were examined. The Psoriasis Area and Severity Index (PASI) and the Pittsburgh Sleep Quality Index (PSQI) were used to assess psoriasis severity and sleep quality, respectively. Presence of MS and its correlations with psoriasis duration, severity and sleep quality were investigated. RESULTS: Of 112 patients, 76 (67.8%) were diagnosed with MS. Of all patients, 74.1% had a high PASI, and 84.8% had a high PSQI. The mean values of psoriasis duration, body mass index, waist circumference, fasting glucose, HOMA-IR, triglyceride levels, blood pressure, PSQI, sleep latency, and daytime sleep dysfunction were significantly higher in the MS group than non-MS group, whereas the mean HDL level was lower. The prevalences of MS, high fasting glucose, and low HDL were significantly higher among female, but not male, patients with severe psoriasis (PASI >10) than those without severe psoriasis. Disease duration, high body mass index, waist circumference, blood pressure, fasting glucose, HOMA-IR, triglyceride levels, low HDL, and poor sleep quality were significantly correlated with the presence of MS. However, only waist circumference, fasting glucose, blood pressure, and low HDL were predictive of the development of MS. CONCLUSIONS: MS is common among psoriasis patients, and especially in females with advanced psoriasis, high fasting glucose, and low HDL levels. Besides diagnostic criteria of MS, a long duration of psoriasis, poor sleep quality and high-HOMA-IR correlate with the development of MS. High fasting glucose and low HDL levels may facilitate MS development in association with psoriasis severity in females.

Demographic and clinical features and subsectoral differences in occupational contact allergens in clothing manufacturing workers.

BACKGROUND: Epidemiologic data on the occurrence of contact dermatitis (CD) and the contact allergens involved in clothing manufacturing and its subsectors are scarce. This study aimed to determine the extent of occupational contact allergy and differences between work subsectors in clothing employees with CD. METHODS: A cross-sectional study was conducted with 272 clothing employees, who complained of CD and were diagnosed with occupational allergic contact dermatitis (OACD). Participants worked in accessory, dyeing, sewing, cutting, knitting, packing, cleaning, and ironing subsectors. Data on demographics, working-subsector, working-duration, and lesion-duration were collected, and participants were examined and patch tested. RESULTS: Participants included 173 females and 99 males. Dyeing workers were most frequently diagnosed with OACD, whereas cutting workers were least. Lesions were mostly located on the hands only. The most frequently detected allergens were nickel sulfate in accessory work; disperse blue-106 in dyeing, sewing, cutting, and knitting; cobalt chloride in packing; p-phenylenediamine in cleaning; and budesonide in ironing. CONCLUSIONS: Contact allergens show significant differences in frequency by work subsectors in clothing employees. Careful monitoring of workers for excessive exposures and for early signs of CD is warranted.

Sleep Quality in Psoriasis Patients and its Relations with Possible Affecting Factors.

OBJECTIVES: Psoriasis (PS) is a chronic, immune-mediated inflammatory skin disease. PS may lead to significant effects on health-related quality of life (HRQoL) and other outcomes. In the present study, an investigation into sleep quality (SQ), and its possible relations with factors which may affect SQ were aimed. METHODS: A total of 74 subjects from both sexes were enrolled in this study, between January and July 2017. Patients were evaluated with their demographics, body mass index (BMI), Psoriasis Area Severity Index (PASI), Pittsburgh Sleep Quality Index (PSQI), Psoriasis Quality of Life Index (PQLI), Self Perception Scale (SPS). Additionally, accompanying chronic diseases, disease duration and severity of pruritus were recorded. Obtained PSQI values were compared with the mentioned parameters concerning the significance of their relations with it. SPSS version 24, 2016 was used to analyse the data, and significance was evaluated with p-values of <0.05, 0.01, and 0.001, and rho (r) values of <0.2, =0.2-0.4, =0.4-0.6, =0.6-0.8 and >0.8. RESULTS: Thirty-seven female and 37 male were studied. The mean age of total of the study population was 47.21±13.91. Mean BMI and mean duration were 30.09± 4.68 kg/m2, and 10.58±9.1 months. Mean values of PASI, PSQI, SPS, and PQLI of the study group were 19.79±16.99, 9.14±5.09, 142.12±23.83, and 21.94±16.31, respectively. Approximately thirty-one percent of them had at least one chronic disease. Alcohol and smoking rates were 17.56%, 50%. PASI was positive/strongly correlated with PQLI and negative/weakly correlated with SPS. No correlation was detected between PSQI values and age, gender, BMI, and SPS values. PSQI was moderately correlated with PQLI, diabetes mellitus (DM), and pruritus severity, whereas it was weak correlated with PASI, hypertension (HT), thyroid diseases and disease duration. PASI and DM showed a predictive effect on SQ. CONCLUSION: SQ is affected by certain factors, such as QoL, disease severity, disease duration, pruritus severity, accompanying disorders, such as HT, DM and thyroid diseases, in which disease severity and DM have predictive effects on SQ in PS patients. Controls of disease activation and prevention of progression in DM may provide to keep SQ in PS.

The effect of Maras powder and smoking on the microRNA deregulation of oral mucosa.

OBJECTIVE: This study aimed to investigate the effects of Maras powder (a type of smokeless tobacco obtained from Nicotiana rustica Linn and mixed with the ashes of wood, especially from oak, walnut or grapevine) on the microRNA (miRNA) deregulation of oral mucosa, and it compares these effects with those of smoking. METHODOLOGY: Oral mucosal samples were collected from 74 patients, consisting of 16 nonusers, 26 smokers, and 32 Maras powder users. Genes associated with oral cancer were selected and 90 microRNAs targeting these genes were identified. MicroRNA were isolated and purified using the microRNA isolation kit. MicroRNA were expressed using Fluidigm RT-PCR. RESULTS: A positive correlation between the duration of Maras powder use with miR-31 expression levels, and a negative correlation between the Maras powder chewing time and miR-372 expression levels was found. In addition, there is a negative correlation between the amount of Maras powder consumed and expression levels of miR-375, miR-378a, miR-145, and miR-10b; moreover, another negative correlation is observed between the number of cigarettes consumed and the expression levels of miR-23a, miR-23b, miR-203a, miR-200b, and miR-375. However, miR-200b and miR-92a levels were downregulated significantly more in Maras powder users when compared with smokers and nonusers (p<0.05). CONCLUSION: The results show both chewing Maras powder and smoking have an effect on deregulation of miR-200b and miR-92a expressions. This leads to the belief that assessing the expression of these two miRNAs is a promising noninvasive method of analysis, especially in mutagen exposures. Finally, large-scale and high-throughput studies may help to identify an extensive miRNA expression profile associated with tobacco use and improve the understanding of oral malignancies.

An extensive nevus of Ota with oro-buccal involvement: a case review and proposal of a new classification system.

Nevus of Ota (NO) also known as nevus fuscoceruleus ophthalmomaxillaris or oculodermal melanocytosis is a rare hamartoma. It is usually characterized by unilateral, patchy and speckled, blue/gray or brown macules on the forehead and periocular area. Here, we report a rare case of NO with oro-buccal involvement, which is an unusual condition. The patient was presented due to the rarity of oro-buccal involvement, extensive and remarkable expression of the lesions, and in order to propose a more comprehensive and neuroanatomy based classification system.

Risk of Obstructive Sleep Apnea Syndrome in Psoriasis Patients.

BACKGROUND: Psoriasis (Ps) is a chronic skin disease that can lead to negative impacts on quality of life (QoL) because of diseaserelated comorbidities. We aimed to investigate the risk of obstructive sleep apnea syndrome (OSAS) in patients with Ps. METHODS: Fifty-seven patients with Ps were included in this study. The patients were evaluated for their demographics, Psoriasis Area Severity Index (PASI), duration of disease, Psoriasis Quality of Life Index (PQLI), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and also Berlin questionnaire (BQ), in terms of the risk groups of OSAS. High and low risk groups were compared with above-mentioned parameters. RESULTS: Of the patients studied, 35 (61.40%) were at high-risk according to BQ. In the high-risk group, body mass index (BMI) was significantly high (P = 0.009), and they were all obese. The mean values of PASI, disease duration, PQLI and PSQI were significantly higher in the high-risk group compared to the low-risk group (each P < 0.05). PASI (P = 0.013), BMI (P = 0.014), PLQI (P = 0.012) and hypertension (HT) (P = 0.030) had significance in prediction of OSAS development, whereas only PASI and BMI showed significant impacts. It was seen that increase in BMI values was slightly more effective than increase in PASI values (1.25- fold against 1.07-fold) in development of OSAS. CONCLUSION: We suggest patients with severe and long-term Ps should be evaluated in terms of OSAS, and OSAS may be accepted as a comorbidity for Ps in the future.

Prevalence of Atopic Dermatitis Criteria among Textile Workers with Occupational Allergic Contact Dermatitis and Effects of Having Atopic Dermatitis on Contact Antigenic Diversity.

OBJECTIVES: Contact dermatitis (CD) is a common skin disease. Occupational contact dermatitis (OCD) is the most frequently seen occupational skin disease and includes both occupational allergic CD (OACD) and occupational irritant CD (OICD). One of the most common sources of OACD is textile products. Individuals with atopic dermatitis (AD) have an increased risk for development of allergic contact dermatitis (ACD). However, the role of AD in the etiopathogenesis of the development of OACD among textile industry workers is not well known. The aim of the present study was to determine the prevalence of AD among textile workers with OACD and to analyze contact antigenic diversity between the workers with and without AD. METHODS: A prospective, cross-sectional study was conducted with 352 textile workers who had previously been diagnosed with OACD. The patients were questioned and examined with respect to AD criteria, demographic features, disease duration, duration of employment until first symptoms, phototype, workplace (subsectors), and location of lesions at control visits. Immediate skin test reactivity was evaluated with a commercial skin prick test panel. The data obtained and the patients' previously recorded patch test results were compared in OACD groups with and without a diagnosis of AD. The results were statistically evaluated with a significance level of p value <0.05. RESULTS: The study population consisted of 124 males and 227 females. The mean age was 35.69±13.65 years. The most commonly seen employment duration, phototype, subsector, and location were 4 to 8 months (26.14%), 9 to 12 months (34.66%), Fitzpatrick type-III (37.50%), dyeing (33.52%), and exclusively the hands (60.51%), respectively. In all, 193 patients (54.83%) met the criteria for the diagnosis of AD. In the OACD group with AD, there was a significant number with 4 major and 16 minor criteria, as well as positivity for 14 contact allergens. CONCLUSION: Most AD criteria, or a diagnosis of AD, are highly detectable among workers with textile-related OACD. The results for patch test allergens may be significantly higher than those of individuals without AD. Textile workers with AD should be warned about the possibility of the early development of OACD.

Blaschko-linear "Congenital Mixed Hemato-lymphangio-keratoma Serpiginosum" Naeviforme: A New Hybrid Entity or Various Morphological Reflections of the Two Different Vascular Abnormalities?

We present the case of a 15-year-old girl who presented with an unusual grouping of lesions on her upper left leg. The lesions had been present since birth. The patient had five different types of lesions: 1) transparent grouped or scattered yellowish vesicles; 2) keratotic-surfaced, grouped dark-yellowish papules; 3) bright-red grouped papules; 4) keratotic-surfaced grouped dark-red papules; and 5) patchy, punctate, and erythematous red macules. All of the lesions were intertwined along the lines of Blaschko and were in the form of irregular serpiginous plaques. Histopathological examinations of the lesions showed three main histological features, and diagnoses of the lesions were made as lymphangioma circumscriptum, lymphangiokeratoma, and verrucous hemangioma. To the best of our knowledge, such intertwined lesions have never been reported in the literature. Hence, we suggest that the name of this unique combination of lesions be "congenital nevoid mixed hemato-lymphangio-keratoma serpiginosum."

The tendency towards the development of psychosexual disorders in androgenetic alopecia according to the different stages of hair loss: a cross-sectional study.

BACKGROUND: Androgenetic alopecia is a common dermatological condition affecting both genders. OBJECTIVE: To evaluate the tendency towards development of psychosexual disorders according to the clinical stages of androgenetic alopecia. METHODS: A cross-sectional study was conducted including 353 patients of both sexes on different clinical stages of hair loss, and the patients were enquired about self-perception, self-esteem, sexual experiences, anxiety and depression states. Hair loss was classified by standardized hair loss scales, and psychological effects were assessed with questionnaires. Results were compared to p<0.05. RESULTS: Negative effects on each psychological parameter of androgenetic alopecia in females were higher than in males. While overall comparisons according to hair loss stages for each parameter were significant in males, only sexual experiences, anxiety and depression values were significant in females. Sexual experiences and depression values were higher in Ludwig 3 than in 1&2, while anxiety was higher in Ludwig 3 than 1. Self-perception values in Norwood 2&2A were higher than 3A, 3V, 4 and 4A, while self-esteem values in 2A were higher than 3&4. Sexual experiences values in 2&2A were lower than 3, 3A, 3V, 4 and 4A, while 3&3A were lower than 4&4A. Depression was lower in 2A than 3, 3A, and 3V, and lower in 2A than 4A. Anxiety was lower in 2A than in 4&4A. STUDY LIMITATIONS: Relatively small number of patients, who were from a single center. CONCLUSIONS: In the management of androgenetic alopecia, it should be considered that patients may need psychological support according to the clinical stages, because of increased tendency to develop psychosexual disorders.

The tendency towards the development of psychosexual disorders in androgenetic alopecia according to the different stages of hair loss: a cross-sectional study

Abstract: Background: Androgenetic alopecia is a common dermatological condition affecting both genders. Objective: To evaluate the tendency towards development of psychosexual disorders according to the clinical stages of androgenetic alopecia. Methods: A cross-sectional study was conducted including 353 patients of both sexes on different clinical stages of hair loss, and the patients were enquired about self-perception, self-esteem, sexual experiences, anxiety and depression states. Hair loss was classified by standardized hair loss scales, and psychological effects were assessed with questionnaires. Results were compared to p<0.05. Results: Negative effects on each psychological parameter of androgenetic alopecia in females were higher than in males. While overall comparisons according to hair loss stages for each parameter were significant in males, only sexual experiences, anxiety and depression values were significant in females. Sexual experiences and depression values were higher in Ludwig 3 than in 1&2, while anxiety was higher in Ludwig 3 than 1. Self-perception values in Norwood 2&2A were higher than 3A, 3V, 4 and 4A, while self-esteem values in 2A were higher than 3&4. Sexual experiences values in 2&2A were lower than 3, 3A, 3V, 4 and 4A, while 3&3A were lower than 4&4A. Depression was lower in 2A than 3, 3A, and 3V, and lower in 2A than 4A. Anxiety was lower in 2A than in 4&4A. Study limitations: Relatively small number of patients, who were from a single center. Conclusions: In the management of androgenetic alopecia, it should be considered that patients may need psychological support according to the clinical stages, because of increased tendency to develop psychosexual disorders.

Risk-Factors and Awareness of HPV in Turkish people with Anogenital Warts in Bagcilar district: a Cross-Sectional Study.

BACKGROUND: Anogenital warts (AGWs) are epithelial tumors which develop as a result of human papilloma virus (HPV) infection. We aimed to assess the sociodemographic, sexual and other possible risk-factors, and awareness of the HPV infection among Turkish people with AGW in the Bagcilar district of Istanbul. METHODS: A cross-sectional study was conducted on 273 patients (183 men, 90 women) with AGW between October 2014 - March 2015. The patients' sociodemographics were recorded along with their possible risk-factors and clinical findings. The patients' answers to questions regarding HPV/AGW were checked for awareness. Data were analyzed by Chi-square test using SPSS (Statistical Package for the Social Sciences) version 15.0. The results were evaluated with P < 0.05 considered significant. RESULTS: The major parameters detected were 26-39 age-range (52.6%), self-employed (54.6%), primary school graduate (44,7%), low/middle income (91.2%), married (59.3%), heterosexual (98.9%), sexually active (93.8%), sex in previous 3 months (87,6%), multi-partners (53.5%), partners without AGW (60.8%), mixed location (32.2%), concomitant verruca on hands (26%), 3-6 month duration (38.8%), non-recurrent lesion (98.2%), tinea cruris [TC](25.3%) and smoking (54.2%). However, self-employed (70.5%), middle-income (47%), polygyny (71.6%), pubic-location (43.2%), long-duration (46.4%), concomitant TC (31.7%) diabetes mellitus (9.8%), and verruca on hands (33.3%) were mostly encountered in males, while housewife (57.7%), low-income (60%), monoandry (67.8%), perianal-location (48.9%), short-duration (58.9%), smoking (64.4%), concomitant candidiasis (15.6%) and  depression (31.1%) were mostly found in females. Awareness of HPV hearing, HPV-AGW and HPV-cancer relationships, transmission-routes, risk-factors (each at 5.5%), and prevention methods (2.2%) was very low. CONCLUSIONS: AGWs are seen in sexually-active, less-educated, married heterosexuals in Bagcilar. Self-employed, middle-income, polygyny, pubic-location, long-duration, concomitant TC and diabetes mellitus, and verruca on hands are mostly seen in males, while housewife, low-income, monoandry, perianal-location, short-duration, smoking, candidiasis and depression are more common in females. Awareness is very low.

Dystrophic-Anagen Effluvium Occurring During Pegylated Interferon-α-2a/Ribavirin Therapy.

INTRODUCTION: Various types of dermatological manifestations have been reported due to hepatitis C virus (HCV) infection and anti-HCV therapy. Some of them have been described during IFN-based therapies. PEG-IFN-α-2a/RBV combination is used as the international standard of treatment for HCV infection for a long time. The combination therapy yields an adverse-event profile similar to standard interferon (IFN) therapy. Some of these adverse effects are rheumatologic, neuropsychiatric and dermatological manifestations including alopecia. CASE PRESENTATION: We reported a 43-year-old woman with dystrophic anagen effluvium (DAE), rheumatoid arthritis and Hashimoto thyroiditis, which were developed under the combination therapy for chronic HCV infection. CONCLUSIONS: Although some cases of alopecia areata (AA) and telogen effluvium (TE) were reported in literature, no case of DAE associated with PEG-INF-α-2a /RBV combination therapy was reported previously.