Pemphigus in the Mediterranean region of Turkey: a study of 148 cases.

BACKGROUND: The purpose of this study was to describe the epidemiological and clinical features, course, response to treatment, and prognosis of pemphigus in the Mediterranean region of Turkey. METHODS: All patients with confirmed pemphigus were prospectively enrolled in two major dermatology departments in the cities of Adana and Antalya in the Mediterranean region between March 1998 and March 2004. Details including demography, findings of clinical examinations, treatment, course, and prognosis were recorded. RESULTS: One hundred and forty-eight patients with pemphigus were diagnosed during the 6-year period, with a prevalence of 1.46 and an annual incidence of 0.24 per 100,000 in this region. There was a female predominance with a male to female ratio of 1:1.4. Pemphigus vulgaris (PV) was the most common clinical subtype, identified in 123 patients (83%). The mean age of onset was 43. In 101 (82%) patients with PV, disease began as persistent oral ulcers. The majority of the patients with PV could be managed with middle or high-dose steroids (60-140 mg/day). Complete clinical remission was obtained in 41 (39.4%) patients. The mortality rate was 4.8%. CONCLUSIONS: A moderately high incidence of pemphigus was found in the Mediterranean region of Turkey as compared with that encountered in other countries. The commonest clinical subtype was PV with a 9.5-fold higher incidence than pemphigus foliaceus. It is more frequent in middle-aged people and has a female predominance. Although a relatively higher dose of steroid was needed to control the PV, the disease completely remitted in a significant proportion of the patients.

An epidemicity of Paederus species in Cukurova region.

Two hundred four patients (117 females, 87 males; age range: 3-80 y) were admitted to our facility between May 1995 and June 1997 and studied to determine the endemicity of the Paederus species, which has been increasing for the last 6 years (especially in May and June) in the Cukurova region of southern Turkey. Clinically, infection with the Paederus species mimics contact dermatitis, herpes zoster, bullous impetigo, and phytophotodermatitis. Definitive diagnosis is made by historical and clinical findings. To determine the main histopathologic features of this infestation, biopsy specimens were obtained from 9 patients and stained with hematoxylin and eosin (H&E). In most patients, the skin lesions were located on the exposed parts of the body. Clinically, these lesions were linear, vesicular, bullous, and/or pustular on erythematous bases and resembled either phytophotodermatitis, herpes zoster, or impetigo rather than classic insect bites. Pederin, which is released from the Paederus species, may cause these lesions. The number of cases has increased markedly during the last 5 years. In the coming years, we expect this number to increase significantly.