COVID-19 Knowledge in Patients with Psoriasis Receiving Systemic Therapy: a Questionnaire Study.

Introduction: Little is known about the impact of patient behavior on the treatment of psoriasis in the COVID-19 pandemic. Objectives: We aimed to investigate the COVID-19 knowledge of the patients with psoriasis receiving systemic therapy in the pandemic. Methods: The patients who received systemic treatment for psoriasis presented to our dermatology outpatient clinic were enrolled in the study. A questionnaire measuring the level of knowledge about COVID-19 and psoriasis was administered to patients. Demographics and disease characteristics of patients were recorded. Results: A total of 183 patients with psoriasis were enrolled in the study. Of the patients, 33.9% thought that psoriasis exposes them to a risk of getting COVID-19, 30.6% declared that psoriasis treatment exposes them to a risk of getting COVID-19, and 59.6% were worried about getting COVID-19. The treatment discontinuation rate was 42.1%. The patients with high scholar level showed more anxiety and discontinued their treatment. Conclusions: The patients with psoriasis did not have adequate knowledge of the effect of both psoriasis itself and its treatment on COVID-19 during the pandemic. The patients on biologic therapy tend to discontinue their treatment based upon the physician's recommendation, whereas those on conventional therapy mostly on their own will. Clinicians should inform patients about current evidence of COVID-19 and psoriasis.

Dermatological Problems in a Neurology Clinic.

BACKGROUND: Little is known about the profile of dermatological problems in patients hospitalized in neurology wards or neurological intensive care units (NICUs). In this study, we aimed to provide the demographic and clinical characteristics of inpatients admitted to the neurology ward or the NICU. METHODS: This study was designed as a retrospective observational study. Medical records of patients who consulted with dermatology while they were hospitalized in the neurology ward or the NICU of our hospital, from January 2016 to June 2022, were reviewed retrospectively. Demographic and clinical characteristics of the patients were recorded. RESULTS: A total of 106 patients, including 86 patients in the ward and 20 patients in the NICU, were included in the study. Forty-nine patients (46.2%) were female and 57 (53.8%) were male. The mean age was 58.47±18.84 years. The frequency of dermatology consultations was 1% overall. The most common causes of hospitalization were ischemic stroke (n=47), demyelinating diseases of the central nervous system (n=10), and encephalitis (n=7). The most common dermatological problems in patients were infectious dermatoses (n=25), drug eruptions (n=18), and physical dermatoses (n=18). While drug eruptions were encountered as a common problem in the neurology ward, physical dermatoses were a common problem in the NICU. CONCLUSION: The frequency of dermatology consultations requested from neurology for inpatients was low, especially in the NICU. Drug eruptions in the neurology ward and physical dermatoses in the NICU are encountered as common problems. Neurologists should pay attention to accompanying dermatological problems as well as neurological diseases. Large-scale prospective studies are needed for dermatological problems in patients hospitalized in the neurology clinic.

A multicentre prospective analysis of the incidence of pemphigoid diseases in Turkey.

BACKGROUND: The differentiation between the pemphigoid diseases is essential for treatment and prognosis. In Turkey, data on the incidence of these diseases are insufficient. Our aim in this study is to determine the incidence, demographics and clinical characteristics associated with diseases of the pemphigoid group. METHODS: We prospectively analysed 295 patients with pemphigoid who visited dermatology clinics of tertiary referral hospitals in 12 different regions of Turkey within a year. The diagnosis was based on clinical, histopathological, direct immunofluorescence (DIF) and serological (multivariant enzyme-linked immunosorbent assay [ELISA], indirect immunofluorescence and mosaic-based BIOCHIP) examinations. Clinical and demographic findings, aetiological factors and concomitant diseases observed in the patients were recorded. RESULTS: A total of 295 (female/male ratio: 1.7/1) patients with pemphigoid were diagnosed in 1-year period. The overall incidence rate of pemphigoid diseases was found to be 3.55 cases per million-years. The ratio of pemphigoid group diseases to pemphigus group diseases was 1.6. The most common pemphigoid type was bullous pemphigoid (BP, 93.2%). The others were epidermolysis bullosa acquisita (3.1%), pemphigoid gestationis (2.4%), linear IgA disease (1%) and mucous membrane pemphigoid (0.3%). The most common (26.8%) possible trigger of the bullous pemphigoid was gliptin derivative drugs. The most common concomitant diseases with pemphigoid were cardiovascular (27.8%) and neurological diseases (23.7%). CONCLUSIONS: This study showed that the increased frequency of bullous pemphigoid reversed the pemphigoid/pemphigus ratio in Turkey. Further studies are warranted regarding the reasons for this increase.

Effects of isotretinoin on the growth rate and thickness of the nail plate.

BACKGROUND: Isotretinoin has various effects on nails. However, the mechanism of how isotretinoin affects the nail plate is unknown. We aimed to investigate the effects of isotretinoin on morphology, growth rate, and thickness of the nail plate. METHODS: A total of 70 acne vulgaris patients treated with isotretinoin and a control group consisting of 68 healthy volunteers were included in the study. Isotretinoin treatment was started at a dose of 0.5 mg/kg per day. Nail changes were noted; length and thickness of the nail plate were measured in all participants every month. RESULTS: The medians of nail growth rates in the isotretinoin and control groups were 3.16 (2.87-3.57) mm/month and 2.89 (2.56-3.19) mm/month, respectively. The medians of nail thickness in the isotretinoin and control groups were 0.47 (0.38-0.53) mm and 0.50 (0.40-0.65) mm, respectively. Statistically significant differences were observed between the groups in terms of nail growth rate and thickness (P < 0.01, P = 0.02, respectively). Nail findings were observed in nine out of 70 patients (12.8%), mostly onychoschizia. CONCLUSION: Isotretinoin gradually increases the nail growth rate and thins the nail plate over time during the course of isotretinoin treatment. Dermatologists prescribing isotretinoin should also consider the nail changes, which may impact the life quality of patients.

Retrospective analysis of patients with psoriasis receiving biological therapy: Real-life data.

The aim of this study is to investigate the demographic and clinical characteristics of patients receiving biological therapy for psoriasis. All patients who received biological treatment for psoriasis were included in the study. Characteristics of patients and PASI responses' rates were evaluated at 6, 12, 16, 24, 36, and 52 weeks. One hundred and three patients enrolled. Of all, 28 patients were using adalimumab (27.2%), 26 were using secukinumab (25.2%), 22 were using infliximab (21.4%), 22 were using ustekinumab (21.4%), 5 were using ixekizumab (4.9%). PASI75 response rates at sixth and 52nd weeks; were 68.1% and 95% for infliximab, 64.3% and 100% for adalimumab, 77.3% and 100% for ustekinumab, 76.9% and 81.3% for secukinumab, respectively. The most common reason for biologic switching was secondary failure. Treatment failure was the main reason of switching therapies. In our study, no statistically significant difference was found between efficacies of biological drugs. It remains unclear in what order and how exactly biological agent switching should be done. There is a need for large-scale studies on the treatment response rates, and survival times of different biologics.

Distribution of childhood skin diseases according to age and gender, a single institution experience.

AIM: Studies on pediatric skin diseases in Turkey are not yet sufficient. It was aimed to characterize the prevalence of skin diseases, age and gender distribution in children living in the Erzincan region. MATERIAL AND METHODS: 10,115 children aged 0-16 years who reached to our outpatient clinic between 01.11.2014 and 30.11.2016 were included in the study. The frequency, age and gender distribution of the skin diseases were examined. The cases were divided into 4 groups; infantile period (0-2 years), preschool period (3-5 years), school period (6-11 years) and adolescence period (12-16 years). Skin diseases were categorized in 10 groups. A total of 148 skin diseases were identified. RESULTS: 5376 of the patients were female (%53.14) and 4739 were male (%46.86). The most common disease groups are; infectious diseases (24.62%), eczema (21.95%), acne&follicular diseases (18.45%) and allergic skin diseases (11.02%). The most common diseases were acne vulgaris (17.82%), warts (10.03%) and irritant contact dermatitis (9.42%). The most common skin diseases in regard of different age groups are; contact dermatitis in the 0-2 years and 3-5 years age groups, warts in the 6-11 years age group, and acne vulgaris in 12-16 years age group. CONCLUSION: Most common diseases in our study are diseases that can be reduced by preventive health care and health education programs. There is a need for broad-based epidemiological studies in this area to establish preventive health care policies and to develop education programs.

Primary inoculation tuberculosis: a report of a rare entity.

Primary inoculation tuberculosis is an exogenous infection resulting from direct inoculation of bacteria into individuals with no acquired immunity to the organism. We report a 63-year-old male patient who was diagnosed with primary inoculation tuberculosis on the basis of clinical appearance and histopathological examination. The findings from this case emphasize the importance of clinical and histopathological findings in this rarely seen form of skin tuberculosis if the organism cannot be shown to grow in culture.

Primary inoculation tuberculosis: a report of a rare entity

Primary inoculation tuberculosis is an exogenous infection resulting from direct inoculation of bacteria into individuals with no acquired immunity to the organism. We report a 63-year-old male patient who was diagnosed with primary inoculation tuberculosis on the basis of clinical appearance and histopathological examination. The findings from this case emphasize the importance of clinical and histopathological findings in this rarely seen form of skin tuberculosis if the organism cannot be shown to grow in culture.

Are all patients with psoriasis at increased risk for coronary artery disease?

Associations have been recently recognized between psoriasis and an increased incidence of atherosclerotic diseases. However, there are scarce data on the prevalence of coronary lesions in patients with psoriasis. The aim of this study was to identify the calcified and non-calcified atherosclerotic coronary lesions in patients with psoriasis compared to controls. Forty patients with psoriasis and 42 control subjects matched for age, sex, and cardiovascular risk profile were included in this case-control study. Coronary lesions were evaluated by a 128-slice dual source multidetector computed tomography scanner. Coronary calcification scoring was calculated according to the Agatston score. The prevalence of atherosclerotic coronary lesions (psoriasis: 15%, controls: 16.7%; P = 0.83) and the mean coronary calcification scoring (psoriasis: 9.9 ± 35.2 Agatston unit, controls 2.8 ± 12.0 Agatston unit; P = 0.81) did not show a significant difference between the two groups. Multivariate analysis identified age ≥48 years and fasting blood glucose ≥99.0 mg/dl as independent predictors of coronary artery disease in patients with psoriasis (F = 30.9; P = 0.001; adjusted R(2) = 0.49). Patients with psoriasis had the same prevalence of calcified and non-calcified atherosclerotic coronary lesions as compared to controls. Our results demonstrated the necessity of considering the age and fasting blood glucose of patients with psoriasis in a decision for further cardiovascular evaluation.

Epicardial fat thickness is independently associated with psoriasis.

BACKGROUND: Several studies have showed an association between psoriasis and cardiovascular (CV) diseases and metabolic syndrome (MS). Assessment of CV risk in patients with psoriasis has become an important issue. Epicardial fat thickness (EFT) is an emerging cardiometabolic risk factor and has been shown to be related to atherosclerosis. EFT has not been studied in the context of psoriasis. OBJECTIVE: To compare the EFT in psoriasis patients with that in control subjects. METHODS: 31 patients with psoriasis and 32 control subjects were included in this case-control study. EFT was evaluated by two-dimensional transthoracic echocardiography. RESULTS: EFT was significantly higher in psoriasis patients compared to controls (p = 0.027). Multiple linear regression analysis showed that the association of EFT with psoriasis was independent of MS and age. CONCLUSION: EFT, which has been suggested as a cardiometabolic risk factor in various diseases, is also independently associated with psoriasis.