The Impact of Inflammatory and Infectious Diseases of Vulvar on Quality of Life.

OBJECTIVES: This study aimed to evaluate the effects of vulvar dermatoses (VD) and vulvar infections (VE) on anxiety, depression scores, general, and dermatological quality of life (QOL) of women. METHODS: We conducted a cross-sectional survey on patients diagnosed with VD and VE. All patients were assessed using a sociodemographic form, Skindex-29 scale, World Health Organization QOL (WHOQOL) BREF scale, Hamilton anxiety rating scale (HAM-A), Hamilton depression rating scale (HAM-D). RESULTS: HAM-A score was significantly higher in the VD group than in the control group. Based on age groups, all subscales of Skindex-29 were found to be higher in women > 50 years. For women with severe pruritus, the symptom subscale was higher in patients with skin involvement and the function and emotion subscales were higher in patients with and emotion subscales were higher in patients with mucosal involvement. CONCLUSIONS: We found that VD was particularly significantly associated with decreased QOL.

Systemic Isotretinoin Treatment and Pregnancy: A Longitudinal Cohort Study from Turkey.

OBJECTIVE: Isotretinoin is known to be the most effective treatment of severe and persistent acne. However, one of the most important adverse effects of this drug is known to be teratogenicity. In this regard, tests are administered before initiating the treatment, to assure that an unknown pregnancy is not present and accordingly, patients are advised to take contraceptive precautions during their systemic isotretinoin treatments. On the contrary, many cases of unwanted pregnancies and relevant abortuses have been reported all over the world. In the Turkish literature, only a few reports have been identified about foetal exposure to isotretinoin. MATERIALS AND METHODS: In this respect, a study was carried out on fifty-seven female patients, aiming to fulfil the gap of information mentioned above. Female patients, with ages ranging between 14 and 35 years, were recruited to the study and they were administered isotretinoin treatments (cumulative dose of 120 mg/kg) for an average period of 6 months. The patients were followed up during and after the treatment for a total period of 18 months. RESULTS: As a result, it has been observed that none of the patients got pregnant during the treatment period and relevantly, no abortuses or foetal abnormalities were recorded. Moreover, none of the patients got pregnant 12 months after the termination of the treatment. Additionally, the socio-demographic analysis of the patients indicates that most of the patients were single and 81% of the patients were sexually inactive. CONCLUSION: Our findings suggest that the low reportage of teratogenicity due to isotretinoin usage in Turkey could be due to several reasons, such as the sociocultural profile of the female patients undertaking the isotretinoin treatment, and strict adherence to contraceptive methods, and/or underreporting of teratogenic incidents due to lack of studies held in cooperation with obstetricians.

Spider bite-induced erythema multiforme.

Erythema multiforme (EM) is an immune-mediated mucocutaneous eruption characterized by symmetrically distributed, polymorphic targetoid lesions, mostly on the distal parts of the extremities. It occurs mostly in the setting of an infection in certain predisposed individuals. A 30-year-old pregnant woman was presented with a necrotic erythematous lesion on her right thigh following a spider bite. As she was pregnant for 16 weeks, no systemic medication was given. On the 8th day of the spider bite an erythematous vesicular and targetoid rash was seen on the distal parts of her extremities. Based on the clinical and histopathological findings, lesions were diagnosed as EM. She had not used any medication for 4 months and she gave no prior history of herpetic infection. So her EM lesions were thought to be an ID reaction most probably due to the spider bite. As far as we know, this is the first reported case of EM induced by a spider bite.

Effect of isotretinoin on prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (aPTT).

Patients with severe acne may need elective/urgent surgical interventions during treatment with isotretinoin and it is critical for the surgeon to consider the possible effects of this medication on coagulation systems. The aim of this study is to determine the changes in prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (aPTT) during isotretinoin treatment. PT, aPTT, and INR values of 51 severe acne patients were evaluated during routine pre-treatment biochemical analysis. Only patients with normal values were included in the study. The results of before and after 1 month treatment were compared statistically. There were no statistically significant change in mean alanine aminotranferease (ALT), aspartate aminotransferase (AST), PT, and INR values after treatment. A significant increase in aPTT was detected. The INR values, which are more trusted and safe, showed no difference. Isotretinoin seems to have no effect on these coagulation parameters.

Plantar pitted keratolysis: a study from non-risk groups.

Pitted keratolysis is an acquired, superficial bacterial infection of the skin which is characterized by typical malodor and pits in the hyperkeratotic areas of the soles. It is more common in barefooted people in tropical areas, or those who have to wear occlusive shoes, such as soldiers, sailors and athletes. In this study, we evaluated 41 patients who had been diagnosed with plantar pitted keratolysis. The patients were of high socioeconomic status, were office-workers, and most had a university degree. Malodor and plantar hyperhydrosis were the most frequently reported symptoms. The weight-bearing metatarsal parts of the feet were those most affected. Almost half the women in the study gave a history of regular pedicure and foot care in a spa salon. Mean treatment duration was 19 days. All patients were informed about the etiology of the disease, predisposing factors and preventive methods. Recurrences were observed in only 17% of patients during the one year follow-up period. This study emphasizes that even malodorous feet among non-risk city dwellers may be a sign of plantar pitted keratolysis. A study of the real incidence of the disease in a large population-based series is needed.

Porokeratosis of Mibelli: successful treatment with cryosurgery.

Porokeratosis of Mibelli, a disorder of keratinization, should be treated because of the possibility of development of malignant epithelial tumors on the porokeratotic lesions. Liquid nitrogen cryosurgery is considered to be particularly useful in the treatment of precancerous and benign skin lesions. We aimed to evaluate the efficiency of this method in the treatment of porokeratosis of Mibelli. Eight patients with 20 porokeratotic lesions were treated with spray cryosurgery. Each lesion was frozen for 30 seconds with a spray tip after the keratotic borders were removed conically by sharp dissection. Eighteen of the 20 lesions were healed successfully with slight atrophy in one session. One more session was necessary for the other two lesions. Liquid nitrogen cryosurgery may be considered superior to other destructive methods in the treatment of porokeratosis of Mibelli, with advantages such as simplicity, high cure rates, low cost, short treatment period, and few complications.