The Use of New Hematological Markers in the Diagnosis of Alopecia Areata.

INTRODUCTION: Alopecia areata (AA) is a non-cicatricial inflammatory and autoimmune hair loss disease. In recent studies, it has been reported that hematological parameters can be used as oxidative stress markers in the diagnosis of many inflammatory diseases due to their low cost and widespread use. OBJECTIVES: In this study, it was aimed to reveal the significant cut-off points of hematological inflammatory markers in AA that can guide clinicians in clinical practice and determine how many times they increase the risk of disease. METHODS: The present study is retrospective case-control type. Seventy patients with AA and seventy healthy controls were included in the study. The hematological parameters in both groups were evaluated retrospectively. RESULTS: Hemoglobulin, monocyte, platelet, monocyte high-density lipoprotein cholesterol (HDL-C) ratio (MHR), monocyte lymphocyte ratio (MLR), platelet lymphocyte ratio (PLR) were high in patients with AA, while the number of lymphocytes was low. In ROC analysis, the optimal cut-off values for the diagnosis of AA were as follows: MLR 0.216, MHR 0.010, and PLR 111.715. In regression analysis, being above the following values of MLR 0.216, MHR 0.010, and PLR 111.715 increased the risk of developing AA by 6.3, 3.8, and 2.7 times, respectively. CONCLUSIONS: It was seen that MHR and PLR, especially MLR, can significantly increase the risk of developing the disease in AA and can also be used as diagnostic markers.

Evaluation of MCV/RDW Ratio and Correlations With Ferritin in Telogen Effluvium Patients.

Introduction: Telogen effluvium is one of the chronic diseases that affect the quality of life (QoL) in women. Genetic factors, vitamin deficiencies, hormonal and environmental conditions take roles in the etiology of hair loss. Objectives: The study aimed to evaluate the RDW(Red cell distribution witdh)/MCV(Mean corpuscular volume) ratio and its correlation with ferritin in Telogen Effluvium patients and to reveal their potential role in the etiopathogenesis of Telogen effluvium. Methods: We retrospectively evaluated the medical data of 250 patients who were admitted to the dermatology outpatient clinic between September 2020 and December 2020 with a diagnosis of telogen effluvium. The control group was created retrospectively from the medical records of 250 healthy individuals. HB(Hemoglobin), HCT(Hematocrit), MPV(mean platelet volume), MCV, RDW, ferritin, and MCV/RDW ratio of both groups were compared and evaluated statistically. Results: All telogen effluvium patients were women in terms of gender. The mean age of the patient group was 33.11 ± 9.66 years and the mean age of the control group was 34.98 ± 12.37 years. The ratio of MCV/RDW, MPV, MCV, and ferritin is lower in the group with telogen effluvium compared to the control group and a statistically significant difference was found (P < 0.05). Conclusions: Iron deficiency anemia is thought of as a factor in female patients with telogen effluvium. Although the data shows the correction of iron deficiency is insufficient telogen effluvium, we proposed that laboratory tests should be routinely used in the diagnosis and treatment phase of patients who apply with the complaint of hair loss.

Retrospective Analysis of Dermatological Diseases in Geriatric Patients During Dermatology Outpatient Department Visits.

Introduction: The elderly population is vulnerable to experience a great number of dermatological diseases thanks to the intrinsic and extrinsic process of aging. Objectives: The aim of this study is to retrospectively investigate the prevalence of dermatological diseases in geriatric patients, their distribution by age and gender, and to provide a reference for studies on aging and skin problems. Methods: In the present study, patients who reported to the dermatology outpatient clinic between January 1 2019, and January 1 2021, were evaluated retrospectively. As a result of examining the records of patients, 887 patients over the age of 65 who met the study protocol were included. Results: The three most common diseases in all geriatric patients were fungal infections, eczematous dermatitis, and pruritus. Fungal infections were frequent in males and the 65-74 age group. In the males, the more frequent were precancerous lesions and malignant neoplasms, whereas in the females it was urticaria and adverse drug reactions. In the logistic regression model, the risk of fungal infection in geriatric patients was increased by being male (odds ratio 1.55, P = 0.006) and being in the range of 65-74 years old (odds ratio 1.46, P = 0.025). Male patients were at significantly higher risk for precancerous and malignant lesions (OR:2.81 P < 0.001) and actinic keratosis (odds ratio 3.26, P < 0.001) in this disease group. Conclusions: Men are more vulnerable to life-threatening skin diseases. It is important to determine risk factors for individuals who are more sensitive to environmental factors in terms of increasing the quality of life and protection from diseases.

Do patients with psoriasis are at higher risk for atherogenity? A case-control study.

BACKGROUND: Psoriasis is a chronic, inflammatory skin disease that is common in both adult and childhood. Patients with psoriasis are at significant risk for the development of many comorbid conditions, including cardiovascular diseases. OBJECTIVES: We aimed to investigate the cardiovascular risk status and serum lipid parameters in patients with psoriasis and to determine the risk of cardiovascular disease by atherogenic indices obtained accordingly. METHODS: This retrospective case-control study was conducted with a total of 142 individuals, 72 patients with psoriasis vulgaris and 70 healthy volunteers over the age of 18 who were admitted to the dermatology outpatient clinic. Demographic information and laboratory values were retrieved from the hospital database. Afterward, atherogenic indexes such as Atherogenic index of plasma (AIP), Castelli Risk Index I and II (CRI-I and II), and Atherogenic coefficient (AC) were calculated. RESULTS: There was a significant difference in lipid profile between the psoriasis patients and the control group. In patients with psoriasis, triglyceride level (140.09 ± 71.20 mg/dl vs. 116.10 ± 63.95, p = 0.037) was higher, while HDL level (44.34 ± 11.77 mg/dl vs. 50.31 ± 11.62, p = 0.003) was lower. Regarding atherogenic indices; AIP (0.10 ± 0.24 vs. -0.04 ± 0.27, p = 0.001), CRI-I (4.63 ± 1.40 vs. 3.94 ± 1.02, p = 0.001), CRI-II (2.98 ± 1.01 vs. 2.61 ± 0.82, p = 0.019) and AC (3.63 ± 1.40 vs.. 2.94 ± 1.02, p = 0.001) were significantly higher in patients with psoriasis. CONCLUSION: Our study shows that patients with psoriasis have higher pro-atherogenic lipid profile and atherogenic indexes at a high risk level. Patients with psoriasis have an increased risk of cardiovascular diseases.

Evaluation of the association between platelet tests and thyroid-stimulating hormone levels in patients with vitiligo.

OBJECTIVE: Vitiligo is a common dermatological disease of unknown cause and progressing with depigmentation and affects approximately 1% of the world population. In the study, we aimed to compare plateletcrit (PCT), mean platelet volume (MPV), platelet (PLT), and thyroid-stimulating hormone (TSH) values in vitiligo patients. MATERIAL AND METHODS: We retrospectively evaluated the medical data of 100 patients who were admitted to the dermatology outpatient clinic between January 2020 and December 2021 with a diagnosis of vitiligo. The control group was retrospectively constituted from medical records of 90 healthy individuals. PCT, MPV, PLT, and TSH levels of both groups were compared statistically. RESULTS: A total of 190 participants (100 vitiligo patients and 90 healthy volunteers) were included in the study. The mean age of the patient group was 38.62 ± 1.62, while the mean age of the control group was 41.52 ± 1.54. There were no differences between the two groups in terms of age and gender. It was found that the mean MPV value in the patient group was lower than the control group (p = 0.00). PLT and PCT values were significantly higher in the patient group than the control group (p = 0.00, p = 0.01, respectively). There was no statistically significant difference between the two groups in terms of TSH (p > 0.05). A negative correlation between MPV and PLT values in the patient group (r = -0.218, p = 0.029), and a negative correlation between MPV and TSH (r = -0.218, p = 0.029), (-0.230, p = 0.021). CONCLUSION: In the study, a comparison of the PCT, MPV, and PLT levels showed a difference between both groups, but no differences in TSH levels. To clarify these results, comprehensive studies with more samples are needed.

Elevated survivin levels in patients with acne vulgaris.

OBJECTIVE: Acne vulgaris is a multifactorial disease of the pilosebaceous unit. As the most common skin disease, it may affect approximately 85% of the young population. Survivin, a member of the inhibitors of the apoptosis (IAP) gene family, can inhibit apoptosis and regulate cell division and proliferation. In the study, we aimed to investigate the potential role of serum survivin in acne vulgaris. METHODS: Forty individuals who were diagnosed with acne vulgaris and forty healthy subjects as the control group were enrolled in the study. Venous blood samples were collected from each participant, and the serum levels of survivin were measured by enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed using SPSS software version 25. RESULTS: The serum survivin levels were statistically significant between the groups, and the levels of survivin were measured as acne vulgaris patients group 153.44 and control group 104.17 pg/ml, respectively (p < 0.018). When the serum survivin levels were compared according to gender, females had higher levels of survivin than the males (168.16 versus 50.45 pg/mL, p = 0.001). A significant correlation was found between acne severity (p = 0.017) and Scale for Acne Scar severity (SCAR-S) score (p = 0.001) according to the survivin levels. In terms of age, no significant relationship was found between age and survivin (p = 0.4048). CONCLUSION: Elevated serum levels of survivin were determined in acne vulgaris. Moreover, there was a significant correlation between acne stage and SCAR-S score according to survivin levels.

Evaluation of the efficacy of pro-yellow laser in the management of vascular skin disorders.

BACKGROUND: Lasers have great importance in the management of vascular skin lesions. AIM: To determine the efficacy of 577-nm pro-yellow laser in cure of certain vascular skin diseases. MATERIAL AND METHODS: Seventy-four patients who are diagnosed as vascular skin diseases were involved in this study. All participants were treated with 577-nm pro-yellow laser with 4-week intervals. The photographs that were taken before and at every following visit were used to evaluate improvement. RESULTS: A significant improvement occurred in port-wine stain, rosacea, facial telangiectasia, venous lake, scrotal angiokeratoma, and cherry angioma cases. CONCLUSION: Vascular skin lesions can be treated with 577-nm pro-yellow laser with a minimal adverse effect and great success rate.

Abnormal foot angles has an association with ingrown toenail.

BACKGROUND: Onychocryptosis, frequently termed ''ingrown toenail'' is a common foot problem in routine dermatology and orthopaedic clinical practice which leads to pain and disability. Although the aetiology of ingrown toenail is not well understood various associated risk factors have been identified with the pathogenesis. MATERIAL AND METHODS: This study was a retrospective investigation of 170 patients with hallux valgus and lateral border ingrown toenail of all stages. The patients were compared with a control group. The radiologic assessment in both groups included right hallux valgus angle, left hallux valgus angle, right first and second intermetatarsal angle, and left first and second intermetatarsal angle. RESULTS: There were 121 female and 49 male patients in the case group and 68 female and 32 male in the control group. The mean age of the case group was 41.1 years and 41.1 years in the control group. A statistically significant difference was found between the case and the control groups in terms of the right hallux valgus angle variable. CONCLUSION: The abnormal hallux valgus angle and the abnormal intermetatarsal angle plays an important role in ingrown toenail aetiology. The X-rays of the feet should be performed to determine the susceptibility of the patients who are admitted to the hospital for ingrown toenail in order to prevent other toes ingrown toenail and for planning the treatment of the patients with an ingrown toenail.

An alternative for the treatment of vulvar syringoma: 577 nm pro-yellow laser.

BACKGROUND: Syringoma is a benign sweat gland tumor. AIM: Vulvar location of syringoma is rare. Although the lesions are asymptomatic, it requires treatment due to the cosmetic concerns. PATIENTS/METHODS: We present a 42-year-old woman with vulvar syringoma. RESULTS: The patient treated with 577 nm pro-yellow laser with a great success. CONCLUSION: A 577 nm pro-yellow laser is a good alternative in the treatment of vulvar syringoma.

Comparison of the efficacy of broad-band targeted UVB phototherapy and topical psoralen with targeted UVA phototherapy in localized vitiligo.

Aim of the study is to compare efficacy of targeted broad-band UVB phototherapy and topical psoralen with targeted UVA phototherapy treatments in localized vitiligo for 3 months prospectively. The cases with symmetrical vitiligo lesions were included in the study. Broad-band targeted UVB was applied on one side and targeted UVA phototherapy with topical psoralen on the other side. Twenty-two patients who were diagnosed with localized vitiligo were enrolled in this study. These cases consisted of 6 (27.3%) females and 16 (72.7%) males aging between 17 and 69 (34.22 ± 14.15). Fifty-four lesions (27 left, 27 right) were compared for treatments. After the first month of the treatments, the sides of the lesions were compared in order to evaluate improvement. Percentages of success were 25% for targeted broad-band UVB microphototherapy and 75% for topical psoralen with targeted UVA microphototherapy. When the two treatment methods were compared with each other, a significant difference was found in terms of treatment response (P = .017). At the end of the third month, the success rates were 37.5% for targeted broad-band UVB microphototherapy and 62.5% for topical psoralen with targeted UVA microphototherapy, however a statistically significant difference was not determined between the two treatments (P > .05). Both targeted broad-band UVB phototherapy and topical psoralen with targeted UVA phototherapy provided repigmentation for localized vitiligo at the end of the third month. Our investigation shows that both treatments are safe and they provide repigmentation with a limited response.

Changing trends in dermatology practice during COVID-19 pandemic: A single tertiary center experience.

The aim of this study was to evaluate the changing trends in dermatology clinical practice at a tertiary center during the coronavirus disease 2019 (COVID-19) pandemic. This retrospective cohort study was conducted on patients who were admitted to Ufuk University Hospital with dermatologic complaints/diseases before and during the pandemic. The patients were divided into two groups: (a) the pre-pandemic period (March-May 2019) and (b) the Pandemic period (March-May 2020). Demographic features, clinical characteristics, dermatologic diseases/complaints, dermatologic procedures/interventions, hospitalization rate, and use of biologic agents were compared between the two groups. Total number of hospital admissions have decreased from 1165 to 717. Admission rates for acne, dermatophytosis, and benign neoplasm of the skin significantly lower during the pandemic period (P values were .02, .04, and .006, respectively). Contact dermatitis, acne accompanying dermatitis, cicatricial hair loss, lichen planus, and zona zoster infection rates were significantly higher (P values were .007, <.001, .009, .04, and .03, respectively). Rates of biopsy and electrocautery procedures were decreased significantly (P values were <.001 and .002, respectively). The hospitalization rate was similar between the groups (P = .51). However, the use of biologic agents significantly decreased during the pandemic period (P = .01). Updated clinical protocols should be established for the new normal period in accordance with these findings.