Evaluation of the Quality of Life and the Demographic and Clinical Characteristics of Patients With Pemphigus With Oral Mucosal Involvement: A Multicenter Observational Study.

INTRODUCTION: Pemphigus vulgaris (PV) is an autoimmune disease primarily affecting the oral mucosa. OBJECTIVES: This study aimed to determine the demographic, clinical and treatment characteristics of PV patients with oral mucosal involvement and to assess the impact on their quality of life. METHODS: We conducted a prospective observational study among 106 patients diagnosed with PV and presenting oral mucosal involvement. Demographic data, clinical and treatment characteristics, and quality of life questionnaires were recorded. RESULTS: The study included 106 patients, 55 (51.89%) were male and there was a predominance of the mucocutaneous subtype in 83 individuals (78.38%). Oral mucosa was the initial site of manifestation in 44 patients (41.51%). Bilateral buccal mucosa was the most frequently affected site. The predominant symptom reported was a burning sensation, noted in 91 patients (85.85%). Oral mucosal examination revealed erosions in 85.85% of the patients. Systemic steroids were the most commonly administered treatment, and rituximab was used in 18 patients (16.98%). A positive and significant correlation was found between pemphigus severity and Oral Health Impact Profile-14, Dermatology Life Quality Index and Dermatological Quality of Life Scale scores (P < 0.05). The presence of superficial ulcers, flaccid bullae, lesion diameter ≥1 cm, and >10 lesions were factors that markedly diminished quality of life. Complete response to treatment was noted in all patients administered rituximab. CONCLUSIONS: The most common area of involvement was bilateral buccal mucosa, and the severity of PV closely correlated with a decline in quality of life measures. These results highlight the need for careful clinical oversight of PV, taking into account its effects on patients quality of life.

One-step synthesized biogenic nanoparticles using Linum usitatissimum: Application of sun-light photocatalytic, biological activity and electrochemical H2O2 sensor.

This study aimed to synthesize Ag NPs as a green catalyst for photocatalytic activity and to examine their biological activities. It was determined that they have high activity in catalytic and biological activities. The green synthesis which is an environmentally friendly and inexpensive method was used to synthesize Ag-NPs using Linum usitatissimum as a reducing agent. Transmission electron microscopy (TEM), infrared to Fourier transform infrared (FTIR) spectroscopy, UV-Visible (UV-Vis) spectroscopy, and X-ray diffraction (XRD) were used to characterize the Ag NPs. In UV-Vis examination, Ag-NPs had intense peaks in the 435 nm region. The antibacterial activity of Ag NPs was investigated, and Ag NPs showed a high lethal effect against S. aureus, E. coli, B. subtilis, and MRSA. In addition, Ag NPs were tested for anticancer activity against the HT-29 colon cancer cell line, MDA-MB-231 breast cancer cell line, healthy cell line L929-Murine Fibroblast cell Lines, and MIA PaCa-2 human pancreatic cancer cell line at various concentrations (1-160 µg/mL) and showed a high anticancerogenic properties against MDA-MB-231 cells. Ag NPs showed the ability of DNA cleavage activity. Also, the antioxidant activity of Ag NPs against DPPH was found to be 80% approximately. Furthermore, the photocatalytic activity of Ag NPs against methylene blue (MB) was determined to be 67.13% at the 180th min. In addition, it was observed that biogenic Ag NPs have high electrocatalytic activity for hydrogen peroxide (H2O2) detection. In the sensor based on Ag NPs, linearity from 1 µM to 5 µM was observed with a detection limit (LOD) of 1.323 µM for H2O2. According to these results, we conclude that the biogenic Ag NPs synthesized using Linum usitatissimum extract can be developed as an efficient biological agent as an antibacterial and anticancer also can be used as a photocatalyst for industrial wastewater treatment to prevent wastewater pollution.

Efficient green photocatalyst of silver-based palladium nanoparticles for methyle orange photodegradation, investigation of lipid peroxidation inhibition, antimicrobial, and antioxidant activity.

Nanotechnology is an interdisciplinary study that has been developing worldwide in recent years and has a serious impact on human life. The fact that the nanoparticles of plant origin are clean, non-toxic, and biocompatible has enabled new fields of study. The Hibiscus sabdariffa (H. sabdariffa) plant has been attracted by scientists because of its impact on health and many other areas. The lipid peroxidation inhibiting activity, antioxidant properties, and antimicrobial properties of H. sabdariffa plant with Ag-Pd metal was ditermined. For the total phenolic component, gallic acid was used as the standard and quarcetin was used for the total flavonoid. The lipid peroxidation inhibition activity of Ag-Pd NPs in ethanol extract was found to be very well compared to the positive control (BHA). The lowest and highest concentrations of DPPH radical scavenging activity were 82.178-97.357%, whereas for BHA these values were found to be 84.142-94.142%. The highest concentration of Ag-Pd NPs at 200 µg/mL the DPPH radical quenching activity was higher than BHA. Ag-Pd NPs showed a good antimicrobial activity against certain pathogenic microorganisms such as Bacillus subtilis, Enterococcus faecalis, Escherichia coli, Pseudomonas aeruginosa, Candida albicans, which are the causative agents of various diseases in humans. The photodegradation activity of Ag-Pd NPs also investigated against Methyl orange dye (MO) under sunlight irradiation for 120 min and was found to be as 67.88.

Green synthesis, characterizations of silver nanoparticles using sumac (Rhus coriaria L.) plant extract and their antimicrobial and DNA damage protective effects.

Today, antimicrobial resistance against bacteria has become an important global public health problem. In this sense, the development of new biomedical solutions is becoming increasingly important. Especially plant-based nanoparticles produced by green synthesis are used in many fields. AgNPs have an important place in nanoscience and nanotechnology, especially in nanomedicine. Therefore, the present study was conducted to synthesize AgNPs using the medicinal plant extract sumac and to characterize them using advanced techniques and to determine the antibacterial activity of some bacteria that cause disease. Nanoparticles produced by green synthesis are used in a wide area around the world due to their many advantages such as environmentally friendly, economically and non-toxically. In this study, AgNPs were biosynthesized using sumac extract and evaluated for their antibacterial potency against Bacillus cereus, Bacillus subtilis, Enterococcus faecalis, Pseudomonas aeruginos, and Candida albicans. UV-Vis spectroscopy of the prepared sumac-mediated silver solution showed the absorption maximum at about 400 nm. According to the TEM results obtained, it was observed that the particles were spherical, approximately 4 nm in size, and showed a homogeneous distribution. The sizes of nanoparticles formed by XRD pattern were supported and silver nanoparticles were obtained. According to the obtained XRD results, the crystal nature of nanoparticles in face-centered cubic structure was confirmed by the peaks in the XRD model corresponding to the planes (111) (200) (220) and (311). It was observed that the synthesized AgNPs provided a strong protection against plasmid DNA damage. It was determined that the inhibition zone diameters of biosynthesized nanoparticles measured in terms of antibacterial activity were between 10 and 14 mm. As a result, the study revealed significant antibacterial activity of the synthesized AgNPs due to extensive membrane damage.

Facile synthesis of biogenic palladium nanoparticles using biomass strategy and application as photocatalyst degradation for textile dye pollutants and their in-vitro antimicrobial activity.

Among biological applications, plant-mediated Pd NPs for multi-drug resistance (MDR) developed in pathogenic bacteria were synthesized with the help of biomass of lemon peel, a biological material, with a non-toxic, environmentally friendly, human-nature green synthesis method. Characterization of synthesized Pd NPs was carried out by UV-Vis spectrometry, Transmissive Electron Microscopy (TEM), X-ray diffraction (XRD), and Fourier Transform Infrared Spectroscopy (FTIR) techniques. According to TEM analysis, Pd NPs were confirmed to be in a spherical shape and the mean particle size was determined to be 4.11 nm. The crystal structure of Pd NPs was checked using XRD analysis and the mean particle size was observed to be 6.72 nm. Besides, the antibacterial activity of Pd NPs was determined against Escherichia coli (E. coli) (ATCC 8739), Bacillus subtilis (B. subtilis ATCC 6633), Staphylococcus aureus (S. aureus ATCC 6538), Klebsiella pneumoniae (K. pneumoniae ATCC 11296) and Serratia marcescens (S. marcescens ATCC) bacteria. Antibacterial activity was determined to be high in Pd NPs which is in conformance with the results acquired. The Pd NPs showed good photocatalytic activity, after 90 min illumination, about 81.55% and 68.45% of MB and MO respectively were catalysed by the Pd NPs catalyst, and 74.50% of RhB dyes were removed at 120 min of illumination. Within the scope of this project, it is recommended to use Pd NPs obtained by the green synthesis in the future as an antibacterial agent in biomedical use and for the cleaning of polluted waters.

Phyto-mediated synthesis of nanoparticles and their applications on hydrogen generation on NaBH4, biological activities and photodegradation on azo dyes: Development of machine learning model.

This work reports the synthesis of the silver-platinum bimetallic nanoparticles (N@Pt-Ag BNPs) reduced by an ethanolic extract of black seed (Nigella sativa, N) using the green synthesis method, these nanoparticles show a great antibacterial, anticancer, and catalytic activity. The characterization of physicochemical properties of Ag-Pt BNP was carried out using UV-visible spectroscopy (Uv-vis), Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), and Transmission electron microscope (TEM) analysis. The structural morphology shows that the N@Pt-Ag BNPs are spherical particles with a diameter of 5.6 nm. The cytotoxic effects of N@Pt-Ag BNPs were examined by MTT test in human breast cancer, human colon cancer, human pancreatic cancer, L929-Murine fibroblast cells. N@Pt-Ag BNPs have been observed to be much more effective in breast cancer cell lines. The cytotoxic effect of N@Pt-Ag BNPs against healthy L929-murine fibroblast cell lines was not observed. Also, high antibacterial activity on each of the bacteria Escherichia coli (E. coli), Bacillus subtilis (B. subtilis), Methicillin-resistant Staphylococcus aureus (MRSA), Staphylococcus aureus (S. aureus), where we note that most strains of E. coli and S. aureus were damaged with a 73% percentage, 67% bacterial inhibition respectively. The results of the catalytic activities of N@Pt-Ag BNPs were obtained by performing the hydrolysis experiments of sodium borohydride (NaBH4). According to the results obtained, TOF, enthalpy, entropy, and activation energy, values were found to be 2497.14 h-1, 13.52 kJ/mol, -137.47 J/mol.K, 16.02 kJ/mol, respectively. N@Pt-Ag BNPs were found to be highly effective catalysts for hydrogen production which this was also confirmed by the machine learning model. The photocatalytic activity of N@Pt-Ag BNPs was tested against methylene blue (MB) dye and the highest activity was found as 80%.

Subcutaneous emphysema after intralesional cryotherapy: An unusual complication.

BACKGROUND: Intralesional cryotherapy (ILC) is a safe and well tolerated by the patient. Subcutaneous emphysema (SE) cases after spray and contact cryotherapy have been described; however, this complication has not been previously reported after ILC. AIM: Our aim is to discuss the possible causes of SE development after ILC. METHOD: We present a young patient that developed SE after ILC applying by insertion of an open-ended needle to the tip of the cryotherapy gun. RESULTS: The development of SE following ILC may have been caused by inward clefting from the ear hole, the usage of an open-ended needle and a lack of safety system. CONCLUSION: It will be safer to apply special methods involving the usage of sealed distal type to prevent SE development.

Insulin Resistance and Metabolic Syndrome in Patients with Seborrheic Dermatitis: A Case-Control Study.

Background: Our knowledge of the systemic effects of seborrheic dermatitis (SD) as a chronic inflammatory skin disease remains limited. We aimed to evaluate metabolic syndrome (MS) and glucose metabolism disorders in patients with SD. Methods: The study includes 53 patients over the age of 18 diagnosed with SD and 50 age-, gender-, and body mass index-matched healthy controls. Demographic data, anthropometric measurements, blood pressure levels, family history of SD and metabolic disorder, smoking history, and severity of the disease in SD patients were obtained. Fasting plasma glucose, insulin, hemoglobin A1c, lipid profile levels, and two-hour plasma glucose in the oral glucose tolerance test (OGTT 2-h PG), homeostasis model assessment of insulin resistance (HOMA-IR), and presence of MS were determined. Results: Weight, waist circumference, family history of SD, family history of metabolic disorder, and smoking status were significantly higher in the SD group compared with the control group (P = 0.04, P = 0.007, P = 0.004, P = 0.004, and P = 0.048, respectively). The levels of fasting plasma insulin and triglyceride, HOMA-IR and OGTT 2-h PG were also significantly higher in the SD group than in the control group (P = 0.0001, P = 0.033, P = 0.0001, and P = 0.049, respectively). In addition, the number of those with insulin resistance was significantly higher in the group with SD (n = 31, 58.49%) than in the control group (n = 11, 22%) (P = 0.0001). Although the rate of MS was higher in patients with SD (n = 12, 22.64%) than the controls (n = 6, 12%), the difference was not significant (P = 0.155). Conclusion: Our findings suggest an association between SD and insulin resistance, which may be due to their common inflammatory pathogenesis. This may be an indicator of susceptibility to diabetes, and these patients can be followed up for conditions associated with insulin resistance and encouraged to adopt a healthy lifestyle.

Green synthesis, characterization and bioactivity of biogenic zinc oxide nanoparticles.

In this study, we tried to enlighten the structure of zinc oxide nanoparticles (ZnO NPs) obtained from Thymbra Spicata L. plant by using green synthesis method in various ways. Some properties of zinc oxide nanoparticles were determined by using the characterization methods that scanning electron microscopy (SEM), Energy Dispersive X-ray analysis (EDX), fouirer transform infrared spectroscopy (FT-IR), X-ray diffraction (XRD), ultraviolet visible spectroscopy (UV-Vis) spectroscopy methods. The detected Zn nanoparticle sizes were determined to be between 6.5 nm and 7.5 nm. In addition to these studies, we investigated the antimicrobial effects of zinc oxide nanoparticles obtained by green synthesis against some pathogens. According to the results, it was seen that zinc oxide nanoparticles formed zones with a diameter of 16.3 mm, 10.25 mm, 13 mm and 10.2 mm, respectively, against Bacillus subtilis ATCC 6633, Escherichia coli ATCC 25952, Pseudomonas aeruginosa ATCC 27853 bacteria and Candida albicans ATTC 90028 fungus, respectively. However, the radical quenching activity (DPPH) of the nanoparticles (Ts-ZnONP (79.67%)) was determined to be quite good compared to the positive control BHA. In addition, it is seen that the protective effect of ZnO NPs against DNA damage increases depending on the concentration. At a concentration of 100 mg/L, the DNA damage inhibitory effect was found to be maximum. In line with the comprehensive results, it was determined that the zinc oxide nanoparticles obtained with the green synthesis method have the potential of use in a wide variety of fields.

Pagetoid dyskeratosis with a palmar localization: Rapid resolution following biopsy.

BACKGROUND: Pagetoid dyskeratosis (PD), which is found in more than 2% of skin biopsy specimens, is accepted as a histopathological finding reflecting the abnormal keratinization process. However, to date, only a limited number of cases have been described to have brown pigmentation on the hands, triggered by friction, and present with pagetoid dyskeratosis as the only sign on histopathology and a parallel ridge pattern on dermoscopy. AIM: To present and discuss the typical clinical, histopathological, and dermoscopic features of pagetoid dyskeratosis, and to draw attention to the spontaneous resolution following biopsy. PATIENT: We present a case of pagetoid dyskeratosis with a palmar localization, which rapidly resolved following biopsy, in a patient with no history of friction. RESULTS: PD is the only important histopathological finding in typical irregular pigmented lesions located in the hand. PD should also be considered in the differential diagnosis of lesions that show parallel ridge pattern on the hand. Two weeks after the biopsy, disappearance of the lesion may be due to the effect of inflammatory response revealed by biopsy. CONCLUSIONS: Although the cause of this condition is not yet fully understood, most cases being associated with friction or rapid spontaneous resolution following biopsy, as in the current case, may indicate the reactive nature of the lesion. Further researches are required to be clarify etiology of PD.

Investigation of the prevalence of hand eczema among healthcare professionals in Turkey: A cross-sectional study.

BACKGROUND: Hand eczema is one of the common occupational dermatoses, having high prevalence among healthcare professionals (HCP). We found no epidemiological data in the literature concerning the prevalence of hand eczema among HCP in Turkey. AIMS: The aim of the present study was to investigate the prevalence of hand eczema among HCP in Turkey and to determine the demographic characteristics and risk factors that cause eczema. METHODS: A clinical assessment- and questionnaire-based cross-sectional study was conducted with 734 HCP working in a tertiary hospital. Demographic characteristics and personal and occupational risk factors were evaluated in terms of the development of hand eczema. RESULTS: The survey response rate was 81.8%. The point prevalence of eczema was 27.6%, and the 12-month prevalence was 45.9%. Age, occupation, duration of work, atopic diseases, handwashing frequency, dry skin, moisturizing frequency, and presence and duration of glove use were important factors in the development of hand eczema. Powdered glove reaction was significantly higher in those with hand eczema (p = 0.0001). CONCLUSIONS: The prevalence of hand eczema is high among HCP in Turkey. Combining self-reported questionnaires with clinical examination findings can provide a more accurate calculation of the prevalence of hand eczema. The availability of epidemiological data on hand eczema can provide guidelines for the prevention and treatment of this condition. Except for situations requiring absolute handwashing, disinfecting hands with alcohol-based lotions and applying a powder-free policy in all healthcare centers will reduce the prevalence of hand eczema among HCP.

Arum italicum mediated silver nanoparticles: Synthesis and investigation of some biochemical parameters.

The science world advancing day by day contributes to living systems in many areas with the development of nanotechnology. Besides being easily obtained from plants, the advantages it brings increase the importance of nanotechnology. Environmentally friendly, economical, and compatible with plants are just a few of the advantages it brings. Silver metal is one of the most preferred active ingredients in nanoparticle synthesis. Arum italicum is used in the treatment of various diseases in the health sector due to the structures it contains. In our study, nanoparticle synthesis was made by using Ag metal with Arum italicum plant. Then, the antimicrobial, DNA damage prevention and DPPH radical quenching activity of Ag NPs/Ai nanoparticles were investigated. The interaction of the plant with Ag, analysis by X-ray diffraction (XRD), UV visible spectrophotometer (UV-vis), scanning electron microscope and energy dispersive X-ray (SEM-EDX), Fourier-converted infrared spectroscopy (FT-IR) methods has been done. It has been observed that Ag NPs/Ai clusters formed by Arum italicum with Ag have an antibacterial effect against Bacillus subtilis, Bacillus cereus, Enterococcus faecalis, Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli pathogens. However, an antifungal effect hasn't been observed against Candida albicans fungus. Pseudomonas aeruginosa bacteria exerted a stronger effect than an antibiotic. It is seen that Ag NPs/Ai has a protective and anti-damage effect against DNA damage. The antioxidant effect of Ag NPs/Ai is remarkable when DPPH radical quenching activity is compared to positive control BHA and BHT.

Characterization of Rheum ribes with ZnO nanoparticle and its antidiabetic, antibacterial, DNA damage prevention and lipid peroxidation prevention activity of in vitro.

This study aims to investigate the antidiabetic, antimicrobial, DNA damage, and lipid peroxidation prevention activity of ZnO NPs/Rr formed as a result of the interaction of Rheum ribes (R.ribes) plant with ZnO. The ZnO NPs/Rr obtained as a result of the reaction were confirmed using high-reliability characterization methods. According to the data obtained as a result of the study, it is seen that the activity of ZnO NPs/Rr to prevent lipid peroxidation is quite strong. Lipid peroxidation inhibition activity of ZnO NPs/Rr at the highest concentration of 250 µg/ml was calculated as % 89.1028. It was observed that ZnO NPs/Rr prevented DNA damage by % 92.1240 at the highest concentration of 100 µg/ml. It was determined that the antidiabetic effect of ZnO NPs/Rr formed by ZnO of R. ribes plant, which is used as a medicinal plant as an antidiabetic, was significant. It appears to have a strong antidiabetic property compared to the positive control acarbose. In our current study, it was observed that ZnO NPs/Rr formed zones ranging from 8 ± 3.0 to 21 ± 4.5 against Gram-positive and Gram-negative microorganisms. It has been determined that ZnO nanoparticles have an antibacterial effect.

Evaluation of the cutaneous wound healing potential of tamanu oil in wounds induced in rats.

AIMS: Tamanu is a plant oil derived from the fruit and seeds of the Calophyllum inophyllum tree. Although scientific data on tamanu oil are limited, it is recommended worldwide for the treatment of abrasions, burns, diabetic wounds and scars. This study aimed to compare the wound healing efficacy of the topical use of tamanu oil with a reference drug in rats. METHODS: Uniform wounds were induced on the dorsum of 21 rats, randomly divided into three groups. The control group received normal saline; the tamanu group received tamanu oil; and the centella group was treated with Centella asiatica. Wound healing was clinically evaluated using wound healing scoring and wound contraction. A biopsy was taken from the wound sites of each rat on days 7, 14 and 21 for histopathological evaluation. RESULTS: Wound contraction was significantly lower in the tamanu group compared with the other groups. On day 7, the intensity of macrophage infiltration and mature granulation tissues were significantly higher in the centella and tamanu groups than in the control group. Fibrosis and collagen density were higher in the tamanu group than the other groups on day 7. CONCLUSION: In wound healing in rats, tamanu oil accelerated the formation of macrophage-granulation tissues-fibrosis and resulted in less wound contraction.

Plasma matrix metalloproteinase-9 level change with omalizumab treatment in chronic spontaneous urticaria.

BACKGROUND: Matrix metalloproteinase-9 (MMP-9) is an enzyme that contributes to inflammation and tissue remodelling. In chronic urticaria, increased plasma levels of MMP-9 and its correlation with disease severity have been shown in several studies, suggesting that MMP-9 could be used to evaluate the effects of new treatments. We aimed to compare MMP-9 levels in chronic urticaria patients with those of healthy patients. Then we planned to investigate the changes in plasma MMP-9 levels with chronic urticaria treatment, the role of this enzyme in demonstrating the efficacy of treatment, and its correlation with C-reactive protein (CRP). METHODS: Forty-one patients with chronic urticaria who were scheduled for omalizumab treatment and 41 sex- and age-matched healthy volunteers were included in the study. In the patient group, before treatment and at the end of the 12th week, the urticaria activity score used for 7 consecutive days (UAS7) was calculated, and the MMP-9 and CRP levels were measured. Plasma MMP-9 levels were measured from venous blood in the control group. RESULTS: The plasma MMP-9 levels of the patients before treatment were significantly higher than those of the control group (P < .01). In the patient group, there was no significant relationship between the UAS7 score and the MMP-9 and CRP levels before treatment. The UAS7 values were 28 ± 7 before omalizumab treatment and 5 ± 6 at the end of the 12th week (P < .0001). The post-treatment MMP-9 levels (1818 ± 297 pg/mL) were higher compared with the pre-treatment values (1617 ± 380) (P < .05). The post-treatment CRP levels of the patients (2.41 ± 2.17 mg/L) were lower than their pre-treatment CRP levels (8.20 ± 19.70) (P < .05). CONCLUSION: MMP-9 levels were not associated with the severity of disease, and MMP-9 levels were not decreased with treatment response. Therefore, MMP-9 cannot be used as a parameter of disease activity in chronic urticaria or to evaluate the efficacy of new treatments.

Assessment of children and adolescent presenting to the dermatology outpatient clinic in Turkey during the coronavirus disease-2019 pandemic.

OBJECTIVE: The coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization on March 11, 2020. During the partial curfews implemented in the pandemic period, the pediatric patients presenting to the dermatology clinic of our hospital were examined taking the necessary precautions. We aimed to identify children and adolescent cases requiring dermatology services and their urgency when the number of COVID-19 cases was rapidly increasing and partial curfews were being imposed in Turkey. METHODS: The study was conducted with pediatric patients that presented to our hospital dermatology outpatient clinic, a tertiary health care institution between March 11, 2020, and May 29, 2020, and their differences according to age groups and presentation period were evaluated. RESULTS: The most common reason for a dermatology clinic visit was acneiform diseases (n=103, 33.3%). According to age groups, the most common diagnosis was eczema diseases in both the 0-2 and 3-6 years groups (n=10 [55.6%] and n=11 [47.8%]), respectively), infectious diseases in the 7-12 years group (n=19, 31.10%), and acneiform diseases in the 13-18 years group (n=100, 48.3%). While 144 patients visited the clinic within the first 15 days after the declaration of pandemic, the number of patients presenting in the following month decreased by more than 80% (n=23 for the second 15-day period and n=14 for the third 15-day period). There was a moderate increase in the number of pediatric dermatology patients 45 days after the declaration of pandemic (n=57 for the fourth 15-day period and n=71 for the fifth 15-day period). A correlation was observed between the number of newly diagnosed COVID-19 cases in Turkey and the number of pediatric patients presenting to our outpatient clinic. CONCLUSION: Considering that non-urgent and follow-up pediatric patients continue to present to dermatology outpatient clinics during the pandemic process, it is necessary to encourage the implementation of patient care methods, such as telemedicine in hospitals as part of the health system.

Effect of video-based patient information on patients' anxiety and pain levels before skin biopsy: a randomized controlled study.

OBJECTIVES: Effective use of technology can provide advantages for both patients and physicians in skin biopsy practice. We aimed to investigate the effects of video-based information on the anxiety, pain and satisfaction levels of patients undergoing biopsy. METHODS: Patients were randomized and divided into two groups as video-informed and verbally informed. The anxiety levels were evaluated using the State-Trait Anxiety Inventory (STAI) and measuring the physiological parameters, systolic and diastolic blood pressure, heart rate, and respiratory rate. After the informing process, the STAI's state form was reevaluated, and physiological parameters were measured again. After the biopsy, the level of pain was evaluated using the visual analog scale (VAS), and patient satisfaction was assessed with the satisfaction scale. RESULTS: Fifty-two in the video-informed group and 50 in the verbally informed group completed the study. Compared to the baseline values, the STAI and STAI-state scores, systolic blood pressure, heart rate and respiratory rate of the patients in the video-informed group decreased (p < 0.0001, p < 0.0001, p = 0.003, p = 0.007, and p < 0.0001, respectively), and the systolic blood pressure, diastolic blood pressure, heart rate and respiratory rate values decreased in the verbally informed group (p < 0.0001, p = 0.014, p = 0.005, and p < 0.0001, respectively). According to VAS, 98.1% of the patients in the video-informed group and 86% of those in the verbally informed group described no or mild pain, and pain levels were lower in the video-informed group (p = 0.030). CONCLUSIONS: Video-based information prior to skin biopsy may be more useful in managing anxiety and pain in patients than traditional verbal information.

Temporal overexpression of IL-22 and Reg3γ differentially impacts the severity of experimental autoimmune encephalomyelitis.

IL-22 is an alpha-helical cytokine which belongs to the IL-10 family of cytokines. IL-22 is produced by RORγt+ innate and adaptive lymphocytes, including ILC3, γδ T, iNKT, Th17 and Th22 cells and some granulocytes. IL-22 receptor is expressed primarily by non-haematopoietic cells. IL-22 is critical for barrier immunity at the mucosal surfaces in the steady state and during infection. Although IL-22 knockout mice were previously shown to develop experimental autoimmune encephalomyelitis (EAE), a murine model of multiple sclerosis (MS), how temporal IL-22 manipulation in adult mice would affect EAE course has not been studied previously. In this study, we overexpressed IL-22 via hydrodynamic gene delivery or blocked it via neutralizing antibodies in C57BL/6 mice to explore the therapeutic impact of IL-22 modulation on the EAE course. IL-22 overexpression significantly decreased EAE scores and demyelination, and reduced infiltration of IFN-γ+IL-17A+Th17 cells into the central nervous system (CNS). The neutralization of IL-22 did not alter the EAE pathology significantly. We show that IL-22-mediated protection is independent of Reg3γ, an epithelial cell-derived antimicrobial peptide induced by IL-22. Thus, overexpression of Reg3γ significantly exacerbated EAE scores, demyelination and infiltration of IFN-γ+IL-17A+ and IL-17A+GM-CSF+Th17 cells to CNS. We also show that Reg3γ may inhibit IL-2-mediated STAT5 signalling and impair expansion of Treg cells in vivo and in vitro. Finally, Reg3γ overexpression dramatically impacted intestinal microbiota during EAE. Our results provide novel insight into the role of IL-22 and IL-22-induced antimicrobial peptide Reg3γ in the pathogenesis of CNS inflammation in a murine model of MS.

Anxiety and depression in pediatric patients with vitiligo and alopecia areata and their parents: A cross-sectional controlled study.

BACKGROUND: Alopecia areata (AA) and vitiligo are associated with various psychiatric comorbidities, and the care of a child with AA or vitiligo may be associated with higher anxiety and depression than healthy children. AIMS: We aimed to identify psychiatric findings in children and adolescent groups with AA and vitiligo and to evaluate the levels of anxiety and depression in their parents. METHODS: This study included 31 patients with AA and 29 patients with vitiligo, aged seven to 17 years, and their parents. Age- and gender-matched 30 controls and their parents were included. The patients and controls completed the Revised Child Anxiety and Depression Scales-Child version (RCADS-C), and their parents completed the parent version (RCADS-P). The parents also completed the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI). In addition, the stressful event history of all cases was noted. RESULTS: Stressful event history was higher in the vitiligo group compared to the AA group, and it was higher in the AA and vitiligo groups compared to the control group. Separation anxiety, generalized anxiety, social phobia, and major depressive disorder (MDD) scores were higher in the AA group than controls according to the RCADS-C. According to the RCADS-P, panic disorder (PD), MDD, and total anxiety scores were higher in the AA group. Only the PD and MDD scores were higher in the vitiligo group than those of the controls based on the RCADS-P. Lastly, no significant difference was observed between the three groups concerning the parents' BAI and BDI scores. CONCLUSIONS: Stressful events were more common in pediatric patients with vitiligo than those with AA. Anxiety symptoms were more prevalent in patients with AA than those with vitiligo.

Vitamin B12, folate levels and somatoform dissociation in conversion disorder.

OBJECTIVE: To evaluate the association of folate and vitamin B12 levels in patients with conversion disorder, and to illuminate the aetiology of conversion disorder by examining depression and somatoform dissociation. METHODS: The case-control study was conducted from March 2014 to May 2015 at the Medical Centre of Yuzuncu Yil University, Van, Turkey, and comprised patients diagnosed with conversion disorder and healthy controls. Blood samples were taken from both groups for vitamin B12 and folate levels. Data was collected using the Beck Depression Inventory and Somatoform Dissociation Scale. Data was analysed using SPSS 18. RESULTS: Of the 100 subjects, 55(55%) were cases with a mean age of 27.05±9.04 years and 45(45%) were controls with a mean age of 26.56± 5.96 years. The mean level of B12 was 283.93±122.96 in cases and 324.62±128.82 in controls (p=0.05). The mean level of folic acid was 5.47±1.84 in cases and 6.07±2.26 in controls (p>0.05). CONCLUSIONS: Physicians need to be vigilant about vitamin B12 levels in patients with conversion symptoms.