Anxiety and Depression in Patients with Alopecia Areata in Eskisehir, Turkey.

Background: Conflicting results have emerged in studies conducted to reveal the relationship between alopecia areata (AA) and depression and anxiety. The comorbidity of depression and anxiety in patients with patchy AA who applied to a tertiary care center will be investigated and compared with a healthy control group. Methods: This study included 86 patients with AA and 85 healthy volunteers. The patients and controls completed Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BDI). Results: The average BDI of the patient group was 13.45±8.59, while in the control group, it was 7.2±5.7 (p = 0.002). The average BAI of the patient group was 12.56±8.76, while in the control group, it was 6.01±5.87 (p = 0.019). Depression was detected in 30.2% (n = 26) of the patients and anxiety was detected in 19.8% (n = 17) of the patients. In the control group, the rate of depression was 5.9% (n = 5) and the rate of anxiety was 7.1% (n = 6). There was a statistically significant difference between the patients and the control group in terms of depression (p < 0.001) and anxiety (p < 0.001). Conclusion: Depression and anxiety were more prevalent in patients with AA than in healthy volunteers. Dermatologists should keep in mind psychiatric diseases such as depression and anxiety that may accompany patients diagnosed with AA.

The Prevalence of Penile Pearly Papules among Young Men.

The aim of this study was to determine the prevalence of pearly penile papules (PPP) among young men in Eskisehir, Turkey. This was a prospective, non-randomized, cross-sectional study. From December 2014 to September 2015, 2613 consecutive male patients who were referred to the dermatology outpatient clinic were included in the study. Patients were inspected for the presence of PPP, localization, and association with human papilloma virus (HPV). A total of 2613 patients were included in the study. The average age of the patients was 21.33±2.08 (mean ± Standard Deviation (SD); ranging from 18 to 24) years. All of the patients were white and circumcised men. Of the 2613 patients, 449 (17.18%) PPP were observed. PPP were localized on the corona of the glans penis (100%), coronal sulcus (18.9%), frenulum (15.1%), ventral shaft (5.3%), and dorsal shaft of the penis (2.4%). Of the 449 patients with PPP, 23 (5.3%) underwent treatment; 73 (16.2%) would consider removal, 7 (1.5%) had a previous treatment for HPV, and 5 (1.1%) had HPV. PPP are encountered very commonly in the pubertal age in boys and young men. All medical practitioners should be familiar with PPP. Their similarity to genital warts may generate a false apprehension of venereal disease and may lead to unwanted and hazardous treatments. Therefore, better health education is needed.

Histologic Evidence of New Collagen Formulation Using Platelet Rich Plasma in Skin Rejuvenation: A Prospective Controlled Clinical Study.

BACKGROUND: Platelet-rich plasma (PRP) is an autologous concentration of human platelets contained in a small volume of plasma and has recently been shown to accelerate rejuvenate aging skin by various growth factors and cell adhesion molecules. OBJECTIVE: This study was conducted to evaluate the efficacy and safety of intradermal injection of PRP in the human facial rejuvenation. METHODS: This study was a prospective, single-center, single-dose, open-label, non-randomized controlled clinical study. PRP injected to the upper site of this right infra-auricular area and all face. Saline was injected to the left infra-auricular area. Histopathological examinations were performed before PRP treatment, 28 days after the PRP, and saline (control) treatments. RESULTS: Twenty women ranging in age from 40 to 49 years (mean age, 43.65±2.43 years) were enrolled in the study. The mean optical densities (MODs) of collagen in the pre-treatment, control, and PRP-treated area were measured. They were 539±93.2, 787±134.15, 1,019±178, respectively. In the MOD of PRP, 89.05 percent improvement was found when MOD of PRP was compared with MOD of pre-treatment. The mean MOD of collagen fibers was clearly highest on the PRP side (p<0.001). The PRP-to-saline improvement ratio (89.05% to 46.01%) was 1.93:1. No serious side effects were detected. CONCLUSION: PRP increases dermal collagen levels not only by growth factors, but also by skin needling (the mesotherapy technique 'point by point'). PRP application could be considered as an effective (even a single application) and safety procedure for facial skin rejuvenation.

Why some of the dermatologists choose to avoid carrying out minimally invasive cosmetic procedures?

BACKGROUND: Some dermatologists choose to avoid carrying out cosmetic dermatology procedures. The aim of this study is to reveal the knowledge and daily outpatient clinic applications of dermatologists in Turkey, and their problems concerning minimally invasive cosmetic procedures (MICPs). MATERIALS AND METHODS: This study was designed as a descriptive cross-sectional study. Between December 2014 and July 2015, a questionnaire was sent to dermatologists by e-mail. RESULTS: Of the 318 participant dermatologists, 233 (73.3%) were female. It was determined that 63.8% of the participants had sufficient knowledge on MICP (very good, good, and medium) while 36.2% had insufficient knowledge (little, very little, and none). About 19.9% of the patients required MICP during outpatient clinic service. The 120 dermatologists who do not apply MICP gave the following reasons: not having adequate training (50%), MICP not being profitable (28.3), not having enough time (25%), being worried about side effects and complications (14.2%), and legal problems (9.2%). CONCLUSION: It was observed that many dermatologists are interested in cosmetic dermatology, received their training on the subject through courses, have sufficient knowledge, and apply these procedures. However, it was also found out that some dermatologists do not apply MICP due to inadequate training, time, and physical constraints.

Do dermatologists have cosmetic procedures?

BACKGROUND: Current approach and ideas of dermatologists about undergoing MICPs themselves are unknown. OBJECTIVE: The aim of this study was to reveal current situation and thought of dermatologists about undergoing minimally invasive cosmetic procedures (MICPs) themselves. METHODS: This study was planned as a cross-sectional, descriptive study and performed between December 2014 and July 2015. A questionnaire comprising 11 questions was sent to dermatologists via electronic mail. RESULTS: Of the 318 dermatologists, 233 (73.3%) were female and 85 (26.7%) were male. It was established that 56 percent (n = 178) of the dermatologists underwent MICPs. There was a statistical difference between the gender and having MICPs (female = 66.1% vs. male = 28.2%; P < 0.001). They selected dermatologists (91%) as a performer and private settings (67.2%). To be young and beautiful (77%), they had MICPs after medical residency (75.3%). Physicians' experience (66.9%) was the most important criterion. Of the dermatologists who did not have MICPs were planning to have MICPs (76.4%). The most frequent reason that stopped them from having MICPs was "not need yet" (62.1%). CONCLUSION: There are some tendencies among the dermatologists while selecting a physician for the procedures. They usually have MICPs after dermatology residency to seem younger and more beautiful by an experienced dermatologist in private setting. Male Turkish dermatologists have MICPs more frequently than the general population. Their satisfaction level with MICPs is very high. Most of dermatologists who do not have MICPs are planning to have MICPs.

A prospective randomized controlled trial assessing the efficacy of adjunctive hyperbaric oxygen therapy in the treatment of hidradenitis suppurativa.

Hyperbaric oxygen therapy (HBOT) appears to enhance wound healing, increase bactericidal activity, and act synergistically with a number of antibiotics. The aim of this study was to evaluate the efficacy of HBOT as an adjunctive therapy in patients with hidradenitis suppurativa (HS) treated with a combination of systemic rifampicin and clindamycin. The study was a prospective, single-center, single-dose, open-label, randomized controlled clinical study of HBOT in patients with moderate to severe HS. Efficacy was measured by modified Sartorius score (SS), HS Severity Index (HSSI), Dermatology Life Quality Index (DLQI), and a visual analog scale (VAS) before treatment and after the completion of 4 and 10 weeks of treatment. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were also measured. Forty-three patients were enrolled in the study. More patients in the HBOT than in the control group showed a decrease of ≥50% from baseline parameters at week 10 for SS (100%), HSSI (100%), DLQI (95.5%), VAS (100%), ESR (100%), and CRP (72.7%). Clinically and statistically significant improvements from baseline were observed at 4 and 10 weeks in HSSI (P = 0.009 at both), SS (P = 0.021 at both), and DLQI (P = 0.044 at week 4, P = 0.009 at week 10). Adjunctive HBOT was considered to be effective in significantly improving antibiotic treatment of HS. The treatment was well tolerated, and no unexpected safety issues were identified.

Effect of preoperative evaluation by a dermatologist on diagnostic accuracy.

BACKGROUND: The accuracy of the diagnosis of skin lesions has an important effect in outcomes in treatment selection and prioritization of the treatment. OBJECTIVE: To assess the effect of preoperative evaluations by dermatologists on the diagnostic accuracy of plastic surgeons. MATERIALS AND METHODS: A retrospective analysis was performed on 1,146 biopsies that were excised by plastic surgeons in our secondary State Hospital. The histopathologic diagnoses were divided into 2 groups according to the preoperative dermatological evaluation, with Group 1 being the lesions that were evaluated by a dermatologist before excision and Group 2 being the lesions that were not evaluated by a dermatologist before excision. The sensitivity and positive predictive values (PPVs) were calculated and compared between the 2 groups using Fisher exact test. RESULTS: The PPVs of the malignant lesions of Groups 1 and 2 were 53.8% and 25.0%, respectively (p = .001). When Group 1 was contrasted with Group 2, the PPVs for the premalignant lesions were 71.4% and 46.8%, respectively (p = .015). The PPV for the benign lesions was 86.3% in Group 1 and 72.6% in Group 2 (p < .001). CONCLUSION: This study demonstrated that the diagnostic accuracy of plastic surgeons was affected positively by preoperative evaluations by a dermatologist.

Primary intraosseous cavernous hemangioma of the toe.

Intraosseous cavernous hemangioma is an uncommon benign vascular tumor. A 21-year-old man presented with a small painless swelling of the left foot's long toe. X-ray examination showed an outgrowing bony lesion that has cortical continuity in the tip of the long toe's distal phalanx lateral aspect. Preoperative examination yielded no final diagnosis. En bloc resection was performed. The histological diagnosis was intraosseous cavernous hemangioma. To the best of our knowledge, this case is a first report of primary intraosseous cavernous hemangioma of the toe.

Prevalence of skin diseases in a dermatology outpatient clinic in Turkey. A cross-sectional, retrospective study.

BACKGROUND: Dermatologic diseases vary widely as a result of geographic location, climate, socioeconomic status, and personal habits, and internal factors, such as age, gender, and heredity. OBJECTIVE: The aim of the study was to determine the main causes for outpatient visits in a dermatology outpatient clinic in Turkey. MATERIALS AND METHODS: The outpatient clinic records of the Dermatology Department of Eskisehir Yunus Emre Government Hospital, dated between 1 January 2011 and 1 January 2012, were retrospectively assessed. Patients were grouped according to age, gender and clinical diagnosis. RESULTS: A total of 11,040 new patients with 12,174 skin problems were included in the study. The study group was 55.7% female and 44.3% male. The age range was between 1 and 99 years. The most commonly encountered diseases were: acne (13.1% of patients), fungal infections (8.5%), contact dermatitis (8.5%), urticaria (8.3%), psoriasis (5.5%), viral warts (4.1%), lichen simplex chronicus (3.0%), callus, atopic dermatitis, and seborrheic dermatitis (2.2% each). CONCLUSIONS: It appears that certain skin diseases acne, fungal infections, contact dermatitis and urticarial cause serious health problems. Public health policies should be implemented in order to manage these problems rationally.