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    Clinical, Demographic and Treatment Characteristics of Pediatric Psoriasis: A Multicenter Study of 150 Patients
    (Galenos Publ House, 2021) Demirbas, Abdullah; Ozyurt, Kemal; Elmas, Omer Faruk; Metin, Mahmut Sami; Atasoy, Mustafa; Tursen, Umit; Kilitci, Asuman
    BACKGROUND/AIMS: Many studies have focused on the epidemiological features of adult and childhood psoriasis. However, only a few studies have been conducted to demonstrate the clinical and demographic characteristics of pediatric psoriasis in Turkey. This study aimed to determine clinical, demographic, and treatment characteristics of childhood psoriasis in a multicenter series. MATERIALS and METHODS: This study was conducted in four different centers that are located in four cities of Turkey between June 2016 and June 2020. The demographic parameters, possible triggering factors (emotional stress, physical trauma, infection, and medication), and clinical characteristics (psoriasis type, psoriasis area severity index, involved areas, nail involvement, joint involvement, subjective symptoms, disease duration, last treatments and duration of use, and history of accompanying diseases) of pediatric patients with psoriasis were retrospectively analyzed. RESULTS: A total of 150 patients from four different centers were enrolled in the study, of whom 71 (47.30%) were males and 79 (52.70%) were females, with a mean age of 13.71 +/- 42 years (age range: 1-18 years). A family history of psoriasis was determined in 20 (13.33%) patients. Possible triggering factors included emotional stress (n=90, 60%), physical trauma (n=21, 14%), infection (n=14, 9.33%), and medication (n=1, 1.67%). The most common area of involvement was the trunk (n=69, 46%) followed by the scalp (n=42, 28%), hand (n=20, 13.33%), and face (n=19, 12.67%). The prevalence of clinical types was as follows: plaque (n=125,83.33%), guttate (n=10, 6.67%), palmoplantar (n=7, 4.67%), inverse (n=6, 4%), and pustular (n=2, 1.33%) psoriasis. Nail and joint involvement were observed in 30 (20%) and 15 (10%) patients, respectively. The last treatments received included topical treatment (n=101, 67.33%), phototherapy (n=23, 15.33%), acitretin (n=16,10.67%), methotrexate (n=9, 6%), and cyclosporine (n=1, 0.67%). CONCLUSION: In our cohort, the clinical types and treatments used for childhood psoriasis were similar to those of other studies, but the rate of family history was lower, whereas the incidence of emotional stress was higher. Addressing the psychological impacts of psoriasis along with its physical aspects may provide better treatment outcomes.
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    Survival of biological therapeutics in psoriasis: retrospective analysis of 3-years data in a Turkish registry, PSORTAKSIS
    (Tubitak Scientific & Technological Research Council Turkey, 2022) Ozyurt, Kemal; Zararsiz, Gokmen; Erta, Ragip; Cephe, Ahu; Kutlu, Omer; Elmas, Omer Faruk; Akku, Muhammet Resat
    Background/aim: PSORTAKSIS is a psoriasis registry, which is used for follow-up of patients in Kayseri City Education and Research Hospital, Dermatology Clinic since 2016 in Turkey. PSORTAKSIS includes demographic data, follow-up clinical findings, laboratory output, and treatment information of patients. Here, drug survivals of biologic therapeutics (BT) according to three-year data of PSORTAKSIS will be presented. Materials and methods: Drug survival of BT in PSORTAKSIS was analyzed from 2016 to March 2019. Results: 158 patients (111 of them BT-naive) with psoriasis under BT were enrolled in the current study. Drug survival analysis of patients with ongoing BT (158 treatment periods) revealed mean survival time as 15.49 months for ustekinumab, 15.37 months for adalimumab, 14.00 months for etanercept, 5 months for infliximab, and 4.59 months for secukinumab. The differences between drug survivals of BT were statistically significant (log-rank test, chi(2) = 79.915, p < 0.0001). Age of onset was found to be the only independent risk factor of drug survival according to regression analysis (p = 0.029). Conclusion: As a conclusion, drug survival of UST was significantly higher than that of TNF-alpha inhibitors and SEC in the treatment of psoriasis. This study revealed that among predictors, age at disease onset may influence drug survival.
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    Therapeutic efficacy and safety of three different modalities in pediatric patients with plantar warts
    (Wiley, 2021) Acar, Emine Muge; Uyar, Belkiz; Elmas, Omer Faruk; Ozyurt, Kemal; Atasoy, Mustafa; Tursen, Umit; Lotti, Torello
    Human papillomavirus infection is relatively common in communities. Thus, determining an effective and painless treatment method, especially in pediatric patients is of utmost importance. This study aimed to compare the outcomes of three different methods of treating plantar warts in pediatric patients. Children with verruca plantaris treated with a salicylic acid-lactic acid combination once daily (SA/LA 1), a salicylic acid-lactic acid combination applied in three to seven layers under occlusion every 3 days (SA/LA 2), or a combination of 5-fluorouracil (0.5%) and salicylic acid (10%) (SA/5-FU) were evaluated retrospectively. Treatment responses and recurrence rates were also evaluated after a minimum of 4 months. Among the 98 children with verruca plantaris, 19 were treated with SA/LA 1, 53 were treated with SA/LA 2, and 18 were treated with SA/5-FU; the eight patients who received cryotherapy were excluded. The mean treatment duration was significantly shorter in the SA/LA 2 group than in the SA/LA 1 group and the SA/5-FU group. (p = 0.000 for both) Application of a salicylic acid-lactic acid combination in multiple layers under occlusion is a safe, painless, and effective treatment method for plantar warts in children.