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Bullous scabies, the light shed on etiopathogenesis and treatment: report of five paediatric cases
(Termedia Publishing House Ltd, 2023) Arslan, Hakan; Gündüz, Özgür
Introduction: Bullous scabies (BS) is an infrequent and atypical presentation of scabies, with a predilection for el- derly males. The mechanism of BS is not fully understood; superinfection, friction due to pruritus, autoeczemation, direct injury from mite's lytic enzymes, cross-reactivity of scabies protein with basal membrane zone antigens are considered to be possible reasons. Aim: To define clinical features of paediatric BS cases, which is an extremely rare subtype of scabies. Material and methods: This is a retrospective study of paediatric BS cases seen at two tertiary care centres. Previ- ously described bacterial culture, antibiogram and follow-up records were investigated retrospectively. Confirmed scabies cases, according to the International Alliance for the Control of Scabies (IACS) with bullae were included. All cases were treated with 10% sulfur ointment for 3 consecutive days, two cycles. Households of cases were also treated simultaneously. Systemic antibiotics were added to patients with elevated acute phase reactants according to the antibiogram results. Informed consent was obtained from patients' parents. Results: Five BS cases were included. Three cases were male, two cases were female. Four cases had staphylococcus aureus, one had group-A beta haemolytic streptococcus positive bullae culture. All cases achieved a rapid complete resolution of symptoms after topical 10% sulfur ointment. Conclusions: Paediatric BS is an extremely rare entity of scabies. Bacterial superinfection plays a key role in bullae formation. 10% sulfur ointment is a highly effective treatment option for paediatric BS.
Melanocytes as the source of the increased melanisation in pigmented epithelial tumours: a holistic approach
(Tubitak Scientific & Technological Research Council Turkey, 2022) Kilitci, Asuman; Elmas, Ömer Faruk; Akdeniz, Necmettin; Gamsizkan, Mehmet
Background/aim: We aimed to elucidate the causes of the increased melanisation in basal cell carcinoma (BCC) and seborrheic keratosis (SK), and the role of melanocytes in this process. Materials and methods: This study was a retrospective-cohort study conducted in the pathology department of a university hospital between January 2019 and October 2020. Forty-nine SK and 30 pigmented BCC were included in our study. SRY-box transcription factor 10 (SOX10), CD68, and Masson???Fontana staining was used for analysis in all samples. A representative section of each specimen was photographed under ??400 magnification to facilitate the assessments of the morphology of the melanocytes and their following morphometric parameters: density, nuclear diameter, and distribution. The density of pigmented keratinocytes in the lesional epidermis was scored. The nuclear diameters of melanocytes located in the nonlesional epidermis, the density of the melanophages, and the presence or absence of ulceration and solar elastosis were also recorded. Results: The morphometric findings confirmed a statistically significant increase in melanocyte density in the BCC group compared with that in the SK group (p < 0.001). Moreover, the nuclear minor diameters in the melanocytes of the BCC sections were significantly higher than those in the SK specimens (p < 0.001). The epidermal melanocytes were distributed diffusely in almost all BCC specimens (96.7%), whereas they were mainly limited to the basal layer in the majority of the SK sections (59.2%). The number of epidermal melanised keratinocytes with a score of 3 was significantly higher in the SK group (n = 31; 63.2%) than in the BCC group (n = 6; 20%) (p = 0.001), and they were the main cells representing the pigmented appearance of the tumours. No significant difference was found between both tumour groups in terms of their melanophage density scores (p = 0.206). Conclusion: This study is the first step towards an objective quantification of the melanocytes in pigmented epithelial tumours and may provide a morphological background for future studies on these skin lesions.
Survival of biological therapeutics in psoriasis: retrospective analysis of 3-years data in a Turkish registry, PSORTAKSIS
(Tubitak Scientific & Technological Research Council Turkey, 2022) Özyurt, Kemal; Zararsız, Gökmen; Ertaş, Ragıp; Cephe, Ahu; Kutlu, Ömer; Elmas, Ömer Faruk; Akkuş, Muhammet Reşat
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.
The potential role of human HIV-1 TAT-Interactive Protein 2 levels in the pathogenesis of contact dermatitis
(Tubitak Scientific & Technological Research Council Turkey, 2021) Metin, Mahmut Sami; Bilen, Handan; Elmas, Ömer Faruk; Akdeniz, Necmettin
Background/aim: Human HIV-1 TAT interactive protein 2 (HTATIP2/TIP30) is a gene that is extensively expressed in human tissues as well as in tumor tissues. This study aimed to explore the potential role of HTATIP2/TIP30 in contact dermatitis (CD), which is one of the most common inflammatory cutaneous conditions. Materials and methods: This cross-sectional study involved adult patients with acute contact dermatitis who were admitted to the outpatient dermatology clinic of a tertiary hospital and healthy adult volunteers without any cutaneous or systemic diseases. The blood concentration of HTATIP2/TIP30 was measured using ELISA kits. Results: The research sample consisted of 31 patients with CD (18 males, 13 females) and 20 healthy control subjects (14 males, 6 females). The mean ages of the patients with CD and healthy volunteers were 37 and 30 years, respectively (p > 0.05). The mean value of serum HTATIP2/TIP30 levels in patients with CD was 1.65 ng ml-1, which is 0.60 ng ml-1 in the control group (p = 0.02) Conclusion: In this study, serum levels of HTATIP2/TIP30 were statistically significantly higher in patients with CD when compared to healthy controls. This outcome may indicate possible role of HTATIP2/TIP30 in the pathogenesis of CD.
A novel marker of systemic inflammation in psoriasis and related comorbidities: chitotriosidase
(Tubitak Scientific & Technological Research Council Turkey, 2021) İlanbey, Bilal; Elmas, Ömer Faruk; Sözmen, Eser Yıldırım; Günay, Umran; Demirbaş, Abdullah; Atasoy, Mustafa; Tursen, Ümit
Background/aim: Chitotriosidase (ChT) is an enzyme secreted by activated macrophages and neutrophils in response to proinflammatory signals. There is growing evidence indicating that ChT activity reflects the systemic inflammatory status. This study aimed to investigate whether serum ChT activity increased in patients with psoriasis and related comorbidities. Materials and methods: This cross-sectional study included 53 (28 with associated comorbidities and 25 without comorbidities) patients with psoriasis and 52 healthy volunteers. All participants underwent laboratory investigations for serum ChT levels, complete blood count, erythrocyte sedimentation rate, C-reactive protein, and serum lipid levels. Results: The patients with psoriasis showed significantly higher levels of ChT activity as compared to the healthy controls (23.5 +/- 11.4 vs. 17.5 +/- 10.4 mu mol/mL/hour; p = 0.015). Additionally, the ChT activity was significantly higher in patients with comorbidities than in those without (p = 0.042). Conclusion: Our data support the pathogenetic role of inflammatory processes induced by macrophage activation in patients with psoriasis and related comorbidities. We believe that high ChT activity in patients with psoriasis may serve as an early prediction of the possible related comorbidities.
Effect of the coronavirus disease-2019 pandemic on the follow-up and treatment of patients with rosacea
(Galenos Publ House, 2023) Durak, Murat; Gündüz, Özgür
Background and Design: This study aimed to investigate the effects of the precautions and preventive measures implemented during the coronavirus disease-2019 (COVID-19) pandemic on the follow-up and treatment processes of patients with rosacea who applied to the Skin and Venereal Diseases outpatient clinic of a university hospital in Turkiye.Materials and Methods: Age, sex, number of hospital admissions, prescribed topical and systemic treatments, total amount of treatment on a box basis, follow-up interval in multiple applications, and number of applications to the Ophthalmology Department were recorded before and during the COVID-19 pandemic. Results: No difference was found in the age and sex distributions of patients with rosacea who applied to the Skin and Venereal Diseases outpatient clinic during the COVID-19 pandemic compared with that before the pandemic. However, the total number of patients decreased. Furthermore, the total number of drugs prescribed to patients and the number of systemic drugs increased proportionally during the COVID-19 pandemic. In addition, the ratio of patients who continued their follow-up and the use of systemic drugs among these patients increased.Conclusion: In this study, the number of admissions decreased and the rate of patients who needed systemic treatment increased. Rosacea and similar dermatoses that required long-term follow-up could be evaluated via teledermatology during periods when application to outpatient clinics for follow-up becomes difficult such as during pandemics and natural disasters.
Darier hastalığı ve akrokeratozis verrusiformis
(2000) Erkek, Emel; Atasoy, Pınar
Darier hastalığı nadir görülen, otozomal dominant geçişli bir keratinizasyon bozukluğu hastalığıdır. Seboreik bölgeleri tutan simetrik keratotik papüller, el ayasında çukurcuklar ve tırnak distrofisi ile karakterizedir. Akrokeratozis verrusiformis (Hopf), el ve ayak dorsumlarında verrü planaya benzeyen poligonal papüller ve tırnak distrofisi ile seyreden, otozomal dominant nadir bir hastalıktır. Darier hastalarının bir kısmında el ve ayak dorsumlarında akrokeratozis verrusiformise benzeyen siğilimsi papüller görülebilir. Burada akrokeratozis verrusiformis benzeri akral lezyonların eşlik ettiği bir sporadik Darier hastalığı olgusu sunulmakta ve akral Darier hastalığı ile akrokeratozis verrusiformisin klinikopatolojik ayırıcı tanıları tartışılmaktadır.
The efficacy of intermittant low-dose systemic corticosteroid therapy in vitiligo
(2004) Erkek, Emel; Birol, Ahu; Kurtipek, Saylam Gülcan; Tunçez, Fatma; Bağcı, Yeter; Koçak, Mukadder
Amaç: Vitiligo depigmente lezyonlar ile karakterize, akkiz, otoimmun bir hastalıktır. Çalısmanın amacı düşük doz, sistemik kortikosteroid tedavisinin vitiligo tedavisindeki rolünü araştırmaktır.Gereç ve Yöntemler: Calışmamıza 16 hasta dahil edilmiştir. Sistemik prednizolon 10-15 mg/gün, haftanın 2 ardışık günü, 6 ay süre ile uygulanmıştır.Bulgular: 14 hastada non-segmental [10 (62.5%) simetrik jeneralize- 4 (25%) akrofasyal) ve 2 (12.5%)] hastada segmental vitiligo tespit edildi. Altı aylık tedavi sonrasinda 6 (37.5%) hastada foliküler repigmentasyon, tespit edilirken 10 (62.5%) hastada tedaviye yanıt alınamadı. Hastaların hiçbirinde tam düzelme tespit edilmedi.Sonuç: İntermitan, düşük doz sistemik kortikosteroid vitiligo tedavisinde etkili bulunmamıştır.
PCR analysis of HSV-negative erythema multiforme for the expression of other herpesviruses
(2003) Koçak, Mukadder; Erkek, Emel; Kısa, Özgül; Güney, Çakır; Birol, Ahu
Background: Herpes simplex virus (HSV) is the primary herpesvirus implicated to have a causal role in erythema multiforme (EM), both in cases with an antecedent herpetic infection and in idiopathic EM. However, the association of EM with several other viral infections has been clearly documented. Objective: The aim of the present study was to investigate a hypothetical role for the remaining members of the herpesvirus family in HSV-negative cases of EM. Methods: Fresh, unfixed lesional skin biopsies from 25 patients with HSV-negative EM were studied for the presence of Epstein-Barr virus(EBV), cytomegalovirus (CMV), human herpesvirus-6 (HHV-6) and human herpesvirus-7 (HHV-7) by using polymerase chain reaction (PCR) and nested PCR. Results: PCR revealed the absence of specific DNA sequences for EBV, CMV, HHV-6 and HHV-7 in all lesional EM specimens analyzed. Conclusion: These findings do not support an etiological role for non-HSV members of the herpesvirus family in HSV-negative EM.
The efficacy of intermittant low-dose systemic corticosteroid in the treatment of alopecia areata
(2004) Birol, Ahu; Erkek, Emel; Tunçez, Fatma; Kurtipek, Sayam Gülcan; Bağcı, Yeter; Koçak, Mukadder
Alopecia areata (AA) is a common cause of non-scarring alopecia characterized by patchy hair loss. AA is difficult to treat because of its chronic and inflammatory nature. The aim of the present study was to investigate the effect of low-dose systemic corticosteroids in the treatment of AA. Fifteen patients with AA were included in this study. Systemic prednisolone 10-15 mg/day on 2 consecutive days per week for 6 months was administered. Fourteen patients (93.3%) had patchy alopecia areata. One patient (6.3%) had alopecia universalis. Seven (46.7%) patients showed complete healing, 5 (33.3%) showed partial response and 3 (20%) did not respond to treatment. Low-dose intermittant corticosteroid therapy may be a successful and well tolerated treatment option in AA and also in patients with alopecia totalis and universalis.
Does influenza subtype H1N1 have a place in the etiology of pityriasis rosea?
(Termedia Publishing House Ltd, 2019) Demirkan, Serkan; Kacmaz, Birgul
Introduction: Pityriasis rosea (PR) is an acute, inflammatory skin disease of unknown cause. Various infectious agents including viruses have been proposed as causative agents and presence of influenza subtype H1N1 was shown in case reports with PR, but the relation was not conclusive. We hypothesited that there may be a relation between PR and H1N1, since both of them are prevalent in the same period as winter or season transitions. Aim: To investigate the effect of the H1N1 virus in PR in this study. Material and methods: Twenty-one female and 12 male PR patients who applied to Kirikkale University Faculty of Medicine Hospital Dermatology Outpatient Clinic were included in the study. Influenza subtype H1N1 IgM and IgG antibodies were detected by enzyme immunoassay (EIA) in sera of patients; tissue biopsy specimens were examined for influenza subtype H1N1 RNA by PCR. Results: Seven (23%) of the 33 patients had positive IgM and IgG antibodies. Influenza subtype H1N1 RNA was not detected in the tissue samples of 33 PR patients. Conclusions: According to the results of this study, we can say that influenza subtype H1N1 does not play a role in PR etiology.
CAG polymorphism in the androgen receptor gene in women may be associated with nodulocystic acne
(Termedia Publishing House Ltd, 2019) Demirkan, Serkan; Sayin, Derya Beyza; Gunduz, Ozgur
Introduction: Acne vulgaris (AV) is a multifactorial, inflammatory disease of the pilosebaceous unit. Hormones play a major role in the pathogenesis of acne. In cases of hyperandrogenism; hirsutism, acne, seborrhoea and alopecia appear in women. However, severe acne can also be seen without evidence of hyperandrogenism. In this case, hypersensitivity of the androgen receptor gene (ARG) encoded in the X chromosome, which is the only receptor for androgens, can be considered. ARG contains a polymorphic CAG triple loop encoding the polyglutamine pathway at the 5'end of exon 1. Aim: To investigate CAG repeat polymorphism in the ARG in nodulocystic acne patients in Turkish population. Material and methods: This prospective clinical study was conducted between 2016 and 2017 in accordance with the tenets of the Declaration of Helsinki. DNA isolation from blood was performed using the RTA (R) Genomic DNA Isolation Kit. The fragment lengths obtained from the device to determine CAG repeat numbers were analysed based on -288 bp length 22 CAG repeat content. Results: A total of 199 subjects; 100 patients (51 males, 49 females) and 99 controls (49 males, 50 females) were included in the study. The mean allele length in the patient group was 19.34; and 19.7 in the control group. There was a statistically significant difference between female patients and the control group, when the patients and control groups were compared by gender (p = 0.0059). Conclusions: The CAG trinucleotide repeat count in the ARG may be associated with acne, without hirsutism findings.
Anti-inflammatory activity of Anthemis tricolor Boiss
(Termedia Publishing House Ltd, 2019) Demirkan, Serkan; Ozcinar, Ozge; Kivcak, Bijen
Introduction: Traditionally, Anthemis genus has been used for the treatment of gastrointestinal disorders, haemorrhoid and stomach ache in Europe. There are several in-vitro and in-vivo studies that showed the pharmacological properties of Anthemis species such as antibacterial, anti-inflammatory, antiedemic and hepatoprotective properties. Aim: Our study referred to the model of inflammation formed in rats; we aimed to evaluate anti-inflammatory properties of A. tricolor extracts. Material and methods: Five different extracts of A. tricolor were tested against the negative control and 2 different topical corticosteroids (betamethasone and hydrocortisone); n-hexane and sesquiterpene extracts of A. tricolor Bois showed significantly reduced erythema compared to the negative control. Results: Only n-hexane and sesquiterpene extracts of A. tricolor have the anti-inflammatory effect. Conclusions: This is the first report on anti-inflammatory activity of A. tricolor and we showed an anti-inflammatory effect of n-hexane and sesquiterpene extract of A. tricolor with UV erythema test as a_result, hence A. tricolor extracts can be used for the treatment of inflammatory skin diseases due to anti-inflammatory activity.
Rationale for the autologous serum skin test in acute versus chronic urticaria
(Termedia Publishing House Ltd, 2019) Demirkan, Serkan; Baccioglu, Ayse
Introduction: Autologous serum skin test (ASST) is a rapid, in-vivo clinical test to detect functional autoantibodies in patients with chronic spontaneous urticaria (CSU), but the rationale for its use in acute urticaria (AU) is unknown. Aim: To evaluate the efficacy of ASST among patients with AU or CSU. Material and methods: Treatment-naIve adult (age >= 18 years) patients with a diagnosis of AU (< 6 weeks' duration) and CSU were enrolled prospectively in a cross-sectional study. Healthy age- and sex-matched subjects served as controls. Besides a detailed history and physical examination, ASST, total immunoglobulin E (IgE), freeT3 (fT3), freeT4 (fT4), anti-thyroglobulin, and anti-TPO levels were assessed in all subjects. Results: Of 101 subjects, mean age was 34.35 +/- 12.68 years and the study comprised 58.4% of females with no difference between AU (n = 27), CSU (n = 46), and control groups (n = 28). The ratio of positivity in ASST was similar between AU (25.9%) and CSU groups (21.7%), but higher than in controls (10.7%, p = 0.33 for all). The ratio of patients with high total IgE levels (> 100 IU/ml) in AU (85.2%) and CSU (65.2%) groups was similar (p = 0.06), but significantly higher than in the control group (10.7%) (p < 0.001 and p < 0.001). The CSU group had significantly higher abnormal thyroid test results (45.7%) than AU (14.8%) and control groups (3.6%) (p = 0.01 and p < 0.001), whereas patients with clinically diagnosed thyroiditis were only in the CSU group (6.5%). In logistic regression analysis, there was no relation found among the possible risk factors for ASST, even if analysed separately as AU, CSU and control groups. Conclusions: Even though thyroid function test levels were found to be related with CSU, and total IgE was associated with urticaria, ASST was found to be of importance. This study confirms that ASST was insufficient to demonstrate autoimmunity and acute-chronic urticaria nature. Further tests indicating auto-antibodies in AU and CSU are needed.
Treatment of multiple eccrine hidrocystoma with oral isotretinoin following erbium-yttrium aluminum garnet laser
(Taylor & Francis Inc, 2019) Demirkan, Serkan
Eccrine hidrocystomes (EH) are benign cystic tumors of dermal eccrine ducts. There is still no gold standard treatment option for EH because of the large number of lesions, the risk of cicatrization and the different treatment options offered. We offer combined oral isotretinoin and following erbium-yttrium aluminum garnet laser treatment as an alternative treatment option in difficult patients with EH.
Elevated Tear Human Neutrophil Peptides 1-3, Human Beta Defensin-2 Levels and Conjunctival Cathelicidin LL-37 Gene Expression in Ocular Rosacea
(Taylor & Francis Inc, 2019) Gokcinar, Nesrin Buyuktortop; Karabulut, Ayse Anil; Onaran, Zafer; Yumusak, Erhan; Yildiran, Fatma Azize Budak
Purpose: To investigate the role of innate immunity in ocular rosacea. Methods: Thirty-two patients with ocular rosacea patients (group-1) and 28 healthy volunteers (group-2) who served as controls were enrolled in the study. Tear function parameters were assessed, conjunctival impression cytology was performed and tear samples were collected. Human-neutrophil-peptides (HNP) 1?3 and human-beta-defensin-2 (hBD-2) levels were measured in tears by using ELISA tests. Cathelicidin leucin-leucin-37 (LL-37), hBD-2, human-beta-defensin-9 (hBD-9) gene expression levels were measured in the conjunctival impression cytology samples using real-time polymerase chain reaction. Results: Tear HNP1-3 (p?=?0.024), hBD-2 (p?
Decreased choroidal thickness in vitiligo patients
(Bmc, 2018) Demirkan, Serkan; Onaran, Zafer; Samav, Guzin; Ozkal, Fatma; Yumusak, Erhan; Gunduz, Ozgur; Karabulut, Ayse
Background: Vitiligo is a disease characterized by depigmented macules and patches that occur as a result of the loss of functional melanocytes from the affected skin through a mechanism which has not been elucidated yet. Destruction of pigment cells in vitiligo may not remain limited to the skin; the eyelashes, iris, ciliary body, choroid, retinal pigment epithelium and meninges may also be affected. This study aims to compare the choroidal thickness of patients with and without vitiligo using optical coherence tomography (OCT). Methods: Spectral-domain optical coherence tomography (SD-OCT) (Retina Scan Advanced RS-3000 NIDEK, Japan) instrument (with lambda = 840 nm, 27,000 A-scans/second and 5 mu m axial resolution) was used for the imaging. Statistical analysis was performed using SPSS 21.0 software package. Results: In all values except optic nevre area measurements, the choroidal thickness of all vitiligo patients was found out to be thinner compared to the control group. Conclusions: In vitiligo, the choroidal thickness may be affected by the loss of melanocytes.
Olfactory bulb volume and olfactory sulcus depth in patients with Behcet's disease
(Cambridge Univ Press, 2018) Dogan, A.; Muluk, N. Bayar; Asal, N.; Sahan, m H.; Inal, M.; Gunduz, O; Arikan, O. K.
Objective To investigate olfactory bulb volume and olfactory sulcus depth in patients with Behcet's disease, using magnetic resonance imaging. Methods Cranial magnetic resonance imaging scans of 27 adults with Behcet's disease (10 males and 17 females) and 27 healthy controls were examined. Olfactory bulb volume and olfactory sulcus depth were measured on coronal, T2-weighted, spectral pre-saturation with inversion recovery sequences. Results Bilateral olfactory bulb volume and right-sided olfactory sulcus depth were significantly lower in the Behcet's disease group than in the control group (p < 0.05). Left-sided olfactory sulcus depth increased with Behcet's disease duration. In both groups, olfactory bulb volume was significantly higher in the left than the right side. There were no gender differences for olfactory bulb volume and olfactory sulcus depth. Positive correlations were determined between right- and left-sided olfactory bulb volume values and between right- and left-sided olfactory sulcus depth values. Conclusion Behcet's disease may decrease olfactory functions, related to lower olfactory bulb volume and olfactory sulcus depth. The affected vascular system and possibly damaged neural system, nasal mucosal lesions, and prolonged nasal mucociliary clearance time may cause olfactory dysfunction. Patient follow up is recommended, with magnetic resonance imaging examinations of the olfactory system if necessary.
Retrospective analysis of endemic melasma patients
(Pagepress Publ, 2017) Demirkan, Serkan; Gunduz, Ozgur; Dayangan, Cemile
Melasma is an acquired diffuse hypermelanosis characterized by localized, symmetrical, irregular, light-to-dark brown maculae occurring in sun-exposed areas of skin. The aim of this retrospective study was to determine demographics of patients, analysis of etiologic factors, clinical features, efficacy and side effects of available topical treatments due to high incidence of melasma patients. In this study melasma patients in Birecik State Hospital were investigated retrospectively. Between January 2014 and October 2015, 1008 patients had diagnosis of melasma in 49,809 applications of 24,603 different patients who admitted to Dermatology Outpatient Clinics. Of the 1008 patients, 263 had completed 3-month treatment period. These patients did not receive treatment in June, July, August and September. All melasma patients were rural and dealing with agriculture. There was no significant difference between female and male patients in terms of age. Of the 253 female melasma patients, only 2 of them had not child and none of them were using hormone drug. Of the 263 patients with melasma, Fitzpatrick skin type was 3 in 79 (30%) patients, 4 in 184 (70%) patients. Sanliurfa city showed higher fertility rate, sun exposure, and skin type than Turkey as a whole. These predisposing factors may explain higher melasma occurrence in Sanliurfa. Patient information about preventive measures and treatment play important role in treatment of cosmetic condition. The most important measure seems to advise patients about sun-protection especially during pregnancy.
A Case of Two Synchronous Cutaneous Collision Tumors
(Gazi Univ, Fac Med, 2017) Ayva, Sebnem Kupana; Tepeoglu, Merih; Gunduz, Ozgur; Yazici, Ilker; Bozdogan, Onder
Cutaneous collision tumors are known as two independent tumors which are close anatomically and separated from one another by well boundaries. We, herein report a 83-year-old female patient with two cutaneous collision tumors in two different localizations at the same time. First cutaneous collision tumor located on left ala nasi was squamous cell carcinoma and basal cell carcinoma and second one located on the right commisure was composed of malignant melanoma (Clark Level IV) and basal cell carcinoma. However, the presence of collision tumors is not uncommon and is often reported in the literature, to the best of our knowledge, it is the first case which shows the association of two synchronous cutaneous collision tumor in the same individual.

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