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   Table of Contents - Current issue
Coverpage
October-December 2022
Volume 16 | Issue 4
Page Nos. 103-134

Online since Monday, November 28, 2022

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ORIGINAL ARTICLES  

Anxiety, depression, COVID-19 anxiety, and the effects of hospital environment on patients presenting to dermatology outpatient clinic during the pandemic p. 103
Nurhan D Aktas, Türkan Güray, Alper Alyanak, Başak Bağcı
DOI:10.4103/tjd.tjd_36_22  
Background: The World Health Organization has defined the COVID-19 infection as a pandemic. Anxiety and depression are emphasized to increase with the pandemic. Aims: The current study aimed to identify anxiety, depression, and COVID-19 anxiety of patients who presented to the dermatology outpatient clinic and the effects of hospital environment on them during the pandemic. Materials and Methods: A questionnaire was applied, including questions about the sociodemographic characteristics, the state of being hesitant about transmission of COVID-19 infection in hospital, pandemic-associated attitudes in hospital, persons and hospital sites thought to be risky for transmission of the infection, opinion about tele-dermatology, State-Trait Anxiety Inventory (STAI1, STAI2), Hospital Anxiety and Depression Scale (HADS), and the COVID-19 Anxiety Scales (CAS). The diagnoses of skin disorders were recorded after examinations. Results: The study included 458 patients (60.7% females, the mean age was 31.8 years) who presented to the dermatology outpatient clinic in March 2021. Of patients, 64.7% rated their hesitancy as moderate and higher about the transmission of the COVID-19 infection in hospital. With the STAI1 scale, the rate of moderate and severe anxiety was 47.6%; with the HADS, the rate of anxiety was 26.6%; with the HADS, the rate of depression was 37.3%; and with the CAS, the rate of anxiety due to COVID-19 was 3.9%. Conclusion: Dermatology patients should be evaluated to be adversely affected at least as much as the other members of the society. Patients found the hospital environment risky in terms of the transmission of COVID-19 infection, creating an additional stress factor.
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Evaluation of the efficacy and safety of topical procyanidin b2 and placebo in the treatment of androgenetic alopecia in men; A randomized, double-blind, placebo-controlled study p. 108
Yıldıray Yeniay, Ercan Arca
DOI:10.4103/tjd.tjd_41_22  
Objective: Androgenetic alopecia (AGA) is a common type of alopecia characterized by the shortening of the anagen phase of hair growth and the miniaturization of hair follicles. TGF-β is a well-known hair cycle catagen phase inducer and is involved in the catagen phase in AGA. Inhibition of TGF-β is recognized as a therapeutic option in the treatment of AGA. Procyanidins are a type of polyphenol that has been shown to inhibit TGF-β activity in vivo, but there haven’t been many studies on their effectiveness. In this study, we aimed to evaluate the efficacy and safety of topical procyanidin B2 in the treatment of male AGA. Materials and Methods: Patients aged between 18 and 50 years who applied to our dermatology outpatient clinic with the complaint of AGA and had Hamilton-Norwood type II-V AGA were included in our study. Those who had received 5-reductase inhibitor or isotretinoin treatment in the previous year, those who had used any medicinal or herbal product that stimulated hair growth, particularly topical minoxidil, in the previous six months, those who had used systemic steroids for more than two weeks in the previous three months, those who had undergone a transplant or scalp reduction, and those who had received radiotherapy or chemotherapy at any point in their lives were excluded from the study. A total of 40 patients who met the current criteria were included in the study. Patients were randomized into two groups to receive 16 weeks of topical procyanidin B2 (n = 20) or placebo (n = 20) therapy. At the end of the treatment, the patients were called for control. The efficacy of topical procyanidin B2 after treatment was evaluated by trichoscan and global photographic evaluation. Results: A total of 40 male patients (mean: 33.32, range: 21–44) with AGA type II-IV were included in the study. There was no significant difference between the two groups in terms of age, duration of hair loss, and AGA type (P > 0.05). At the end of the study, there was a significant increase in total hair count in the topical procyanidin B2 group compared to the placebo group compared to baseline (P < 0.05). Anagen hair count was also significantly increased in the topical procyanidin B2 group (P < 0.05). Conclusion: In this placebo-controlled study, we think that topical procyanidin B2 is an effective and safe treatment option in the treatment of AGA patients.
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Requirement of re-excision in surgical margin positive basal cell carcinoma cases without macroscopic residual lesions (our experience of 714 cases and a review of the literature) p. 115
Dinçer Altinel, Gaye Toplu, Merdan Serin
DOI:10.4103/tjd.tjd_45_22  
Background: Basal cell carcinoma (BCC) is a local aggressive tumor, which almost never metastasizes. In this study, we investigated the results of our BCC cases in the last 9 years. Objective: The aim of this study was to better understand the re-excision requirements in positive surgical margin BCC cases. Methods: Seven hundred fourteen patients operated between 2012 and 2021 were included in the study. Localization, subtype, and re-excision results were investigated. Statistical Analysis Used: Descriptive analysis was performed. Results: The mean patient age was 66.9 years (range = 17–98 years). The most common localization for BCC was nasal region (n = 235), and the most common histopathological subtype was nodular (n = 298). Seventy-eight patients had positive margins following the excision. Thirty-eight re-excisions were performed. Thirty-one re-excisions revealed scar without any residue tumor. None of the 78 cases with positive surgical margin returned with a relapse. Conclusion: We evaluated the reliability and efficiency of our excision limits with the pathological evaluation. We achieved significantly high cure rates, even by reducing our excision margins up to 1 mm in critical anatomical structures.
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Increased oxidative stress and imbalance dynamic thiol–disulfide homeostasis in Rosacea p. 120
Eray M Guler, Beyza N Ozkan, Nazan Yilmaz, Fatma P Ozgen, Nazan S Taslidere, Selman Aktas, Ozlem Su Kucuk
DOI:10.4103/tjd.tjd_96_22  
Background: Rosacea is a chronic progressive inflammatory disease and characterized by facial erythema, telangiectasias, papules, and pustules. The disease is more common in women than in men while affecting 2%–10% of the population. Though the pathogenesis of rosacea is not fully understood, oxidative stress is one of the asserted pathogenic factors. In this study, we purposed to assess the oxidative stress and thiol–disulfide homeostasis (TDH) in rosacea disease. Materials and Methods: Forty patients with rosacea and 40 healthy people as a control group, both in ages of 18–70 years, with the same demographic characteristics were included, who were applied to the Istanbul Training and Research Hospital Dermatology Clinic. Serum total antioxidant status (TAS), total oxidant status (TOS), total thiol (TT), and native thiol (NT) levels were evaluated by using the automated and spectrophotometric method according to Erel and Neselioglu. Oxidative stress index (OSI), disulfide (DIS) levels, and NT/TT, DIS/TT and DIS/NT percentages were calculated mathematically. Results: TAS, TT, and NT levels were decreased in rosacea patients compared with the healthy group, whereas TOS, OSI, and DIS levels were increased. Additionally, although DIS/TT and DIS/NT percentages were higher in patients, NT/TT ratio was lower than the healthy group, and these findings were statistically significant (p < 0.001). Conclusion: The results showed that oxidative stress levels were increased in rosacea patients and TDH shifted toward DIS formation. It has been thought that oxidative stress is a parameter that may be utilized in the clinical evaluation of the disease.
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Value of the BIOCHIP mosaic-based indirect immunofluorescent technique in the diagnosis of dermatitis herpetiformis among patients with chronic pruritus p. 125
Burçin C Bozca, Derya Mutlu, Soner Uzun
DOI:10.4103/tjd.tjd_101_22  
Background: The BIOCHIP mosaic-based indirect immunofluorescence technique is a practical, standardized test, and it has been used successfully in the diagnosis of autoimmune bullous dermatosis in recent years. Objectives: The study aimed to examine the diagnostic value of the BIOCHIP to identify dermatitis herpetiformis (DH) in patients with chronic pruritus (CP). Materials and Methods: This single-center case–control study included patients who applied to a dermatology clinic between July 2020 and December 2020. The diagnosis of DH was confirmed by direct immunofluorescence (DIF) test. In cases without DIF positivity, the diagnosis was established with a complete response to a long-term gluten-free diet and/or a swift response to dapsone treatment. All analyses were performed using SPSS version 21 (SPSS Inc., Chicago, IL, USA). The diagnostic performance of the variables was evaluated using receiver operating characteristic (ROC) curve analysis. P values < 0.05 were considered statistically significant. Results: GAF 3X (gliadin analog fusion peptide), as measured by the BIOCHIP method, had an area under the ROC curve of 0.854 (95% confidence interval: 0.688–1.000) for DH diagnosis with sensitivity, specificity, positive predictive, and negative predictive values of 72.73%, 100%, 100%, and 93.62%, respectively, demonstrating an overall accuracy of 94.55%. Conclusion: DH could be determined with nearly excellent accuracy by BIOCHIP GAF 3X analysis among patients with CP. BIOCHIP-based determination of GAF 3X was found to be superior to Enzyme-Linked ImmunoSorbent Assay (ELISA)-based determination of GAF 3X.
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LETTER TO THE EDITOR Top

Dermoscopy of pseudoxanthoma elasticum p. 131
Bhagyashree B Supekar, Pallavi R Rokade, Jayesh I Mukhi
DOI:10.4103/tjd.tjd_44_22  
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