Turkish Journal of Dermatology

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The color of human skin varies according to race, ethnicity, and geographic location, which leads to differing appearances of the same cutaneous condition. The nonwhite population is projected to increase worldwide in the coming decades owing to globalization and changing demographics. Thus, this review aims to focus on the varying nature of cutaneous conditions in this population, which differ from traditional descriptions in textbooks. A thorough search of PubMed, MEDLINE, Cochrane, and Google Scholar databases was done for relevant articles focusing on appearances of various dermatoses in skin of color. Erythematous diseases such as psoriasis, pityriasis rosea, and atopic dermatitis presented with inconspicuous/less conspicuous erythema in individuals with colored skin. Postinflammatory pigmentary changes were frequent in individuals with Fitzpatrick Grading III to VI and in the darker phenotypes, the hyperpigmentation may be difficult to distinguish from normal skin color. Acne hyperpigmented macules are encountered as primary lesions in colored skin, causing a considerable amount of apprehension in affected individuals. Hypopigmented disorders such as arsenicosis, macular postkala-azar dermal leishmaniasis, and dhoti or saree-induced depigmentation were particularly observed in this population. A focused review addressing the visual aspects, especially the color of skin diseases in individuals with Fitzpatrick Grading III to VI is the need of the hour to sensitize dermatologists regarding the specific dermatoses and reaction patterns occurring in this population.

Background/Aim: Melasma causes significant emotional and psychological effects in patients. Therefore, the investigation of the quality of life in patient with melasma has become increasingly important. In this study, we aimed to learn the demographic features of female patients with melasma in the north of Turkey, assess associated factors, and research how melasma affects quality of life. Materials and Methods: The demographic and etiological characteristics of 71 female patients with melasma were recorded. Dermatology Quality of Life (DQoL) index and Melasma Quality of Life Scale (MelasQoL-Tr) were completed by all patients in the presence of a dermatologist. Results: When the patients were evaluated according to age, marital status, education, duration of melasma, and age of onset melasma, there was no significant relationship in terms of MelasQoL. There was a statistically significant correlation in positive direction at moderate-good levels between MelasQoL and DQoL scores. Conclusion: Based on our study, melasma significantly affects quality of life in women. This situation clearly illustrates the need to give patients treatment not just based on clinical aspects but also including psychological features of the disease.

Biotinidase deficiency (BD) is an autosomal recessively inherited inborn error of metabolism that causes multisystemic manifestations, including developmental delay, seizures, hypotonia, vision problems, hearing loss, ketolactic acidosis, and various cutaneous findings at the early stages of life. Treatment consists of oral biotin that is effective in the prevention of complications. We present a case of a 4-year-old boy with partial BD with fingertip desquamation that could be resolved by increasing biotin dosage.

Background: Chronic urticaria (CU) is defined as the persistence of urticarial lesions for more than 6 weeks. Omalizumab, a human monoclonal anti IgE antibody, has been used as a new therapeutic option in CU patients unresponsive to high-dose second-generation antihistamines. Aims and Objectives: This study is aimed to examine the clinical and demographic characteristics of CU patients treated with omalizumab in our clinic and to define parameters related to therapeutic response. Materials and Methods: Patients who were followed up with the diagnosis of CU between January 2014 and June 2020 were evaluated retrospectively. The data obtained from patients’ electronic files were analyzed using SPSS23 program. Results: 167 patients (125 female, 42 male) were included. The mean age was 45.34 ± 14.76 years. The mean disease duration at the onset of omalizumab was found to be 47.41 ± 63.26 months. Complete response to treatment was observed in 45.9%, 48%, and 52% of patients at 3rd, 6th, and 12th months of omalizumab treatment, respectively. The baseline total IgE level was evaluated in 107 patients and a statistically significant correlation was observed between complete response to treatment at 3rd month and higher baseline total IgE levels (P < 0.001). Conclusion: Omalizumab provided a significant therapeutic response and the patients did not need any other treatment, while patients with high pretreatment IgE levels showed a better and earlier response. These results may guide clinicians in predicting patients’ response to omalizumab.

Background: Nail changes associated with chemotherapeutic drugs are common and can compromise the quality of life of cancer patients if left overlooked by a clinician. Aim: The aim of this study was to study the common pattern of nail changes caused by chemotherapeutic drugs. Materials and Methods: A single-institutional prospective observational study was conducted for patients with histopathologically proven malignancy without prior nail changes undergoing first-line systemic chemotherapy. Analysis of frequency distribution and associations of categorical variables was performed by Chi-square test and multivariate analysis, using IBM SPSS statistics version 21 for Windows. P ≤ 0.05 was considered statistically significant. Results: The incidence of nail changes in the present study was 42% (182 out of 434 cases). Nail changes were commonly observed following 1–2 cycles of chemotherapy, and most of them were Grade 1 changes. The most common nail change observed was chromonychia (49%), followed by onychorrhexis (29%). Chemotherapeutic drugs frequently associated were taxane (65.3%) and platinum compounds (57.7%). Nail changes found associated with taxane included the largest varieties, i.e., chromonychia, onychorrhexis, splinter hemorrhage, Terry′s nail, half-and-half nail, Beau′s lines, onychodystrophy, and paronychia. Nail changes associated with platinum drugs were onychorrhexis and chromonychia. Adriamycin, bleomycin, vinblastine, and dacarbazine regimen was associated with leukonychia. Adriamycin and cyclophosphamide both were independently associated with chromonychia. Conclusion: A knowledge of chemotherapy-induced nail changes can avoid inadvertent diagnostic interventions and improve the quality of life by timely and proper patient counseling.

Paraneoplastic syndromes are multisystemic diseases that are seen in association with solid organ tumors and lymphomas. Immune-mediated polyneuropathy, encephalopathy, cerebellar degeneration, and Guillain–Barre syndrome have all been described as paraneoplastic neurologic disorders. Clinical symptoms may appear before the diagnosis of associated malignancy creating diagnostic confusion. Tumor-derived peptides, hormones, and mediators are shown to be associated with paraneoplastic syndromes. Herein, we present an unusual case of stage 4 diffuse large B-cell lymphoma with cutaneous metastatic nodules presenting initially as paraneoplastic polyneuropathy.

Online since 30^th May 2019