Dermatological Complaints Research Articles

A Retrospective Study to Evaluate the Impact of In-Patient Dermatological Consultations on Diagnostic Accuracy in a Tertiary Care Setting.

Background:Dermatology is primarily an outpatient specialty. However, dermatology consultations play an important role in care of inpatients. Data on inpatient dermatological consultations in tertiary care settings is limited.Objectives:To evaluate clinical characteristics of inpatient dermatological consultations and effect on clinical outcomes in a tertiary care setting.Methods:This was a single-center retrospective study where the records of all dermatological consultations for patients admitted under various specialties, emergency services, and intensive care units (ICU) at our tertiary care institute over 2 years period were reviewed. The details of patients, primary care unit, dermatological complaints, diagnosis, investigations performed, treatment given, and follow-up were recorded and analyzed.Results:Total of 1717 dermatologic consultations (1000 males) were recorded, with mean age of study population being 33.6 ± 21.6 years (median - 32 years). Out of total 1717 patients, 136 (7.9%), 321 (18.7%), 1135 (66.1%), and 125 (7.3%) patients were infants, children, adolescents, adults, and elderly, respectively. The most frequent diagnostic group was infective diseases (586; 34.1%) followed by inflammatory diseases (442; 25.7%), mucocutaneous adverse drug reactions (160; 9.3%), and autoimmune diseases (65; 3.8%). Primary team's diagnosis was concordant with the dermatology consultation in 1112 (64.8%) patients and discordant observations were recorded in 605 patients (35.2%). Most discordant dermatological diagnoses included inflammatory disorders such as lichen planus, atopic dermatitis, bullous pemphigoid; mechanical disorders; nutritional deficiency disorders, and benign neoplasms.Conclusion:Common skin conditions account for a large majority of dermatologic consultations in a hospital setting. Inpatient dermatology consultations improve the diagnostic accuracy.

HPV Vaccination Status and Resolution of Warts in Pediatric Patients.

Background:Warts are a common dermatologic complaint with an increased incidence within the pediatric population. Warts are caused by multiple strains of the human papillomavirus (HPV). There is little research on how a patient's HPV immunization status affects the response to treatment of warts in pediatric patients.Aims:The purpose of this study is to investigate the relationship between HPV vaccination status and wart resolution.Materials and Methods:This is a retrospective chart review that investigates the relationship between response to routine treatment of warts and a subject's HPV vaccination status.Results:There was no significant relationship found between HPV vaccination status and resolution of warts (p = 0.797). However, there was a significant positive correlation between having the HPV vaccine and number of visits for the treatment of warts (r = 0.180, P = 0.024).Conclusion:This study did not show a significant correlation between HPV vaccination status and wart resolution, although it demonstrated a significant positive relationship between those immunized with the HPV vaccine and an increased number of treatment visits. Possible explanations for this unexpected correlation include the variation in HPV vaccine formulation, vaccination status, and frequency of office visits, since vaccinated patients are more likely to be compliant with office visits.

Clinical Pattern and Patch Test Profile of Hand Eczema in Hospital Employees in a Tertiary Care Hospital of North India.

Introduction:Health care workers form an important occupational group with a high risk of hand eczema. All health care professionals are exposed to a variety of allergens and irritants which can cause hand dermatitis, resulting in significant morbidity.Aims and Objectives:To assess the clinical profile of hand eczema in hospital employees, to perform patch test in relevant cases and to find out the most common sensitizers in them.Materials and Methods:This was a cross-sectional, hospital-based study in which the staff was screened for features of hand eczema and patch testing was done in the suspected cases of allergic contact dermatitis.Results:Out of 340 employees screened, 46 employees (13.5%) suffered from hand eczema. The most common type was wear and tear dermatitis accounting for 17 (36.9%) cases, followed by discoid eczema, pompholyx, focal palmar peeling, finger-tip eczema, hyperkeratotic eczema, ring eczema, and unspecified types. Patch testing was positive in 15 (32.6%) cases. The most common allergen was paraphenylene diamine, followed by fragrance mix, nitrofurazone, mercaptobenzothiazole, potassium bichromate, black rubber mix, and thiuram mix. A statistically significant association (0.001) was found with an underlying history of atopy.Conclusion:Hand eczema is a commonly encountered dermatological complaint in many hospital employees. Proper counseling, work, up, patch testing, and treatment can mitigate the symptoms in such employees.

Medical and socioeconomic challenges of private dermatocosmetology clinics during COVID-19 pandemic: A survey from Turkey.

Coronavirus 2019 (COVID-19) disease has rapidly spread worldwide with a multitude effects on daily life. Since the transmission risk increases with close contact, some cosmetic procedures are considered high risk and majority of them had to be postponed or canceled in private dermatocosmetology clinics especially during the heavy period of the outbreak. We aimed to document the medical and socioeconomic problems emerged in dermatocosmetology clinics in Turkey caused by COVID-19 pandemic and to discuss the management strategies taken by dermatologists. This survey research was conducted with 100 dermatologists who work in private dermatocosmetology clinics. The survey included 38 questions about office re-arrangements including patient admission and office environment, safety precautions taken for cosmetic procedures, management of clinic staff, and financial impact of the pandemic. A remarkable decrease in major cosmetic interest was reported in private clinics; meanwhile, there was an increase in applicants for noncosmetic dermatological complaints. The most avoided cosmetic procedures were application of skin care devices, lasers, chemical peeling, and thread lifting, while botulinum toxin injection was the most performed procedure. Nearly half of the participants had severe financial damage. Of the participants, 55% reported that they worked anxiously during this period and 60% believed that they managed the early period of the pandemic successfully. Private dermatocosmetology clinics have to work in a totally different period that they have never experienced before. The pandemic has had serious impacts on both medical and socioeconomic issues which had to be managed carefully.

An Innovative Model for Providing Dermatology Services Within Primary Care.

ObjectiveDermatologic complaints are common in outpatient pediatrics. However, pediatric dermatology specialty care can be difficult to access. We aimed to test the feasibility of co-locating dermatology services within primary care and increase the proportion of patients treated for basic skin complaints within the medical home while decreasing wait times.MethodsThe Rapid Assessment of Skin Health (RASH) clinic was created within a hospital-based primary care clinic in 11/2013. The clinic was staffed by 2 pediatricians trained in the dermatology department and supported with specialist advice as needed. Referral volume and wait times to dermatology and RASH clinic were tracked for visits between 11/1/12 and 10/31/18. A chart review was also conducted on a subset of RASH clinic visits. Primary care providers (PCPs) were surveyed about their experiences.ResultsFifty-eight percent of patients referred for a dermatologic complaint were scheduled in RASH clinic. Wait times for new patient appointments in RASH clinic were significantly shorter than for new dermatology appointments in the previous 12 months (mean 36 days vs 65 days, P < .001). The monthly number of referrals to dermatology also decreased significantly after the RASH clinic opened (24/month vs 12/month, P < .001). Ten percent of RASH patients were referred on to dermatology. In a survey of PCPs (N = 67), 76% said the RASH clinic was “extremely/very helpful.”ConclusionsProviding dermatologic care to low or moderate complexity patients within the medical home is feasible and leads to better access to care. This innovative model could be spread to other clinics and subspecialties.

406TF A RASHonal Approach to the Diagnosis of Dermatologic Emergencies

Dermatologic complaints are common presentations to the emergency department. Though most causes of rash are benign, it is critical that emergency physicians be able to recognize the dermatologic manifestations of critical illness. In 1984 Lynch et al proposed an algorithmic approach to the identification of dermatologic processes, and since then several modified Lynch algorithms have been developed and expanded. This learning module will introduce learners to an established series of algorithms designed to organize and narrow the differential diagnosis of serious rash. Learners will be challenged to sort the classic rashes of many dermatologic diseases using this approach and will practice recognizing the classic rashes of many dermatologic emergencies. This module is intended for medical students and both junior and senior learners in emergency medicine and is designed to be presented at didactic conference. By the end of this learning module, the learner will be able to: 1.) apply a systematic approach to the evaluation of acute dermatologic disease; 2.) categorize the classic rashes of many dermatologic emergencies, utilizing a visual diagnosis approach; 3.) develop pattern recognition in the identification of dermatologic emergencies; 4.) discuss the etiology, presentation, examination, complications, diagnosis and treatment of patients with various dermatologic diseases. This module is a modified team-based learning session. Learners will complete a preparatory self-directed module prior to attending didactic conference that will review the approach to an undifferentiated rash, key elements of the history and physical exam, history/physical red flags, and rash morphology. This will be followed by a short Individual Readiness Assurance Test (IRAT). At the beginning of the didactic session, teams of 5-7 learners with participate in a Team Readiness Assurance Test (TRAT). For the application exercise, pictorial examples of many serious dermatologic conditions will be presented, and teams will compete to correctly identify them. Rashes will be classified into one of four categories (petechial/purpuric, erythematous, maculopapular, and vesiculobullous) and sorted into diagnostic algorithms. The exercise will focus on visual examples in order to develop pattern recognition. Learners will be evaluated by an IRAT, a TRAT, and by a short post-module survey to assess the learner’s subjective ability to identify and manage dermatologic emergencies. Recognizing potentially life-threatening dermatologic disease is a critical skill for the emergency physician. This educational module will provide learners with the tools to promptly recognize the most critical rashes, and to ensure that life-threatening conditions are not overlooked.

Palmoplantar Pustulosis: A Case Report.

IntroductionDermatology complaints account for 3.3% of emergency department (ED) visits per year. Most rashes are benign, but there are a select few that emergency physicians must be familiar with as delay in treatment could be life threatening.Case ReportA well-appearing, 76-year-old male presented to the ED with multiple coalescing pustules to his palms and soles and was transferred to the nearest tertiary care hospital for dermatology consult. He was diagnosed with palmoplantar pustulosis and discharged home with a five-day course of clobetasol propionate 0.05% cream twice daily and outpatient dermatology follow-up.ConclusionPalmoplantar pustulosis is an uncommon skin condition characterized by recurrent eruptions of sterile pustules localized to the palms and soles. Emergency physician awareness of this rare diagnosis may help prevent hospital admissions and lead to earlier initiation of treatment with outpatient dermatology follow-up.

Clinical Outcome of Surgically Treated Leiomyosarcoma of the Extremities: A Retrospective Overview.

This study was interested in extremity leiomyosarcoma with focus on clinical outcome after surgery with or without adjuvant therapy. A retrospective case series of all patients with leiomyosarcoma, surgically treated between 2000 and 2015 and a minimum follow-up of 2 years, was drawn from institutional databases in Belgium and the Netherlands. Postoperative complications were reported with the Radiation Therapy Oncology Group (RTOG) and the Henderson classification. Seventy-five patients were operated on, of whom 47 underwent (neo)adjuvant therapy. Infection was observed in 11 patients, seven associated with (neo)adjuvant radiotherapy. Dermatological complaints were observed in 26 patients, 10 associated with (neo)adjuvant radiotherapy. Overall survival was 60%. Local recurrence occurred in 11 (15%) patients. This study describes favourable clinical outcome following (neo)adjuvant radiotherapy. In the future, larger databases on leiomyosarcoma should enhance the power of these findings and define the benefits of adjuvant therapy in leiomyosarcoma.

Eyelid dermatitis in patients referred for patch testing: Retrospective analysis of North American Contact Dermatitis Group data, 1994-2016

Eyelid dermatitis is a common dermatologic complaint. To characterize patients with eyelid dermatitis. Retrospective analysis (1994-2016) of North American Contact Dermatitis Group data. Of 50,795 patients, 2332 (4.6%) had eyelid dermatitis only, whereas 1623 (3.2%) also had dermatitis of the eyelids and head or neck. Compared with patients without eyelid involvement (n=26,130), groups with eyelid dermatitis only and dermatitis of the eyelid and head or neck were significantly more likely to be female, white, and older than 40years, and to have a history of hay fever, atopic dermatitis, or both (P<.01). Final primary diagnoses included allergic contact dermatitis (eyelid dermatitis only: 43.4%; dermatitis of the eyelid and head or neck: 53.5%), irritant contact dermatitis (eyelid dermatitis only: 17.0%; dermatitis of the eyelid and head or neck: 9.8%), and atopic dermatitis (eyeliddermatitis only: 13.1%; dermatitis of the eyelid and head or neck: 13.8%). Top 5 currently relevant allergens included nickel sulfate (eyelid dermatitis only: 18.6%; dermatitis of the eyelid and head or neck: 22.5%), fragrance mix I (eyelid dermatitis only: 16.5%; dermatitis of the eyelid and head or neck: 18.3%), methylisothiazolinone (eyelid dermatitis only: 16.5%; dermatitis of the eyelid and head or neck: 17.7%), gold sodium thiosulfate (eyeliddermatitis only: 14.7%; dermatitis of the eyelid and head or neck: 11.4%), and balsam of Peru (eyelid dermatitis only: 11.9%; dermatitis of the eyelid and head or neck: 12.6%). Both eyelid-involvement groups were significantly more likely to react to gold sodium thiosulfate, carmine, shellac, dimethylaminopropylamine, oleamidopropyl dimethylamine, and thimerosal (P<.05) compared with the no eyelid involvement group. Lack of specific distribution patterns of eyelid dermatitis and no long-term follow-up data. Patch testing remains a critical tool in evaluating patients with eyelid dermatitis.

Dermatological manifestations in diabetes mellitus

Diabetes mellitus (DM) is the common endocrine disorder, which affects all ages and socioeconomic groups. The prolonged hyperglycemia may responsible for the diabetic complications. Multiple factors contribute to the onset of cutaneous manifestations in diabetes mellitus. The present study aimed tostudy the pattern of various cutaneous manifestations associated with diabetes mellitus.The present study was conducted at Dermatology, Diabetic Clinic of a teaching tertiary care centre hospital. A total of 120 subjects were included in this study. Patients were selected on the basis of dermatological signs and/or symptoms. Detailed history and clinical examination with special emphasis on dermatological complaints and signs was done for all the study subjects. Under aseptic conditions, blood samples were collected and used for the estimation of blood glucose, bacterial infections-Gram stain and isolation of organism by culture, fungal infections- KOH (potassium hydroxide) mount, Gram stain (for Candida) and isolation of organism by culture. Skin biopsies were performed wherever necessary.In the present study, 120 subjects were included from both genders. Pruritus was the predominant symptom observed. Acrochordons, Candidial Balanoposthitis, Tinea Corporis were observed in highest number of patients. Infective dermatoses were observed in 72 (60%) patients. The non-infective dermatoses was reported in 56 (46.7%) patients. On bacterial culture, Pyogenic Ulcer was observed in 4. KOH test and culture were carried on 14 candidal infections and 17 dermatophyte infection and observed KOH mount positive were observed in 11 cases and culture positive was observed in 8 cases.In the present study results indicates pruritus was the most common symptom in diabetic subjects. Infective dermatoses were more common than the non-infective dermatoses. Tinea corporis/cruris was most common clinical entity. 21.6% patients suffered from cutaneous bacterial infections, the most frequently encountered clinical entity being furunculosis. Staphylococcus aureus The commonest non-infective clinical entity was acrochordons(skin tags). Patients with diabetes may develop cutaneous manifestations of diabetic complications. Careful dermatological examination and follow-up of diabetes mellitus patients is required to provide them adequate skin management.

The Retrospective Analysis of Demodex spp. Results in Aydın Adnan Menderes University Faculty of Medicine Hospital Parasitology Laboratory.

Demodex spp. is one of the most common ectoparasites in humans. The aim of the present study is to evaluate the positivity of Demodex spp. in our Parasitology Laboratory, retrospectively. The study included Demodex spp. suspected cases from different departments between 2008 and 2017. The link between Demodex spp. and demographics and symptoms was investigated. In addition, Demodex spp. was evaluated regarding symptoms and distribution pattern (U, T and diffuse region). Demodex spp. was detected in 576 (78%) of 738 cases. There was no relationship between sex and parasite positivity, but frequency was lower in cases below 19 years. There was a relationship between presence of parasite and redness, itching, burning and rash. The parasite density was higher in U region (n=335, 58.2%). When clinical findings and parasite number were statistically compared; itching, burning and rash were significantly higher in patients with parasite density ≥5 parasites/cm2, while a similar result was not observed in patients with redness. Given its prevalence and its relationship with the clinical findings; we believe that Demodex is an important parasitic disease for our province and should be evaluated in cases with various dermatological complaints in the face.

Dermatology in primary care: an audit of the proportion of patients who present to general practice with a dermatological problem that could be self-managed.

A considerable proportion of GPs' workload is dermatological. It is important to investigate what common skin conditions encountered in primary care can be self-managed, in an effort to alleviate the burden on primary care. The purpose of the audit was to identify the proportion of consultations that are dermatological in nature and analyse potential for self-management by patients. Data was collected using the patient electronic record system (EMIS) in general practice. A search was made for all consultations from the 17 April to 15 May 2019, which included all new presenting complaints that were dermatological in nature. The criteria for self-management included advising over the counter (OTC) medication or reassurance. On the other hand, a case was deemed not self-manageable if prescription only medication (POM) was prescribed or if a referral to dermatology was made. There were a total of 2175 consultations, where 246 (11.31%) cases were dermatological. Of the 246, 80 cases (32.5%) could be self-managed. There were 46 different dermatological presenting complaints of which the 5 most common included: rash (51 cases), dermatitis (44 cases), acne vulgaris (13 cases), moles (12 cases), dry skin (11 cases). None of the acne or moles cases could be self-managed, whereas 23%, 68.2%, 72.7% of rashes, dermatitis, and dry skin cases, respectively, could be self-managed. Certain dermatological conditions have more potential for self-management than others. Research into teledermatology as a means of addressing patient concern and providing clinical information is important in order to reduce unnecessary consultations.

Prevelance and Causes of Facial Hyperpigmentation in Egypt: Dermoscopic and Histopathological Study

Abstract Background One of the most common dermatological complaints from patients with skin of color is dyspigmentation, particularly hyperpigmentation. The challenge for clinicians is to establish correct diagnoses along with successful treatments to meet the needs of the increasingly diverse population. Aim of the Work To identify the prevalence and the causes of facial hyperpigmented lesions in Egyptian people by using dermoscope and histopathological examination. Patients and Methods This study is a prospective cross-sectional non-controlled study that included 125 patients with facial hyperpigmentary lesions on the face. The patients were randomly recruited from the outpatient clinic of Dermatology at Ain Shams University Hospitals, during the period from July 2017 till December 2018. Results In our study, 67 patients (44%) had melasma; 25patient (16%) PIH and 23 (15%) patients showed freckles. In addition, SK was diagnosed in 10 patients (6%), phototoxicity in 4 patients (2.5%), 11(7.5%) patient was diagnosed with LPP, riehls melanosis was also diagnosed in 3 patients (2%), 2 patient presented with epidermal naevi (1.8%) and one patient presented with naevus of ota (0.5%) and one with solar lentigo (0.5%). Conclusion Dermoscopic examination can be dignostec in some diseases like SK and it can be helpful the determine the level of pigmentation and to expect the treatment results. And correlation between histopathology and dermoscopy can be helpful to reach the final diagnosis ant to determine the best treatment choice.

Comparative Study of Dermatological Diseases of the Elderly in Relation to the Rest Population.

BackgroundAccording to Eurostat, the geriatric population in Greece constitutes almost 21.8% of the total population, with an increasing tendency. Skin diseases of the elderly often originate from internal medicine diseases. The aim of this study was to identify different dermatological conditions among patients over 65 years of age compared to younger patients.MethodsThe present study was conducted between May 2015 and December 2017 in public medical offices in the Municipality of Thessaloniki. A total of 8422 patients of all ages were screened and their dermatological problem was recorded. The sample was then divided into two age groups. The first group was composed of 3629 elderly patients over 65 years of age. The second group consisted of 4793 patients up to 65 years old.ResultsPruritus was the main dermatological complaint in the elderly (14.2%) compared to the younger age group (1%), who were more interested in their mole examination (15.1%). Precancerous lesions (4%) and skin cancers (2.4%) presented more frequently in elderly patients than in people younger than 65 years old (0.7% and 0.5%, respectively).ConclusionThere are significant differences in the frequency and etiology of dermatological diseases between the two age groups. Pruritus and non-cancerous tumors of the elderly are considered to be the main findings of geriatric dermatology.

Pupillary Membrane Persistence in a Feline

Background:Pupillary membrane persistence (PMP) is a congenital abnormality, which is not usually reported in felines. It is characterized by remnants of the fetal membrane that persist as filamentous tissue across the pupil. In general, this change does not cause any clinical symptoms. However, the filaments may either attach to the cornea and cause small opacities in it or attach to the lens and cause cataracts. In most cases, there is no visual impairment, so treatment is not prescribed. This report aims to describe a case of PMP in a domestic cat diagnosed at the Veterinary Hospital of the State University of Santa Cruz (HV-UESC). Case: A two-and-a-half-year-old mixed-breed castrated male cat was brought to the HV-UESC with dermatological complaints. Upon physical examination, the animal was alert with a body temperature, heart, and respiratory rate within the normal parameters for the feline species. The lymph nodes were non-reactive, and the coloration of the oral mucosa was normal. There was no ophthalmic complaint from the owner, nor any loss of visual acuity. In addition, the animal had moderate pruritus, redness, and alopecia in the region of the ears, head, neck, chest, and back. Bristle samples were collected for an optical microscope analysis and an infestation with lice (Felicola subrostratus) was confirmed. An endectocide containing selamectin (15 mg; single application every 30 days) was prescribed. During physical examination, filamentous tissue crossing from iris to iris through pupil was observed in both eyes. The eyelid, corneal, and pupillary reflexes were within normal ranges. An ophthalmic evaluation did not identify conjunctival hyperemia or episcleral vessel congestion, and the eyelid, corneal, and pupillary reflexes were determined to be within the normal range. A slit-lamp biomicroscopy did not detect any anterior chamber alteration besides the filamentous tissue previously mentioned. An examination of the fundus of the eye by direct ophthalmoscopy revealed that the crystalline lens, retina, optic nerve, and retinal vessels all looked normal with no other ophthalmic alteration. Thus, the diagnosis was PMP, and because of the absence of visual impairment or any other ophthalmic abnormality, no treatment was initiated. Discussion: Feline PMP is a rare condition. Since the present case, a few studies about this alterations in cats were found in the literature about. As in cats, this ophthalmopathy is uncommon in horses and cattle. The present report describes a case of PMP, a poorly described alteration in veterinary medicine, which was diagnosed by ophthalmic examination and slit-lamp biomicroscopy. As reported previously, PMP was an incidental finding during physical examination, since most animals with this alteration present little impairment of visual acuity. However, in some cases, membranous filaments may attach to the cornea and/or lens causing opacities and/or cataracts that may result in vision defects. This did not occur in the present case. In previous studies too, other ophthalmic alterations beyond PMP were not observed, thus corroborating the findings of our case. In the present case, as there were no other ophthalmic changes, it was not necessary to initiate any type of treatment. In conclusion, the lack of information regarding the epidemiology of PMP in cats warrants further studies of this alteration. Although infrequent in cats, this condition can easily be diagnosed in the routine examinations of this species.

Depression mediates cutaneous body image and facial appearance dissatisfaction in insomnia

This study examined the relationship between dissatisfaction with cutaneous body image and facial appearance with symptoms of insomnia whilst incorporating the mediating role of anxiety and/or depression after accounting for co-morbid sleep disorder symptoms. Participants (n = 241) completed online measures assessing insomnia symptoms, anxiety and depression symptoms, and satisfaction with cutaneous body image and facial appearance. Symptoms of insomnia were independently related to greater dissatisfaction with cutaneous body image and facial appearance in univariate analyses. However, linear regression analyses determined these relationships to be partially mediated by depression, but not anxiety. Expanding on prior research, these findings suggest that whilst increased symptoms of insomnia may influence dissatisfaction with cutaneous and facial features, these relationships may be partially attributed to the experience of depressive symptoms often co-morbid with both insomnia and dermatological complaints. Treatment approaches for individuals with insomnia may benefit from targeting and improving negatively appraised aspects of physical self-perception.

Classification and characteristics of periorbital hyperpigmentation.

Periorbital hyperpigmentation (POH) is among the commonest esthetic and dermatological complaints. Despite its frequency, there are inadequate information detailing its incidence and prevalence. This subsequently leads to lack of comprehensive POH classification and stratification of impact on an individual's general well'being. Malaysia, a multiracial country with an expansive expatriate population, provides a unique opportunity to identify demographics of POH and subsequently attempts to group this esthetic and dermatological entity. This study aims to develop a new and clinically relevant POH classification system and to measure impact on quality of life of POH individuals. One hundred patients with POH were enrolled, of which all underwent clinical assessment by a clinician. Objective assessment with mexameter and digital analysis were performed. All recruited patients also completed a questionnaire based on dermatology life quality index (DLQI). Assessments noted the commonest type of POH among the subjects was vascular (51%) with the least being pigmentary (6%). The location of POH majority involved both the upper and lower eyelids (65%). DLQI scoring shows that a majority (58%) did not disrupt their quality of life. Vascular type POH was the frequent most form observed, and involvement tends to occur on both eyelids. A majority of noted that POH does not affect they QOL, but the due consideration must be given in those whom are moderately and minimally affected. A thorough and comprehensive holistic approach is required in managing POH despite its focal presentation as it does affect a patient's quality of life.

Changes in dermatological complaints among healthcare professionals during the COVID-19 outbreak in Turkey

This questionnaire study evaluates dermatological complaints that may arise due to hygiene measures and anxiety among healthcare professionals (HCPs) during the COVID-19 outbreak. A total of 526 volunteers, consisting of doctors and nurses, participated. Demographic features, personal hygiene behavior, personal protective equipment (PPE) use, Hospital Anxiety and Depression Scale-Anxiety (HADS-A) parameters, and symptoms of various dermatological diseases (xerosis, eczema, acne, hair loss, palmar hyperhidrosis, xeromycteria, urticaria, aphthous stomatitis, and seborrheic dermatitis) were investigated. Although the frequency and severity of many dermatological complaints increased during the pandemic period, the most frequent increase was observed in the frequency of complaints suggesting xerosis and eczema. We found that complaints suggesting xerosis and eczema were seen on the hands 2.44 and 3.57 times, respectively, as a result of washing hands 10 times/day, and that handwashing times of 10 seconds or more significantly increased the risk of eczema (5.44 times). Another remarkable result was a fivefold increase in acne complaints among those using any mask. The severity of all complaints except hair loss and seborrheic dermatitis correlated significantly with HADS-A. Our study showed that the frequency and severity of some dermatological complaints increased in HCPs.

Skin diseases in geriatrics and their effect on the quality of life: A hospital-based observational study.

Background:World's population is aging at a very fast pace with 8.5% of current population being aged 65 years and above. Indian figures also reflect the exponential growth in number of older people. With advancing age a myriad of health-related problems arise. Due importance is given to diseases associated with high mortality such as malignancies, diabetes, and cardiovascular illness. However, skin diseases though being prevalent lack priority. This study is being conducted to identify the common geriatric dermatoses prevalent in sub-Himalayan region of Uttarakhand and also to assess their effect on the quality of life.Aims:The aims of this study are to study the pattern and frequency of dermatoses in patients aged 60 years and above and to assess the effect of dermatoses on their quality of life.Methods:In total, 117 patients aged 60 years and above presenting to Dermatology outpatient department were recruited from 1st August 2018 to 31st October 2018 after obtaining written informed consent. Socio-demographic details, presence of co-morbidities, and dermatological complaints were recorded on a data collection form. Skin diseases were categorized into seven categories for statistical analysis. For assessing the effect of dermatoses on the quality of life of participants, Dermatology Life Quality Index was administered.Results:Out of 117 patients, two-thirds were males. Mean age of patients was 68.60 ± 7.011. Out of total, 40% patients had one or more comorbidity. Erythemato-squamous disorders were the commonest dermatoses seen in 40% patients. This was followed by infections and infestations (33.3%). In total, 17% patients had senile pruritus and age-related skin disorders. Around 16% reported moderate to large effect on their quality of life.Conclusion:Skin diseases are an important cause of psycho-social morbidity among geriatric population. Their special needs must be addressed by making appropriate changes in national health policies. It is imperative to include skin health as a component to assess the overall wellbeing of geriatrics.

Dientamoeba fragilis Dost mu, Düşman mı? İstanbul’dan farklı Kohortlara Ait Hasta ve Sağlıklı Bireylerle Yürütülen Bir Çalışma

Objective: Dientamoeba fragilis is an intestinal protozoan found in colonic lumen and it has been demonstrated that it can lead to various gastrointestinal and dermatological complaints. It has been discussed lately that D. fragilis can be found also in high prevalence among healthy individuals and could be a member of healthy gut microbiota. The aim of this study was to compare the prevalence of D. fragilis between patient and healthy-control groups from Istanbul, and to study clinical outcomes of the infection it causes on the patient group ,and patient characteristics. Method: Stool samples of 184 patients admitted to Acıbadem Health Group hospitals in Istanbul between 2016-2018, and 156 healthy controls were examined in the study. After microbiological and parasitological assessments of stool samples, DNA isolation was made followed by conventional PCR test using specific primers. Results: D. fragilis was detected in 15 of 184 (8.2%) patients and 42 of 156 (26.9%) controls, and the intergroup difference was significant (p&lt;0.05). In the study group Salmonella spp. was detected in 3, and Rotavirus in 1 of the D. fragilis positive individuals. Six out of 15 D. fragilis positive individuals in the study group were women and their average age (n=24.3) was higher than other groups (p=0.25). Fifty-five of 57 (96.5%) D. fragilis positive individuals were in the pediatric age group. The leading complaints were diarrhea, anorexia and abdominal pain, while 3 of the 15 patients reported itching and urticaria. Conclusion: These preliminary results related to the metropolitan city of Istanbul tend to support the fact that D. fragilis may show pathogenic effects in some cases but it is more common among healthy individuals. Considering the similar results from different regions of the world, further studies are essential to unveil under which conditions D. fragilis is silent (friend) and acts as a pathogen (foe).