Palmar eritem avuç içlerinde simetrik yerleþimli kýzarýklýkla kendisini gösteren bir durumdur. Çok farklý nedenlerle ortaya çýkabilen ve sýk görülen bir durumdur. Çoðu kez asemptomatik olarak seyreder ve zaman zaman saðlýklý bireylerde de yapýsal bir özellik olarak görülebilir. Etyolojisinde sistemik hastalýklar, ilaçlar, kimyasallar, neoplaziler, infeksiyonlar rol oynamaktadýr. Çoðu kez göz ardý edildiðini düþündüðümüz palmar eritemin eþlik ettiði patolojilerin gözden geçirilmesi, deðiþik formlarýnýn tanýmlanabilmesi ve bu yakýnmayla baþvuran hastalara yaklaþýmda rehber olabilmesi amacýyla bu derleme hazýrlanmýþtýr.

Palmar erythema is a clinical sign presenting with symetrical erythema of both palms. It is usually asymptomatic and may seldom be seen in healthy individuals. Systemic diseases, drugs, chemicals, neoplasms and infections may play a role in the etiology. We prepared this review on palmar erythema, an issue which we believe is usually clinically underestimated, in order to view associated pathologies, to describe different forms and to be a guide in patient assessment.

AMAÇ: Fototrikogram (FTG), saç hastalýklarýnýn tanýsýnda kullanýlan yarý invaziv bir metoddur. Bu çalýþmada, uzun süreli saç dökülme þikayeti olan 55 kadýn hastadaki FTG bulgularý araþtýrýldý. GEREÇ-YÖNTEM: Hastalar Ludwig sýnýflamasý ve saç çekme testine göre üç gruba ayrýldý. Hem midskalp hem oksipital bölgelerine dermoskopa baðlanan dijital kamera yoluyla FTG uygulandý. Saç dansitesi, ince ve uzamayan saç yüzdeleri hesaplandý. BULGULAR: Hastalarýn 14’ü AGA, 10’u saç çekme testi(+), 31’i saç çekme testi(-) idi. AGA grubunda saç dansitesi midskalpte oksiputa göre anlamlý olarak düþükken, ince ve uzamayan saç yüzdeleri yüksekti. Saç çekme testi(+) grupta saç dansitesi midskalpte oksiputa göre anlamlý olarak yüksekken, saç çekme testi(-) grupta uzamayan saç yüzdesi yüksekti. Midskalpte saç dansitesi AGA grubunda diðer iki gruba göre anlamlý olarak düþükken, ince saç yüzdesi yüksekti. Midskalpte uzamayan saç yüzdesi AGA ve saç çekme testi(+) grupta, saç çekme testi(-) gruba göre anlamlý olarak yüksekken, oksiputta saç çekme testi(+) ve saç çekme testi(-) grup arasýnda anlamlý fark vardý.
SONUÇ: FTG, tek baþýna taný koydurucu deðildir. Üç parametrede de standart sapmalarýn yüksekliði, normal deðerden bahsetmeyi imkansýz kýlar. Ýki bölge karþýlaþtýrýlarak yapýlacak FTG, erken dönem AGA da taný koymaya yardýmcý olabilir.

Backgorund and Design: The phototrichogram (PTG) is a deminvasive test to define hair loss. In this study, PTG findings in 55 women complaining of hair loss for a long time were examined. MATERIALS-METHODS: The patients were divided into three groups according to Ludwig classification and hair pull test. FTG was applied to the patients’ midscalp and occipital regions by digital camera attached to a dermoscope. Hair density, percentages of thin hair and non-growing hair were estimated. RESULTS: Fourteen of patients were AGA, 10 were hair pull test (+), 31 were hair pull test (-). In AGA group while hair density was statistically lower on the midscalp than occiput, percentages of thin hair and non-growing hair were higher. In hair pull test (+) group, hair density was higher on the midscalp than occiput. In hair pull test (-) group, percentage of non-growing hair was higher. On the midscalp, while hair density was statistically lower in AGA group than the other groups, percentage of thin hair was higher. On the midscalp percentage of non-growing hair was statistically higher in AGA group and hair pull test (+) group than hair pull test (-) group. On the occiput there was statistically difference between hair pull test (+) group and hair pull test (-) group. CONCLUSION: PTG alone isn’t enough diagnostic tool. Because standart deviations of three parametres are high, their normal value can not be mentioned. PTG done by comparing two regions can be helpful to diagnose early AGA.

AMAÇ: Esansiyel hiperhidroz kesin etyolojisi bilinmeyen aþýrý terleme bozukluðudur. Ayný zamanda psikiyatrik yönü önemli bir hastalýktýr. Özellikle sosyal anksiyete bozukluðunun önemli bir parçasý olmasýna karþýn psikiyatrik yaklaþýmlar sýnýrlýdýr. Çalýþmamýzda esansiyel hiperhidrozlu olgularýn sosyal fobik kaygý ve kaçýnma düzeyleri ile durumluk ve sürekli kaygý derecelerinin saðlýklý kontrol bireylerle karþýlaþtýrýlmasý amaçlanmýþtýr.
GEREÇ-YÖNTEM: Yirmi altý esansiyel hiperhidrozlu ve 22 kontrol grubunda sosyal ortamlarda fobik kaygý ve kaçýnma düzeyleri ile durumluk ve süreklilik kaygý dereceleri ölçülmüþ ve karþýlaþtýrýlmýþtýr.. BULGULAR: Hastalar 26 (E/K: 11/15) ve kontrol grubu ise 22 (E/K: 11/11) kiþiden oluþmaktadýr. Hasta grubunda Liebowitz sosyal fobi ölçeði, kaygý düzeyleri 24–74 (47.1±11.5) arasýnda ve kaçýnma düzeyleri 24–80 (44.1±11.5) puan arasýnda deðiþmekteyken kontrol grubunda sýrasýyla 26–66 (43.0±13.4) ve 26–83 (41.5±13.3) puan arasýnda saptandý. Hasta grubunda durumluk kaygý puaný 23–58 (39.7±7.1) arasýnda, süreklilik kaygý puaný 42-59 (49.6±4.5) arasýnda, kontrol grubunda ise sýrasýyla 21–66 (36.2±11.3) ve 29–71 (43.3 ± 10.5) puanlar arasýnda bulunmuþtur.
SONUÇ: Kiþinin içinde bulunduðu koþullardan baðýmsýz olarak kendini nasýl hissettiðini ölçen sürekli kaygý düzeyi hiperhidrozlu grupta saðlýklý gruba göre anlamlý yüksek saptanmýþtýr. Bu sonuç bize esansiyel hiperhidrozun psikolojik yanlarý olan dermatolojik bir hastalýk olabileceði izlenimini vermektedir.

Background and Design: Essential hyperhidrosis is a disorder without obvious etiology. At the same time, hyperhidrosis is a disease with considerable psychological features. Although it is particularly an important part of social anxiety, psychiatric approaches are limited. In this study, we aimed to compare the scores of social phobia, anxiety and avoidance levels and state and trait anxiety points of essential hyperhidrosis with healthy individuals. MATERIALS-METHODS: The scores of social phobia, anxiety and avoidance of 26 patients with essential hyperhidrosis and 22 healthy individuals were measured.
RESULTS: The patient group and control group are consisted of 26 (M/F: 11/15) and 22 (M/F: 11/11) individuals, respectively. In patient group Liebowitz social phobia scores, anxiety and avoidance levels were being changed with between 24–74 (47.1±11.5) and 24–80 (44.1±11.5) points, respectively. In control group the points were between 26–66 (43.0±13.4) and 26–83 (41.5±13.3). State and trait anxiety points were 23–58 (39.7±7.1) and 42-59 (49.6±4.5) in patient group, 21–66 (36.2±11.3) and 29–71
(43.3 ± 10.5) in control group, respectively. CONCLUSION: Trait anxiety levels were statistically higher in hyperhidrosis group than healthy controls. So we should suggest that hyperhidrosis is a dermatologic disease with psychological features.

AMAÇ: Otolog serum testinin (OST) otoimmün ürtiker tanýsýnda önemli bir rol oynadýðý bilinmektedir. Bu çalýþmada OST ve hücresel immünite belirleyicilerinin iliþkili olup olmadýklarýný araþtýrdýk. GEREÇ-YÖNTEM: Bu amaçla 68 hasta ve 37 kontrol grubuna OST ve tüberkülin deri testi (TDT) uygulandý ve T-lenfosit alt gruplarý ölçüldü. BULGULAR: OST kontrol grubuna göre ürtikerli hastalarda anlamlý olarak pozitif bulundu. TDT yanýtý 32 hastada pozitifti. T-lenfosit alt gruplarý CD4: %41.3±3.4, CD8: %34±6.5, CD4/CD8: %1.2, CD3: %66±8.8 þeklindeydi. SONUÇ: Sonuç olarak kronik ürtiker hastalarýnda OST’nin, TDT yanýtý ve T-lenfosit alt gruplarý ile iliþkili olmadýðýný belirledik.

Background and Design: It has been demonstrated that the autologous serum skin test (ASST) has an important role in clinical test for detection of autoimmune-based urticaria. The aim of this study was to evaluate the ASST and cell immunity modifiers.
MATERIALS-METHODS: We examined 68 patients and 37 control subjects, performed ASST and tuberculin skin reactivity (TST) and measured T-lymphocyte subsets.
RESULTS: ASST was significantly positive in urticaria patients compared to control subjects. Thirty-two patients had positive TST reactivity. T-lymphocyte subsets were as follows: CD4: %41.3±3.4, CD8: %34±6.5, CD4/CD8: %1.2, CD3: %66±8.8. ASST was not related to the TST reactivity and T-lymphocyte subsets. CONCLUSION: These data provided that ASST does not seem to be associated with TST reactivity and T-lymphocyte subsets.

AMAÇ: Bu çalýþmada çeþitli benin, premalin ve malin deri lezyonlarýnda proliferasyon belirleyicilerinin rolü ve bu lezyonlarda insan papilloma virusu (HPV) pozitifliðinin saptanmasý amaçlandý. GEREÇ-YÖNTEM: Çalýþmaya, parafin bloktaki 62 doku [12 seboreik keratoz (SK), 10 keratoakantom (KA), 8 aktinik keratoz (AK), 22 bazal hücreli karsinom (BHK) ve 10 skuamöz hücreli karsinom (SHK)] alýndý. Doku örnekleri, Ki-67, p21 ve bcl-2 ekspresyonunu belirlemek amacýyla, immünohistokimyasal yöntemle çalýþýldý. HPV DNA’sýný tespit etmek için PCR uygulandý. BULGULAR: BHK tanýsý almýþ olan iki dokuda HPV (tip-16) pozitifliði saptandý. Lezyonlarda Ki-67, p21 ve bcl-2 ekspresyonu sýrasý ile þu þekildeydi: KA

Background and Design: This study was designed to investigate the role of proliferation markers in various benign, premalignant and malignant skin lesions and also aimed to detect HPV positivity in these lesions. MATERIAL-METHOD: A total of 62 paraffin blocks [12 seborrheic keratoses (SK), 10 keratoacantoma (KA), 8 actinic keratoses (AK), 22 basal cell carcinoma (BCC), and 10 squamous cell carcinoma (SCC)] were included in the study. Specimens were studied immunohistochemically for the expression of Ki-67, p21 and bcl-2. PCR was performed to detect HPV DNA. RESULTS: HPV positivity was detected in two tissues of BCC (HPV type-16). In the lesions, the Ki-67, p21 and bcl-2 expressions were found to be increased respectively: KA

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Multipl endokrin neoplazi tip 2B (MEN 2B) medüller tiroid kanseri, feokromositoma ve mukozal nöromlarla karakterize otozomal dominant geçiþli nadir bir sendromdur. MEN 2B’nin en belirgin özelliði olgularýn hemen hemen hepsinde görülen multipl mukozal nöromlardýr. Genellikle asemptomatik olan bu benin lezyonlar çoðunlukla doðumda veya ilk birkaç yýl içinde görülür. Burada dil üzerindeki mukozal nöromlarý 5 yýl önce geliþen 50 yaþýnda bir kadýn ile 2 yýl önce geliþen 29 yaþýnda bir erkek olgu sunulmaktadýr. Kadýn olguda serum kalsitonin düzeyi hafif yüksek bulunurken, erkek olguda adenomatöz hiperplaziye baðlý nodül saptandý. Hastalar MEN 2B’nin geliþebilecek diðer bulgularý açýsýndan takibe alýndý.

Multiple endocrine neoplasia type 2B (MEN 2B) is a rare autosomal dominant process characterized by medullary thyroid carcinoma, pheochromocytoma and mucosal neuromas. Multiple mucosal neuromas are considered the pathognomonic feature of MEN 2B and are observed in almost all patients. These benign lesions are usually asymptomatic and often present at birth or in the first few years of life. We describe a 50-year-old woman and a 29-year-old man with mucosal neuromas on the tongue that appeared 5 and 2 years ago, respectively. Screening for MEN 2B showed slight elevation in serum calcitonin levels in one of the patient while a nodule associated with adenomatous hyperplasia was observed in the other. Follow-up visits were established for the appearance of other manifestations of MEN 2B.

Granulom anulare genellikle anüler yerleþimli papüllerle seyreden, sýk görülen bir deri hastalýðýdýr. Klinikte lokalize, jeneralize, subkutan ve perforan tiplerde görülür. En sýk görülen lokalize form tipik olarak el ve ayaklarda yerleþir. Literatürde ekstremiteler ve gövdede eritemli plaklarla mikozis fungoidesi taklit eden ve histolojik olarak interstisyel granulom anulare bulgularý gösteren yama tarzý granulom anulare olgularý bildirilmiþtir. Burada karýn alt kýsmýnda intersitisyel histiyositik paternde yama tarzý granulom anuleri olan 70 yaþýnda bir kadýn olgu sunulmaktadýr.

Granuloma annulare is a common skin disorder that usually presents with papules arranged as annular plaques. It has varying clinical presentations including localized, generalized, subcutaneous, and perforating forms. The localized form of granuloma annulare is the most common one and typically arises on the hands and feet. In the literature there have been reports of patch granuloma annulare that resembles mycosis fungoides with erythematous plaques on the extremities and trunk, and shows the histologic features of interstitial granuloma annulare. We report a 70-year-old woman with patch granuloma annulare on the lower part of her abdomen revealing an interstitial histiocytic pattern.

Aplazia kutis, lokalize epidermis, dermis ve subkutan doku yokluðuyla karakterize nadir görülen bir malformasyondur. Nadiren lezyonla ayný bölgede kas ve kemik gibi alt dokularda hipoplazi veya aplazi olabilir. Aplazia kutis vakalarýnýn %85’i saçlý deri, %15’i diðer lokalizasyonlarda görülür. Burada, 3 yaþýndaki kýz çocuðunda geç tespit edilen, aplazia kutis lezyonuna eþlik eden abdominal duvar defekti olgusu sunulmaktadýr. Aplazia kutis skar lokalizasyonunda abdominal herniasyonla baþvuran hastada, hipoplastik abdominal duvar komputerize tomografiyle gösterilmiþtir.

Aplasia cutis is a rare malformation characterized by localized absence of epidermis, dermis and subcutaneous tissue. Muscle and bone tissues beneath the lesion may rarely be hypoplastic or aplastic as well. Eighty-five percent of aplasia cutis cases are found in the scalp and fifteen percent of all cases involve other locations. Here, a 3 year old girl who has a recently detected abdominal muscle hypoplasia during evaluation of abdominal hernia beneath an aplasia cutis lesion is presented.