An English scientific presentation in front of audience is not always so easy. Practice and pre-preparation will improve and sharpen your presentation skills. In this article, helpful hints will introduce to help in preparation and delivery of a scientific talk. Early preparation and practice are the key points to make a good international talk. This article may help residents in dermatology training who are the first time english language presenter. A good talk should be informative and focused on subject. A good delivery with supportive slides is another important point. A general rule is to finish the talk on time. Practice is only defense against making major errors in calculating the actual time of your talk. The purpose of this article is to offer some guidelines for preparing an excellent english talk for the young residences.

Alternative medicine is defined as the methods used independently or instead of conventional medicine, but the complementary medicine is mainly used to describe methods used in conjunction with or to comlement the conventional medical therapies.It is known by many of dermatologists that a lot of patients with dermatological problems try to use complementary and alternative medical methods because of having no cure with the conventional medical treatments. Complementary and alternative medical condition in our country was analysed and the recipe suggestions were discussed in this review.

Background and Design: Most patients with dermatological complaints first present to their general practitioners. In the present study, we aimed to investigate the experiences of primary care physicians on dermatological diseases and their opinions of undergraduate education.
Materials and Methods: A questionnaire composed of 15 questions was prepared and was completed by practitioners working in family and community health centers.
Results: We included 124 out of 142 practitioners working in family and community health centers in Denizli. Sixty-five practitioners responded the questionnaire. It was recorded that health screening in schools and/or public education were performed as preventive dermatology in 42.8% of the institutions that the practitioners were working in. The most frequent diseases encountered were eczema (37.1%), mycosis (22.7%), urticaria (10.3%), acne (7.2%) and psoriasis (6.9%), respectively. It was determined that practitioners were in need of dermatoscopy among the procedures that are not used routinely by practitioners and in need of education for potassium hydroxide and Wood lamp examination among the procedures that can be used by practitioners easily. It was found that the average dermatology training period for general practitioners was 3.5±2 weeks and most practitioners stated that this duration was insufficient. On-the-job training (median score 8.5), giving place to primary care institutions during education period (median score 8.1), giving place to dermatology during internship (median score 7.8) and case discussions (median score 7.8) were the education facilities that were reported to contribute mostly to postgraduate practical approach.
Conclusion: The present study establishes very important data about practitioners’ approach to patients with dermatological complaints. Practitioners’ opinions of undergraduate education are also of importance because the suggestions were made according to postgraduate experiences.

Background and Design: Henoch-Schonlein purpura is affected often the skin, joints, gastrointestinal tract and kidneys and common systemic vasculitis of childhood. Henoch-Schonlein purpura are many and varied symptoms, also it was followed in children policlinics and hospitalized diseases for an important role. We aimed to determination of the patients with Henoch-Schönlein purpura by examination of their clinical analyses.
Material and Method: The medical records of 212 patients with Henoch-Schönlein purpura in our polyclinics have been retrospectively studied. These patients were analyzed age groups, diagnosed seasons, held systems, laboratory findings, the treatments, complications and prognosis. SPSS 13 statistical software package was used for data analysis.
Results: The mean age of the patients was 9.33±3.20 years. The disease was more frequently demonstrated in fall and winter seasons. There was no statistically assosiation between age groups with season, joint involvement, central nerveous system involvement, gastrointestinal system involvement and scrotal involvement but there was a positive correlation between age groups and renal involvement.
Conclusion: The treatment duration increases with the age of the patient and the necessity to use a combined treatment (antihistaminic, non-steroid anti-inflammatory treatment and steroids) increases.

Background and Design: In this study, we aimed to evaluate the effects of a formula composed of millet extract, wheat germ oil, calcium pantothenate and L-cystine in women with diffuse alopecia by using Digital Phototrichogram (Trichoscan).
Materials and methods: We evaluated female patients who presented to Gazi University Faculty of Medicine Department of Dermatology between January 2008 and November 2008 with the complaint of diffuse hair loss. Digital phototrichogram was performed in the frontal and occipital regions of the patients. Using this method, anagen: telogen ratios were determined. 53 female patients whose ages were between 18 and 50 and who were diagnosed as having telogen effluvium type diffuse alopecia were included in the study. The patients were given a capsule containing 140 mg millet extract, 271 mg wheat germ oil, 2 mg L-cystine and 10 mg calcium pantothenate three times a day for three months. The criteria for assessing the efficacy of the therapy included number of hair loss per day, hair pull test and digital phototrichogram.
Results: The reduction of daily average hair loss after the treatment was statistically significant. Statistically significant difference was found between the pre- and post-treatment results of the hair pull test. Before the treatment, the average anagen ratio was determined to be 69.0±11.2 in the frontal region, and 72.3±9.4 in the occipital region. After the treatment, the anagen ratio increased to 76.4±11.2 in the frontal region and to 79.9±8.6 in the occipital region. The increase in the anagen hair rate in the frontal and occipital regions after the treatment was found to be statistically significant.
Conclusion: As a result, it was found that the formula composed of millet extract, wheat germ oil, L-cystine and calcium pantothenate may be effective in the treatment of telogen effluvium. However, controlled studies including larger groups of diffuse alopecia patients and placebo groups are needed.

Background and Design: Epidermal growth factor receptor (EGFR) inhibitors may cause different adverse cutaneous reactions including acneiform (pustular, papulopustular) eruption. Rarely, other specific targeted cancer therapy agents may cause similar pustular eruptions. The aim of this study was to evaluate the adverse skin reactions, mainly acneiform eruptions caused by these chemotherapeutic agents.
Material and Methods: We retrospectively analyzed the data of 23 patients who developed acneiform eruption due to chemotherapeutic agents between May 2007 and April 2011. The drugs causing acneiform eruption, clinical features of eruption, other associated dermatologic adverse reactions and the treatment modalities used for the acneiform reaction were noted.
Results: EGFR inhibitors such as erlotinib and cetuximab were the main drugs causing acneiform eruption in 21 patients. Everolimus and bevacizumab in combination with irinotecan were responsible in two patients. The eruption occurred on the face in all patients. The trunk, neck and the scalp were other affected body parts in some patients. The periorbital area on the face was generally spared. Xerosis and paronychia were the main associated adverse cutaneous reactions. Trichomegaly was another finding in two patients. The patients, who could have been followed, responded to topical or systemic antibiotics, or some medications for acne vulgaris/rosacea. Chemotherapy could be continued in all patients.
Conclusion: Dermatologists need to know the specific eruptions occurring with chemotherapy drugs, especially EGFR inhibitors in order to develop the best approach without discontinuation of cancer therapy. Acneiform eruptions due to chemotherapeutics are most commonly seen on the face sparing periorbital area. Other reactions including mainly xerosis, paronychia and trichomegaly can also occur.

Background and Design: Acne scars on the face are still an important cosmetic problem. In this study, we aimed to determine the efficacy and safety of intradermal injections of autologous fibroblasts for the treatment of acne scars.
Materials and Methods: This was an open, prospective, phase 3, pilot study. Six adults with acne scars (4 male, 2 female; age range: 21- 35 years) were included in this study. Autologous cultured fibroblasts (20 million/ml) were given as two doses administered with two weeks interval. Efficacy evaluation was performed 2, 4, 6, and 12 months after the first injections. Subjective improvement scores were noted by patient and clinicians at every follow-up visit.
Results: An improvement in acne scars of more than 50% was observed in two of the 6 at 6 months while five of the 6 patients and clinicians also noted 50% to 75% improvement with the treatment at 12 months. The best results were obtained at 12 months. No serious side effects were detected.
Conclusion: In this pilot study, intradermal injections of autologous fibroblast were found to be effective and safe for acne scars.

Background and Design: There are numerous therapeutic methods for hair removal with various success rates. The aim of this study was to evaluate the efficacy of Intense Pulse Light (IPL) method for hair removal.
Materials and Methods: Ninety patients, who applied for their unwanted hair, were included in the study. IPL was applied to the face, neck, axillary areas, bikini line, sternal area, periareolar areas, and upper and lower extremities. An IPL device (L900 A&M, France) was used for hair removal. The results were evaluated according to the clinical improvement (0-25%, 25-50%, 50-75%, 75% and more) and patients’ satisfaction (very satisfied, satisfied, less satisfied, not satisfied). All results were analyzed using Chi-square test and statistical analysis was performed by SPSS 15.0 for Windows.
Results: There were eighty-eight female (97.8%) and two male (2.2%) patients. The mean age of the patients was 33.62±11.11 (15- 55) years. 13.3% of patients had polycystic ovary syndrome. The mean number of treatments was 6.5 (min-max= 2-11). 53.2% of patients had 50-75% clinical response and 53.2% of patients were satisfied. There were no side effects except mild erythema.
Conclusion: We observed that IPL for hair removal was safe and moderately effective in our patients.

Merkel cell carcinoma is a rare, aggressive, malignant cutaneous tumor. It usually appears on the sun-exposed areas such as the head and neck in the elderly. A 72-year-old female patient was admitted to our clinic with the complaints of a big mass on her face. She described that the mass on her left cheek rapidly grew in three months. Her family and own medical history was unremarkable for skin cancers. On physical examination, there were no pathological findings except for a palpable submandibular lymphadenopathy. Dermatological examination revealed a giant tumoral lesion 9x9 cm in diameter, containing crusted and ulcerated areas on her left cheek. Histopathological examination of the specimen obtained from the lesion showed a neoplastic infiltration consisting small, atypic cells with big, round, hyperchromatic nucleus, narrow cytoplasms, and prominent nucleoulus in some areas, showing high mitotic activity. The neoplasm, which had apoptotic bodies and necrobiosis, also invaded the full thickness of the skin, and the epidermis was very thin. In immunochemistry, CK20 was strongly positive, S100 was focally positive, and EMA was positive, while synaptophysin, chromogranin, vimentin, CD3, CD20, as well as CD45, and CD99 were all negative. Based on these findings, the patient was diagnosed as having Merkel cell carcinoma. On the systemic screening for metastases, nodular lesions in the lungs compatible with metastases were detected on computed tomography. By the consultations with plastic and reconstructive surgeons and oncologists, she was accepted as inoperable and etoposide monotherapy was administered. In this report, we aimed to underline the importance of early diagnosis while presenting a case of giant Merkel cell carcinoma which shows an aggressive progression with lung metastases.

Lichen planus pemphigoides (LPP) is a disease characterized by tense bullae arising on lichen planus papules and on clinically uninvolved skin, lichenoid infiltration and subepidermal bulla in histopathology, and linear deposits of IgG and C3 along basal membrane zone on direct immunofluorescence. This rare bullous dermatosis is usually idiopathic. However, in a few cases in the literature, it has been reported to be induced by hepatitis B, malignancies, phototherapy and some medications such as ramipril, captopril, cinnarizine and simvastatin. We reported a 35-year-old woman with LPP possibly induced by bisoprolol.

Impetigo herpetiformis (IH), if left untreated, is associated with a high rate of perinatal morbidity and mortality and may lead to the decision of termination of pregnancy. There are various and effective therapeutic agents available for the treatment of the disease. A 23-year-old woman with a history of plaque psoriasis presented with a sudden generalized pustular eruption on the 25th week of her first gestation. The diagnosis was made based on the clinical and histopathological findings. The patient was treated with systemic prednisolone (2 mg/kg/d) first and, cyclosporine A (3 mg/kg/d) was added to the treatment after two weeks because prednisolone was not effective alone. The lesions did not regress despite four weeks of combined treatment with prednisolone and cyclosporine. Intravenous immunoglobuline (IVIG) (0.3 g/kg/d, 6 days) was added on the 30th week of gestation and resulted in regression of cutaneous rashes. On the 33rd week of gestation, IVIG (0.7 g/kg/d, 3 days) was repeated due to reactivation of pustules, and an improvement was observed. In this case report, we called attention to IVIG therapy in IH, for having the pregnancy continued enough for the fetal maturation before the delivery.

Lymphangioma circumscriptum (LS) is a superficial lymphatic malformation which consists of dilated lymphatic channels. Clinically, it presents as grouped translucent vesicles, which usually contain clear lymph fluid but may also contain red blood cells due to hemorrhage. It has been suggested that pulsed dye laser (PDL), which efficacy is known in vascular lesions, has also been successfully used for such lympangiomas with hemorrhagic character. In the literature, two patients who had LS and whose lesions responded well to PDL treatment have been reported. Here, we describe a 14-year-old woman with LS who had vesicles on her left shoulder some of which showed hemorrhagic character and who gave an inadequate partial response to the treatment with PDL.