Background and Design: Micrographic surgery is an intraoperative microscope-controlled surgery which aims at the excision of the entire tumor by achieving 100% control of the surgical margins with horizontal sectioning. In micrographic surgery, the healthy skin is preserved maximally due to the stepwise excision of the tumor using narrow margins. Due to its highest cure rates and maximal tissue preserving properties, it is the treatment of choice for high-risk non-melanoma skin cancers. Micrographic surgery is not routinely included in the dermatologic surgical procedures in Turkey. The aim of this study was to provide the availability of micrographic surgery for selected patients.
Materials and Methods: During 2010-2015, 116 non-melanoma skin cancers that belong to 102 patients (53 male, 49 female) were treated with micrographic surgery. All tumors were located on the head or neck, and exhibiting at least one high-risk factor for recurrence. Micrographic surgery was performed with the Munich method between 2010 and 2013, and with Mohs surgery between 2013 and 2015.
Results: The mean age of patients was 65.86±12.33 years (range: 33-90 years). The localization of the tumors was the head (n=112) and the neck (n=4). The number of micrographic surgery sessions to eliminate the tumor was 1 session for 55 (47.41%), 2 sessions for 55, and more than 2 sessions for 8 (6.89%) of the tumors. Six of the defects were left for secondary intention healing, 31 were repaired primarily and 13 defects were repaired with full thickness skin grafts whereas 66 were repaired with flaps.
Conclusion: The results of this study showed that microscopic eradication of non-melanoma skin cancer necessitates more than one session for more than half of the cases, illuminating that microscopic extension of non-melanoma skin cancer beyond clinically apparent tumor is very likely. The results support that for tumors located on the head and neck where healthy skin should be preserved maximally for functional and cosmetic reasons, the use of micrographic surgery is a necessity.

Background and Design: Occupational hand eczema is a commonly encountered problem. The time interval between onset and diagnosis is often long and this leads to increased morbidity. Besides dermatologists, family practitioners and workplace doctors play a role in the diagnosis and treatment of the disease. We aimed in our study to evaluate the discrepancies in how the disease is diagnosed and how the patients are handled between these specialty groups. We also aimed to determine the level of knowledge about occupational eczema and how the knowledge could be increased.
Materials and Methods: This was a descriptive study performed between January 2012 and December 2013. A questionnaire was sent via email to dermatologists, family practitioners and workplace doctors.
Results: A total of 393 doctors, including 313 dermatologists, 53 family practitioners and 27 workplace doctors were enrolled in the study. Sixty-three percent of the doctors were examining 10-100 patients with hand eczema in a mouth. Eighty-five percent was “always” asking the occupation of the patient. 71.7% was asking “everytime” what materials are handled in the work place. The answers to the question “What is your approach to the patient after you diagnose occupational hand eczema” was “I refer the patient” and “I tell the patient to quit the job” was higher in family practitioners and family doctors. The center for referral was “dermatologists” for the workplace doctors and family practitioners while dermatologists referred the patients to “a clinic performing patch tests” or “occupational diseases centers”. 91.2% of the responders stated that they wanted to have more knowledge about occupational eczema and the issue of wonder mostly found was “the allergens/irritants encountered in the workplace”.
Conclusion: A high number of the respondents stated that they wanted to gain more knowledge about occupational eczema. More courses, meetings, seminars are required to be performed on this topic and more papers or text-books concerning the subject should be published. In addition, special centers for the diagnosis, care and rehabilitation of these patients are needed.

Background and Design: Basal cell carcinoma (BCC) is the most frequently observed cancer. Its ethiopathogenesis is not totally clarified. In recent years one of the factors mentioned on ethiopathogenesis is ‘fusion regions’. In our study we aimed to investigate whether the number of BCC is more or not in anatomic areas which contain more fusion regions.
Materials and Methods: Three hundred twenty-eight BCC case whose anatomic region is indicated in histopathology report is taken into study. Fusion regions are determined according to the mapping system given in Tessier’s publication. First the number of total fusion region for each anatomic area on face is calculated. Then, the number of BCC located in each anatomic area and the number of fusion region located in the same anatomic area are compared. In conclusion findings are commented with respect to cause result relationship.
Results: The most important anatomic areas with respect to fusion region number were forehead and lip. In forehead and lip there were 11fusion regions. 34 BCC on forehead and 14 BCC on lip are observed. There were 10 fusion regions on around the eye and a total of 74 BCC were observed on both periorbital area. But 9 fusion area is detected on nose area where BCC is mostly present (135).
Conclusion: More BCC is not observed in anatomic areas where fusion region is plenty compared to anatomic areas where fusion region is less. As a result; in BCC development, it is seen that only fusion regions do not have ethiopathogenetic importance.

Background and Design: Genital warts, a very common sexually-transmitted infection, negatively affect the quality of life of patients especially from the psychosocial point of view. In this study, we aimed to investigate the effects of genital warts on the quality of life by comparing patient and control groups.
Materials and Methods: Eighty patients and 75 healthy individuals were included in the study. The 36-item Short-form health survey (SF-36) and Dermatology life quality index (DLQI) were administered to patients whereas the control group was given only the SF-36. The obtained data were evaluated together with the clinical and demographical data by comparing the patient and control groups.
Results: According to the sub-dimensions of the SF-36, a significant effect was observed in the patient group compared to the control group for the general health, vitality and mental health. The average DLQI score was 5.14±4.13. In all sub-dimensions of SF-36, the scores in female patients were found to be statistically significantly lower than in male patients. No significant correlation was determined between clinical characteristics and quality of life.
Conclusion: Genital warts are a disease which negatively affects the quality of life and results in psychosocial problems and changes in sexual activity.

Different clinical and histopathologic types of dermatofibromas (benign fibrous histiocytoma (FH)) have been defined. Cellular dermatofibroma accounts for approximately 5% of benign FH. In the relevant literature, there are reported cases of lung metastases and inguinal lymph node metastases. In this paper we present a 25-year-old women who presented to our outpatient clinic with 3x4 cm nodule mass in the distal tibia and received the histopathological diagnosis of cellular dermatofibroma after total excision. In the literature, cases of dermatofibroma metastasizing to the lung and inguinal lymph nodes have been reported. We present this rare case of cellular dermatofibroma to highlight its potential for distant metastasis.

Lichen myxedematosus is a chronic, inflammatory, systemic dermatose characterized by dermal musin deposition and increased fibroblasts in the absence of thyroid dysfunction. It is usually seen together with paraproteinemia. It is clinically classified as scleromyxedema (papular mucinosis), localized lichen myxedematosus, and atypical lichen myxedematosus. Etiopathogenesis of the disease which is very difficult to treat is still unknown. Herein, we present a case of atypical scleromyxedema without monoclonal gammopathy mimicking angioedema, rapidly developing and responding to steroid treatment.

Pseudoxanthoma elasticum-like papillary dermal elastolysis (PXE-PDE) is a rare acquired non-inflammatory disorder characterized by papules that clinically resemble PXE and histologically by a total or partial loss of elastic fibers in the papillary dermis. It typically affects elderly women. Here, we present a 60-year-old woman diagnosed with PXE-PDE which is a rarely encountered condition.

Psoriasis is associated with cutaneous and systemic overexpression of several proinflammatory cytokines. The aim of this study was to investigate the relationship between susceptibility to psoriasis and polymorphisms of tumor necrosis factor alpha (TNF-α), interferon gamma (INF-γ), interleukin (IL-10), IL-6 and transforming growth factor beta (TGF-β). Eighty-nine patients with psoriasis and 201 healthy controls were enrolled into the study. The patient group was divided into 2 subgroups as early-onset (group 1) and late-onset (group 2). The cytokine gene polymorphisms in each group were determined by polymerase chain reaction-single specific primer. When the whole and only group 1 patients were compared with the controls, TGF-β TT/GC genotype was significantly high in the whole and group 1 patients. When we compared the group 1 and group 2, the frequency of IFN-γ AA genotype was found to be significantly high in group 1 which lost significance after Bonferroni correction. Patients with moderate symptoms had a significantly high frequency of IL-10 GCC/GCC genotype that did not remain significant after correction. These data from our small group of patients demonstrated that the only significant difference between the whole patient group and the controls was for TGF-β TT/GC genotype with a higher frequency in the patients. Due to the involvement of many other genes relating to the activity of Th1 cytokines, further studies are required to determine the molecular basis of the susceptibility to psoriasis.