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Skorlama sistemleri, hastalýða ait parametrelerin deðerlendirilerek hastanýn klinik þiddetini objektif olarak saptama amacýyla geliþtirilmiþ olan ölçeklerdir. Vücut yüzey alaný, görsel analog skala ve doktor global deðerlendirme skoru dermatolojik hastalýklarýn klinik þiddetinin deðerlendirilmesi amacýyla en sýk kullanýlan genel skorlama sistemleridir. Bu skorlama sistemleri dýþýnda akne (akne vulgaris, akne skarlarý), alopesi (androgenetik alopesi, traksiyonel alopesi), Behçet hastalýðý, büllöz hastalýklar (otoimmün büllöz hastalýklar, toksik epidermal nekroliz, epidermolizis bülloza), dermatit (atopik dermatit, kontakt dermatit, dishidrotik egzama), hidradenitis suppurativa, hirsutismus, konnektif doku hastalýklarý (dermatomyozit, sistemik lupus eritematozusun (LE) deri tutulumu, diskoid LE, skleroderma), liken planopilaris, mastositoz, melanositik lezyonlar-melanom, melazma, mikozis fungoides/Sezary sendromu, onikomikoz, oral liken planus, pitiriyazis rozea, psoriasis (psoriasis vulgaris, psoriatik artrit, týrnak psoriasisi), sarkoidoz, ürtiker ve anjiyoödem ve vitiligo gibi çok sayýda dermatolojik hastalýk için spesifik skorlama sistemleri de geliþtirilmiþtir. Hastalýk þiddet skorlama yöntemleri, dermatoloji alanýnda klinik pratikte hastalýðýn þiddetinin belirlenerek prognoz hakkýnda fikir sahibi olunabilmesi, hasta için uygun tedavinin belirlenmesi, uygulanan tedavinin etkinliðinin deðerlendirilmesi, klinik araþtýrmalarda ise farklý tedavi yöntemlerinin etkinliklerinin karþýlaþtýrýlabilmesi gibi amaçlarla giderek daha yaygýn olarak kullanýlmaktadýr.

Scoring systems have been developed to interpret the disease severity objectively by evaluating the parameters of the disease. Body surface area, visual analogue scale, and physician global assessment are the most frequently used scoring systems for evaluating the clinical severity of the dermatological diseases. Apart from these scoring systems, many specific scoring systems for many dermatological diseases, including acne (acne vulgaris, acne scars), alopecia (androgenetic alopecia, tractional alopecia), bullous diseases (autoimmune bullous diseases, toxic epidermal necrolysis), dermatitis (atopic dermatitis, contact dermatitis, dyshidrotic eczema), hidradenitis suppurativa, hirsutismus, connective tissue diseases (dermatomyositis, skin involvement of systemic lupus erythematosus (LE), discoid LE, scleroderma), lichen planoplaris, mastocytosis, melanocytic lesions, melasma, onychomycosis, oral lichen planus, pityriasis rosea, psoriasis (psoriasis vulgaris, psoriatic arthritis, nail psoriasis), sarcoidosis, urticaria, and vitiligo, have also been developed. Disease severity scoring methods are ever more extensively used in the field of dermatology for clinical practice to form an opinion about the prognosis by determining the disease severity; to decide on the most suitable treatment modality for the patient; to evaluate the efficacy of the applied medication; and to compare the efficiency of different treatment methods in clinical studies.

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Amaç: Postadölesan akne, relapslarla seyreden kadýnlarda sýk görülen bir hastalýktýr. Tedavisi zordur. Çalýþmamýzda postadölesan akneli kadýnlarda hiperandrojeneminin klinik ve biyokimyasal özelliklerini ve metabolik sendrom (MS), dislipidemi gibi metabolik bozukluklarýn prevalansýný deðerlendirmeyi amaçladýk. Gereç ve Yöntem: Çalýþma Temmuz 2014 ve Aralýk 2014 tarihleri arasýnda polikliniðimize postadölesan akne þikayeti ile baþvuran 50 kadýn hasta ile gerçekleþtirildi. Hastalarda androgenetik alopesi (AGA), hirsutizm, polikistik over sendromu (PKOS), MS, dislipidemi ve obezite varlýðý deðerlendirildi. Bulgular: Postadölesan akneli kadýnlarda sebore %56, hirsutizm %40, AGA %26, PKOS ise %24 oranýnda saptandý. Hastalarda MS prevalansý %24, dislipidemi prevalansý ise %44 idi. AGA ve hirsutismuslu olgularda MS oraný olmayanlara göre anlamlý derecede daha yüksek bulundu (p=0,001, p=0,044). Menstrüel düzensizlik ve PKOS mevcudiyeti ile MS varlýðý açýsýndan anlamlý bir iliþki kurulamadý (p=0,707, p=0,448). AGA, hirsutizm, PKOS ve menstrüel düzensizlik varlýðý ile de dislipidemi açýsýndan anlamlý iliþki bulunmadý (p=0,612, p=0,684, p=0,416, p=0,612) Sonuç: Postadölesan akneli kadýnlarda hiperandrojenemi klinik bulgularýndan hirsutizm, AGA, PKOS yüksek oranda görüldü ancak androjenik hormon profilinde minimal anormallik saptandý. Sonuç olarak postadölesan dirençli akne; kadýnlarda PKOS erken tanýsýnda tip 2 diabetes mellitus, hiperkolesterolemi ve MS geliþimini önlemek için erken bir belirteç olarak düþünülebilir.

Background and Design: Postadolescent acne is a disease with relapses frequently seen in women. Treatment is difficult. In our study, we aimed to investigate the clinical and biochemical characteristics of hyperandrogenism and the prevalence of metabolic disorders, such as metabolic syndrome (MS) and dyslipidemia in women with postadolescent acne. Materials and Methods: This study was conducted on 50 women who attended our department with the complaint of postadolescent acne between July 2014 and December 2014. The presence of androgenetic alopecia (AGA), hirsutism, polycystic ovary syndrome (PCOS), MS, dyslipidemia, and obesity was evaluated. Results: Seborrhea was present in 56%, hirsutism in 40%, AGA in 26%, and PCOS in 24% of women with postadolescent acne. The prevalence of MS and dyslipidemia was 24% and 44%, respectively. The prevalence of MS was significantly higher in patients with AGA and hirsutism. There was no association of MS with menstrual irregularity and PCOS. There was no significant association of dyslipidemia with AGA, hirsutism, PCOS, and menstrual irregularity. Conclusion: Clinical symptoms of hyperandrogenism, such as hirsutism, AGA, and PCOS were more common in women with postadolescent acne but androgenic hormone profile abnormalities were minimal. As a result, postadolescent acne resistant to treatment may be considered as an early marker in the early diagnosis of PCOS in women to prevent the development of type 2 diabetes mellitus, MS and hypercholesterolemia.

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Amaç: Aþýrý kilolu ve obezlerde tespit edilen dermatozlarý, beden kitle indeksi (BKÝ) 25.0 kg/m2’nin altýnda olan kiþilerden elde edilen verilerle karþýlaþtýrarak obezitenin deri saðlýðýnda oluþturduðu etkilere dikkat çekmektir.
Gereç ve Yöntemler: Çalýþma, polikliniðe baþvuran 18 yaþýndan büyük 510 gönüllü katýlýmcý ile yapýldý. BKÝ, 25.0 kg/m2‘den küçük olan 150 kiþi normal kilolu olan kontrol grubu, BKÝ 25.0-29.9 kg/m2 arasýndaki 130 kiþi aþýrý kilolu grubu, BKÝ 30.0 kg/m2 den büyük olan 230 kiþi ise obez grubu oluþturdu. Olgularýn ayrýntýlý dermatolojik muayeneleri yapýlarak veriler kaydedildi.
Bulgular: Çalýþmaya 194'ü erkek, 316‘sý kadýn toplam 510 katýlýmcý dahil edildi. Katýlýmcýlarýn yaþ ortalamasý kontrol grubunda 32.05±10.9, aþýrý kilolu grubunda 44.91±13.4 ve obez grubunda 39.78±16.4 idi. Çalýþmada, aþýrý kilolu ve obez grupta en sýk görülen dermatozlar sýklýk sýrasýna göre; stria distensa 316 (%62), plantar hiperkeratoz 249 (%48.8), distrofik selülit 216 (%42.4), akrokordon 204 (%40), akantozis nigrikans 135 (%26.4), variköz ven 134 (%26.3) ve keratozis pilaris 108 (%21.2) idi.
Sonuç: Birçok dermatoz, insülin direnci ve mekanik etkilere baðlý olarak obez ve aþýrý kilolularda normal kilolu kiþilerden daha sýk gözlenmektedir.

Background and Design: The aim of the present study is to compare dermatoses detected in overweight and obese individuals with the data obtained from individuals with body mass index (BMI) below 25.0 kg/m2 and to emphasize the effects of obesity on skin health.
Material and methods: The study was performed with 510 volunteer participants aged above 18 years, who were admitted to a policlinic. One hundred fifty individuals with normal weight who had a BMI below 25.0 kg/m2 constituted the control group, 130 individuals with BMI between 25.0-29.9 kg/m2 constituted the overweight group, and 230 individuals with BMI above 30.0 kg/m2 constituted the obese group. A detailed dermatological examination was performed and the data was recorded.
Results: A total of 510 participants, 194 males and 316 females, were included in the study. The mean age was 32.05±10.9, 44.91±13.4, and 39.78±16.4 in the control, overweight, and obese groups, respectively. The most common dermatoses in the overweight and obese groups were striae distensae in 316 individuals (62%), plantar hyperkeratosis in 249 individuals (48.8%), dystrophic cellulitis in 216 individuals (42.4%), acrochordon in 204 individuals (40%), acanthosis nigricans 135 (26.4%), varicose veins in 134 individuals (26.3%), and keratosis pilaris in 108 individuals (21.2%).
Conclusion: Several dermatoses are more frequently seen in obese and overweight individuals when compared with normal weight individuals due to insulin resistance and mechanical effects.

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Amaç: Türk Dermatoloji Derneði Dermatoalerji Çalýþma Grubu, dermatologlarýn mevcut bilgi kaynaklarýný ve pratiðini öðrenmek ve dermatoalerji alanýnda gelecekteki eðitim ve projeler için alt yapý oluþturmak amacýyla bir anket çalýþmasý planlamýþtýr. Gereç ve Yöntem: Bu ankette toplam 42 soruda katýlýmcýlara yama, foto yama testi, delme testi, otolog deri testi, ilaç testleri ve mesleki egzamalarla ilgili olarak uygulama yapýp yapmadýklarý, yapýyorlarsa uyguladýklarý endikasyonlar, kaç uygulama gerçekleþtirebildikleri, eðitimlerini nereden ve nasýl aldýklarý ve kullandýklarý alerjen panellerine dair ayrýntýlý sorgulama yapýldý. Anketler dermatoalerji grubu üyelerinin bölgelerinde kendileri tarafýndan uygulatýldý ve ayrýca 13-17 Kasým 2013 tarihinde Ankara’da düzenlenen 21. Lütfü Tat Sempozyumu Dermatoalerji paneli sýrasýnda daðýtýlarak veriler toplandý. Bulgular: Anket çalýþmamýzýn sonucu dermatologlarýn günlük pratiðinde en sýk kullandýklarý testlerin sýrasýyla delme testi, yama testi, ilaçla deri testi, otolog serum deri testi, foto yama testi olduðunu gösterdi. Sonuç: Türkiye’deki dermatologlarýn çoðunluðunun dermatoalerji testlerini uygulayabilecek bilgi ve beceriye sahip olduðunu saptadýk. Bununla birlikte ilaçlarla deri testi, gýda ve ilaçla oral provokasyon testlerinin eðitimine yönelik uzmanlýk sonrasý bilimsel toplantýlarla eksikliklerin giderilmesi gerektiði sonucuna varýlmýþtýr.

Background and Design: The Turkish Society of Dermatology, Dermatoallergy Study Group planned a survey study to search sources of knowledge and practices of dermatologists in the field of dermatoallergy and establish a basis for further educational activities and projects. Materials and Methods: In this survey, a questionnaire consisting of 42 questions was completed by the participants for detailed evaluation of their practices of patch, photopatch, prick, autologous serum skin testing, drug tests and occupational dermatitis, indications, number of applications, background sources, and allergen panel used. The survey was carried on either under the supervision of the group members in their area or by distributing and collecting the questionnaire during the Dermatoallergy panel of the 21st Prof. Dr. Lütfü Tat Symposium held in Ankara on 13-17 November 2013. Results: The results of our survey revealed that the most commonly used tests in dermatoallergy practice were prick test, patch test, drug test, autologous serum skin testing, and photopatch test, respectively. Conclusion: We found out that most of the dermatologists in Turkey have the sufficient knowledge and practice to perform dermatoallergy tests. However, further scientific training courses on oral food challenge and drug provocation tests are required to improve the practice of dermatologists.

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Bazal hücreli karsinomlar (BHK) epidermis ya da kýl folikülündeki pluripotent kök hücreden çýkan tümörlerdir. Nadir görülen berrak hücreli varyantý gibi çok sayýda histolojik alt tipi olup nöroendokrin diferansiyasyon (NED) gibi deðiþik yönlere diferansiyasyon kapasitesine sahiptirler. Seksen bir yaþýnda kadýn hasta sað kaþ üzerinde kitle þikayeti ile baþvurdu. Uygulanan eksizyonel biyopsi materyalinin histolojik incelemesinde NED’i düþündüren rozet benzeri yapýlar oluþturan berrak hücreli BHK görüldü. Ýmmünhistokimyasal çalýþmada tümör hücreleri kromogranin ve CD56 ile pozitif boyandý. Bu olgu literatürde bildirilen NED gösteren ilk berrak hücreli BHK olgusudur.

Basal cell carcinomas (BCC) are tumors arising from pluripotent stem cells of the epidermis or hair follicles. There are many histological subtypes such as clear cell, a rare variant, and they have the capacity to differentiate towards distinct directions such as neuroendocrine differentiation (NED). An 81-year-old female patient presented with a mass on the lateral side of the right eyebrow. Excisional biopsy was performed. Histopathologic examination revealed clear cell BCC with prominent rosette-like structures suggesting NED. Immunohistochemically, tumor cells were positive for chromogranin and CD56. This is the first reported case of clear cell basal carcinoma with NED.

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Büllöz hemorajik dermatoz, heparin kullanýmýna baðlý nadir görülen bir yan etkidir. Biz burada enoksaparin kullanýmý sonrasý hemorajik bülleri geliþen bir olgu sunuyoruz. Lezyonlarý ilerleyen günlerde gerilemesine raðmen hasta bül oluþumunu takiben 45. günde intrakraniyal hemoraji nedeniyle kaybedilmiþtir.

Bullous hemorrhagic dermatosis is a rare adverse effect of subcutaneous heparin injection. Here, we report a case of hemorrhagic bullous dermatosis occurred after enoxaparin use. The patient's lesions had resolved but she died 45 days after development of hemorrhagic bullous dermatosis due to intracranial hemorrhage.

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