Amaç: Bu çalýþmada %5’lik stronsiyum (Sr) klorür hekzahidratýn radyoterapiye (RT) baðlý geliþen deri toksisitesini önleyici ve/veya tedavi edici etkisinin olup olmadýðýnýn araþtýrýlmasý amaçlandý.
Gereç ve Yöntem: Dört buçuk-beþ aylýk, 200-210 gram aðýrlýðýnda 64 adet, diþi Wistar albino sýçan kullanýldý ve sýçanlar her bir grupta 8 sýçan olacak þekilde rastgele 8 gruba ayrýldý.
Bulgular: Radyo Terapi Onkoloji Grubu Akut Radyasyon Morbidite Puanlama Kriterleri (RTOG) ve histopatolojik bulgulara göre karþýlaþtýrma yapýldýðýnda kontrol grubu ile diðer gruplar arasýndaki fark istatistiksel olarak anlamlýydý (p<0,05). Fakat RT grubu ile diðer tedavi gruplarý arasýnda istatistiksel olarak fark yoktu (p>0,05). Ayrýca tedavi gruplarý arasýnda anlamlý farklýlýk yoktu (p>0,05). Gruplar transforme-edici büyüme faktörü-β’nýn immünohistokimyasal deðerlendirmesine göre karþýlaþtýrýldýðýnda istatistiki sonuçlar: Grup 1 ve 4 (p=0,015), grup 1 ve 5 (p=0,014), grup 1 ve 6 (p=0,035), grup 1 ve 8 (p=0,046), grup 2 ve 6 (p=0,047), grup 4 ve 6 (p=0,031) þeklindeydi. Gruplar tümör nekroz faktörü-α’nýn immünohistokimyasal deðerlendirmesine göre karþýlaþtýrýldýðýnda istatistiki sonuçlar: Grup 1 ve 2 (p=0,024), grup 1 ve 8 (p=0,045) þeklindeydi.
Sonuç: Topikal olarak kullanýlan %5 konsantrasyondaki Sr RT’nin deri üzerinde yan etkilerini önlemek için yeterli deðildir. Bu sonuç RTOG puanlama, histopatolojik bulgular ve immünolojik belirteçlerle desteklenmiþtir.

Background and Design: This study aimed to investigate whether 5% strontium (Sr) chloride hexahydrate has preventive or therapeutic effects on the radiotherapy (RT)-induced adverse skin effects.
Materials and Methods: Sixty-four female Wistar albino rats weighing 200-210 g, aged 4.5-5 months were divided into eight groups. Results: There were significant differences between control group and the other groups according to the Radiation Therapy Oncology Group Acute Radiation Morbidity Scoring Criteria (RTOG) and histopathological findings (p<0.050). However, there were no significant differences between RT group and treatment groups (p>0.05). In addition, there were no significant differences among treatment groups (p>0.05). Statistical results were as follows according to the immunohistochemical evaluation of transforming growth factor-β: group 1 and 4 (p=0.015), group 1 and 5 (p=0.014), group 1 and 6 (p=0.035), group 1 and 8 (p=0.046), group 2 and 6 (p=0.047), group 4 and 6 (p=0.031); and according to the immunohistochemical evaluation of tumor necrosis factor-α: group 1 and 2 (p=0.024), group 1 and 8 (p=0.045).
Conclusion: Topical treatment with Sr at a concentration of 5% is insufficient to prevent the side effects of RT involving the skin, as assessed by the RTOG scoring, histopathological findings, and immunological markers.

Amaç: Ýskemi modifiye albümin (ÝMA), albümin kobalt baðlama testi ile ölçülen, iskemi ve oksidatif stresin göstergesi olan bir biyomarkýrdýr. Androgenetik alopesi (AGA) erkeklerde görülen saç kaybýnýn en önemli nedenidir. Androjenik hormonlar, yaþ, etnik, ailesel ve çevresel faktörlerden etkilenen saç kaybý bireylerde ruhsal, sosyal ve fiziksel yetersizliklere yol açabilmektedir. Bu çalýþmada AGA’yý etkileyen faktörler ve çeþitli alanlarda kullanýlan önemli bir belirteç olan ÝMA ile AGA arasýndaki iliþkinin ortaya konmasý amaçlanmýþtýr.
Gereç ve Yöntem: Çalýþmaya AGA’sý olan 50 erkek olgu ile (18-35 yaþ arasýndaki) AGA’sý olmayan 30 erkek olgu (ayný yaþ aralýðýnda) alýndý. Evre 3 ve üzerinde olanlar çalýþma grubuna dahil edildi. Kan örnekleri 12 saat açlýk sonrasý alýndý. Kan glukoz, total kolesterol, yüksek dansiteli lipoprotein (HDL), düþük dansiteli lipoprotein (LDL), trigliserid, insülin, testosteron ve dehidroepiandesteron-sülfat (DHEA-S) ve albümin deðerleri otoanalizörde bakýldý. ÝMA örnekleri MINDRAY BS 2000 otoanalizörüne aplike edilerek çalýþýldý. Bulgular: Çalýþmaya 50 AGA’lý 30 kontrol toplam 80 olgu alýndý. Çalýþma grubu ile kontrol grubu yaþ ortalamasý (p=0,179), vücut kitle indeksi (p=0,847), DHEA-S (p=0,247), testosteron (p=0,874), lipit profili [trigliserid (p=0,086), total kolesterol (p=0,492), HDL (p=0,993), LDL (p=0,544)], insülin direnci (p=0,399) ve ÝMA (p=0,976) açýsýndan deðerlendirildiðinde iki grup arasýnda istatistiksel olarak anlamlý fark yoktu. Buna karþýn ailede kellik öyküsü çalýþma grubunda istatistiksel olarak anlamlý derecede fazlaydý (p=0,000) ve AGA derecesi ile insülin direnci arasýnda pozitif yönde bir korelasyon vardý (r=0,296; p=0,037).
Sonuç: Kozmetik ve psikososyal birçok soruna neden olan AGA’nýn; ailesinde kellik öyküsü olanlarda daha sýk gözlendiði ve AGA derecesi ile insülin direnci arasýnda pozitif yönde bir korelasyon olduðu saptandý. AGA ile ÝMA arasýnda ise anlamlý bir iliþki olmadýðý belirlendi.

Background and Design: Ischemia-modified albumin (IMA) is a biomarker, which is an indicator of ischemia and oxidative stress, and measured by the albumin cobalt binding test. Androgenetic alopecia (AGA) is the most important cause of hair loss in males. Hair loss that is affected by androgenic hormones, age, and ethnic, family and environmental factors, may lead to psychological, social and physical problems in some individuals. The aim of the present study was to investigate the factors affecting AGA, and the correlation between AGA and IMA.
Materials and Methods: Fifty male patients with AGA aged 18-35 years and 30 males of similar age without AGA were included in the study. Patients with AGA stage 3 or higher were included in the study group. Blood samples were collected after a 12-hour fasting period. Blood glucose, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride, insulin, testosterone, dehydroepiandrosterone-sulfate (DHEA-S), and albumin levels were analyzed using an autoanalyzer. IMA values were evaluated using a MINDRAY BS 2000 autoanalyzer.
Results: A total of 80 individuals were included in the study. There was no significant difference in mean age (p=0.179), body mass index (p=0.847), DHEA-S (p=0.247), testosterone (p=0.874), lipid profile [triglyceride (p=0.086), total cholesterol (p=0.492), HDL (p=0.993), LDL (p=0.544)], insulin resistance (p=0.399) and IMA (p=0.976) between study group and control group. Additionally, a family history of alopecia was found to be significantly higher in the study group (p=0.000). Moreover, there was a positive correlation between AGA grade and insulin resistance (r=0.296; p=0.037).
Conclusion: AGA, which leads to many cosmetic and psychosocial problems, was more frequent in individuals with a family history of alopecia; also, there was a positive correlation between AGA stage and insulin resistance. On the other hand, there was no significant correlation between AGA and IMA.

Amaç: Dermoskopinin týrnak hastalýklarýnda kullanýmý oldukça yenidir. Psoriatik týrnakta dermoskopi, klinik özellikler tipik olmadýðýnda týrnak yataðý ve týrnak matriksi anormalliklerinin daha iyi görülebilmesine olanak saðlar. Bu çalýþmada, psoriatik týrnaktaki bulgularýn dermoskopi ile incelenerek sýklýðýný saptamak, klinik muayene ile dermoskopik muayene yöntemini kýyaslamak ve hastalýk þiddet göstergelerinin birbirleriyle olan iliþkilerini incelemek amaçlanmýþtýr.
Gereç ve Yöntem: Çalýþmaya týrnak tutulumu olan 40 psoriazisli hasta alýndý. Hastalýðýn deri tutulumunun þiddeti Psoriazis Alan Þiddet Ýndeksi (PAÞÝ), týrnak tutulumunun þiddeti Týrnak Psoriazisi Þiddet Ýndeksi (NAPSI) ile belirlendi. Hastalarýn týrnaklarý hem klinik olarak hem de bilgisayarlý dermoskop ile deðerlendirildi.
Bulgular: En sýk görülen klinik bulgu pitting (%92,5), dermoskopik bulgu lökoniþi (%92,5) olarak saptandý. Klinik NAPSI ve dermoskopik NAPSI skorlarý arasýnda istatistiksel olarak anlamlý fark bulunmadý (p>0,05). PAÞÝ ile klinik ve dermoskopik NAPSI skorlarý arasýnda istatistiksel olarak anlamlý bir iliþki yoktu (p>0,05). Dermoskopik olarak, týrnak yataðýndaki kapiller damarlarýn dilate ve uzamýþ olduðu görüldü, fakat bu bulgunun hastalýk þiddeti ile herhangi bir iliþkisi saptanmadý. Hastalýk süresi ile týrnak tutulum süresi arasýnda pozitif bir korelasyon izlendi (p<0,05). Týrnak tutulum süresi ile klinik ve dermoskopik NAPSI skorlarý arasýnda pozitif yönde, istatistiksel olarak anlamlý bir iliþki mevcuttu (p<0,05).
Sonuç: Týrnak dermoskopisinin, klinik olarak týrnak psoriazisi teþhisinin þüpheli olduðu izole týrnak tutulumlarýnda biyopsi öncesi tanýyý destekleyici, non-invaziv bir yöntem olmasý sebebiyle tercih edilebilir olduðu düþünüldü.

Background and Aim: The use of dermoscopy in nail diseases is quite recent. Dermoscopy allows a better visualisation of abnormalities of the nail bed and matrix in case of atypical clinical features in psoriatic nail. This study aimed to determine the frequency of findings in psoriatic nail by dermoscopic examination, to compare dermoscopy with clinical examination and to investigate the relationships between the indicators of disease severity.
Materials and Methods: This study included 40 patients who presented with psoriatic nail. The severity of skin involvement of the disease was determined by the Psoriasis Area Severity Index (PASI) and the severity of nail involvement was determined by the Nail Psoriasis Severity Index (NAPSI). Patients' nails were evaluated both by clinical examination and dermoscopy.
Results: The most common clinical and dermoscopic findings were pitting (92.5%) and leukonychia (92.5%), respectively. No statistically significant difference was observed between the clinical and dermoscopic NAPSI scores (p>0.05). No statistically significant relationship was noted between the PASI and the clinical and dermoscopic NAPSI scores (p>0.05). Dermoscopically, dilated, extended capillary vessels were observed in the nail bed but without the evidence of a relationship with disease severity. A positive correlation was noted between the duration of the disease and the duration of nail involvement (p<0.05). There was a statistically significant positive relationship between the duration of nail involvement and the clinical and dermoscopic NAPSI scores p<0.05.
Conclusion: Nail dermoscopy was considered to be a preferable method as a supportive and non-invasive procedure prior to biopsy in cases of isolated nail involvement where clinical diagnosis of nail psoriasis is suspicious.

Amaç: Biyolojik tedaviler döneminde, IgE’yi inhibe eden monoklonal antikor olan omalizumabýn (OMZ), büllöz pemfigoidin (BP) tedavisi için etkili olduðu kabul edilmiþtir. Bu çalýþma BP tedavisinde OMZ kullanýmýna iliþkin klinik deneyimlerimizi deðerlendirmektedir.
Gereç ve Yöntem: On bir hastanýn retrospektif verilerinin analizi gerçekleþtirilmiþtir.
Bulgular: OMZ tedavisiyle 7 hasta klinik düzelme gösterdi. Üç hastada araya giren komorbiditeler nedeni ile tedavi kesilmiþtir. Hastalarýmýzdan hiçbirinde dikkate deðer advers olay izlenmemiþtir.
Sonuç: OMZ, orta-þiddetli BP’ler için umut vaad eden bir kortikosteroidden koruyucu tedavi opsiyonu olabilir. Gelecekte, OMZ tedavisinin BP tedavisindeki etkinliðini deðerlendiren randomize kontrollü çalýþmalara ihtiyaç vardýr.

Background and Design: In the era of biological therapies, omalizumab (OMZ), a monoclonal antibody which inhibits IgE, has been postulated to be effective in the treatment of bullous pemphigoid (BP). We report our clinical experience with the use of OMZ in the treatment of BP.
Materials and Methods: Retrospective data analyses of eleven patients were performed.
Results: Seven patients receiving OMZ treatment demonstrated clinical improvements. Three patients terminated treatment because of intermittent co-morbidities. None of the patients had any significant adverse events.
Conclusion: OMZ may be a promising corticosteroid-sparing treatment option for moderate to severe BP patients. Future randomized controlled trials are indicated to evaluate the efficacy of OMZ in the treatment of BP.

Liken planus (LP) yetiþkin popülasyonda %0,2-1 oranýnda görülür ve etiyolojisi tam olarak bilinmemektedir. Eroziv liken planus (ELP), LP’nin nadir gözlenen bir formu olup oral mukoza, palmoplantar bölge ve genital bölgede yerleþen aðrýlý erode plaklar ile karakterize bir tablodur ve tedaviye oldukça dirençlidir. ELP’de palmoplantar tutulum oldukça nadir görülür. Bu olgu sunumunda yaklaþýk yedi yýldýr taný alamamýþ, dorsal yüzeylerin de tutulduðu her iki plantar yüze yerleþen bir ELP olgusu sunulmuþtur. Hastaya 3 mg/kg/gün siklosporin-A tedavisi baþlanmýþ ve takipleri sýrasýnda lezyonlarýn gerilediði saptanmýþtýr. Plantar ELP tedaviye dirençli olmasý, skar býrakabilme özelliði, rekürrens gösterebilmesi, komorbid patolojilerle birlikteliði ve prekanseröz özellik göstermesi sebebiyle uzun yýllar takibi gerekli olan bir tablo olmasý nedeniyle önemlidir.

Lichen planus (LP) affects 0.2-1% of adult population and the etiology is not fully known. Erosive lichen planus (ELP) is a rare form of LP. LP, characterized by painful erosive plaques involving the oral mucosa and palmoplantar and genital areas, is quite resistant to treatment. Palmoplantar involvement of ELP is very uncommon. Herein, we present an ELP patient with both plantar and dorsal feet involvement in whom the diagnosis of ELP was not established for 7 years. The patient was started on 3 mg/kg/day cyclosporin-A treatment and regression of the lesions was observed during follow-up. Plantar ELP is a condition which needs years of patient monitoring due to treatment resistance, scar tissue formation, recurrence, association of comorbid pathologies, and malignant transformation potential.

Akrodermatitis kontinua Hallopeau (AKH) akral bölgelere lokalize eritem ve püstüler lezyonlar ile karakterize kronik ve tekrarlayýcý enflamatuvar bir hastalýktýr. Bu hastalarda týrnak distrofisi, matriks hasarý, anoniþi ve kemik-eklem deformasyonlarý görülebilir. Spontan remisyon nadir olup AKH’nin tedavisinde kullanýlan terapötik ajanlarýn çoðu ile uzun süreli remisyon saðlanmasýnýn zor olduðu gösterilmiþtir. Kortikosteroidler, katran, ditranol, fluorourasil, kalsipotriol ve takrolimus AKH’nin topikal tedavisinde deðiþen baþarý oranlarý ile kullanýlmýþtýr. Buradaki olguda, sol el baþparmakta topikal kortikosteroide dirençli AKH günde iki kez sadece açýk uygulanan topikal takrolimus ile baþarýlý þekilde tedavi edildi. Ýlacýn uygulama sýklýðý giderek azaltýldý. Yedi buçuk aylýk takibin sonunda tama yakýn iyileþme görüldü, ancak hastada, haftada bir kez uygulanan tedavi protokolünün 21. haftasýnda ilaç kullanýmýna devam ederken rekürrens izlendi. Bu aþamada, gündüz açýk uygulanan ve gece kapatýlan takrolimus ve intralezyonel triamsinolon asetonid enjeksiyonu etkili olmadý. Hastalýk daha sonra topikal uygulanan kalsipotriol ve klobetasol ile kontrol altýna alýnabildi.

Acrodermatitis continua of Hallopeau (ACH) is a chronic and recurrent inflammatory disorder characterized by erythema and pustular lesions localized on the acral regions. Nail dystrophy, matrix destruction, anonychia, and bone and joint deformation may be seen in patients with ACH. Spontaneous remission is rare, and it has proved difficult to achieve long-lasting remission with most of the therapeutic agents used in the treatment of ACH. Corticosteroids, tar, dithranol, fluorouracil, calcipotriol, and tacrolimus have been used in the topical treatment of ACH with variable success. In the present case, initially, topical corticosteroid-resistant ACH localized on the left thumb was successfully treated with open applied topical tacrolimus ointment alone twice daily. Application frequency of the agent was tapered gradually. There was near-complete healing at the end of 7.5 months of follow-up, but at the end of the 21 weeks of once-weekly therapy regimen, recurrence was observed. At this stage, topical daily open-applied and overnight occlusive treatment with tacrolimus and intralesional triamcinolone acetonide injection was ineffective. Then, the disease could be controlled with the topically applied calcipotriol and clobetasol.