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In vivo reflektans konfokal mikroskopi (RKM) bir deri lezyonunu biyopsi gerektirmeksizin hücresel düzeyde deðerlendirmeye imkan veren bir taný yöntemidir. Malign ve benign deri tümörlerinin ve inflamatuvar dermatolojik hastalýklarýn taný ve takibinde invaziv olmayan yüksek çözünürlüklü görüntüleme saðlar. RKM son yýllarda tüm dünyada giderek artarak kullanýlmaya baþlanmýþtýr. RKM incelemesinde kullanýlan standart terminoloji Ýngilizce olarak tanýmlanmýþtýr. Bu çalýþmada RKM kullanýmýnda Türkçe terminoloji oluþturarak, ülkemizdeki dermatologlarýn ortak bir dilde iletiþim kurmasýný saðlamak ve bu yeni taný tekniðinin terminolojisine aþina olunmasý amaçlanmýþtýr. RKM konusunda tecrübeli altý dermatolog çalýþmaya katýldý. Ýngilizce’de kullanýlan RKM terminolojisi belirlendi ve Türkçe’ye çevrildi. Türkçe terimler ve tanýmlarý her katýlýmcý tarafýndan gözden geçirildi ve grupta fikir birliði saðlandý. Son olarak filoloji bölümü terimlerin son halini inceledi ve çalýþma sonuçlandýrýldý. Çalýþmanýn sonucunda terimlerin tanýmlamalarý ve çevirileri belirlenerek Türkçe RKM terminolojisi oluþturuldu. Terimler ve açýklamalarý görseller eþliðinde tabloda gösterildi. Oluþturulan Türkçe RKM terminolojisi, Türkçe konuþan dermatologlarýn bulgularýný homojen bir dilde tanýmlamalarýný saðlayacaktýr.

In vivo reflectance confocal microscopy (RCM) is a diagnostic method to examine a skin lesion at the cellular level in vivo without biopsy. It provides non-invasive, high resolution imaging for diagnosis and follow-up of malignant, benign skin tumors and inflammatory dermatologic diseases, and its use is spreading worldwide. Standard terminology which has been used in RCM was described earlier in the English language. This study aimed to propose a Turkish terminology for RCM to allow Turkish-speaking dermatologists to communicate in a homogeneous language and familiarize themselves with the terminology of this new diagnostic technic. Six Turkish-speaking dermatologists with RCM experience participated in the study. RCM terminology used in English was determined and translated into Turkish. Turkish terms and their definitions were reviewed by each participant and the consensus was provided in the group. Finally, philology department examined the last version of the terms and the study was finalized. The terms, definitions and the translations of the terms have been identified, and the Turkish RCM terminology has been created and shown. Turkish RCM terminology will provide Turkish-speaking dermatologists to describe their findings in a homogenous language.

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Amaç: Koronavirüs hastalýðý-2019 (COVID-19) sonrasý kriz dönemi ve normalleþme sürecinin dermatoloji pratiðine etkisini ortaya koymayý ve böylece gelecekte karþýlaþýlabilecek olasý saðlýk problemlerine iþaret etmeyi amaçladýk.
Gereç ve Yöntem: Þubat ve Temmuz 2020 tarihleri arasýnda (COVID-19 öncesi, kriz dönemi ve normalleþme süreci) dermatoloji polikliniklerine baþvuran tüm hastalar çalýþmaya dahil edildi. Yaþ, cinsiyet, baþvuru tarihleri, teþhisler ve tedavi yöntemleri gibi veriler elektronik veri tabanýndan alýndý.
Bulgular: Normalleþme sürecindeki hasta sayýsý (%32,3) kriz dönemine göre (%11,5) artarken, pandemi öncesine göre (%56,2) hala anlamlý derecede daha düþüktü. Ýdiyopatik jeneralize pruritus, alopesi areata ve herpes zoster gibi strese baðlý hastalýklarýn daðýlýmýndaki deðiþimin istikrarlý bir þekilde birbirine paralel seyretmesi ve kriz döneminde ve normalleþme sürecinde sýrasýyla artma ve azalma eðiliminde olmasý dikkat çekiciydi. Kriz dönemine yansýmayan kontakt dermatit sýklýðýndaki artýþ normalleþme sürecinde belirginleþmiþti (p<0,001). Uyuz oranýnda anlamlý bir deðiþiklik yoktu (p=0,276). Ancak uyuz hastalarýnýn sayýsýndaki kayda deðer azalma dikkat çekiciydi.
Sonuç: Strese baðlý hastalýklardaki azalma, sosyal stresin normalleþme ile azalmaya baþladýðýný göstermektedir. Halk saðlýðýný ilgilendiren uyuz ve zührevi hastalýklar ihmal edilmemelidir. Hastalýklarýn oranlarý ve hasta sayýsý, pandemi sonrasýnda karþýlaþabileceðimiz sorunlar hakkýnda fikir vericidir. Pandemi sýrasýnda dermatolojik hastalýklarýn eðilimlerini ve deðiþen saðlýk sistemini anlamak, gelecekte karþýlaþýlabilecek olasý sorunlarýn çözümünü saðlayacaktýr.

Background and Design: This study aimed to reveal the effects of the crisis period and normalization process after the Coronavirus disease-2019 (COVID-19) pandemic on dermatology practice to anticipate future health problems.
Materials and Methods: All patients were enrolled from the dermatology outpatient clinics between February and July 2020 (pre-COVID-19 period, crisis period, and normalization period). Data such as age, sex, application dates, diagnoses, and treatment methods were received from the electronic registration database.
Results: The number of patients in the normalization period (32.3%) increased relative to that in the crisis period (11.5%), and it was significantly lower than that before the pandemic (56.2%). Remarkably, the change in the distribution of stress-related diseases, such as idiopathic generalized pruritus, alopecia areata, and herpes zoster, stably paralleled each other and the increase and decrease trends during the crisis and normalization periods, respectively. The increase in the frequency of contact dermatitis, which was not reflected in the crisis period, became evident in the normalization period (p<0.001). No significant change was found in the rate of scabies (p=0.276). However, the number of patients with scabies was remarkably decreased.
Conclusion: The decrease in stress-related diseases indicates that social stress started to decrease with normalization. Scabies and venereal diseases, which concern public health, should not be neglected. Disease rates and the number of patients provide an idea about potential problems after the pandemic. Understanding the trends in dermatological diseases and the changing health system during the pandemic will aid in solving future problems.

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Amaç: Çocukluk çaðýnda güneþ ýþýðýna maruziyeti, yetiþkinlikte deri kanseri için ana risk faktörlerinden biridir. Bu yüzden deri kanserlerini önleme kampanyalarýnýn ana hedeflerinden biri çocuklarý ultraviyole (UV) ýþýnlarýndan korumaktýr. Bu çalýþma, anaokulunda çocuðu olan ebeveynlerin deri kanseri ile ilgili risk düzeylerini, algýlarýný, bilgi düzeylerini ortaya çýkarmak ve bunlarý etkileyen faktörleri belirlemek amacýyla yapýlmýþtýr. Ayrýca hem kendileri hem çocuklarý için uyguladýklarý güneþten korunma davranýþlarýnýn belirlenmesi hedeflenmiþtir.
Gereç ve Yöntem: Kesitsel tipteki bu araþtýrma, Ýlçe Milli Eðitim Müdürlüðü’ne baðlý 10 anaokulundaki çocuklarýn ebeveynleri ile yürütülmüþtür. Araþtýrmaya 1.147 öðrencinin ebeveyni katýlmýþtýr.
Bulgular: Ebeveynlerin Deri Kanseri ve Güneþ Bilgi Ölçeði puan ortalamasý 13,01±3,43, Güneþten Korunma Davranýþ Ölçeði puan ortalamasý ise 25,46±5,73 olarak bulunmuþtur. Güneþten Korunma Davranýþ Ölçeði alt boyutlarý incelendiðinde; ebeveynlerin güneþten kaçýnma puan ortalamasýnýn 12,52±1,95, güneþten koruyucu ürün kullanma puan ortalamasýnýn 7,97±4,02 ve þapka kullanma puan ortalamasýnýn 4,95±2,58 olduðu belirlenmiþtir. Ebeveynlerin çocuklarý için en az uyguladýklarý güneþten korunma davranýþý giysilerle (%37,3) ve güneþ koruyucu ürünlerle korumadýr (%29,0). En sýk uyguladýklarý koruma davranýþý ise çocuklarýnýn þapka takmalarýný (%25,2) ve gölgede durmalarýný (%22,0) saðlamalarýdýr. Ebeveynlerin çocuklarýný güneþten koruma davranýþlarýný çocuðunun yaþý, cinsiyeti, deri tipi, yaz mevsiminde açýk alanda zaman geçirmesi, son bir yýlda güneþ yanýðý oluþmasý, deri muayenesi yapmasý ve deri kanseri riski algýsý düzeyinin etkilediði saptanmýþtýr (p<0,05).
Sonuç: Ebeveynlerin deri kanseri ve güneþten korunma ile ilgili bilgi düzeyleri, kendilerine ve çocuklarýna yönelik güneþten korunma davranýþlarý orta düzeydedir. Deri kanseri insidansýnýn azaltýlmasýnda, çocuklarda UV ýþýða maruz kalmayý azaltmak için güneþten korunmada ebeveyn davranýþlarý çok önemli olup, doðru tutum ve davranýþlarý artýrmak önemli bir strateji olacaktýr.

Background and Design: Sunlight exposure during childhood is one of the main risk factors for skin cancer in adulthood. Therefore, one primary strategy to prevent skin cancer is to protect children from ultraviolet (UV) light. This study aimed to assess the risk level, perceptions, and knowledge level of skin cancer and the associated factors in parents of kindergarteners, as well as determine sun protection behaviors for both parents and their children.
Materials and Methods: This was designed as a cross-sectional study, and data were collected from the parents of children at 10 kindergartens associated with the District National Education Directorate. Parents of 1,147 students participated in the study.
Results: The Skin Cancer and Sun Knowledge Scale mean score of parents was 13.01±3.43 (range: 0-25) and the Sun Protection Behavior Scale mean score was 25.46±5.73 (range: 8-40). The sun protection behaviors that were least preferred by parents for their children were protective clothes (37.3%) and sun protection products (29.0%). The most common protection behaviors of parents involved making their child wear a hat (25.2%) and stay in the shade (22.0%). Sun protection behaviors of children were affected by the child’s age, gender, skin type, time spent in sunlight during summer, formation of sunburn during the last year, having a medical examination for skin, and skin cancer risk perception (p<0.05).
Conclusion: The parents’ knowledge about skin cancer and sun protection as well as sun protection for themselves and their children was moderate. Behaviors of parents are very important to decrease the exposure of children to UV light and reduce skin cancer incidence. Thus, improving parental behaviors is an important strategy.

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Amaç: Psoriazis kronik inflamatuvar bir hastalýktýr ve inflamasyon sürecinde çeþitli biyokimyasal belirteçler rol oynar. Çalýþmamýzda interlökin-12 (IL-12), IL-17a, IL-22 ve IL-23, yüksek-sensitif C-reaktif protein (hs-CRP), tümör nekroz faktörü-alfa (TNF-α) ve serum büyüme farklýlaþma faktörü-15 (GDF-15) düzeylerini ölçtük ve serum GDF-15’in inflamasyon ve hastalýk þiddeti ile iliþkisini saptamayý amaçladýk.
Gereç ve Yöntem: Çalýþmamýza plak tipi psoriazis tanýsý ile 50 ardýþýk hasta dahil edildi. Tüm hastalar için dermatolojik incelemeler yapýldý ve psoriazis alan þiddet indeksi (PAÞÝ) skorlarý kaydedildi. PAÞÝ’si 10’un altýnda olan hastalar hafif (grup 1), 10 ila 20 arasýnda orta (grup 2) ve 20’den fazla þiddetli (grup 3) olarak kabul edildi.
Bulgular: Hasta ile kontrol grubu arasýnda yaþ, cinsiyet, IL-17a ve IL-22 açýsýndan herhangi bir fark izlenmedi. IL-12 ve IL-23 açýsýndan ise istatistiksel olarak anlamlý olmayan farklýlýk izlendi. Fakat hs-CRP, TNF-α ve GDF-15 açýsýndan ise iki grup arasýnda anlamlý farklýlýk mevcuttu. GDF- 15’in 3 grupta da anlamlý olarak farklý olduðu bulundu (p<0,001). PAÞÝ skoru ile hastalýk süresi (p=0,005), hs-CRP (p=0,003), TNF-α (p=0,002) ve serum GDF-15 düzeyleri (p<0,001) arasýnda anlamlý bir korelasyon gözlendi. Ciddi PAÞÝ skorunu öngörebilen serum GDF-15 düzeyleri de alýcý iþletim karakteristiði analizinde >1498,5 pg/mL (eðri altýnda kalan alan: 0,813, p<0,001) olarak bulundu.
Sonuç: PAÞÝ skoruna ek olarak, GDF-15 düzeylerinin tedavi ve sistemik inflamasyonun izlenmesinde, hastalýðýn þiddetinin belirlenmesinde ve etkili tedavinin saðlanmasýnda bir rehber olabileceðini düþünüyoruz.

Background and Design: Psoriasis is a chronic, inflammatory disease, and several biochemical markers play role in its inflammatory process. This study measured the levels of interleukin-12 (IL-12), IL-17a, IL-22 and IL-23, high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α) and serum growth differentiation factor-15 (GDF-15) and aimed to detect the relationship of serum GDF-15 level with inflammation and disease severity.
Materials and Methods: This study included 50 consecutive patients diagnosed with plaque-type psoriasis. For all patients, dermatological examinations were performed, and psoriasis area severity index (PASI) scores were recorded. Patients with PASI <10 were considered to have mild (group 1), 10-20 moderate (group 2), and >20 severe (group 3) psoriasis.
Results: No difference was observed between the patient and the control groups in terms of age, sex, IL-17a and IL-22. A statistically nonsignificant difference was detected in terms of IL-12 and IL-23. However, there was significant difference between two groups in terms of hs-CRP, TNF-α and GDF-15. GDF-15 was significantly different in all three groups (p<0.001). A significant correlation was observed between PASI score and disease duration (p=0.005), hs-CRP (p=0.003), TNF-α (p=0.002), and serum GDF-15 levels (p<0.001). The serum GDF-15 level that can predict a high PASI score was >1498.5 pg/mL (area under the curve: 0.813, p<0.001) in the receiver operating characteristic curve analysis. This study is mainly limited by the lack of follow-up and pre- and post-treatment assessment. Inflammatory markers were measured only in the serum, and their tissue levels are unknown.
Conclusion: In addition to PASI score, GDF-15 levels can be a guide in monitoring treatment and systemic inflammation, determining the disease severity, and providing efficient treatment.

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Amaç: Hidradenitis süpürativa (HS), apokrin bezlerin kronik, inflamatuvar bir deri hastalýðýdýr. Ortalama trombosit hacminin (MPV) birçok inflamatuvar hastalýk için risk faktörü olduðu ve inflamatuvar yanýtýn belirteci olarak kullanýlabileceði gösterilmiþtir. Bu çalýþmanýn amacý, HS tanýlý hastalarda MPV ve trombosit sayýsý parametrelerini deðerlendirmek ve saðlýklý kontrollerle karþýlaþtýrmaktýr.
Gereç ve Yöntem: Eylül 2014 ve Ekim 2019 tarihleri arasýnda kliniðimizde izlenen 97 HS tanýlý hasta ile 78 saðlýklý kontrol grubu çalýþmaya dahil edildi. Hastalarýn MPV ve trombosit sayýsý parametreleri retrospektif olarak karþýlaþtýrýldý.
Bulgular: Deðiþkenler, hasta ve kontrol grubuna göre karþýlaþtýrýldýðýnda MPV deðeri, hasta grubunda 10,17±0,94 iken saðlýklý kontrollerde 9,53±0,63 olarak saptandý. Ýki grup arasýnda anlamlý fark bulundu (p<0,05). Trombosit deðerleri arasýnda anlamlý fark saptanmadý.
Sonuç: MPV düzeyleri HS tanýlý hastalarda saðlýklý kontrol grubuna göre anlamlý düzeyde yüksekti. Buna dayanarak MPV deðerinin bu hasta grubunda da bir inflamatuvar belirteç olarak kullanýlabilir olduðunu düþünüyoruz.

Background and Design: Hidradenitis suppurativa (HS) is a chronic inflammatory condition of the apocrine glands. The mean platelet volume (MPV) is a risk factor for many inflammatory diseases and can be used as a marker of inflammatory response. This study aimed to evaluate the MPV and platelet count in patients with HS and compare them with those of healthy controls.
Materials and Methods: Between September 2014 and October 2019, 97 patients diagnosed with HS and 78 healthy controls were included. Their MPVs and platelet counts were compared retrospectively.
Results: The MPV was 10.17±0.94 in the patient group and 9.53±0.63 in the control group, with the difference being significant (p<0.05). No significant difference was noted between the groups in terms of platelet values.
Conclusion: The MPV was significantly higher in patients with HS than in healthy controls. Based on this finding, the MPV may be used as an inflammatory marker in this patient group.

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Amaç: Psoriazis multifaktöriyel, kronik inflamatuvar bir deri hastalýðýdýr. Hastalýðýn klinik ve epidemiyolojik özellikleri farklý yaþ gruplarýnda deðiþkenlik gösterir. Tedavi seçiminde hastanýn yaþý önemli bir faktördür. Bu çalýþmada psoriazis hastalarýnda epidemiyolojik ve klinik özelliklerin 4 farklý yaþ grubunda karþýlaþtýrmalý olarak deðerlendirilmesi amaçlanmýþtýr.
Gereç ve Yöntem: Kliniðimize 2006-2016 yýllarý arasýnda baþvuran psoriazis hastalarýnýn dosyalarý geriye dönük olarak incelendi. Hasta dosyalarýndan cinsiyet, yaþ, hastalýk süresi, aile öyküsü, klinik psoriazis tipi, psoriazis alan ve þiddet indeksi, týrnak ve eklem tutulumu, eþlik eden komorbiditeler ve dermatozlar, kullanmakta olduklarý tedaviler not edildi. Veriler 0-18, 19-40, 41-65 ve 65 yaþ üzeri olmak üzere dört yaþ grubunda karþýlaþtýrmalý olarak deðerlendirildi.
Bulgular: Toplam hasta sayýsý 374 (%54,3 erkek, %45,7 kadýn) idi. Hastalarýn yaþlarý 6-85 (ortalama: 42,17±18,54) arasýndaydý. Hastalarýn %16’sý 0-18 yaþ, %26,7’si 19-40 yaþ, %45,5’i 41-65 yaþ arasýndaydý ve %11,8’i 65 yaþýn üzerindeydi. Guttat psoriazis ve jeneralize püstüler psoriazis erkeklere göre kadýnlarda daha sýk görüldü (p=0,001). Plak tip psoriazis tüm yaþ gruplarýnda en çok görülen klinik tip iken, 0-18 yaþ arasýnda guttat psoriazis sýklýðý (%31,7) diðer yaþ gruplarýna göre istatistiksel olarak anlamlý artmýþ saptandý (p<0,001). Týrnak tutulumu 41-65 yaþ grubunda %64,7 iken 0-18 yaþ grubunda %18,3 idi (p<0,001). Eklem tutulum sýklýðý 0-18 yaþ grubunun %1,7’sinde, 19-40 yaþ grubunun %4’ünde, 41-65 yaþ grubunun %8,8’inde ve 65 yaþ üstünün %9,1’inde saptandý (p<0,001). Yaþla birlikte komorbidite sýklýðýnýn anlamlý olarak arttýðý görüldü (p<0,001).
Sonuç: Bu çalýþmada yaþýn, psoriazisin klinik tiplerin daðýlýmý, týrnak ve eklem tutulumu, komorbiditeler ve tedavi yöntemlerinin seçiminde istatistiksel olarak anlamlý bir faktör olduðu saptanmýþtýr.

Background and Design: Psoriasis is a multifactorial, chronic inflammatory skin disease. Clinical and epidemiological parameters in psoriasis may vary in different age groups. The age of the patient is significant in the choice of treatment. We therefore aimed at performing a general and comparative assessment of epidemiologic and clinical parameters of patients with psoriasis according to four age groups.
Materials and Methods: We assessed the files of patients with psoriasis who applied to our clinic between 2006 and 2016. Sex, age, duration of disease, family history of psoriasis, clinical types, psoriasis area and severity index, nail and joint involvement, associated comorbidities and dermatoses, and treatments for psoriasis were obtained from the patient files. They were then evaluated comparatively in four age groups: 0-18 years, 19-40 years, 41-65 years and over 65 years.
Results: We enrolled 374 patients (54.3% male, 45.7% female). Age of the patients were between 6 years and 85 years (mean: 42.17±18.54 years), with 16% of the patients between the age of 0-18, 26.7% between 19-40, 45.5% between 41-65 and 11.8% above 65. Guttate psoriasis and generalized pustular psoriasis were observed more frequently in females (p=0.001). Plaque psoriasis was the most observed clinical type in all age groups, while between the age of 0-18 years, the frequency of guttate psoriasis (31,7%) increased significant compared to that in other age groups (p<0.001). Nail involvement in 41-65 years occurred in 64.7% of patients, while it was 18.3% in the 0-18 age group (p<0.001). Frequency of joint involvement was identified in 1.7% of the 0-18 age group, 4% of 19-40 age group, 8.8% of 41-65 age group and 9.1% of the age group above 65 years (p<0.001). Frequency of comorbidities significantly increased with increase in age (p<0.001).
Conclusion: In this study, age was noted as a significant factor in distribution of clinical types, nail and joint involvement, comorbidities and selection of treatment modalities.

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Ýzotretinoin genellikle þiddetli akne tedavisinde kullanýlýr. Ýzotretinoin ile bildirilen mukokutanöz, metabolik, nörolojik ve psikiyatrik, oftalmolojik, hematolojik yan etkiler, teratojenite gibi birçok yan etki vardýr. Bunlar arasýnda mukokutanöz yan etkiler en yaygýn olanlardýr ve sýklýkla doza baðlý bir þekilde geliþirler. Burada 20 yaþýnda sistemik izotretinoin kullanan bir erkek hastada görülen dizüri sunulmuþ olup, izotretinoinin ürolojik etkileri hakkýndaki literatür gözden geçirilmiþtir.

Isotretinoin is often used in the treatment of severe acne. However, many adverse reactions were reported, including mucocutaneous, metabolic, neurological and psychiatric, ophthalmologic, hematologic side effects and teratogenicity. The mucocutaneous are the most common side effects and often develop in a dose-dependent manner. I present a case of a 20-year-old male with the unusual non-specific dysuria only and review the literature on the urological effects of isotretinoin.

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Brucella, dünya çapýnda görülen en yaygýn zoonotik enfeksiyondur. Hastalýðýn seyri sýrasýnda kas-iskelet, sinir, genitoüriner ve kardiyovasküler sistemleri ilgilendiren ciddi komplikasyonlarla karþýlaþýlabilir; ancak kutanöz komplikasyonlar nadiren bildirilmiþtir. Burada vulvar bölgede apsesi ve deri purpurasý olan Brucella olgusu sunulmaktadýr. Deri döküntüleri ve vajinal mukozal bölge lezyonlarýnda Brucella’nýn da ayýrýcý tanýda daima akýlda tutulmasý gereken bir enfeksiyon hastalýðý olduðunu vurgulamak istiyorum.

Brucellosis is the most widespread zoonotic infection. Severe complications involving the musculoskeletal, nervous, genitourinary, and cardiovascular systems could be encountered during the course of the disease. However, cutaneous complications are rarely discussed. I present a case of Brucella with vulvar abscess and skin purpura. Brucella is an infectious disease that should always be kept in mind in the differential diagnosis of skin rashes and lesions of the vaginal mucosa.

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