BackgroundAndrogenetic alopecia is a common dermatological condition affecting both genders.ObjectiveTo evaluate the tendency towards development of psychosexual disorders according to the clinical stages of androgenetic alopecia.MethodsA cross-sectional study was conducted including 353 patients of both sexes on different clinical stages of hair loss, and the patients were enquired about self-perception, self-esteem, sexual experiences, anxiety and depression states. Hair loss was classified by standardized hair loss scales, and psychological effects were assessed with questionnaires. Results were compared to p<0.05.ResultsNegative effects on each psychological parameter of androgenetic alopecia in females were higher than in males. While overall comparisons according to hair loss stages for each parameter were significant in males, only sexual experiences, anxiety and depression values were significant in females. Sexual experiences and depression values were higher in Ludwig 3 than in 1&2, while anxiety was higher in Ludwig 3 than 1. Self-perception values in Norwood 2&2A were higher than 3A, 3V, 4 and 4A, while self-esteem values in 2A were higher than 3&4. Sexual experiences values in 2&2A were lower than 3, 3A, 3V, 4 and 4A, while 3&3A were lower than 4&4A. Depression was lower in 2A than 3, 3A, and 3V, and lower in 2A than 4A. Anxiety was lower in 2A than in 4&4A.Study limitationsRelatively small number of patients, who were from a single center.ConclusionsIn the management of androgenetic alopecia, it should be considered that patients may need psychological support according to the clinical stages, because of increased tendency to develop psychosexual disorders.

Background: Psoriasis is an inflammatory skin disease that may lead to comorbidities, including metabolic syndrome (MS). Objective: We determined the prevalence of MS and its correlation with psoriasis duration, severity, and sleep quality in psoriasis patients. Methods: A total of 112 subjects with chronic plaque psoriasis were studied. Demographics, MS parameters, disease duration, severity, and sleep quality were examined. The Psoriasis Area and Severity Index (PASI)and the Pittsburgh Sleep Quality Index (PSQI) were used to assess psoriasis severity and sleep quality, respectively. Presence of MS and its correlations with psoriasis duration, severity and sleep quality were investigated. Results: Of 112 patients, 76 (67.8%) were diagnosed with MS. Of all patients, 74.1% had a high PASI, and 84.8% had a high PSQI. The mean values of psoriasis duration, body mass index, waist circumference, fasting glucose, HOMA-IR, triglyceride levels, blood pressure, PSQI, sleep latency, and daytime sleep dysfunction were significantly higher in the MS group than non-MS group, whereas the mean HDL level was lower. The prevalences of MS, high fasting glucose, and low HDL were significantly higher among female, but not male, patients with severe psoriasis (PASI >10) than those without severe psoriasis. Disease duration, high body mass index, waist circumference, blood pressure, fasting glucose, HOMA-IR, triglyceride levels, low HDL, and poor sleep quality were significantly correlated with the presence of MS. However, only waist circumference, fasting glucose, blood pressure, and low HDL were predictive of the development of MS. Conclusions: MS is common among psoriasis patients, and especially in females with advanced psoriasis, high fasting glucose, and low HDL levels. Besides diagnostic criteria of MS, a long duration of psoriasis, poor sleep quality and high-HOMA-IR correlate with the development of MS. High fasting glucose and low HDL levels may facilitate MS development in association with psoriasis severity in females.  

Anaplastic thyroid carcinoma is a significantly fatal endocrine neoplasm, with an average survival time of 4–12 months following diagnosis. The present study reports the case of a 57-year-old male patient who presented to the Bağcılar Training and Research Hospital (Istanbul, Turkey) due to swelling in the neck and difficulty swallowing. The jugular mass biopsy results were consistent with a diagnosis of anaplastic thyroid cancer. The patient was regarded to have advanced-stage subcarinal, paratracheal, aortopulmonary, trancheobronchial and mediastinal lymphadenopathies and exhibited a good prognosis following chemotherapy. However, the patient succumbed one month later due to the emergence of diffuse skin lesions. The histopathological and immunohistochemical assessment of the skin biopsy displayed the characteristics of the underlying thyroid carcinoma.

Orf (contagious ecthyma) is a zoonotic infection caused by a dermatotropic parapoxvirus that commonly infects sheep, goats, and oxen. Parapoxviruses are transmitted to humans through contact with an infected animal or fomites. Orf virus infections can induce ulceration, and papulonodular, pustular, or ecthymic lesions of the skin after contact with an infected animal or contaminated fomite. Rarely, orf virus provokes extensive vasculo-endothelial proliferation as a skin manifestation. Here, we present the case of an 8-year old female with poxvirus-induced vascular angiogenesis that developed 10 days after a thermal burn. An 8-year-old female presented at our outpatient clinic with red swellings and a yellow-brown crust on them. After a thermal burn with hot water, she went to a clinic and the burn was dressed with nitrofurazone and covered for 2 days. When the dressing was removed after 2 days, nodules were seen in the burnt areas. When the clinical findings were considered with the histopathological features, a reactive vascular proliferation due to a viral agent was suspected. Following PCR, parapoxvirus ovis was detected. Viral infections such as pox virus can trigger pyogenic granulomas or pyogenic granuloma-like vascular angiogenesis. Infectious agents must be considered when dealing with pyogenic granuloma-like lesions.

This is a case of generalized annular elastolytic giant cell granuloma (AEGCG) associated with borrelia infection and genes of p-30, p-31, p-39 RESUMEN Se trata de un caso de granuloma elastolítico anular de células gigantes (GEACG) generalizado, asociado con infección por Borrelia y con los genes de p-30, p-31, p-39. Una posible reacción transmediada del tipo de célula T que podría haber inducido la GEACG, se discute a partir del concepto de "proteínas de shock térmico (PST) y mímica molecular".Palabras claves: Granuloma anular elastolítico de células gigantes, Borrelia burgdorferi, proteínas de shock térmico, enfermedad de Lyme, mímica molecular West Indian Med J 2015; 64 (4): 447From:

A Bullous Pilomatricoma Developed after Hepatitis A VaccinationThe Editor, Sir, Pilomatricomas originate from hair matrix cells and usually appear as firm, solitary and asymptomatic nodules beneath the skin. These tumours occur mostly in children. They are generally located on the face and neck (1). Bullous pilomatricoma is an uncommon lesion and only few cases of this variant have been reported in the literature (1, 2). We report a 7-year old girl with a pilomatricoma showing bullous appearance. The patient suffered from a dome shaped, bullous mass on the left arm. The 1.5 × 1.5 cm lesion presented one month previously and progressively enlarged. In the history of the patient, there was a hepatitis A vaccination to the same area with the bullous lesion, about four months earlier. Two days after the vaccination, severe inflammation occured in the same region. The patient did not have any family history of such or mechanical trauma. On dermatologic examination, a dome shaped, red-brown coloured, semi-translucent bullae was noted (Fig. 1A).The bullae collapsed inward with palpation and a firm, small, painless mass was felt at the bottom of the lesion. When the lesion was pressed with the tip of a pen, it had a wrinkledatrophic appearance (Fig. 1B). The other physical and systemic examination findings were normal and there was no lymphadenopathy. Routine haematological and biochemical examinations of the patient were within the normal limits. With dermatoscopy, red-coloured tortuous small vessels on an irregular white opacity, which settled on a livid-red background, were observed (Fig. 1C).Needle aspiration material of the bullae was haemorrhagic and its microbiological culture was sterile. With these findings, the diagnosis of the lesion was made as a "bullous pilomatricoma". The mass was totally removed with surgical excision. On histopathological examination, the tumour nests were composed of eosinophilic shadow cells, basophilic cells and surrounded by a fibrous capsule in the deep dermis. Calcium salt depositions were observed in the tumour mass. In the superficial dermis, marked lymphoedema and increased numbers of dilated lymphatics filled with eosinophilic lymph fluid were observed (Fig. 2). Bullous pilomatricoma is a very rare form of pilomatricoma (3). Their incidence is between 3% and 6% (1). Although pilomatricomas can be associated with other genetic disorders such as myotonic dystrophy and Gardner's syndrome, the bullous variant is not associated with these syndromes (2). The bullous lesions are located mostly in the shoulder and upper extremity and predominantly in females. They are usually asymptomatic lesions (1, 2). Clinical characteristics reported include semi-transparent, erythematous, bluish or skin-coloured, heavily folded or striae-like, flaccid blisters overlying a solitary, firm-to-hard nodule (2, 4). Mechanical irritations such as continuous mechanical stimulation, scratching and pinching trauma and continuous pressure play an important role in the development of bullous pilomatricomas ...

Objectives: Psoriasis (PS) is a chronic, immune-mediated inflammatory skin disease. PS may lead to significant effects on healthrelated quality of life (HRQoL) and other outcomes. In the present study, an investigation into sleep quality (SQ), and its possible relations with factors which may affect SQ were aimed. Methods: A total of 74 subjects from both sexes were enrolled in this study, between January and July 2017. Patients were evaluated with their demographics, body mass index (BMI), Psoriasis Area Severity Index (PASI), Pittsburgh Sleep Quality Index (PSQI), Psoriasis Quality of Life Index (PQLI), Self Perception Scale (SPS). Additionally, accompanying chronic diseases, disease duration and severity of pruritus were recorded. Obtained PSQI values were compared with the mentioned parameters concerning the significance of their relations with it. SPSS version 24, 2016 was used to analyse the data, and significance was evaluated with p-values of <0.05, 0.01, and 0.001, and rho (r) values of <0.2, =0.2-0.4, =0.4-0.6, =0.6-0.8 and >0.8. Results: Thirty-seven female and 37 male were studied. The mean age of total of the study population was 47.21±13.91. Mean BMI and mean duration were 30.09± 4.68 kg/m 2 , and 10.58±9.1 months. Mean values of PASI, PSQI, SPS, and PQLI of the study group were 19. 79±16.99, 9.14±5.09, 142.12±23.83, and 21.94±16.31, respectively. Approximately thirty-one percent of them had at least one chronic disease. Alcohol and smoking rates were 17.56%, 50%. PASI was positive/strongly correlated with PQLI and negative/ weakly correlated with SPS. No correlation was detected between PSQI values and age, gender, BMI, and SPS values. PSQI was moderately correlated with PQLI, diabetes mellitus (DM), and pruritus severity, whereas it was weak correlated with PASI, hypertension (HT), thyroid diseases and disease duration. PASI and DM showed a predictive effect on SQ. Conclusion: SQ is affected by certain factors, such as QoL, disease severity, disease duration, pruritus severity, accompanying disorders, such as HT, DM and thyroid diseases, in which disease severity and DM have predictive effects on SQ in PS patients. Controls of disease activation and prevention of progression in DM may provide to keep SQ in PS.

Coronavirus disease 2019 (COVID-19) was detected for the first time in December 2019 in Wuhan, China, as a novel pneumonia causing respiratory tract infection. 1 COVID-19, indicating person-to-person transmission and an asymptomatic course, has rapidly spread to the entire world. 2 Previous studies have shown that infectious disease outbreaks have been associated with mental health symptoms and disorders (eg, depression, anxiety, post-traumatic stress disorder, insomnia) in survivors, family members, healthcare workers (HCW), and members of affected communities. 3,4 Acne vulgaris (AV) is a common inflammatory skin disease of the pilosebaceousünit (PSU) manifesting with comedones, inflammatory follicular papules and pustules, and occasionally nodular cystic lesions on the sebaceous skin regions including the face, nape, chest, and back. 5 All ages considered, its prevalence is about 9.5%. Several