• Users Online: 266
  • Print this page
  • Email this page
Export selected to
Endnote
Reference Manager
Procite
Medlars Format
RefWorks Format
BibTex Format
  Most popular articles (Since December 11, 2018)

 
 
  Archives   Most popular articles   Most cited articles
 
Hide all abstracts  Show selected abstracts  Export selected to
  Viewed PDF Cited
ORIGINAL ARTICLES
Treatment response in patients with moderate-to-severe psoriasis who had inadequate response to prior secukinumab
Tai-Siang Chiu, Tsen-Fang Tsai
0, 0(0):0-0
DOI:10.4103/ds.ds_36_18  
Background/Objective: Secukinumab is an effective treatment for psoriasis, and it has been reported to be effective in patients who failed on multiple prior biologics. However, treatment failure of secukinumab is possible and the alternative management in these patients remains poorly studied. Methods: We reviewed the treatment efficacy of all patients with moderate-to-severe psoriasis who used secukinumab as monotherapy and did not reach Psoriasis Area Severity Index 75 (PASI 75) response at week 16 (primary failure) or later (secondary failure). The treatment response of these patients during subsequent treatments was recorded. Optimal PASI improvement between weeks 12 and 20 and at the end of observation period was recorded. Results: Traditional systemic treatment (n = 4), etanercept (n = 1), adalimumab (n = 6), secukinumab weekly reloading (n = 2), or ustekinumab (n = 4) was administered in 16 patients (one with both ustekinumab and adalimumab). Six patients reached PASI 75 at week 16, including three (50%) with adalimumab. PASI 75 response was maintained in four patients at the end of observation period. Two (50%) of them used adalimumab, one used methotrexate plus acitretin, and the other used secukinumab. Conclusion: Adalimumab demonstrates better response in patients with refractory psoriasis to secukinumab. Traditional systemic medication and re-loading of secukinumab can also provide some benefits.
  923 81 -
REVIEW ARTICLE
Advances in systemic treatment for adults with moderate-to-severe atopic dermatitis
Yung-Tsu Cho, Chia-Yu Chu
January-March 2019, 37(1):3-11
DOI:10.4103/ds.ds_48_18  
Atopic dermatitis (AD) is generally considered a T-helper type 2-dominated disease. Adult AD is often more severe and less manageable by topical therapies and may require systemic immunosuppressants that bear notable side effects and organ toxicities. There is an unmet need for safe and effective long-term therapy in this population. Dupilumab, a fully human monoclonal antibody, dually inhibits interleukin (IL) IL-4 and IL-13 signaling and has demonstrated promising efficacy and acceptable safety profile in several Phase III trials, followed by recent Food and Drug Administration approval for the treatment of moderate-to-severe AD in adults whose disease is inadequately controlled with topical therapies. Dupilumab may also serve as a new treatment option when other systemic medications have failed or are inadvisable. Nevertheless, long-term safety data beyond 1 year and comparison with the existing therapies remain to be investigated. Other emerging agents targeting pruritogenic proteins, chronic inflammation, and epidermal hyperplasia are under vigorous clinical development. In particular, nemolizumab, blocking IL-31-mediated pruritus, has been reported in Phase II trials to provide symptom relief by interrupting the itch-scratch cycle. Accompanied by thorough characterization of different phenotype and endotype subsets, the era of precision medicine could bring new prospects in the optimal treatment of AD.
  756 194 -
EDITORIAL
A memoriam for Stephen Katz, a legend of physician scientist and master mentor in dermatology
Chih-Hung Lee
January-March 2019, 37(1):1-2
DOI:10.4103/ds.ds_3_19  
  567 150 -
ORIGINAL ARTICLES
Patient's perception and importance of clear/almost clear skin in moderate-to-severe plaque psoriasis: Results of clear about psoriasis survey in Taiwan
Yu-Huei Huang, Tsu-Man Chiu, Ji-Chen Ho, Chih-Chiang Chen, Rosaline Chung-Yee Hui, Po-Ju Lai, Tsen-Fang Tsai
January-March 2019, 37(1):12-18
DOI:10.4103/ds.ds_28_18  
Background: Psoriasis has been reported to impact patients' health-related quality of life. Limited data are available on patients' perception of this disease and the importance of clear/almost clear skin as a treatment goal in Taiwan. Objectives: A clear about Psoriasis worldwide survey was conducted among patients with moderate-to-severe psoriasis to assess patients' perspective on the impact of psoriasis on their personal and professional lives, treatment satisfaction, and the importance of achieving clear/almost clear skin. Here, we report the data for the Taiwanese patient population. Methods: A 20-min survey consisting of multiple choice questions and validated scales to assess disease severity and patient' quality of life was conducted between October 2015 and March 2016. Patients (age ≥18 years) with medically diagnosed moderate-to-severe psoriasis (Psoriasis Area and Severity Index [PASI] score ≥10 or PASI >5 to <10, plaques on visible or sensitive areas), not participated in any online surveys on psoriasis in the past 4 weeks were included in the survey. Results: Eighty-four respondents (male, 56%) with an average PASI score of 17.1 were analyzed. The majority of respondents (77%) had not achieved clear/almost clear skin and 71% believed that it is unachievable. Overall, 20% of patients did not feel comfortable telling their doctor that they want clear/almost clear skin, and 32% had never discussed it. Furthermore, 19% of patients were dissatisfied with their current treatment and 46% were uncertain if they were satisfied or dissatisfied. Overall, 96% of respondents experienced either discrimination or humiliation in daily life and 51% felt that psoriasis affected their professional life. Conclusions: The results of this survey demonstrate that, despite significant progress in the management of psoriasis, the treatment satisfaction level of patients remains suboptimal in Taiwan. The data highlight the need for patients to discuss their treatment goals with clinicians.
  482 121 -
Evaluation of anxiety sensitivity in patients with psoriasis
Hilal Kaya Erdogan, Ali Ercan Altinoz, Ersoy Acer, Zeynep Nurhan Saracoglu, Muzaffer Bilgin
January-March 2019, 37(1):28-32
DOI:10.4103/ds.ds_5_18  
Background/Objectives: Psoriasis is an inflammatory skin disease characterized by erythematous squamous plaques. It has negative physical, psychological, and social effects. Psychiatric comorbidities such as anxiety and depression can accompany to psoriasis. In our study, we aimed to evaluate the anxiety sensitivity (AS) in psoriasis patients. Methods: We included 89 psoriasis patients, 44 controls with nonpsychodermatological disease and 59 healthy volunteers to study. Dermatological examinations were performed, and the Psoriasis Area and Severity Index (PASI) values were calculated. Participants completed a sociodemographic information form, Beck Anxiety Inventory and AS Index-3. Results: Both the psoriasis group and the control group with nonpsychodermatological disease had higher anxiety scores than the healthy control group. Psoriasis patients were found to have higher AS scores than both control group with nonpsychodermatological disease and healthy controls. When the psoriasis group was divided into two groups according to the presence of systemic disease or psoriatic arthritis; there was no difference between the groups in terms of psychometric measurements. Furthermore, there was no significant correlation between PASI scores and disease duration and psychometric evaluations. Conclusion: Our study is the first to show that the AS of psoriasis patients is significantly higher than healthy controls and of those with nonpsychodermatological diseases. It is not clear that high AS in these patients is a predisposing factor to the disease or a consequence of the disease.
  371 84 -
Association of leptin, resistin, and high-molecular-weight adiponectin levels with psoriasis area and severity index scores, obesity, and insulin resistance in psoriasis patients
Emine Müge Acar, Nilsel İlter, Şehri Elbeg
January-March 2019, 37(1):33-39
DOI:10.4103/ds.ds_9_18  
Background: Psoriasis is frequently associated with obesity and cardiovascular diseases. Adipocytokines have been implicated in the pathogenesis of psoriasis and its cardiometabolic comorbidities. Objectives: The aim of this study was to assess the roles of leptin, resistin, and high-molecular-weight (HMW) adiponectin in psoriasis as well as their relationship with Psoriasis Area and Severity Index (PASI), obesity, and insulin resistance. Materials and Methods: Forty-six psoriasis patients and equivalent age-, sex-, and body mass index (BMI)-matched controls were recruited in this study. PASI, waist and hip circumferences, and waist/hip ratio (WHR) were recorded, and total body fat mass (TBFM) values were measured using a bioimpedance body composition analyzer. Fasting serum leptin, resistin, and HMW adiponectin levels were measured, and homeostasis model assessment values for insulin resistance (HOMA-IR) were calculated. Results: After the adjustment for anthropometric variables, leptin levels did not differ significantly between the groups (P = 0.736). The patient group showed significantly elevated resistin and lower HMW adiponectin levels (P = 0.007, P= 0.010, respectively). The correlation of serum leptin, resistin, and HMW adiponectin with PASI was not significant (r = −0.100, P= 0.506; r = −0.053, P= 0.726; r = −0.103, P= 0.494, respectively). HOMA-IR positively correlated with leptin and negatively correlated with HMW adiponectin (r = 0.426, P < 0.001; r = −0.393, P < 0.001, respectively). The correlation of leptin and resistin with BMI was direct while that of HMW adiponectin with BMI was inverse (r = 0.532, P < 0.001; r = 0.240, P= 0.021; r = −0.408, P < 0.001, respectively). No significant differences were detected regarding TBFM, and waist and hip circumferences (P = 0.187, P = 0.090, P= 0.543, respectively). However, WHR was significantly higher in the patient group (P = 0.015). Conclusion: Altered adipocytokine levels in psoriasis patients suggest a possible role of adipocytokines in the relationship between psoriasis and its metabolic comorbidities. Fat distribution is also different from the healthy population with similar TBFM values, and abdominal obesity, which is an independent cardiovascular risk factor, is more prevalent in psoriasis patients.
  323 43 -
Differential expression of PTEN and PDCD4 tumor suppressors in melanoma and microRNA-21-positive melanoma cells and squamous carcinoma cells
Kao-Hui Liu, Woan-Ruoh Lee, Ya-Ju Hsieh, Chia-Lun Chou, Ming-Chung Jiang, Shing-Chuan Shen
January-March 2019, 37(1):19-27
DOI:10.4103/ds.ds_17_18  
Background:In vitro cell experiments show that microRNA-21 downregulates the PTEN and PDCD4 tumor suppressor and promote melanoma cell proliferation and invasion. We examined microRNA-21, PTEN, and PDCD4 expressions in various melanoma cells as well as in melanoma specimens to define the actual expression profile of these tumor regulators. Materials and Methods: The microRNA-21, PTEN, and PDCD4 expressions in human keratinocytes and melanoma cells were analyzed by reverse-transcription polymerase chain reaction (RT-PCR) and real-time RT-PCR and immunoblotting. PTEN and PDCD4 expressions in melanoma patients were analyzed by immunohistochemistry. Results: RT-PCR and quantitative real-time PCR assays showed that A375 melanoma cells, squamous cell carcinoma (SCC-25), and SCC-4 skin squamous carcinoma cells expressed a higher level of microRNA-21 than HaCaT human keratinocytes. This inconsistent staining pattern of PTEN and PDCD4 in a melanoma tumor mass is not understandable, because the expression level of microRNA-21 in melanoma specimens are different. The expression of PDCD4 was not inversely correlated with the levels of microRNA-21 in these cells. In addition, we also found that only A2058 cells expressed low PTEN level and that A375, SCC-25, and SCC-4 cells expressed high PTEN levels. Furthermore, expression of PDCD4 was higher in the highly malignant B16F10 mouse melanoma cells than in B16 F0 cells; by contrast, both B16F0 and B16F10 cells expressed PTEN at high levels. Conclusion: Although PDCD4 and PTEN are targets of microRNA-21-dependent inhibition, PTEN and PDCD4 expressions are regulated in a more complex manner in skin cancer; not all microRNA-21-positive skin cancers certainly lose their normal PTEN and PDCD4 tumor suppressor functions.
  291 69 -
BRIEF REPORT
Childhood and adolescent psoriasis in Taiwan: A retrospective analysis from a single medical center
Hsi Yen, Hsing-Jou Su, Thi-Tuong Vi Tran, Pei-Lun Kuo, Julia Yu-Yun Lee, Tak-Wah Wong
January-March 2019, 37(1):46-49
DOI:10.4103/ds.ds_26_18  
There are limited studies regarding childhood and adolescent psoriasis in Taiwan. A total of 86 pathologically confirmed cases diagnosed from 1989 to 2017 were retrospectively reviewed. Mean disease onset age was 10.51 years, and plaque psoriasis was the most common type. Compared to studies on Caucasian and other Asian populations, we found a lower estimated prevalence, higher rate of psoriasis limited to the nail at presentation, and higher prevalence of psoriatic arthritis. The most common comorbidities were related to atopy and metabolic syndrome. Positive family history of psoriasis and psoriasis preceded by infection were significantly associated with moderate-to-severe disease.
  281 67 -
CASE REPORTS
Idiopathic lymphoplasmacellular mucositis of the vulva in a patient with partial interferon-γ receptor 1 deficiency
Kuan-Yu Chen, Tseng-Tong Kuo, Ya-Ching Chang, Rosaline Chung-Yee Hui, Ya-Hui Chuang
January-March 2019, 37(1):50-52
DOI:10.4103/ds.ds_18_18  
We report a case of idiopathic lymphoplasmacellular mucositis (ILPM) of the vulva in a 48-year-old woman with partial interferon-γ receptor 1 (IFN-γR1) deficiency. The lesion had an unusual ulcerovegetative presentation. Remarkable response was observed with oral and topical steroids in the first 3 weeks. However, the lesion recurred after tapering oral steroids and continuous low-dose oral steroids were required to suppress recurrence. To the best of our knowledge, this is the first case report of ILPM in a patient with partial IFN-γR1 deficiency. ILPM should be included in the differential diagnosis of persistent vulvar ulcerovegetative lesions.
  265 55 -
ORIGINAL ARTICLES
Dermatoscopic assessment of nailfold capillary abnormalities in Behçet's disease and correlation of the findings with disease activity and severity
Duru Tabanlioglu-Onan, Pinar İncel-Uysal, Yıldız Hayran, Günay Şahin-Dalgiç, Mutlu Hayran, Ferda Artüz, Başak Yalçin
January-March 2019, 37(1):40-45
DOI:10.4103/ds.ds_10_18  
Background: A small number of studies used nailfold capillaroscopy (NC) in the evaluation of nailfold capillary changes in Behçet's disease (BD). The purpose of this study was to investigate the characteristics and frequency of nailfold capillary changes in BD by dermatoscopy and videodermatoscopy and to develop a scoring system for those capillary changes to predict the activity and severity of the disease. Methods: We performed NC on 40 BD patients and 20 healthy controls with dermatoscopy and videodermatoscopy. Capillary morphology, distribution, and density were analyzed qualitatively and quantitatively. We also assessed the activity and severity of the disease with BD Current Activity Form and BD Severity Score Classification and evaluated the relation of these scores with morphology scores and capillary density. Results: Capillary morphologic alterations were encountered significantly more in BD group (P < 0.05). Loss of continuity in capillary loops and irregularity of capillary distribution were significantly more frequent in BD group compared to healthy controls (P = 0.003 and P < 0.001). Morphology score was significantly higher in BD patients compared to control group (P < 0.001); however, we could not detect a significant relation between capillary morphology and density and the activity and severity of BD. Conclusion: Although we could not demonstrate a significant relation between capillary changes and the activity and severity of BD, we consider that NC performed with dermatoscopy can reflect the presence and extent of microvascular involvement and thereby might have diagnostic and prognostic value in BD.
  263 55 -
Methods for diagnosing onychomycosis: Acomparative study of 459cases
Yang-Chih Lin, Pei-Lun Sun, Pa-Fan Hsiao, Fang-Ju Sun, Yu-Hung Wu
April-June 2019, 37(2):63-66
DOI:10.4103/ds.ds_6_18  
Background: Onychomycosis is a common infectious nail problem but shares similar clinical presentation with some other noninfectious disorders, such as psoriasis and lichen planus. Acorrect diagnosis is essential to proper management. There are three common tests used in the outpatient clinic, including direct potassium hydroxide(KOH) examination, nail plate histology study, and fungal culture. Objective: This study aimed to compare the accuracy and feasibility among these three tests in the diagnosis of onychomycosis. Materials and Methods: We retrospectively reviewed the patients diagnosed with onychomycosis and had positive result of any of the three tests from June 2005 to June 2015. The age, gender, and results of the diagnostic methods were collected and analyzed. Results: Atotal of 459patients were enrolled. The positive rates were significantly different between nail plate histology study(93.0%, 427/459), KOH examination(67.3%, 309/459), and fungal culture(42.1%, 193/459)(P<0.05). Conclusions: Nail plate histology study has the highest positive rate in the diagnosis of onychomycosis than KOH examination and fungal culture. However, KOH examination is most inexpensive and is the fast way to obtain the result with moderate reliability. Acombination of two or three diagnostic tests could provide useful information to the clinician to manage onychomycosis appropriately.
  247 48 -
CASE REPORTS
Pigmented basal-cell carcinoma of the upper lip: A report of a case and review of the literature
Natsuko Matsumura, Anna Furukawa, Kazuki Ueda, Akihiko Oyama, Toshiyuki Yamamoto
January-March 2019, 37(1):53-55
DOI:10.4103/ds.ds_32_18  
Basal-cell carcinoma (BCC) rarely occurs on the lip. We herein report a case of an 89-year-old male, who presented with a blackish nodule on the vermilion border and the outer mucosa of the right side of the upper lip. A diagnosis of pigmented BCC was made by histopathological examination. The patient was successfully treated by Abbe flap with excellent esthetic and functional results. We have reviewed 64 cases of lip BCCs previously reported. There was no gender predominance, and the upper lip was involved 1.5 times higher than the lower lip. There was no lymph node metastasis, and thus, lip BCC had a good prognosis.
  236 55 -
ORIGINAL ARTICLES
The role and relationship of the serum D-dimer level and autologous serum skin test response in chronic spontaneous urticaria
Bok Won Park, Ye Ji Jang, Eun Byul Cho, Eun Joo Park, Kwang Ho Kim, Kwang Joong Kim
April-June 2019, 37(2):67-71
DOI:10.4103/ds.ds_13_18  
Background: The severity of chronic urticaria(CU) may be associated with the D-dimer level, and CU patients often have other autoimmune disorders. The autologous serum skin test(ASST) is believed to identify autoimmune/autoreactive diseases in CU patients. Aim: This study evaluated whether the levels of D-dimer, total immunoglobulin E(IgE), and autoimmune markers, such as antithyroid peroxidase(TPO) and antithyroglobulin(TG), differ between ASST-positive and ASST-negative patients among CU patients. In addition, the study assessed whether these laboratory findings were related to CU severity. Methods: The study enrolled 54 adults with CU (16 ASST positive, 38 ASST negative). D-dimer, total IgE, autoimmune marker(anti-TPO and anti-TG), and thyroid hormone levels and the urticaria activity score(UAS) were measured. Results: The levels of D-dimer, total IgE, anti-TPO, and anti-TG and the thyroid function test result showed no difference between the ASST-positive and ASST-negative groups. The UAS was higher in the ASST-positive group than in the ASST-negative group, but the ASST-positive group showed a better treatment response. The UAS was higher in patients with an elevated D-dimer level than in those with a normal level. Total IgE was related to the UAS in only the ASST-negative group, and anti-TPO and anti-TG levels were not related to the UAS. Conclusions: There were no associations between the ASST response and the D-dimer level, total IgE level, thyroid function test results, and thyroid autoantibody levels. However, our findings suggest that the ASST response, D-dimer level, and total IgE level are potential predictors of CU severity.
  231 29 -
CASE REPORTS
The gift of honeymoon: An interesting case of furuncular myiasis caused by Dermatobia Hominis in Taiwan and review of the literature
Yung-Wei Chang, Han-Chi Tseng
April-June 2019, 37(2):93-97
DOI:10.4103/ds.ds_27_18  
Travel-related cutaneous diseases are very common, and among them, myiasis ranks in the fourth place. Hereby, we present a case of a 28-year-old Taiwanese woman infested by Dermatobia hominis during honeymoon trip to Amazonas region and Peru. The diagnosis was confirmed by extracting the larva intraoperatively. The epidemiology, distinctive life cycle, clinical features, auxiliary diagnostic tools, therapeutic methods, and prophylactic measures of human botfly infestation will be discussed in the article. Owing to the progressive increment of international travels and ecological explorations, raising awareness of tropical diseases should be more emphasized.
  186 36 -
CORRESPONDENCE
Effective treatment of patterned pigmented lesion with low-fluence neodymium-doped yttrium aluminum garnet laser
Min Wha Choi, Tai Kyung Noh, Tae Young Han, June Hyunkyung Lee
January-March 2019, 37(1):60-61
DOI:10.4103/ds.ds_7_18  
  176 43 -
Response to comment on report of two cases of cutaneous Mycobacterium abscessus infection complicating professional decorative tattoo
Po-Hua Chen, Chia-Hua Wu
January-March 2019, 37(1):58-59
DOI:10.4103/ds.ds_42_18  
  173 45 -
ORIGINAL ARTICLES
The effect of striae gravidarum on quality of life in a sample of Turkish pregnant woman population
Atiye Ogrum, Hatice Yilmaz Dogru
April-June 2019, 37(2):72-76
DOI:10.4103/ds.ds_22_18  
Background: Striae gravidarum is a commonly occurred physiological change among women with pregnancy. Although these changes are accepted as physiological, the lack of therapeutical and preventive techniques led to impaired quality of life of women. The aim of this study is to evaluate the effect of striae gravidarum on quality of life in a sample of Turkish pregnant woman population and the usage of cream/lotion to prevent the striae. Methods: Women with pregnancy whose completed 36weeks of their pregnancy and admitted to the Obstetrics and Gynecology outpatient unit between March 2017 and August 2017 were included in the study. The severity of striae was assessed using Davey's score. The effects of striae on patient's quality of life were evaluated by Skindex-29 questionnaire. The usage of cream/lotion whether or not was also asked and recorded. Results: Atotal of 153 women with pregnancy were included in the study. Of those 43.1%(n=66) was primiparae and 56.9%(n=87) was multiparae. The prevalence of striae gravidarum in total, primiparae and multiparae was 75.8%, 66.7%, and 82.7%, respectively. There was a weak positive correlation found between the parity and severity of striae(ρ =0.190, P =0.018). The emotion and symptom score of primiparae women with severe striae were higher than women without striae(P=0.001; P =0.028, respectively). The usage of cream/lotion was significantly higher in primiparae compared to multiparae(P<0.001). The symptom and emotion scores of the women with striae those applied cream were higher than nonusers(P<0.001; P =0.038, respectively). Conclusions: Striae gravidarum may cause psychological and physical effects among women, especially primiparae women with severe striae and negatively affects the quality of life. Cream/lotion may be used to prevent striae development and reduce symptoms of pregnant women with higher emotion scores.
  186 31 -
Using a nonablative monopolar radiofrequency laser in the treatment of acne vulgaris
Ju-Yeon Choi, Sang Hyeon Hwang, Junghwa Yang, Ga-Young Lee
April-June 2019, 37(2):77-81
DOI:10.4103/ds.ds_4_18  
Background: Acne vulgaris is a prevalent cutaneous disorder that significantly affects patient quality of life. There have been several reports of successful acne treatment using lasers. However, few studies have reported the use of radiofrequency(RF) lasers for acne. Objective: The purpose of this study was to evaluate the efficacy and safety of a noninvasive monopolar RF laser in the treatment of acne vulgaris on the face. Methods: Arandomized, prospective, split-face study was performed. Eleven participants were recruited. Patients were treated with the RF laser on one half of the face and no laser treatment on the other half. Two treatments were performed at 2-week intervals. Patients returned for follow-up 2weeks after the final treatment. Results: After 4weeks, the lesion counts of papules, comedones, red macules, and the sebumeter measured values all significantly decreased on the treated area compared to those on untreated areas. In the photograph analysis, the grade of acne(using Cook's acne grading method) also significantly improved after treatment. Patients reported tolerable pain and mild erythema with laser treatment. However, there were no permanent adverse events. Conclusion: Treatment with the noninvasive RF laser successfully reduces acne lesions(papules, comedones, and red macules) and sebum secretion without severe adverse events.
  179 38 -
CORRESPONDENCE
Comment on report of two cases of cutaneous Mycobacterium abscessus infection complicating professional decorative tattoo
Masoud Keikha
January-March 2019, 37(1):56-57
DOI:10.4103/ds.ds_41_18  
  167 38 -
CASE REPORTS
Sparing of injection sites in patients with extensive psoriasis treated with various biologics
Ya-Chu Tsai, Tsen-Fang Tsai
April-June 2019, 37(2):90-92
DOI:10.4103/ds.ds_31_18  
Although biologic agents have emerged as the preferred strategy for moderate-to-severe psoriasis, sparing around injection sites may be an underreported effect and represent inadequate systemic efficacy with fair local response of biologic treatment for psoriasis. Herein, we report six cases of extensive psoriasis presenting injection site sparing at biologics administration sites.
  134 27 -
Radix Aucklandiae(dried root of Saussurea costus)-induced acute generalized exanthematous pustulosis confirmed by patch testing
Po-Han Ho, Yung-Tsu Cho, Chia-Yu Chu
April-June 2019, 37(2):98-102
DOI:10.4103/ds.ds_16_18  
A 40-year-old female presented with rapid-onset generalized erythematous eruption with pustules agminated over the flexural areas and the flanks for 2days. In skin histopathology, extensive subcorneal pustules, spongiosis and neutrophilic exocytosis, papillary dermal edema, and perivascular and interstitial mixed-cell infiltrates were observed. No psoriasis history but irregular intake of numerous kinds of Chinese herbal medications and the last-modified regimen including Radix Aucklandiae 14days before the onset of pustular eruption were unveiled. Patch test showed positive result with only Radix Aucklandiae. Thus, acute generalized exanthematous pustulosis induced by Radix Aucklandiae was diagnosed.
  138 22 -
CORRESPONDENCE
Pityriasis rubra pilaris with acantholysis mimicking pemphigus foliaceus: Adiagnostic pitfall
Teng-Li Lin, Chao-Kuei Juan, Yi-Ju Chen, Chi-Shun Yang, Chien-Shan Chiu
April-June 2019, 37(2):106-107
DOI:10.4103/ds.ds_30_18  
  114 27 -
ORIGINAL ARTICLES
Burnout syndrome among dermatologists and assessment of prevalence and risk factors: A nationwide survey
Ezgi Ozkur, Ilknur Kivanc Altunay, Emel Calikoglu, Meltem Onder
0, 0(0):0-0
DOI:10.4103/ds.ds_46_18  
Background: Burnout is a syndrome of emotional exhaustion, depersonalization, and a sense of low personal accomplishment. Increasing patient volumes and rising health-care systems' productivity targets also pose a risk of burnout in all specialties including dermatology. The aim of the present study was to study burnout syndrome in dermatologists and determine related factors. Materials and Methods: Dermatologists who were actively working (n = 2005) were E-mailed a questionnaire via the Turkish Dermatology Society, and 422 (21%) completed it anonymously. The first part of the questionnaire comprised demographic and work-related characteristics, and the second part was formed by the Turkish version of the Maslach Burnout Inventory (MBI). The MBI is a 22-item questionnaire for the assessment of burnout in the following three dimensions: emotional exhaustion, depersonalization, and low personal accomplishment. Results: Emotional exhaustion and depersonalization scores of residents were significantly higher (P < 0.001), and personal accomplishment scores were significantly lower (P < 0.001) than that of the other groups. Dermatologists in the private sector had significantly lower scores for emotional exhaustion (P < 0.001) and depersonalization (P < 0.001) and significantly higher scores for personal accomplishment (P < 0.001) than those working in the public sector. Emotional exhaustion and depersonalization scores were significantly higher in participants who worked on weekends, those intended to change workplace, and had at least one chronic illness (P < 0.05 for all comparisons). A positive correlation was found between emotional exhaustion and depersonalization (r = 0.691, P < 0.001), number of patients (r = 0.355, P < 0.001), and number of shifts (r = 0.344, P < 0.001), and there was a negative correlation between personal accomplishment (r = −0.485, P < 0.001), age (r = −0.301, P < 0.001), number of vacation days (r = −0.149, P = 0.002), and years in the profession (r = −0.288, P < 0.001). Conclusion: Our study sheds light on factors that influence burnout and also indicates a need for health-care reforms for dermatologists' satisfaction and burnout, as well as patient satisfaction and quality of care.
  120 13 -
The relationship between pityriasis rosea, seasonal factors, and other herpetic infections: A time series analysis
Sibel Berksoy Hayta, Rukiye Güner, Selim Çam, Melih Akyol
0, 0(0):0-0
DOI:10.4103/ds.ds_33_18  
Background: Data on seasonal variation and viral etiology in Pityriasis rosea (PR) have been conflicting. The aim of this study was to investigate the association of PR and other herpetic infections, taking seasonal changes into account. Methods: The data were collected retrospectively from electronic health registry systems in Sivas in the Central Anatolia region of Turkey between 2008 and 2016. According to their clinical types, other herpetic infections were investigated. Environmental factors such as humidity, temperature, and rainfall for the relevant period were added into the model. Time series methods (augmented Dickey–Fuller unit root test and regression analysis) were used in the analysis. Results: A total of 1207 PR patients were included in the study. The number of PR patients was calculated to be 0.462 times that of the same period in the previous year. The incidence of PR increased significantly when the rate of infections caused by varicella-zoster virus decreased and the rate of infections caused by herpesvirus Type 1 and humidity increased (P < 0.05). Conclusion: Environmental factors such as humidity are important in the emergence of the PR. Furthermore, the incidence of PR may be inversely affected by varicella-zoster infections contrary to the relationship between PR and herpesvirus Type 1 infections.
  103 25 -
CASE REPORT
Case report of two brothers with a novel homozygous mutation in ALOX12B leads to autosomal recessive congenital ichthyosis: Which type and which subtype? Two siblings with a novel homozygous mutation in ALOX12B
Evren Gumus
0, 0(0):0-0
DOI:10.4103/ds.ds_35_18  
Ichthyosis is a heterogeneous group of rare genetic skin disorders characterized by furfuraceous and dry skin. The classification of ichthyosis has always been a challenging process as genodermatoses. Here, we report a novel homozygous mutation in ALOX12B in two siblings with autosomal recessive congenital ichthyosis. We aimed to evaluate two brothers' genotype-phenotype association in the light of the last nomenclature information.
  114 12 -