Aslı Aksu Çerman

Background and Objectives: This study aimed to characterize the clinical spectrum, diagnostic delay, treatment patterns, and outcomes of pediatric mycosis fungoides (MF) and to identify predictors of early response. Methods: This national multicenter retrospective study included patients diagnosed with histopathologically confirmed MF before 18 years of age. Demographic, clinical, histopathologic, immunophenotypic, staging, treatment, and follow‐up data were collected. Early response at 3–6 months (partial/complete response) was analyzed using logistic regression. Results: A total of 133 patients were included; 60.9% (81/133) were male. Median age at diagnosis was 13 years (IQR, 9–15) and median diagnostic delay was 18 months (IQR, 8–48). Classic morphology was recorded in 78.2% (104/133), and hypopigmented MF in 36.1% (48/133); overlapping morphologies were documented in 42.1% (56/133). Stage IA disease was present in 59.4% (79/133). Phototherapy was used in 60.9% (81/133). Early response occurred in 91.0% (121/133). BSA < 10% was independently associated with higher odds of early response (aOR 8.42, 95% CI 1.71–41.54; p = 0.009), whereas older age at diagnosis predicted lower odds (aOR 0.81 per year, 95% CI 0.67–0.98; p = 0.029). Relapse occurred in 28.5% (37/130) within median follow‐up of 22 months (median time to relapse of 8 months); 67.6% (25/37) relapsed within 12 months. Conclusion: In this cohort, pediatric MF presented at an early stage. Despite favorable early responses, relapse occurred in nearly one third, often within the first year, supporting long‐term surveillance. Higher BSA involvement and older age at diagnosis were associated with reduced early response.

Geriatric psychodermatology addresses the complex interaction between the skin and the psyche in older adults, shaped by aging-related physiological changes, multimorbidity, and psychosocial factors. Management in the geriatric population is particularly challenging due to polypharmacy, drug interactions, and the high prevalence of neurological and psychiatric comorbidities. Chronic pruritus and xerosis are among the most common dermatological complaints in older adults and often have multifactorial etiologies, including systemic diseases, inflammatory dermatoses, and psychogenic factors. Chronic itch significantly impairs quality of life and may contribute to increased morbidity. Common psychodermatological disorders in the elderly include psychogenic pruritus, lichen simplex chronicus, prurigo nodularis, delusional infestation, neurotic excoriations, and scalp dysesthesia. Effective management requires a multidisciplinary approach integrating dermatological care with psychopharmacological and psychotherapeutic interventions, with careful consideration of treatment safety in older patients.

Introduction: Considering its visible nature, facial dermatoses may result in more prominent psychosocial effects. Objectives: We aimed to compare quality of life, anxiety, depression, perceived stress, stress coping strategies, and body image in individuals with facial and trunk dermatosis. Methods: A total of 120 patients; 60 with facial dermatosis, 60 with trunk dermatosis and 60 healthy volunteers were included in the study. Demographic and clinical features were recorded and participants were evaluated with Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS), Stress Coping Attitudes Inventory (SCAI), and Body Image Scale (BIS). Results: In trunk dermatosis patient group, the DLQI, HADS and PSS scores were significantly higher, while the BIS scores were significantly lower than the facial dermatosis group and the controls (p=0.001 for each). Avoidance subscores of the SCAI were significantly higher in the trunk dermatosis group compared to the facial dermatosis group (p=0.005). Acceptance/Cognitive Restructuring subscore of the SCAI was found to be higher in the facial dermatosis than the trunk dermatosis group (p=0.037). A significant positive correlation was found between the PSS score and HADS-Anxiety score (β= 0.426 p<0.001) and between DLQI and HADS-Anxiety score (β=0.271 p=0.023). Conclusion: Patients with trunk dermatosis experienced more stress, anxiety, depression, distortion of body perception, and the impact on quality of life was more pronounced. This situation was thought to be related to the fact that patients with facial dermatosis used positive coping strategies, and in patients with trunk dermatosis, negative strategies were more common.

Introduction: The full range of cutaneous comorbidities associated with keratinocyte skin cancers remains to be elucidated. Objectives: We aimed to examine other skin diseases in patients with keratinocyte cancer (KC) and to reveal potential associations between them. Methods: Included in the study were 200 patients with KC and 200 disease-free controls. To identify any additional concomitant dermatological conditions, all study groups underwent examination by 2 dermatologists. Results: In patients with KC, 87.5% were diagnosed with basal cell carcinoma and 13.5% were diagnosed with squamous cell carcinoma. There was no statistically significant difference between the two groups regarding sunscreen use habits (P =0.284). Patients with KC exhibited a significantly elevated odds ratio for the presence of rosacea (OR 5.13, 95% CI 3.2-8.3, P=0.000) and especially erythematotelangiectatic rosacea (ETR) subtype (OR 5.03, 95% CI 3.1-8.2, P=0.000). An ROC curve analysis was conducted to assess the efficacy of rosacea in differentiating between the control group and patients with KC. The sensitivity, specificity, negative predictive value and positive predictive value for rosacea were 45.5%, 86%, 61.2% and 76.5%, respectively (AUC 0.658, 95% CI 0.604-0.711, P=0.000), while for ETR it was 44%, 86.5%, 60.7% and 76.5%, respectively (AUC 0.653, 95% CI 0.599-0.706, P=0.000). The presence of rosacea demonstrated a significant efficacy in differentiating patients with KC from the control group in all localizations (P< 0.05). Conclusion: The risk of rosacea in patients with KC, particularly those with the ETR subtype, was found to be significantly elevated, irrespective of age, gender, and localization.

Introduction: Redundancy of psychological comorbidities in acne vulgaris may contribute to disturbed eating attitude. Objective: The aim of this study was to investigate possible relation between acne vulgaris and disturbed eating attitude. Methods: One hundred acne patients and 86 healthy volunteers evaluated by the Symptom Checklist-90 Revised (SCL-90) and possible indicative of disordered eating using the Eating Attitudes Test-40 (EAT-40) and Eating Disorders Examination-Questionnaire (EDEQ). Results: Mean EAT-40 score was significantly higher in acne group (24.1±17.4) compared to control group (14.2±9.0) (P=0.001). Global score of EDEQ and all subscores were statistically higher in acne group (for each P=0.001). The ratio of participants who meaningful scores for Restraint Eating and Weight Concern subscores of EDEQ was significantly higher in the patient group compared to the control group (P=0.003; P=0.034 respectively). Obsessive-compulsive and Depression subscores of SCL-90-R among acne patients who had meaningful EAT-40 scores were statistically higher compared to those had EAT-40 scores <30 (P=0.030; P=0.006 respectively). Conclusion: Because of higher mortality and morbidity rates clinicians should screen acne patients for possible disordered eating psychopathology, with particular attention to those with obsessive-compulsive and depression.

Vitiligo is a generally asymptomatic acquired depigmentation disorder, limiting the utility of general dermatology quality of life (QoL) scales that may not adequately reflect the psychosocial burden experienced by patients. The aim of our study was to translate the vitiligo-specific quality-of-life instrument (VitiQoL) with maximum score of 90, into Turkish language, and to culturally adapt and validate it for use in the Turkish population. The VitiQoL was initially cross‑culturally adapted to Turkish through forward‑backward translation. The Turkish version of the VitiQoL together with the dermatology life quality index (DLQI) and the Skindex‑16 scale were applied to Turkish vitiligo patients. A total of 148 consecutive volunteer vitiligo patients were included in the study. The internal consistency of the Turkish version of the VitiQoL was excellent (Cronbach’s alpha = 0.915). Since the Turkish version of the VitiQoL item 13 had a corrected item-total correlation lower than 0.3 (0.264), it was removed from the survey. VitiQoL-TR includes 14 items, with the removal of item 13 (Cronbach’s alpha = 0.922). Exploratory factor analyses revealed two distinct factors within the VitiQoL scale: participation limitation and stigma. Forty-six (31.08%) of the participants completed the VitiQoL-TR twice, 10–14 days apart. The test and retest scores of the VitiQoL-TR had a strong significant correlation (r = 0.883; p < 0.001). The intraclass correlation coefficient was 0.939. There was a strong significant correlation between the VitiQoL-TR score and the Skindex-16 score (r = 0.848; p < 0.001), and a moderate significant correlation with the DLQI score (r = 0.696; p < 0.001) thus confirming the convergent validity. In conclusion, the maximum value of the scale is 84 instead of 90. This should be taken into consideration when conducting international studies and comparing international data. The VitiQoL-TR is a valid and reliable health-related QoL tool for assessing the QoL of Turkish vitiligo patients.

Ingrown toenails (IGTN) are a prevalent, debilitating nail disorder that occurs when the edge of the nail plate grows abnormally to penetrate the periungual dermis. Multiple risk factors have been identified in the etiology. In this study, we aimed to investigate the risk factors that predispose patients to IGTN. This prospective, case-control study consisted of 130 patients with IGTN and 130 age- and sex-matched controls. The sociodemographic data, clinical features, and predisposing factors were questioned. Multivariate logistic regression (Enter and Forward: LR) analysis was applied to determine the risk factors related to IGTN. The IGTN group comprised 63 (48.5%) females and 67 (51.5%) males with a median age of 31 (IQR = 28.25) years. The most common type of IGTN in the study group was distal-lateral ingrowing in 115 (88.5%) patients. The median duration of IGTN was 5.5 (IQR = 10) months. In the multivariate regression analyses, the presence of improper nail trimming (OR: 7.063; 95% CI: 3.604–13.843), presence of hyperhidrosis (OR: 2.648; 95% CI: 1.198–5.853), poor foot hygiene (OR: 4.873; 95% CI: 2.271–10.456), presence of foot/toe deformity (OR: 5.413; 95% CI: 1.508–19.427), presence of increased curvature of the nails (OR: 2.588; 95% CI: 1.024–6.543), presence of onychomycosis (OR: 3.506; 95% CI: 1.267–9.705), increase in BMI (OR: 1.126; 95% CI: 1.038–1.221) were found to be the predisposing factors that increased the risk of IGTN. Improper nail trimming, hyperhidrosis, poor foot hygiene, onychomycosis, increased curvature of the nails, foot/toe deformity and increase in BMI were found to contribute significantly to the etiopathogenesis of the disease. Considering that most of these risk factors were modifiable, informing the public about risk factors will reduce the frequency of IGTN, and modifying risk factors in patients will enable rapid control of the disease and reduce recurrences.

Introduction: In recent years, the role of the mammalian target of rapamycin (mTOR) pathway, which is one of the intracellular signaling pathways and known as the main control pathway of metabolism, in the pathogenesis of psoriasis has been emphasized. Objectives: We sought to investigate the importance of the mTOR pathway in the pathogenesis of psoriasis. Methods: Forty patients with psoriasis and 40 healthy volunteers were included in this case-control study. Serum fasting mTORC1 and mTORC2 levels of the study groups were examined by enzyme-linked immunosorbent assay. Results: Serum mTORC1 and mTORC2 levels were significantly lower in patients with psoriasis than controls (p= 0.001). A positive correlation was found between serum mTORC1 and serum mTORC2 levels in patients with psoriasis (p=0,001, r=0,826). Conclusion: The lower serum levels of mTORC1 and mTORC2 complexes which are active signalling molecules in the cell, were found to be lower in patient with psoriasis, suggesting that it may be an indicator of increased intracellular activation of these molecules. Our opinion that agents that can effectively inhibit both mTOR complexes may be more effective in the treatment of psoriasis.