Nahide Onsun

Background: In 2009, the International Agency for Research on Cancer (IARC) classified UV-emitting tanning devices as carcinogenic to humans (Group 1). This study aimed to describe ten-year trends in sunbed use prevalence across Europe and examine differences by country and sociodemographic and phenotypic characteristics. Methods: Euromelanoma survey data collected between 2009 and 2018 from 33 countries were analysed among individuals voluntarily attending free skin examinations. Annual sunbed use prevalence and 95% confidence intervals were estimated by country, with stratified analyses by gender, age, education level, and skin phototype. Associations with sunbed use were investigated using mixed-effects logistic regression models. Results: A total of 343,675 participants were included. Among Euromelanoma campaign participants, current sunbed use declined over the study period, declining from approximately 12.8% in 2009 to below 6% by 2018, despite year-to-year fluctuations. Women, adults aged 20–35 years and individuals with skin phototypes III–IV exhibited the highest odds of sunbed use (OR Female vs. Male = 3.01, 95%CI [2.91–3.12], OR 20–35 vs. >35 = 2.54, 95%CI [2.47–2.61], and OR Type III–IV vs. Type I–II = 1.52, 95%CI [1.47–1.56], respectively). Marked heterogeneity was observed across countries. Mixed-effects analyses showed a strong temporal decline that was significantly steeper among younger participants, particularly those aged 20–35 years, than among individuals older than 35 years. Conclusions: Indoor tanning prevalence declined across Europe between 2009 and 2018, during a period of evolving post-IARC regulatory and preventive measures. Persistent sociodemographic disparities and substantial between-country heterogeneity highlight the need for targeted, country-specific prevention strategies and continued monitoring of indoor tanning behaviors.

Psoriasis (PsO), psoriatic arthritis (PsA), rheumatoid arthritis (RA), and ankylosing spondylitis (AS) are chronic inflammatory disorders classified as immune-mediated inflammatory diseases (IMIDs). Although these diseases share common pathogenic mechanisms, they can affect different parts of the body. Nail involvement is important in PsO. However, nail findings in RA and AS have not been extensively investigated despite their inflammatory presentation, similar to PsO. This study aimed to investigate clinical and onychoscopic nail findings in patients with RA and AS and compare their distribution and patterns with those observed in patients with PsO and PsA. One hundred patients (25 in each group) with confirmed diagnoses of PsO, PsA, AS, and RA and at least 1 clinically detectable nail finding were included. A total of 1000 fingernails were examined clinically, and 200 fingernails were examined onychoscopically. The distributions of clinical and onychoscopic findings were assessed and compared across the 4 disease groups. Demographic data, laboratory findings (C-reactive protein, human leukocyte antigen B27, rheumatoid factor, anti-cyclic citrullinated peptide), PsO Area and Severity Index, and Nail PsO Severity Index were recorded. Pitting and onycholysis were the most common findings in PsO and PsA, leukonychia predominated in AS, and vertical ridges/trachyonychia were frequent in RA. Onychoscopy showed that clustered dotted vessels were significantly more frequent in PsO and PsA, whereas parallel dotted/short linear vessels (“fish school-like pattern”) were significantly more frequent in RA. Megacapillaries, microhemorrhagic dots, and coiled and tortuous capillaries were numerically more frequent in AS. Some vascular findings were associated with elevated C-reactive protein, human leukocyte antigen B27 positivity, and rheumatoid factor positivity. Nail findings in patients with IMIDs may reflect underlying inflammatory and vascular changes. Richer nail findings in PsO and PsA may be linked to keratinocyte-driven inflammation, whereas vascular alterations may play a more prominent role in the nail findings observed in RA and AS. Differences in clinical and onychoscopic nail patterns across disease groups suggest that detailed nail examination and onychoscopy may provide supportive clinical clues and aid in the clinical differentiation of IMIDs.

Çakıcı ÖA, et al. Ann Dermatol. 2025 Mar;37:e7. https://doi.org/10.5021/ad.24.057

Background: Ten-year survival and retention rate data on biologics are extremely limited, and there is a need to evaluate these metrics based on real-world data as well as on the results of clinical studies. Objective: The objective of this study was to assess the long-term survival rates of adalimumab and infliximab in real-life practice. Methods: This study is based on data from the Turkish Psoriasis Registry and the digital records of the Medical School of Bezmialem Vakif University. Baseline data including demographic characteristics, duration of treatment, use of combination treatments, modified regimens, and reasons for treatment termination were extracted. Results: In total, 404 patients (228 on adalimumab and 176 on infliximab) treated between July 1, 2005, and December 31, 2020, were identified. The retention rate was 7.4% for infliximab and 3.5% for adalimumab after 10 years (p = 0.85). Conclusions: The efficacy of infliximab and adalimumab diminishes over time. There were no significant differences in the retention rate between the two drugs, but the survival time was longer for infliximab according to Kaplan-Meier analysis.

Psoriasis is a chronic inflammatory disease associated with obesity and metabolic syndrome. Adipokines are thought to be a link between psoriasis and obesity. Leptin, adiponectin, and omentin are b...

Background: Clinical features, types of Kaposi sarcoma, and treatment outcomes have not been well‐defined in Turkey. In this study, we reviewed records of the patients who had been diagnosed with Kaposi sarcoma in the last decade in a single center and evaluated treatment results.Methods: Medical records of the Kaposi sarcoma patients seen in the last decade in a single tertiary center were evaluated in detail.Results: A total of 27 patients were identified; 18 patients had been checked for HHV8; and 16 of those patients were positive for HHV8. One patient was positive for HIV. Two patients having mycosis fungoides and myasthenia graves developed iatrogenic KS after immunosuppressive treatments. Interferon α was used in 21 patients; 8 patients achieved complete response; and 11 patients achieved a partial response. No serious side effects were observed. Systemic involvement did not develop in any patients except lymph node involvement in a patient with widespread skin lesions.

Background Some studies have investigated the relationship between Behçet’s disease (BD) and insulin resistance; however, since they did not exclude obese patients from their sample, it remains unclear whether BD itself causes insulin resistance independently of obesity. Methods The study included 60 patients with BD and 45 age-, gender- and body mass index (BMI)-matched healthy controls. Obese patients with a BMI of ≥30 kg/m² were excluded. Insulin resistance according to the homeostasis model assessment for insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI), fasting plasma glucose, and one-hour and two-hour plasma glucose in the oral glucose tolerance test (OGTT 1-h and OGTT 2-h PG, respectively) were evaluated in all patients. Results The mean fasting plasma glucose levels and the rate of those with impaired glucose tolerance according to OGTT 2-h PG were significantly higher in the BD patients compared to the controls. The rates of those with insulin resistance according to HOMA-IR and QUICKI were significantly higher in the BD patients than in the controls. When compared to the control group, the rates of those with impaired fasting glucose and impaired glucose tolerance were significantly higher and the mean QUICKI value was significantly lower in the active group, in contrast to the inactive group. Conclusions Insulin resistance occurs in BD patients independently of obesity. In the follow-up of BD patients, especially in the active phase, not only fasting blood glucose but also other diagnostic tests for insulin resistance should be added to the examination panels.

CoronoVac is a non-viable vaccine for severe acute respiratory syndrome coronavirus 2 (SARSCoV-2). Nowadays, there has been vaccination program for at-risk groups and older adults in Turkey. We here present 72-year-old male psoriasis patient who developed generalized pustular psoriasis flare after administration of CoronoVac. The COVID-PCR test was negative and investigations for flare etiology were all normal. He was first (to the best of our knowledge) psoriasis patient who developed an erythrodermic flare after the first dose of CoronaVac vaccine.

There have been a number of investigations of the efficacy and safety of etanercept. This study was performed to obtain long-term drug survival data (ie, time to drug discontinuation) for etanercept, and the reasons for its discontinuation. The study population consisted of patients with psoriatic arthritis and psoriasis followed up by our clinic, registered in the Turkish Psoriasis Registry (PSR-TR) and treated with etanercept for at least 4 weeks between January 1, 2005, and January 31, 2020. The efficacy of etanercept was evaluated in terms of the Psoriasis Area and Severity Index (PASI) 75, PASI 90 and PASI 100 response rates at 12, 24, 36, and 48 weeks, and annually thereafter. The behaviors of the patients with respect to the use of etanercept, and the outcomes of those who continued to use it during the COVID-19 pandemic, were also investigated.