Where are we in cosmetics and esthetics practices in educational clinics in Turkey? Ezgi Ozkur, Emre Kaynak, Mehmet Salih Gürel Turkish Journal of Dermatology 2019 13(3):95-98 Objective: Cosmetic dermatology has recently gained importance with the recent increase in demand. The aim of this study is to identify cosmetic dermatology training in Turkey and to assess instructors' attitudes toward cosmetic dermatology training during residency and current cosmetic dermatology practices. Methods: This is a cross-sectional questionnaire study conducted with instructors to investigate the practice of cosmetics dermatology, the technical equipments, number of patients, and their ideas in the clinics that provide dermatology specialty education in Turkey. Results: At least one cosmetic procedure was found to be performed in 69% of the clinics that participated in the study (n = 55), and no cosmetic procedure was performed in 31% of the clinics. The mean number of application was 13.2 ± 12.3 weekly in the clinics that performed cosmetics procedure. The most common procedures were botulinum toxin injection with 63.6% (n = 35), chemical peeling with 60% (n = 33), and platelet-rich plasma with 60% (n = 33), respectively. The most common laser application was neodymium-doped yttrium aluminum garnet (28/55). The mean time spent for cosmetic procedures was 1–5 h weekly in the clinics which performed cosmetic procedures. Seventy-six percent (n = 42) of the participants felt inadequate for performing cosmetics procedures, and 95% (n = 52) reported that cosmetic dermatology education was required. Conclusions: Both theoretical and practical education must be given in educational clinics, and the infrastructure must be created, and the educational schedule must be standardized.

Histopathological findings in patients with lipoid proteinosis Isa An, Muhammet Emin Güldür, Mustafa Aksoy, Yavuz Yeşilova, Murat Ozturk Turkish Journal of Dermatology 2019 13(3):99-102 Objective: Lipoid proteinosis (LP) is a rare autosomal recessive genodermatosis characterized by the accumulation of amorphous hyaline substance in the skin and mucous membranes. In this study, the histopathological findings of the patients who were admitted to our clinic and diagnosed with LP were examined. Materials and Methods: This prospective study included 18 patients who presented to our clinic between January 2014 and December 2018 and were confirmed by histopathological examination. A punch biopsy including epidermis, dermis, and subcutaneous tissues was obtained from the lesional skin of each patient evaluated clinically, and the material was stained with hematoxylin and eosin stain and periodic acid–Schiff (PAS) stain. These preparations were evaluated by a pathologist experienced in dermatopathology. Results: The most common histopathological findings in the epidermis were hyperkeratosis (88.8%) and pigmentary incontinence (83.3%) in the basal layer. The most common histopathological findings in the dermis were amorphous substance accumulation (100%), perivascular PAS positivity (33.3%), and PAS positivity around eccrine glands (11.1%). Conclusion: The findings of our study were similar to the histopathological findings of late-term skin lesions in LP patients previously described in the literature. In order to better understand the histopathological findings of skin lesions of LP patients, studies with a large number of patients including early skin lesions of LP are needed.

Dermoscopic features of cutaneous leishmaniasis lesions Naime Eroglu, Isa An, Mustafa Aksoy Turkish Journal of Dermatology 2019 13(3):103-108 Objective: This study aimed at determining the dermoscopic characteristics of cutaneous leishmaniasis (CL) and comparing these characteristics to the previous results. Materials and Methods: The prospective study included a total of 225 lesions from 69 patients with the ages between 1 and 70 years who were admitted to our dermatology clinic between March 1, 2016, and August 1, 2016, diagnosed with CL using smears of skin lesions, and did not receive any previous antileishmanial treatment. Results: When the lesions were dermoscopically examined for their general characteristics, the most common findings were erythema (100%), teardrop-like structures (59.1%), and hyperkeratosis (53.3%). The most common vascular structures in the lesions were linear vessels (50.2%), dotted vessels (39.6%), and hairpin-like vessels (32.9%). Conclusion: Our data were comparable to those of the previous studies in literature. Although there is no specific dermoscopic feature specific to CL, we presume that dermoscopic findings may contribute to differential diagnosis in the presence of clinically similar cutaneous lesions.

Internalized stigma in patients with acne vulgaris, vitiligo, and alopecia areata Asli Bilgiç Temel, Selen Bozkurt, Yesim Senol, Erkan Alpsoy Turkish Journal of Dermatology 2019 13(3):109-116 Background: Internalized stigma, another aspect of stigma, is the adoption of negative attitudes and stereotypes of the society regarding people's illness. Aims and Objectives: The primary aim of this study was to investigate the internalized stigma state of acne vulgaris (AV), vitiligo, and alopecia areata (AA) patients and to identify the factors influencing internalized stigma. Materials and Methods: A total of 150 patients (50 AV, 50 vitiligo, and 50 AA) who applied to the outpatient clinic were consecutively enrolled in this study. The sociodemographic characteristics of the patients were recorded. In addition, patients answered the Internalized Stigma Scale (ISS), the Dermatology Life Quality Index, the Perceived Health Status, the General Health Questionnaire, and the Acne Quality of Life Scale. Results: In this study, the Cronbach's alpha coefficient for the whole ISS scale was calculated as 0.91 for AV, 0.91 for vitiligo, and 0.93 for AA. Conclusion: The present study indicates that patients with AV, AA, and vitiligo internalize the negative stereotype judgment of the society for themselves. High levels of internalized stigma in the studied patients presented a parallel trend to the negative quality of life (QoL). Therefore, internalized stigma may be one of the major factors affecting the QoL in these diseases.

The efficacy of interfollicular epidermal stem cells versus bone marrow-derived mesenchymal stem cells in cutaneous wound healing in diabetic rats Osman Kose, Aysel Pekel Turkish Journal of Dermatology 2019 13(3):117-122 Objective: Many sources of stem cells, such as bone marrow stem cells, embriyonic stem cells, adipose-derived stem cells, epidermal stem cells were used extensively for diabetic wound healing. This study investigated whether interfollicular epidermal stem cell versus bone marrow-derived mesenchymal stem cell effectiveness in the enhancement of diabetic wound healing. Methods: The streptozotocin-induced Spraque-Dowley rats with 5 mm punch biopsy were used. Rats were divided into three groups: group I diabetic controls receiving no stem cells; group II, rats receiving bone marrow-derived mesenchymal stem cells; group III, rats receiving interfollicular epidermal stem cells. Wound healing was assessed clinically that regarding healing time and wound size. Results: Clinical results showed that wound size was significantly reduced in mesenchymal and interfollicular epidermal stem cell-treated groups as compared with controls. Complete wound-healing times were 19.4±2.85 days in bone marrow-derived mesenchymal stem cells group versus 20.3±3.45 days in interfollicular epidermal stem cells group and 24.7±4.17 in the control group. In the measurement of the wound area, there were no significant differences between the bone marrow-derived mesenchymal stem cells group (P=0.115) and interfollicular epidermal stem cells group (P=0.085). Conclusions: Interfollicular epidermal stem cells were found as effective as bone marrow-derived mesenchymal cells in the treatment of the diabetic wound.