Objective To evaluate the changing trends in dermatology clinical practice at a tertiary center during the coronavirus disease 2019 (COVID‐19) pandemic. Method This retrospective cohort study was conducted on patients who were admitted to Ufuk University Hospital with dermatologic complaints/diseases before and during the pandemic. The patients were divided into two groups: 1) the Pre‐pandemic period (March‐May 2019) and 2) the Pandemic period (March‐May 2020). Demographic features, clinical characteristics, dermatologic diseases/complaints, dermatologic procedures/interventions, hospitalization rate, and use of biologic agents were compared between the two groups. Results Total number of hospital admissions have decreased from 1165 to 717. Admission rates for acne, dermatophytosis, and benign neoplasm of the skin significantly lower during the pandemic period (p values were 0.02, 0.04, and 0.006, respectively). Contact dermatitis, acne accompanying dermatitis, cicatricial hair loss, lichen planus, and zona zoster infection rates were significantly higher (p values were 0.007, <0.001, 0.009, 0.04 and 0.03, respectively). Rates of biopsy and electrocautery procedures were decreased significantly (p values were <0.001 and 0.002, respectively). The hospitalization rate was similar between the groups (p=0.51). However, the use of biologic agents significantly decreased during the pandemic period (p=0.01). Conclusion Updated clinical protocols should be established for the new normal period in accordance with these findings. This article is protected by copyright. All rights reserved.

Objective To evaluate the utility of systemic‐immune inflammation index (SII) in the management of patients with psoriasis. Method This retrospective case‐control study was conducted on patients who were admitted to the dermatology outpatient clinic. Patients with psoriasis (n = 71) were compared with a age and gender‐matched control group (n = 70) with other non‐inflammatory dermatologic diseases. Study and control groups were compared in terms of clinical characteristics and SII values (neutrophil X platelet/lymphocyte). Afterwards, 50th percentile value (4.5) for psoriasis area severity index (PASI) was calculated for the study group. Two subgroups were formed according to PASI values: (1) PASI < 4.5 group (n = 36) and (2) PASI ≥ 4.5 (n = 35). Clinical characteristics and SII values were also compared between these two subgroups. Furthermore, SII values were compared according to the presence of scalp, joint, nail, and genital area involvement in the study group. Finally, a receiver operating characteristic (ROC) curve analysis was performed in order to assess the performance of SII in determining the activation of psoriasis in the study group. Results Significantly higher SII values were found in patients with psoriasis. PASI ≥ 4.5 subgroup and patients with nail and genital involvement had also significantly higher SII values (P < .05). A cut‐off value of 575.8 was calculated with 66.7% sensitivity and 66% specificity for psoriasis activation. Conclusion SII may be used for the prediction of psoriasis activation.

Background Alopecia areata (AA) and generalized form, universalis (AU) are common causes of noncicatricial alopecia, targeting anagen hair follicles. A dominant interferon‐gamma transcriptional signaling and cytotoxic T lymphocytes were accused as the main drivers of disease pathogenesis. Tofacitinib is a Janus kinase inhibitor that has been proven to interfere with the positive feedback loop between the follicular cell and the cytotoxic T lymphocytes in AA. There is an increasing number of studies reporting success with tofacitinib in AA. Aims We aimed to assess oral tofacitinib's safety and efficacy in 13 recalcitrant AA and AU patients. Methods This is a retrospective pilot study performed between 2017 and 2020. The demographic features and the treatment responses were evaluated with Severity of Alopecia Tool score changes. Results Thirteen recalcitrant alopecia areata patients (3 AA, 10 AU), aged between 17 and 49, were included in the study. The treatment duration was 3‐15 months. All three AA patients responded well; however, the therapy was unsuccessful in five of ten AU patients. Relapse was observed in one of the AA and three of the AU responders. Acneiform lesions and elevation of transaminases were the major side effects. Conclusion Tofacitinib seems to be more promising and thriving in the treatment of AA than AU. Starting the therapy earlier can bring more successful results. Unfortunately, even in the cases that fully respond to treatment, relapse can be observed after discontinuation of the treatment. It is essential to inform patients about this situation in reducing the frustrations that may occur later.

Background/Aim To evaluate the correlation of systemic immune inflammation index (SII), neutrophil‐to‐lymphocyte ratio (NLR), derived neutrophil‐to‐lymphocyte ratio (NLR), and platelet‐to‐lymphocyte ratio (PLR) with disease severity in recurrent aphthous stomatitis (RAS). Methods The present retrospective cohort study was performed on patients with RAS. Patients were divided into three groups: 1) Major (n = 75), 2) Minor (n = 123), and 3) Herpetiform aphthae (n = 17). The study groups were compared in terms of demographic features, acute phase proteins, and complete blood cell count parameters. Moreover, correlation analyses were performed for the correlation of ulcer severity score (USS) with C‐reactive protein (CRP), SII, erythrocyte sedimentation rate (ESR), ferritin, dNLR, NLR, and PLR. Results Significantly higher values were observed for USS, neutrophil count, ferritin, SII, NLR, and dNLR (p < 0.05 for all) in the major and herpetiform aphthae groups compared to the minor aphthae group. Positive, strong, significant correlations were observed between USS, SII, and NLR (r = 0.80 for SII, r = 0.74 for NLR and p < 0.001 for both). Positive, moderate, significant correlations were observed between USS, PLR, ESR, and CRP (r = 0.54 for PLR, r = 0.39 for ESR, r = 0.36 for CRP, and p < 0.001 for all). Positive, weak, significant correlations were observed between USS, dNLR, and ferritin (r = 0.13 and p = 0.05 for ferritin, r = 0.27 and p < 0.001 for dNLR). Conclusion Higher values of SII, NLR, dNLR, and PLR were associated with disease severity in patients with RAS.

Onychocryptosis, frequently termed ''ingrown toenail'' is a common foot problem in routine dermatology and orthopaedic clinical practice which leads to pain and disability. [1][2][3] Although the aetiology of ingrown toenail is not well understood various associated risk factors have been identified with the pathogenesis. 4 It is known that there is an association between hallux valgus angle (HVA) and ingrown toenail, it has been reported that increased HVA in the patients with ingrown toenail.The objective of this study was to analyse the relationship between the HVA and intermetatarsal angle (IMA) with the ingrown toenail. There were 121 female and 49 male patients in the case group and 68 female and 32 male in the control group. The mean age of the case group was 41.1 years and 41.1 years in control group. A statistically significant difference was found between the case and the control groups in terms of right HVA variable. In this article we found that IMA has an association with ingrown toenail, too. The Xrays of the feet should be performed to determine the susceptibility of the patients who are admitted to the hospital for ingrown toenail in order to prevent other toe ingrown toenail and for planning the treatment of the patients with ingrown toenail.