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    The effect of COVID-19 on development of hair and nail disorders: a Turkish multicenter, controlled study
    (Wiley, 2023) Kutlu, Omer; Demircan, Yuhanize Tas; Yildiz, Kenan; Kalkan, Goknur; Demirseren, Duriye Deniz; An, Isa; Oba, Muazzez Cigdem
    Background A broad spectrum of skin diseases, including hair and nails, can be directly or indirectly triggered by COVID-19. It is aimed to examine the type and frequency of hair and nail disorders after COVID-19 infection. Methods This is a multicenter study conducted on consecutive 2171 post-COVID-19 patients. Patients who developed hair and nail disorders and did not develop hair and nail disorders were recruited as subject and control groups. The type and frequency of hair and nail disorders were examined. Results The rate of the previous admission in hospital due to COVID-19 was statistically significantly more common in patients who developed hair loss after getting infected with COVID-19 (P < 0.001). Telogen effluvium (85%) was the most common hair loss type followed by worsening of androgenetic alopecia (7%) after COVID-19 infection. The mean stress scores during and after getting infected with COVID-19 were 6.88 +/- 2.77 and 3.64 +/- 3.04, respectively, in the hair loss group and were 5.77 +/- 3.18 and 2.81 +/- 2.84, respectively, in the control group (P < 0.001, P < 0.001). The frequency of recurrent COVID-19 was statistically significantly higher in men with severe androgenetic alopecia (Grades 4-7 HNS) (P = 0.012; Odds ratio: 2.931 [1.222-7.027]). The most common nail disorders were leukonychia, onycholysis, Beau's lines, onychomadesis, and onychoschisis, respectively. The symptoms of COVID-19 were statistically significantly more common in patients having nail disorders after getting infected with COVID-19 when compared to the control group (P < 0.05). Conclusion The development of both nail and hair disorders after COVID-19 seems to be related to a history of severe COVID-19.
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    Rates of skincare product and cosmetic procedure use in patients with acne vulgaris and the effective factors: A multicenter study with 1,755 patients
    (Wiley, 2022) Kayiran, Melek Aslan; Karadag, Aye Serap; Alyamac, Gokcen; Cemil, Bengu Cevirgen; Demirseren, Duriye Deniz; Demircan, Yuhanize Tas; Aksoy, Hasan
    Background Skincare products and cosmetic procedures are used as an adjunct or complementary to conventional drug therapy for acne vulgaris (AV). Objective To evaluate the use of skincare products and the frequency of cosmetic procedures in AV treatment. Methods A total of 1,755 patients with AV completed the survey prepared by the researchers and the Cardiff Acne Disability Index (CADI) questionnaire. The clinical findings and the Food and Drug Administration (FDA) severity scores were recorded by the dermatologists. Results For AV, 66.7% of the patients stated that they used skincare products and 26.7% had undergone cosmetic procedures. The use of skincare products was statistically significantly higher in women (female: 74.5%, male: 57.7%, p < 0.0001); older people (users: 22 +/- 7.6years, non-users: 21.2 +/- 5.7 years, p < 0.0001); patients with a higher CADI score (users: 7 +/- 3.7, non-users: 6.9 +/- 4.3, p = 0.010); FDA severity score 2 and 3 (FDA-1: 58.1%; FDA-2: 72.4%, FDA-3: 73%, FDA-4: 67%, p < 0.0001); long-term disease (users: 57 +/- 43 months; non-users: 47.7 +/- 42.3 months, p < 0.0001); facial involvement (present: 70.2%, absent: 51.4%, p = 0.017); high income levels (users: 73.5%; non-users: 26.5%, p = 0.001); and graduate or post-graduate degrees (undergraduate <=%62.8, graduate >=%76.8, p < 0.0001). The rate of cosmetic procedures was higher in those with higher CADI scores (users: 7.8 +/- 3.8; non-users: 7.1 +/- 3.96, p < 0.0001); older patients (users: 22.7 +/- 10.7 years; non-users: 21.3 +/- 5 years, p < 0.0001); high school (25.6%); and graduate (28.9%) education (p = 0.043), those with lower disease severity (FDA-1: 31.1%; FDA-2: 28.5%, FDA-3: 27.1%, FDA-4: 20.4%, p = 0.022); smokers (smokers: 32.5%; non-smokers: 25.5%, p = 0.020), and those with AV in the family (present: 29.8%; absent: 24.2%, p = 0.009). The patients most frequently used cleansers (85.2%) as cosmetic products, and most commonly underwent skincare treatment (71%) as an interventional procedure. They mostly learned about such products and methods from the Internet, and 33.3% of the participants had undergone procedures performed by non-physicians. Conclusion The patients generally choose skincare products as a result of their Internet search and sometimes have these procedures performed by non-physicians. Dermatologists should be aware of this situation and inform their patients about appropriate products and procedures.
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    Use of complementary and alternative medicine among patients with acne vulgaris and factors perceived to trigger the disease: A multicentre cross-sectional study with 1571 patients
    (Wolters Kluwer Medknow Publications, 2022) Kayiran, Melek Aslan; Karadag, Ayse Serap; Alyamac, Gokcen; Cemil, Bengu Cevirgen; Demirseren, Duriye Deniz; Demircan, Yuhanize Tas; Aksoy, Hasan
    Background: Acne vulgaris (AV) is among the common skin diseases for which patients refer to complementary and alternative medicine (CAM). Aims and Objectives: To investigate the approaches to CAM methods and factors believed to increase the disease in 1,571 AV patients. Materials and Methods: The sociodemographic characteristics of the patients and disease severity according to the Food and Drug Administration criteria were recorded. The Cardiff Acne Disability Index (CADI) was used to assess the impact of acne on the patient's life and the history of CAM use was noted. The patients also listed the factors that they thought worsened their disease and reported their gluten-free diet experiences. Results: Of all the patients, 74.41% had a history of using CAM methods. CAM use was significantly higher in women, patients with severe AV, those with a higher CADI score and non-smokers. As a CAM method, 66.37% of the patients reported having used lemon juice. The respondents most frequently applied CAM methods before consulting a physician (43.94%), for a duration of 0-2 weeks (38.97%). They learned about CAM methods on the internet (56.24%) and considered CAM methods to be natural (41.86%). The patients thought that food (78.55%) and stress (17.06%) worsened their disease. They considered that the most common type of food that exacerbated their symptoms was junk food (63.84%) and a gluten-free diet did not provide any benefit in relieving AV (50%). Conclusion: Physicians need to ask patients about their CAM use in order to be able to guide them appropriately concerning treatments and applications with a high level of evidence.