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    Allergic sensitization in patients with pruritus sine materia in the absence of a somatic cause
    (2020) Pekmezci, Erkin
    Aim: Pruritus sine materia in the absence of a somatic cause is generally attributed to psychogenic factors, but it is also well known that psychological stress may affect skin through its impacts on immune response. In this three-year retrospective study we aimed to reveal the allergic sensitization of patients with chronic pruritus without a somatic cause. Material and Methods: Three hundred and sixty five male and female patients with widespread chronic pruritus between 6 and 75 years old were retrospectively recruited. In addition to routine hematologic examination, skin prick test and serum total IgE measurement were performed on each patient.Results: In cutaneous examination, the patients had no visible manifestation except self excoriations in some, and all had normal values in hematologic laboratory examination. Altogether 10% of patients had positive results for both skin prick test and serum total IgE, and 42% of patients had positive results for either skin prick test and/or serum total IgE, which may be regarded as a presentation of immediate type hypersensitivity.Conclusion: Considering the quite high positive ratios obtained for both skin prick test and serum total IgE, it may be encouraging to perform these tests routinely on the patients with pruritus sine materia, both for revealing a probable allergic tendency and for better handling the treatment modalities.
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    Long duration single pulse intense pulsed light application in erythematotelangiectatic rosacea: An instrumental retrospective study
    (2020) Pekmezci, Erkin
    Aim: Erythematotelangiectatic rosacea is a challenging condition due to poor therapeutic options. Treatment with intense pulsed light is partially effective after numerous sessions. Regarding the ‘thermal relaxation time’ principle and characteristic histopathology of erythematotelangiectatic rosacea, dilated capillaries and venules throughout the dermis, we proposed that directly targeting the largest vessels available by applying a long duration single pulse intense pulsed light mode, should decrease the mean number of treatment sessions to obtain a significant outcome. Material and Methods: Eighty seven erythematotelangiectatic rosacea patients who completed the proposed one month apart, four times consequtive intense pulsed light treatments with 25 ms pulse duration, single pulse and 10 J/cm2 fluence in the years of 2017-2019 were recruited retrospectively. Instrumental evaluations and self-assessment scorings were performed during the treatment period.Results: No adverse effect was recorded. Instrumentally evaluated results revealed a significant erythema quenching effect obtained at the end of 2nd treatment session (p=0.0011). Considering the decrease in erythema, both the instrumental and self-assessment values were found extremely significant after the 4th session, compared to initial values (p0.0001, for both).Conclusion: Considering the fast improvement recorded, intense pulsed light therapy with long pulse duration, single pulse, and low fluence may present a time saving and effective treatment option in erythematotelangiectatic rosacea patients with varied levels of severity. Also, the satisfactory outcome obtained by directly targeting the largest vessels available beginning from the initiation of therapy period, may be regarded as an indicator of the practicability of an identical mode of intense pulsed light treatment in diverse clinical presentations of erythematotelangiectatic rosacea.