People have used the traditional Turkish bath for centuries to cleanse themselves, maintain their health, and treat various diseases. The communal use of these areas may contribute to the development and spread of certain dermatoses due to contact with water and environmental factors. Tinea pedis, verruca, molluscum contagiosum, and Pseudomonas aeruginosa folliculitis are among these infections. Undoubtedly, pseudomonal infections are the most well-known waterborne infectious diseases. Pseudomonas aeruginosa folliculitis (hot tub folliculitis), Pseudomonas hot-foot syndrome, toe web infections, ear infections, and ecthyma gangrenosum are the most common clinical presentations. Public baths may provide suitable environments for fungal colonization in cases of insufficient disinfection, long-term public use, high user density, and elevated water temperatures. Common fungal infections, including tinea pedis, tinea corporis, and tinea unguium, are most likely attributed to increased exposure to fungal pathogens and skin maceration. Scabies and pediculosis are parasitic infections that can be transmitted in communal living spaces, but their treatment also involves bathing. There are limited data on the number of infectious dermatoses acquired from Turkish baths. Given that most baths undergo frequent disinfection and the water does not remain stagnant, it can be concluded that bath-related infections are uncommon.

Objectives: The aims of this study were to assess the 24-hour ambulatory BP levels and to determine the prevalence of abnormal circadian BP dipping patterns in women with hypopituitarism secondary to Sheehan syndrome.
Methods: This was a cross-sectional study including 35 women with complete anterior hypopituitarism secondary to Sheehan syndrome and 47 age- and body-mass index-matched control women. Subjects receiving treatment for hypertension were not included. All participants underwent clinical examination, laboratory tests, and BP measurement using ambulatory 24-hour monitoring. Results: The mean age was 61.3±10.6 years in patients vs 60.5±8.5 years in controls (p=0.720). Compared to controls, women with Sheehan syndrome had a higher prevalence of dyslipidemia (p=0.032) and metabolic syndrome (p=0.028). The prevalence of hypertension was 68% in patients and 62% in controls (p=0.520). Altered day-night BP variation was more frequent in patients (85%) than in controls (54%) (p=0.004). Additionally, patients had a significantly higher prevalence of nocturnal hypertension (38% versus 3%; p=0.002). Sheehan syndrome was positively associated with a non-dipper and riser BP profile (Odds Ratio=4.7, 95% confidence interval: 1.54–14.33, p=0.004).
Conclusion: Women with hypopituitarism secondary to Sheehan syndrome had a higher disruption of the circadian BP rhythm than controls. Although the prevalence of newly diagnosed hypertension was comparable between patients and controls, women with Sheehan syndrome had a higher prevalence of nocturnal hypertension.

Objectives: Ganglion cysts are the most common benign masses of the hand and wrist, frequently requiring surgical intervention due to symptoms such as pain, weakness, or aesthetic concerns. Open excision is a widely used method with varying recurrence rates reported in the literature. However, risk factors contributing to recurrence remain incompletely understood. Our study aims to evaluate the recurrence rates following open excision of wrist ganglion cysts and identify patient-related and surgical factors influencing recurrence.
Methods: Patients who underwent wrist ganglion excision between 2012 and 2024 were identified using the National Healthcare Implementation Communique code 611650. Exclusion criteria included cases without ganglion pathology confirmation, follow-up of less than one year, volar cysts, multiple cysts, first-time surgery for recurrence at the institution, incomplete medical records, and arthroscopic excision. Recurrence rates were calculated, and patient demographics, cyst characteristics, and surgical variables were recorded. Surgical experience was defined as years worked as an orthopedic surgeon. Cyst volume was measured using Magnetic Resonance Imaging data.
Results: A total of 109 patients with dorsal wrist ganglion cysts who underwent surgical excision were retrospectively reviewed. The overall recurrence rate is 11.9%. Ganglion cysts are more commonly observed in women and laborers. Surgical experience and the use of a tourniquet were found to be associated with recurrence (p<0.001 and p=0.019, respectively). Correlation analysis revealed no significant correlation between recurrence and age, follow-up duration, or cyst volume. According to the multivariate regression analysis, the most significant risk factors for recurrence are tourniquet use and surgical experience.
Conclusion: The use of a tourniquet and high surgical experience reduce the recurrence rate after open excision of ganglion cysts.

Objectives: This study introduces a novel anatomical closure technique in posterior lumbar interbody fusion (PLIF) surgery utilizing Adjustable Cross-Link (ACL) support to improve hemostasis, minimize drain duration, and enhance postoperative outcomes.
Methods: A retrospective analysis was conducted on 44 patients undergoing single-level PLIF with total laminectomy. Nineteen patients received standard closure (Group 1), while 25 underwent ACL-assisted closure (Group 2). Outcomes, including blood loss, drain usage, and functional recovery, were compared between the groups.
Results: Group 2 demonstrated significantly lower blood loss (p=0.044), reduced drain index (p<0.001), and shorter hospital stays (p<0.05) compared to Group 1. Early-stage visual analogue scale (VAS) for low back pain was also lower in Group 2 (p<0.001). Complication rates were lower in Group 2 (4.0% vs. 10.5%), with no reoperations required. Functional recovery, assessed by ODI scores, showed significant improvements in both groups.
Conclusion: ACL-assisted anatomical closure significantly reduces blood loss, shortens drain duration, and enhances early functional outcomes. Its mechanical stability facilitates better muscle healing and reduces postoperative complications, highlighting its potential as a superior closure method in PLIF surgeries.

Objectives: This study was conducted to evaluate the radiological and clinical results of platelet-rich plasma (PRP) therapy in degenerative meniscal lesions.
Methods: Seventy patients with pain and grade 2 degenerative meniscal lesions on MRI (Magnetic Resonance Imaging) were included in the study. All patients underwent Knee Injury and Osteoarthritis Score (KOOS), Tegner-Lysholm, International Knee Documentation Committee Score (IKDC), Visual Analog Scale (VAS) clinical scores, and MRI scans before and 6 months after the injection.
Results: There was a statistically significant increase in Tegner-Lysholm, KOOS, and IKDC scores after the procedure (p=0.001; p<0.01), and a statistically significant decrease in VAS score after the procedure (p=0.001; p<0.01). However, no statistically significant difference was observed in MRI parameters (p>0.05).
Conclusion: It has been shown that the use of intra-articular PRP in painful degenerative meniscal lesions improves knee functions and helps reduce pain. However, no significant difference was observed in MRI controls. The results of our study indicate that the use of intra-articular PRP injection in patients with grade 2 meniscus degeneration improves clinical scores but does not result in significant improvement in degeneration as measured by MRI.

Objectives: Reconstruction of lower extremity soft tissue defects, which may occur due to various reasons, is challenging. Although different methods have been described in lower extremity reconstruction, the peroneal artery perforator flap has unique advantages. This study aims to present the use of the peroneal artery perforator flap, which is gaining popularity day by day, to treat crus defects.
Methods: Twelve patients with middle or distal third crus defects who underwent reconstruction with peroneal artery perforator flaps were included in the study. The patients were evaluated according to age, gender, etiology, complications, defect area, and defect and flap size. The etiology included chronic wounds in one patient, trauma in six, and tumors in five. Among the patients diagnosed with tumors, two had squamous cell carcinoma, two had malignant melanoma, and one had dermatofibrosarcoma protuberans.
Results: The average age of the patients was 45.9 years. Four of the patients were female, and eight were male. Nine of the defects were located in the middle third of the crus, and three were distal. The flaps ranged in size from 78 to 210 cm². Venous insufficiency was observed in two flaps, and partial necrosis developed distally in one of them. All flaps survived.
Conclusion: The peroneal artery perforator flap is a versatile option that can be used in the middle and distal parts of the crus.

Objectives: In the early years of defining Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS), its prevalence among homosexual men gave rise to prejudices, the development of immunodeficiency, and lethal infections, causing fear and panic in society. Unethical approaches hindered patients from accessing healthcare services, creating substantial barriers from diagnosis to treatment in the fight against HIV/AIDS. This study aimed to explore the diagnostic significance of an ethical approach toward HIV-positive patients, guided by demographic data.
Methods: Demographic patient characteristics and stigmatization during HIV testing were assessed using a 47-question questionnaire. The research commenced on 01/05/2019 and concluded on 01/05/2020, with questionnaires administered online during the COVID-19 pandemic. Statistical analysis employed the SPSS 21.0 (Armonk, New York: IBM Corp.) package, cross-tabulating survey questions and comparing answers using the Chi-square test. Additionally, multivariate logistic regression analysis was conducted to identify factors associated with perceptions of ethical violations.
Results: The study included 121 participants, with 91% identifying as male, 3% as female, 1.7% stating another gender identity, 2.5% declining to specify, and 1.7% not responding to the question. Participant ages ranged from 19 to 66 years, with a mean of 37.9±10.5. Prior to HIV testing, written consent was obtained from 62.8% of patients, while 37.2% declined to provide consent. Among those who consented, 31.4% reported feeling insufficiently informed about the procedure. During result disclosure, 25.6% found the approach impolite, with abrupt and insufficient information. Additionally, 24% noted the presence of a third person during disclosure, while 25.6% reported breaches of patient confidentiality. Logistic regression analysis revealed that age was the only statistically significant factor associated with perceived ethical violations (p=0.010).
Conclusion: This study highlights critical ethical deficiencies in Türkiye’s HIV testing procedures, with 31.4% of patients reporting inadequate consent and 25.6% experiencing unprofessional result disclosure. These findings underscore the urgent need for patient-centered protocols to ensure ethical standards and reduce stigma.

Objectives: A common incidental radiological finding in asymptomatic adults is primary empty sella (PES). We examined the clinical, radiological and hormonal features of patients with PES to identify risk factors and guide follow-up strategies.
Methods: The study included 120 patients with PES. Data on patients was obtained retrospectively and included details on symptoms, diseases, as well as radiological, biochemical and hormonal findings. Patients were divided into two groups (partial and total) according to sella turcica cerebrospinal fluid volume and pituitary height. They were also classified as having isolated hormone deficiency (HD), hypopituitarism or panhypopituitarism according to the severity of pituitary insufficiency.
Results: HD was found in 83.3% of the study group. The most common causes were growth hormone deficiency and central hypo-gonadism. The two groups were indistinguishable with regard to pituitary insufficiency; however, panhypopituitarism was more prevalent in the total PES group (60.5% vs 30.5%). PES was more common in women, while both general and severe HD were more common in men. Pituitary height was positively correlated with thyroid stimulating hormone, free T4, insulin-like growth factor-1, testosterone, estradiol, adrenocorticotropic hormone and cortisol (r=0.275, p=0.002; r=0.277, p=0.002; r=0.394, p<0.001; r=0.319, p<0.001; r=0.195, p=0.032; r=0.220, p=0.016; r=0.310, p=0.001). Low pituitary height and male gender were associated with an increased risk of panhypopituitarism (p=0.002 vs p=0.015).
Conclusion: Pituitary insufficiency is common in PES, but panhypopituitarism is more common in total PES. Low pituitary height and male gender are risk factors for panhypopituitarism. Patients with these characteristics should be monitored more closely.

Objectives: Surgical intervention is often an inevitable process in individuals’ lives and constitutes a significant source of stress not only physically but also psychologically. The fear and anxiety associated with surgery typically begin in the preoperative period, extend through the intraoperative phase, and may persist even after discharge. This situation directly affects patients’ adaptation to the surgical process and the speed of postoperative recovery, thereby significantly influencing both individuals’ quality of life and the overall effectiveness of healthcare services.
Methods: This cross-sectional and analytical study was conducted with 100 patients aged 18 years and older who had no communication problems and underwent elective surgery in the department of thoracic surgery. Participants completed a questionnaire consisting of a sociodemographic data form, the Surgical Fear Questionnaire (SFQ), and the Post-Discharge Recovery Scale (PDRS). Descriptive statistics were presented using frequencies, means, standard deviations, and minimum and maximum values. For vari-ables with normal distribution, the independent samples t-test and Pearson correlation test were used for analysis. A p-value of <0.05 was considered statistically significant.
Results: Among the participants, 73.0% were male, 50.0% were primary school graduates, and 76.0% were married. The mean post-discharge recovery score of the study group was 55.4±14.5. Participants who were married, had no chronic illness, had a spouse as a caregiver, had two or fewer previous hospitalizations, and had undergone one or fewer previous surgeries had significantly higher post-discharge recovery scores (p=0.033, p=0.047, p=0.033, p=0.045, and p=0.008, respectively). Post-discharge recovery was moderately and negatively correlated with surgical fear (r=-0.400, p=0.034).
Conclusion: In this study, the relationship between preoperative surgical fear levels and post-discharge recovery was evaluated, and a significant negative correlation was identified. The findings are consistent with previously reported results in the literature, supporting the notion that surgical fear may adversely affect the recovery process through both physiological and psychological mechanisms. According to the study results, patients who were married and received postoperative care from their spouses had higher levels of recovery. This suggests that social support—particularly spousal support—serves as an important protective fac-tor during the surgical process. Additionally, individuals with chronic illnesses were found to have significantly lower levels of post-discharge recovery. This may be explained by the physiological burden of chronic diseases, their impact on the immune system, and challenges in treatment adherence. In summary, the study highlights that reducing surgical fear, strengthening social support systems, and improving chronic disease management may contribute positively to the postoperative recovery process.

Objectives: Psoriasis is a chronic inflammatory papulosquamous skin disease whose psychological and interpersonal effects are underrecognized. This study aimed to evaluate dyadic adjustment and sexual functioning in patients with psoriasis and their spouses, in comparison with healthy controls.
Methods: The study included three groups: psoriasis patients (n=47), their spouses (n=40), and healthy controls (HC) (n=42). The Psoriasis Area and Severity Index (PASI) and the Dermatology Life Quality Index (DLQI) were administered to the patient group, while the Family Dermatology Life Quality Index (FDLQI) was administered to the spouse group. The Short Form-12 Health Survey (SF-12), the Dyadic Adjustment Scale–Revised (RDAS), the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), and the Arizona Sexual Experiences Scale (ASEX) were administered to all three groups.
Results: Sexual dysfunction was observed in 83% of patients, 65% of spouses, and 50% of healthy controls. RDAS total and subscale scores (consensus, cohesion, satisfaction) were significantly lower in patients and spouses compared with healthy controls (p<0.001). Patients had significantly higher BDI scores than both spouses (p=0.016) and controls (p=0.002), and significantly lower physical and mental SF-12 scores. In spouses, FDLQI scores positively correlated with BDI (r=0.369, p=0.021) and negatively with SF-12 mental scores (r=–0.505, p=0.001). Regression analysis revealed that depressive symptoms (p=0.004) and disease duration (p=0.049) significantly predicted sexual dysfunction.
Conclusion: Psoriasis exerts a substantial psychosocial burden not only on patients but also on their spouses. Addressing relational and sexual well-being in clinical care may improve overall quality of life for affected couples.

Objectives: The objective of this study is to examine the association between nutritional status and the incidence of fractures in elderly patients with osteoporosis, while also evaluating other clinical, anthropometric, and biochemical factors related to these outcomes.
Methods: Geriatric patients diagnosed with osteoporosis who presented to the outpatient clinic were included from January 2016 to December 2019. In addition to demographic, clinical, anthropometric, and laboratory data, we examined bone mineral density (via DEXA), nutritional status, sarcopenia assessment, and the presence and types of fractures. Nutritional status was assessed using multiple validated tools, including the Geriatric Nutritional Risk Index (GNRI).
Results: A total of 181 patients (79% females) with a mean age of 78.12±6.65 years were included in the study. The fracture incidence recorded during follow-up was 40.88% (n=74). The mean age of the fracture group was significantly higher than that of the non-fracture group. GNRI, with a cut-off value of ≤100.6, significantly distinguished patients without fracture. Sarcopenia was present in 57.46% of patients, with no significant difference between fracture and non-fracture groups (p=0.642). Multivariable logistic regression indicated that older age (OR: 1.090, 95% CI: 1.022–1.162, p=0.009), fewer medications (OR: 0.868, 95% CI: 0.791–0.953, p=0.003), and low DEXA vertebra T-score (OR: 0.436, 95% CI: 0.285–0.668, p<0.001) were independently associated with fracture likelihood.
Conclusion: Malnutrition is correlated with increased fracture risk among older adults with osteoporosis, whereas sarcopenia prevalence was high but not independently associated with fractures.

Objectives: This study aimed to investigate the risk of neoplasm (RON) and the risk of malignancy (ROM) in cases diagnosed as salivary gland neoplasm of uncertain malignant potential (SUMP), with subclassification based on cytomorphologic features.
Methods: A retrospective review was conducted on salivary gland fine-needle aspiration (FNA) specimens diagnosed as SUMP between 2018 and 2022 in a tertiary care setting. Each case was re-evaluated by two pathologists and subclassified into basaloid, oncocytic, or clear cell/other categories according to the dominant cytomorphologic pattern. RON and ROM were calculated for the overall SUMP category and for each cytomorphologic subgroup.
Results: Among 41 SUMP cases, the basaloid subtype was the most common (70.7%), followed by the oncocytic (19.5%) and the clear cell/others (9.8%). Histopathological confirmation was available in 65.9% of cases, all of which were neoplastic, resulting in a RON of 100%. The overall ROM was 29.6%. The ROMs by subgroup were 25% for basaloid, 40% for oncocytic, and 50% for clear cell/others. Pleomorphic adenoma was the most frequently encountered benign neoplasm (33.3%), and basal cell carcinoma was the most common malignant diagnosis (18.5%). The majority of malignant cases (87.5%) were located in the parotid gland.
Conclusion: This study confirms the consistently high neoplastic potential of SUMP lesions and highlights the variation in malignancy risk among different cytomorphologic subtypes. Although the ROM differed among the subgroups, they all demonstrated clinical relevance, supporting the utility of cytomorphologic subclassification in salivary gland cytopathology. These findings may contribute to more refined risk assessment and patient management within the Milan System framework.

Objectives: Anaphylaxis, which has been increasing in frequency parallel to other allergic diseases in recent years, is a life-threatening, acute systemic reaction. Physicians working in pediatric emergency departments (PED) should recognize the signs and symptoms of anaphylaxis and administer initial treatment. This study aims to evaluate the demographic, clinical, and laboratory findings of patients diagnosed with anaphylaxis in the pediatric emergency unit of a tertiary care facility.
Methods: Patients diagnosed with anaphylaxis in our unit at the PED were retrospectively reviewed between 2016 and 2023.
Results: A total of 100 patients were diagnosed with anaphylaxis in our pediatric emergency department, including 39 girls and 61 boys. Of these patients, 3% were under 2 years of age, 25% were between 2–6 years, and 72% were over 6 years old. In 83% of the cases, anaphylaxis occurred at home, while 11% occurred during medication administration at a hospital. Triggers were identified in 81% of the patients, whereas 19% were diagnosed with idiopathic anaphylaxis. The most common triggers were medications. Food-related anaphylaxis was the second most common trigger, with cow’s milk being the most frequent at 8%. The most commonly affected system was the skin and mucosa in 97% of cases. When examining the relationship between age groups and triggers, food allergies were most frequent in children under 2 years old (p<0.001). The average tryptase level measured during anaphylaxis was 5.27 ug/L (1.43–33.6), with idiopathic cases showing a significantly higher average of 9.15 ug/L (6.29–33.6) (p=0.005).
Conclusion: Anaphylaxis is a systemic reaction that can be fatal if not treated quickly and accurately. Adrenaline is the single most effective treatment, and pediatric emergency physicians play a crucial role in this context. Our findings suggest that tryptase levels in pediatric patients are often below the widely accepted cut-off; however, larger studies are needed before reference ranges can be redefined.

Objectives: The quality of transurethral resection of bladder tumor (TURBT) significantly affects disease management. Pathology specimens that do not contain detrusor muscle (DM) may be associated with low clinical staging. The aim of this study was to evaluate the factors affecting the detection of DM in TURBT.
Methods: A total of 1014 patients who underwent TURBT between June 2016 and June 2024 and met the inclusion criteria were enrolled in the study. The requirements for good-quality TURBT were complete resection and detection of DM in the pathology specimen. All procedures were performed by a total of 17 residents under the supervision of a specialist doctor.
Results: DM was obtained statistically significantly more often in patients with large (≥3 cm), multiple, and solid tumors. In addition, DM was observed more frequently in the pathology specimens of patients with high-grade tumors, variant histology (VH), or accompanying carcinoma in situ (CIS). The effect of surgical experience on obtaining DM was evaluated, and senior residents (4th year and final year) were found to be more successful than junior residents (3rd year) (65.3% vs. 58%, p=0.021). Multivariate analysis revealed that tumor architecture and tumor size were significant factors influencing DM acquisition.
Conclusion: Surgical success in the TURBT procedure has not been clearly defined, but it is known to be affected by many factors. In our study, the rate of DM detection was found to be lower in low-risk tumors. Increasing experience during urology residency was associated with higher-quality TURBT outcomes.

Objectives: This study aimed to evaluate the awareness, knowledge, and attitudes of parents regarding retinopathy of prematurity (ROP) and its follow-up in a tertiary referral center.
Methods: In this cross-sectional survey conducted at a single ROP center in Turkey from March to August 2025, 608 parents of infants born at <34 weeks' gestation and/or ≤1700 g birth weight, and those of infants with higher gestational age or birth weight who required cardiopulmonary support, completed a validated 15-item questionnaire during their infant’s first ROP examination. A structured questionnaire, including sociodemographic data, knowledge about ROP, its consequences, treatment options, and adherence to follow-up, was administered. Associations between parental education level and ROP awareness were analyzed.
Results: Among 608 parents (59% mothers, 41% fathers; mean age 29.7±3.2 years), only 16.6% recognized that ROP screening differs from a routine eye exam. Overall, 81% were unaware of ROP, and 86% did not know it could cause blindness. Only 14% had received information about ROP, mainly from physicians (63.5%) or the internet (34.1%). While 71% were unsure about treatability and 37% acknowledged the importance of follow-up, 90% reported willingness to attend recommended visits. Higher educational level was significantly associated with ROP awareness (p<0.001), with university-educated parents showing the greatest knowledge (p<0.05).
Conclusion: Parental knowledge regarding ROP examinations was generally found to be low. A higher level of knowledge about ROP was observed among university graduates. Efforts to improve adherence to ROP follow-up should include systematic training programs for healthcare professionals, structured guidance for parents, and the widespread implementation of educational materials. In this context, integrating targeted educational interventions into routine care may contribute to long-term success in ROP management.

Polydactyly is a congenital extremity malformation defined by the presence of additional digits. The mirror foot anomaly, regarded as a rare variant of preaxial polydactyly, is characterized by a mirror image duplication of the foot. Due to the variability of mirror foot patterns reported in the literature, defining the term “mirror foot” remains challenging. In this case study, we present the treatment of a five-year-old male patient with a mirror foot anomaly who was admitted to our outpatient clinic. There is no consensus on the optimal surgical management strategy, and very few cases have been documented in the literature.

Idiopathic scrotal elephantiasis is a rare yet physically and psychologically debilitating condition characterized by chronic lymphedema of the scrotum. This case report presents an 18-year-old male with progressive scrotal enlargement over seven years. The patient applied to our clinic due to discomfort and occasional discharge. Clinical examination revealed scrotal edema without systemic involvement. Diagnostic imaging excluded other pathologies. Surgical intervention was planned, and 1.2 kg of excess tissue was meticulously excised while preserving the testes and spermatic cords. No complications were observed during the postoperative recovery period that necessitated secondary surgical intervention.
Treatment options for idiopathic scrotal elephantiasis range from conservative management, such as elevation, compression therapy, and skin care, to surgical interventions, including vascularized lymph node transfer (VLNT) and lymphaticovenous anastomosis (LVA), in addition to tissue excision. This case report aims to underline the significance of early diagnosis, tailored treatment, and comprehensive postoperative care.

Myasthenia gravis (MG) is an autoimmune disorder characterized by abnormal neuromuscular conduction. The thymus is believed to play a key role in the pathogenesis of MG; therefore, thymectomy is an important treatment option for the disease. As MG exacerbations and new-onset MG cases following Coronavirus Disease 2019 (COVID-19) vaccinations have been previously reported in the literature, various complications highly related to autoimmunity, such as Guillain–Barré syndrome, have also been described after vaccination. A previously healthy girl developed her first life-threatening systemic MG attack following administration of the messenger RNA (mRNA) BNT162b2 COVID-19 vaccine. Despite receiving treatment targeting MG, her clinical status did not show significant improvement, which led to the decision to perform thymectomy via the video-assisted thoracoscopic surgery (VATS) approach. After the procedure, a significant improvement was observed in her clinical condition. We aimed to contribute to the literature on this rarely encountered condition by reporting the first paediatric case in our country presenting with BNT162b2 vaccination-associated generalized weakness and severe respiratory distress, who was diagnosed with MG and thymoma during follow-up, in the light of contemporary literature. This case also serves as a warning for other mRNA vaccines.

Iodine-containing antiseptics and contrast agents used in neonates can lead to hypothyroidism, which, although often transient, may require prolonged treatment in some cases. Untreated hypothyroidism, even if temporary, can negatively impact neurodevel-opment, particularly in preterm infants. In addition, gastrointestinal disorders such as short bowel syndrome or ileus may hinder oral levothyroxine absorption, necessitating alternative administration routes.
Here, we present a late preterm neonate who developed hypothyroidism after iodine-containing contrast agent use for diagnos-ing total intestinal aganglionosis. The patient failed to respond to oral and rectal levothyroxine administration due to functional ileus and persistent gastrointestinal drainage. Subsequently, levothyroxine was administered via the buccal route by diluting the tablet form. The treatment resulted in rapid normalization of thyroid function tests, with no adverse effects observed.
In our case, buccal administration of diluted levothyroxine tablets was found to be a beneficial treatment approach for managing hypothyroidism in a patient unable to tolerate oral therapy due to intestinal dysmotility and malabsorption, particularly in the absence of alternative formulations. Furthermore, it highlights the importance of monitoring thyroid function in neonates exposed to iodine-containing agents, especially those with gastrointestinal motility disorders. Buccal levothyroxine may provide a practical solution for managing hypothyroidism in similar clinical scenarios.

Erythema multiforme (EM) is a self-limiting, immune-mediated condition characterized by target-like lesions, often triggered by infections, with herpes simplex virus (HSV) being the most common agent. In rare cases, EM may present following Blaschko’s lines, a pattern of cutaneous mosaicism. We report a unique case of EM in a 17-year-old male with lesions distributed along Blaschko’s lines across his arm, trunk, and leg, marking the most extensive presentation of EM in this pattern to date. The patient had no history of HSV infection or drug use, except for cannabis consumption, which was considered a probable trigger based on the Naranjo Adverse Drug Reaction Probability Scale. Histopathological analysis confirmed the diagnosis of EM, and the lesions resolved with topical clobetasol propionate. This case highlights the rare occurrence of EM along Blaschko’s lines in a young patient and suggests cannabis as a potential trigger, contributing to the understanding of atypical presentations and etiology in EM.