The relationship between sleep quality and chronotype differences and urticaria severity in patients with chronic spontaneous urticaria.

INTRODUCTION: Chronic spontaneous urticaria (CSU) is characterized by persistent or recurrent pruritic lesions that last more than 6 weeks. Patients with CSU may experience sleep disturbances, particularly due to itching. Biological rhythms (chronotypes) are categorized as morningness, intermediate, and eveningness types. This study evaluates the relationship between sleep quality, chronotype, and disease severity in CSU patients. METHODS: The study included 53 CSU patients and 50 healthy controls. A sociodemographic data form was completed, and the disease severity was determined utilizing the Urticaria Activity Score over 7 days (UAS7). The Hospital Anxiety and Depression Scale (HADS), Insomnia Severity Index (ISI), and Pittsburgh Sleep Quality Index (PSQI) scales as well as the Morningness-Eveningness Scale (MEQ) were applied to the participants. RESULTS: The CSU group had a significantly higher body mass index (BMI) than that of the healthy control group. In terms of sleep and chronotype scales, compared to the control group, the CSU group had higher ISI scores as well as subscale scores on the PSQI subscales, with the exception of habitual sleep efficiency and total PSQI scores. There was no difference between MEQ scores. In the correlation analysis, the UAS7 and PSQI total scores were found to be correlated, whereas in the logistic regression analysis the estimated relative risk of BMI and PSQI total score for CSU was found to be 1.13 and 1.45, respectively. CONCLUSIONS: When dealing with CSU patients, it is necessary to conduct a sleep quality assessment as part of a holistic evaluation.

Effect of systemic isotretinoin therapy on semen parameters.

PURPOSE: Vitamin A has multiple functions in the human body, being involved in growth, epithelial differentiation, vision, immune function and reproduction. While normal spermatogenesis is influenced by several factors, it requires vitamin A. Systemic isotretinoin is a vitamin A derivative that is used in the treatment of many dermatological diseases, especially acne vulgaris (AV). There is limited research on the changes in semen parameters after systemic isotretinoin therapy in humans. Our study investigates the presence of varicoceles in patients undergoing systemic isotretinoin therapy for AV and examines whether there were any changes in the semen parameters before and after treatment. METHODS: Included in the study were 46 men patients who were scheduled for systemic isotretinoin therapy for AV. Before treatment, the patients underwent a physical examination and ultrasonography for varicoceles assessment. The patients underwent spermiogram before treatment and after 6 months of treatment. The spermiogram assessments included semen volume, sperm concentration, total sperm count, progressive motility, viability and sperm morphology. RESULTS: After treatment, there was an increase in semen volume, sperm concentration, total sperm count, progressive motility and vitality from the pre-treatment values, but a deterioration in the sperm morphology (p < .05). Comparing patients with and without varicoceles revealed more changes in semen parameters after treatment in those with varicoceles. There was a statistically significant difference in sperm concentration (p < .001). CONCLUSIONS: Systemic isotretinoin therapy negatively affects sperm morphology, but has positive effect on other semen parameters, and these changes in semen parameters occur more frequently in patients with varicoceles.KEY MESSAGESAcne vulgaris is a very common disease and systemic isotretinoin is used as the most effective agent in its treatment.Systemic isotretinoin positively affects semen parameters except sperm morphology.Changes in semen parameters are more common in patients with varicocele.