Analysis of factors influencing target PASI responses and side effects of methotrexate monotherapy in plaque psoriasis: a multicenter study of 1521 patients.

Methotrexate (MTX) is commonly used as first-line systemic treatment agent in psoriasis. We aimed to evaluate the clinical characteristics and treatment responses of patients with psoriasis undergoing MTX monotherapy. Data from adult patients with plaque psoriasis who received MTX monotherapy for at least 3 months between April 2012 and April 2022 were retrospectively evaluated in 19 tertiary care centers. Our study included 722 female and 799 male patients, a total of 1521 participants. The average age of the patients was 44.3 ± 15.5 years. Mode of treatment was oral in 20.4% of patients while in 79.4% it was subcutaneous. The median treatment duration was 8 months (IQR = 5-15). The median weekly dose was 15 mg (IQR = 11-15). 1448 (95.2%) patients were taking folic acid supplementation. At week 12, 16.3% of the patients achieved PASI (Psoriasis Area and Severity Index) 90 response while at week 24, 37.3% achieved it. Logistic regression analysis for week 12 identified the following independent factors affecting PASI 90 achievement positively: median weekly MTX dose ≤ 15 mg (P = 0.011), subcutaneous administration (P = 0.005), no prior systemic treatment (< 0.001) and folic acid use (0.021). In logistic regression analysis for week 24; median weekly MTX dose ≤ 15 mg (P = 0.001), baseline PASI ≥ 10 (P < 0.001), no prior systemic treatment (P < 0.004), folic acid use (P = 0.001) and absence of comorbidities (P = 0.009) were determined as independent factors affecting the achievement of PASI 90. Adverse effects were observed in 38.8% of the patients, with nausea/vomiting (23.9%) and transaminase elevation (13%) being the most common. The most common reasons for interruptions (15.3%) and discontinuations (27.1%) of the treatment were patient related individual factors. The use of MTX as the first systemic treatment agent, at doses ≤ 15 mg/week and concurrent folic acid application are positive predictive factors for achieving the target PASI response both at weeks 12 and 24. In our study, which is one of the most comprehensive studies on MTX treatment in psoriasis, we observed that MTX is an effective and safe treatment option.

Validity and reliability of the Sitting Assessment Scale in cerebral palsy.

AIM: The aim of this study was to examine the validity and reliability of the Sitting Assessment Scale (SAS) in individuals with cerebral palsy (CP). METHODS: The study included 34 individuals with a diagnosis of spastic CP. Individuals were evaluated with the Gross Motor Function Classification System and the Manual Ability Classification System. SAS and Trunk Control Measurement Scale (TCMS) were applied to the participants. The intraclass correlation coefficient (ICC) was calculated to determine the intraobserver and interobserver reliability of the scale scored by three different physiotherapists at two different time intervals. Internal consistency was calculated with Cronbach's ⍺ coefficient. The fit between SAS and TCMS for criterion-dependent validity was evaluated using Pearson Correlation Analysis. RESULTS: According to the GMFCS level, 79.41% of the children were mildly (Level I-II), 14.71% were moderately affected (level III), and 5.88% were severely affected (level IV). Intra > observer and interobserver reliability values of SAS were extremely high (ICCinterrater > 0.923, ICCintrarater > 0.930). It was observed that the internal consistency of SAS had high values (Cronbach ⍺test > 0.822, Cronbach ⍺retest > 0.804). For the criterion-dependent reliability; positive medium correlations found between SAS with Total TCMS Static Sitting Balance (r = 0.579, p < 0.001), with TCMS Selective Movement Control (r = 0.597, p < 0.001), with TCMS Dynamic Reaching (r = 0.609, p < 0.001), and with TCMS Total (r = 0.619, p < 0.001). CONCLUSION: SAS was found to have high validity and reliability in children with CP. In addition, the test-retest reliability of the scale was also high. SAS is a practical tool that can be used to assess sitting balance in children with CP.

A Comparison of Clinical, Demographic and Treatment Characteristics of Pediatric-Onset and Adult-Onset Patients Diagnosed With Localized Scleroderma.

INTRODUCTION: Morphea localized scleroderma (LS) is a rare skin disease with unknown pathogenesis, which causes sclerosis of the dermis and subcutaneous tissue. OBJECTIVES: It was aimed to compare the characteristics of patients with pediatric and adult-onset morphea. METHODS: A retrospective analysis was performed on the records of 183 adult morphea patients. The demographics, clinical and laboratory characteristics, and treatment options of the patients were recorded. Adult patients with morphea over the age of 18 were divided into two groups according to the age of onset and compared. RESULTS: Twenty-two percent (N = 41) of the patients had pediatric-onset morphea (POLS) and 77.6% (n=142) had adult-onset morphea (AOLS). While POLS had a higher head-neck involvement, AOLS had a higher breast involvement (P < 0.001 and P = 0.043). Patients with linear morphea were younger, and more frequently had at least one laboratory anomaly (P = 0.016 versus 0.024). Anti-dsDNA positivity and low hemoglobin (Hb) were observed more frequently in patients with breast involvement. Patients with inguinal involvement, on the other hand, had lower Hb and a higher rate of diabetes, and those patients were older (P = 0.042, 0.040, and 0.012, respectively). CONCLUSIONS: Clinical characteristics and accompanying laboratory anomalies of the patients with morphea depend on the age of onset, involvement areas and the types of morphea, having such data readily available should guide the holistic approach for, and the monitoring process of, the disease.

The Validity and Reliability of the Turkish Version of the Telerehabilitation Acceptance Scale (Health Care Professionals' Form).

Purpose: This study was conducted to examine the Turkish validity and reliability of the Telerehabilitation Acceptance Scale Health Care Professionals' Form (TRAS-HP). Methods: Health care professionals between the ages of 18 and 65 years were included. TRAS-HP was used to assess study participants' acceptance of telerehabilitation. Turkish translation of the scale was followed by confirmatory and explanatory factor analyses. Internal consistency and test-retest reliability were calculated. Results: Of the participants, 158 (65.83%) were female and 82 (34.17%) were male. Explanatory factor analysis revealed a three-factor structure explaining 71.87% of the total variation with one item removed. Confirmatory factor analysis determined that the model fit indices (the root mean square error of approximation = 0.080, adjusted goodness of fit index = 0.857, goodness of fit index = 0.899, and chi-square/degrees of freedom = 2.516) were satisfactory. The subdimensions' factor loads ranged from 0.78 to 0.82. After confirmatory and explanatory factor analysis, the 16-item TRAS-HP was reduced to 14 items. Internal consistency (cronbach alpha = 0.947) and test-retest reliability (intraclass correlation coefficient: 0.927) were extremely high. Conclusions: With this study, the Turkish validity and reliability of TRAS-HP were demonstrated, and it was revealed that they are a suitable tool for determining the acceptance and awareness of telerehabilitation of health care professionals working in rehabilitation.

Examining the presence of sarcopenia in women with rheumatoid arthritis: Case-control study.

INTRODUCTION: The aim of this study was to compare the frequency of sarcopenia, functional status, fear-avoidance behaviors, biopsychosocial status and quality of life in RA women with healthy controls. METHODS: 25 RA women and 25 healthy women were included in the study. Definition of sarcopenia was assessed using parameters recommended by the European Working Group on Sarcopenia (EWGSOP): Bioimpedance analysis for muscle mass (body fat ratio, skeletal muscle mass, skeletal muscle mass index); grip and knee extension strength for muscle strength and 4-m course gait speed test for physical performance was applied. Functional status was evaluated with the Health Assessment Questionnaire (HAQ), fear-avoidance behaviors with the Tampa Kinesiophobia Scale (TKS), biopsychosocial status with the Biopsychosocial Questionnaire (BETY-BQ), and quality of life with Short Form-36 (SF-36). RESULTS: While none of the healthy women had sarcopenia, severe sarcopenia was detected in 7 (28%) of the women with RA. When RA and healthy groups were compared; skeletal muscle mass (p: 0,004); skeletal muscle mass index (p: 0,011); grip strength-right (p:0.001) and left (p:0.001); knee extension strength-right (p:0.001) and left (p:0.001), 4-m course gait speed test (p:0.001), HAQ (p:0.001), TKS (p:0.001), BETY-BQ (p:0.001), SF-36 physical (p:0.001) ve mental component (p:0.001) results were significant in favor of the healthy group while there was no difference in body fat ratio (p>0.05). CONCLUSION: In women with RA, the frequency of sarcopenia is higher, and functional status, fear-avoidance behaviors, biopsychosocial status and quality of life are worse than healthy.

Evaluation of daily and social participation of children with Cerebral Palsy across different age groups with a focus on the 'F'-words: Function, family, fitness, fun, friends and future.

BACKGROUND: The impact of disability differs across cultures. This study aimed to determine the predictors of participation in children with cerebral palsy (CP) in Turkey, based on the six F-words. METHODS: Cross-sectional study exploring participation profiles of 450 children with CP, aged between 2 and 18 years. Pediatric Evaluation of Disability Inventory (PEDI) evaluated functional skills, and Assessment of Life Habits (LIFE-H) version 3.0 assessed daily and social participation. Hierarchical linear regression models were done to determine the predictors of participation in daily activities (PDA) and social roles (PSR) in three age groups (2-4, 5-13 and 14-18 years) based on the 6 F-words (mobility of PEDI for 'fitness'; four classification systems and self-care of PEDI for 'functioning'; social functions of PEDI for 'friends'; demographic information by parents for 'family'; the recreation of LIFE-H for 'fun'; and different stages of development for 'future'). RESULTS: The most important predictors for total PDA by age group were: self-care (p = 0.012) of PEDI in 2-4 y; self-care (p = 0.001) and mobility (p = 0.005) of PEDI in 5-13 y; GMFCS (p = 0.006) and mobility (p = 0.002) of PEDI in 14-18 y. Significant predictors for PSR differed by age group: self-care (p = 0.001) of PEDI in 2-4 y; self-care (p = 0.023) and mobility (p = 0.006) of PEDI in 5-13 y; and GMFCS (p = 0.004) and MACS (p = 0.003) in 14-18 y. CONCLUSIONS: Six F-words of function and fitness focussed on self-care in younger children with an increasing emphasis on mobility and ability levels according to age. Therefore, rehabilitation for different aspects of the functional levels is needed to improve participation in life across the six F-words framework; plus take into consideration context, age-differences, family's expectations, life requirements, environmental needs, and cultural differences.

Vitamin D levels in patients with seborrheic dermatitis.

OBJECTIVE: Seborrheic dermatitis is a common papulosquamous skin disease with unknown pathogenesis. The aim of our study was to determine the serum level of 25-hydroxy vitamin D in patients with seborrheic dermatitis SD. METHODS: A total of 53 patients and 60 healthy controls were included in the study. Serum vitamin D, calcium, phosphorus, and parathormone levels were measured in the patient and control groups, and a comparison was made between the two groups regarding these parameters. RESULTS: Severe vitamin D deficiency was more frequent among patients with seborrheic dermatitisSD compared to controls (52.8 vs. 25.8%, p=0.003). In patients with severe vitamin D deficiency, seborrheic dermatitis SD was detected more frequently at an early age (p=0048) and in women (p=0.015). No correlation was found between the seborrheic dermatitis skin involvement site and vitamin D level. CONCLUSION: The fact that vitamin D levels decreased in patients with seborrheic dermatitis SD and patients with severe vitamin D deficiency develop seborrheic dermatitis SD earlier suggests that the low levels of vitamin D are related to seborrheic dermatitis.

Oxidative Stress and Thiol/Disulfide Homeostasis in Human Papillomavirus Infections.

Introduction: Viral warts are a group of dermatological diseases caused by human papillomavirus (HPV). Several studies have demonstrated an association between HPV infections and oxidative stress. Thiols are important components of cellular redox homeostasis as antioxidant molecules in the organism. Aim: This study aimed to investigate the role of oxidative stress in patients with HPV infection by analyzing native thiol/disulfide homeostasis. Material and Methods: Forty-two patients with HPV infection and 40 healthy subjects were analyzed for the levels of native thiols, total thiols, and disulfide. Disulfide/native thiol, disulfide/total thiol, and native thiol/total thiol ratios were also calculated. Results: Disulfide and total thiol levels were higher in the patients compared to the healthy controls. The disulfide/native thiol ratio was also higher in the patient group. Native and total thiol levels decreased with the increasing duration of the disease. Conclusion: The native thiol/disulfide homeostasis was shifted toward disulfide in the patients' group, indicating the existence of oxidative stress in HPV infection.

The effects of fatigue, gross motor function, and gender on participation in life situations of school-aged children with cerebral palsy: A parental perspective.

OBJECTIVE: To investigate the effects of fatigue, gross motor function, and gender on participation in life situations of school-aged children with cerebral palsy (CP) from a parental perspective. METHODS: The study included 209 children with CP aged between 5 and 13 years (mean age, 8.06 ± 2.41 years; girls, 45.5%) and their parents. Fatigue, gross motor function, and participation status were evaluated with the Pediatric Quality of Life (PedsQL), Gross Motor Function Classification System (GMFCS), and the Assessment of Life Habits (Life-H) questionnaire, respectively. The effects of fatigue, gross motor function, and gender on participation were investigated with linear regression analysis. RESULTS: According to parental reports, 79.9% of the children had fatigue. Children in all GMFCS levels experienced fatigue. Fatigue and GMFCS levels were dependent variables, and therefore only simple linear regression analyses were performed. Fatigue explained 38-43% of the variances in daily activities, social roles, and total Life-H scores, while gross motor function explained 48-65% of the variances in scores (p < 0.001). Gender had no effect on participation scores (p > 0.05). CONCLUSION: More than two thirds of the school-aged children with CP had fatigue. Fatigue and poor gross motor function had a negative effect on participation in daily activities and social roles.

Complementary and alternative treatment methods practiced by parents in pediatric cases diagnosed with atopic dermatitis.

INTRODUCTION: Atopic dermatitis (AD) is a chronic, recurrent, and inflammatory skin disease experienced mostly in childhood. Chronicity of the disease, relapses, constant need of regular skin care causes seeking for alternative treatments. AIM: The aim of this study is to evaluate the complementary and alternative treatments (CAT) used by parents' caregivers in pediatric patients diagnosed with AD, and the association between CAT use and patient characteristics. MATERIALS AND METHODS: A questionnaire questioning the sociocultural and demographic characteristics of the family, the clinical findings of the patients, their treatments and CAT applications was recorded. RESULTS: Eighty-three patients were included in the study. 68.7% of the patients used at least one type of CAT. Vitamins and oils were the most commonly used CAT (48.8% and 47%, respectively) and 73.3% of the patients using CAT continued normal AD treatment while using CAT. The biggest factor affecting CAT choice was the advice of the immediate circle (75%), and 40.6% of the patients stated that they benefited from the complementary therapy. CONCLUSIONS: CAT are widely used in AD. Physicians should know the socio-cultural structure of the region they are in, the CAT used and their side effects, and inform the families.

Investigation of the relationship between seborrheic dermatitis and metabolic syndrome parameters.

BACKGROUND: Seborrheic dermatitis (SD) is a common, chronic inflammatory disease with relapses and remissions. OBJECTIVES: So we planned to investigate the relationship between SD and metabolic syndrome (Mets). METHODS: 54 patients over 18 years of age without known diabetes mellitus, hypertension, coronary artery disease who were clinically diagnosed with SD in our clinic and 47 healthy controls were included in the study. Body mass index (BMI) was calculated of all participants. Complete blood count, fasting blood sugar (FBG), triglyceride (TG), total cholesterol, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) were examined. The relationship between the presence of MetS, disease severity, and duration was investigated. RESULTS: Average age of patients was 35.4 (sd: 12). Average age of controls was 32.9 (sd: 10.7). MetS was detected in 35.2% (n = 19) of the patient group and 10.6% (n = 5) of the control group. The presence of MetS was higher in SD patients than in the control group (p = 0.004). The rate of people with high TG was significantly higher in the SD group than the controls (p = 0.015). HDL level was significantly lower in the patient group (p = 0.050). Systolic and diastolic blood pressure were high in patients (p = 0.016, p = 0.029). CONCLUSIONS: Seborrheic dermatitis should be considered as a MetS marker and the presence of MetS should be examined in this group of patients. This can be helpful for the early diagnosis of a systemic disease complex with numerous complications. Also, treatment of MetS can also improve SD lesions.

Cutaneous findings in patients with chronic venous insufficiency.

BACKGROUND: Venous hypertension causes many different cutaneous findings such as varicosities, telangiectasia, edema, and pigmentation, dermatitis, and venous ulcers on the skin. OBJECTIVE: This study aims to investigate the cutaneous signs and symptoms of chronic venous insufficiency (CVI) and to examine their contribution to early diagnosis. METHODS: A total of 150 patients were included in the study who applied to the dermatology outpatient clinic and were diagnosed with skin disease related to CVI or had skin findings. Patient's age, gender, complaints, occupation, additional diseases, drug usage, history of prolonged standing and travel, smoking habit, number of pregnancies, history of varicose veins in the family, dermatological diagnosis/findings, and venous Doppler ultrasonography reports were examined retrospectively. RESULTS: 56% of patients were women. Mean age was 56.69 ± 13.6 years. Overall, 82.7% of total patients had at least one skin finding. The most frequent skin findings except varicose veins were insufficiency dermatitis accounted for 32.7% of patients, telangiectasia, and pigmentation which were comprised 25.3%, 19.3% of the total number of patients respectively. In addition to this, 48.7% of patients had itching problems and 32.7% had pain. Moreover, 46% of patients presented superficial vein insufficiency, while 8.7% had deep vein insufficiency. For 47.3% of patients, vein diameter dilation was observed and 11.3% suffered from perforating vein insufficiency. In terms of Clinical-Etiologic-Anatomic-Pathophysiologic (CEAP) classification, scores of 52% of the patients were C3 and lower, while scores of 48% of total patients were C4a and higher. CONCLUSIONS: Early diagnosis and treatment of chronic venous insufficiency could prevent further chronic processes such as venous ulceration which is an advanced CVI finding. Thus, assessing the early skin findings might be important to identify the underlying venous insufficiency disease.

Can thiol-disulfide balance be an indicator of oxidative stress for hyperhidrosis?

BACKGROUND: Hyperhidrosis is responsible for various causes. The increased reactive oxygen radical production with insufficient antioxidant mechanism capacity may play a role in the etiopathogenesis of hyperhidrosis. It is probable to gather data about oxidative stress by detecting plasma thiol/disulfide ratio. The aim of this study was to determine whether thiol-disulfide balance changes in patients with hyperhidrosis. METHODS: The files of patients who were diagnosed with hyperhidrosis in the dermatology outpatient clinic between 2015 and 2018 and whose native thiol, total thiol, and disulfide values were examined for any reason were examined. RESULTS: Seventy-three patients were included in the study. 33 of the patients with hyperhidrosis were primary. Mean age; for primary hyperhidrosis patients (PHH) = 26.36 ± 7.61, primary hyperhidrosis (PHH) control group = 27.16 ± 7.94; secondary hyperhidrosis (SHH) patients = 47.88 ± 12.29, SHH control (45.40 ± 12.02). The native thiol values of PHH (469.93 ± 56.82 µmol/L) were higher than SHH (440.64 ± 62.72) (p = 0.024). However, as a result of thiol-disulfide comparison between hyperhidrosis patients (PHH and SHH) and control groups, disulfide levels increased (p = 0.04). In the PHH group, total thiol was measured as 512 ± 54.84 µmol/L, and SHH was measured as 484.11 ± 58.9 µmol/L, (p = 0.074). CONCLUSION: Serum thiol levels in SHH increased more than PHH. As a result of thiol-disulfide comparison between hyperhidrosis patients and control groups, the balance shifted in favor of disulfide and oxidative side.

An online pilates exercise program is effective on proprioception and core muscle endurance in a randomized controlled trial.

BACKGROUND: Proprioception is important for stability of body segments, postural control, and functionality. However, there are no studies in literature showing effects of online Pilates exercises that create proprioceptive inputs on vertebra on trunk proprioception. AIMS: This study aims to reveal effect of online Pilates exercises conducted on trunk proprioception and core muscle endurance in healthy individuals. METHODS: We included thirty-three healthy individuals between ages of 18 and 25 in study. Individuals were randomly divided into two groups. There were 17 individuals in Pilates group (PG), and 16 individuals in control group (CG). The PG was given online Pilates exercises by the physiotherapist in groups 3 days a week for 6 weeks, 1 h a day. There was no exercise program recommended for individuals in CG. We evaluated trunk proprioception with an inclinometer, core muscle endurance with three core endurance tests created by McGill, and prone bridge tests. All evaluations completed just before start of study and 2 days after 6-week training. RESULTS: Two groups had similar demographic characteristics, and there was no difference between baseline measurements (p > 0.05). While improvement observed in PG in trunk proprioception and all of core muscle endurance tests (p < 0.05), no statistically significant difference reported in CG (p > 0.05). CONCLUSIONS: We revealed that online Pilates exercises performed at mat level for 6 weeks in healthy individuals had positive effects on trunk proprioception and core muscle endurance with this study. Contribution of Pilates exercises to development of both muscular endurance and proprioceptive senses, even if performed at a distance, is important.

Physical activity and exercise benefits/barriers in mothers of children with motor disabilities.

BACKGROUND: Mothers of children with motor disabilities face physical and emotional burdens. AIMS: This study aimed to determine the physical activity levels, exercise-related barriers, and facilitators in mothers of children with motor disabilities and investigate the differences between the physical activity levels of mothers who have children with different motor functional status. METHODS: In this cross-sectional study, mothers were assessed with the Exercise Benefits/Barriers Scale (EBBS) and International Physical Activity Questionnaire short form (IPAQ-SF). The motor functional status of the children was classified by Gross Motor Function Classification System (GMFCS), and the mothers were divided into two groups (GMFCS level I, II = mild motor disability n = 28, GMFCS level III-V = moderate-to-severe motor disability, n = 37) according to the motor level of their children. RESULTS: Sixty-nine mothers (36.56 ± 7.25 65) were included in this study. None of the mothers had adequate levels of physical activity (0%). According to the EBBS, the most frequently reported exercise barrier was lack of time (mothers of children with mild motor disability n = 26, 92.85%, the mothers of children with moderate-to-severe motor disability n = 34, 91.89%). The physical activity levels of the mothers of children with mild motor disability were higher compared to the mothers of children with moderate-to-severe motor disability (p = 0.032). CONCLUSION: This study has revealed that the physical activity levels of mothers of children with motor disabilities are low, and this is related to the gross motor function level of the children. The focus should be on increasing the physical activity levels of mothers of children with motor disabilities.

Investigation of plasma thiol/disulfide balance in male patients with androgenetic alopecia.

BACKGROUND: Androgenetic alopecia (AGA) is the most common cause of hair loss in men. In addition to genetic and hormonal factors, oxidative stress (OS) is suggested as a factor in the etiology. AIM: In this study, we aimed to investigate the presence of OS due to thiol disulfide balance deterioration in male patients with AGA. MATERIALS AND METHODS: A total of 45 male AGA patients and 42 healthy male controls were included in the study. Native thiol, disulfide, and total thiol levels were assessed through automated spectrophotometry. The relationship between total protein, albumin, native thiol, disulfide, and total thiol levels in addition to demographic and clinical characteristics of the patients were examined. RESULTS: The mean age of the patients was 32.6 ± 10 years, and the median AGA duration in the patients was 3 years. There was no statistically significant difference in terms of native thiol, disulfide, total thiol levels, disulfide/total thiol, disulfide/native thiol, and native thiol/total thiol ratios between AGA patients and controls. Native thiol and total thiol levels negatively correlated with age and AGA duration, while disulfide levels only correlated with age.Albumin and native thiol levels were significantly lower in patients with low vitamin D levels (p = 0.040 and p = 0.021, respectively); however, total thiol and native thiol/total thiol ratio values were significantly higher. CONCLUSION: According to this study, thiol disulfide homeostasis is in balance in male patients with AGA. In patients with emotional stress and vitamin D deficiency, the balance appears to be shifted in favor of oxidative stress.

Clinic and demographic characteristics of pediatric patients with Lichen sclerosus.

BACKGROUND: Lichen sclerosus (LS) is a chronic disease of the skin, for which the pathogenesis is not known. It can lead to various changes of the skin and the genital area, potentially leading to both functional as well as cosmetic problems for the patient, thus disrupting the quality of life. In this study; the purpose was to review the clinical characteristics and the treatments of the 15 pediatric patients under the age of 18 followed up in our out-patient clinic with a diagnosis of LS and to compare the findings with literature data. METHODS: Between 2011 and 2017, the files of 15 patients diagnosed clinically and/or histologically with LS in our clinic were retrospectively examined. The demographic characteristics, clinic and laboratory findings, treatment options of the patients are reported. RESULTS: Of the patients included in the study 14 were girls and one was a boy. The average age was 11.6 years (5-17 years), the average age for the initial disease was 7.8 years (2-13 years). The average duration of the disease at the diagnosis was 3.9 years. The most common form was genital vulvar type (8/14 girls) without anal and cutaneous involvement, and each of them suffered from itching. One of the cases had genital LS as well as extragenital morphea lesions. Two of the 15 patients were ANA positive. The other antibodies were negative. In two cases with extragenital involvement, lesions were widespread and they were in blachkoid form. CONCLUSION: LS is a chronic disease that progresses with recurrences and regressions. In our study, the most common LS type was genital type (60%). There was extragenital involvement in 6 patients (40%). Extragenital involvement was the most common on the trunk. Diagnosis, treatment and follow-up during childhood is highly important to prevent any possible future anatomical or psychological damage and genital malignancies.

Research on the Balance of Thiol-Disulfide in Blood Serum in Women with Telogen Effluvium.

BACKGROUNDS: Telogen effluvium (TE) is the most common reason for hair loss in humans. Although the exact etiopathogenesis of TE has not been revealed clearly and completely, multifactorial etiologies are to be blamed. In recent years, since oxidative stress (OS) has been shown to play an important role in the etiopathogenesis of so many diseases, the effects of OS on several skin diseases are researched and analyzed. Thiols are antioxidant components that include sulfur group, and the balance of thiol-disulfide has an important role in the formation and prevention of OS. This balance is destroyed in many diseases and its effect on TE is not clearly understood yet. OBJECTIVES: In this study, we aimed to search the thiol-disulfide balance that could reveal OS in patients with TE. MATERIALS AND METHODS: Fifty-two patients with TE and control group of 46 persons were included in the study. Native thiol, disulfide, and total thiol levels were evaluated by a new, automatic spectrophotometric method. Disulfide/native thiol, disulfide/total thiol, and native thiol/total thiol rates were calculated. RESULTS: There was no statistical difference between TE patients and control group in terms of native thiol, disulfide, and total thiol levels. Thiol-disulfide balance was fixed and not affected in TE patients.

Thiol/disulfide homeostasis as a marker of oxidative stress in rosacea: a controlled spectrophotometric study.

BACKGROUND: Rosacea is the chronic inflammatory disease of the facial skin. Although its aetiology is not clear yet, inflammatory processes triggered by oxidative stress and oxidation of lipids have been suggested to play a role. While studies on the relationship between inflammation and oxidative stress are ongoing, thiol metabolism and its role in oxidative stress have also begun to be investigated. Thiols are among the key molecules of protein metabolism in the organism and they are the firstly consumed antioxidants in case of oxidative stress. Thiols regulate intracellular redox metabolism and protect keratinocytes against the results of oxidative alterations in the stratum corneum. There is a balance known as dynamic thiol/disulfide homeostasis between thiols and their oxidized forms; disulfides. AIM: This study aimed to determine the effects of oxidative stress on protein metabolism in rosacea patients by investigating thiol/disulfide homeostasis using a newly developed and fully automated method. Determination of plasma thiol levels provides important clues regarding the extent of free radical-mediated oxidation of proteins causing damage in rosacea. METHODS: The study included 50 rosacea patients who were diagnosed clinically or histopathologically with rosacea and 42 age- and gender-matched healthy controls. Plasma levels of native thiol, total thiol, and disulfide were determined. The following ratios were calculated: disulfide/native thiol ratio, disulfide/total thiol ratio, and native thiol/total thiol ratio. RESULTS: The mean age was 41.8 ± 10.5 in the rosacea patients (35 females) and 42.5 ± 10.3 years in the control group (33 females). The mean disulfide level was found to be significantly higher in the rosacea patients than in the control group (23.4 ± 5.5 µM/L and 17.3 ± 6.2µM/L, respectively; p < 0.001). The mean disulfide/native thiol ratio (0.055 ± 0.016 vs. 0.041 ± 0.017) and the mean disulfide/total thiol ratio (0.049 ± 0.012 vs.0.037 ± 0.013) were significantly higher and the mean native thiol/total thiol ratio (0.884 ± 0.118 vs. 0.923 ± 0.027) was significantly lower in the patients as compared with the controls (p < 0.05 for all). CONCLUSION: In rosacea patients, the thiol/disulfide balance was observed to shift towards disulfides, which could be considered an indicator of oxidative stress in rosacea.