Conjunctival impression cytology, ocular surface and tear-film changes in patients with lichen planus.

BACKGROUND: Lichen planus (LP) is an immune-mediated chronic mucocutaneous disease. Rarely, LP affects the conjunctiva, resulting in conjunctival inflammation, cicatrization and scarring of the subepithelium and cornea, causing keratitis and keratoconjunctivitis sicca. To date, there has been no case-control study examining the ocular findings in LP. AIM: To assess ocular surface health and tear-film changes in patients with LP. METHODS: In total, 20 patients and 24 healthy controls were enrolled in the study. Ocular surface changes were evaluated by conjunctival impression cytology, while tear-film functions were measured by the Schirmer test, break-up time, and fluorescein and lissamine green scoring. RESULTS: There was a significant difference in Schirmer test results, conjunctival lissamine green staining scores, and conjunctival impression-cytology grades between the groups. CONCLUSIONS: LP may cause ocular surface changes and reduction in tear production, therefore it seems reasonable to evaluate these patients for symptoms and signs of dry-eye disease. We consider that LP should be included in the differential diagnosis of dry-eye disease, as this has important therapeutic and prognostic implications.

Anxiety, depression, and nature of acne vulgaris in adolescents.

BACKGROUND: The reported prevalence of acne in adolescence is variable; improved treatment may have modified its prevalence and severity; acne has been related to psychiatric morbidity for many years. METHODS: Two thousand six hundred and fifty-seven high school students were examined, and adolescents with acne were interviewed about the subject of acne vulgaris. The severity of acne was graded using the Global Acne Grading System (GAGS). The Hospital Anxiety and Depression (HAD) scale was evaluated for one of every two subjects with acne (n = 308) and for the same number of sex-matched control subjects (n = 308) to determine the prevalence of depression and anxiety. RESULTS: Six hundred and fifteen of the subjects (23. 1%) were determined to have acne. Acne prevalence in girls and boys was 16.1% and 29.2%, respectively (P < 0.001). Two hundred and twenty-five (15.8%) of 1424 boys and only 109 (8.8%) of 1233 girls had moderate or severe/very severe acne (P < 0.001), but the GAGS scores in the groups of boys and girls with acne were not significantly different. The acne and control groups showed no significant differences in the HAD anxiety and depression subscale scores. The HAD anxiety subscale scores of girls were significantly higher than those of boys in the acne group. The severity of acne was not correlated with the HAD anxiety or depression subscale scores. CONCLUSIONS: Acne results in higher anxiety in adolescent girls. Although acne and moderate/severe acne are more common in adolescent boys, the severity of acne was found to be similar in boys and girls with acne. Adolescent girls are more vulnerable than boys to the negative psychological effects of acne.

Psychiatric disorders in patients attending a dermatology outpatient clinic.

BACKGROUND: Psychiatric comorbidity in patients with skin disorders has been reported. OBJECTIVE: To find out the prevalence of psychiatric disorders in dermatology outpatients and to investigate the factors that affect the psychiatric symptoms. METHODS: 256 patients attending our dermatology outpatient clinic completed a 12-item General Health Questionnaire (GHQ) following their dermatologic examination. A standardized personal interview was performed to establish a psychiatric diagnosis in patients sampled by using a stratified random sampling method. RESULTS: The prevalence of psychiatric disorders was found to be 33.4% in the study group. The mean of the total GHQ scores of the sample group (n = 256 patients) was 3.656. The duration of the dermatologic complaints, sex of the subjects, localization of the lesions, and dermatologic diagnosis did not affect the total GHQ scores of the patients. CONCLUSION: Psychiatric comorbidity in 33.4% of the dermatology outpatients indicates the need for considering emotional factors for an effective management of the cutaneous disorders.

Auditory evoked potentials in vitiligo patients.

There is convincing evidence that vitiligo is a systemic disorder influencing the whole pigmentary system, including melanocytes in the inner ear. Cochlear melanocytes and also melanin-containing cellular elements of the auditory system may be affected in vitiligo and interfere with the conduction of action potentials. We conducted a prospective clinical trial to determine hearing status and auditory evoked potentials in 50 patients affected by vitiligo and compared the results with those of 50 healthy controls. I, III, V latencies and amplitudes and I-III, III-V, I-V interpeak latencies were compared with each group. Statistical evaluation was accomplished using the t-test. With the exception of two subjects, all patients demonstrated normal audiological results. No statistically significant difference was noted between the study group and controls in regard to latencies, interpeak latencies and amplitudes. We conclude that auditory investigations supported by postmortem histopathological studies of the inner ear and brainstem may provide more accurate knowledge in vitiligo patients.

High-frequency hearing and reflex latency in patients with pigment disorder.

PURPOSE: To investigate the activities of inner ear melanin in patients with pigment variations and disorders. Our purpose was to find evidence on the effects of melanin-containing cells by measuring the high-frequency threshold and the latency of stapes reflex in patients with vitiligo. PATIENTS AND METHODS: Twenty-nine patients with active vitiligo and 41 healthy subjects were included in this study. Pure tone thresholds were determined at frequencies between 250 and 16,000 Hz. Ipsilateral and contralateral stapes reflexes were measured at 1,000, 2,000, and 4,000 Hz. After we compared the results in the control and vitiligo groups by using the Mann-Whitney U test for each frequency, we compared women and men separately to eliminate gender differences. RESULTS: Pure tone thresholds of the vitiligo group were significantly lower than the control group at 4,000, 6,000, 8,000 and 10,000 Hz (P < .05). The statistically different thresholds were 8,000 and 10,000 Hz in women, compared with 4,000, 6,000, 8,000, 10,000, 12,500, and 16,000 Hz in men (P < 0.05). Reflex latencies for the two groups were not statistically different. CONCLUSION: Vitiligo, which is a type of pigment disorder, seems to be an effective factor in hearing loss, and men are more susceptible to it than women. The mechanism for this condition might be the absence of the preventive function of melanin-containing cells in the inner ear.

Reproducibility of the Finn chamber nickel patch test in two different phases of the ovulatory menstrual cycle.

BACKGROUND: Studies on nickel patch test reactivity and reproducibility of positive tests at different points of the menstrual cycle are heterogeneous. OBJECTIVE: To investigate if non-reproducibilities of positive nickel sulphate patch tests in the two different phases of ovulatory menstrual cycles with the endocrine evidence of luteal phase adequacy are statistically different. METHODS: 15 women (group 1) with positive Finn chamber(R) nickel patch test results in the follicular phase of the ovulatory cycle and 13 women (group 2) with positive Finn chamber nickel patch test results in the luteal phase of the ovulatory cycle were tested again in the counter-phases of their ovulatory cycle, with a scheduled interval of 6 weeks following the first tests. Reproducibilities of the tests in the two groups were evaluated statistically. RESULTS: 3 of the positive test results in group 1 (20%) and 2 of the positive test results in group 2 (15.4%) were non-reproducible. The difference was not statistically significant. CONCLUSION: The reproducibility of positive Finn chamber nickel patch tests does not seem to be affected by the changes in the follicular and luteal phases of the ovulatory cycle.