Systemic comorbidities associated with rosacea: a multicentric retrospective observational study.

BACKGROUND: Once considered a disorder limited to the skin, rosacea is now known to be associated with systemic disorders. The aim of this study was to determine what systemic comorbidities accompany rosacea and to determine the relationship between the type, severity, and duration of rosacea, and the presence of and type of systemic comorbidities. METHODS: This retrospective multicenter study was conducted by the Turkish Society of Dermatology Acne Study Group. Thirteen dermatology clinics throughout Turkey participated in the study. A structured physician-administered questionnaire was used to collect patient demographics, clinical findings, and lifestyle data. The principal rosacea subtype, physician global assessment of severity, and duration of rosacea were recorded. Physicians recorded each participant's medical history, including current and past comorbidities, duration of any such comorbidity, and the use of medications to treat any comorbidities. RESULTS: The study included 1,195 rosacea patients and 621 controls without rosacea aged 18-85 years. As compared to the controls, more of the rosacea patients had respiratory tract, gastrointestinal system, and metabolic and hepatobiliary system disorders in a rosacea's severity- and duration-dependent manner. CONCLUSION: Clinicians must be aware of the potential for systemic comorbidities in rosacea patients, which becomes more likely as disease duration and severity increase.

Methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism in psoriasis in southern Turkey

Abstract: Background: Psoriasis is a multigenic and multifactorial dermatological disease linked to cardiovascular diseases. Increased levels of homocysteine in patients with psoriasis have been demonstrated in many studies. The most frequently investigated genetic defect that plays a role in homocysteine metabolism is single point substitution (C to T) located on the 677th nucleotide of the methylenetetrahydrofolate reductase gene (MTHFR). Objective: In this study, we aimed to investigate methylenetetrahydrofolate C677T polymorphism in psoriasis patients in Turkey. Methods: The study included 96 patients with psoriasis and 77 controls from southern Turkey. Methylenetetrahydrofolate C677T polymorphism was analysed using the Polymerase Chain Reaction-Restriction Fragment Length Polymorphism methods. Results: In the psoriasis group, 34 CC (35.4%), 46 CT (47.9%) and 16 TT (16.7%) genotypes were found, respectively; while in the control group, the figures were 39 (50.6%), 35 (45.5%), 3 (3.9%). Homozygote and heterozygote T alleles of methylenetetrahydrofolate C677T polymorphism were significantly higher in the psoriasis than in the control group (p=0.013). Conclusion: We firstly found a correlation between methylenetetrahydrofolate C677T polymorphism and psoriasis among the southern Turkish population.

Intralesional Vitamin D Injection May Be an Effective Treatment Option for Warts.

BACKGROUND: Plantar warts are typically resistant to treatment. In recent years, treatments have included administration of intralesional tuberculin; measles, mumps, rubella vaccine; and Candida albicans antigen immunotherapy. To the best of our knowledge, there are no reports of intralesional vitamin D administration for the treatment of warts. AIM: To evaluate the efficacy and safety of intralesional vitamin D treatment for plantar warts. METHODS: Twenty patients with single or multiple plantar warts were included in this study. Vitamin D(3) (0.2 mL, 7.5 mg/mL) was injected into the base of the warts after prilocaine (0.1 mL, 20 mg/mL) injection. A maximum of 5 warts were treated in 1 session, with at maximum 2 injections performed at 4-week intervals. RESULTS: In total, 16 of 20 patients (80%) showed complete resolution of warts, and 1 patient showed partial resolution. Three patients failed to show any response. No recurrence or serious adverse effects were observed. CONCLUSION: Intralesional vitamin D(3) may be an effective treatment option for warts.

Leishmaniasis recidiva cutis of the lips mimicking granulomatous cheilitis.

Leishmaniasis recidiva cutis (LRC) is an unusual form of acute cutaneous leishmaniasis. Herein, we present a case of LRC of the lips mimicking granulomatous cheilitis. An 8-year-old, Syrian child admitted with a swelling and disfigurement of his lips for 4 years. Abundant intra and extracellular Leishmania amastigotes were determined in the smear prepared from the lesion with Giemsa stain. Histopathology showed foamy histiocytes and leishmania parasites within the cytoplasm of macrophages in the epidermis and a dense dermal mixed type inflammatory cell infiltrate composed of lymphocytes, foamy histiocytes with multinucleated giant cells. On the basis of anamnestic data, the skin smears results, clinical and histopathologic findings, LRC was diagnosed. The patient was treated with meglumine antimoniate intramuscularly and fluconazole orally. Cryotherapy was applied to the residual papular lesions. The lesion improved markedly at the first month of the treatment.

Assessment of thyroid function and lipid profile in patients with postadolescent acne in a Mediterranean population from Turkey.

BACKGROUND: Postadolescent acne is defined as acne that is seen even after the age of 25 years, regardless of the age at onset. The causes of postadolescent acne have not been completely clarified up to now. Androgens are considered to be the major factor involved in pathogenesis. OBJECTIVE: We aimed to investigate the status of thyroid functions and lipid levels in patients with postadolescent acne and determine the effects of lifestyle and environmental factors on postadolescent acne in a Turkish population. METHODS: In total, 184 patients and 82 healthy controls were enrolled in the study. Thyroid function and lipid profiles of all participants were analyzed. RESULTS: The mean age of patients was 30.4 ± 4.9 years (25-50). The mean age of control group was 30.0 ± 4.4 years (25-40). Cigarette smoking was significantly associated with postadolescent acne (P < 0.001). No significant differences were observed between patients with postadolescent acne and control subjects in triglyceride, total cholesterol, and low-density lipoprotein cholesterol levels, thyroid hormone profiles, and thyroid ultrasound scans. High-density lipoprotein cholesterol levels were significantly decreased with postadolescent acne (P = 0.01). CONCLUSIONS: To our knowledge, this is the first study to investigate the thyroid functions and lipid profile in men and women with postadolescent acne. In this study, there was no relationship between thyroid functions and postadolescent acne. However, an association with low high-density lipoprotein cholesterol levels and postadolescent acne was detected. Further investigations with more patients in different populations are needed to determine the causes of postadolescent acne.

Vitamin D status in patients with rosacea.

BACKGROUND: Rosacea is a common chronic skin condition affecting the face. In recent years, significant evidence shows that vitamin D plays an important role in modulating the immune system. Vitamin D and its analogues via these mechanisms are playing an increasing role in the management of atopic dermatitis, psoriasis, vitiligo, acne and rosacea. OBJECTIVES: In our study, we aimed to investigate the relationship between serum vitamin D levels in patients with rosacea and analyze the association of vitamin D with clinical features. METHODS: Forty-four rosacea patients and 32 healthy control subjects were included into the study. 25-hydroxyvitamin D (25(OH)D), calcium and intact parathyroid hormone were measured. Deficiency of vitamin D is defined as the level of 25(OH)D being less than 20 ng/ml. RESULTS: Thirty-three female and 11 male patients were included in the study. The mean age of patients was 48.6 ± 11.5. The mean levels of vitamin D levels were found as 21.4 ± 9.9 and 17.1 ± 7.9 in patients and controls, respectively. The difference was statistically significant (p = 0.04). The prevalence of vitamin D deficiency in patients with rosacea was 38.6% and 28.1% in healthy controls (p = 0.34). CONCLUSIONS: To the best of our knowledge, our study is the first study for evaluating serum vitamin D levels of patients with rosacea in the literature. Patients with rosacea have relatively high serum vitamin D levels compared to control groups. The result of our study suggests that increased vitamin D levels may lead to the development of rosacea. To confirm status of vitamin D levels in patients with rosacea, larger epidemiological studies are needed.

Narrow-band ultraviolet B phototherapy in childhood.

BACKGROUND: Narrow-band ultraviolet B (UVB) has been used for skin diseases in children. However, the use of phototherapy in childhood has limited due to the possible risk of skin cancer. The aim of this study is to evaluate the efficacy and safety of the narrow-band UVB phototherapy in children for the treatment of various skin diseases. METHODS: The data of the children aged 16 years or under who were treated with narrow-band UVB in our clinic's phototherapy unit were analyzed, retrospectively. RESULTS: The study included 77 children (42 girls, 35 boys) aged 5-16 years (mean 12.18 ± 3.53) who were treated with a total of 81 courses of narrow-band UVB phototherapy in the last 4.5 years. The majority of patients had vitiligo (47%) and psoriasis (39%). Thirty-four (44.2%) patients showed complete response, 15 (19.5%) good response, 12 (15.6%) partial response, 5 (6.5%) poor response and 11(14.3%) no response. Acute side effects of phototherapy were observed only in 11 (14.3%) patients. CONCLUSIONS: Narrow-band UVB phototherapy is an effective and well-tolerated treatment in childhood.

Necrotizing fasciitis in a patient with bullous pemphigoid treating with systemic steroid.

Necrotizing fasciitis (NF) is a rarely seen, life-threatening soft tissue infection characterized by progressive necrosis of skin, subcutaneous tissues and fasciae. Herein, we present a case of NF in a patient with bullous pemphigoid. A 78-year-old female patient was admitted with the left leg pain, swelling, redness and blistering. Streptococcus pyogenes was isolated from the wound culture. In the skin biopsy and the left leg magnetic resonance imaging, signs of NF were observed. The diagnosis of NF was considered. Then, urgent surgical debridement was performed by the department of plastic surgery. While under treatment with intravenous antibiotics therapy, unfortunately the patient died of acute renal insufficiency.