Type D personality, anxiety sensitivity, social anxiety, and disability in patients with acne: a cross-sectional controlled study.

INTRODUCTION: Acne has long been associated with many psychiatric comorbidities. AIM: To determine anxiety and depression levels, social phobia frequency, social anxiety level, subjective stress perception, anxiety sensitivity, disability, and the frequency of type D personality in patients with acne. MATERIAL AND METHODS: In total, 61 patients with acne aged > 16 years and 61 age, gender, and educationally matched healthy volunteers were included in the study. The patients and healthy controls were evaluated using the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 criteria for social anxiety disorder and completed the Liebowitz Social Anxiety Scale, Sheehan Disability Scale, Anxiety Sensitivity Index, Hospital Anxiety and Depression Scale, Perceived Stress Scale (PSS), and Type D Scale-14. RESULTS: Depression, anxiety, social anxiety, self-reported stress, anxiety sensitivity, and disability levels were significantly higher in patients with acne than in healthy controls (p < 0.05). Type D personality was more prevalent in patients with acne than in healthy controls (49% vs. 18%, p < 0.001). CONCLUSIONS: To our knowledge, this study is the first reported in which type D personality and anxiety sensitivity, as well as social anxiety disorder according to the DSM-5 criteria, was evaluated in patients with acne compared with healthy controls. This study shows that patients with acne have higher levels of depression, anxiety, social anxiety, self-reported stress, anxiety sensitivity, and disability, and a greater prevalence of type D personality, than healthy controls. Psychiatric evaluation of patients with acne may aid the detection of mental disorders.

Insights into chest computed tomography findings in Behcet's disease.

INTRODUCTION: To evaluate the spectrum and frequency of abnormal chest multidedector computed tomography (MDCT) findings in Behcet's disease(BD). MATERIALS AND METHODS: Chest MDCT scans of 44 patients referred to radiology department for chest symptoms those had prior or newly established diagnosis of BD between 2009-2016 were retrospectively reviewed. Abnormal findings within pulmonary artery (PA), lungs, other large vessels, heart, mediastinum, pleura and pericardium were noted. RESULT: Sixteen patients had one ore more computed tomography (CT) findings related to BD. PA involvement was most common (27.2%) presentation revealing thrombosis in 8 and aneurysms in 4 of 12 patients. Mean PA diameter was 29 ± 3.7 mm. Patients with PA involvement had significantly higher PA diameters than those without (p< 0.001). Hypertrophied bronchial artery seen as serpiginous vessels around hilum was a common finding (66.6%). Lung parenchyma findings was rarely isolated and usually associated with PA involvement with subpleural alveolar opacities, focal atelectasis and ill-defined nodular opacities. Cardiac filling defects were accompanying lesions in most of patients with PA aneurysms (75%). CONCLUSIONS: BD is associated with a wide spectrum of simultaneous involvement of discrete anatomical sites. PA enlargement and hypertrophied bronchial artery is a clue for patients with PA involvement. Heart chambers should be checked for filling defects particularly in patients with PA aneurysms.

Disseminated eruptive granuloma annulare induced by levetiracetam.

Granuloma annulare (GA) is a benign, granulomatous cutaneous disease without clear etiology. Disseminated and drug induced granuloma annulare is a rare presentation. We present a 47-year-old woman with diffuse circular erythematous eruptions following treatment with levetiracetam. Her clinical and histopathological findings were compatible with the diagnosis of granuloma annulare. To the best of our knowledge, there is no previous report of this skin disease as a result of levetiracetam use. We report this case to highlight this antiepileptic drug as a possible etiologic agent in disseminated granuloma annulare.

Facial pigmentation with demodex Mite; a mere coincidence or an association?

Demodex mites may induce inflammatory cutaneous reactions such as papulopustular rosacea and demodex folliculitis; both may lead to post inflammatory pigmentation. A 59-year-old man presented with an asymptomatic, hyperpigmented plaque on his face. Histological and clinical findings displayed Riehl-like facial pigmentation. Multiple demodex mites at the follicular infundibulum in the biopsy material were remarkable. There are limited publications about demodex-associated pigmentation. We report this case to point out that various hyperpigmentation disorders may occur simultaneously with demodex mites.

A case of elephantiasis nostras verrucosa treated by acitretin.

Elephantiasis nostras verrucosa is a rare disorder characterized by dermal fibrosis, hyperkeratotic, verrucous, and papillomatous lesions that result from both chronic filarial and nonfilarial lymphedema. Various treatment options have been reported for this disease. We present a 64-year-old man with erythrodermic psoriasis and elephantiasis nostras verrucosa in whom the lesions were resolved almost completely after acitretin treatment.

Subclinical ocular inflammation in patients with recurrent aphthous stomatitis.

OBJECTIVE: Recurrent aphthous stomatitis (RAS) is the major finding of Behçet's disease as well as an inflammatory disease. We compared the choroidal thickness (CT) in patients with RAS with healthy volunteers. METHODS: Patients with RAS (n = 34) and age- and sex-matched controls (n = 34) were evaluated using spectral-domain optical coherence tomography (OCT). CT measurements were executed at 3 different points (subfoveal, nasal, and temporal). Laboratory parameters were determined for patients and controls. RESULTS: The mean subfoveal CT in the RAS and control groups were 356.7 ± 91.7 µm and 326.3 ± 86.6 µm, respectively. The RAS group demonstrated significantly higher subfoveal CT than the control group (p = 0.008). CONCLUSION: This was the first reported study demonstrating a significantly higher subfoveal CT in patients with RAS. Further studies investigating the risk for subclinical ocular inflammation in this patient population are warranted.

Components of the alternative complement pathway in patients with psoriasis.

INTRODUCTION: Psoriasis is a chronic inflammatory skin disease. Adipose tissue plays important roles in the events that regulate body metabolism. This study determined the levels of complement 3 ( C3), acylation-stimulating protein (ASP), and adipsin, which take part in the alternate complement pathway, and are synthesized in and secreted by adipose tissue. METHODS: Thirty-two patients with psoriasis were matched with 22 controls in terms of age, sex, body mass index, and lipid profiles. Serum C3, ASP, and adipsin levels were measured in both groups. RESULTS: The serum C3 level was higher and ASP and adipsin levels were lower in the patient group, but these differences were not significant (p = 0.708, p = 0.628, and p = 0.218, respectively). ASP and adipsin levels were correlated positively in patients with psoriasis (p = 0.029). CONCLUSION: To our knowledge, this study is the first to evaluate ASP and adipsin levels in patients with psoriasis. The roles of ASP and adipsin in the etiopathogenesis of psoriasis are unclear. Although not statistically significant, the lower ASP and adipsin levels in the patient group suggest a potential anti-inflammatory role of these proteins in psoriasis. Further studies should examine the relationships between ASP/adipsin and psoriasis.

Gorlin-Goltz syndrome.

Gorlin-Goltz syndrome is a rare multisystemic disease inherited in an autosomal dominant pattern. It is characterized by numerous basal cell carcinoma of the skin, jaw cysts, and skeletal anomalies such as frontal bossing, vertebral anomalies, palmoplantar pits, and falx cerebri calcification. There is a tendency to tumors including medullablastoma, fibroma, rabdomyoma, leiomyosarcoma etc.. The diagnosis is based on major and minor clinical and radiologic criteria. Early diagnosis and treatment are of utmost importance in reducing the severity of long-term sequelae of this syndrome. In this article, we present a 15-year-old boy who was admitted to our clinic with brown-black papules and plaques on his scalp and was thought to have Gorlin-Goltz syndrome. He had a history of medulloblastoma that was treated with surgical resection followed by cranial radiotherapy and unilateral retinoblastoma. We present this case, because association of Gorlin-Goltz syndrome and retinoblastoma has not been described previously in the literature and we aimed to draw attention to radiation-induced basal cell carcinomas.

Extra-medial thickness of carotid artery in patients with Behçet's disease: evaluation of atherosclerotic vessel wall changes with a novel carotid artery ultrasound index.

OBJECTIVES: Chronic inflammation and endothelial dysfunction are the characteristic features of Behçet's disease (BD). We researched carotid extra-medial thickness (cEMT), a novel ultrasound parameter for atherosclerotic vessel wall changes, and carotid intima media thickness (cIMT), a widely accepted marker of subclinical atherosclerosis, in patients with BD, and we evaluated the relationship between these two parameters. MATERIALS AND METHODS: In total, 31 patients with BD were matched to 26 control subjects based on age, gender, and major cardiovascular risk factors. Laboratory parameters, including lipid profile, were measured for both patients and controls. B-mode ultrasonography was used to assess the cEMT and cIMT. RESULTS: There was no significant difference in the cEMT values between the patients with BD and the control group (P = 0.90). cIMT in the BD group was significantly higher compared with the control group (P = 0.021). There was a significant positive correlation between cIMT and cEMT (r = 0.585, P = 0.001). Both cEMT and cIMT were positively correlated with age and the presence of arthritis. There was linear correlation with sedimentation, C-reactive protein, and cEMT. CONCLUSIONS: To the best of our knowledge, this is the first study to evaluate both cEMT and cIMT in BD. This study presents morphological evidence of subclinical atherosclerosis in terms of cIMT. Although there was no significant increment in cEMT, it has the potential to assess endothelial dysfunction in BD. Further studies are required to confirm this finding.

Serum Visfatin, Adiponectin, and Tumor Necrosis Factor Alpha (TNF-α) Levels in Patients with Psoriasis and their Correlation with Disease Severity.

Psoriasis is a chronic, autoimmune, and inflammatory disease of unknown etiology, characterized by T lymphocyte mediated keratinocyte proliferation. In recent years the relationship between psoriasis and adipose tissue cytokines has been reported. Psoriasis as a triggering factor for the immune and metabolic disorders can be associated with diabetes mellitus, abnormal lipid metabolism, and metabolic syndrome. In this study we assessed the adipose tissue cytokines visfatin, adiponectin, and tumor necrosis factor-α (TNF-α) levels in psoriasis patients and evaluated the relationship between disease severity and cytokines. The study included 42 patients with psoriasis and 42 healthy individuals. Visfatin, adiponectin, and TNF-α levels were measured in both the psoriasis and the control group. The disease severity index was assessed in psoriatic patients by means of PASI. The relationship between visfatin, adiponectin, TNF-α, PASI score, and obesity was evaluated. When serum TNF-α, adiponectin, and visfatin levels of the patient group were compared with those of the control group, the TNF-α levels were statistically higher (p = 0.00) and the adiponectin levels were statistically lower (p = 0.024). The visfatin levels were higher in the psoriatic patients compared to the control group, but this difference was not statistically significant (p = 0.73). The relationship between PASI-TNF-α and between PASI-adiponectin was statistically significant (p = 0.009 and p = 0.004). A positive correlation was observed between body mass index (BMI) and visfatin (p = 0.031). These results indicate that TNF-α and adiponectin play a part in psoriasis etiopathogenesis and can be used as parameters to evaluate the severity of the disease. However, the role of visfatin in psoriasis pathogenesis is unclear. Further clinical studies are needed to clarify the effect of visfatin in psoriatic patients.