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OBJECTIVES: Skin changes in acromegaly are often the first sign of the disease. The aim of this study was to describe the cutaneous findings in patients with acromegaly. In addition, a secondary aim was to investigate the possible association of these findings with remission status and concomitant endocrinopathies. DESIGN, PATIENTS, AND MEASUREMENTS: In this prospective multicenter study, 278 patients over the age of 18 years with acromegaly who were followed up in 14 different tertiary healthcare institutions were included. These patients, who were followed up by the Endocrinology Department, were then referred to a dermatologist for dermatological examination. The frequency of skin lesions was investigated by detailed dermatologic examination. Dermatological diagnosis is reached by clinical, dermatological and/or dermoscopic examination, and rarely skin punch biopsy examinations in suspicious cases. The possible association of the skin findings between remitted and nonremitted patients and with concomitant endocrinopathies were evaluated. RESULTS: The most common skin findings in patients with acromegaly in our study were skin tags (52.5%), cherry angiomas (47.4%), seborrhoea (37%), varicose veins (33%), acneiform lesions (28.8%), hyperhidrosis (26.9%) and hypertrichosis (18.3%). Hypertrichosis was significantly more prevalent in patients nonremitted (p: .001), while xerosis cutis was significantly more prevalent in patients remitted (p: .001). The frequency of diabetes mellitus and hypothyroidism was significantly higher in patients with varicose veins and seborrhoeic keratosis than those without. Additionally, the coexistence of hypothyroidism, hyperthyroidism and galactorrhea was significantly higher in patients with Cherry angioma than in those without Cherry angioma (p-values: .024, .034 and .027, respectively). The frequency of hypogonadism in those with xerosis cutis was significantly higher than in those without (p: .035). CONCLUSIONS: Cutaneous androgenization findings such as skin tag, seborrhoea, acne and acanthosis nigricans are common in patients with acromegaly. Clinicians should be aware that skin findings associated with insulin resistance may develop in these patients. It can be said that the remission state in acromegaly has no curative effect on cutaneous findings. Only patients in remission were less likely to have hypertrichosis. This may allow earlier review of the follow-up and treatment of acromegaly patients presenting with complaints of hypertrichosis. Additionally, it can be said that patients with skin findings such as cherry angioma may be predisposed to a second endocrinopathy, especially hypothyroidism. Including dermatology in a multidisciplinary perspective in acromegaly patient management would be beneficial to detect cutaneous findings earlier.
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Acromegalia , Enfermedades de la Piel , Humanos , Acromegalia/complicaciones , Acromegalia/patología , Femenino , Masculino , Persona de Mediana Edad , Adulto , Estudios Prospectivos , Enfermedades de la Piel/patología , Enfermedades de la Piel/epidemiología , Enfermedades del Sistema Endocrino/complicaciones , Enfermedades del Sistema Endocrino/epidemiología , Anciano , Piel/patología , Adulto Joven , Hipertricosis/patología , Hipertricosis/epidemiología , Hiperhidrosis/epidemiología , Hiperhidrosis/complicaciones , Hiperhidrosis/etiología , Hemangioma/complicaciones , Hemangioma/patologíaRESUMEN
Importance: Kindler epidermolysis bullosa is a genetic skin-blistering disease associated with recessive inherited pathogenic variants in FERMT1, which encodes kindlin-1. Severe orofacial manifestations of Kindler epidermolysis bullosa, including early oral squamous cell carcinoma, have been reported. Objective: To determine whether hypoplastic pitted amelogenesis imperfecta is a feature of Kindler epidermolysis bullosa. Design, Settings, and Participants: This longitudinal, 2-center cohort study was performed from 2003 to 2023 at the Epidermolysis Bullosa Centre, University of Freiburg, Germany, and the Special Care Dentistry Clinic, University of Chile in association with DEBRA Chile. Participants included a convenience sampling of all patients with a diagnosis of Kindler epidermolysis bullosa. Main Outcomes and Measures: The primary outcomes were the presence of hypoplastic pitted amelogenesis imperfecta, intraoral wounds, gingivitis and periodontal disease, gingival hyperplasia, vestibular obliteration, cheilitis, angular cheilitis, chronic lip wounds, microstomia, and oral squamous cell carcinoma. Results: The cohort consisted of 36 patients (15 female [42%] and 21 male [58%]; mean age at first examination, 23 years [range, 2 weeks to 70 years]) with Kindler epidermolysis bullosa. The follow-up ranged from 1 to 24 years. The enamel structure was assessed in 11 patients, all of whom presented with enamel structure abnormalities. The severity of hypoplastic pitted amelogenesis imperfecta varied from generalized to localized pitting. Additional orofacial features observed include gingivitis and periodontal disease, which was present in 90% (27 of 30 patients) of those assessed, followed by intraoral lesions (16 of 22 patients [73%]), angular cheilitis (24 of 33 patients [73%]), cheilitis (22 of 34 patients [65%]), gingival overgrowth (17 of 26 patients [65%]), microstomia (14 of 25 patients [56%]), and vestibular obliteration (8 of 16 patients [50%]). Other features included chronic lip ulcers (2 patients) and oral squamous cell carcinoma with lethal outcome (2 patients). Conclusions and Relevance: These findings suggest that hypoplastic pitted amelogenesis imperfecta is a feature of Kindler epidermolysis bullosa and underscore the extent and severity of oral manifestations in Kindler epidermolysis bullosa and the need for early and sustained dental care.
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Epidermólisis Ampollosa , Humanos , Masculino , Femenino , Adulto , Adulto Joven , Preescolar , Adolescente , Niño , Epidermólisis Ampollosa/complicaciones , Persona de Mediana Edad , Estudios Longitudinales , Enfermedades Periodontales/complicaciones , Enfermedades Periodontales/epidemiología , Carcinoma de Células Escamosas/patología , Amelogénesis Imperfecta/complicaciones , Amelogénesis Imperfecta/genética , Amelogénesis Imperfecta/patología , Estudios de Cohortes , Neoplasias de la Boca/patología , Neoplasias de la Boca/complicaciones , Gingivitis/patología , Gingivitis/etiología , Queilitis , ChileRESUMEN
BACKGROUND: Psoriasis is an important health problem responsible for morbidity and workforce loss. In recent years, anti-IL-23 drugs have become essential in psoriasis treatment. OBJECTIVES: This study aimed to investigate the efficacy and safety of guselkumab therapy, recently used in Turkey, by examining real-life data over 36 weeks. METHODS: A total of 39 psoriasis patients (>18 years old) who received guselkumab treatment between December 2021 and December 2022 in the dermatology department of our hospital were included in the study. Patients" ages, sexes, body mass index (BMI), comorbidities, duration of illness, drugs used before guselkumab treatment, clinical response to guselkumab treatment, and side effects, if any, were recorded. Psoriasis Area and Severity Index (PASI) scores at baseline and Weeks 4, 12, 24, and 36 were evaluated, as well as the Dermatology Life Quality Index (DLQI) at the beginning and end of the study. RESULTS: The PASI scores at Weeks 4, 12, 24, and 36 and the DLQI at Week 36 decreased statistically compared with baseline (p < 0.05). The PASI score at baseline and Weeks 4, 24, and 36 did not differ between groups based on IL-17 use (p > 0.05). No significant correlation was observed between BMI, disease duration, and PASI scores at baseline and Weeks 4, 12, 24, and 36. No side effects were observed in any of the patients during treatment. CONCLUSION: This study includes real-life data on the use of guselkumab therapy for psoriasis in the Turkish population. Based on the results, guselkumab is a highly effective and safe treatment.
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Anticuerpos Monoclonales Humanizados , Psoriasis , Calidad de Vida , Índice de Severidad de la Enfermedad , Humanos , Psoriasis/tratamiento farmacológico , Psoriasis/diagnóstico , Femenino , Masculino , Turquía/epidemiología , Anticuerpos Monoclonales Humanizados/administración & dosificación , Anticuerpos Monoclonales Humanizados/efectos adversos , Adulto , Persona de Mediana Edad , Resultado del Tratamiento , Fármacos Dermatológicos/administración & dosificación , Fármacos Dermatológicos/efectos adversos , Fármacos Dermatológicos/uso terapéuticoRESUMEN
Hidradenitis suppurativa (HS) is a chronic inflammatory disease. Recently published studies have suggested the use of markers of inflammation to monitor HS patients. These studies discuss the platelet/lymphocyte ratio (PLR), neutrophil/lymphocyte ratio (NLR), pan-immune-inflammation value (PIV), and systemic immune-inflammation index (SIII), which are also used in other inflammatory diseases. This study aimed to compare the blood parameters, including NLR, PLR, SIII, and PIV, in HS patients and healthy individuals, and determine their correlation with disease severity. The study included 81 HS patients and 61 healthy volunteers. The patients' medical records and laboratory values of the control group were reviewed retrospectively. HS severity was assessed using Hurley staging. NLR, PLR, SIII, and PIV values were calculated based on complete blood counts. NLR, SIII, and PIV values were significantly higher in HS patients compared to the healthy control group and were positively associated with disease severity. There was no significant difference observed in PLR values concerning disease severity. This study suggests that NLR, SIII, and PIV values can be utilized as simple and cost-effective tests to monitor disease activity and severity in HS patients. However, larger and more comprehensive studies are needed to establish diagnostic cutoff values, and further evaluation of sensitivity and specificity is required.
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Hidradenitis Supurativa , Humanos , Hidradenitis Supurativa/diagnóstico , Estudios Retrospectivos , Linfocitos , Inflamación/diagnóstico , Plaquetas , NeutrófilosRESUMEN
PURPOSE: This study aimed to investigate the relationship between skin parameters and CAD. MATERIALS AND METHODS: The study included 50 patients diagnosed with coronary artery disease as the patient group and 45 volunteers without any known coronary artery disease as the control group. The participants' skin TEWL, pH, temperature, electrical capacitance, sebum, and elasticity values were measured using noninvasive methods at the forehead, back, and forearm. FINDINGS: Skin temperature was significantly higher in the back and forehead regions in the patient group. No difference was found between the sebum values of the patient and control groups at the back and forehead. A significantly higher result was obtained for the forearm area. The pH was significantly lower in the patients' forearm, although the obtained values were within the normal range. The TEWL was significantly higher in patients in all three regions. In terms of flexibility, R2 was significantly higher in the back and forehead regions of the patient group, and the R6 was significantly higher in the patient group in all three regions. In addition, there was no correlation between skin parameter and SYNTAX score increase measurements. CONCLUSION: It can be suggested that skin sebum and TEWL measurements can be accepted as cheap and noninvasive methods of predicting CAD.
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Enfermedad de la Arteria Coronaria , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/metabolismo , Humanos , Concentración de Iones de Hidrógeno , Sebo , Piel/metabolismo , Fenómenos Fisiológicos de la Piel , Pérdida Insensible de AguaRESUMEN
The question how second-generation antihistamines (sgAHs) should be used when chronic spontaneous urticaria (CSU) is under control with omalizumab is still unanswered. This study aimed to investigate the effectiveness of as-needed sgAHs in patients with well-controlled urticaria under omalizumab treatment. Patients from four different urticaria centers who were treated with omalizumab 300 mg/4 weeks for at least 3 months, had well-controlled urticaria (Urticaria Control Test: 16 > UCT≥12) and were using sgAHs only if needed, were included in this study. In order to assess effectiveness of sgAHs, change in the itch, hives, and total itch-hives scores before and after sgAHs were evaluated using modified urticaria activity score-twice daily. Fifty-three patients [38 female (71.7%)] with mean age 41.1 ± 11.4 years were included in this study. Median sgAH intake per patient throughout the 4 week-intervals was 3 (2-5) tablets. sgAH intake decreased itch, hives and total itch-hives scores 45.7% ± 52.9, 42.4% ± 39.1, and 50.2% ± 51.1, respectively (P < .001 for all). This decrease was similar in both isolated-urticaria and urticaria-and-angioedema phenotypes. Baseline IgE levels were positively correlated with the decrease of three symptom scores (r = 0.31, P = .05; r = 0.375, P = .017; r = 0.31, P = .05, respectively) that showed in patients with higher baseline total IgE levels, as needed sgAH intake decreased the symptom scores less. Our study showed that sgAHs may still be an effective option for the treatment of the intermittent symptoms in patients with well-controlled urticaria under omalizumab treatment. Baseline total IgE levels may be used as a potential biomarker for sgAH effectiveness in these patients.
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Antialérgicos , Urticaria Crónica , Urticaria , Adulto , Antialérgicos/efectos adversos , Enfermedad Crónica , Femenino , Antagonistas de los Receptores Histamínicos/uso terapéutico , Humanos , Persona de Mediana Edad , Omalizumab/efectos adversos , Resultado del Tratamiento , Urticaria/diagnóstico , Urticaria/tratamiento farmacológicoRESUMEN
A new type of coronavirus (coronavirus disease 2019; COVID-19), which emerged in the People's Republic of China, spread all over the world over time and became a pandemic. Dermatological symptoms seen during the course of the disease have gained importance over time. Studies have shown that many dermatological findings such as erythematous rash, urticaria, pseudo-chilblain, maculopapular, livedo/necrosis, and vesicular lesions may accompany the disease. In this study, a 24-year-old female patient with maculopapular lesions who had no previous history of allergy or dermatological disease and regressed without any dermatological treatment is presented.
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Pemphigus is a group of rare and life-threatening autoimmune blistering diseases of the skin and mucous membranes. Although they occur worldwide, their incidence shows wide geographical variation, and prospective data on the epidemiology of pemphigus are very limited. Objective of this work is to evaluate the incidence and epidemiological and clinical features of patients with pemphigus in Turkey. All patients newly diagnosed with pemphigus between June 2013 and June 2014 were prospectively enrolled in 33 dermatology departments in 20 different provinces from all seven regions of Turkey. Disease parameters including demography and clinical findings were recorded. A total of 220 patients were diagnosed with pemphigus during the 1-year period, with an annual incidence of 4.7 per million people in Turkey. Patients were predominantly women, with a male to female ratio of 1:1.41. The mean age at onset was 48.9 years. Pemphigus vulgaris (PV) was the commonest clinical subtype (n=192; 87.3%), followed by pemphigus foliaceus (n=21; 9.6%). The most common clinical subtype of PV was the mucocutaneous type (n=83; 43.2%). The mean Pemphigus Disease Area Index was 28.14±22.21 (mean ± Standard Deviation). The incidence rate of pemphigus in Turkey is similar to the countries of South-East Europe, higher than those reported for the Central and Northern European countries and lower than the countries around the Mediterranean Sea and Iran. Pemphigus is more frequent in middle-aged people and is more common in women. The most frequent subtype was PV, with a 9-fold higher incidence than pemphigus foliaceus.
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Pénfigo/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Pénfigo/diagnóstico , Pénfigo/inmunología , Estudios Prospectivos , Turquía/epidemiología , Adulto JovenRESUMEN
Angina bullosa hemorrhagica (ABH) is a benign disorder of the oral cavity. Clinically, oral, blood-filled blisters are seen. To give a proper diagnosis, one should rule out any other cause. We aim to present this case in order to emphasize this rare cause of oral bullae which is necessary to be differentiated from many serious dermatological and hematological disorders.
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BACKGROUND:: Isotretinoin is a synthetic analog of vitamin A. Recent studies support a role for retinoic acid in the recovery of olfactory function following injury in mice. OBJECTIVE:: This study aimed at determining the effect of isotretinoin on olfactory function in patients who have acne and are otherwise healthy. METHODS:: Forty-five patients (aged 25-40 years) with acne were included in the study. All patients underwent a rhinological examination. Olfactory function was assessed by the Sniffin' Sticks Test. The test was assessed at baseline and in the third month of isotretinoin treatment. RESULTS:: Isotretinoin improved the performance of patients in the olfactory test. The SST score increased from 8.7±1.09 to 9.5±1.19 (p<0.001), prevalence of hyposmia decreased from 40% to 24% and normosmia increased from 60% to 75% (p=0.059). The percentage of patients whose olfactory function was categorized as "good" increased from 6% to 21.3%. This increase was statistically significant (p<0.05). STUDY LIMITATIONS:: Absence of a control group is one of the limitations of this study. Also, we did not evaluate patients with smell test after stopping isotretinoin treatment. CONCLUSION:: We examined the effect of systemic isotretinoin on olfactory function. It can be concluded from the present investigation that isotretinoin therapy improves the sense of smell.
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Acné Vulgar/tratamiento farmacológico , Isotretinoína/uso terapéutico , Olfato/efectos de los fármacos , Tretinoina/uso terapéutico , Adolescente , Adulto , Femenino , Humanos , Isotretinoína/farmacología , Masculino , Estudios Prospectivos , Tretinoina/farmacología , Adulto JovenRESUMEN
Abstract: Background: Isotretinoin is a synthetic analog of vitamin A. Recent studies support a role for retinoic acid in the recovery of olfactory function following injury in mice. Objective: This study aimed at determining the effect of isotretinoin on olfactory function in patients who have acne and are otherwise healthy. Methods: Forty-five patients (aged 25-40 years) with acne were included in the study. All patients underwent a rhinological examination. Olfactory function was assessed by the Sniffin' Sticks Test. The test was assessed at baseline and in the third month of isotretinoin treatment. Results: Isotretinoin improved the performance of patients in the olfactory test. The SST score increased from 8.7±1.09 to 9.5±1.19 (p<0.001), prevalence of hyposmia decreased from 40% to 24% and normosmia increased from 60% to 75% (p=0.059). The percentage of patients whose olfactory function was categorized as "good" increased from 6% to 21.3%. This increase was statistically significant (p<0.05). Study limitations: Absence of a control group is one of the limitations of this study. Also, we did not evaluate patients with smell test after stopping isotretinoin treatment. Conclusion: We examined the effect of systemic isotretinoin on olfactory function. It can be concluded from the present investigation that isotretinoin therapy improves the sense of smell.
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Humanos , Masculino , Femenino , Adolescente , Adulto , Adulto Joven , Olfato/efectos de los fármacos , Tretinoina/uso terapéutico , Isotretinoína/uso terapéutico , Acné Vulgar/tratamiento farmacológico , Tretinoina/farmacología , Isotretinoína/farmacología , Estudios ProspectivosRESUMEN
BACKGROUND: The skin is one of the most affected organs in tuberous sclerosis complex and angiofibromas are seen in almost 80% of such patients. These benign tumors impose a great psycho-social burden on patients. OBJECTIVE: The aim of the study was to evaluate the effectiveness and tolerability of topical sirolimus for facial angiofibromas in patients with tuberous sclerosis complex. METHODS: This was a prospective, single-blinded, cross-over study which involved twelve patients. We investigated the effect and safety of topical 0.1% sirolimus, which was obtained by crushing sirolimus tablets and mixing it with petrolatum. The patients were asked to apply the cream to one side of their face, and vaseline to the other side. The effect of topical sirolimus was evaluated using the "facial angiofibroma severity index." RESULTS: There was a significant improvement in the redness and extension of the tumors on the sides to which the active ingredient was applied. Some side effects such as itching and irritation occurred in three patients, which were treated with topical hydrocortisone cream. CONCLUSION: Topical sirolimus appears to be a promising, fairly well tolerated treatment for facial angiofibromas in patients with tuberous sclerosis complex. Although its efficacy diminishes with time, repetitive usage is effective.
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Angiofibroma/diagnóstico , Angiofibroma/tratamiento farmacológico , Antibióticos Antineoplásicos/administración & dosificación , Sirolimus/administración & dosificación , Esclerosis Tuberosa/diagnóstico , Esclerosis Tuberosa/tratamiento farmacológico , Administración Tópica , Niño , Estudios Cruzados , Femenino , Humanos , Masculino , Estudios Prospectivos , Método Simple Ciego , Resultado del TratamientoRESUMEN
BACKGROUND/OBJECTIVE: Acne vulgaris is one of the most common diseases of the youth. Systemic isotretinoin is the only drug which acts on all of the etiopathogenic mechanisms of acne. Isotretinoin has some well-known side effects. Besides these, there is a suspicion whether it affects fertility or not. Previously, we conducted a study about isotretinoin's effect on ovarian reserve which showed deteriorative reserve. In this study, we aimed to evaluate the long-term effects of systemic isotretinoin on female fertility. MATERIALS AND METHODS: Of the 82 female patients who were enrolled in the first study, 79 patients were included in this study. Twelve months after the end of systemic isotretinoin treatment, patients were reevaluated by using the same parameters which include anti-Mullerian hormone (AMH), ovarian volume (OV), antral follicle count (AFC), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, free testosterone and total testosterone. RESULTS: The changes in the mean AMH, OV and AFC were statistically significant between the sixth and eighteenth months (the end of systemic isotretinoin treatment and 12 months treatment free). The mean AMH, OV and AFC values at the beginning and at the 18th month were statistically similar. CONCLUSION: The deteriorative effects of systemic isotretinoin treatment on ovarian reserve, which can be accepted as an indicator of female fertility, diminish in time.
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Acné Vulgar/tratamiento farmacológico , Fármacos Dermatológicos/efectos adversos , Isotretinoína/efectos adversos , Reserva Ovárica/efectos de los fármacos , Ovario/efectos de los fármacos , Administración Oral , Adolescente , Adulto , Hormona Antimülleriana/sangre , Fármacos Dermatológicos/administración & dosificación , Fármacos Dermatológicos/uso terapéutico , Estradiol/sangre , Femenino , Hormona Folículo Estimulante/sangre , Humanos , Isotretinoína/administración & dosificación , Isotretinoína/uso terapéutico , Hormona Luteinizante/sangre , Estudios Prospectivos , Testosterona/sangre , Factores de Tiempo , Adulto JovenRESUMEN
BACKGROUND: Systemic isotretinoin (13-cis-retinoic acid) is effective in the treatment of acne vulgaris. The most common side effects are mucocutaneous ones. Hematuria seen secondary to isotretinoin treatment is thought to be due to mucosal dryness in the urinary system. This study aims to determine the frequency of hematuria in acne vulgaris patients during isotretinoin treatment. MATERIALS AND METHOD: Eighty-eight subjects aged 16-32 years were included in the study group and 52 subjects were in the control group. The subjects were treated for 6 months and were monitored monthly by complete urine analyzes. They were also examined each month in terms of cheilitis, xerosis, epistaxis, rectal bleeding, fatigue, myalgia, weight loss, dry eye, conjunctivitis, headache, dysuria and pollakiuria. RESULTS: In the study group, 15 subjects (17%) had hematuria at least once during the study, and in the control group, four subjects (7.7%) had hematuria. The difference was not statistically significant (p = 0.118). Among the subjects who had hematuria, 11 of them (73.3%) were female and four of them (33.3%) were male in the study group while all the subjects with hematuria in the control group were female. Hematuria and gender did not show a statistically significant correlation. CONCLUSION: Hematuria was observed in 17% of the study group; this frequency rate was not different from that of the normal population. In subjects having isotretinoin treatment, if all the other reasons or disorders are excluded, one must keep in mind that hematuria may be due to isotretinoin use.
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Acné Vulgar/tratamiento farmacológico , Fármacos Dermatológicos/efectos adversos , Hematuria/inducido químicamente , Isotretinoína/efectos adversos , Acné Vulgar/orina , Adolescente , Adulto , Fármacos Dermatológicos/uso terapéutico , Femenino , Hematuria/orina , Humanos , Isotretinoína/uso terapéutico , Masculino , Adulto JovenRESUMEN
INTRODUCTION: The association between vitiligo and thyroid disease is not fully investigated especially in paediatric patients. AIM: To determine the incidence of vitiligo and thyroid disorders in children. This is the first report from middle Anatolia and the second report from Turkey. MATERIAL AND METHODS: A retrospective chart review was performed to examine the presence of thyroid abnormalities in paediatric patients who had been admitted to the dermatology department with vitiligo. RESULTS: A total of 155 paediatric patients, including 80 (52%) male and 75 (48%) female patients were included. The mean age was 8.6 years. Non segmental vitiligo was the most common type of the disease in 140 (90%) reviewed patients, while segmental vitiligo appeared only in 15 (10%) patients. The mean onset of vitiligo was 5.6 ±0.9 years. A family history of vitiligo was found in 14 (9%) children. Thirty-four (22%) patients had thyroid function tests and/or thyroid autoantibody abnormality. All of these patients had non segmental vitiligo. It was statistically significant (p < 0.05) in types of vitiligo and thyroid disease parameters. CONCLUSIONS: Our results show that it may be useful to screen thyroid in children with non segmental vitiligo.
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Lipoid proteinosis (LP) is an uncommon, autosomal, recessively inherited disorder. It is typically characterized by hoarseness from early infancy, together with various cutaneous manifestations such as waxy papules, acneiform scarring, and eyelid beading. A 42-year-old woman was admitted to our dermatology outpatient clinic complaining of rigidity of the oral mucosa and limitation in tongue movement. She also had a burning sensation and decreased taste perception in the mouth while eating, as well as hoarseness of voice. She was diagnosed with lipoid proteinosis. The typical cutaneous manifestations of LP include waxy yellow papules with generalized skin thickening on the face, extremities, and trunk. Here we report a case with significant mucosal involvement but less skin involvement.
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Proteinosis Lipoidea de Urbach y Wiethe/patología , Adulto , Femenino , Humanos , Mucosa Bucal/patologíaRESUMEN
BACKGROUND/OBJECTIVES: Androgenetic alopecia (AGA) occurs due to the effect of androgens and genetic predisposition. The association between hyperandrogenism and insulin resistance (IR) has been clearly documented. In recent years there have been reports supporting the presence of IR in AGA. The study aimed to investigate the presence of IR in women with AGA and discern whether or not it is associated with hyperandrogenism. METHODS: Overall, 77 women with AGA were included in the study. Patients with Ludwig grades I-III AGA were enrolled in the study. Blood samples were drawn for measurements of hormone profile, basal insulin and fasting blood glucose (FBG). An oral glucose tolerance test was performed on another day. IR was assessed by the homeostasis model assessment score. RESULTS: All IR parameters were significantly higher in the 75 study subjects without DM than in the control group (P < 0.05). After excluding five patients with IGT, the level of all IR parameters were still higher than in the control group (P < 0.05). Hyperandrogenemia was found in 30 (40%) patients. When this second group (n = 45) (excluding patients with hyperandrogenemia) was compared with the control group on IR, all parameters except for basal insulin were significantly higher in the second group than in the controls (P < 0.05). CONCLUSION: Our results suggest a relation between IR and AGA in female patients. We showed for the first time that the association of AGA and IR is independent of hyperandrogenemia.