Obstructive sleep apnea syndrome in patients with chronic idiopathic urticaria.

Urticaria is a disease which progresses with itchy papules and plaques called urtica, obstructive sleep apnea syndrome (OSAS) is defined as daytime sleepiness and obstructive apnea and hypopnea attacks during sleep. In this study, we aimed to investigate the relationship between urticaria and OSAS. Thirty-one patients with chronic idiopathic urticaria were included in the study. Body mass indexes (BMIs) were calculated and polysomnography findings were recorded. Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index were used to evaluate daytime sleepiness. The prevalence and severity of urticaria were calculated using the urticaria activity score (UAS). Chronic Urticaria Quality of Life Questionnaire was applied to patients. OSAS was detected in 13 (41.9%) of 31 patients. Then, 11 of the 13 patients had mild, 1 had moderate, and 1 had severe OSAS in the patient group. OSAS was not detected in the control group. A positive correlation was found between apnea-hypopnea index and BMI, the UAS scores in the patient group (respectively, r = .537, P = .002, r = .407, P = .023). In this study, we found that the frequency of OSAS in patients with urticaria was more than that in the normal population. Doctors treating urticaria should consider a comorbidity disease such as OSAS and regulate the treatment according to these two diseases.

Management of a glottic squamous cell carcinoma with cutaneous metastasis.

INTRODUCTION: Oral cavity malignancies constitute 30% of head and neck cancers. The most common distant metastatic sites of glottic carcinoma are usually lung, liver and bone. Although the cutaneous metastasis of head and cancers have been reported with an incidence of 0.7-2.4%, skin metastasis of glottic carcinoma is extremely rare. CASE REPORT: A 69-year-old male patient was admitted to the emergency department with hemoptysis, dyspnea, weakness in lower extremities and difficulty in swallowing. There were subcutaneous lesions with a diameter of 2-5 cm in the scalp, posterior chest wall, nose and abdomen. In addition, there was an ulcerating, painful mass on the right lateral part of the tongue. The biopsy of lesions on tongue and skin revealed a glottic squamous cell carcinoma with cutaneous metastasis.Management and outcome: The patient was treated with cisplatin 50 mg/m2 on day 1, cetuximab 500 mg/m2 on day 1 and 5-fluorouracil 1000 mg/m2 daily on days 1 and 2, repeated every two weeks. After the first cycle of chemotherapy, the lesions on the skin regressed and dysphagia improved. DISCUSSION: There are limited data about the incidence, diagnostic measures and treatment modalities of glottic cancer with cutaneous metastasis. Our case could provide an important experience to literature by its atypical presentation and treatment-sensitive nature.

Thiol/disulfide homeostasis and its relationship with insulin resistance in patients with rosacea.

BACKGROUND: Rosacea is a chronic inflammatory cutaneous disease that can be associated with cardiometabolic disorders. Oxidative stress is included in the pathogenesis of rosacea, and thiol-disulfide homeostasis (TDH) acts as antioxidants. OBJECTIVE: To evaluate the TDH and metabolic parameters in patients with rosacea. MATERIAL AND METHODS: A total of 42 rosacea patients and 50 controls participated in this prospective study. Demographic data, clinical entities, anthropometric measurements, and laboratory findings were recorded. Additionally, TDH was measured by an automated spectrophotometric method. RESULTS: Rosacea patients had greater body mass index values (27.9 ± 5.2 kg/m² vs. 23 ± 1.4 kg/m², p < 0.001), waist-hip ratios (0.87 ± 0.1 vs. 0.77 ± 0.8, p < 0.001), and insulin resistance (3.0 ± 2.0 vs. 1.3 ± 0.5, p < 0.001) compared with controls. Disulfide levels, the disulfide/native thiol ratio (DNTR), and the disulfide/total thiol ratio (DTTR) were increased (p < 0.05) in rosacea patients. Native thiol and total thiol levels and the native/total thiol ratio (NTTR) were decreased in rosacea patients (p < 0.05). Different rosacea subtypes had no effect on oxidative stress markers. The duration of illness and insulin resistance values significantly correlated with DNTR and DTTR in the rosacea group (p < 0.05). CONCLUSION: Rosacea has a metabolic milieu with increased oxidative stress and insulin resistance.

Evaluation of Erythroid Disturbance and Thiol-Disulphide Homeostasis in Patients with Psoriasis.

This study aims to assess how mean corpuscular volume (MCV), red cell distribution width (RDW), and thiol-disulphide homeostasis are altered in psoriasis patients. This is a cross-sectional review of 76 healthy volunteers and 87 psoriasis patients who were consecutively admitted to the department of dermatology. Psoriasis patients and healthy controls were statistically similar with respect to age, sex, body mass index, blood pressures, and disease duration (p > 0.05 for all). When compared to healthy controls, psoriasis patients had significantly higher MCV, RDW, C-reactive protein (CRP), disulphide, disulphide/native thiol, and disulphide/total thiol (p < 0.001 for all). However, psoriasis patients had significantly lower native thiol and native thiol/total thiol (p = 0.009 and p < 0.001, respectively). When compared to healthy controls, the patients with Psoriasis Area Severity Index (PASI) ≤ 10 and patients with PASI > 10 had significantly higher MCV, disulphide, disulphide/native thiol, and disulphide/total thiol (p < 0.001 for all). The patients with PASI ≤ 10 and patients with PASI > 10 had significantly lower native thiol/native thiol than healthy controls (p < 0.001 for all). The psoriasis patients with PASI > 10 had significantly higher RDW and CRP than healthy controls and patients with PASI ≤ 10 (p < 0.001 for all). Disulphide, disulphide/native thiol, disulphide/total thiol, and native thiol/total thiol correlate significantly with both PASI scores and disease duration. Thiol-disulphide homeostasis is enhanced in psoriasis patients. Ongoing inflammation and increased oxidative stress in psoriasis patients also trigger the formation of prooxidants which are neutralized by antioxidants such as thiols. That is why plasma thiol levels are decreased in psoriasis patients.