Investigation of allergenicity of some cosmetic mixtures by using ex vivo local lymph node assay-BrdU endpoints.

BACKGROUND: Balsam of Peru and fragrance mix are commonly used in cosmetic products. Allergy to fragrance is the most common cause of cosmetic contact dermatitis. METHODS: In the present study, ex vivo local lymph node assay-5-bromo-2'-deoxyuridine (LLNA-BrdU) was used to evaluate the dermal sensitization potential of these cosmetic mixtures. The stimulation index values and estimated concentration (EC3) values were calculated and the potency classification was found for each mixture. At the same time, in order to measure the irritant effect without having to use additional animals, a combination of ex vivo LLNA-BrdU and the irritancy assay was conducted. RESULTS: Th1 [interleukin (IL)-2, interferon-γ] and Th2 cytokine (IL-4, IL-5) releases from lymph node cell culture were investigated as non-radioactive endpoints. According to the results of ex vivo LLNA-BrdU assays, EC3 values were found to be 3.09% (moderate) for balsam of Peru and 4.44% (moderate) for fragrance mix. Cytokine analysis results indicate that both Th1 and Th2 cytokines are involved in the regulation of murine contact allergy and can be considered as useful endpoints. CONCLUSION: In conclusion, according to our results, fragrance mix and balsam of Peru can be considered as moderate sensitizers; however, in high concentrations, both of them have irritation properties. The cytokines investigated can be considered as the endpoints of the ex vivo LLNA-BrdU assay.

Allergenicity evaluation of fragrance mix and its ingredients by using ex vivo local lymph node assay-BrdU endpoints.

The present studies were performed to compare the differences between sensitization potency of fragrance mix and its ingredients (oak moss absolute, isoeugenol, eugenol, cinnamal, hydroxycitronellal, geraniol, cinnamic alcohol, alpha amyl cinnamal), by using ex vivo LLNA-BrdU ELISA. The SI and EC3 values were calculated and potency classification was found for the mixture and for each ingredients. TH1 cytokines (IL-2, IFN-γ) and TH2 cytokines (IL-4, IL-5) releases from lymph node cell culture were also investigated as contact sensitization endpoints. The EC3 values were calculated and the potency of contact sensitization were classified for fragrance mix, oak moss absolute, isoeugenol, eugenol, cinnamal, hydroxycitronellal, geraniol, cinnamic alcohol, alpha amyl cinnamal respectively: 4.4% (moderate), 3.4% (moderate), 0.88% (strong), 16.6% (weak), 1.91% (moderate), 9.77% (moderate), 13.1% (weak), 17.93% (weak), 7.74% (moderate). According to our results it should be concluded that exposure to fragrance mix does not constitute an evidently increased hazard compared to exposure to each of the eight fragrance ingredients separately. Cytokine analyses results indicate that both TH1 and TH2 cytokines are involved in the regulation of murine contact allergy and can be considered as useful endpoints.

Body dysmorphic disorder in university students with skin diseases compared with healthy controls.

Body dysmorphic disorder appears relatively frequently in dermatological and cosmetic surgery settings; in fact, dermatologists may be the type of practitioner most often consulted by patients with body dysmorphic disorder. The aim of this study was to evaluate body dysmorphic disorder symptoms in Turkish university students with skin diseases. A total of 107 outpatients diagnosed with any skin disease and 109 age- and sex-matched healthy subjects recruited from the students of the same university were enrolled in the study. Subjects in both the patient and the control groups completed the Beck Depression Inventory and the Body Dysmorphic Symptoms Scale (BDSS). Groups differed on the basis of BDSS scores (t = 3.74, p = 0.001), with higher scores in the group with skin diseases compared with those for healthy controls. Subjects with skin diseases and higher BDSS scores had higher Beck Depression Inventory scores compared with those with lower BDSS scores (z = 4.13, p = 0.001). This study suggests that patients with skin disease have higher body dysmorphic disorder scores compared with healthy controls.

Comparison of depression, anxiety and life quality in acne vulgaris patients who were treated with either isotretinoin or topical agents.

BACKGROUND: Since the introduction of isotretinoin to the market, many adverse psychiatric effects, including depression, anxiety and suicide attempts were reported. The aim of this study was to determine whether patients with acne who were treated with isotretinoin experienced significant increases in psychiatric symptoms over a 4-month period compared with patients who received topical acne therapy. METHODS: Seventy-eight acne patients were allocated either to isotretinoin treatment (study group) (n = 37) or to topical treatment (control group) (n = 41). Their psychological status was evaluated at the baseline, second and fourth months of the treatment. All patients were required to complete the dermatology life quality index (DLQI), the Hospital anxiety and depression (HAD) scale, and the beck depression inventory (BDI). RESULTS: The two groups were not different from each other in terms of DLQI, BDI, HAD-A, HAD-D and total HAD scores at baseline. However, at the end of the second month quality of life was more impaired in the topical treatment group compared to the isotretinoin group (P < 0.05), and there were no difference between two groups in terms of BDI, HAD-A, HAD-D, and total HAD scores (P > 0.05). At the end of fourth month quality of life and all psychological test scores had improved more in the isotretinoin group compared to topical treatment group (P < 0.05). CONCLUSION: Results of the present study indicate that there is no increase in depressive and anxiety symptoms in the isotretinoin treatment group compared to that in the topical group. Instead, successful treatment of acne seems to improve both depressive and anxiety symptoms and improve quality of life.

Anxiety and depression in patients with pityriasis rosea compared to patients with tinea versicolor.

BACKGROUND: Few researchers have specifically evaluated how the quality of life of patients with pityriasis rosea (PR) and tinea versicolor (TV) are affected. There are even less studies exploring the psychological status of these patients. The objective of this study was to investigate and compare quality of life and psychological status of patients with PR and TV. METHOD: Thirty-six patients with pityriasis rosea and 43 patients with tinea versicolor (N = 79) were selected for the study. All patients were required to complete Dermatology Life Quality Index (DLQI) and Hospital Anxiety and Depression (HAD), Hospital Anxiety and Depression-Depression (HAD-D), and Hospital Anxiety and Depression-Anxiety (HAD-A) scales. RESULTS: Both groups did not differ from each other with regard to DLQI, HAD-D, HAD-A, and total HAD scores (p > 0.05). With regard to cutoff points of HAD-A, 11 patients in the PR group and 15 patients in the TV group had anxiety. The number of patients with depression in pityriasis rosea and tinea versicolor groups were 11 and 13 respectively. Depression and anxiety scores were highly correlated with DLQI scores in both patients with PR and TV. CONCLUSIONS: Results of the present study indicate that patients with PR and TV are at risk for psychopathology. Uncertainties about the etiology and length of recovery period in PR and location of disease to visible parts and recurrent nature of the disease in TV groups might have affected the patients' psychological status.

Topical tetracycline in the treatment of acne vulgaris.

BACKGROUND: Topical tetracycline was the first topical antibiotic approved for the treatment of acne, its use has been limited because of the skin penetration problems of the active ingredient. OBJECTIVES: The objective of this study was to evaluate the effectiveness of a new formulation of topical tetracycline [Imex, tetracycline hydrochloride 3%, 20g] monotherapy in the treatment of mild to moderate acne vulgaris. METHODS: The sample group consisted of 87 volunteer students of both sexes with grade 1 to grade 2 acne as assessed by Investigator's Global Assessment (IGA) severity grading system. Subjects were instructed to apply topical tetracycline twice daily for 8 weeks. Subject were evaluated at baseline and at weeks 2, 4, and 8. RESULTS: Of 87 subjects, 68 completed the 8-week treatment period. The mean reduction rates of opened comedones were 55.4%, closed comedones were 27.1%, papules were 24.8%, pustules were 27.3%. After 8 weeks of treatment, a statistically significant reduction was only observed in the mean counts of the papules and pustules (P < 0.001). CONCLUSION: Tetracycline is a well-tolerated topical agent and is particularly effective in the treatment of inflammatory lesions in acne.

Creatine phosphokinase values during isotretinoin treatment for acne.

BACKGROUND: Muscle-related complaints and high creatine phosphokinase (CPK) blood levels have been reported in 15-50% of patients with acne treated with isotretinoin. Clinical investigations about CPK levels in isotretinoin therapy were few, and most of them were case reports. The aim of this study was to investigate the incidence, course, and clinical significance of severe hyperphosphokinasemia in isotretinoin therapy for acne. METHODS: A total of 89 patients were treated with isotretinoin for moderate or severe acne at our dermatology department. At the initial visit and during the monthly follow-up visits, hemoglobin, hematocrit, leukocytes, thrombocyte, renal function tests (urea and creatinine), direct and indirect bilirubin, liver enzymes [serum glutamate oxaloacetate (SGOT), serum glutamate pyruvate transaminase (SGPT), gamma glutamil transpeptidase (GGT), and alkaline phosphotase (ALP)], lipid profile [total cholesterol, very low density lipoproteins (VLDL), low density lipoproteins (LDL), high density lipoproteins (HDL), and triglycerides], urine analysis, and CPK were requested. We asked all patients about muscle-related complaints, weakness, exercise, and compared CPK levels. RESULTS: Elevated CPK levels were recorded in only five patients during treatment period. Maximum serum CPK values recorded for each patient ranged between 292 and 569 IU/l. Only one patient out of five had myalgia and four patients were completely asymptomatic. CONCLUSIONS: In conclusion, marked hyperCPKemia with or without muscle-related complaints in isotretinoin-treated patients with acne is a benign phenomenon; therefore, it is logical to reserve measurement of CPK levels as well as renal tests for cases with severe muscle pain.

Dietary glycemic index and glucose, insulin, insulin-like growth factor-I, insulin-like growth factor binding protein 3, and leptin levels in patients with acne.

BACKGROUND: Several isolated observations have suggested that acne can develop in groups when a high glycemic index diet is adopted. OBJECTIVE: This study was designed to examine associations among daily diet glycemic index, glycemic loads, serum insulin levels, and acne. METHODS: A total of 49 patients with acne and 42 healthy control subjects were included in the study. At the initial visit, fasting glucose, insulin, insulin-like growth factor-I, insulin-like growth factor binding protein 3, and leptin levels were measured. A voluntary self-completed questionnaire was administered and participants were asked how frequently they consumed the specified amount of food. Overall glycemic index and dietary glycemic load were calculated. RESULTS: No significant differences were observed between patients with acne and control subjects in serum glucose, insulin, leptin levels, overall glycemic index, or dietary glycemic load. LIMITATIONS: The information and data obtained from this questionnaire were limited to patients' own recollections. CONCLUSION: Results of this study indicate that dietary glycemic index, glycemic load, and insulin levels do not have a role in pathogenesis of acne in younger patients.

Body image satisfaction and anxiety of a Turkish sample of university students with skin diseases.

The aim of this study was to evaluate perception of body image and anxiety of 221 university students presenting to the dermatology outpatient clinic with a skin disease and 205 students without skin disease. Analysis of anxiety and body image scores yielded differences by sex and age in both groups. The group with skin disease had lower scores on body image. Acne vulgaris seems to be the most disturbing among the skin diseases, and this was more prominent in younger patients.

Incidence of depression related to isotretinoin treatment in 100 acne vulgaris patients.

The incidence of depression in acne patients using isotretinoin was assessed in 100 patients with moderate and nodulocystic acne. All patients received 0.75-1.00 mg/kg/day of isotretinoin for 20-28 weeks after acne was assessed. All patients' acne lesions were improved at the end of the treatment period. Psychological state was evaluated at baseline, at Month 3, and Month 6 by a psychiatrist using a Turkish version of the Hamilton Depression Rating Scale. Only one patient's score increased to the clinical level of depression at Month 3 of treatment and declined to subclinical levels at Month 6. Although Hamilton scores increased at Month 3 over baseline scores, except for one patient, others' scores remained below the subclinical level for depression. At the end of Month 6, the mean score decreased below that at Month 3. These changes in means might be related to the onset of clinical effect of isotretinoin.