The relationship between TNF-α, IL-1, IL-12, IL-17, IL-23, IL-36 expression and treatment response in psoriasis histopathologically and immunohistochemically.

AIM: There is no marker that can predict whether there is resistance to treatment in patients with psoriasis. In this study, we investigated the relationship between the staining rates of TNF-α, IL-1, IL-12, IL-17, IL-23, and IL-36 markers immunohistochemically from cutaneous biopsy and the treatment success. METHODS: The patients who were followed up in the dermatology clinic with the diagnosis of plaque-type psoriasis vulgaris and received biological treatment and previously had cutaneous biopsy were included in the study. The cutaneous biopsies of the cases that met the conditions were re-sectioned and subjected to immunohistochemical examination for TNF-α, IL-1, IL-12, IL-17, IL-23, and IL-36. RESULTS: Comparing the staining scores with psoriasis area severity index (PASI); A statistically significant positive correlation was found between PASI and TNF-α staining score (p = 0.034). A statistically significant positive correlation was found between PASI and IL-17 staining score (p = 0.004). When the staining scores and PASI response rates of psoriasis treatment were evaluated in terms of correlation; there was a positive correlation between TNF-α, IL-17, and IL-23 immunohistochemical staining rates and PASI response rates. CONCLUSIONS: In line with the data obtained from our study, we think that making immunohistochemical scoring before the biological treatment decision in psoriasis patients will be beneficial in treatment selection. In this respect, our study may open a new era in the selection of biological treatments for psoriasis.

Evaluation of inflammatory and hematological parameters in patients diagnosed with COVID-19.

INTRODUCTION: This study aims to research the effects of hematological and inflammatory parameters on the prognosis of COVID-19 disease and hospitalization duration. METHODOLOGY: One hundred and eighty-six patients with COVID-19 and a control group consisting of 187 healthy individuals were included in the study. Hematological variables and inflammatory parameters of the patients were recorded on the first and the fifth days of hospitalization. RESULTS: White blood cell count, lymphocyte count, and platelet count were statistically lower, and mean platelet volume (MPV), neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) levels were higher in the patient group compared to the control group. It was observed that the neutrophil count and MPV level were lower, and the platelet count and ferritin level were statistically higher on the fifth day of follow-up compared to the admission day. In contrast, there was a significantly positive correlation between the duration of hospitalization and the fifth day D-dimer (r = 0.546, p < 0.001) and ferritin (r = 0.568, p < 0.001); in addition, there was a negative correlation between the duration of hospitalization and admission day lymphocyte count and the fifth-day lymphocyte count. CONCLUSIONS: Increased levels of ferritin and D-dimer, and decreased count of lymphocytes are among the important factors affecting the duration of hospitalization for COVID-19 patients. Furthermore, we think that neutrophil count and MPV levels are low, and platelet count and ferritin levels are high during the disease. Therefore, these parameters can be used as prognostic indicators of the disease.

The relationship between hidradenitis suppurativa and irritable bowel syndrome: a cross-sectional study.

BACKGROUND: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder in which one experiences abdominal pain, tension, cramping, bloating, and changes in the form and frequency of defecation, without an underlying organic disease. Many skin diseases have been reported to be more common in people with functional bowel disease. To our knowledge, however, no previous study investigated the potential relationship between hidradenitis suppurativa (HS) and IBS. In this study, we aimed to examine the potential association between IBS and HS. METHODS: Patients with HS and healthy subjects were enrolled in this cross-sectional study. All participants were assessed for the presence of IBS. ROME IV criteria were used to identify IBS cases. Hurley staging, modified Sartorius score, and physician's global assessment score were applied to define clinical severity and staging of HS. RESULTS: According to the Rome IV diagnostic criteria, 54 (67.50%) of 80 HS patients and 23 (28.75%) of 80 control group were diagnosed with IBS. The frequency of IBS was statistically significantly higher in the patient group than in the control group (P < 0.001). No statistically significant difference was found between the two groups in terms of abnormal stool frequency and family history of IBS (P = 0.28, P = 0.862, respectively). Abnormal stool form, mucus in stool, abdominal distension, feeling of incomplete evacuation were statistically significantly higher in HS patients compared to the controls (P = 0.01, P = 0.02, P < 0.001, P = 0.001, respectively).

Treatment of keratosis pilaris rubra with 577-nm pro-yellow laser.

OBJECTIVE: Keratosis pilaris rubra (KPR) is a rare group of idiopathic hereditary disorders of keratinization, and it is considered as variants of keratosis pilaris. It is characterized by a well-defined erythema and small, keratotic follicular papules that are seen on the cheeks and preauricular area. Keratosis pilaris rubra is an aesthetically distressed situation, and especially vascular erythema is the most common complaint. In recent years, pro-yellow (577 nm) laser, laser system with yellow light wavelength, has been used as an alternative for seeking more effective treatment especially in vascular lesions. However, in the literature, pro-yellow laser therapy has never been used before in keratosis pilaris rubra. Therefore, we wanted to evaluate the effectiveness of the pro-yellow laser in keratosis pilaris rubra patients. MATERIALS AND METHODS: In our study, four patients with keratosis pilaris rubra treated with pro-yellow laser in our Cosmetology Unit between December 2017 and March 2019 were evaluated. The first session was started with 20 j/cm2 and the dose increased 2 j/cm2 at each session. The dose was increased up to 26 j/cm2 , a total of four sessions (20-22-24-26 j/cm2 ) was applied in treatment. All the sessions were used in treatment scanner mode. RESULTS: Objectifying a clearance of erythema >75% was clinically evident in three patients, in the fourth patient, erythema regressed approximately 50%. There has been no recurrence of the lesions after a minimum three months follow-up. There was no permanent side effect in any patient. CONCLUSION: Pro-yellow laser is a well option for the treatment of keratosis pilaris rubra, and we think that it could be a safety choice therapy. In addition, a well tolerance to treatment and a low incidence of serious side effects make it a very reliable therapy. Further clinical studies are needed to improve our findings.

Does omalizumab use in chronic spontaneous urticaria results in improvement in sexual functions?

BACKGROUND: Chronic spontaneous urticaria (CSU) is a disease that can affect the patient's quality of life (QoL), sexual functions, and mood. OBJECTIVE: We planned a retrospective study to investigate the effects of omalizumab use in CSU patients on sexual function. We also aimed to evaluate the sexual function, quality of life (QoL), and mood of CSU patients compared to the control group consisting of idiopathic pruritus patients. METHODS: A review of patients' records with CSU attending the dermatology outpatient clinic from January 2020 to June 2020 was done. Urticaria activation score (UAS7), Beck depression inventory (BDI), Dermatology life quality index (DLQI), female sexual function index (FSFI) to female participants, and the international index of erectile function (IIEF) to male participants were used to assess the impact of the disease on patients' life. The obtained data were analyzed by using SPSS software. RESULTS: Each one of the mean UAS, BDI, and DLQI score values decreased significantly in weeks in omalizumab group patients. IIEF score in male patients and FSFI score in female patients also increased in weeks in omalizumab group patients. CONCLUSIONS: Omalizumab can play an effective role in enhancing the sexual function of CSU patients in addition to improving their DLQI.

Cutaneous and Allergic reactions due to COVID-19 vaccinations: A review.

INTRODUCTION: The pandemic caused by the novel coronavirus disease 2019 (COVID-19) has had an unprecedented impact on the overall health and the global economy. Vaccination is currently the most dependable strategy to end the pandemic, despite the slower-than-hoped-for rollout, particularly for low-to-middle-income countries, and the uncertain duration of protection afforded by vaccination. The spike protein of the virus (immunodominant antigen of the virus) is the main target of the approved and candidate SARS-CoV-2 vaccines. This protein binds to the ACE2 receptor of the host cell, initiating the entry of the virus into the cell and the chain of subsequent events ending to Acute Respiratory Distress Syndrome. The safety profile of these vaccines needs is closely assessed. METHODS: This comprehensive review includes searching the PubMed, EMBASE, and Web of Science databases using the keywords "coronavirus", "COVID-19", "vaccine", "cutaneous reactions", "allergic reactions", and "SARS-CoV-2". Manual searching of reference lists of included articles augmented the research. The research was updated in June 2021. RESULTS: In this narrative review, we tried to investigate and discuss the cutaneous and allergic reactions related to SARS-CoV-2 vaccines currently available in the literature. As a result, although COVID-19 vaccines can be reported to develop allergic and anaphylactic reactions, especially after m-RNA vaccines, they remain at a low rate, and it is observed that these reactions may develop more frequently, especially in patients with previous allergies and mast cell disorders. Fortunately, these reactions are generally transient, benign, self-limited. CONCLUSION: Although there is still no definitive evidence, as dermatologists, we must be aware of the possibility of cutaneous reactions, newly diagnosed dermatoses, or exacerbation of existing dermatoses that may develop after the COVID-19 vaccinations.

Relationship between rosacea and chronic obstructive pulmonary disease: Rosacea and comorbidities: Rosacea and comorbidities.

BACKGROUND: Rosacea is a chronic inflammatory skin disease that has been reported to be associated with many systemic disorders including respiratory diseases. AIMS: This study aims to investigate respiratory function in patients with rosacea. PATIENTS/METHODS: Patients with rosacea and age- and gender-matched healthy volunteers were included in this cross-sectional study. Spirometric pulmonary function tests including the percentage of forced vital capacity (FVC%), percentage of forced expiratory volume in one second (FEV 1%), forced expiratory flow at 25-75% of FVC (FEF 25-75%), and FEV 1/FVC ratio was assessed in both patient and controls. The potential relationship between rosacea severity and pulmonary functions was assessed. RESULTS: A total of 120 patients with rosacea and 120 healthy controls were enrolled in the study. Compared to the controls, FEV 1%, FEV 1/FVC%, and FEF 25-75% values were significantly lower in patients with rosacea. Lower FEV 1/FVC% values were found to be associated with disease severity. FEV 1%, FEV 1/FVC%, and FEF 25-75% values were found to be more useful in differentiating the patients from healthy subjects. CONCLUSIONS: This study showed that patients with rosacea may have abnormal respiratory function compared to healthy subjects. Besides, disease severity was associated with worse respiratory functions. We believe that patients with rosacea, particularly those with additional risk factors, should be screened for respiratory disorders.

The effect of 577-nm pro-yellow laser on demodex density in patients with rosacea.

BACKGROUND: The pro-yellow laser is a yellow light wavelength (577-nm) laser system. Rosacea is a chronic inflammatory disorder that occurs with facial flushing, erythema, papules, pustules, and telangiectasia. Demodex parasites (Demodex folliculorum and brevis) also play a role in the pathogenesis of rosacea. AIM: The aim of our study is to evaluate the effect of pro-yellow laser on demodex density (Dd) in patients with rosacea. PATIENTS/METHODS: This retrospective study was planned for the patients with rosacea whose demodex mite densities were examined and treated with pro-yellow laser and were evaluated between 2019 and 2020 in the cosmetology unit. The laser light was applied at a dose of 20 J/cm2 in the scanner mode (the 80% coverage) in all the patients. The demodex density per cm2 was routinely evaluated before the treatment, and the demodex density values in the fourth week after the treatment were recorded from the patients' files. RESULTS: There were 27 females (79.4%) and seven males (20.6%) evaluated in the study. While the demodex density was 18.1 ± 10.7 (min: 0-max: 48, Q1:12-Q3:22) per cm2 before the pro-yellow laser treatment in the cases, the demodex density was 10.2 ± 7.9 (min: 0-max: 30, Q1:4.75-Q3:12) per cm2 in the fourth week after the treatment. After the pro-yellow laser treatment, the demodex intensity decreased significantly compared to before the laser treatment (p = 0.001). There was no significant correlation between the decrease in the density of the demodex mite and the success of the treatment (p = 0.46). CONCLUSION: This is the first study in the literature investigating the change in demodex density in rosacea patients treated with pro-yellow laser therapy. In this study, it was shown that pro-yellow laser treatment is effective in reducing the density of demodex.

Comparison of anti-TNF and IL-inhibitors treatments in patients with psoriasis in terms of response to routine laboratory parameter dynamics.

BACKGROUND: Biological agent treatments represent a relatively new field and their effects on routine laboratory parameters are not fully known as there has been little research in the area. In our study, we aimed to evaluate the differences between the two main biological treatment groups and their effects on routine laboratory parameters. METHODS: Patients were enrolled when they had received treatment for more than six months with biological treatments between January 2013 and April 2020. The available data on routine laboratory parameters were collected by routine blood tests before the treatment, at three months, and at the final evaluation. RESULTS: When the changes in routine laboratory parameters were evaluated by treatment, it was found that the NLR and CRP values decreased statistically significantly in the anti-TNF group compared to the IL inhibitor group. In addition, strong suppression of these inflammation parameters means strong suppression of the immune system response. In addition, AST, ALT, and creatinine values were found to be statistically significantly higher in the anti-TNF group compared to the IL inhibitor group. CONCLUSIONS: In our study, anti-TNF treatments are shown to be more effective in reducing inflammation parameters while IL antagonists are safer in terms of biochemical parameters.

Treatment considerations for Behçet disease in the era of COVID-19: A narrative review.

COVID-19 is a multisystem disease caused by severe acute respiratory syndrome coronavirus 2. It has been declared a pandemic by the World Health Organization in March 2020 and the outbreak still keeps its impacts worldwide. Behçet disease (BD) is a multi-systemic vasculitis involving the skin, mucosa, eyes, joints, nervous system, cardiovascular system, and gastrointestinal system. The precise etiopathogenesis of the disorder is unknown but autoimmunity is believed to play a key role. A considerable part of patients with BD are susceptible to immunosuppression and are more predisposed to infections than healthy individuals. Hence, the protection and control measures for patients with BD against the COVID-19 are of the utmost significance. Given the requirement to balance proper treatment of BD with the smallest risk of COVID-19 associated mortality and morbidity, we aimed to review the management of BD in the era of the pandemic with a special focus on treatment considerations. According to current expert recommendations, there is no reason to discontinue topical treatments, colchicine, and nonsteroidal antiinflammatory drugs. Systemic steroids can be used at the lowest possible dose if needed. Ongoing treatments can be continued unchanged in patients with no suspected or confirmed COVID-19. In cases with COVID-19 symptoms, immunosuppressive and biological agents can be temporarily stopped but the decision should be made on a case by case basis. Considering their potential beneficial effects on the course of COVID-19, colchicine, pentoxifylline, and dapsone can be considered as safe treatment options in BD.

Effect of the COVID-19 pandemic on the anxiety and depression levels in patients who applied to the cosmetology unit.

The relationship between the skin and the brain is based on their origin from the same ectodermal structure, as well as being affected by similar hormones and neurotransmitters. At this point, psychodermatology forms a common field of study based on the relationship and interaction between psychiatry and dermatology. Cosmetology is a special group within dermatology, and the psychosocial needs of this group differ. In this study, it was aimed to examine the moods such as anxiety, fear and depression experienced by the patients during their application to the cosmetology unit during the COVID-19 pandemic process and to compare them with the control group. A total of 162 cases, 80 cases from the cosmetology unit meeting the specified conditions and 82 cases as the control group, were retrospectively evaluated. In all participants, the Coronavirus Anxiety Scale (CAS) scores decreased significantly compared to the beginning of the pandemic (P = .001). In the study, while depression (HAM-D) and general anxiety (HAM-A) were higher in the cosmetology group compared to the control group (P = .049 and P = .001, respectively), there was no difference in coronavirus anxiety scores (CAS) (P = .24). It should be known that patients who underwent cosmetological procedures during the pandemic period may have anxiety and depression. In this patient group, which requires a special psychodermatological approach, pandemic effects should also be considered. In patients who apply to cosmetology units during the pandemic period, attention should be paid to the relationship between surreal cosmetological process requests and their anxiety and depression state.