Effects of oral isotretinoin treatment for acne vulgaris patients on anger responses and the relationship with temperament

SUMMARY OBJECTIVE: Isotretinoin is the only medication against all the factors involved in acne vulgaris pathogenesis. The aim of our study was to verify whether patients with acne vulgaris receiving isotretinoin therapy exhibit elevated anger levels and to observe the correlation between age, temperament traits, and anger. METHODS: The study group comprised a sum of 100 cases, involving 50 individuals with acne vulgaris-required high-dose retinol therapy and 50 controls who did not start any medication. RESULTS: Our study showed that anger levels increased with drug use. A positive correlation between cyclothymic temperament, the anxiety-related behavior subdimension, and the introvert and passive-aggressive subdimension of interpersonal anger reactions has been recognized. In addition, a positive one was observed between hyperthymic temperament and the introvert subdimension, which is one of the anger-related thoughts and interpersonal anger reactions. CONCLUSION: This study elucidates anger dimensions such as anger-related thoughts, behaviors, and reactions in individuals who received retinol treatment for acne vulgaris. In addition to anger and its dimensions, temperament was also investigated. Although several studies have investigated the relationship between acne vulgaris and psychiatric symptoms, to the best of our knowledge, no research has been reported in the English-language literature regarding the relationship between anger dimensions and temperament after retinol treatment that might make our study an original and valuable contribution to the literature.

Effects of oral isotretinoin treatment for acne vulgaris patients on anger responses and the relationship with temperament.

OBJECTIVE: Isotretinoin is the only medication against all the factors involved in acne vulgaris pathogenesis. The aim of our study was to verify whether patients with acne vulgaris receiving isotretinoin therapy exhibit elevated anger levels and to observe the correlation between age, temperament traits, and anger. METHODS: The study group comprised a sum of 100 cases, involving 50 individuals with acne vulgaris-required high-dose retinol therapy and 50 controls who did not start any medication. RESULTS: Our study showed that anger levels increased with drug use. A positive correlation between cyclothymic temperament, the anxiety-related behavior subdimension, and the introvert and passive-aggressive subdimension of interpersonal anger reactions has been recognized. In addition, a positive one was observed between hyperthymic temperament and the introvert subdimension, which is one of the anger-related thoughts and interpersonal anger reactions. CONCLUSION: This study elucidates anger dimensions such as anger-related thoughts, behaviors, and reactions in individuals who received retinol treatment for acne vulgaris. In addition to anger and its dimensions, temperament was also investigated. Although several studies have investigated the relationship between acne vulgaris and psychiatric symptoms, to the best of our knowledge, no research has been reported in the English-language literature regarding the relationship between anger dimensions and temperament after retinol treatment that might make our study an original and valuable contribution to the literature.

The acromegaly treatment satisfaction questionnaire (Acro-TSQ): turkish adaptation, validity, and reliability study.

PURPOSE: The patient-reported outcome becomes important to evaluate the situation perceived by the patients and to develop new strategies. This study aims to adapt the Acromegaly Treatment Satisfaction Questionnaire (Acro-TSQ), which was specially developed for patients with acromegaly, into Turkish by conducting a validity and reliability study. METHODS: After the translation and back-translation process, Acro-TSQ was filled in by face-to-face interviews with 136 patients diagnosed with acromegaly and currently receiving somatostatin analogue injection therapy. Internal consistency, content validity, construct validity, and reliability of the scale were determined. RESULTS: Acro-TSQ had a six-factor structure and explained 77.2% of the total variance in the variable. The Cronbach alpha value calculated for internal reliability showed high internal consistency (Cronbach's alpha = 0.870). Factor loads of all items were found to be between 0.567 and 0.958. As a result of EFA analysis, one item fell into a different factor in the Turkish version of the Acro-TSQ, different from its original form. CFA analysis shows that acceptable fit values are obtained for fit indices. CONCLUSION: The Acro-TSQ, a patient-reported outcome tool, shows good internal consistency, and good reliability, suggesting it is an appropriate assessment tool for patients with acromegaly in the Turkish population.

Changes in Intimacy and Sexuality During the COVID-19 Pandemic: A Qualitative Analysis of Data from a Survey on Partnered Individuals in Eight European Countries.

This qualitative study explores experiences of intimacy and sexuality during the first phase of the COVID-19 pandemic of 3357 participants from Croatia, the Czech Republic, the Netherlands, France, Germany, Portugal, Sweden, and Turkey. Data were collected through open-ended questions within a survey on sexuality during the pandemic. Based on a reflexive thematic analysis three themes occurred. The first theme No change was described by 41% when summarizing their sex life during the pandemic. The second theme Positive change was experienced by 25%, and the third theme Negative change by 21%. An overarching theme then emerged as: "Still the same trajectories, but the pandemic could be a catalyst for improved or worsened sex- life." For those intimate partnered individuals who already had problems with intimacy and sexuality before the COVID-19 pandemic it seemed to remain the same or deteriorated throughout the pandemic. For those with positive experiences of intimacy and sexuality before the COVID-19 pandemic it remained the same or improved throughout the pandemic. These findings are relevant for researchers and clinicians in developing preventive and supportive interventions in the context of crisis and social isolation.

Perceived Changes in Sexual Interest and Distress About Discrepant Sexual Interest During the First Phase of COVID-19 Pandemic: A Multi-Country Assessment in Cohabiting Partnered Individuals.

Due to COVID-19 pandemic, different restrictive measures in terms of physical distancing and lockdowns have been introduced in most European countries, affecting all facets of social life. Currently, little is known about how partnered individuals perceive changes in their sexual life during this complex emergency. This study explored retrospectively assessed changes in sexual interest for one's partner and levels of distress related to perceived sexual interest discrepancy during the first phase of the pandemic in a large-scale online sample of partnered individuals (n = 4813; Mage = 38.5 years, SD = 10.74) recruited between May and July 2020 in seven European Union countries and Turkey. We also examined the possible role of approach/avoidance motives for sex in reported changes in sexual interest and associated distress. Most participants (53%) reported no change in their sexual interest during the pandemic, followed by those who reported an increase (28.5%). The pattern was similar across the eight countries. Distress about discrepant sexual interest, which was only weakly related to changes in sexual interest, was significantly associated with relationship quality and emotional closeness with a partner, coping with and worrying about the pandemic, and specific motivation for sex. In contrast to avoidant and relationship-focused approach motivation, ego-focused approach motivation was related to stable sexual interest during the pandemic. The current study contributes to the understanding of the link between sexual interest and complex emergencies. Considering that the COVID-19 pandemic continues, the reported experiences and perceptions are prone to change.

Efficacy of the combination of Q-switched Nd:YAG laser and microneedling for melasma.

BACKGROUND: Melasma is a common, multifactorial, and recurring disease which is not easy to treat. AIMS: The purpose of this study is to evaluate the efficacy of microneedling in combination with Q-switched neodymium-doped yttrium aluminum garnet laser (QsNd-YAG laser) for treatment of melasma. PATIENTS/METHODS: Fifteen female patients with epidermal or mixed-type melasma on the face were included in the study. Patients were first treated with QsNd-YAG laser, and then with microneedling containing mesotherapy products of biomimetic peptides, at the same session. Modified Melasma Area Severity Index (mMASI) scores were calculated before the first session and again 2 weeks after the last session. The same treatment protocol was repeated every 2 weeks for five sessions within period of 3 months of therapy. The evaluation was performed according to the before and after photographs taken from three angles including 90-degree front and 45 degrees from left and right with the VISIA device. RESULTS: Of the 15 patients included in the study, the mean mMASI scores before and after treatment were 9.2 ± 5.7 (3.8-23.1) and 3.6 ± 4.0 (0.6-16.8), respectively. mMASI scores were significantly reduced after completion of the protocol. Six (40%) patients had "very good response," 4 (26.7%) patients had "good response," and 5 (33.3%) patients were "unresponsive." Six (40%) patients were followed up for 1 year, and only 1 patient had a recurrence (6.7%). CONCLUSIONS: In addition to the use of photoprotective measures, multimodality treatment including QsNd-YAG laser and microneedling with mesotherapy products containing biomimetic peptides is effective to treat melasma and they work synergistically.

ACUTE FROSTED RETINAL PERIPHLEBITIS IN A PATIENT WITH MEDITERRANEAN FEVER.

PURPOSE: To present a case of frosted branch periphlebitis in a young Armenian patient with familial Mediterranean fever. METHODS: Case report. RESULTS: A 37-year-old man presented with a unilateral decreased visual acuity and floaters for 4 days on the left eye (LE). Visual acuity was 20/20 in the right eye (RE) and 20/28 in the LE. Anterior segment and fundus examinations of the RE were normal. Slit-lamp examination of LE revealed a mild nongranulomatous anterior uveitis and vitritis. Intraocular pressure was 19 mmHg in the RE and 12 mmHg in the LE. Fundoscopy of the LE showed typical appearance of frosted branch periphlebitis with perivascular sheathing of the retinal veins and scattered retinal hemorrhages. Fluorescein angiography of the RE was normal. The LE showed optic disk and segmented vascular staining without macular leakage. Optical coherence tomography of the RE was normal; LE demonstrated a localized macular thickening and few intraretinal cysts. The detailed ophthalmologic history was negative. The general history and workup were significant for familial Mediterranean fever and a positive lupus anticoagulant. One week later, the fundus findings worsened with a severe decrease of visual acuity of the LE to 20/200. A single intravitreal (IVT) injection of bevacizumab was performed. Three weeks after injection, fundus findings progressively improved with a decrease of the macular thickening and an improvement of the visual acuity to 20/25. Clinical improvement continued up to the last visit (19 weeks after the injection) with a visual acuity that reached back 20/20 with no signs of active inflammation. CONCLUSION: This case demonstrates a possible association between unilateral frosted branch periphlebitis and familial Mediterranean fever.

Evaluation of a Handheld Dermatoscope in Clinical Diagnosis of Primary Cicatricial Alopecias.

INTRODUCTION: Clinical diagnosis of primary cicatricial alopecias presents difficulties. Studies regarding their trichoscopic features are scarce and mostly not comprehensive. The aim of this study is to evaluate the potential benefit of a handheld dermatoscope in clinical diagnosis of primary cicatricial alopecias. METHODS: In all, 69 patients with primary cicatricial alopecias were included in this prospective study. Preliminary diagnoses were established clinically, and confirmed by scalp biopsy in all cases. Trichoscopic examination was performed using a polarized-light handheld dermatoscope with tenfold magnification. The images were taken using a digital camera with threefold optical zoom. RESULTS: The following findings were significantly more common, or noted only, in particular types of primary cicatricial alopecias: "target" pattern blue-grey dots, perifollicular scaling, perifollicular cast in lichen planopilaris (n = 27); short vellus hairs, tufted hairs, crust formation, yellowish tubular scaling, pustule, red dots in folliculitis decalvans (n = 17); large keratotic yellow dots in discoid lupus erythematosus (n = 7); yellow dots, yellow dots with "three-dimensional" structure, black dots in dissecting cellulitis of the scalp (n = 6). Absence of vellus hairs was observed in patients with lichen planopilaris, frontal fibrosing alopecia, and discoid lupus erythematosus without a significant difference between the groups. Short vellus hairs were detected in all types, including frontal fibrosing alopecia (n = 7). CONCLUSION: We suggest that a polarized-light handheld dermatoscope is useful for revealing several typical trichoscopic features of primary cicatricial alopecias that guide clinical diagnosis. As a novel observation, our data indicate that absence of vellus hairs is not an identifying feature for frontal fibrosing alopecia.

Definition of videodermoscopic features of demodicosis.

BACKGROUND: Diagnosis of demodicosis is usually confirmed by standardized skin surface biopsy. The skin of the patients with demodicosis is usually very sensitive. There is a need for new noninvasive tests. Videodermoscopic findings of demodicosis have not been validated yet. Our aim was to provide a noninvasive and easy method for diagnosis of demodicosis by using videodermoscopy. MATERIALS AND METHODS: This study included 26 patients with demodicosis which were confirmed with microscopy and responded well to anti-Demodex therapy Twenty-six age- and sex-matched individuals without demodicosis constituted the control group. Dermatologic evaluation included clinical observation along with microscopy. All photographs of the clinical and dermoscopic findings were taken with videodermoscope. RESULTS: Demodex tails representing "Demodex mites" were a common feature in all patients. Gray dots were described as the second major videodermoscopic finding. Epidermal scale and red dots were also observed with higher prevalence than the other videodermoscopic features. We defined a new finding as follicular annular pigmentation corresponding to the facial pigmentation with demodicosis by videodermoscopy. CONCLUSIONS: We concluded that it seems possible to confirm the clinical diagnosis of demodicosis by videodermoscopy, with similar results to handheld dermoscopy. Demodex tails should be considered as a sign of demodicosis, whereas detection of gray dots, epidermal scale, and red dots may raise the suspicion of demodicosis.

Clinical evaluation of alopecias using a handheld dermatoscope.

BACKGROUND: There are numerous reports of the value of videodermatoscopy in the clinical evaluation of alopecia. Studies performed with a handheld dermatoscope are scarce and limited to a few disease entities. OBJECTIVE: The aim of this study was to evaluate the potential benefit of a handheld dermatoscope in the clinical diagnosis of alopecia. METHODS: In all, 144 patients with alopecia and 144 age- and sex-matched control subjects were enrolled in the study. Diagnoses were established clinically, and confirmed by scalp biopsy in doubtful cases. Dermatoscopic examination was performed by a polarized-light handheld dermatoscope with a 10-fold magnification. The images were obtained by a digital camera with a 3-fold optical zoom. RESULTS: The dermatoscopic patterns of circular hairs, dirty dots, epidermal scale, and pustules showed no statistically significant difference between patients and control subjects. The following features were significantly more common, or observed solely, in particular types of alopecia: hair diameter diversity, peripilar sign, and empty follicles in androgenetic alopecia; yellow dots, black dots, tapering hairs, and broken hairs in alopecia areata; absence of follicular openings, tufted hairs, white dots, follicular hyperkeratosis, pili torti, red dots, honeycomb pigment pattern, pink-white appearance, crusts, and pustules in primary cicatricial alopecias. LIMITATIONS: Evaluation of all primary cicatricial alopecias in the same cluster. CONCLUSIONS: We suggest that a polarized-light handheld dermatoscope attached to a digital camera provides a practical and useful aid for the clinical diagnosis of alopecias.

A moderate response to plasmapheresis in nephrogenic systemic fibrosis.

Nephrogenic systemic fibrosis (NSF) is a recently identified idiopathic cutaneous fibrosing disorder that occurs in the setting of renal failure. The disease initially called nephrogenic fibrosing dermopathy is closely linked to exposure to gadolinium-based contrast media used during magnetic resonance imaging in patients with renal insufficiency. Although little is known about the pathogenesis of this disease, the increased expression of transforming growth factor-beta has been demonstrated recently. Herein, we present a case of NSF was partially treated due to a moderate and temporary response to plasmapheresis with no recurrence for 6 months, but returned at the end of 6(th) month.

New treatment options for atypical hemolytic uremic syndrome with the complement inhibitor eculizumab.

Hemolytic uremic syndrome (HUS) is a disease characterized by microangiopathic hemolytic anemia, consumptive thrombocytopenia, and renal impairment. Often HUS is triggered by Shiga-like toxin- producing ESCHERICHIA COLI. Less common is atypical HUS (aHUS), which is caused by defective complement control. aHUS is associated with mutations in genes encoding complement regulatory proteins in ~50% of patients with this syndrome. Furthermore, autoantibodies that inactivate to factor H have also been linked to the disease. Initial triggers include infections, use of endothelial-affecting drugs, malignancies, transplantation, and pregnancy. Advances in our understanding of the pathogenesis of atypical HUS suggest that complement inhibition may be used as treatment for the disease. We discuss the potential benefit of the complement inhibitor eculizumab for the treatment of aHUS.

Beneficial effects of docosahexaenoic acid on active avoidance performance in 1K-1C hypertensive rats.

The present study evaluated the role of chronic docosahexaenoic acid (DHA) supplementation on active avoidance learning task performance in experimental hypertension. Male Wistar rats were randomly divided into five experimental groups as follows: control, sham, DHA treated, 1K-1C hypertensive, and 1K-1C hypertensive+DHA treated. Hypertension was induced in 1K-1C rats via placing a silver clip (0.20-mm ID) around the left renal artery following a right uninephrectomy. DHA (36 mg/kg/day) was given to the treatment groups for 60 days by gastric gavage. Arterial blood pressure was measured by using the tail-cuff method. Active avoidance responses were determined by an automated shuttle-box. In brain (cerebrum) and hippocampus tissues, thiobarbituric acid reactive substances (TBARS) and nitrite levels were measured by fluorometric methods. DHA supplementation decreased blood pressure in hypertensive rats. Data from active avoidance training indicated that performance of active avoidance learning tasks were significantly impaired in 1K-1C hypertensive rats, but was completely restored by DHA supplementation. Increased cerebrum TBARS levels in 1K-1C rats were abolished by DHA administration. Cerebrum nitrite levels were lower in the DHA, 1K-1C and 1K-1C+DHA treated groups compared to controls. Hippocampus nitrite levels were lower in DHA treated and 1K-1C hypertensive rats compared to controls and higher in 1K-1C+DHA treated rats compared to the 1K-1C group. Our data indicates that DHA supplementation improves the performance of active avoidance learning tasks which is impaired in experimental hypertension. These affirmative changes might be due to a DHA-induced decrease in lipid peroxidation which may in turn limit the consumption of nitric oxide (NO) which promotes active avoidance learning.