Assessment of ischaemia-modified albumin level in patients with psoriasis.

BACKGROUND: Ischaemia-modified albumin (IMA) is increased in diseases associated with oxidative stress, as detected using the albumin cobalt-binding test. Oxidative stress plays an important role in the development of psoriasis. AIM: To investigate circulating IMA levels in patients with psoriasis and its association with the disease characteristics. METHODS: Serum IMA and albumin concentrations were evaluated in 26 patients with psoriasis and 26 healthy controls matched for age, gender and body mass index. Levels of albumin, IMA and adjusted IMA were compared between the groups. RESULTS: IMA and adjusted IMA were significantly higher in patients with psoriasis [0.55 ± 0.04 and 0.54 ± 0.05 absorbance units (ABSU), respectively] than in healthy controls (0.38 ± 0.04 and 0.38 ± 0.05 ABSU, respectively). The two groups had similar albumin levels, but there was a negative correlation between IMA and albumin levels in patients with psoriasis. IMA did not correlate with any disease characteristics. CONCLUSIONS: IMA levels are higher in patients with psoriasis than in healthy controls. IMA might be produced through an adaptive response to chronic hypoxia and oxidative stress, which might play a role in the systemic inflammation seen in psoriasis.

Evaluation of the efficacy of methotrexate and cyclosporine therapies on psoriatic nails: a one-blind, randomized study.

BACKGROUND: Treatment of psoriatic nail is difficult. OBJECTIVE: The aim of this study was to evaluate and compare the efficacy and safety of methotrexate and cyclosporine in psoriatic nail. METHODS: Thirty-seven psoriatic patients with nail involvement were randomized to treatment with methotrexate (initial dose, 15 mg per week) or cyclosporine (initial dose, 5 mg per kg of bodyweight per day) for 24 weeks. The primary outcome was the Nail Psoriasis Severity Index (NAPSI). The Psoriasis Area and Severity Index (PASI), doctor and patient global score were also measured. The scores were determined by a blinded observer. RESULTS: Seventeen patients completed the study in each group. The mean percentages of reduction of the NAPSI score after methotrexate and cyclosporine treatments were 43.3% and 37.2%, respectively. No significant differences between the treatment groups was found for in the NAPSI, PASI, physician's and patient's global score at the end of the study period. The methotrexate group showed a significant improvement in nail matrix scores and the cyclosporine group in nail bed score. CONCLUSION: Moderate effectiveness on psoriatic nail was found in the two treatment agents and there were no significant differences in efficacy between the groups. A significant improvement was detected in methotrexate group for the nail matrix findings, and in cyclosporine group for the nail bed findings.

The levels of depression, anxiety and quality of life in patients with chronic idiopathic urticaria.

BACKGROUND: Chronic idiopathic urticaria (CIU) is associated with severely impaired quality of life (QoL). OBJECTIVE: To determine the levels of depression, anxiety and QoL in CIU patients. PATIENTS AND METHODS: This study included 73 patients with CIU, and 34 healthy subjects matched for age and sex were used as controls. The levels of depression, anxiety and QoL were assessed with the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI) and the World Health Organization Quality of Life Assessment-Brief (WHOQOL-BREF), respectively. The reliability and validity of the Turkish versions of these instruments have been examined. RESULTS: When compared with healthy controls, patients with CIU had significantly higher BDI and BAI scores and significantly lower physical health and psychological health subscale scores of the WHOQOL-BREF. BDI, BAI and all domains of WHOQOL-BREF were unrelated to age, duration of illness, urticaria activity score (UAS) and visual analogue score (VAS). There was a negative significant correlation between all domains of WHOQOL-BREF and BDI and BAI. CONCLUSION: Our data confirm that QoL is markedly reduced in CIU patients. Physical health and psychological health were found to be the areas QoL most affected in CIU patients. And also we have found that CIU patients frequently suffer from depression and anxiety. The severity of these parameters was found to be positively correlated with the extent of QoL decrease.

En coup de sabre accompanied by pachydermoperiostosis: a case report.

Scleroderma en coup de sabre, a variant of localized scleroderma is a disorder characterized by fibrosis of connective tissue. We report a 21-year-old female with scleroderma en coup de sabre accompanied by pachydermoperiostosis. She was born to consanguineous parents and her older sister also had pachydermoperiostosis characterized by clubbing of the digits, enlargement of distal parts of the extremities. The two disorders were diagnosed by clinical examination, histological and x-ray findings. In contrast to scleroderma, pachydermoperiostosis is a hypertrophic process characterized by periosteal proliferation of the tubuler bones and hypertrophic skin changes. We discuss this interesting coexistence and review the literature.

Pathergy reaction in different body areas in Behçet's disease.

Behçet's disease (BD) is a chronic inflammatory multisystemic disorder characterized mainly by vasculitis. Although the pathergy reaction (PR) has been accepted as one of the major criteria in this disease, there is a lack of a standardized method to measure PR. The aim of this study was to evaluate results of PR in different body areas and the effect on the positive rate of PR of application of numerous needle pricks. The pathergy test was performed using simultaneous 16 needle pricks with 20G disposable needles on different body areas of 56 patients with BD, 49 patients with recurrent aphthous stomatitis (RAS) and 17 healthy subjects. No positive PR was found in healthy controls, but was observed in nine patients with RAS (18.3%). It was detected in 48 of 56 patients with BD, a positive rate of 85.7%. The site most frequently positive for PR was the forearm, while the least frequent was the abdomen. Multiple needle pricks could play an important role in increasing the positive rate of PR in BD, and it may be important in the investigation of aetiological factors in RAS.

Evaluation of the association between null genotypes of glutathione-S-transferases and Behcet's disease.

Glutathione S-transferases (GST) play an important role in oxidative stress related syndromes. An imbalance of the oxidant and antioxidant systems is important in the pathogenesis of Behcet's disease (BD). The objective of this study was to evaluate the association of null genotypes of GST-M1 and GST-T1 with BD since some preliminary molecular genetic data were recently published. Ninety-four Turkish BD patients (42 male, 52 female, 37.1+/-10.4 years) and 140 healthy volunteers (70 male, 70 female, 36.8+/-11.7 years) matched for age and gender with the patients as the control group were included in the study. Distributions of GST-M1 and GST-T1 genotypes were determined by multiplexed PCR using three sets of primers for GST-M1, GST-T1, and beta-globulin genes. There was no association between BD and the frequencies of GST-M1 and GST-T1 null genotypes when compared to controls by separate analysis. However, by cross and pooled combination analysis there was a significant association between the frequencies of pooled GSTs with one or both null genotypes in BD and controls. This is the first evidence that the association between the frequencies of GST-M1 and GST-T1 null genotypes and BD might be dependent on the interaction of multiple null allele polymorphisms rather than a single null allele of GST-M1 and GST-T1.