Cortical thickness and surface area in patients with obsessive compulsive disorder and their unaffected siblings.

Little is known about the underlying neurobiological mechanisms in patients with obsessive-compulsive disorder (OCD). We aimed to examine cortical thickness and surface area in individuals with OCD and their unaffected siblings, comparing them to healthy controls. 30 patients with OCD, 21 unaffected siblings (SIB) and 30 controls underwent structural magnetic resonance imaging. Structural images were analyzed using the FreeSurfer software package (version 6.0). Compared to healthy controls, both OCD and SIB groups showed significantly lower cortical thickness in the right anterior insula. Surface areas of the superior frontal gyrus, paracentral gyrus and precuneus of the right hemisphere were also reduced in OCD patients compared to controls. There were no significant differences in cortical thickness and surface area between the OCD and SIB groups. We did not detect any significant differences in subcortical volumes between groups. Lower cortical thickness in the right anterior insula in both OCD patients and unaffected siblings may represent a potential structural endophenotype for OCD.

Fronto-striatal structures related with model-based control as an endophenotype for obsessive-compulsive disorder.

Recent theories suggest a shift from model-based goal-directed to model-free habitual decision-making in obsessive-compulsive disorder (OCD). However, it is yet unclear, whether this shift in the decision process is heritable. We investigated 32 patients with OCD, 27 unaffected siblings (SIBs) and 31 healthy controls (HCs) using the two-step task. We computed behavioral and reaction time analyses and fitted a computational model to assess the balance between model-based and model-free control. 80 subjects also underwent structural imaging. We observed a significant ordered effect for the shift towards model-free control in the direction OCD > SIB > HC in our computational parameter of interest. However less directed analyses revealed no shift towards model-free control in OCDs. Nonetheless, we found evidence for reduced model-based control in OCDs compared to HCs and SIBs via 2nd stage reaction time analyses. In this measure SIBs also showed higher levels of model-based control than HCs. Across all subjects these effects were associated with the surface area of the left medial/right dorsolateral prefrontal cortex. Moreover, correlations between bilateral putamen/right caudate volumes and these effects varied as a function of group: they were negative in SIBs and OCDs, but positive in HCs. Associations between fronto-striatal regions and model-based reaction time effects point to a potential endophenotype for OCD.

White matter microstructure and connectivity in patients with obsessive-compulsive disorder and their unaffected siblings.

OBJECTIVE: We aimed to examine white matter microstructure and connectivity in individuals with obsessive-compulsive disorder (OCD) and their unaffected siblings, relative to healthy controls. METHODS: Diffusion-weighted magnetic resonance imaging (dMRI) scans were acquired in 30 patients with OCD, 21 unaffected siblings, and 31 controls. We examined white matter microstructure using measures of fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD). Structural networks were examined using network-based statistic (NBS). RESULTS: Compared to controls, OCD patients showed significantly reduced FA and increased RD in clusters traversing the left forceps minor, inferior fronto-occipital fasciculus, anterior thalamic radiation, and cingulum. Furthermore, the OCD group displayed significantly weaker connectivity (quantified by the streamline count) compared to controls in the right hemisphere, most notably in edges connecting subcortical structures to temporo-occipital cortical regions. The sibling group showed intermediate streamline counts, FA and RD values between OCD and healthy control groups in connections found to be abnormal in patients with OCD. However, these reductions did not significantly differ compared to controls. CONCLUSION: Therefore, siblings of OCD patients display intermediate levels in dMRI measures of microstructure and connectivity, suggesting white matter abnormalities might be related to the familial predisposition for OCD.

Empathy, and its relationship with cognitive and emotional functions in alcohol dependency.

BACKGROUND: Empathy can be defined as the ability to understand the other's thoughts and feelings. It contains both cognitive and emotional components. AIMS: The aim of this study was to investigate the empathy ability of patients with alcohol dependency in association with cognitive and emotional functions, after acute detoxification and during long-term abstinence. METHODS: Thirty-three alcohol dependent inpatients that completed a detoxification process and stayed abstinent throughout the study, and 33 healthy comparison subjects that matched the patients for age, gender, and education level were included in the study. All the participants were administered the Facial Emotion Identification Test (FEIT), Facial Emotion Discrimination Test (FEDT), Trail Making Test (TMT), Digit Span Test (DST), Auditory Consonant Trigram Test (ACT), and Empathy Quotient Scale (EQS). All the tests were repeated after 3 months of abstinence. RESULTS: At the first evaluation conducted after detoxification, patients performed significantly worse than healthy comparisons in almost all tests. At the second evaluation, which was conducted after 3 months of abstinence, the patients improved significantly in all measures, and no significant differences were detected between the patient and comparison groups. There were significant correlations between the test scores and EQS score. CONCLUSIONS: Alcohol dependency has deleterious effects on empathy ability, and cognitive and emotional functions. Those impairments can improve with abstinence. Empathy ability has strong relationships with cognitive and emotional functions.

Frequency of body dysmorphic disorder among patients with complaints of hair loss.

BACKGROUND: Body dysmorphic disorder (BDD) is a psychiatric condition in which a disabling preoccupation with a non-existent or slight defect in appearance is the main symptom. Hair concerns are frequent in patients with BDD. OBJECTIVES: The purpose of this study was to determine the prevalence of BDD among patients with complaints of hair loss. METHODS: A validated BDD questionnaire (BDDQ) was administered to 150 patients with complaints of hair loss and 150 control subjects who were selected from among general dermatology (GD) patients. Standard statistical tests were performed (descriptive analysis, chi-squared tests, non-parametric tests). Differences that achieved a P-value of <0.05 were considered statistically significant. RESULTS: Among patients with complaints of hair loss, 42 of 142 subjects retained in the study (29.6%; 31 females and 11 males) were diagnosed with BDD. Furthermore, 25.6% of female patients and 52.4% of male patients were diagnosed with BDD (P = 0.013). Hair concerns were more common in males than in females (P < 0.05). In the GD group, four control subjects (2.7%, all female) were diagnosed with BDD; all of their concerns focused on the body and acne. CONCLUSIONS: The incidence of BDD is about 10 times higher in patients with complaints of hair loss than it is in GD patients and is higher in males. Awareness of the condition and the referral of selected patients to mental health professionals is crucial.

Juvenile localized scleroderma with port wine stain: coincidental or possible common pathogenetic association.

Port wine stain and juvenile localized scleroderma are two different dermatoses usually encountered in pediatric age group. Up to now, there are reports of morphea patients initially diagnosed and treated as port wine stain. Coexistence of both diseases is not found yet. We herein present a case of juvenile localized scleroderma on the left side of trunk, with congenital port wine stain located on the ipsilateral face at V1-V2 distribution.

Epidemiología de dermatosis pediátricas en la región centro-occidental de Anatolia en Turquía / Epidemiology of pediatric skin diseases in the mid-western anatolian region of Turkey

Antecedentes. El campo de la dermatología pediátrica ha ganado relevancia con el aumento de la cantidad de pacientes pediátricos y la discrepancia de las dermatosis respecto de las presentaciones en adultos. Nuestro objetivo fue describir la frecuencia y la distribución de las dermatosis pediátricas, los procedimientos de diagnóstico y los tratamientos indicados. Métodos. Estudio epidemiológico transversal. Se recolectaron datos acerca de los patrones diagnósticos, los métodos diagnósticos y las modalidades de tratamiento en las consultas ambulatorias de dermatología pediátrica a lo largo de 18 meses. Resultados. Los diagnósticos más prevalentes fueron las enfermedades infecciosas (27,9%), incluidas las verrugas virales (17,5%), seguidas de acné o enfermedades acneiformes (19,9%) y alergias (14,5%). Entre las pruebas diagnósticas, fue necesario realizar exámenes histopatológicos en el 5,2% de los casos, en general para diagnosticar lesiones inflamatorias y tumorales. En la mayoría de los casos, se emplearon tratamientos tópicos (49,3%), seguidos por tratamientos sistémicos (32,4%). Conclusiones. Las verrugas virales representaron las dermatosis más frecuentes, y es importante que la salud pública incorpore medidas preventivas contra la transmisión del VPH en los niños.

Background: The field of pediatric dermatology has gained importance with the increment of pediatric patients and the discrepancy of their skin diseases with the adult versions. We aimed to describe frequency and distribution of pediatric skin diseases, and the diagnostic procedures and treatments prescribed. Methods: Cross-sectional epidemiological study. We collected data about diagnostic patterns, diagnostic methods and treatment modalities in pediatric dermatology outpatient clinic visits over 18 months. Results: Infectious diseases (27.9%) and among them viral warts (17.5%) were the most prevalent diagnoses, followed by acne-acneiform diseases (19.9%) and allergic diseases (14.5%). Among the diagnostic tests histopathology was required in 5.2%, usually to diagnose inflammatory and tumoral lesions. Topical treatments (49.3%) were followed by systemic treatments (32.4%) in majority of cases. Conclusions: Viral warts were among the most common dermatoses, and preventive measures for HPV transmission should become important part of public health efforts in children.

Psoriasis y alopecia areata con traquioniquia concurrente en una paciente pediátrica con síndrome de Turner / Coexistence of psoriasis, and alopecia areata with trachyonychia in a pediatric patient with Turner Syndrome

El síndrome de Turner es un trastorno genético caracterizado por anomalías del cromosoma X. Se ha descrito en asociación con muchas enfermedades autoinmunitarias y con dermatosis como psoriasis, vitiligo y alopecia areata. La traquioniquia se caracteriza por el aspecto opaco irregular de la lámina ungueal de las 20 uñas. Puede manifestarse en forma idiopática o puede estar asociada con otras dermatosis. En este documento, presentamos el caso de una niña de seis años de edad con síndrome de Turner y diagnóstico de psoriasis, alopecia areata y traquioniquia, y quisiéramos remarcar una posible relación entre estas enfermedades.

Turner syndrome is a genetic disorder characterized by abnormalities of the X chromosome. An association with many autoimmune diseases is described as well as skin diseases such as psoriasis, vitiligo and alopecia areata. Trachyonychia is characterized by irregular opaque appearance on the nail plate of all 20 nails. It may be idiopathic or it can be associated with other dermatological diseases. Herein, we present a 6 years old girl with Turner syndrome who had diagnoses of psoriasis, alopecia areata and trachyonychia and we would like to draw attention to the possible relationship between these diseases.

Epidemiología de dermatosis pediátricas en la región centro-occidental de Anatolia en Turquía / Epidemiology of pediatric skin diseases in the mid-western anatolian region of Turkey

Antecedentes. El campo de la dermatología pediátrica ha ganado relevancia con el aumento de la cantidad de pacientes pediátricos y la discrepancia de las dermatosis respecto de las presentaciones en adultos. Nuestro objetivo fue describir la frecuencia y la distribución de las dermatosis pediátricas, los procedimientos de diagnóstico y los tratamientos indicados. Métodos. Estudio epidemiológico transversal. Se recolectaron datos acerca de los patrones diagnósticos, los métodos diagnósticos y las modalidades de tratamiento en las consultas ambulatorias de dermatología pediátrica a lo largo de 18 meses. Resultados. Los diagnósticos más prevalentes fueron las enfermedades infecciosas (27,9%), incluidas las verrugas virales (17,5%), seguidas de acné o enfermedades acneiformes (19,9%) y alergias (14,5%). Entre las pruebas diagnósticas, fue necesario realizar exámenes histopatológicos en el 5,2% de los casos, en general para diagnosticar lesiones inflamatorias y tumorales. En la mayoría de los casos, se emplearon tratamientos tópicos (49,3%), seguidos por tratamientos sistémicos (32,4%). Conclusiones. Las verrugas virales representaron las dermatosis más frecuentes, y es importante que la salud pública incorpore medidas preventivas contra la transmisión del VPH en los niños.(AU)

Background: The field of pediatric dermatology has gained importance with the increment of pediatric patients and the discrepancy of their skin diseases with the adult versions. We aimed to describe frequency and distribution of pediatric skin diseases, and the diagnostic procedures and treatments prescribed. Methods: Cross-sectional epidemiological study. We collected data about diagnostic patterns, diagnostic methods and treatment modalities in pediatric dermatology outpatient clinic visits over 18 months. Results: Infectious diseases (27.9%) and among them viral warts (17.5%) were the most prevalent diagnoses, followed by acne-acneiform diseases (19.9%) and allergic diseases (14.5%). Among the diagnostic tests histopathology was required in 5.2%, usually to diagnose inflammatory and tumoral lesions. Topical treatments (49.3%) were followed by systemic treatments (32.4%) in majority of cases. Conclusions: Viral warts were among the most common dermatoses, and preventive measures for HPV transmission should become important part of public health efforts in children.(AU)

Psoriasis y alopecia areata con traquioniquia concurrente en una paciente pediátrica con síndrome de Turner / Coexistence of psoriasis, and alopecia areata with trachyonychia in a pediatric patient with Turner Syndrome

El síndrome de Turner es un trastorno genético caracterizado por anomalías del cromosoma X. Se ha descrito en asociación con muchas enfermedades autoinmunitarias y con dermatosis como psoriasis, vitiligo y alopecia areata. La traquioniquia se caracteriza por el aspecto opaco irregular de la lámina ungueal de las 20 uñas. Puede manifestarse en forma idiopática o puede estar asociada con otras dermatosis. En este documento, presentamos el caso de una niña de seis años de edad con síndrome de Turner y diagnóstico de psoriasis, alopecia areata y traquioniquia, y quisiéramos remarcar una posible relación entre estas enfermedades.(AU)

Turner syndrome is a genetic disorder characterized by abnormalities of the X chromosome. An association with many autoimmune diseases is described as well as skin diseases such as psoriasis, vitiligo and alopecia areata. Trachyonychia is characterized by irregular opaque appearance on the nail plate of all 20 nails. It may be idiopathic or it can be associated with other dermatological diseases. Herein, we present a 6 years old girl with Turner syndrome who had diagnoses of psoriasis, alopecia areata and trachyonychia and we would like to draw attention to the possible relationship between these diseases.(AU)

Epidemiology of pediatric skin diseases in the mid-western Anatolian region of Turkey.

BACKGROUND: The field of pediatric dermatology has gained importance with the increment of pediatric patients and the discrepancy of their skin diseases with the adult versions. We aimed to describe frequency and distribution of pediatric skin diseases, and the diagnostic procedures and treatments prescribed. METHODS: Cross-sectional epidemiological study. We collected data about diagnostic patterns, diagnostic methods and treatment modalities in pediatric dermatology outpatient clinic visits over 18 months. RESULTS: Infectious diseases (27.9%) and among them viral warts (17.5%) were the most prevalent diagnoses, followed by acne-acneiform diseases (19.9%) and allergic diseases (14.5%). Among the diagnostic tests histopathology was required in 5.2%, usually to diagnose inflammatory and tumoral lesions. Topical treatments (49.3%) were followed by systemic treatments (32.4%) in majority of cases. CONCLUSIONS: Viral warts were among the most common dermatoses, and preventive measures for HPV transmission should become important part of public health efforts in children.

Coexistence of psoriasis, and alopecia areata with trachyonychia in a pediatric patient with Turner Syndrome.

Turner syndrome is a genetic disorder characterized by abnormalities of the X chromosome. An association with many autoimmune diseases is described as well as skin diseases such as psoriasis, vitiligo and alopecia areata. Trachyonychia is characterized by irregular opaque appearance on the nail plate of all 20 nails. It may be idiopathic or it can be associated with other dermatological diseases. Herein, we present a 6 years old girl with Turner syndrome who had diagnoses of psoriasis, alopecia areata and trachyonychia and we would like to draw attention to the possible relationship between these diseases.

Abnormal white matter integrity in long-term abstinent alcohol dependent patients.

A number of diffusion tensor imaging (DTI) studies have reported substantial white matter (WM) abnormalities in alcohol-dependent patients. These studies were usually performed in recovering alcohol-dependent patients who had been abstinent for days to several weeks. The current study was designed to examine WM microstructure and decision-making in a sample of long-term abstinent alcohol-dependent patients. The study included 12 subjects with alcohol dependence who had been abstinent for at least 6 months before testing and scanning and 13 healthy control subjects. The Iowa Gambling Task (IGT) was used to measure decision-making. We found that the long-term abstinent alcohol-dependent group had significantly higher radial and axial diffusivity (RD and AD, respectively) values in frontal, temporal and parietal WM than was found in the healthy control group despite showing no difference in fractional anisotropy (FA) values in comparison to controls. In conclusion, we found widespread WM changes in long-term abstinent alcohol-dependent patients compared with healthy controls. Our findings suggested that AD and RD should be included in analyses of DTI data in addition to the more commonly studied FA. In the current study, FA values of the detoxified alcoholics had recovered and were comparable to those of the controls, whereas significant changes in AD and RD were still observed in some clusters in the frontal, parietal and temporal lobes of detoxified alcoholics even after 27.8 months.

Treatment of primary hyperhidrosis with tap water iontophoresis in paediatric patients: a retrospective analysis.

OBJECTIVES: Primary hyperhidrosis is an under-recognized condition in children and adolescents. Iontophoresis is the second line of treatment for palmoplantar hyperhidrosis following topical treatment. The studies evaluating the efficacy of iontophoresis in children are limited. We aimed to investigate the efficacy and reliability of tap water iontophoresis in children with primary hyperhidrosis. METHODS: Twenty-one patients aged under 18 years, who received iontophoresis for primary palmoplantar hyperhidrosis, were included in the study. In our clinic, tap water iontophoresis was administered at regular intervals, starting with five times per week and decreased to once a week on fifth week. Then maintenance sessions once a week for 6 weeks are recommended. The presence of excessive sweating was scored by visual analogue scale (VAS): "0" as continuation of excessive sweating and "10" as the absence of excessive sweating. The demographic and clinical data were collected from files. Also, patients fulfilled a questionnaire for efficacy on follow-up visit. RESULTS: Nineteen patients completed the whole 21 sessions. The mean VAS score was 5.89 ± 1.49 at the end of the 15th session and 6.36 ± 2.06 at the end of the treatment. Side effects were well tolerated. Only seven patients were still free of excessive sweating on third months after treatment. The mean satisfaction score was 4.95 ± 2.38, as measured by VAS where 0 indicated dissatisfaction and 10 indicated high satisfaction. CONCLUSION: Tap water iontophoresis is an effective method of treatment for primary palmoplantar and axillary hyperhidrosis in paediatric patients. But there are still unanswered questions about the mechanism of action, ideal session intervals and protocols for maximum efficacy.

Epidemiology of pediatric skin diseases in the mid-western Anatolian region of Turkey. / Epidemiology of pediatric skin diseases in the mid-western Anatolian region of Turkey.

BACKGROUND: The field of pediatric dermatology has gained importance with the increment of pediatric patients and the discrepancy of their skin diseases with the adult versions. We aimed to describe frequency and distribution of pediatric skin diseases, and the diagnostic procedures and treatments prescribed. METHODS: Cross-sectional epidemiological study. We collected data about diagnostic patterns, diagnostic methods and treatment modalities in pediatric dermatology outpatient clinic visits over 18 months. RESULTS: Infectious diseases (27.9

) and among them viral warts (17.5

) were the most prevalent diagnoses, followed by acne-acneiform diseases (19.9

) and allergic diseases (14.5

). Among the diagnostic tests histopathology was required in 5.2

, usually to diagnose inflammatory and tumoral lesions. Topical treatments (49.3

) were followed by systemic treatments (32.4

) in majority of cases. CONCLUSIONS: Viral warts were among the most common dermatoses, and preventive measures for HPV transmission should become important part of public health efforts in children.

Coexistence of psoriasis, and alopecia areata with trachyonychia in a pediatric patient with Turner Syndrome. / Coexistence of psoriasis, and alopecia areata with trachyonychia in a pediatric patient with Turner Syndrome.

Turner syndrome is a genetic disorder characterized by abnormalities of the X chromosome. An association with many autoimmune diseases is described as well as skin diseases such as psoriasis, vitiligo and alopecia areata. Trachyonychia is characterized by irregular opaque appearance on the nail plate of all 20 nails. It may be idiopathic or it can be associated with other dermatological diseases. Herein, we present a 6 years old girl with Turner syndrome who had diagnoses of psoriasis, alopecia areata and trachyonychia and we would like to draw attention to the possible relationship between these diseases.