Optimization and reactor-scale production of plant growth regulators by Pleurotus eryngii.

The aims of the this study are to select the best cultivation type for plant growth regulator (PGR) production, to optimize PGR production with statistical experimental design, and to calculate bioprocess parameters and yield factors during PGR production by P. eryngii in flask and reactor scales. Submerged fermentation was the best cultivation type with 4438.67 ± 37.14, 436.95 ± 27.31, and 54.32 ± 3.21 mg/L of GA3, ABA, and IAA production values, respectively. The Plackett-Burman and Box-Behnken designs were used to determine effective culture parameters and interactive effects of the selected culture parameters on PGR production by Pleurotus eryngii under submerged fermentation. The statistical model is valid for predicting PGR production by P. eryngii. After these studies, maximum PGR production (7926.17 ± 334.09, 634.92 ± 12.15, and 55.41 ± 4.38 mg/L for GA3, ABA, and IAA, respectively) was reached on the 18th day of fermentation under optimized conditions. The optimum formula was 50 g/L fructose, 3 g/L NaNO3, and 1.5 g/L KH2PO4, 1 mg/L thiamine, incubation temperature 25 °C, initial medium pH 7.0, and an agitation speed of 150 rpm. The kinetics of PGR production was investigated in batch cultivation under 3-L stirred tank reactor conditions. Concentrations of GA3, ABA, and IAA of 10,545.00 ± 527.25, 872.32 ± 21.81, and 60.48 ± 3.48 mg/L were obtained at the reactor scale which were 4.1, 3.4, and 2.3 times higher than the initial screening values. The specific growth rate (µ), the volumetric (rp) and specific (Qp) PGR production rates, 486.11 mg/L/day and 107.43 mg/g biomass/day for GA3, confirmed the successful transfer of optimized conditions to the reactor scale. In the presented study, PGR production of P. eryngii is reported for the first time.

Flask and reactor scale production of plant growth regulators by Inonotus hispidus: optimization, immobilization and kinetic parameters.

The aims of the presented study are to compare submerged, static, and solid-state fermentation in the production of gibberellic acid (GA3), indole acetic acid (IAA), and abscisic acid (ABA) by Inonotus hispidus, to optimize with a statistical approach, and to determine the kinetic parameters under flask and reactor conditions. The maximum concentrations of GA3, (2478.85 ± 68.53 mg/L), ABA, (273.26 ± 6.17 mg/L) and IAA (30.67 ± 0.19 mg/L) were obtained in submerged conditions. After optimization, these values reached 2998.85 ± 28.85, 339.47 ± 5.50, and 34.56 ± 0.25 mg/L, respectively. Immobilization of fungal cells on synthetic fiber, polyurethane foam, and alginate beads resulted in an increase in plant growth regulators (PGR) production by 5.53%- 5.79% under optimized conditions. At the reactor scale, a significant increase was observed for GA3 concentration, 5441.54 mg/L, which was 2.14 and 1.45 times higher than non-optimized and optimized conditions in the flask scale, respectively. The maximum values for ABA and IAA were 390.39 and 44.79 mg/L, respectively. Although the specific growth rate (µ) decreases relatively from non-optimized flask conditions to optimized reactor conditions, it was observed that the PGR amounts produced per liter medium (rp) and per gram biomass (Qp) increased significantly. This is the first report on the synthesis of PGR by Inonotus hispidus which could be crucial for sustainable agriculture.

Evaluation of the efficacy, safety, and side effects of secukinumab in patients with moderate-to-severe psoriasis: real-world data from a retrospective multicenter study

Abstract Background: Clinical studies have demonstrated that IL-17A inhibition with secukinumab is effective for clearing the skin of patients with psoriasis and has a favorable safety profile. Objective: The authors aim to determine whether secukinumab is effective and safe for the treatment of moderate-to-severe chronic psoriasis based on clinical experience with this drug. Method: The authors conducted a multicenter retrospective study in nine referral centers and included patients with psoriasis who had received secukinumab between March 2018 to November 2020. Data on demographic characteristics, Psoriasis Area and Severity Index (PASI) scores, and previous treatments were collected from medical records. Patients were evaluated at 12, 24, and 52 weeks with respect to response to treatment and side effects. Results: In total, 229 patients were recruited for the study. A PASI score improvement of ≥90 points over the baseline was achieved by 79%, 69.8%, and 49.3% of patients at weeks 12, 24, and 52, respectively. The most common adverse events wereCandida infections and fatigue. In total, 74 (32%) patients discontinued treatment by week 52, including due to adverse events, or secondary ineffectiveness. Study limitations: Retrospective design. Conclusions: These findings suggest that secukinumab therapy is reasonably effective in patients with moderate-to-severe psoriasis. Comorbidities and time length of the disease can affect the response to treatment. The rates of adverse events were high in this patient population.

Evaluation of the efficacy, safety, and side effects of secukinumab in patients with moderate-to-severe psoriasis: real-world data from a retrospective multicenter study.

BACKGROUND: Clinical studies have demonstrated that IL-17A inhibition with secukinumab is effective for clearing the skin of patients with psoriasis and has a favorable safety profile. OBJECTIVE: The authors aim to determine whether secukinumab is effective and safe for the treatment of moderate-to-severe chronic psoriasis based on clinical experience with this drug. METHOD: The authors conducted a multicenter retrospective study in nine referral centers and included patients with psoriasis who had received secukinumab between March 2018 to November 2020. Data on demographic characteristics, Psoriasis Area and Severity Index (PASI) scores, and previous treatments were collected from medical records. Patients were evaluated at 12, 24, and 52 weeks with respect to response to treatment and side effects. RESULTS: In total, 229 patients were recruited for the study. A PASI score improvement of ≥90 points over the baseline was achieved by 79%, 69.8%, and 49.3% of patients at weeks 12, 24, and 52, respectively. The most common adverse events wereCandida infections and fatigue. In total, 74 (32%) patients discontinued treatment by week 52, including due to adverse events, or secondary ineffectiveness. STUDY LIMITATIONS: Retrospective design. CONCLUSIONS: These findings suggest that secukinumab therapy is reasonably effective in patients with moderate-to-severe psoriasis. Comorbidities and time length of the disease can affect the response to treatment. The rates of adverse events were high in this patient population.

Insulin Resistance and Metabolic Syndrome in Patients with Seborrheic Dermatitis: A Case-Control Study.

Background: Our knowledge of the systemic effects of seborrheic dermatitis (SD) as a chronic inflammatory skin disease remains limited. We aimed to evaluate metabolic syndrome (MS) and glucose metabolism disorders in patients with SD. Methods: The study includes 53 patients over the age of 18 diagnosed with SD and 50 age-, gender-, and body mass index-matched healthy controls. Demographic data, anthropometric measurements, blood pressure levels, family history of SD and metabolic disorder, smoking history, and severity of the disease in SD patients were obtained. Fasting plasma glucose, insulin, hemoglobin A1c, lipid profile levels, and two-hour plasma glucose in the oral glucose tolerance test (OGTT 2-h PG), homeostasis model assessment of insulin resistance (HOMA-IR), and presence of MS were determined. Results: Weight, waist circumference, family history of SD, family history of metabolic disorder, and smoking status were significantly higher in the SD group compared with the control group (P = 0.04, P = 0.007, P = 0.004, P = 0.004, and P = 0.048, respectively). The levels of fasting plasma insulin and triglyceride, HOMA-IR and OGTT 2-h PG were also significantly higher in the SD group than in the control group (P = 0.0001, P = 0.033, P = 0.0001, and P = 0.049, respectively). In addition, the number of those with insulin resistance was significantly higher in the group with SD (n = 31, 58.49%) than in the control group (n = 11, 22%) (P = 0.0001). Although the rate of MS was higher in patients with SD (n = 12, 22.64%) than the controls (n = 6, 12%), the difference was not significant (P = 0.155). Conclusion: Our findings suggest an association between SD and insulin resistance, which may be due to their common inflammatory pathogenesis. This may be an indicator of susceptibility to diabetes, and these patients can be followed up for conditions associated with insulin resistance and encouraged to adopt a healthy lifestyle.

Investigation of the prevalence of hand eczema among healthcare professionals in Turkey: A cross-sectional study.

BACKGROUND: Hand eczema is one of the common occupational dermatoses, having high prevalence among healthcare professionals (HCP). We found no epidemiological data in the literature concerning the prevalence of hand eczema among HCP in Turkey. AIMS: The aim of the present study was to investigate the prevalence of hand eczema among HCP in Turkey and to determine the demographic characteristics and risk factors that cause eczema. METHODS: A clinical assessment- and questionnaire-based cross-sectional study was conducted with 734 HCP working in a tertiary hospital. Demographic characteristics and personal and occupational risk factors were evaluated in terms of the development of hand eczema. RESULTS: The survey response rate was 81.8%. The point prevalence of eczema was 27.6%, and the 12-month prevalence was 45.9%. Age, occupation, duration of work, atopic diseases, handwashing frequency, dry skin, moisturizing frequency, and presence and duration of glove use were important factors in the development of hand eczema. Powdered glove reaction was significantly higher in those with hand eczema (p = 0.0001). CONCLUSIONS: The prevalence of hand eczema is high among HCP in Turkey. Combining self-reported questionnaires with clinical examination findings can provide a more accurate calculation of the prevalence of hand eczema. The availability of epidemiological data on hand eczema can provide guidelines for the prevention and treatment of this condition. Except for situations requiring absolute handwashing, disinfecting hands with alcohol-based lotions and applying a powder-free policy in all healthcare centers will reduce the prevalence of hand eczema among HCP.

The impact of COVID-19 pandemic on psoriasis patients, and their immunosuppressive treatment: a cross-sectional multicenter study from Turkey.

BACKGROUND: Immunosuppressive therapy has been a great concern during the pandemic. This study aimed to evaluate the pandemic's impact on psoriasis patients treated with immunosuppressive drugs. MATERIAL AND METHODS: The multicenter study was conducted in 14 tertiary dermatology centers. Demographic data, treatment status, disease course, and cases of COVID-19 were evaluated in patients with psoriasis using the immunosuppressive treatment. RESULTS: Of 1827 patients included, the drug adherence rate was 68.2%. Those receiving anti-interleukin (anti-IL) drugs were more likely to continue treatment than patients receiving conventional drugs (OR = 1.50, 95% CI, 1.181-1.895, p = .001). Disease worsening rate was 24.2% and drug dose reduction increased this rate 3.26 and drug withdrawal 8.71 times. Receiving anti-TNF or anti-IL drugs was associated with less disease worsening compared to conventional drugs (p = .038, p = .032; respectively). Drug withdrawal causes were 'unable to come' (39.6%), 'COVID concern' (25.3%), and 'physician's and patient's co-decision' (17.4%). Four patients had COVID-19 infection with mild symptoms. The incidence was 0.0022% while it was 0.0025% in the general population. CONCLUSION: Our study shows that psoriasis patients using systemic immunosuppressive do not have a higher, but even lower COVID-19 risk than the general population, and treatment compliance with biological drugs is higher.

Evaluation of the cutaneous wound healing potential of tamanu oil in wounds induced in rats.

AIMS: Tamanu is a plant oil derived from the fruit and seeds of the Calophyllum inophyllum tree. Although scientific data on tamanu oil are limited, it is recommended worldwide for the treatment of abrasions, burns, diabetic wounds and scars. This study aimed to compare the wound healing efficacy of the topical use of tamanu oil with a reference drug in rats. METHODS: Uniform wounds were induced on the dorsum of 21 rats, randomly divided into three groups. The control group received normal saline; the tamanu group received tamanu oil; and the centella group was treated with Centella asiatica. Wound healing was clinically evaluated using wound healing scoring and wound contraction. A biopsy was taken from the wound sites of each rat on days 7, 14 and 21 for histopathological evaluation. RESULTS: Wound contraction was significantly lower in the tamanu group compared with the other groups. On day 7, the intensity of macrophage infiltration and mature granulation tissues were significantly higher in the centella and tamanu groups than in the control group. Fibrosis and collagen density were higher in the tamanu group than the other groups on day 7. CONCLUSION: In wound healing in rats, tamanu oil accelerated the formation of macrophage-granulation tissues-fibrosis and resulted in less wound contraction.

Plasma matrix metalloproteinase-9 level change with omalizumab treatment in chronic spontaneous urticaria.

BACKGROUND: Matrix metalloproteinase-9 (MMP-9) is an enzyme that contributes to inflammation and tissue remodelling. In chronic urticaria, increased plasma levels of MMP-9 and its correlation with disease severity have been shown in several studies, suggesting that MMP-9 could be used to evaluate the effects of new treatments. We aimed to compare MMP-9 levels in chronic urticaria patients with those of healthy patients. Then we planned to investigate the changes in plasma MMP-9 levels with chronic urticaria treatment, the role of this enzyme in demonstrating the efficacy of treatment, and its correlation with C-reactive protein (CRP). METHODS: Forty-one patients with chronic urticaria who were scheduled for omalizumab treatment and 41 sex- and age-matched healthy volunteers were included in the study. In the patient group, before treatment and at the end of the 12th week, the urticaria activity score used for 7 consecutive days (UAS7) was calculated, and the MMP-9 and CRP levels were measured. Plasma MMP-9 levels were measured from venous blood in the control group. RESULTS: The plasma MMP-9 levels of the patients before treatment were significantly higher than those of the control group (P < .01). In the patient group, there was no significant relationship between the UAS7 score and the MMP-9 and CRP levels before treatment. The UAS7 values were 28 ± 7 before omalizumab treatment and 5 ± 6 at the end of the 12th week (P < .0001). The post-treatment MMP-9 levels (1818 ± 297 pg/mL) were higher compared with the pre-treatment values (1617 ± 380) (P < .05). The post-treatment CRP levels of the patients (2.41 ± 2.17 mg/L) were lower than their pre-treatment CRP levels (8.20 ± 19.70) (P < .05). CONCLUSION: MMP-9 levels were not associated with the severity of disease, and MMP-9 levels were not decreased with treatment response. Therefore, MMP-9 cannot be used as a parameter of disease activity in chronic urticaria or to evaluate the efficacy of new treatments.

Assessment of children and adolescent presenting to the dermatology outpatient clinic in Turkey during the coronavirus disease-2019 pandemic.

OBJECTIVE: The coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization on March 11, 2020. During the partial curfews implemented in the pandemic period, the pediatric patients presenting to the dermatology clinic of our hospital were examined taking the necessary precautions. We aimed to identify children and adolescent cases requiring dermatology services and their urgency when the number of COVID-19 cases was rapidly increasing and partial curfews were being imposed in Turkey. METHODS: The study was conducted with pediatric patients that presented to our hospital dermatology outpatient clinic, a tertiary health care institution between March 11, 2020, and May 29, 2020, and their differences according to age groups and presentation period were evaluated. RESULTS: The most common reason for a dermatology clinic visit was acneiform diseases (n=103, 33.3%). According to age groups, the most common diagnosis was eczema diseases in both the 0-2 and 3-6 years groups (n=10 [55.6%] and n=11 [47.8%]), respectively), infectious diseases in the 7-12 years group (n=19, 31.10%), and acneiform diseases in the 13-18 years group (n=100, 48.3%). While 144 patients visited the clinic within the first 15 days after the declaration of pandemic, the number of patients presenting in the following month decreased by more than 80% (n=23 for the second 15-day period and n=14 for the third 15-day period). There was a moderate increase in the number of pediatric dermatology patients 45 days after the declaration of pandemic (n=57 for the fourth 15-day period and n=71 for the fifth 15-day period). A correlation was observed between the number of newly diagnosed COVID-19 cases in Turkey and the number of pediatric patients presenting to our outpatient clinic. CONCLUSION: Considering that non-urgent and follow-up pediatric patients continue to present to dermatology outpatient clinics during the pandemic process, it is necessary to encourage the implementation of patient care methods, such as telemedicine in hospitals as part of the health system.

Effect of video-based patient information on patients' anxiety and pain levels before skin biopsy: a randomized controlled study.

OBJECTIVES: Effective use of technology can provide advantages for both patients and physicians in skin biopsy practice. We aimed to investigate the effects of video-based information on the anxiety, pain and satisfaction levels of patients undergoing biopsy. METHODS: Patients were randomized and divided into two groups as video-informed and verbally informed. The anxiety levels were evaluated using the State-Trait Anxiety Inventory (STAI) and measuring the physiological parameters, systolic and diastolic blood pressure, heart rate, and respiratory rate. After the informing process, the STAI's state form was reevaluated, and physiological parameters were measured again. After the biopsy, the level of pain was evaluated using the visual analog scale (VAS), and patient satisfaction was assessed with the satisfaction scale. RESULTS: Fifty-two in the video-informed group and 50 in the verbally informed group completed the study. Compared to the baseline values, the STAI and STAI-state scores, systolic blood pressure, heart rate and respiratory rate of the patients in the video-informed group decreased (p < 0.0001, p < 0.0001, p = 0.003, p = 0.007, and p < 0.0001, respectively), and the systolic blood pressure, diastolic blood pressure, heart rate and respiratory rate values decreased in the verbally informed group (p < 0.0001, p = 0.014, p = 0.005, and p < 0.0001, respectively). According to VAS, 98.1% of the patients in the video-informed group and 86% of those in the verbally informed group described no or mild pain, and pain levels were lower in the video-informed group (p = 0.030). CONCLUSIONS: Video-based information prior to skin biopsy may be more useful in managing anxiety and pain in patients than traditional verbal information.

Anxiety and depression in pediatric patients with vitiligo and alopecia areata and their parents: A cross-sectional controlled study.

BACKGROUND: Alopecia areata (AA) and vitiligo are associated with various psychiatric comorbidities, and the care of a child with AA or vitiligo may be associated with higher anxiety and depression than healthy children. AIMS: We aimed to identify psychiatric findings in children and adolescent groups with AA and vitiligo and to evaluate the levels of anxiety and depression in their parents. METHODS: This study included 31 patients with AA and 29 patients with vitiligo, aged seven to 17 years, and their parents. Age- and gender-matched 30 controls and their parents were included. The patients and controls completed the Revised Child Anxiety and Depression Scales-Child version (RCADS-C), and their parents completed the parent version (RCADS-P). The parents also completed the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI). In addition, the stressful event history of all cases was noted. RESULTS: Stressful event history was higher in the vitiligo group compared to the AA group, and it was higher in the AA and vitiligo groups compared to the control group. Separation anxiety, generalized anxiety, social phobia, and major depressive disorder (MDD) scores were higher in the AA group than controls according to the RCADS-C. According to the RCADS-P, panic disorder (PD), MDD, and total anxiety scores were higher in the AA group. Only the PD and MDD scores were higher in the vitiligo group than those of the controls based on the RCADS-P. Lastly, no significant difference was observed between the three groups concerning the parents' BAI and BDI scores. CONCLUSIONS: Stressful events were more common in pediatric patients with vitiligo than those with AA. Anxiety symptoms were more prevalent in patients with AA than those with vitiligo.

Multicenter study evaluating the impact of COVID-19 outbreak on dermatology outpatients in Turkey.

COVID-19 pandemic has a significant impact on public health, whether directly or indirectly. The first case was seen in Turkey on March 11, and the World Health Organization (WHO) declared a pandemic on March 12, 2020. The study aimed to document the effect of pandemic on dermatology outpatient clinics in Turkey. Fifteen tertiary hospitals from 13 provinces were included in the study, which was conducted between January 12 and May 12, 2020. The International Codes of Diseases (ICD-10) categories and patients' characteristics were evaluated before and after the pandemic. A total of 164 878 patients, 133 131 before and 31 747 after the pandemic, were evaluated. The daily hospital applications were found reduced by 77%. The three of the most frequent diagnoses; dermatitis, acne, and psoriasis remained unchanged after the pandemic. While the frequency of herpes zoster, scabies, urticaria, pityriasis rosea and sexually transmitted diseases increased significantly; allergic and irritant contact dermatitis decreased after the pandemic. The applications regarding cutaneous neoplasms were considerably reduced during the pandemic, and this effect was more pronounced in cities with higher COVID incidence. The pandemic caused a noteworthy reduction in the number of patients accessing dermatological care. The pandemic caused significant changes in the frequency of a wide range of dermatological diseases. The application of cutaneous neoplasms is considerably reduced after the pandemic, and this effect was more pronounced in cities where pandemics are frequent. Therefore, the pandemic has resulted on numerous impacts on many critical issues in dermatology and dermatological care.

Effect of omalizumab use on glucose homeostasis in non-diabetic patients with chronic urticaria.

PURPOSE: In some diabetic patients receiving omalizumab therapy, blood glucose regulation is impaired. However, the effect of omalizumab on glucose homeostasis in non-diabetic patients remains unknown. METHODS: The patients were given subcutaneous omalizumab at a dose of 300 mg every four weeks for the treatment of chronic urticaria in this study. Fasting blood glucose, fasting plasma insulin, total cholesterol, triglyceride, and high-density (HDL) and low-density lipoprotein (LDL) were studied before and at the 12th week of treatment. The homeostatic model assessment for insulin resistance (HOMA-IR) was used to determine insulin resistance. RESULTS: Forty of the 45 patients included in the study completed 12 weeks of treatment. While fasting blood glucoses (p = 0.011) and HOMA-IR values (p = 0.027) were significantly increased in the 12th week, the increase in fasting insulin level was not significant (p = 0.07). After treatment, 10 patients developed impaired fasting glucose and 13 developed insulin resistance. CONCLUSION: The increase in blood glucose levels may be associated with the paradoxically increase of histamine levels in the blood by omalizumab. If this increase cannot be balanced with insulin, patients may develop impaired glucose tolerance and insulin resistance. Therefore, we suggest that patients using omalizumab should be followed up for glucose homeostasis and insulin resistance.

Long-term follow-up effect of omalizumab in chronic spontaneous urticaria and its association with serum C-reactive protein levels.

This study aims to determine the efficacy of omalizumab, a humanized monoclonal anti-immunoglobulin E antibody, in patients with chronic spontaneous urticaria (CSU) refractory to conventional therapy, together with the evaluation of serum CRP levels. All the patients with a diagnosis of CSU who were continuously treated with omalizumab (300 mg/mo) for at least 3 months between June 2016 and July 2019 were included in this study. Urticaria activity score (UAS-7) was used for assessment of disease activity. Serum CRP levels were also retrospectively analyzed. When UAS-7 scores before the initiation of therapy were compared to the week 4, 12, 24, and 36 scores after the treatment, each were significantly different from the pretreatment results (P < .01). CRP level prior to treatment was found to be strongly correlated with baseline UAS scores of the patients' (P = .00). At the 12th week of treatment, decline of CRP level was positively and strongly correlated with the decline of UAS (P = .037). In this study, mean UAS decreased, mean rescue medication use declined, and overall therapeutic response improved with omalizumab treatment. Additionally, significant correlation between the decline of CRP levels and treatment response was found.

Dermoscopic characteristics of acral melanocytic nevi in children and adolescents.

BACKGROUND/OBJECTIVE: There are limited data on the dermoscopic characteristics of acral nevi in the population under 18 years old. Our aim was to determine the frequency of acral volar nevi in children and adolescents, characterize their dermoscopic patterns, and identify relationships with age and location. METHODS: We prospectively examined the palms and soles of 1319 patients presenting to our outpatient clinic from July 2018 to April 2019. RESULTS: Acral volar nevi were observed in 28% of the children and adolescent population included in the study. A total of 474 nevi from 365 patients were examined. The presence of nevi increased with age. The most common dermoscopic pattern was parallel pigmented furrows, detected in 57.8% of nevi. The other patterns observed were combination (14.1%), fibrillar (10.1%), and latticelike (8.8%). The parallel furrow and globulostreak-like patterns were more common on the palms, whereas the fibrillar and combination patterns were more frequently seen on the plantar surfaces. While the frequency of the parallel pigmented furrow pattern did not differ between the 0- to 12-year and 13- to 18-year age-groups, the dotted variants of the parallel furrow were observed more frequently in the 0- to 12-year-olds (58.2%) than in the 13- to 18-year-olds (41.7%). A combination pattern and its most common variant, parallel furrow + crista dotted pattern, were detected at a significantly higher rate in the 0- to 12-year group (22.1% and 16.3%, respectively) compared to the 13- to 18-year group (11.4% and 6%, respectively). CONCLUSIONS: Acral melanocytic nevi are common in children and adolescents, and their dermoscopic patterns may be associated with anatomic localization and age.

Histologic Evidence of New Collagen Formulation Using Platelet Rich Plasma in Skin Rejuvenation: A Prospective Controlled Clinical Study.

BACKGROUND: Platelet-rich plasma (PRP) is an autologous concentration of human platelets contained in a small volume of plasma and has recently been shown to accelerate rejuvenate aging skin by various growth factors and cell adhesion molecules. OBJECTIVE: This study was conducted to evaluate the efficacy and safety of intradermal injection of PRP in the human facial rejuvenation. METHODS: This study was a prospective, single-center, single-dose, open-label, non-randomized controlled clinical study. PRP injected to the upper site of this right infra-auricular area and all face. Saline was injected to the left infra-auricular area. Histopathological examinations were performed before PRP treatment, 28 days after the PRP, and saline (control) treatments. RESULTS: Twenty women ranging in age from 40 to 49 years (mean age, 43.65±2.43 years) were enrolled in the study. The mean optical densities (MODs) of collagen in the pre-treatment, control, and PRP-treated area were measured. They were 539±93.2, 787±134.15, 1,019±178, respectively. In the MOD of PRP, 89.05 percent improvement was found when MOD of PRP was compared with MOD of pre-treatment. The mean MOD of collagen fibers was clearly highest on the PRP side (p<0.001). The PRP-to-saline improvement ratio (89.05% to 46.01%) was 1.93:1. No serious side effects were detected. CONCLUSION: PRP increases dermal collagen levels not only by growth factors, but also by skin needling (the mesotherapy technique 'point by point'). PRP application could be considered as an effective (even a single application) and safety procedure for facial skin rejuvenation.

Erythrocyte zinc level in patients with atopic dermatitis and its relation to SCORAD index.

INTRODUCTION: Atopic dermatitis (AD) is a chronic, pruritic inflammatory disease, characterized by a relapsing-remitting course. The pathogenesis of atopic dermatitis is not completely understood, although the disorder appears to result from the complex interaction between immune abnormalities, genetic and environmental factors. Trace elements are essential for normal functioning of the immune system. AIM: To determine zinc levels in serum and erythrocytes of patients with AD using an atomic absorption spectrometric technique and to investigate the relationship between those levels and disease activity. MATERIAL AND METHODS: Sixty-seven patients and 49 controls were enrolled into the study. The disease severity of AD patients was determined according to the Scoring Atopic Dermatitis (SCORAD) index. We measured zinc levels in serum and erythrocytes by the atomic absorption spectrophotometric technique. RESULTS: Erythrocyte zinc levels were significantly lower in AD patients than in the control group (p < 0.001), whereas serum zinc levels did not differ between the groups (p = 0.148). In the AD patient group there was a negative correlation between the SCORAD score and erythrocyte zinc levels (r = -0.791; p < 0.001). CONCLUSIONS: The negative relationship between disease severity and erythrocyte zinc levels might suggest an immunopathological link between AD progression and intracellular zinc metabolism.