Evaluation of the Quality of Life and the Demographic and Clinical Characteristics of Patients With Pemphigus With Oral Mucosal Involvement: A Multicenter Observational Study.

INTRODUCTION: Pemphigus vulgaris (PV) is an autoimmune disease primarily affecting the oral mucosa. OBJECTIVES: This study aimed to determine the demographic, clinical and treatment characteristics of PV patients with oral mucosal involvement and to assess the impact on their quality of life. METHODS: We conducted a prospective observational study among 106 patients diagnosed with PV and presenting oral mucosal involvement. Demographic data, clinical and treatment characteristics, and quality of life questionnaires were recorded. RESULTS: The study included 106 patients, 55 (51.89%) were male and there was a predominance of the mucocutaneous subtype in 83 individuals (78.38%). Oral mucosa was the initial site of manifestation in 44 patients (41.51%). Bilateral buccal mucosa was the most frequently affected site. The predominant symptom reported was a burning sensation, noted in 91 patients (85.85%). Oral mucosal examination revealed erosions in 85.85% of the patients. Systemic steroids were the most commonly administered treatment, and rituximab was used in 18 patients (16.98%). A positive and significant correlation was found between pemphigus severity and Oral Health Impact Profile-14, Dermatology Life Quality Index and Dermatological Quality of Life Scale scores (P < 0.05). The presence of superficial ulcers, flaccid bullae, lesion diameter ≥1 cm, and >10 lesions were factors that markedly diminished quality of life. Complete response to treatment was noted in all patients administered rituximab. CONCLUSIONS: The most common area of involvement was bilateral buccal mucosa, and the severity of PV closely correlated with a decline in quality of life measures. These results highlight the need for careful clinical oversight of PV, taking into account its effects on patients quality of life.

A Comparison of Clinical, Demographic and Treatment Characteristics of Pediatric-Onset and Adult-Onset Patients Diagnosed With Localized Scleroderma.

INTRODUCTION: Morphea localized scleroderma (LS) is a rare skin disease with unknown pathogenesis, which causes sclerosis of the dermis and subcutaneous tissue. OBJECTIVES: It was aimed to compare the characteristics of patients with pediatric and adult-onset morphea. METHODS: A retrospective analysis was performed on the records of 183 adult morphea patients. The demographics, clinical and laboratory characteristics, and treatment options of the patients were recorded. Adult patients with morphea over the age of 18 were divided into two groups according to the age of onset and compared. RESULTS: Twenty-two percent (N = 41) of the patients had pediatric-onset morphea (POLS) and 77.6% (n=142) had adult-onset morphea (AOLS). While POLS had a higher head-neck involvement, AOLS had a higher breast involvement (P < 0.001 and P = 0.043). Patients with linear morphea were younger, and more frequently had at least one laboratory anomaly (P = 0.016 versus 0.024). Anti-dsDNA positivity and low hemoglobin (Hb) were observed more frequently in patients with breast involvement. Patients with inguinal involvement, on the other hand, had lower Hb and a higher rate of diabetes, and those patients were older (P = 0.042, 0.040, and 0.012, respectively). CONCLUSIONS: Clinical characteristics and accompanying laboratory anomalies of the patients with morphea depend on the age of onset, involvement areas and the types of morphea, having such data readily available should guide the holistic approach for, and the monitoring process of, the disease.

Vitamin D levels in patients with seborrheic dermatitis.

OBJECTIVE: Seborrheic dermatitis is a common papulosquamous skin disease with unknown pathogenesis. The aim of our study was to determine the serum level of 25-hydroxy vitamin D in patients with seborrheic dermatitis SD. METHODS: A total of 53 patients and 60 healthy controls were included in the study. Serum vitamin D, calcium, phosphorus, and parathormone levels were measured in the patient and control groups, and a comparison was made between the two groups regarding these parameters. RESULTS: Severe vitamin D deficiency was more frequent among patients with seborrheic dermatitisSD compared to controls (52.8 vs. 25.8%, p=0.003). In patients with severe vitamin D deficiency, seborrheic dermatitis SD was detected more frequently at an early age (p=0048) and in women (p=0.015). No correlation was found between the seborrheic dermatitis skin involvement site and vitamin D level. CONCLUSION: The fact that vitamin D levels decreased in patients with seborrheic dermatitis SD and patients with severe vitamin D deficiency develop seborrheic dermatitis SD earlier suggests that the low levels of vitamin D are related to seborrheic dermatitis.

Epidemiological characteristics of different types of adult acne in Turkey: a prospective, controlled, multicenter study.

INTRODUCTION: Acne occurring in adults over the age of 25 years is known as acne tarda or adult acne. Three types of adult acne are recognized: persistent, late-onset, and recurrent acne. Most studies do not compare the characteristics between the three variants. In addition, little is known about adult acne in males. This study describes the epidemiological factors of adult acne and investigates certain triggering factors by sex and different types of adult acne. METHODS: A multicenter, prospective, descriptive study was conducted. Patients with adult acne and an acne-free control group were compared regarding medical history, family history, smoking and drinking habits, and dietary factors. In addition, triggering and prognostic factors were investigated by sex and three different types of acne: persistent, late-onset, and recurrent acne. RESULTS: The participants included 944 (88.56%) female and 122 (11.44%) male patients with adult acne, and 709 (73.85%) female and 251 (26.15%) male control patients. The consumption of crackers, chocolate, and pasta was significantly more common in the acne group than in the control group (p = 0.017, 0.002, and 0.040, respectively). Male patients with adult acne had a significantly longer disease duration than female patients with adult acne (p = 0.024). The most common type of acne was recurrent acne, followed by persistent and late-onset acne. Among patients with persistent acne, 14.5% had polycystic ovary syndrome (PCOS), whereas 12.2% of patients with recurrent acne and 11.1% of patients with late-onset acne had PCOS. Severe acne was more common in the persistent acne type (28.13%). The cheek (59.90%) was the most common involvement area, and stress (55.23%) was the most common triggering factor regardless of sex. CONCLUSIONS: Although adult female and male patents with adult acne share similar triggering factors, the involvement areas can differ, which may indicate the additional hormonal etiology of female adult acne. Further epidemiological studies on adult acne in both sexes may illuminate the pathogenesis of the disease, thus making possible the development of new treatment strategies.

Internalized Stigma in Hidradenitis Suppurativa: A Multicenter Cross-Sectional Study.

BACKGROUND: Hidradenitis suppurativa (HS) causes significant physical, social, and psychological burdens. Internalized stigma, acceptance of negative attitudes and stereotypes of society regarding a person's illness, has not been studied previously in HS. OBJECTIVES: The objective of this study was to investigate the internalized stigma state of HS patients and identify the factors affecting it. METHODS: This multicenter, prospective, cross-sectional study included 731 patients. Internalized Stigma Scale (ISS), Hurley staging, Physician Global Assessment, Dermatology Life Quality Index (DLQI), Skindex-16, Beck Depression Inventory-II (BDI-II), and Visual Analog Scale (VAS)-pain score were used in the study. RESULTS: The mean ISS value (57.50 ± 16.90) was comparable to the mean ISS values of studies in visible dermatological and various psychiatric diseases. A significant correlation was found between the mean values of ISS and all disease activity scores, quality of life measures, BDI-II, and VAS-pain scores. Obesity, family history, low education and income level, vulva/scrotum involvement and being actively treated are significant and independent predictive factors for high internalized stigma in multivariate analysis. CONCLUSIONS: HS patients internalize society's negative judgements, which may create a profound negative effect on access to health care. Therefore, in addition to suppressing disease activity, addressing internalized stigma is fundamental for improving health care quality.

Oxidative Stress and Thiol/Disulfide Homeostasis in Human Papillomavirus Infections.

Introduction: Viral warts are a group of dermatological diseases caused by human papillomavirus (HPV). Several studies have demonstrated an association between HPV infections and oxidative stress. Thiols are important components of cellular redox homeostasis as antioxidant molecules in the organism. Aim: This study aimed to investigate the role of oxidative stress in patients with HPV infection by analyzing native thiol/disulfide homeostasis. Material and Methods: Forty-two patients with HPV infection and 40 healthy subjects were analyzed for the levels of native thiols, total thiols, and disulfide. Disulfide/native thiol, disulfide/total thiol, and native thiol/total thiol ratios were also calculated. Results: Disulfide and total thiol levels were higher in the patients compared to the healthy controls. The disulfide/native thiol ratio was also higher in the patient group. Native and total thiol levels decreased with the increasing duration of the disease. Conclusion: The native thiol/disulfide homeostasis was shifted toward disulfide in the patients' group, indicating the existence of oxidative stress in HPV infection.

Complementary and alternative treatment methods practiced by parents in pediatric cases diagnosed with atopic dermatitis.

INTRODUCTION: Atopic dermatitis (AD) is a chronic, recurrent, and inflammatory skin disease experienced mostly in childhood. Chronicity of the disease, relapses, constant need of regular skin care causes seeking for alternative treatments. AIM: The aim of this study is to evaluate the complementary and alternative treatments (CAT) used by parents' caregivers in pediatric patients diagnosed with AD, and the association between CAT use and patient characteristics. MATERIALS AND METHODS: A questionnaire questioning the sociocultural and demographic characteristics of the family, the clinical findings of the patients, their treatments and CAT applications was recorded. RESULTS: Eighty-three patients were included in the study. 68.7% of the patients used at least one type of CAT. Vitamins and oils were the most commonly used CAT (48.8% and 47%, respectively) and 73.3% of the patients using CAT continued normal AD treatment while using CAT. The biggest factor affecting CAT choice was the advice of the immediate circle (75%), and 40.6% of the patients stated that they benefited from the complementary therapy. CONCLUSIONS: CAT are widely used in AD. Physicians should know the socio-cultural structure of the region they are in, the CAT used and their side effects, and inform the families.

Investigation of the relationship between seborrheic dermatitis and metabolic syndrome parameters.

BACKGROUND: Seborrheic dermatitis (SD) is a common, chronic inflammatory disease with relapses and remissions. OBJECTIVES: So we planned to investigate the relationship between SD and metabolic syndrome (Mets). METHODS: 54 patients over 18 years of age without known diabetes mellitus, hypertension, coronary artery disease who were clinically diagnosed with SD in our clinic and 47 healthy controls were included in the study. Body mass index (BMI) was calculated of all participants. Complete blood count, fasting blood sugar (FBG), triglyceride (TG), total cholesterol, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) were examined. The relationship between the presence of MetS, disease severity, and duration was investigated. RESULTS: Average age of patients was 35.4 (sd: 12). Average age of controls was 32.9 (sd: 10.7). MetS was detected in 35.2% (n = 19) of the patient group and 10.6% (n = 5) of the control group. The presence of MetS was higher in SD patients than in the control group (p = 0.004). The rate of people with high TG was significantly higher in the SD group than the controls (p = 0.015). HDL level was significantly lower in the patient group (p = 0.050). Systolic and diastolic blood pressure were high in patients (p = 0.016, p = 0.029). CONCLUSIONS: Seborrheic dermatitis should be considered as a MetS marker and the presence of MetS should be examined in this group of patients. This can be helpful for the early diagnosis of a systemic disease complex with numerous complications. Also, treatment of MetS can also improve SD lesions.

Cutaneous findings in patients with chronic venous insufficiency.

BACKGROUND: Venous hypertension causes many different cutaneous findings such as varicosities, telangiectasia, edema, and pigmentation, dermatitis, and venous ulcers on the skin. OBJECTIVE: This study aims to investigate the cutaneous signs and symptoms of chronic venous insufficiency (CVI) and to examine their contribution to early diagnosis. METHODS: A total of 150 patients were included in the study who applied to the dermatology outpatient clinic and were diagnosed with skin disease related to CVI or had skin findings. Patient's age, gender, complaints, occupation, additional diseases, drug usage, history of prolonged standing and travel, smoking habit, number of pregnancies, history of varicose veins in the family, dermatological diagnosis/findings, and venous Doppler ultrasonography reports were examined retrospectively. RESULTS: 56% of patients were women. Mean age was 56.69 ± 13.6 years. Overall, 82.7% of total patients had at least one skin finding. The most frequent skin findings except varicose veins were insufficiency dermatitis accounted for 32.7% of patients, telangiectasia, and pigmentation which were comprised 25.3%, 19.3% of the total number of patients respectively. In addition to this, 48.7% of patients had itching problems and 32.7% had pain. Moreover, 46% of patients presented superficial vein insufficiency, while 8.7% had deep vein insufficiency. For 47.3% of patients, vein diameter dilation was observed and 11.3% suffered from perforating vein insufficiency. In terms of Clinical-Etiologic-Anatomic-Pathophysiologic (CEAP) classification, scores of 52% of the patients were C3 and lower, while scores of 48% of total patients were C4a and higher. CONCLUSIONS: Early diagnosis and treatment of chronic venous insufficiency could prevent further chronic processes such as venous ulceration which is an advanced CVI finding. Thus, assessing the early skin findings might be important to identify the underlying venous insufficiency disease.

Can thiol-disulfide balance be an indicator of oxidative stress for hyperhidrosis?

BACKGROUND: Hyperhidrosis is responsible for various causes. The increased reactive oxygen radical production with insufficient antioxidant mechanism capacity may play a role in the etiopathogenesis of hyperhidrosis. It is probable to gather data about oxidative stress by detecting plasma thiol/disulfide ratio. The aim of this study was to determine whether thiol-disulfide balance changes in patients with hyperhidrosis. METHODS: The files of patients who were diagnosed with hyperhidrosis in the dermatology outpatient clinic between 2015 and 2018 and whose native thiol, total thiol, and disulfide values were examined for any reason were examined. RESULTS: Seventy-three patients were included in the study. 33 of the patients with hyperhidrosis were primary. Mean age; for primary hyperhidrosis patients (PHH) = 26.36 ± 7.61, primary hyperhidrosis (PHH) control group = 27.16 ± 7.94; secondary hyperhidrosis (SHH) patients = 47.88 ± 12.29, SHH control (45.40 ± 12.02). The native thiol values of PHH (469.93 ± 56.82 µmol/L) were higher than SHH (440.64 ± 62.72) (p = 0.024). However, as a result of thiol-disulfide comparison between hyperhidrosis patients (PHH and SHH) and control groups, disulfide levels increased (p = 0.04). In the PHH group, total thiol was measured as 512 ± 54.84 µmol/L, and SHH was measured as 484.11 ± 58.9 µmol/L, (p = 0.074). CONCLUSION: Serum thiol levels in SHH increased more than PHH. As a result of thiol-disulfide comparison between hyperhidrosis patients and control groups, the balance shifted in favor of disulfide and oxidative side.

Investigation of plasma thiol/disulfide balance in male patients with androgenetic alopecia.

BACKGROUND: Androgenetic alopecia (AGA) is the most common cause of hair loss in men. In addition to genetic and hormonal factors, oxidative stress (OS) is suggested as a factor in the etiology. AIM: In this study, we aimed to investigate the presence of OS due to thiol disulfide balance deterioration in male patients with AGA. MATERIALS AND METHODS: A total of 45 male AGA patients and 42 healthy male controls were included in the study. Native thiol, disulfide, and total thiol levels were assessed through automated spectrophotometry. The relationship between total protein, albumin, native thiol, disulfide, and total thiol levels in addition to demographic and clinical characteristics of the patients were examined. RESULTS: The mean age of the patients was 32.6 ± 10 years, and the median AGA duration in the patients was 3 years. There was no statistically significant difference in terms of native thiol, disulfide, total thiol levels, disulfide/total thiol, disulfide/native thiol, and native thiol/total thiol ratios between AGA patients and controls. Native thiol and total thiol levels negatively correlated with age and AGA duration, while disulfide levels only correlated with age.Albumin and native thiol levels were significantly lower in patients with low vitamin D levels (p = 0.040 and p = 0.021, respectively); however, total thiol and native thiol/total thiol ratio values were significantly higher. CONCLUSION: According to this study, thiol disulfide homeostasis is in balance in male patients with AGA. In patients with emotional stress and vitamin D deficiency, the balance appears to be shifted in favor of oxidative stress.

Clinic and demographic characteristics of pediatric patients with Lichen sclerosus.

BACKGROUND: Lichen sclerosus (LS) is a chronic disease of the skin, for which the pathogenesis is not known. It can lead to various changes of the skin and the genital area, potentially leading to both functional as well as cosmetic problems for the patient, thus disrupting the quality of life. In this study; the purpose was to review the clinical characteristics and the treatments of the 15 pediatric patients under the age of 18 followed up in our out-patient clinic with a diagnosis of LS and to compare the findings with literature data. METHODS: Between 2011 and 2017, the files of 15 patients diagnosed clinically and/or histologically with LS in our clinic were retrospectively examined. The demographic characteristics, clinic and laboratory findings, treatment options of the patients are reported. RESULTS: Of the patients included in the study 14 were girls and one was a boy. The average age was 11.6 years (5-17 years), the average age for the initial disease was 7.8 years (2-13 years). The average duration of the disease at the diagnosis was 3.9 years. The most common form was genital vulvar type (8/14 girls) without anal and cutaneous involvement, and each of them suffered from itching. One of the cases had genital LS as well as extragenital morphea lesions. Two of the 15 patients were ANA positive. The other antibodies were negative. In two cases with extragenital involvement, lesions were widespread and they were in blachkoid form. CONCLUSION: LS is a chronic disease that progresses with recurrences and regressions. In our study, the most common LS type was genital type (60%). There was extragenital involvement in 6 patients (40%). Extragenital involvement was the most common on the trunk. Diagnosis, treatment and follow-up during childhood is highly important to prevent any possible future anatomical or psychological damage and genital malignancies.

Research on the Balance of Thiol-Disulfide in Blood Serum in Women with Telogen Effluvium.

BACKGROUNDS: Telogen effluvium (TE) is the most common reason for hair loss in humans. Although the exact etiopathogenesis of TE has not been revealed clearly and completely, multifactorial etiologies are to be blamed. In recent years, since oxidative stress (OS) has been shown to play an important role in the etiopathogenesis of so many diseases, the effects of OS on several skin diseases are researched and analyzed. Thiols are antioxidant components that include sulfur group, and the balance of thiol-disulfide has an important role in the formation and prevention of OS. This balance is destroyed in many diseases and its effect on TE is not clearly understood yet. OBJECTIVES: In this study, we aimed to search the thiol-disulfide balance that could reveal OS in patients with TE. MATERIALS AND METHODS: Fifty-two patients with TE and control group of 46 persons were included in the study. Native thiol, disulfide, and total thiol levels were evaluated by a new, automatic spectrophotometric method. Disulfide/native thiol, disulfide/total thiol, and native thiol/total thiol rates were calculated. RESULTS: There was no statistical difference between TE patients and control group in terms of native thiol, disulfide, and total thiol levels. Thiol-disulfide balance was fixed and not affected in TE patients.

Thiol/disulfide homeostasis as a marker of oxidative stress in rosacea: a controlled spectrophotometric study.

BACKGROUND: Rosacea is the chronic inflammatory disease of the facial skin. Although its aetiology is not clear yet, inflammatory processes triggered by oxidative stress and oxidation of lipids have been suggested to play a role. While studies on the relationship between inflammation and oxidative stress are ongoing, thiol metabolism and its role in oxidative stress have also begun to be investigated. Thiols are among the key molecules of protein metabolism in the organism and they are the firstly consumed antioxidants in case of oxidative stress. Thiols regulate intracellular redox metabolism and protect keratinocytes against the results of oxidative alterations in the stratum corneum. There is a balance known as dynamic thiol/disulfide homeostasis between thiols and their oxidized forms; disulfides. AIM: This study aimed to determine the effects of oxidative stress on protein metabolism in rosacea patients by investigating thiol/disulfide homeostasis using a newly developed and fully automated method. Determination of plasma thiol levels provides important clues regarding the extent of free radical-mediated oxidation of proteins causing damage in rosacea. METHODS: The study included 50 rosacea patients who were diagnosed clinically or histopathologically with rosacea and 42 age- and gender-matched healthy controls. Plasma levels of native thiol, total thiol, and disulfide were determined. The following ratios were calculated: disulfide/native thiol ratio, disulfide/total thiol ratio, and native thiol/total thiol ratio. RESULTS: The mean age was 41.8 ± 10.5 in the rosacea patients (35 females) and 42.5 ± 10.3 years in the control group (33 females). The mean disulfide level was found to be significantly higher in the rosacea patients than in the control group (23.4 ± 5.5 µM/L and 17.3 ± 6.2µM/L, respectively; p < 0.001). The mean disulfide/native thiol ratio (0.055 ± 0.016 vs. 0.041 ± 0.017) and the mean disulfide/total thiol ratio (0.049 ± 0.012 vs.0.037 ± 0.013) were significantly higher and the mean native thiol/total thiol ratio (0.884 ± 0.118 vs. 0.923 ± 0.027) was significantly lower in the patients as compared with the controls (p < 0.05 for all). CONCLUSION: In rosacea patients, the thiol/disulfide balance was observed to shift towards disulfides, which could be considered an indicator of oxidative stress in rosacea.

The effect of tinea versicolor on thiol/disulphide homeostasis.

INTRODUCTION: Tinea versicolor is a superficial fungal infection caused by Malassezia spp. Malassezia spp. is a member of the normal human skin flora. It becomes a pathogen by transforming from the yeast form to the mycelium form. The oxidant/antioxidant homeostasis may be responsible for this. Thiol/disulphide homeostasis is a new marker indicating oxidative stress. This homeostasis is affected in many illnesses. AIM: To investigate the thiol/disulphide homeostasis in patients with tinea versicolor. MATERIAL AND METHODS: Forty-two patients with tinea versicolor (median age: 36 years, min.-max.: 19-58) and 36 healthy controls (median age: 32 years, min.-max.: 18-60) were included in the trial. The levels of native thiol, disulphide, and total thiol were measured by an automated method in the patient and control groups. Disulphide/total thiol, disulphide/native thiol and native thiol/total thiol rates were calculated as percentage. RESULTS: For the patient group and the control group, the native thiol levels were found to be 464.32 ±51.48 mmol/l and 465.18 ±51.32 mmol/l, disulphide levels - 19.80 ±7.08 mmol/l and 21.27 ±8.90 mmol/l, total thiol levels - 503.92 ±53.65 mmol/l and 508.07 ±56.59 mmol/l, respectively. No statistical difference was detected between the two groups. CONCLUSIONS: Thiol/disulphide homeostasis was not affected in tinea versicolor. According to our findings, oxidative stress seems to have no role in the pathogenesis of tinea versicolor.

Investigation on aetiological factors in patients with hyperhidrosis.

BACKGROUND: Hyperhidrosis is a condition where the amount of sweat released to skin surface increases due to the over-active eccrine sweat glands. Hyperhidrosis causes considerable psychosocial distress in affected people. It affects the quality of life and leads to social anxiety disorders. AIMS: No study has been conducted in our country to investigate the epidemiological, clinical, and laboratory data of patients with hyperhidrosis. In this study, we aimed to retrospectively investigate the clinical and demographic characteristics, causes of sweating and laboratory findings in patients treated for hyperhidrosis at our outpatient clinic and to compare these data with the literature data. MATERIALS AND METHODS: A retrospective review was conducted on medical records of patients diagnosed with and treated for hyperhidrosis at outpatient clinic between 2014 and 2017. Adults aged over 18 years were included in study. Age and gender of patients, type and localization of sweating, duration of disease, age of onset of sweating, presence of stress, fever, joint pain and comorbidity, family history, medication use, and examination results were recorded. RESULTS: Records of a total of 70 patients consisting of 30 men and 40 women with hyperhidrosis were examined. Overall mean age was 37.1 years. Mean age was 41 years in women and 32 years in men. Most frequent forms were palmoplantar and axillary hyperhidrosis for primary hyperhidrosis (primary HH), and head-neck and generalized hyperhidrosis for secondary hyperhidrosis (secondary HH). Most common comorbidities were diabetes mellitus, thyroid disease, non-specific joint and bone pain, cardiovascular disease, and neuropsychiatric disease. Cases with secondary HH had a history of drug use (antithyroid drugs, nonsteroidal anti-inflammatory drugs, antidiabetic agents, antidepressants, and antihypertensives). CONCLUSION: This is the first study that investigated the characteristics of patients with primary and secondary HH in our country. These characteristics can help determine the cause and apply treatment for hyperhidrosis by an appropriate examination and approach.

Investigation of thiol-disulphide balance in patients with acute urticaria and chronic spontaneous urticaria.

BACKGROUND: Thiol-disulphide balance plays a major role in health and diseases. This balance may be disrupted by various diseases. We aimed to determine status of the effect of thiol-disulphide balance in urticaria. OBJECTIVES: We aimed to investigate the thiol-disulphide balance in patients with acute urticaria (AUP) and chronic spontaneous urticaria (CSU). METHODS: Study included 53 AUP and 47 healthy controls plus 57 patients with chronic spontaneous urticaria (CSUP) and 57 healthy controls. Levels of native thiols, disulphides and total thiols were evaluated in plasma using a new and automated spectrophotometric method. Ratios of disulphides/total thiols, disulphides/native thiols and native thiols/total thiols were calculated. RESULTS: For AU, there was no statistical difference compared to control group in levels of native thiols, disulphides and total thiols. For CSU, however, there was an increase in levels of native thiols, disulphides and total thiols and the ratio of thiol/disulphide in favour of disulphide. CONCLUSION: Thiol-disulphide balance was not affected by AU but shifted towards to disulphide in CSU indicating the presence of oxidative stress (OS).

The weeks and the cumulative doses of the first adverse events related to oral isotretinoin in acne patients: analysis of 300 patients.

BACKGROUND: The purpose of our study is to find out in which weeks and in which cumulative doses the side effects emerge and to study whether or not there is a significant variance between the observed period and doses of the emergent side effects of the patients taking the daily doses of below and above 0.5 mg/kg. METHODS: Patients were started treatment with doses of 0.25-1 mg/kg isotretinoin, and a form was given to the patients to mark which probable side effects occurred in which weeks and called for weekly follow-up for the first 2 months. RESULTS: The median of the complaints of emerged side effects such as chellitis, dry face and facial erythema, photobia and nyctalopia was in less than 4 weeks. When the doses taken below and above 0.5 mg/kg are compared, the side effects observed to have differences between both the week they occurred and the cumulative doses are xerosis, dry face, exacerbation of acnes, nervousness, and somnolence. CONCLUSIONS: We believe that knowing which weeks the side effects are observed first, warning about the side effects that may especially occur in the first 4 weeks, and ensuring some measures are taken before the side effects are observed will increase the success of patient compatibility and management of side effects.

Atypical pityriasis rosea: clinical evaluation of 27 patients.

BACKGROUND: Pityriasis rosea (PR) is a common, acute, self-limiting inflammatory skin disease. It can easily be recognized with its typical clinical presentation. However, unusual clinic presentations can cause difficulty in diagnosis. Up to now, not many atypical forms are reported. OBJECTIVE: To determine the clinical characteristics of patients with atypical pityriasis rosea. METHODS: A total of 27 cases, diagnosed as atypical PR by clinical and/or histopathological examination and applied to the outpatient clinic of dermatology department between the years 2007 and 2015 were analyzed retrospectively. RESULTS: The ages of patients ranged from 2 to 59 years. Of these patients, 15 (55.6%) were male and 12 (44.4%) were female. The male-to-female ratio was 5-4. Five patients had papular, four patients had purpuric, three patients had vesicular, two patients had follicular, one patient had erythema multiforme-like and one patient had eczematous drug-induced atypical form of pityriasis rosea. There were 12 cases of localized, two cases of segmental pityriasis rosea. Four of the localized forms also had atypical morphology. Histopathological evaluation was required for diagnosis in 12 (44.4%) patients. CONCLUSIONS: PR can appear in many different uncommon forms. Localization and skin rush can be misleading and diagnosis can be compelling.

Cutaneous drug reactions in children: a multicentric study.

INTRODUCTION: According to studies conducted in outpatients, it is estimated that 2.5% of children who are treated with a drug will experience a cutaneous adverse drug reaction (CADR). AIM: To analyze the CADR reports involving pediatric patients recorded by three different university hospitals for describing common, serious, and interesting cutaneous drug eruption patterns. MATERIAL AND METHODS: For this purpose, the patients' data from three different universities were reviewed retrospectively. Diagnosis was based on history, clinical findings and laboratory test results. The CADRs were classified into seven categories; urticaria, angioedema, maculopapular eruption, fixed drug eruption, erythema multiforme, acute generalized exanthematous pustulosis, drug rash with eosinophilia and systemic symptoms syndrome. RESULTS: A total of 122 patients who had CADRs were enrolled in the study. The most frequently detected cutaneous drug reactions were urticaria + angioedema. Most of patients had no previous experience with the same drug and the most common causative agent of CADRs was antimicrobials. CONCLUSIONS: Since CADRs are relatively rare, the current multicentric study can provide meaningful information about the cutaneous eruption patterns of commonly used drugs.