Evaluation of the Dermatological Life Quality Index, sexual dysfunction and other psychiatric diseases in patients diagnosed with vitiligo with and without genital involvement.

BACKGROUND: Because skin lesions affect self-image, vitiligo affects an individual's emotional and psychological well-being, sexual life and relationships with other people. The literature contains a limited number of studies regarding the localization of vitiligo with respect to its effect on certain variables. AIM: To investigate the effects of the presence or absence of genital involvement in vitiligo on sexual dysfunction, dermatological quality of life (QoL), and susceptibility to other psychiatric disorders such as anxiety and depression. METHODS: In total, 90 patients who were admitted to the dermatology outpatient clinic of a tertiary university hospital; the patients included 30 patients with vitiligo with genital involvement, 30 patients with vitiligo without genital involvement and 30 controls (HCs). All groups were evaluated with the Dermatological Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HAD), Arizona Sexual Experience Scale (ASEX) and Golombok-Rust Inventory of Sexual Satisfaction (GRISS). RESULTS: The HC groups exhibited lower total scores on the DLQI, HAD total score, ASEX and GRISS compared with the vitiligo groups (P < 0.05). No statistically significant difference was found between the vitiligo group with genital involvement and the vitiligo group without genital involvement in terms of DLQI, and total scores for HAD, ASEX and GRISS (P > 0.05). CONCLUSION: The presence or absence of genital involvement in vitiligo did not have dissimilar effects on the individual's QoL, or their sexual and psychological state.

Evaluation of hearing function in patients with lichen planus.

Lichen planus (LP) is a chronic, autoimmune, inflammatory disease. We believe that tympanic membrane and outer ear canal can be affected by the disease and since it is an autoimmune disease inner ear involvement may be seen. The aim of this study was to evaluate hearing functions in patients with LP. Thirty patients with LP and 28 healthy controls were involved in the study. Pure tone audiometry, tympanogram and Transient Evoked Otoacoustic Emissions tests were applied to the patients. When the airway hearing thresholds of the patient and control groups in the 125-8000 Hz frequency range were compared, statistically significant differences were found at 4000, 6000 and 8000 Hz frequencies in the right ear and at 125, 4000, 6000 and 8000 Hz frequencies in the left ear. In the LP patient group, 6 patients had sensorineural hearing loss, 3 patients had conductive hearing loss, and 2 patients had mixed hearing loss. Of the 3 patients with conductive hearing loss, 2 had cutaneous and 1 had both mucosal and cutaneous involvement. Of the patients with mixed hearing loss, 1 had cutaneous and 1 had both mucosal and cutaneous involvement. In patients with sensorineural hearing loss, 1 had mucosal, 3 had cutaneous, and 2 had both mucosal and cutaneous involvement. Sensorineural, conductive or mixed hearing loss can be observed in LP patients.

Is the periodontal status a risk factor for the development of psoriasis?

BACKGROUND AND OBJECTIVES: Psoriasis is a common, chronic, inflammatory, and hyperproliperative skin disease. It has been known that the infectious agents play a role in triggering and exacerbation of the disease. Periodontal diseases are chronic inflammatory gum diseases initiated by microorganisms in dental plaques. This study intended to determine the role of periodontal diseases, as chronic infective foci in psoriasis. MATERIALS AND METHODS: A total of 76 patients, who applied to Faculty of Medicine, Department of Dermatology, Inönü University, diagnosed as psoriasis and a control group consisting of 76 dermatologic patients without any systemic disease at similar age and gender were included the study. The dental examinations of the subjects were done by the Community Periodontal Index of Treatment Needs index system, using a periodontal probe. RESULTS: Significant difference was identified between the patients with psoriasis and control group, in terms of CPI (Community Periodontal Index), oral hygiene habits, frequency of tooth brushing and flossing (P = 0.01, P = 0.001, P = 0.01, P = 0.05, respectively). A positive correlation between the severities of psoriasis and dental disease was determined, but this difference was not statistically significant (P = 0.204). CONCLUSION: The periodontal disease may affect psoriasis as a chronic infectious focus and probably through proinflammatory cytokines. In order to clarify the exact role of periodontal disease in psoriasis, the issue should be studied in larger series with serum cytokine levels.

Delayed diagnosis of bullous pyoderma gangrenosum with acute myelogenous leukemia.

Pyoderma gangrenosum (PG) is a rare, but serious neutrophilic dermatosis characterized by recurrent painful cutaneous ulcerations. It is commonly associated with inflammatory bowel disease, rheumatoid arthritis, and hematological malignancies. Because laboratory evaluations and histologic features of PG are nonspecific, diagnosis is based on the clinical features of the ulcer and requires exclusion of other conditions that cause such ulceration. The disease responds to glucocorticoids, immunosuppressives, and anti-inflammatory drugs. We present a 30-year-old man with acute myelogenous leukemia (subtype M5) and bullous PG. Treatment with high-dose prednisolone was successful.

Do cigarette smoke and vitamin E affect the development of endometrial pinopods? An animal study.

OBJECTIVES: To study the effects of cigarette smoke and vitamin E on the development of endometrial pinopods. STUDY DESIGN: Eighteen female and 12 male Swiss albino mice, 12-14 weeks old, with a mean weight of 25g (standard deviation 5g) were used in this study. Female mice were divided into three equal groups. Every day for 10 weeks, mice in Group 1 (control group) received normal saline intraperitoneally; mice in Group 2 were exposed to smoke from 20 cigarettes/day using a smoke machine; and mice in Group 3 were exposed to smoke from 20 cigarettes/day using a smoke machine and also received 50mg/kg vitamin E intraperitoneally. After 10 weeks, vaginal smears were taken from the female mice and they were copulated with the 12 male Swiss albino mice on the day of oestrus. Day 0 was defined as the day on which sperm were detected in the vagina by smear test. Mice were killed at the end of Day 5, which was considered to represent the optimal day for implantation. The uteri were removed and the effects of cigarette smoke and vitamin E on the development of endometrial pinopods were studied using an electron microscope. RESULTS: The endometrial tissue of the control group appeared morphologically normal, with short microvilli, cytoplasm and pinopods in the form of cytoplasm and cell membrane enlargements in patches. In total, 149 pinopods were counted in the control group using a scanning electron microscope (two histologists performed the analysis and were blinded to each other's findings). In the smoke-exposed group, the cytoplasmic structure was degenerated considerably, and fewer pinopods were counted (n=11). The number of pinopods in mice who were exposed to cigarette smoke and vitamin E (n=67) was significantly higher compared with the cigarette-exposed group (p=0.002), but considerably lower compared with the control group (p=0.002). CONCLUSION: Smoke exposure led to a significant decrease in the development of endometrial pinopods. Vitamin E, an antioxidant, partially reversed the adverse effects of cigarette smoke. This suggests that cigarettes may have a negative effect on fertility by decreasing the number of pinopods. However, this negative effect can be reduced using vitamin E. More studies should be conducted to support this finding.