Does maternal exposure to artificial food coloring additives increase oxidative stress in the skin of rats?

Glutathione-S-transferase (GST) and cytochrome P450 family 1 subfamily A polypeptide 1 (CYP1A1) metabolize and detoxify carcinogens, drugs, environmental pollutants, and reactive oxygen species. Changes of GST expression in tissues and gene mutations have been reported in association with many neoplastic skin diseases and dermatoses. Widely used artificial food coloring additives (AFCAs) also reported to effect primarily behavioral and cognitive function and cause neoplastic diseases and several inflammatory skin diseases. We aimed to identify the changes in expression of GSTs, CYP1A1, and vascular endothelial growth factor (VEGF) in rat skin which were maternally exposed AFCAs. A rat model was designed to evaluate the effects of maternal exposure of AFCAs on skin in rats. "No observable adverse effect levels" of commonly used AFCAs as a mixture were given to female rats before and during gestation. Immunohistochemical expression of GSTs, CYP1A1, and VEGF was evaluated in their offspring. CYP1A1, glutathione S-transferase pi (GSTP), glutathione S-transferase alpha (GSTA), glutathione S-transferase mu (GSTM), glutathione S-transferase theta (GSTT), and VEGF were expressed by epidermal keratinocytes, dermal fibroblasts, sebaceous glands, hair follicle, and subcutaneous striated muscle in the normal skin. CYP1A1, GSTA, and GSTT were expressed at all microanatomical sites of skin in varying degrees. The expressions of CYP1A1, GSTA, GSTT, and VEGF were decreased significantly, while GSTM expression on sebaceous gland and hair follicle was increased. Maternal exposure of AFCAs apparently effects expression of the CYP1A1, GSTs, and VEGF in the skin. This prominent change of expressions might play role in neoplastic and nonneoplastic skin diseases.

The effects of systemic isotretinoin and antibiotic therapy on the microbial floras in patients with acne vulgaris.

BACKGROUND: Although there are several studies about the alteration in skin flora, limited number of reports about changes in the microbial contents and their resistance profile of other body sites in patients treated with isotretinoin for acne vulgaris. OBJECTIVES: The aim of this study was to investigate the effects of systemic isotretinoin and antibiotic therapy on the microbial floras of oropharynx, nose and feces in acne patients. METHODS: Treatment groups of isotretinoin and antibiotics consisting of 20 and 15 patients, respectively were included. Microbiological culture samples were taken at baseline and once a month during 4-6 months of treatment period. RESULTS: Difference in microbial flora throughout the treatment period was detected at least among one of all culture samples of 15 (75%) and 5 (33%) patients in isotretinoin and antibiotic groups. There was statistically significant difference between two groups in means of alteration of the microbial flora (P = 0.013). The difference was definitely observed among nasal cultures (65%) in isotretinoin group and fecal cultures (20%) in the other. Staphylococcus aureus colonization was prominent in the microbial floras of nose and oropharynx and 2 of 14 nasal isolates were detected to be methicilline resistant while Escherichia coli with extended spectrum beta lactamase activity was detected in fecal floras of patients in isotretinoin group. CONCLUSIONS: Systemic isotretinoin and antibiotic treatments in acne patients precisely caused variations in the microbial floras of several sites of the body, while isotretinoin was commonly more responsible than antibiotics. Knowing that alterations in the microbial colonization of the flora regions may preceede infectious disease and bacterial resistance, treatment options and follow-up procedures in acne vulgaris should be carefully determined to reduce the risk of destruction of the microbial flora.

[Early melanoma as opposed to a benign nevus, nevus-associated melanoma, or halo nevus with regression?]. / Frühes Melanom neben einem benignen Nävus, nävusassoziiertes Melanom oder regressiver Nävus?

A 43-year-old woman, in whom a melanoma associated with a melanocytic nevus had been removed 2 years previously, came for a follow-up examination presenting with two light brown to medium brown maculae measuring approximately 7x5 mm with a flat papular center. One of the lesions was surrounded by a large white halo about 2 mm in size. The differential diagnosis on clinical grounds included a halo nevus with a second common nevus, a nevus with regression, and a melanoma associated with a nevus. Under the dermatoscope, an unremarkable homogeneous/reticular pattern could be seen and in one portion hallmarks of regression, namely gray tones and distinct gray-black dots. The diagnosis based on histopathological analysis was that of an atypical congenital nevus with regression.

Is there any relationship between serum and urine neopterin and serum interferon-gamma levels in the activity of Behcet's disease?

BACKGROUND: Behcet's disease (BD) is a chronic, inflammatory, multisystem vasculitic disorder. There is no reliable laboratory marker that indicates disease activity. Neopterin is an immunological marker of cellular immune activation, which is secreted by monocytes/macrophages as a result of interferon-gamma (IFN-gamma) secretion by activated T lymphocytes. OBJECTIVE: We aimed to investigate serum and urine neopterin levels in BD patients. METHODS: Forty-five patients who were diagnosed according to the criteria of the International Study Group for BD and 45 age- and sex-matched healthy controls were enrolled in the study. Disease activity was considered by clinical findings. Serum and urine neopterin levels and serum IFN-gamma levels were measured. RESULTS: The mean values of serum and urine neopterin levels were 12.68 +/- 4.87 nmol/L and 167.53 +/- 148.73 micromol/mol creatinine, respectively, in BD patients (P = 0.000 and P = 0.008, respectively), which were statistically significantly different from the control group. However, there was no significant statistical difference between serum and urine neopterin levels of the clinically active and inactive patients. It was also found that the mean value of serum IFN-gamma levels was higher in healthy controls than in BD patients (P = 0.000). CONCLUSIONS: We conclude that serum and urinary neopterin measurement can not be used as a reliable laboratory marker as the BD patients' serum and urinary neopterin levels do not increase in the active stage even though these levels increase when compared to healthy controls.

Traumatic lingual ulcer in a child: Riga-Fede disease.

Riga-Fede disease RFD is an extremely rare, benign inflammatory disorder characterized by reactive, traumatic ulceration of the oral mucosa especially located on the tongue. It is most commonly associated with natal or neonatal teeth in newborns. Mucosal lesions are often caused by repetitive traumatic damage due to backward and forward motions of the tongue over the lower incisors. Failure to diagnose and treat these lesions properly may result in inadequate food intake, growth retardation and permanent lingual deformity. We report a 15-month-old healthy infant with tongue ulcer diagnosed as RFD based on history and clinical features.

Evaluation of activatory and inhibitory natural killer cell receptors in non-segmental vitiligo: a flow cytometric study.

BACKGROUND: Recent observations established the role of altered cellular immunity and autoimmune hypothesis in the pathogenesis of vitiligo. There have been several reports discussing T-cell and natural killer (NK) cell populations, but NK cell receptors were not evaluated in vitiligo. OBJECTIVE: The purpose of this investigation was to assess the role of T and NK cells as well as activatory and inhibitory NK cell receptor alterations in the pathogenesis of vitiligo and whether any aberrations were correlated with clinical findings of the disease. PATIENTS/METHODS: Fifty-three patients with non-segmental vitiligo and 45 age- and sex-matched healthy controls were enrolled in the study. The percentages of lymphocytes, granulocytes, monocytes and CD3, CD4, CD8, CD14, CD16, CD56, CD45, CD45RA, CD54RO, CD28, CD80, CD94, CD158a, KIR3DL-1 receptors as well as CD94, CD158a, KIR3DL-1 receptors on CD16(+) cells were detected by using flow cytometry. The patient and control groups were compared in terms of the results of flow cytometric analysis, and the results were assessed regarding the type and activity of vitiligo. RESULTS: The percentages of CD16(+)CD56(+), CD3(+)CD16(+)CD56(+), CD8(+) and CD45RO(+) cells were significantly increased in vitiligo group compared with the controls. No difference was detected between the patients and control groups in percentages of CD3(+), CD4(+), CD3(-)CD16(+)CD56(+), CD28(+), CD45(+), CD45RA(+), CD94(+), CD158a(+) and KIR3DL-1(+) cells. The percentage of CD16(+)CD158a(+) cells was significantly decreased in a randomized selected group of vitiligo patients. There were no differences in percentage expression of studied cell surface antigens between patients in the active or stable period. CD3(+) cells were significantly increased in generalized form, and CD45RO(+) cells were significantly increased in acral/acrofacial form when compared with the other types of vitiligo. CONCLUSIONS: These results indicate further evidence for T and NK cell abnormalities in non-segmental vitiligo. The present data show that NK cell activation may be responsible in the pathogenesis of vitiligo in conformity with decreased inhibitory and increased activatory NK cell receptors.

Assessment of information and education about topical corticosteroids in dermatology outpatient departments: experience from Turkey.

BACKGROUND: Topical corticosteroids are commonly used in dermatological practice. The aim of this study was to assess the baseline level of knowledge about topical steroids in a group of dermatology patients and to evaluate the impact of educational materials on patients' level of information. METHODS: A 10-item questionnaire was developed, and 126 patients who were prescribed topical steroids for several dermatologic diseases were asked mostly about side-effects of the drugs. Three different educational methods were used in parallel to the questionnaire: verbal (n = 42), written (n = 42) or verbal and written (n = 42). The same questions were asked again 1 or 2 weeks later. RESULTS: Only 7.1% of the study group mentioned that they were informed by doctors about the side-effects of topical steroids before they were administered. The baseline information scores about topical corticosteroids were higher in high school and college graduates and in those who noted side-effects or who were informed about side-effects before administration. A statistically significant difference was detected between pre- and posteducation scores of patients in the whole group and within the three groups of different educational methods (P < 0.001). Posteducation scores of the combined verbal- and written-educated group were higher than the written-educated group or the verbal-educated group. CONCLUSION: The present study indicated that patient knowledge is enhanced by any kind of educational method, and particularly written information supported by verbal instructions given in dermatology outpatient departments. Moreover, we conclude that the 10-item questionnaire can be used in Turkey to assess patients' knowledge about topical corticosteroids.

Acquired reactive perforating collagenosis.

Acquired perforating disorder has been recognized as an uncommon distinct dermatosis in which altered collagen is eliminated through the epidermis. Several disorders accompanied by itching and scratching were reported to be associated with reactive perforating collagenosis. A 67-year-old white woman diagnosed as acquired reactive perforating collagenosis with poorly controlled diabetes mellitus and congestive cardiac failure is presented.

The role of the antioxidative defense system in papulopustular acne.

Acne vulgaris frequently occurs in the second decade of life. The pathogenesis of the disease is multifactorial. In this study, we aimed to investigate the role of reactive oxygen species in inflammation of acne by determining the activity of antioxidant defense enzymes in leukocytes. Fifty-two patients with papulopustular type acne vulgaris and 36 healthy controls were enrolled. The severity of the disease was examined by the Global Acne Grading System, and the activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase (CAT) enzymes as well as the level of thiobarbituric acid reactive substance (TBARS) were detected in leukocytes. The activities of SOD and GSH-Px were significantly decreased in the acne group. CAT activity and TBARS level were higher in patients than controls. Only a poor correlation was detected between GSH-Px activity and severity of the disease. Antioxidative defense enzymes are impaired in papulopustular acne, and drugs with antioxidative effects might be valuable in treatment.

Amyloidosis of the tongue with kappa light chain disease.

A 70-year-old woman presented with a painful, red tongue with papules associated with xerostomia and systemic symptoms including weight loss, difficulty in swallowing and breathing, haemochezia and leg swelling. Biopsy from the tongue demonstrated amyloid deposits and, on further investigation, kappa chain disease was diagnosed. Primary systemic amyloidosis was diagnosed and the patient died within weeks of presentation.