Evaluation of Foot Deformities in Patients With Ingrown Nails.

INTRODUCTION: Ingrown nail is a condition caused by the perforation of the periungual soft tissues on nail folds by the sides of nail plaque, causing inflammation and severe pain. Recently, the role of foot anatomical disorders in ingrown nail development has been emphasized. OBJECTIVES: The main objective of this study aimed to determine whether foot deformities played significant roles in ingrown nail development with objective radiological parameters. METHODS: The study included 64 patients diagnosed with clinical ingrown nail and 71 patients as controls without any ingrown nail history. In both groups, we evaluated the bilateral foot radiographs of patients with ingrown nails for hallux valgus angle (HVA), interphalangeal angle (IPA), and intermetatarsal angle (IMA) associated with hallux valgus, and the calcaneal pitch angle (CPA), talohorizontal angle (THA), and talometatarsal angle (TMA) related to pes planus. RESULTS: No significant difference was found in terms of hallux valgus radiological measurements of HVA, IPA and IMA as well as pes planus radiological measurements of CPA and TMA values, when compared to controls. THA was statistically significantly higher in the control group (P = 0.025). There was a moderate strength positive relationship between ingrown nail stage and measured TMA for pes planus diagnosis (rho = 0.326; P = 0.04), yet there are no significant correlations between ingrown nail stage and other angles. CONCLUSIONS: Therefore, we do not recommend foot anatomy correction in the prevention and treatment of ingrown nails, unless there is an accompanying foot deformity; however, pes planus is a foot deformity that can accompany patients with severely ingrown nails.

A Rare Cutaneous Hamartomatous Adnexal Tumor: Trichofolliculoma.

Introduction: Trichofolliculoma is a very rare, benign hamartomatous skin adnexal tumor originating from the hair follicle. The tumor which presents as a papule or nodule is usually observed on the scalp and face. Case Presentation: We report the case of a 49-year-old female who presented with a solitary papule on the nose. The lesion which was observed macroscopically and dermoscopically compatible with trichofolliculoma was completely removed by punch biopsy. The diagnosis of trichofolliculoma was confirmed histopathologically, and no recurrence was observed in the follow-up. Conclusion: Trichofolliculomas can macroscopically mimic some skin cancers such as basal cell carcinoma and sebaceous carcinoma. Awareness of its typical clinical and dermoscopic features facilitates diagnosis and prevents aggressive surgical intervention.

The role of cystatin-C and fetuin-A in the determination of early atherosclerotic risk in psoriasis patients.

Psoriasis is associated with an increased risk of atherosclerosis. The objective of this study is evaluate the relationship between carotid intima-media thickness (CIMT) serum and cystatin-C, fetuin-A levels in determining the increased risk of subclinical atherosclerosis in psoriasis patients. In this study, age and gender compatible 80 psoriasis patients and 78 healthy individuals were included. For both groups, serum cystatin-C, fetuin-A, high-sensitivity C-reactive protein (hs-CRP), oxidized low-density lipoprotein (ox-LDL), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride, total cholesterol, and creatinine levels were recorded and carotid intima-media thickness (CIMT) was measured via B-mode ultrasonography by cardiology department. In binary comparisons between patient and control groups, cystatin-C, fetuin-A, hs-CRP, and CIMT values were higher in psoriasis patients and there was a statistically significant difference (P < .05). In control group, serum HDL-C level was statistically significant higher (P < .05). There was no statistically significant difference in hs-CRP, ox-LDL, LDL-C, triglyceride, total cholesterol, and creatinine levels between the groups (P > .05). Our study supported that psoriasis is a risk factor for development of atherosclerosis and we think that cystatin-C can be used as an important marker in determining subclinical atherosclerosis in patients with psoriasis.

Serpentine supravenous hyperpigmentation related to carboplatin and vinorelbine chemotherapy: A case report.

Serpentine supravenous hyperpigmentation (SSH) is a unique type of chemotherapy-associated drug eruption, characterized by hyperpigmentation along the superficial venous network. Histopathology reveals an increase in melanin production without destruction of basal cells of the epidermis or dermal inflammatory infiltrate. Herein, we describe a patient who developed SSH after repeated intravenous infusions with carboplatin and vinorelbine; two medications that have been uncommonly reported in association with SSH previously.

Plasma-soluble urokinase plasminogen activator receptor (suPAR) levels in psoriasis patients and correlation with disease severity.

OBJECTIVE: Psoriasis is a chronic, relapsing, inflammatory, hyper-proliferative skin disease. Plasma-soluble urokinase plasminogen activator receptor (suPAR) is released from the cell membrane-bound plasminogen activator and is a new biomarker of systemic inflammation. The aim of this study is to investigate plasma levels in psoriasis patients and determine their correlation with the Psoriasis Area and Severity Index (PASI) score. MATERIALS AND METHODS: The plasma suPAR levels of 50 healthy individuals and 65 psoriasis patients were measured using the Micro-ELISA method and the relation with PASI was investigated. RESULTS: On comparing plasma suPAR levels of the psoriasis patients with the control group consisting of healthy individuals, no statistically significant difference was determined (5.29 ng/ml ± 2.12 and 6.03 ng/ml ± 2.42, respectively, p = 0.326; Table 1). Likewise, there was no significant correlation between the suPAR levels and PASI score (r = 0.147, p = 0.243 > 0.05). CONCLUSION: There was no statistically significant difference in the plasma SuPAR levels of psoriasis patients compared to the control group. Nevertheless, we firmly believe that plasma SuPAR, a new biomarker, could indicate disease severity if conducted with larger patient series and with moderate to severe psoriasis patients.

Faun tail: a rare cutaneous sign of spinal dysraphism.

Faun tail is a triangle-shaped hypertrichosis of the lumbosacral region. It is a rare condition and it can be a cutaneous marker of underlying spinal cord anomaly. We report on a 17-year-old female patient with hypertrichosis on the lumbosacral area since birth that was later diagnosed with tethered cord in magnetic resonance imaging.

The importance of neutrophil lymphocyte ratio in patients with psoriasis.

OBJECTIVE: The aim of this study is to assess the neutrophil lymphocyte ratio (NLR) as an inflammatory marker in patients with psoriasis and to compare it with healthy subjects and to evaluate the correlation with the severity of the disease. METHODS: 104 psoriasis patients and 70 healthy persons were included as the control group. The laboratory results were recorded retrospectively from the patients' files and controls. NLR was calculated by the division of the neutrophil count to the lymphocyte count in the hemogram test. The dermatology examinations and psoriatic area severity index (PASI) scoring were performed by the same dermatologist. RESULTS: Leukocyte, neutrophil, NLR levels of the psoriasis patients were significantly elevated compared to those of the control group (p<0.05, p<0.01 and p<0.01 respectively). There were no correlation between NLR and PASI score (p>0.05) in the patient group. CONCLUSIONS: NLR, an emerging marker of inflammation, is higher in patients with psoriasis. Therefore we have suggested that this marker can be used for following of the psoriasis patients.

Assessment of lipocalin 2, clusterin, soluble tumor necrosis factor receptor-1, interleukin-6, homocysteine, and uric acid levels in patients with psoriasis.

BACKGROUND: Chronic inflammation may play a role in psoriasis pathogenesis. Lipocalin 2, clusterin, soluble tumor necrosis factor receptor-1 (sTNFR-1), interleukin-6, homocysteine, and uric acid are inflammatory and/or biochemical markers. However, both the roles of these markers and the pathogenesis of psoriasis are unknown. OBJECTIVE: The aim of this study was to investigate serum levels of lipocalin 2, clusterin, sTNFR-1, interleukin-6, homocysteine, and uric acid in patients and controls groups. METHODS: Fifty-six patients with psoriasis and 33 healthy controls were included in the study. Serum concentrations of the markers were evaluated by ELISA. The Psoriasis Area and Severity Index (PASI) was evaluated in all psoriasis patients. Body mass index (BMI) was calculated by dividing weight (kg) by height (m) squared. RESULTS: The serum value of lipocalin and sTNFR-1 were significantly higher in psoriasis patients than in controls (resp., P < 0.001, P < 0.05). The others showed no significant differences between psoriasis and the control groups (all of them P > 0.05). The mean PASI score in the patient group was 8.3 ± 6.5. CONCLUSIONS: These findings suggest that lipocalin 2 and sTNFR-1 might play a role in the pathogenesis of psoriasis and can be used as markers of the disease.

Kyrle's disease.

Kyrle's disease (KD) is a dermatosis which was first described by Kyrle as "hyperkeratosis follicularis et parafollicularis in cutem penetrans" in 1916. Perforating dermatoses are a heterogeneous disorder group characterised by transepithelial elimination. KD has been seen in association with multiple disorders, including diabetes mellitus, renal and liver diseases, congestive heart failure, hyperlipidaemia, infective diseases and abnormal metabolism of vitamin A. This case report presents two patients with KD with associated systemic disease.

Eruptive vellus hair cysts: report of a pediatric case with partial response to calcipotriene therapy.

Eruptive vellus hair cysts (EVHCs) are characterized by asymptomatic, follicular, comedonelike papules usually located on the anterior chest and abdomen. We present a pediatric case of EVHC associated with attention deficit hyperactivity disorder that partially responded to calcipotriene cream within 2 months. Our aim is to refamiliarize clinicians with a common albeit frequently unrecognized disorder of vellus hair follicles.

Response to vaccination against hepatitis B in patients with Behcet's disease.

BACKGROUND AND AIM: Hepatitis B virus infection is an important public health problem in Turkey. Although hepatitis B vaccination is regarded as safe and effective for the general population, recommendations for hepatitis B immunization in patients with Behcet's disease are not clear. The aim of the present study was to elucidate the response of patients with Behcet's disease to hepatitis B vaccination and to determine whether hepatitis B vaccination has any adverse effects on the course of the disease. METHODS: Thirteen patients with Behcet's disease and 15 healthy individuals were enrolled into a prospective study. All subjects received the 3-dose series of routine hepatitis B vaccine. Anti-hepatitis B surface response was evaluated 1-3 months after the third dose of vaccine. RESULTS: The responder rates for patient and control groups were 12/13 (92.8%) and 14/15 (93.8%), respectively. Statistical analysis showed no significant difference between the two groups in terms of both the responder rates and mean antibody titers. CONCLUSIONS: These preliminary findings might suggest that the majority of patients with Behcet's disease develop protective antibody response after hepatitis B vaccination and that the immune response against hepatitis B surface antigen is adequate, efficient and intact.