Measurement of the serum zonulin levels in patients with acne rosacea.

OBJECTIVE: Although the etiopathogenesis of acne rosacea has not yet been clearly elucidated, it has been discussed over the years that autoimmunity may play a role. Genetic and environmental factors are known to have combined effects in the background of autoimmunity, but it has recently been emphasized that an impaired intestinal barrier system is also involved in the development of the disease. Zonulin is a protein that reversibly increases intestinal permeability. This study aimed to evaluate the zonulin levels in acne rosacea. METHODS: A total of 61 individuals, 30 diagnosed with acne rosacea and 31 healthy controls, were included in this study. There was no difference between the two groups in terms of age, gender, and body mass index. Zonulin was studied using the enzyme-linked immunosorbent assay. RESULTS: The serum zonulin levels were found to be significantly higher in the patient group than in the control group (18.5 ± 2.9 ng/ml and 13.2 ± 2.7 ng/ml, respectively; p < .001). CONCLUSION: This is the first study in the literature to demonstrate that the serum zonulin levels are increased in patients with acne rosacea.

Investigation of coenzyme Q10 levels and predisposing factors in patients with striae gravidarum.

BACKGROUND: Striae gravidarum (SG) can cause pregnant women severe psychological stress. OBJECTIVE: This study aimed to compare primigravidas with and without SG concerning fasting blood coenzyme Q10 (CoQ10), age, skin type, family history, gestational weight gain, pre- and post-pregnancy BMI, daily water consumption during pregnancy, gender and weight of baby, and the educational level. METHODS: The study included 79 primigravidas in the gestational week of 36 or above. The patients were divided into two groups based on the presence of SG. The fasting blood CoQ10 levels and other associated parameters were compared between the groups. RESULTS: Of the 79 primigravidas, 35 (44.3%) had SG. There was no statistically significant relationship between striae and CoQ10 (P = 0.144 and P = 0.189, respectively). Predisposing factors for striae were young pregnancy, light skin color, family history, high pre- and post-pregnancy BMI, increased gestational weight gain, and increased newborn weight. There was no significant relationship between striae development and educational level or water consumption during pregnancy. CONCLUSION: This is the first study to show that CoQ10 did not significantly differ between women with and without SG. Further studies with a larger case series are needed to elucidate predisposing factors for striae and involvement of CoQ10 in this condition.

Demographic and Clinical Features of Hidradenitis Suppurativa in Turkey.

BACKGROUND: The literature contains conflicting reports on the epidemiology and frequency of hidradenitis suppurativa (HS), a chronic, recurrent inflammatory disease of the apocrine glands. OBJECTIVE: To evaluate the clinical and demographic characteristics of HS cases in Turkey and investigate the similarities with world epidemiology. METHOD: The records of 208 patients that presented to our polyclinics and were diagnosed with HS between June 2012 and July 2017 were retrospectively evaluated. RESULTS: Of the cases, 68.3% were male and 31.7% were female. Of the patients, 75.5% had no family history of HS, 60.6% were smokers, 39.4% were aged 20-29 years, and 36.1% were aged 30-39 years. The most commonly involved regions were the axilla (62%), groin (50.5%), and gluteus (15.9%). According to univariate analyses, male patients had higher disease stages than females (odds ratio=1.67). The patients with groin involvement, high body mass index (BMI), and low education level (0-8 years) had higher risk of severe disease stage (odds ratio=1.63, 8.91, and 1.51, respectively). The most commonly used treatment was oral antibiotics in Hurley stages I and II, and surgical intervention in Hurley III. In all 3 Hurley stages, clavulanic acid-amoxicillin combination was the mostly used systemic antibiotic (41.8%, 43.2%, and 47.8%, respectively). CONCLUSIONS: This is the first epidemiological study on HS in the Turkish population, where HS shows male predominance. Male gender, low education level, absence of acne, high BMI, and groin involvement were associated with severe disease stages. Determining associated comorbidities and possible risk factors is important in progression and prevention of the disease.

Evaluation of thiol/disulfide homeostasis in patients with pityriasis rosea.

Purpose: Pityriasis rosea (PR) is a common, self-limiting, inflammatory skin disease with an acute onset. The etiology of PR is not yet clearly known but the defect in the oxidation system involved in many papulosquamous skin diseases may play a role. Thiol/disulfide homeostasis is a new marker of oxidative stress and has been studied in many diseases in recent years. The aim of this study to investigate thiol/disulfide homeostasis in PR patients. Material and methods: Thirty-four patients (18 females, 16 males; median age 26 years) that presented to the Dermatology Clinic of Istanbul Medipol Mega University Hospital between November 2017 and December 2018 and were clinically and/or histopathologically diagnosed with PR, and 30 healthy individuals (16 females, 14 males; median age 27 years) were included in the study. The serum native thiol and total thiol were measured by a novel colorimetric, automated method. The disulfide levels and disulfide/native thiol ratios were also calculated from these measured parameters. Results: There was no statistically significant difference in the serum native thiol and total thiol concentration between the PR and control groups (p = 0.711 and 0.788, respectively). Disulfide, disulfide/native thiol, and disulfide/total thiol levels were significantly higher in patients with PR (p = 0.002, 0.006 and 0.006, respectively). Conclusions: The thiol-disulfide balance shifted toward disulfide in patients with PR. This demonstrates the importance of oxidative stress in the etiopathogenesis of PR using a new marker.

Case for diagnosis. Atypical fibroxanthoma.

Atypical fibroxanthoma is a rare superficial fibrohistiocytic tumor. Clinically, it presents itself as a painless, solitary, ulcerated, and slow-growing nodule found mainly on sun-exposed areas - especially of the head and neck - of elderly individuals. The diagnosis is based on histopathological and immunohistochemical features. Immunohistochemical staining plays a critical role for the exclusion of differential diagnoses. Since atypical fibroxanthoma has an indolent clinical course, surgical excision is adequate for treatment. We present a case of atypical fibroxanthoma on the ear of a patient.

Case for diagnosis. Atypical fibroxanthoma

Abstract Atypical fibroxanthoma is a rare superficial fibrohistiocytic tumor. Clinically, it presents itself as a painless, solitary, ulcerated, and slow-growing nodule found mainly on sun-exposed areas - especially of the head and neck - of elderly individuals. The diagnosis is based on histopathological and immunohistochemical features. Immunohistochemical staining plays a critical role for the exclusion of differential diagnoses. Since atypical fibroxanthoma has an indolent clinical course, surgical excision is adequate for treatment. We present a case of atypical fibroxanthoma on the ear of a patient.

Pityriasis Rosea Recurrence is Much Higher than Previously Known: A Prospective Study.

Pityriasis rosea is a common acute exanthema of unknown aetiology, which causes severe anxiety. In this study, the demographic data of pityriasis rosea patients, who presented to our clinic between 2013 and 2017, were prospectively recorded. The patients with a confirmed pityriasis rosea diagnosis were followed up for 4 years in order to investigate the recurrence rate. Of the clinically suspected patients, having a typical history of pityriasis rosea manifestations, a herald patch, and/or secondary coloured squamous lesions, 400 were confirmed by biopsy to have pityriasis rosea. The 4-year follow-up was completed in 212 patients, of whom 136 (64.2%) were female and 76 (35.8%) were male. The recurrence rate was determined as 25.9% at the end of the 4-year follow-up period.

Serum leptin, adiponectin, resistin and ghrelin levels in psoriatic patients treated with cyclosporin.

Cyclosporin has various effects on adipose tissue and glucose metabolism. This situation may lead to changes in serum levels of adipocyte-derived cytokines which have influence on the pathogenesis of psoriasis. The aim of this study was to evaluate the effect of cyclosporin treatment on some adipocyte-derived cytokines in psoriatic patients. This case-control study was performed between June 2009 and March 2010, at the Department of Dermatology of Meram School of Medicine. Serum leptin, adiponectin, resistin and ghrelin levels were assessed in 26 patients with psoriasis before and after cyclosporin treatment and body mass index-matched 26 healthy control subjects. The adipokines levels were compared between the groups. Serum leptin, ghrelin, resistin and adiponectin levels in patients with psoriasis before the treatment were higher than those of the control group but the differences were not statistically significant. A positive correlation between serum leptin and family history of psoriasis was detected (r = 0.398, P = 0.044). A strong negative correlation between the Psoriasis Area and Severity Index and serum ghrelin levels was seen (r = -0.52, P = 0.001) and there was a strong positive correlation between the Nail Psoriasis Severity Index and serum resistin levels (r = 0.62, P = 0.001). Following the treatment, a significant increase was seen in the serum level of adiponectin (P = 0.02) and resistin (P = 0.003). The correlations between the adipokines and the disease parameters before the treatment were lost after the treatment. Our results suggest that levels of some adipocyte-derived cytokines in psoriatic patients are affected by cyclosporin treatment.