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BACKGROUND: Acne vulgaris is a multifactorial disease of the skin. Several studies have shown that elevated levels of serum insulin-like growth factor-I (IGF-I) correlate with overproduction of sebum and acne. Recently functional relationship between IGF-I (CA) polymorphism and circulating IGF-I levels in adults has been reported. AIMS: The aim of our study was to investigate for the first time whether IGF-I (CA) polymorphism might be involved in the pathogenesis of acne or not. METHODS: We included 115 acne patients and 117 healthy subjects to the study. The clinical grade of acne was assessed based on the Global Acne Grading System. Participants were questioned about diabetes mellitus, PCOS and other systemic disease. We searched for the IGF-I (CA) 19 polymorphism in this study. The IGF-I (CA) 19 polymorphism was performed by polymerase chain reaction. RESULTS: We categorized the IGF-I (CA) 19 polymorphism area into three groups as lower than 192 bp, 192–194 bp and higher than 194 bp. We found that the frequency of genotype IGF-1 (CA) 19 gene was significantly different between control and acne patients (P = 0.0002). A significant association between IGF-I (CA) genotypes and severity of acne was found (P = 0.015). No significant difference was found between male and female patients (P > 0.05). CONCLUSIONS: Our results suggest that IGF-I (CA) 19 polymorphism may contribute to a predisposition to acne in Turkish patients.

BACKGROUND: Psoriasis is an inflammatory disease characterized by increased squamous cell proliferation and impaired differentiation. Vitamin D, Calcitriol, and its analogues are successfully used for psoriasis therapy. However, it is unknown why some psoriasis patients are resistant to Vitamin D therapy. Vitamin D mediates its activity by a nuclear receptor. It is suggested that polymorphisms and haplotypes in the VDR gene may explain the differences in response to vitamin D therapy. MATERIAL/METHODS: In this study, 102 psoriasis patients and 102 healthy controls were studied for VDR gene polymorphisms. The Fok I, Bsm I, Apa I and Taq I polymorphisms were examined by PCR-RFLP, and 50 subjects received vitamin D therapy to evaluate the association between VDR gene polymorphisms and response to vitamin D therapy. Existence of cutting site is shown by capital letters, and lack was shown by lower case. The haplotypes were analysed by CHAPLIN. RESULTS: There was significant difference in allele frequency of T and genotype frequency of Tt between cases and controls (p values 0.038 and 0.04, respectively). The Aa and bb genotypes were significantly higher in early onset than late onset psoriasis (p values 0.008 and 0.04, respectively). The genotypes Ff, ff and TT are significantly different between vitamin D3 therapy responders and non-responders (p values 0.04, 0.0001, 0.009, respectively). To the best of our knowledge, this is the first report showing importance of VDR gene haplotypes in psoriasis, the significance of the Wald and LR (Likelihood Ratio) statistics (p=0,0042) suggest that FfBbAatt is a disease-susceptibility haplotype. CONCLUSIONS: Haplotype analysis is a recent and commonly used method in genetic association studies. Our results reveal a previously unidentified susceptibility haplotype and indicate that certain haplotypes are important in the resistance to vitamin D3 therapy and the onset of psoriasis. The haplotypes can give valuable data where genotypes unable to do.

BACKGROUND: Plantar warts are refractory to any form of treatment. High cure rates have been reported with a topical proprietary formulation consisting of 1% cantharidin, 5% podophyllotoxin and 30% salicylic acid (CPS). However, no data exists comparing the efficacy of this formulation with another treatment. Cryotherapy is a method that is also widely used in the treatment of plantar warts. Likewise, there is no evidence that it is more effective than any topical treatment. OBJECTIVE: We aim to compare the efficacy of topical CPS and cryotherapy in the treatment of plantar warts. METHODS: Patients with plantar warts were consecutively treated with either cryotherapy or topical CPS. Both treatments were performed every 2 weeks for up to five sessions. In patients without complete clearance, the therapy was switched to the other treatment option. RESULTS: Twenty-six patients with a total of 134 warts were included. Fourteen patients were completely cleared of their warts with topical CPS, whereas only in five of 12 patients (41.7%) warts were completely cleared with cryotherapy (P=0.001). In seven patients without complete clearance, the therapy was switched to CPS. Four of these patients missed the follow-up. While the two of the remaining three patients were cleared of their warts, one patient's warts still failed to clear. CONCLUSION: Topical CPS is more effective than cryotherapy in the treatment of plantar warts.

Bacillary angiomatosis (BA) is an infectious disease which occurs predominantly in immunosuppressive patients and rarely in immunocompetent individuals. We had a case of BA who presented with a red cutaneous nodule on his left leg of which histopathological examination revealed marked lobular proliferation of capillaries throughout the interstitium and clusters of bacilli with hematoxylin-eosin and Warthin-Starry stains, respectively. Antibody titer against Bartonella henselae was 1/32. The only systemic disease the patient had was chronic hepatitis B. HIV was negative and no other immunosuppressive status was established. In this case we believe that the immunological differences secondary to chronic hepatitis B could have caused a tendency for the disease development. © 2010 Japanese Dermatological Association.

Propionibacterium acnes is the main bacterial etiologic agent in acne vulgaris pathogenesis. The rate of antibiotic resistant P. acnes isolates is less than 10% in our country. The aim of this study was to biotype P. acnes strains which were isolated from acne vulgaris patients and to investigate the biotype distribution in our region. P. acnes isolates from 64 patients (18 male, 46 female; mean age 19 +/- 3.1 years) were included in the study and biotyped by sugar-specific pH changes using sorbitol, erythritol and ribose. Results were compared with the global acne grading scores and clinical types of the patients. The frequency rates of P. acnes biotypes were found as follows; 40 strains (62.5%) were biotype I, 3 (4.7%) were biotype II, 20 (31.3%) were biotype III and one (1.6%) was biotype IV, whereas biotype V was not detected. The acne cases who were admitted to dermatology outpatient clinics mostly complained of papulopustuler and nodulocystic lesions. Therefore the detection of antibiotic resistance rates of P. acnes strains by mass screening of the community has a growing importance. Since P. acnes biotype III is the main biotype which causes the most severe acne reactions, the 31.3% rate of frequency found in our study, can not be overlooked. As a result, this data should be considered as a guide while prescribing antibiotics for the treatment of acne patients.

Henoch-Schölein purpura is usually a disease of children presenting with arthralgia, abdominal pain, renal involvement, and palpable purpura. Viral and bacterial infections may have a role in its etiology. We present a 32-year-old male patient with recurrent Henoch-Schölein purpura in association with a chronic hepatitis B infection of ten years duration. The patient had received lamuvidine and interferon-alpha for the treatment of hepatitis B infection for a year. The skin lesions disappeared with the treatment of the hepatitis B infection. Four months after discontinuation of the therapy, the purpuric papules reappeared with reactivation of the hepatitis B infection. Although rarely reported, hepatitis B virus infection should be considered in patients with Henoch-Schölein purpura.

Background: Flatfoot in which a normal arch fails to develop is a common deformity in both children and adults. A frequently-used treatment is an over-the-counter insole to normalize foot mechanics and relieve pain. This study was designed to evaluate the effects of over-the-counter silicone insoles on the gait patterns of patients with flexible flatfoot. Methods: Thirty-four adults (24 women and nine men, average age 43.7 ± 9.7 years) with bilateral symptomatic flatfoot deformities were included in the study. Flatfoot was diagnosed by a lateral talometatarsal angle of more than 4 degrees and a talocalcaneal angle of more than 30 degrees. Three-dimensional gait analysis and video recordings were done at a single session. All patients walked at self-selected speeds over a 10-meter walkway with and without insoles. Time-distance parameters and kinematic and kinetic characteristics of gait in the sagittal plane were evaluated by a quantitative gait analysis system. Results: Mean lateral talometatarsal and talocalcaneal angles were 6.3 ± 2.5 degrees and 56.1 ± 8.6 degrees, respectively. There was no difference in gait parameters with or without the insoles. Conclusions: Over-the-counter insoles have no beneficial effect in normalizing forces acting on the foot and on the entire lower extremity in adults with flexible flatfoot. Copyright © 2007 by the American Orthopaedic Foot & Ankle Society, Inc.