Search

Introduction: The role of oxidative stress in the pathogenesis of psoriasis has been investigated in previous studies with conflicting results. On the other hand, well-established treatments currently used in psoriasis exert their effects via a boost of oxidative stress. Recently, a strong positive association between psoriasis, metabolic syndrome and dyslipidemia has also been described showing the complex nature of the disease., Aim: To examine thiol/disulphide homeostasis, a newly developed homeostasis assay in psoriasis and evaluate the possible association between thiol/disulphide homeostasis and dyslipidemia in psoriasis., Material and Methods: The study population included 92 psoriasis patients and 71 healthy subjects. Serum native thiol, total thiol and disulphide levels were investigated in patients with psoriasis and in healthy subjects. In addition, lipid profile (serum total cholesterol, triglyceride, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol) levels were investigated in both groups. The association between thiol-disulphide parameters and dyslipidemia was also evaluated., Results: Serum total cholesterol and triglyceride levels were found to be higher in patients with psoriasis than in the healthy group. Lower plasma disulphide and higher native thiol levels were found in patients with psoriasis indicating an antioxidant status., Conclusions: To our knowledge, this is the first study showing the shift of dynamic thiol/disulphide homeostasis towards the thiol form in psoriasis which indicate higher antioxidant status.

Many people widely use herbal therapies for health problems in the world. Although these herbal therapies sometimes may be useful for some disorders they are not risk free. Ceratocephalus falcatus is an annual, wild plant which is a member of Ranunculaceae family. There are few case reports of phytodermatitis due to the Ranunculaceae family. We present a 58-year-old woman with irritant phytodermatitis due to C. falcatus.

A 14-year-old girl presented with hyperkeratotic, pitted, skin-colored papules on a slightly erythematous surface on her palms and erythematous and squamous papules around her ankles. She was clinically and histopathologically diagnosed with lichen nitidus, which is observed rarely on the palms., (© 2013 Wiley Periodicals, Inc.)

Clinical characteristics of vitiligo had been reported in different countries previously. This is the second report from Turkey and it is from a different region of Turkey, middle Anatolia, and a more detailed study. The age and sex of patients, onset age, duration, areas of involvement, course, clinical types and severity of the disease, family history of vitiligo, associated disorders, the values of vitamin B12, folic acid, ferritin, iron and hemoglobin, antithyroglobulin and antithyroid peroxidase antibodies and positivity of viral markers were obtained from the records of the patients retrospectively. The study involved 93 vitiligo patients with a mean age of 37.4±17.05 years. The median age of onset disease was 33 years and onset age of disease was significantly lower in women. Of the patients, 24.8% had family history. The most frequent form of vitiligo was vitiligo vulgaris. Facial involvement was the most common localization. Trunk involvement was significantly higher in women but anogenital involvement was significantly higher in men. Of the patients, 40.3% had another autoimmune disease, 19.7% of the patients had low ferritin levels, 12% had low iron levels, 9.9% had anemia, 4.9% had low vitamin B12 levels, 3.8% had low folic acid levels and 4.3% had positivity of viral markers. The age of onset and the incidence of family history were higher and sites of involvement according to sex were different from the published work. The knowledge of clinical characteristics, course and associated conditions of vitiligo may improve the approach of dermatologists to vitiligo patients., (© 2011 Japanese Dermatological Association.)

Background: Epidemiologic researches about oral mucosal lesions have been performed in different populations. But, in dermatology outpatients, oral mucosal lesions have not been investigated previously., Objective: We aimed to determine the prevalence of oral mucosal lesions among dermatology outpatients and the relationship between OML and smoking, alcohol intake, denture and dental filling use and skin diseases., Methods: Randomly selected 1041 dermatology outpatients were examined for dermatological diseases and oral mucosal lesions. All of the patients were questioned about smoking, alcohol intake, denture and dental filling use., Results: In 235 patients, oral mucosal lesions were recorded. 268 (25.7%) of the patients had history of smoking, 42 (4%) drinking alcohol and 180 (17.3%) denture and dental filling. 32 (64%) of the smokers, 54 (30%) of denture users and 10 (23.8%) alcohol consumers had at least one OML. Age and smoking were found as significant risk factors for oral mucosal lesions. Fissured tongue was the most common oral lesion and it was seen significantly higher in patients with denture. Smoking was risk factor for coated tongue and linea alba., Conclusions: Oral mucosa should be examined carefully even if the patients do not attend with the complaint of oral lesions, especially in elderly patients, smokers and denture users.

Background: There are few published clinical trials concerning upper gastrointestinal (GI) involvement in Behçet's disease (BD), and most have been performed on patients with upper GI tract symptoms., Aim: We sought to determine whether routine endoscopy is indicated in asymptomatic patients with BD and whether Helicobacter pylori plays a role in the pathogenesis of BD., Methods: Forty consecutive patients with BD and 40 age- and gender-matched controls with tinea pedis were studied. All patients underwent fiberoptic esophagogastroduodenoscopy. Urea breath test was used to identify H. pylori., Results: Abnormalities were noted in 37 patients (93%): hiatal hernia (53%), antral gastritis (33%), pan-gastritis (23%), gastric ulceration (8%), and duodenal ulceration (8%). Helicobacter pylori was found in 26 patients (65%) with BD and in 28 controls (70%) (no significant difference by chi-squared test, P > 0.05). We found a high incidence of upper GI abnormalities in BD, but the abnormalities were not specific for the disorder., Conclusions: Routine endoscopy and screening for H. pylori infection may not be necessary in asymptomatic patients with BD.

The mechanism for vascular involvement of Behçet disease (BD) includes arterial and venous thrombosis. Although the exact etiology of systemic vasculitis and thrombosis is still unknown, many hypotheses have been suggested. One of these hypotheses is that hyperhomocysteinemia causes vascular disease and thrombosis. The aim of this study was to compare the levels of homocysteine, vitamin B(12), and folic acid of BD patients with those of recurrent aphthous stomatitis (RAS) patients and healthy controls. Forty-five BD patients, 47 RAS patients, and 69 healty control subjects were included in this study. Vitamin B(12), folic acid, and homocysteine levels of the patients and controls were measured, and statistical differences among the groups were determined. BD patients had mostly cutaneous symptoms. Arthritis and ocular and vascular involvement were seen in 24.4%, 22%, and 11% of BD patients, respectively. No significant difference was detected among the groups in the levels of vitamin B(12), folic acid, and homocysteine. There was no significant difference in any parameters according to sex and age of the patients and activity of BD and if the patients with BD were treated or not. Homocysteine level inversely correlated with vitamin B(12) and folic acid levels in the BD group. We could not find any differences in homocysteine, vitamin B(12), and folic acid levels between BD and RAS patients and controls. This may be due to the fact that our patients mostly had cutaneous symptoms rather than vascular involvement.

Objective: The aim of this study was to determine the incidence of skin disorders in patients with hemiplegia and paraplegia. Several skin disorders have been reported previously in these patients., Methods: Seventy inpatients with hemiplegia, 30 with paraplegia, and 90 individuals as a control group were included in the study., Results: The most common skin disorder in the patient group was tinea pedis, which was observed in 18 of the 100 patients. The other common dermatological disorders in the patient group were onychomycosis of the toenails (n = 14), xerosis of the extremities (n = 13) and reduction in hair on the lower extremities (n = 12). The incidence of tinea pedis (p = 0.004), onychomycosis of the toenails (p = 0.010), xerosis of the extremities (p = 0.017) and reduction in hair on the lower extremities (p = 0.027) in the patient group were significantly more common than in the control group. There was no significant correlation between tinea pedis, onychomycosis of the toenails, xerosis of the extremities and reduction in hair on the lower extremities and the duration of hemiplegia and paraplegia., Conclusion: Dermatological disorders are observed more commonly in hemiplegic and paraplegic patients than in controls, therefore routine dermatological examination should be performed in these patients.

Background: Many people use unconventional therapies for health problems, but the extent and pattern of this use in dermatology have not been studied in detail. This article reports the first investigation on the use of unconventional therapies in dermatology in Turkey., Aim: To determine the prevalence and characteristics of unconventional therapies used by dermatology outpatients in Turkey., Methods: A questionnaire was employed to determine the use of unconventional therapies in patients attending a dermatology clinic in Ankara, Turkey. The patients were questioned about the number of attendances at dermatology clinics, whether they had ever used unconventional therapies and/or drugs without the suggestion of a medical doctor for the current dermatologic disorder, and the forms of unconventional therapies employed. The data were compared statistically with the age, sex, and education status of the patients., Results: The respondents included 443 men and 563 women, with a total of 1006 patients. The mean age of the patients was 36.62 +/- 17.55 years. Of the 1006 patients, 337 (33.5%) had used at least one form of unconventional therapy. The most common diagnoses of the patients using unconventional therapy were acne, psoriasis, contact dermatitis, and fungal infections. The most frequent forms of unconventional therapy used by the patients were humectants, cologne, spiritual healing, and herbs. Unconventional therapy use according to the sex, age, and education status of the patients did not show any significant difference. A significant relationship was found between some forms of unconventional therapy and some skin disorders, including: generalized pruritus and application of cologne; warts and spiritual healing; fungal infections and application of henna; psoriasis and herbal therapy or spiritual healing; alopecia areata and application of garlic; acne and application of lemon juice, clay, or cosmetics., Conclusion: Regardless of patient age, sex, and education status, dermatology outpatients use unconventional therapies for their health. Dermatologists should be aware of the tendency of patients to use unconventional therapies and should guide patients towards the use of harmless treatments.

Sarcoidosis is a granulomatous inflammation of unknown origin that varies in severity and distribution. We present a case of sarcoidosis with involvement of the skin, lacrimal, parotid, and submandibular glands. The patient had been previously misdiagnosed as having angioedema and allergic contact dermatitis; he had the rare finding of panda sign on gallium scintigraphy.

Background: Hyperhomocysteinaemia is a risk factor for atherosclerotic cardiovascular disease, stroke, peripheral arterial occlusive disease and venous thrombosis. An association between psoriasis and cardiovascular diseases has been reported., Aim: The aim of our study was to examine serum homocysteine, folic acid and vitamin B12 levels in psoriasis patients., Material and Methods: We performed a cross-sectional study in 70 consecutive outpatients with chronic plaque psoriasis and 70 age- and gender-matched controls. Serum levels of homocysteine, vitamin B12 and folic acid levels were measured in both groups., Results: Serum homocysteine, folic acid and vitamin B12 levels did not differ between patient and control groups. In psoriasis patients, homocysteine levels correlated directly with psoriasis severity as measured by psoriasis area and severity index. Serum homocysteine level inversely correlated with serum folic acid levels in the patient group., Discussion: Homocysteine levels correlated with psoriasis area and severity index in the patient group, which shows the disease severity. The increase in cardiovascular mortality with the severity of psoriasis might be also due to the effects of homocysteine.

Intravenous immunoglobulin (IVIG) is sterilized and purified human plasma which contains supra-physiologic levels of immunoglobulin G. IVIG is currently used in the treatment of immunodeficiency syndromes, inflammatory disorders and infectious diseases. Although numerous immunomodulatory mechanisms have been suggested, the exact mechanisms of action are poorly understood. There is also accumulating evidence that high-dose IVIG is efficacious in the treatment of some skin diseases, despite the lack of evidence from randomized, double-blind, placebo-controlled trials. Though in most cases, IVIG is only effective in combination with other immunomodulating strategies, it offers new hope for the treatment of many severe dermatologic conditions. This article focuses on the efficacy and safety of IVIG therapy in skin diseases.

Dyskeratosis congenita (DC) is a rare inherited disorder that is usually seen in males, consisting of the triad of leukoplakia of the mucous membranes, nail dystrophy, and skin pigmentation. We present a case of DC associated with esophageal stricture, Chiari 1 malformation, absence of inferior vena cava, webbed neck, and low posterior hair neck. A 22-year-old man attended our clinic with leukoplakia of the oral mucosa and nail dystrophy. In addition to these findings, poikilodermia on his neck and upper and lower extremities, bilateral ectropion, webbed neck, and low posterior hair neck was detected on dermatologic examination. Esophagoscopy demonstrated esophageal stricture. Cranial magnetic resonance imaging showed tonsillar herniation, and thoracoabdominal computed tomography revealed absence of inferior vena cava.

This study documents the spectrum and frequency of skin disorders in a total of 2370 children encountered in a dermatology outpatient clinic in Turkey. Infectious skin diseases were most frequently observed (27.6%) followed by, eczemas (17.9%), acne (14,5%), papulosquamous diseases (6.9%), hair diseases (4.1%), pigmentation disorders (3.8%), generalized pruritus (2.8%), urticaria (2.7%), and insect bite (2.3%). Epidemiologic data are useful in planning of the health care and taking preventive measures to decrease the prevalence of skin disorders in children.

Multiple myeloma is a malignant plasma cell proliferative disorder that produces a monoclonal immunoglobulin protein. The skin involvement and the development of bullous disease are rarely seen features in multiple myeloma. We present a 55-year-old man with a longstanding, large, tense bullous eruption and hypertrophic scars over his body accompanied recently with weight loss and fatique. He had no response to the previous treatments, which included oral glucocorticoids and dapsone. Histologic examination of the lesions revealed subepidermal bullae, while no immunoflourescence staining was observed. In a further detailed laboratory examination, multiple myeloma was detected. After the treatment of multiple myeloma with chemotherapy, the lesions regressed. Patients with longstanding, recurrent, unusual bullous eruption should be investigated for the development of multiple myeloma.

Background: Xeroderma pigmentosum (XP) is a rare, autosomal recessive genodermatosis in which affected individuals exhibit sun sensitivity, cutaneous pigment abnormalities, and a high incidence of skin cancers of sun-exposed skin., Methods: We studied the clinical features of 12 XP patients from Turkey, who were followed for 5 years., Results: Consanguinity was confirmed in 10 cases. The onset of hyperpigmented macules and photosensitivity was between the ages of 6 months and 5 years (average age, 25 months). The first appearance of cutaneous tumors was at 3-28 years of age (average age, 12 years). In nine of the 12 patients, cutaneous malignancies were confirmed histopathologically, and all nine were squamous cell carcinomas. One patient developed both squamous cell carcinoma and malignant melanoma., Conclusions: This study presents the epidemiological and clinical features of Turkish XP patients. We believe this study will provide new data for further studies in the future.

Background: Epidermodysplasia verruciformis (EV), is an unusual genodermatosis characterized by persistent human papilloma virus infection with an autosomal recessive inheritance pattern. Clinically, it is characterized by flat wart-like lesions, scaly hypo- and hyperpigmented macules and/or patches, which resemble pityriasis versicolor, and development of early beginning nonmelanoma cutaneous carcinomas., Methods: The epidemiological and clinical features of seven cases with EV that have been followed up for 5 years were included in the study., Results: Seven cases consisted of four males and three females. All seven cases were working outdoors. Three cases were the product of consanguineous marriages. The onset of the lesions was between the ages of 1-20 years (the average age was 9.29 years). The initial appearance of cutaneous tumors were between the ages 15-34 years (average age: 21.28 years). Six of seven cases had malignant cutaneous tumors, of which histopathological examination revealed squamous cell carcinoma (SCC). Three of our cases had radiotherapy previously for the existing SCCs. These cases had more early malignant transformations., Conclusion: Radiotherapy applied against the SCC previously, together with sunlight exposure may cause early malignant transformation of skin lesions and the destructive tumors.

Nickel sulphate frequently causes allergic contact dermatitis; less known effects are nasal inflammation (rhinitis) and bronchial asthma. In this study, we aimed to find if there is a relationship between asthma and nickel sensitivity. Asthmatic patient, non-asthmatic atopic, and healthy control groups were patch tested with nickel sulphate. Nickel sensitivity was more prevalent in the asthmatic patient group compared to the non-asthmatic atopic and healthy control groups.

A 5-month-old boy presented with multiple, pinkish-yellow, umblicated, varicelliform vesicles on his trunk. The lesions first appeared on his scalp 2 months earlier. There was also an erythematous, moist and erosive eruption on both axillae, inguinal regions and intergluteal sulcus. He had been treated with topical antibacterial and antiviral therapies. Histopathological investigation of the lesions revealed the diagnosis of Langerhans cell histiocytosis. Systemic involvement was not detected, although detailed investigation was performed. We present our case because he had a varicelliform and intertriginous eruption but did not have internal organ and haematological involvement.