Vitamin D levels in actinic keratosis: a preliminary study

Abstract: Background: Recent studies that investigated the effect of vitamin D on skin cancer risk have exhibited inconsistent results. Objective: The aim of the study was to evaluate vitamin D status in patients with actinic keratosis. Methods: A cross-sectional study was conducted on 31 patients with actinic keratosis and 29 healthy controls. Serum vitamin D levels in the study group were determined by liquid chromatography/tandem mass spectrometry. Results: Serum 25(OH)D levels in patients with actinic keratosis were significantly higher than those of the healthy controls (P=0.04). Prevalence of 25(OH)D deficiency was significantly higher in the healthy controls (75.9%) compared to the patients with actinic keratosis (54.8%), but the difference was not statistically significant (P= 0.09). Study limitations: The cross-sectional design of the study, data on smoking based on patient self-report, and subjects' different dietary habits, which can influence 25(OH)D levels, are the study's limitations. Conclusion: Serum vitamin D level can be used as a marker for ultraviolet B radiation from sun exposure; therefore, it can be used in individuals at risk of actinic keratosis. Oral intake of vitamin D through diet or supplements is proposed instead of prolonged ultraviolet exposure to maintain adequate vitamin D serum levels. Further research is needed to elucidate the role of vitamin D in skin carcinogenesis.

Frequency, severity and related factors of androgenetic alopecia in dermatology outpatient clinic: hospital-based cross-sectional study in Turkey

Abstract: BACKGROUND: Androgenetic alopecia (AGA) is a patterned hair loss occurring due to systemic androgen and genetic factors. It is the most common cause of hair loss in both genders. In recent years, many studies investigating the relation between systemic diseases and androgenetic alopecia presented controversial results. OBJECTIVES: In this study we aimed to investigate the frequency of androgenetic alopecia, the presence of accompanying systemic diseases, the relation between body mass index and androgenetic alopecia severity and the association of hyperandrogenemia signs with androgenetic alopecia in patients who referred to our outpatient clinic. METHODS: Patients who referred to our clinic between October 2013 and May 2014 were included in the study. Diagnosis of androgenetic alopecia was made upon clinical findings. Presence of seborrhea and acne in both genders, and hirsutism in women, were examined. Age, gender, smoking habit and alcohol consumption, age of onset of androgenetic alopecia, family history, accompanying systemic diseases and abnormalities of menstrual cycle were recorded. RESULTS: 954 patients (535 women, 419 men) were included in the study. Androgenetic alopecia prevalence found was 67.1% in men and 23.9% in women. Androgenetic alopecia prevalence and severity were correlated with age in both genders (p=0,0001). Frequency of accompanying systemic diseases were not significantly different between patients with and without androgenetic alopecia (p=0,087), except for hypertension, which was significantly more frequent in men with androgenetic alopecia aged between 50 and 59 years. Study limitations: Despite the exclusion of other causes of alopecia, differentiation of Ludwig grade 1 AGA from telogen effluvium based on clinical features alone is difficult. CONCLUSIONS: In our study the rate of androgenetic alopecia was found to be higher than the other studies made in Asian and Caucasian populations.

Hepatitis C and hepatitis B virus infections in the etiopathogenesis of pemphigus

BACKGROUND: Previous studies have shown that some viral infections may be triggers for autoimmune diseases. The role of viral infections in the etiopathogenesis of pemphigus has also been investigated. OBJECTIVES: To investigate the relationship between pemphigus and the hepatitis B and C virus infections. METHODS: This retrospective study included 62 patients with pemphigus and 50 healthy controls of matching ages and genders. The control group included relatives who accompanied the orthopedic patients to the hospital but had no history of systemic and/or autoimmune diseases. RESULTS: The group of patients with pemphigus was composed of 43 (69.3%) females and 19 (29.7%) males, and the mean age was 48.08 ± 15.38. The hepatitis C virus antibody was negative in all of the patients. Hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (HBsAb), or both, were studied in 44 of the 62 patients. Two (4.3%) of these patients were positive for HBsAg and found to have HBV infection. Fourteen of them were HBsAb positive. Two (4%) of the 50 control subjects showed hepatitis C virus antibody positivity, while only 1 (2%) patient with pemphigus displayed HBsAg positivity. There was no statistically significant difference between the two groups for hepatitis B and C virus infections. CONCLUSIONS: This study does not support an association between pemphigus and hepatitis B and/or C virus infections. .

Use of Complementary and Alternative Medicine and Assessment of Dermatology Quality of Life Index among Dermatology Outpatients: A Cross-sectional Comparative Study.

Aims: The aims of this study were to examine the frequency of complementary and alternative medicine (CAM) use among dermatology outpatients, and compare the socio demographic factors and dermatology life quality index (DLQI) values between CAM users and non-users. The CAM approaches and knowledge of the patients were also evaluated. Study Design: A descriptive cross-sectional study design was used. Place and Duration of Study: This study was conducted at the Sisli Etfal Training and Research Hospital Dermatology outpatient clinic, between January of 2011 and May of 2011. Method: A total of 522 consecutive patients were included in this study. The patients were older than 18 years old, and answered an interviewer-administered questionnaire about CAM use. The demographics, dermatological condition, CAM treatment, time of usage, benefits and side effects, and the patients’ answers from the questions about CAM were recorded. The quality of life was evaluated using the Turkish version of the DLQI questionnaire. Results: The prevalence of CAM use was 16.8%, and the mean age of CAM users (28.2±14.3) was statistically lower than that of non-CAM users (36.0±16.9): 50% of the CAM users did not know the definition of CAM; 56.8% learned the CAM treatment model from a friend, neighbour or relative; 61.3% used CAM because of dissatisfaction with conventional medicine; 10% of the CAM users explained that they had benefits; and 18.2% claimed that they had side effects. There was a statistically significant difference between the mean DLQI scores of the CAM users (13.2±5.2) and non-users (11.5±4.2) (p=.05). Conclusion: This study determined that the usage of CAM was common; however, the knowledge of CAM was poor in our patients. The most commonly used CAM treatment was herbal therapy, and the major factors for choosing CAM were the disease duration and dissatisfaction with western conventional medicine. The measurement of the DLQI of the patients showed that CAM users were the patients most greatly affected by their skin conditions.

Generalized papular and sclerodermoid eruption: Scleromyxedema.

Scleromyxedema (SM) is a rare chronic progressive and highly intractable cutaneous disease with unknown etiology, affecting both genders equally between 30 and 50 years. The disease is characterized with mucin deposits in the skin and/or other organs. In fact it is a clinicopathological subset of lichen myxedematosus (LM) according to a new classification. Sclerodermiform plaques and lichenoid papules are characteristic cutaneous lesions. An elevation of IgG λ (lambda) chain exists in most cases and extracutaneous involvement occurring with variable systemic findings is also detected. Generalized form is quite difficult to treat and may even be fatal. Herein, we present a male patient with typical features of generalized papular and sclerodermoid LM variety and with benign outcome by isotretinoin.