Tear functions in patients with vitiligo.

BACKGROUND: Vitiligo is a common, acquired, pigmentary disorder characterized by the loss of melanocytes. In this study, we evaluated the ophthalmalogic abnomalies of patients with vitiligo with regard to tear functions. METHODS: The patients and control subjects underwent examinations via the Schirmer's test, tear film break-up time (BUT), and Rose Bengal staining. RESULTS: Schirmer test values in patients with vitiligo were lower than those in the control subjects, but the differences were not statistically significant (P = 0.200). In addition, the BUT values of patients with vitiligo were also significantly lower (P < 0.001), and the Rose Bengal scores of patients with vitiligo were significantly higher (P < 0.001) than the scores of the control subjects. When comparing only the vitiligo subgroups, the Schirmer test scores and BUT values of patients with acrofacial vitiligo were significantly lower than those of patients with generalized vitiligo (P = 0.001). Furthermore, the Rose Bengal scores of patients with acrofacial vitiligo were significantly higher than the scores of patients in the generalized subgroup (P = 0.011). CONCLUSION: This study revealed that there is a decrease in tear production in patients with vitiligo, particularly in those with the acrofacial type of vitiligo.

Histopathologic Study of Pathergy Test in Behçet's Disease.

BACKGROUND: The pathergy test (PT) is important in the diagnosis of Behçet's disease (BD). However, misinterpretation of the test might cause false-positive or false-negative results. Therefore, immunopathologic and histopathologic tests are recommended with PT. AIMS AND OBJECTIVES: The aim of this study is to determine histopathologic findings of positive pathergy reaction at BD. MATERIALS AND METHODS: This study was performed on 23 patients with BD. All patients were in active period of the disease. After 48 h from the injection, biopsy was performed on positive pathergy lesions. RESULTS: Of the specimen from positive PT lesions of patients with BD, nine revealed mixed type inflammatory cell infiltration (39.1%), two revealed lobular panniculitis without vasculitis (8.7%), two revealed neutrophil rich infiltration (8.7%), and five revealed lymphocyte rich infiltration (21.7%) at the subcutaneous tissue. Mixed type inflammatory cell infiltration (43.4%), endothelial swelling and thickening (17.3%), erythrocyte extravasation (26.0%), perivascular cell infiltration (13.0%), lymphocytic vascular reaction (8.6%), lymphocytic vasculitis (13.0%), and leukocytoclastic vasculitis (21.7%) were detected in dermis by histopathologic examinations. There was no statistically significant difference between histopathologic findings and sex, family history, and systemic involvement except uveitis. CONCLUSION: This is an exceptional study since it is the first study that determines subcutaneous tissue findings of positive pathergy reaction in Behçet patients. In our study, uveitis was found to be statistically significant in the patients who had vasculitis in dermis. It can be a clue for prediction of disease severity and course. Further, studies that include wide number of patients will better illuminate the correlation between subcutaneous tissue findings and disease severity and clinical course.

Demographic and clinical features of 521 Turkish patients with Behçet's disease.

BACKGROUND: The aim of this study is to reveal demographic and clinical features of Behçet's disease (BD) in a Turkish population. METHODS: We retrospectively evaluated the clinical findings of 521 patients with BD. RESULTS: A total of 521 patients (287 female and 234 male) were included in this study. Onset signs: oral ulceration (72.7%) was followed by genital ulceration (3.1%), ocular involvement (1.0%), and erythema nodosum-like lesions (ENLL) (0.2%). In 120 patients (23%), the onset manifestation compromised more than one symptom. During follow-up, in females and males respectively, oral ulceration was found in 100%, genital ulceration in 90.9% and in 82.5%, papulopustular lesions in 52.6% and in 71.4%, positive pathergy test in 45.3% and in 48.7%, ENLL in 43.6% and in 31.6%, ocular involvement in 36.9% and in 58.1%, gastrointestinal involvement in 6.6% and in 5.6%, joint involvement in 4.2% and in 6.4%, vascular involvement in 1.7% and in 10.6%, neurological involvement in 0% and in 4.7% and pulmonary involvement in 0.7% and in 0.7%. Genital ulceration and ENLL were found to be statistically higher in females than males. Papulopustular lesions and ocular, neurological, and vascular involvement were significantly higher in males than females. CONCLUSIONS: In our study, systemic involvement was higher in males than females, as the disease is more severe in males than females. As the only initial finding of the disease can be genital ulceration or ocular manifestations, gynecologists, urologists, ophthalmologists, and family practitioners must keep in mind BD as a differential diagnosis.

Serum levels of natriuretic peptides in patients with Behcet's disease.

The objective of our study was to elucidate serum levels of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and C-type natriuretic peptide (CNP) in Behcet's disease (BD) patients with active and inactive period. The multicenter study included 53 patients with active (n = 28) and inactive (n = 25) BD (mean age, 34.3 +/- 9 years; 15 men and 38 women) satisfying the International Study Group criteria and 26 healthy controls (mean age, 34.4 +/- 6.1 years; seven men and 19 women) matched for age and gender from a similar ethnic background. Serum natriuretic peptides levels were determined by enzyme immunoassay kit. Mean serum ANP concentrations in the active patients (4.01 +/- 1.21 ng/ml) were significantly lower than in the healthy controls (5.76 +/- 1.99 ng/ml, p = 0.004). Mean serum BNP levels were found to be significantly higher in both the active (6.19 +/- 2.97 ng/ml) and inactive (6.49 +/- 2.88 ng/ml) BD groups compared with the control group (3.82 +/- 1.1 ng/ml, p = 0.004 and p = 0.001, respectively). Mean serum CNP concentrations in the active patients (0.49 +/- 0.12 ng/ml) were significantly lower than in the inactive patients (0.65 +/- 0.2 ng/ml, p = 0.017) and the healthy controls (0.8 +/- 0.27 ng/ml, p < 0.001). Our results suggest that changes in natriuretic peptide levels may be associated with vasculitis that play role in the etiopathogenesis of the BD.