Peripheral nervous system involvement in patients with Behçet disease.

BACKGROUND: Central nervous system involvement in Behçet disease (BD) has been well documented, but studies evaluating peripheral nervous system involvement are relatively uncommon. OBJECTIVE: The aim of this study is to evaluate the frequency and characteristics of peripheral nervous system involvement in BD. METHODS: Sixty-nine BD patients (36 women, 33 men) followed by neurology and dermatology outpatient clinics between October 1999 and October 2004 were enrolled into study. A careful history was taken and physical and neurologic examinations were done. All other medical causes that may be related to peripheral nervous system involvement were studied. All patients underwent nerve conduction studies using standard electrophysiologic procedures. RESULTS: Peripheral nervous system involvement was detected in 13 patients. There was no sign and symptom related to peripheral nervous system involvement in these patients. Causes other than BD were found in 5 patients with polyneuropathy. Asymptomatic delay in conduction velocities of the median nerves was detected in 3 patients. In 5 patients with clinically evident peripheral nerve involvement due to BD, 3 had sensorimotor and 2 had sensory axonal neuropathies. CONCLUSION: Axonal type polyneuropathy may be seen in BD patients. Peripheral involvement may be detected by electrophysiological examinations in asymptomatic BD patients.

Lipid peroxidation and homocysteine levels in Behçet's disease.

BACKGROUND: The aim of this study was to investigate serum paraoxonase (PON1) activity in relation to homocysteine, malondialdehyde (MDA) and lipid parameters in active and inactive Behçet's disease (BD). METHODS: A total of 46 consecutive BD patients and 25 healthy control subjects were included in the present study. RESULTS: Serum PON1 activity in both active and inactive BD was significantly lower compared with healthy subjects (p<0.05). When compared to the control group, serum MDA levels were significantly higher in both active and inactive BD (p<0.05). Serum C-reactive protein (CRP) and homocysteine concentrations were significantly higher in active BD than those in inactive BD and control subjects (p<0.05). In addition, there was significant negative correlation between serum PON1 and MDA levels (r=-0.697, p<0.05) and serum PON1 activity was also negatively correlated with homocysteine levels (r=-0.428, p<0.05) in BD patients. CONCLUSIONS: Decreased PON1 could explain the increased lipid peroxidation and oxidative stress observed in BD. Also, according to our results, we suggest that homocysteine may contribute to decreased serum PON1 activity.

Adapalene vs. metronidazole gel for the treatment of rosacea.

BACKGROUND: Rosacea is a common, chronic dermatosis that requires long-term therapy. Oral isotretinoin and topical and/or oral antibiotics are effective, but their usage may be limited due to side-effects. OBJECTIVE: The goal of the study was to compare the efficacy of topical adapalene gel (0.1%) and topical metronidazole gel (0.75%) in the treatment of patients with papulopustular rosacea. METHODS: This study included 55 patients with papulopustular rosacea. Diagnostic efforts were focused on clinical and histological features. Patients were randomly assigned to the adapalene (n = 30) and metronidazole (n = 25) groups. Sunlight protection factor 20 cream was used to protect all patients from sunlight. The characteristics and numbers of inflammatory papules, pustules, erythema and telangiectasia were scored at baseline and after 2, 4, 8 and 12 weeks. Side-effects were recorded at each visit. RESULTS: Fifty patients, 27 in the adapalene group and 25 in the metronidzaole group, completed the study. Significant reductions in the total number of inflammatory lesions were found in the adapalene group compared with the metronidazole group. There was no significant difference in the scores of erythema and telangiectasia in the adapalene group. However, a significant reduction in erythema was seen in the metronidazole group. CONCLUSIONS: Adapalene gel is well tolerated and can be used as an alternative for topical treatment of papulopustular rosacea.

Is topical metronidazole effective in seborrheic dermatitis? A double-blind study.

BACKGROUND: Seborrheic dermatitis is a common, chronic, papulosquamous dermatosis. Although several types of treatment have been developed, repetitive treatment courses are often necessary. AIM: To perform a randomized, placebo-controlled, double-blind clinical study with metronidazole 0.75% gel in patients with mild to moderate seborrheic dermatitis of the face. METHODS: Eighty-four patients (52 males and 32 females) with seborrheic dermatitis were enrolled in the study. Patients were randomly allocated to the application of metronidazole 0.75% gel or placebo to their facial lesions, twice daily for 8 weeks. Patients were scored with regard to the severity of the lesions at the initial evaluation and every 2 weeks for 2 months. All patients were evaluated for a final assessment of improvement at the end of the study. RESULTS: At baseline, both treatment groups were comparable in terms of demographic data and lesion severity score. Seventy-eight patients (48 males and 30 females), 48 (62%) in the metronidazole group and 30 (38%) in the placebo group, completed the study. Two patients in the metronidazole group and four patients in the placebo group left the study. There was no statistically significant difference in the change in the mean severity score between the two groups at the end of the study (P > 0.05). At the final evaluation of the response at 8 weeks, no statistically significant difference was found between the treatment groups (P > 0.05). Metronidazole gel was generally tolerated well during the study. CONCLUSIONS: Metronidazole 0.75% gel and placebo show similar efficacy in the treatment of seborrheic dermatitis.