Type D personality, anxiety sensitivity, social anxiety, and disability in patients with acne: a cross-sectional controlled study.

INTRODUCTION: Acne has long been associated with many psychiatric comorbidities. AIM: To determine anxiety and depression levels, social phobia frequency, social anxiety level, subjective stress perception, anxiety sensitivity, disability, and the frequency of type D personality in patients with acne. MATERIAL AND METHODS: In total, 61 patients with acne aged > 16 years and 61 age, gender, and educationally matched healthy volunteers were included in the study. The patients and healthy controls were evaluated using the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 criteria for social anxiety disorder and completed the Liebowitz Social Anxiety Scale, Sheehan Disability Scale, Anxiety Sensitivity Index, Hospital Anxiety and Depression Scale, Perceived Stress Scale (PSS), and Type D Scale-14. RESULTS: Depression, anxiety, social anxiety, self-reported stress, anxiety sensitivity, and disability levels were significantly higher in patients with acne than in healthy controls (p < 0.05). Type D personality was more prevalent in patients with acne than in healthy controls (49% vs. 18%, p < 0.001). CONCLUSIONS: To our knowledge, this study is the first reported in which type D personality and anxiety sensitivity, as well as social anxiety disorder according to the DSM-5 criteria, was evaluated in patients with acne compared with healthy controls. This study shows that patients with acne have higher levels of depression, anxiety, social anxiety, self-reported stress, anxiety sensitivity, and disability, and a greater prevalence of type D personality, than healthy controls. Psychiatric evaluation of patients with acne may aid the detection of mental disorders.

Facial pigmentation with demodex Mite; a mere coincidence or an association?

Demodex mites may induce inflammatory cutaneous reactions such as papulopustular rosacea and demodex folliculitis; both may lead to post inflammatory pigmentation. A 59-year-old man presented with an asymptomatic, hyperpigmented plaque on his face. Histological and clinical findings displayed Riehl-like facial pigmentation. Multiple demodex mites at the follicular infundibulum in the biopsy material were remarkable. There are limited publications about demodex-associated pigmentation. We report this case to point out that various hyperpigmentation disorders may occur simultaneously with demodex mites.

Ocular findings in patients with psoriasis.

BACKGROUND: Psoriasis is a chronic inflammatory disease affecting skin, nails, and joints. Although there are not many reports in the literature, ocular findings occur in approximately 10% of patients, in mostly those who have psoriatic arthritis. In this study, we aimed to evaluate eye involvement in psoriasis patients. METHODS: This study was performed on a total of 100 psoriasis patients and a group of 100 healthy individuals. History was taken from all study and control subjects, and dermatological, systemic, and ophthalmological examinations were performed and Schirmer and BUT values were measured. Constant variables were compared using the t-test, and categorical variables were compared using chi-square test. Relationship between ocular findings and sex, age, duration of psoriasis, PASI score, presence of psoriatic plaques on the eyelid, nail involvement, and psoriatic arthritis was evaluated using logistic regression analysis. Statistical analyses were performed individually for both right and left eyes. RESULTS: The number of ocular findings in both eyes in the patient group was found to be statistically higher than that in the control group. Schirmer and BUT values were statistically lower in the patient group than those in the control group. CONCLUSIONS: Although results of our study support the necessity of routine ophthalmological examination of psoriasis patients for early diagnosis and treatment, we believe that further studies are required on the etiopathogenesis of ocular involvement in psoriasis patients.

Identification of an Alu-mediated 12.2-kb deletion of the complete LPAR6 (P2RY5) gene in a Turkish family with hypotrichosis and woolly hair.

Hypotrichosis is a rare form of progressive hair loss characterized by sparse and occasionally woolly hair that is curly and breaks easily. Disease-causing mutations in LIPH, LPAR6 and KRT74 have recently been identified. We describe a four-generation pedigree from Turkey following an autosomal recessive pattern, in which the four affected members had hypotrichosis and woolly hair. By sequencing LPAR6 and the use of SNP arrays, we revealed a homozygous loss of the entire LPAR6 gene in the affected individuals. We hypothesize that the 12-kb deletion resulted from illegitimate recombination secondary to slip-replication. The orientation of three Alu repeats around LPAR6 may have provoked the formation of a 'triple-barrel' structure during replication, thereby allowing strand slipping. This first report of complete LPAR6 loss expands the spectrum of known LPAR6 mutations and suggests a novel mechanism for this gene and for the formation of DNA rearrangements in general.

Impression cytology of the ocular surface and tear function in patients with periocular vitiligo.

PURPOSE: We evaluated the ocular surface and tear function in patients with periocular vitiligo in this prospective, case-control study. METHODS: Sixty eyes of 30 vitiligo patients with periocular involvement and 100 eyes of 50 control subjects were included in the study. Patients and control subjects were compared for Schirmer test and tear film break-up time (BUT) results and impression cytology findings graded according to Nelson's classification. RESULTS: The mean BUT value was 9.5 ± 4.1 seconds in patients with periocular vitiligo and 13.1 ± 4.2 seconds in the control group. The difference was statistically significant (p=0.005). Thirty-seven eyes (61.7%) in the vitiligo group and 28 eyes (28.0%) in the control group had BUT values less than 10 seconds (p<0.001). The mean Schirmer test value was 14.6 ± 4.3 mm in patients with periocular vitiligo and 15.1 ± 4.4 mm in the control group (p>0.05). Nineteen eyes (31.7%) in patients with periocular vitiligo and 8 eyes (8.0%) in the control group had grade 2-3 changes according to Nelson's classification (p<0.001). Three eyes (5.0%) in the periocular vitiligo group and none of the eyes in the control group had inflammation signs in the impression cytology analysis. CONCLUSIONS: In patients with periocular vitiligo, ocular surface and tear function alterations may occur. Further studies on ocular surface involvement in periocular vitiligo patients may help to increase understanding of the pathophysiology of vitiligo.

Inner ear involvement in Behçet's disease.

OBJECTIVE: To assess cochlear involvement and hearing loss in patients with Behçet's disease (BD). METHOD: Forty-two patients with BD and 24 sex and age matched healthy subjects were included in the study. pure-tone audiometry including high frequencies (250-16000Hz) and DPOAE were performed to all participants. Results of the audiological evaluation were compared and correlation between the audiologic status and clinical manifestations of the BD were investigated. RESULTS: Bilateral sensorineural hearing loss was detected in 27 (64.3%) patients. Hearing thresholds were found to be higher in patients with BD at all of the frequencies except at 500Hz when compared to control group (p<0.05). The difference in the hearing levels tend to increase in high frequencies. Compared with control group, distortion products and SNR of the BD patients were lower in all of the tested frequencies (p<0.05) which indicates weaker outer hair cell motility. There was no correlation between the clinical manifestations and the audiological parameters. CONCLUSION: Even having hearing levels within normal limits in speech frequencies, increased hearing thresholds in high frequencies and decreased signal-noise ratios (SNR) in distortion product otoacoustic emission (DPOAE) indicate a cochlear involvement in patients with BD.

Seroprevalence of Borrelia burgdorferi infection among forestry workers and farmers in Duzce, north-western Turkey.

Borrelia burgdorferi infection is the most frequent tick-transmitted disease worldwide. Our aim was to assess the seroprevalence of B. burgdorferi infection among forestry workers and farmers in Duzce, in the north-west region of Turkey. Blood samples from 349 forestry workers and farmers and 193 healthy blood donors were obtained to determine the presence of antibodies to B. burgdorferi. A two-step testing strategy was used; the sera were initially tested by ELISA and then by Western blot (WB) IgG. Demographic data regarding residence, age, gender, profession, tick bite history, contact with animals, and symptoms involving the skin, nervous system, and osteoarticular system were collected by questionnaire. All results were evaluated statistically using the chi2 test. The seroprevalence of B. burgdorferi was 10.9% (n=38) in forestry workers and farmers and 2.6% (n=5) in blood donors by ELISA, with a statistically significant difference (p<0.001). Seropositivity rates were related to age, gender, and common risk factors for the disease. IgG seropositivity was confirmed in four (1.1%) sera by WB. In this first seroepidemiological report from the northwest region of Turkey, tick bite exposure was found to be high, whereas B. burgdorferi infection was not common. Preventive measures against tick exposure and further studies to determine the distribution of Lyme disease in Turkey are proposed.

Preliminary study among truck drivers in Turkey: effects of ultraviolet light on some skin entities.

In this study, we aimed to compare driver (left) and opposite (right) sides for some skin entities in drivers. We also evaluated the effect of occupational duration, age and skin type among this population. One hundred and forty-eight truck drivers were included in this study. Sun exposed areas were classified. Dermatological entities such as actinic keratosis, solar lentigo, seborrheic keratosis, melanocytic nevus, spider angioma, ephelid, basal cell carcinoma (BCC), squamous cell carcinoma, and melanoma were compared to driver and right sides. In addition, drivers were divided into two subgroups according to: (i) age (subgroups A1, 20-40 years, and A2, >40 years); (ii) occupational duration (subgroups O1, 1-10 years, and 02, >10 years); and (iii) skin type (subgroups S1, skin types I and II, and S2, skin types III and IV. Each of the two subgroups were compared with respect to the total prevalence (left and right sides) of lesions excluding the location. Seborrheic keratosis and lentigo solaris were found to be increased on the driver side of the face (P = 0.00) and ear (P = 0.013), respectively. Statistically significant increases of lesions on the driver side were determined according to the subgroups: melanocytic nevi were found to be increased on the driver side in A1 (P = 0.00), A2 (P = 0.00), O2 (P = 0.00), S1 (P = 0.00) and S2 (P = 0.006) groups; actinic keratoses were found to be significantly increased on the driver side in A2 and O2 groups (P = 0.03 for both).

Collision tumour of trichofolliculoma and basal cell carcinoma.

A 52-year-old woman presented with a 2-year history of a reddish nodule on the right nasolabial sulcus. Histopathological examination revealed that the nodule was composed of trichofolliculoma and basal cell carcinoma. There was no transitional zone between the two neoplasms. The diagnosis was made as a collision tumour of trichofolliculoma and basal cell carcinoma.

Giant condylomata accuminata of scrotum representing as carcinoma (a case report).

In this case report a 51-year-old man admitted with a large warty lesion of scrotum representing as carcinoma was presented. A wide surgical resection of the lesion was done with the hystopathologic diagnosis of condyloma accuminata. He was followed for 12 months with satisfactory functional and cosmetic result with no recurrence with the time being.

Recurrent aphthous stomatitis: investigation of possible etiologic factors.

OBJECTIVE: To investigate the association of serum vitamin B(12), folic acid, iron, calcium, magnesium, and phosphorus levels as well as family history and cigarette smoking with recurrent aphthous stomatitis (RAS). METHODS: Thirty-four patients with RAS and 32 control subjects were included in this controlled prospective screening study. Both groups received a questionnaire, and serum screening tests were performed. The collected data were analyzed using chi(2) test and binary logistic regression analysis. RESULTS: Family history was found to be the most significant predisposing factor for RAS among the investigated ones. Regarding the serum tests, only vitamin B(12) was found to have significant correlation with RAS. Patients with vitamin B(12) deficiency, positive family history, and nonsmoking status have been found to have the highest risk for having RAS. CONCLUSIONS: RAS is a multifactorial disease. Positive family history, vitamin B(12) deficiency, and nonsmoking status are among the important predisposing factors.

Subungual osteochondroma: a diagnostic dilemma.

Osteochondroma is the most common skeletal neoplasm of all benign bone tumors. However, it rarely occurs subungually. In this location, the lesion may penetrate the skin, causing nail deformity, and can easily be misdiagnosed. We report two cases of subungual osteochondroma of the distal phalanges of the first toes with cutaneous penetration and discuss the clinical, histologic, and radiographic features and the treatment options.

Lipoid proteinosis: an unusual presentation with verruca vulgaris.

Lipoid proteinosis (LP) is a very rare, autosomally recessive, inherited disease. It is also known as Urbach Wiethe disease or Hyalinosis cutis et mucosa. LP usually runs a benign, stable, and slowly progressing course. We present one LP case with additional unusual dermatologic involvement; verruca vulgaris was superimposed on papular lesions of LP. To our knowledge, this case is the first and only one described in the literature. In this presentation, we discuss the possibility of predisposition to Human Papilloma Virus (HPV) infections in LP.

Eyelid involvement in acanthosis nigricans: the importance of systemic screening.

A 53-year-old man presented with thickening and hyperpigmentation of the eyelids. After the diagnosis of acanthosis nigricans was made, further investigation of a possible underlying disorder, including biochemical and instrumental examinations, indicated the presence of glucose intolerance, which had been diagnosed 3 years after the clinical appearance of acanthosis nigricans. Eyelid involvement in acanthosis nigricans is rare. Ophthalmologists should be aware of the possibility that acanthosis nigricans can exist in the periocular area and perform a systemic assessment of the patient for the presence of an underlying condition.

A neglected case of macrodystrophia lipomatosa of the foot in an elderly man.

Macrodystrophia lipomatosa is a rare disorder characterized by three-dimensional enlargement of one or more fingers or toes with predominantly fibroadipose tissue. Radiographically, it appears as hypertrophy of soft tissues and bones. The pathologic findings are infiltration and hypertrophy of adipose tissue in subcutaneous tissue, nerve sheaths, and periosteum. Macrodystrophia lipomatosa is usually diagnosed during childhood. The case presented here involves the most elderly patient with the condition ever reported, to our knowledge. As such, it may advance current knowledge of macrodystrophia lipomatosa. Special emphasis is given to the unique "bridge" formation seen radiographically in this case.