Evaluation of the relationship between serum G protein-coupled estrogen receptors (GPER-1) levels and the severity and duration of the disease in patients with androgenetic alopecia: A case-control study.

There are studies revealing the effects of estrogen receptors alpha (α) and beta (ß) on hair follicles. However, the effects of G protein-coupled estrogen receptors (GPER-1) on hair follicles have not been elucidated. This study aims to evaluate the relationship between serum GPER-1 levels and the severity and duration of the disease in patients with androgenetic alopecia (AGA). The study included 81 patients with AGA aged 18 to 50 years (22 men and 19 women with an onset of AGA more than 5 years, and 20 men and 20 women with an onset of AGA less than 5 years) and 40 healthy controls (20 men, 20 women). The mean age of participants with AGA was 29.12 ± 8.15 (18-50), and the mean age of the control group was 25.21± 4.71 (19-42). Serum GPER-1 levels were measured, and the relationship between GPER-1 levels and duration of the disease, severity of the disease, and sex was statistically evaluated. The serum level of GPER-1 was significantly higher in patients with AGA as compared to the control group (p < 0.001). A negative correlation was found between serum GPER-1 levels and the duration of the disease in both men and women (p < 0.001, r = 0.793; p < 0.001, r = 0.711, respectively). There was a significant relationship between serum GPER-1 levels and the severity of the disease in both men and women (p = 0.003; p = 0.002, respectively). Additionally, a significant difference in GPER-1 levels was noted between male and female patients with AGA (p = 0.001). However, no statistically significant relationship was identified between GPER-1 levels and estrogen levels (p = 0.097). The higher levels of GPER-1 in patients with AGA compared to the control group, and the significant relationship between GPER-1 levels and both the duration and severity of the disease, suggest an estrogen-independent role of GPER-1 in the pathogenesis of AGA. The fact that GPER-1 levels are high in the early stages of AGA when inflammation is prominent suggests that treatments targeting these receptors may be effective at this stage.

The effect of family history of atherosclerosis and other risk factors on changes in serum lipid levels in acne patients treated with isotretinoin.

BACKGROUND: Oral isotretinoin causes changes in serum lipid values. These changes are not seen in every patient, regardless of dose. It is unclear what causes these changes and how often serum lipid values should be followed up. AIMS: We aimed to evaluate the relationship between the change in serum lipid values and personal and familial risk factors. METHODS: Serum lipid values at baseline (0th), 1st, 3rd, and 6th months of isotretinoin treatment of acne patients aged 16 years and over using oral isotretinoin at a dose of 0.5-1 mg/kg/day between January 2017 and December 2019 were recorded retrospectively. The relationship between personal and familial risk factors and changes in serum lipid values were evaluated statistically. RESULTS: In pairwise comparison, a significant difference was detected between the 0th and 1st month, 0th and 3rd month, 0th and 6th month, and 1st and 6th month in the average serum lipid (Low-density lipoprotein (LDL), high-density lipoprotein (HDL), very low-density lipoprotein (VLDL), total cholesterol, triglyceride) levels. However, no significant difference was detected between 3rd and 6th month. The change in LDL levels between the 0th and the 3rd month was significantly higher in those with a family history of atherosclerosis than those without a family history of atherosclerosis (p = 0.034). The change in VLDL levels between the 0th and 6th month was significantly higher in those with a family history of atherosclerosis than those without a family history of atherosclerosis (p = 0.022). It was observed that the changes in total cholesterol and VLDL levels between the 0th and 3rd month increased as body mass index (BMI) increased (p = 0.03, p = 0.014, respectively). Similarly, the changes in triglyceride and VLDL levels between 0th and 6th month and between 1st and 6th month increased by an increase in BMI (respectively; p = 0.006, p = 0.019; p = 0.016, p = 0.022). The increase in the levels of VLDL between the 1st and the 6th month was found to be significantly higher in smokers than in non-smokers (p = 0,032). CONCLUSION: We recommend evaluation of serum lipids values in the 0th, 1st, and 3rd month in all acne patients using oral isotretinoin and that these values have to be checked monthly in the following months for smokers, those with a history of atherosclerosis, and those with a BMI above normal.

Dermatoses in overweight and obese children and their relationship with insulin and skin color.

BACKGROUND/AIM: The aim of the present study was to investigate the prevalence of obesity-related dermatoses in obese children, and the association between these dermatoses and insulin resistance as well as skin color. METHODS: Obese, overweight, and normal weight children according to body mass index who were followed up and treated in the outpatient clinics were included in the study. Dermatological examinations of the participants were performed, and fasting insulin and glucose levels were checked. RESULTS: The obese and overweight children were evaluated as the patient group (70 girls, 41 boys, mean age: 12.37 ± 3.14 years). One hundred one healthy children with normal weight were determined as the control group (59 girls, 42 boys, mean age: 12.15 ± 2.43). The first five common dermatoses in the patient group when compared with the control group were keratosis pilaris (KP), striae distensae, hyperhidrosis, acanthosis nigricans (AN), and plantar hyperkeratosis. The first five dermatoses which were positively correlated with formation and insulin resistance were KP, striae distensae, AN, hyperhidrosis, and plantar hyperkeratosis. According to the Fitzpatrick skin scale, we found that the darker the skin color, the higher the probability of AN and KP (OR, 0.298; 95% CI, 0.106-0.834, p = 0.021; OR, 0.306; 95% CI, 0.117-0.796, p = 0.015, respectively). CONCLUSION: Some dermatoses associated with obesity and insulin resistance were not found in obese children, or there was no significant association. These results indicate that many skin morbidities may be prevented by preventing and treating obesity and insulin resistance in the early period.

Knowledge and Protective Behaviors of Teachers on Skin Cancer: A Cross-Sectional Survey Study from Turkey.

BACKGROUND: People socialize and receive education and training for the first time outside the home at school, where their teachers act as role models. Teachers play a crucial role in instilling sun-protection habits in children. Avoiding the sun between 10 a.m. and 4 p.m., staying in the shade, wearing sun-protective clothing, wearing sunglasses, wearing hats, using sunscreen products, and using an umbrella are some of the sun-protection methods described in the literature. This study sought to assess teachers' skin cancer knowledge and attitudes (SC). METHODS: In this cross-sectional study conducted between 21 September 2020, and 21 October 2020, 647 teachers from 30 schools in Kahramanmaras were included with their consent. The number of teachers employed at Kahramanmaras was 1863. Accordingly, the sample was found to be 641 with a 5% margin of error and a 99% confidence interval. Schools were selected by a simple random method. Teachers' knowledge and behaviors were assessed using a 25-point questionnaire designed by the literature data to gauge the level of SC knowledge. RESULTS: Of the 647 teachers included in this study, 230 (35.5%) were male, and 417 (64.5%) were female. The mean age of the participants was 38.44 ± 8.79 (min = 22, max = 65) years. The knowledge level of the teachers about SC was 13.54 ± 4.48 (min = 0, max = 23). The internet (75.9%) was the most preferred source of information. SC knowledge level was significantly higher in those with SC in their families and birthmarks on their bodies. (p < 0.001, p = 0.042, respectively). The rate of precaution taken to protect from the sun was higher in those with higher knowledge (p = 0.032). Women, primary school teachers, those with skin type 1, those with multiple nevi, and those with a high level of SC knowledge used statistically significantly more sunscreen (p = 0.001, p = 0.003, p < 0.001, p = 0.037, p = 0.002, respectively). CONCLUSIONS: It was found that the knowledge level of teachers about skin cancer and sun-protective behaviors was moderate. Correct behaviors increased as knowledge about SC grew. Information and recommendations made on the Internet should be made by experts. Additionally, health policymakers should implement projects aimed at improving teachers' knowledge and behaviors and, through them, teaching students about SC; as such projects would significantly contribute to both public health and health economics.

How are Acne Vulgaris Patients Using Oral Isotretinoin Affected by Covid-19?

Introduction: It has been reported that the use of oral isotretinoin may have positive and negative effects on the course of COVID-19 and the risk of transmission. Objectives: The purpose of our study is to evaluate how our patients that took oral isotretinoin during the pandemic were affected by COVID-19. Methods: The clinical processes of moderate-to-severe acne vulgaris patients between March 2020 and February 2021 were evaluated. Results: Of 102 moderate-to-severe acne patients, 67 were using oral isotretinoin and 35 were using a topical treatment. Of 27 patients who tested positive for COVID-19, 16 (59.3%) were using oral isotretinoin and 11 (40.7%) were using topical treatment, there was no statistical difference in the rates of COVID-19 positivity between the two groups (P = 0.412). The rates of positive tests for COVID-19 were similar between contacted patients of two groups (P = 0.391). Loss of smell/taste was lower in patients using oral isotretinoin compared to patients receiving topical treatment (46.7% and 72.7%, respectively.). Headache symptoms were less common in patients using oral isotretinoin (P = 0.047). Conclusions: The use of oral isotretinoin did not cause an increase or decrease in the risk of COVID-19 transmission. The patients using oral isotretinoin had a lower incidence of taste/smell loss and headache.

Evaluation of serum G protein-coupled estrogen receptor 1 (GPER-1) levels in patients with androgenetic alopecia.

The effect of oestrogens in androgenetic alopecia (AGA) pathophysiology has not been clearly understood. However, they are considered to have a place in the AGA pathogenesis as the androgens do. The effects of estrogen occur via the estrogen receptors alpha and beta, and the recently discovered G protein-coupled estrogen receptor 1 (GPER-1). Aim of this study is to examine serum GPER-1 levels of AGA patients and to evaluate the place of them in AGA pathogenesis for the first time through the literature. 40 AGA patients with clinical AGA stage 2-3-4 diagnoses according to the Hamilton-Norwood classification for males, and AGA stage 2 according to Ludwig system for females and with normal serum dihydroepiandrosterone sulfate, estradiol, total testosterone, progesterone, follicle stimulating hormone and luteinizing hormone were included in the study in addition to 40 healthy controls with similar characteristics by means of age and gender. We received the medical history and performed the physical examinations. We measured serum GPER-1 levels. Serum GPER-1 levels of AGA patients and the control group were 30.43 ± 3.83 ng/mL and 14.18 ± 3.61 ng/mL (mean ± SD), respectively. The levels were detected as significantly increased in AGA group compared with the control group (p = 0.007). No serum GPER-1 level differences were found among female and male patients (p = 0.101). Significantly high levels of serum GPER-1 levels in AGA patients without any relationship between gender and GPER-1 Levels compared with healthy controls reminded us that GPER-1 might have a role in AGA pathogenesis independent from the gender.