Nail changes in patients with inflammatory bowel diseases.

BACKGROUND/AIM: Inflammatory bowel disease (IBD) is a group of inflammatory conditions of the colon and small intestine. To our knowledge, no studies to date pertain to the profile of nail changes in IBD, except for onychomycosis. We aimed to study the frequency and pattern of nail changes among patients with IBD and evaluate their potential relationships with several parameters in IBD. MATERIALS AND METHODS: The study included 73 patients with IBD and 51 healthy control subjects. Nails of both groups were examined for changes with regard to color, striations, texture, curvature of nail plates, dystrophy of nail plates, and pigmentation. Mycological examinations were performed when onychomycosis was suspected. RESULTS: Nail changes were statistically higher in patients with IBD than in the control group (P = 0.001). The presence of onychomycosis was significantly more common in patients with IBD (P = 0.041). Subungual hyperkeratosis and brownish discoloration of the nail were the most common findings in patients with IBD. CONCLUSION: Our study is the first report showing all nail changes in IBD. Further studies with more subjects are needed to reveal more detailed information about nail changes in IBD.

Assessment of subclinical left ventricular dysfunction in patients with psoriasis by speckle tracking echocardiography: A Speckle Tracking Study.

BACKGROUND: Psoriasis is a systemic inflammatory disease and is reportedly associated with adverse cardiovascular risks. Left ventricular (LV) function has not been studied comprehensively in psoriasis. OBJECTIVES: This study was conducted to study LV mechanics in patients with psoriasis by speckle tracking echocardiography. METHODS: The study population consisted of 40 patients with psoriasis and 35 age- and sex-matched control subjects. Two-dimensional echocardiography images were obtained from LV apical four-chamber (4C), long axis (LAX), and two-chamber (2C) views. Peak longitudinal strain and strain rate were obtained from 4C, LAX, and 2C views. Global strain and strain rate were calculated by averaging data for the three apical views. RESULTS: Patients with psoriasis had significantly lower mean ± standard deviation (SD) 4C (17.1 ± 1.7 vs. 19.2 ± 2.3; P < 0.01), LAX (16.6 ± 1.5 vs. 19.5 ± 2.3; P < 0.01), and 2C (16.5 ± 1.5 vs. 19.4 ± 2.2; P < 0.01) peak longitudinal strain values compared with the control group. Moreover, mean ± SD LV global strain (16.6 ± 1.5 vs. 19.9 ± 2.1; P < 0.01) and strain rate (1.39 ± 0.30 vs. 1.51 ± 0.20; P < 0.01) values were found to be significantly lower in the psoriasis group. In a multiple regression model, global strain was independently associated with high-sensitivity C-reactive protein (ß = 0.29, P = 0.04), duration of disease (ß = 0.35, P < 0.01), ejection fraction (EF) (ß = 0.38, P =0.01), and the ratio of early diastolic mitral inflow velocity to early diastolic annular velocity (E/E' ratio) (ß = 0.34, P =0.02). Also, in a multiple regression model, global strain rate was independently associated with duration of disease (ß = 0.36, P < 0.01), EF (ß = 0.32, P = 0.01), and E/E' ratio (ß = 0.35, P < 0.01). CONCLUSIONS: Using 2-D strain imaging, we have demonstrated that patients with psoriasis have lower LV functions.

Assessment of thyroid function and lipid profile in patients with postadolescent acne in a Mediterranean population from Turkey.

BACKGROUND: Postadolescent acne is defined as acne that is seen even after the age of 25 years, regardless of the age at onset. The causes of postadolescent acne have not been completely clarified up to now. Androgens are considered to be the major factor involved in pathogenesis. OBJECTIVE: We aimed to investigate the status of thyroid functions and lipid levels in patients with postadolescent acne and determine the effects of lifestyle and environmental factors on postadolescent acne in a Turkish population. METHODS: In total, 184 patients and 82 healthy controls were enrolled in the study. Thyroid function and lipid profiles of all participants were analyzed. RESULTS: The mean age of patients was 30.4 ± 4.9 years (25-50). The mean age of control group was 30.0 ± 4.4 years (25-40). Cigarette smoking was significantly associated with postadolescent acne (P < 0.001). No significant differences were observed between patients with postadolescent acne and control subjects in triglyceride, total cholesterol, and low-density lipoprotein cholesterol levels, thyroid hormone profiles, and thyroid ultrasound scans. High-density lipoprotein cholesterol levels were significantly decreased with postadolescent acne (P = 0.01). CONCLUSIONS: To our knowledge, this is the first study to investigate the thyroid functions and lipid profile in men and women with postadolescent acne. In this study, there was no relationship between thyroid functions and postadolescent acne. However, an association with low high-density lipoprotein cholesterol levels and postadolescent acne was detected. Further investigations with more patients in different populations are needed to determine the causes of postadolescent acne.

Neutrophil to lymphocyte ratio in Behçet's disease as a marker of disease activity.

INTRODUCTION: Behçet's disease (BD) is a rare autoimmune disease. The neutrophil to lymphocyte ratio (NLR) is used as a marker of inflammation in several diseases nowadays. This study investigated the NLR as an inflammation marker in BD. METHODS: Sixty-five patients diagnosed with BD and 100 healthy subjects were enrolled in this study retrospectively. The white blood cell (WBC), neutrophil, and lymphocyte counts were recorded, and the NLR was calculated from these parameters. RESULTS: The NLR and the CRP and WBC levels were higher in patients with BD than controls (p < 0.001, p < 0.001, and p = 0.026, respectively). In addition, the NLR was higher in patients with active BD than in those with inactive BD (p = 0.033). DISCUSSION: The results demonstrate that the NLR is higher in patients with active BD compared to controls and those with inactive BD.

Assessment of left ventricular dyssynchrony in patients with psoriasis.

BACKGROUND: Psoriasis is an inflammatory disorder, which has been reported to be associated with cardiovascular (CV) risks. Although increased CV risks in psoriasis are well established, there are no data about changes of contraction synchrony in psoriasis. Therefore, we aimed to study the left ventricular (LV) contraction synchrony in patients with psoriasis with narrow QRS and normal ejection fraction. METHODS: Fifty patients with psoriasis and 50 age- and sex-matched control subjects were included in the study. LV dyssynchrony was investigated by color-coded tissue Doppler imaging. RESULTS: In the psoriasis group, the mean high-sensitive C-reactive protein values were significantly higher compared with the controls. Peak A velocity, deceleration time, isovolumetric relaxation time, and E/E' values were higher in the psoriasis group; however, E/A ratio and average Em were higher in the control group. LV systolic dyssynchrony parameters [including standard deviation of Ts of the 12 LV segments (Ts-SD-12), maximal difference in Ts between any two of the 12 LV segments, standard deviation of Ts of the six basal LV segments, and maximal difference in Ts between any two of the six basal LV segments] were found to be higher in the psoriasis group. The patients with ventricular dyssynchrony (a Ts-SD-12 >34.4 ms) were higher in the psoriasis group than the control group (34% vs. 6%, P < 0.01). CONCLUSION: In patients with psoriasis with normal ejection fractions and narrow QRS, LV systolic dyssynchrony is an early manifestation of heart involvement and may coexist with diastolic dysfunction.

Investigation into the frequency of Helicobacter pylori infection with carbon 14 urea breath test in patients with vitiligo.

BACKGROUND/AIM: Vitiligo is a common, acquired depigmenting skin disorder. The relationship between Helicobacter pylori (HP) infection and autoimmune dermatological disease has been previously reported. However, the frequency of HP infection in patients with vitiligo has not been reported. In this study, we aimed to investigate the frequency of HP infection with the carbon 14 (C14) urea breath test (UBT) in patients with vitiligo. MATERIALS AND METHODS: This study included 34 patients (18 males and 16 females) with vitiligo and 30 age- and sex-matched healthy controls. HP infection was diagnosed using the C14 UBT (Heliprobe). Statistical analysis was performed using SPSS 19. RESULTS: The frequency of HP infection was 64.7% in the patient group and 33.3% in the control group according to the C14 UBT (chi- square test, P = 0.012). HP infection frequency is statistically significantly higher in patients with vitiligo. CONCLUSION: To the best of our knowledge, this is the first investigation of the frequency of HP positivity in patients with vitiligo. To better understand the role of HP in vitiligo as an etiological or initiating factor, further experimental and clinical studies with a greater number of patients are needed.

Generalized hair casts due to traction.

Peripilar keratin casts, also called pseudonits or hair casts, are thin, elongated, greyish-white, cylindrical, sleeve-like structures that encircle the hair shaft and can easily be slid along the hair. They may be clinically misdiagnosed as nits. In addition to physical removal, keratolytic lotions or shampoos are helpful. We report an 11-year-old girl with pseudonits. Although it is not a rare condition, underdiagnosis is common.