A comparison of hyaluronic acid and estradiol treatment in vulvovaginal atrophy.

OBJECTIVE: This study aims to compare the effects of vaginal estrogen and hyaluronic acid on vulvovaginal atrophy. PATIENTS AND METHODS: This randomized controlled study included a total of 300 patients, with 150 patients in each group (Group E and Group H). The VHI score was determined based on a pre-treatment evaluation conducted by a gynecologist. After one month of receiving vaginal estrogen in Group E and vaginal hyaluronic acid in Group H, the patients were re-evaluated by their physicians. RESULTS: A statistically significant difference was found between the pre- and post-treatment VHI scores in Group E and Group H (p = 0.000; p = 0.000). No statistical difference was found between Group E and Group H in terms of treatment efficacy (p = 0.712). The pre- and post-treatment complaints of dryness, itching, dyspareunia, burning, and dysuria were found to be statistically significant in Group E and Group H (p = 0.000; p = 0.000; p = 0.000; p = 0.000; p = 0.000 in Group E, respectively) (p = 0.000; p = 0.000; p = 0.000; p = 0.000; p = 0.000 in Group H, respectively). No statistical difference was observed regarding dyspareunia, dysuria, and burning complaints (p = 0.632; p = 0.106; p = 0.128, respectively). However, hyaluronic acid was found to be significantly more effective for itching complaints (p = 0.002), while estrogen was found to be significantly more effective for dryness complaints (p = 0.012). CONCLUSIONS: Hyaluronic acid and estrogen were equally effective in vaginal treatment. Hyaluronic acid may be preferred for patients in whom hormonal therapy is contraindicated or for those who prefer non-hormonal therapy.

Irritable bowel syndrome in patients with chronic pruritus of undetermined origin.

BACKGROUND: Chronic pruritus is an important distressing condition that is often refractory to treatment. Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that occurs without an organic cause. OBJECTIVES: We aimed to investigate the relationship between chronic pruritus of undetermined origin (CPUO) and IBS. METHODS: Eighty patients with chronic pruritus (CP) of undetermined origin and fifty healthy control subjects without pruritus were included into the study. All of the participants were examined by a gastroenterologist for concomitant IBS. RESULTS: The frequency of IBS was found higher in patients with CP of undetermined origin (P: 0.02), but we did not observe any significant association between pruritus intensity and either presence of IBS (P: 0.08) or the subtypes of the syndrome (P: 0.40). Furthermore, patients with CP of undetermined origin between 40 and 60 years, female gender and longer duration of the disease were found to be significantly associated with the presence of IBS (P: 0.02, P: 0.01 and P < 0.001). CONCLUSIONS: We found that the frequency of IBS was higher in patients with CP than in healthy controls. Our study is the first report about the relation between CP of undetermined origin and IBS. Further studies with larger numbers of the patients are needed to show association between IBS and CPUO using laboratory tests to define underlying diseases such as lactose intolerance, functional dyspepsia and emotional diseases.

Trichoscopy in paediatric patients with tinea capitis: a useful method to differentiate from alopecia areata.

OBJECTIVES: Trichoscopy (hair and scalp dermatoscopy) facilitates the diagnosis of hair and scalp disorders. The aim of our study was to identify the trichoscopic features in diagnosis of tinea capitis (TC) and to compare these findings with alopecia areata (AA). MATERIALS AND METHODS: Our study included 15 children with TC and 10 children with AA as a control group. Affected areas of the scalp on all the cases were analysed under a magnification of 20X and 40X by a digital dermatoscope (MoleMax II). RESULTS: Broken and dystrophic hairs were found in dermatological examination of all the patients with TC. In addition, corkscrew hairs, comma hairs and black dots were observed respectively. Yellow dots, exclamation mark hairs and vellus hair were observed in patients with AA. CONCLUSIONS: Broken and dystrophic hairs, corkscrew hairs, comma hairs and black dots were observed only in patients with TC; yellow dots, exclamation mark hairs and vellus hairs were observed only in patients with alopesi areata. Further studies with larger numbers of patients are needed to determine specific trichoscopic findings of TC and to access differential diagnosis.

Increased epicardial fat tissue is a marker of subclinical atherosclerosis in patients with psoriasis.

BACKGROUND: Carotid intima-media thickness (CIMT) is a potential indicator of subclinical atherosclerosis in patients with psoriasis. Epicardial fat thickness (EFT) is proposed as a new cardiometabolic risk factor. OBJECTIVE: To evaluate the association between EFT and CIMT in patients with psoriasis. METHODS: This was a cross-sectional and observational study; 65 patients with psoriasis and 50 age- and sex- matched control subjects were included. Data about echocardiographic EFT, CIMT, anthropometric measurements and metabolic profile were obtained. RESULTS: The EFT and CIMT were significantly increased (7.3 ± 0.5 vs. 6.5 ± 0.5 mm, P < 0.01; 0.74 ± 0.11 vs. 0.60 ± 0.07 mm, P < 0.01, respectively) in patients with psoriasis compared with the controls. EFT was significantly correlated with CIMT (r = 0.69, P < 0.01). In a multiple linear regression model in which EFT was independently associated with psoriasis (ß = 0.45, P < 0.01), age (ß = 0.33, P = 0.01), CIMT (ß = 0.50, P < 0.01), body mass index (ß = 0.25, P = 0.01), high-sensitivity C-reactive protein (ß = 0.32, P < 0.01) and duration of disease (ß = 0.34, P = 0.03). CONCLUSIONS: We demonstrated that EFT and CIMT are increased in patients with psoriasis, and that echocardiographic EFT is closely correlated with CIMT in patients with psoriasis. The echocardiographic assessment of EFT may have the potential to be a simple marker of subclinical atherosclerosis and increased cardiovascular risk in patients with psoriasis.

Factors influencing skin ageing in a Mediterranean population from Turkey.

BACKGROUND: Skin ageing is a continuous process, with intrinsic factors determining which extrinsic factors (chronic sun exposure and other environmental factors, particularly smoking) have the greatest effect. AIM: To investigate the effects of lifestyle and environmental factors on skin ageing in a Mediterranean population from Ankara, Turkey. METHODS: In total, 574 (337 women, 237 men; age range 18-89 years) were enrolled into the study. Data were collected on age, gender, weight, height, body mass index (BMI), skin phototype, smoking status, consumption of alcohol (> 3 units/week) and coffee (> 1 cup/day), sun exposure, use of sunscreen and sunglasses, and involvement in sports and physical activities. The Daniell skin-wrinkling grading system was used as a marker of skin ageing. RESULTS: We found that male gender, chronic sun exposure and number of pack-years of cigarette smoking significantly contributed to the formation of facial wrinkles. There was a negative correlation between facial wrinkling and the use of sunscreen and sunglasses and facial wrinkling (P < 0.001 for both). We did not find any significant association between wrinkling score and alcohol consumption, coffee consumption, sports participation or d skin phototype. Moreover, wrinkling score was significantly higher in patients with a BMI < 25 kg/m(2) than in patients with a BMI > 25 kg/m(2) (P < 0.018). Multiple logistic regression analysis was conducted after adjusting for age, gender, smoking status, alcohol consumption, skin phototype, sun exposure, and use of sunglasses and topical sun protection. We found that gender and age were significantly associated with skin ageing (P < 0.014 and < 0.001, respectively). CONCLUSION: In this study, older age, male gender, low BMI, smoking and chronic sun exposure had a negative influence on skin ageing in a Turkish population.

Hepatic duct stone associated with chlamydia sepsis: a rare condition in childhood.

Stone formation in the biliary system is a rare condition in infants. A few cases of bile stones in the biliary tree have been reported with underlying predisposing factors, such as sepsis and antibiotic usage. This article describes a surgically treated 16-week-old infant with recurrent cholangitis who had a bile stone in the hepatic duct after chlamydia sepsis.