Serum Visfatin, Adiponectin, and Tumor Necrosis Factor Alpha (TNF-α) Levels in Patients with Psoriasis and their Correlation with Disease Severity.

Psoriasis is a chronic, autoimmune, and inflammatory disease of unknown etiology, characterized by T lymphocyte mediated keratinocyte proliferation. In recent years the relationship between psoriasis and adipose tissue cytokines has been reported. Psoriasis as a triggering factor for the immune and metabolic disorders can be associated with diabetes mellitus, abnormal lipid metabolism, and metabolic syndrome. In this study we assessed the adipose tissue cytokines visfatin, adiponectin, and tumor necrosis factor-α (TNF-α) levels in psoriasis patients and evaluated the relationship between disease severity and cytokines. The study included 42 patients with psoriasis and 42 healthy individuals. Visfatin, adiponectin, and TNF-α levels were measured in both the psoriasis and the control group. The disease severity index was assessed in psoriatic patients by means of PASI. The relationship between visfatin, adiponectin, TNF-α, PASI score, and obesity was evaluated. When serum TNF-α, adiponectin, and visfatin levels of the patient group were compared with those of the control group, the TNF-α levels were statistically higher (p = 0.00) and the adiponectin levels were statistically lower (p = 0.024). The visfatin levels were higher in the psoriatic patients compared to the control group, but this difference was not statistically significant (p = 0.73). The relationship between PASI-TNF-α and between PASI-adiponectin was statistically significant (p = 0.009 and p = 0.004). A positive correlation was observed between body mass index (BMI) and visfatin (p = 0.031). These results indicate that TNF-α and adiponectin play a part in psoriasis etiopathogenesis and can be used as parameters to evaluate the severity of the disease. However, the role of visfatin in psoriasis pathogenesis is unclear. Further clinical studies are needed to clarify the effect of visfatin in psoriatic patients.

Extra-medial thickness of carotid artery in patients with Behçet's disease: evaluation of atherosclerotic vessel wall changes with a novel carotid artery ultrasound index.

OBJECTIVES: Chronic inflammation and endothelial dysfunction are the characteristic features of Behçet's disease (BD). We researched carotid extra-medial thickness (cEMT), a novel ultrasound parameter for atherosclerotic vessel wall changes, and carotid intima media thickness (cIMT), a widely accepted marker of subclinical atherosclerosis, in patients with BD, and we evaluated the relationship between these two parameters. MATERIALS AND METHODS: In total, 31 patients with BD were matched to 26 control subjects based on age, gender, and major cardiovascular risk factors. Laboratory parameters, including lipid profile, were measured for both patients and controls. B-mode ultrasonography was used to assess the cEMT and cIMT. RESULTS: There was no significant difference in the cEMT values between the patients with BD and the control group (P = 0.90). cIMT in the BD group was significantly higher compared with the control group (P = 0.021). There was a significant positive correlation between cIMT and cEMT (r = 0.585, P = 0.001). Both cEMT and cIMT were positively correlated with age and the presence of arthritis. There was linear correlation with sedimentation, C-reactive protein, and cEMT. CONCLUSIONS: To the best of our knowledge, this is the first study to evaluate both cEMT and cIMT in BD. This study presents morphological evidence of subclinical atherosclerosis in terms of cIMT. Although there was no significant increment in cEMT, it has the potential to assess endothelial dysfunction in BD. Further studies are required to confirm this finding.

Tear and serum vitamin D levels in children with allergic rhinoconjunctivitis

BACKGROUND: Although solid cohort studies confirmed a preventative role for the anti-oxidant vitamin D in allergic asthma, a limited number of studies focused on allergic rhinoconjunctivitis (ARC). Here, we aimed to determine 25-hydroxycholecalciferol levels in tear and serum in young allergic rhinoconjunctivitis patients as compared to their apparently healthy matched controls. METHODS: In total, 22 children with allergic rhinoconjunctivitis and 31 healthy control subjects underwent serum total IgE and 25-hydroxycholecalciferol measurements. Tear levels of 25-hydroxycholecalciferol were also determined in both groups. RESULTS: The mean serum total IgE level in the ARC group (143.6 ± 132.8 IU/ml) was significantly higher than that in the control group (54.8 ± 44.1 IU/ml; p = 0.03). Serum 25(OH)D levels were significantly higher in the ARC group (34.1 ± 12.7 ng/ml) than in the healthy controls (21.8 ± 11.3 ng/ml; p = 0.001). CONCLUSIONS: To our knowledge, this is the first reported study to show an association between serum 25-hydroxycholecalciferol and ARC in a childhood group. Higher levels of serum 25-hydroxycholecalciferol in children with allergic rhinoconjunctivitis may indicate a possible aetiopathogenic mechanism in the development of allergic rhinoconjunctivitis. This is also the first report to examine tear fluid vitamin D levels in paediatric ARC patient

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Tear and serum vitamin D levels in children with allergic rhinoconjunctivitis.

BACKGROUND: Although solid cohort studies confirmed a preventative role for the anti-oxidant vitamin D in allergic asthma, a limited number of studies focused on allergic rhinoconjunctivitis (ARC). Here, we aimed to determine 25-hydroxycholecalciferol levels in tear and serum in young allergic rhinoconjunctivitis patients as compared to their apparently healthy matched controls. METHODS: In total, 22 children with allergic rhinoconjunctivitis and 31 healthy control subjects underwent serum total IgE and 25-hydroxycholecalciferol measurements. Tear levels of 25-hydroxycholecalciferol were also determined in both groups. RESULTS: The mean serum total IgE level in the ARC group (143.6±132.8IU/ml) was significantly higher than that in the control group (54.8±44.1IU/ml; p=0.03). Serum 25(OH)D levels were significantly higher in the ARC group (34.1±12.7ng/ml) than in the healthy controls (21.8±11.3ng/ml; p=0.001). CONCLUSIONS: To our knowledge, this is the first reported study to show an association between serum 25-hydroxycholecalciferol and ARC in a childhood group. Higher levels of serum 25-hydroxycholecalciferol in children with allergic rhinoconjunctivitis may indicate a possible aetiopathogenic mechanism in the development of allergic rhinoconjunctivitis. This is also the first report to examine tear fluid vitamin D levels in paediatric ARC patients.

Metabolic acidosis in an infant associated with permethrin toxicity.

Pyrethroids are broad-spectrum insecticides. Permethrin intoxication due to topical application has not been documented in humans. We report a 20-month-old infant who had used 5% permethrin lotion topically for scabies treatment. Approximately 60 mL (20 mL/day) was used and after the third application he developed agitation, nausea, vomiting, respiratory distress, tachycardia, and metabolic acidosis. His clinical symptoms and metabolic acidosis normalized within 20 hours. His follow-up was unremarkable. Toxicity of permethrin is rare, and although permethrin is a widely and safely used topical agent in the treatment of scabies and lice, inappropriate use may rarely cause toxicity. Moreover, in cases of unexplained metabolic acidosis, topically applied medications should be carefully investigated.

Basic histological structure and functions of facial skin.

The skin and its appendages that derive from the epidermis (hair follicles, sweat glands, sebaceous glands, nails, and mammary glands) establish the integumentary system. Histologically, skin has two main layers-the epidermis and the dermis-with a subcutaneous fascia called the hypodermis, which lies deep in the dermis. The epidermis is formed of four to five layers of cells made mostly out of keratinocytes, along with three other different and less abundant cells. The dermis underlies the epidermis. The hypodermis is a looser connective tissue that is located beneath the dermis. It blends to the dermis with an unclear boundary.

Comparison of partial matrixectomy and combination treatment (partial matrixectomy + phenol) in ingrown toenail.

UNLABELLED: To compare only partial matrixectomy and combination techniques (partial matrixectomy + phenol application) in the treatment of patients with an ingrown toenail in terms of recurrence, residual pain level and time of return to daily activities. METHODS: The study included 118 patients with moderately ingrown toenails who were unresponsive to conservative treatment together with severely ingrown toenail patients. Of these patients, 76 cases were treated with a partial matrixectomy technique and 42 patients received combination treatment. Patients having nail infection received preoperative oral antibiotics. RESULTS: Of 118 patients, 87 were males and 31 were females. The disease relapsed in seven (9.2%) of the patients treated with the partial matrixectomy technique, and in two (4.8%) patients from the combination treatment group (p=0.5). No statistically significant difference was found between the groups in terms of return time to daily activities (p=0.5) nor in terms of residual pain (p=0.7). CONCLUSIONS: Treatment costs and operation times of patients who underwent phenol application in addition to partial matrixectomy were found to be higher compared to only partial matrixectomy, however combined therapy was not found to be superior to only partial matrixectomy in terms of recurrence, post-op pain and return to daily activities.

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.

Carbamazepine-induced hypogammaglobulinemia.

Carbamazepine is used to control seizures. Its common side effects are sleep disorders, anorexia, nausea, vomiting, polydipsia, irritability, ataxia, and diplopia. Involvement of the immune system is rare, and few cases of decreased immunoglobulin levels have been reported. We describe a patient with low immunoglobulin levels due to carbamazepine use who presented with recurrent urinary tract infection. Intravenous immunoglobulin was administered, and immunoglobulin levels increased to safer levels after discontinuation of carbamazepine. Previous reports describe severe infection after carbamazepine-induced hypogammaglobulinemia. Therefore, in patients using antiepileptics, particularly carbamazepine, serum immunoglobulin levels should be checked in those with recurrent infections.