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.

Isotretinoin treatment in patients with acne vulgaris: does it impact muscle strength, fatigue, and endurance?

The objective of this study was to evaluate the effects of isotretinoin on muscle strength, fatigue, and endurance in patients with acne vulgaris. The study included 27 patients with acne vulgaris who underwent treatment with isotretinoin as well as 26 control patients for comparison. Participants in the treatment group received oral isotretinoin 0.5 mg/kg once daily for 1 month followed by an increased dose of 1 mg/kg once daily for 2 months. Isokinetic measurements were obtained from the hamstrings and quadriceps on the nondominant side of the body at baseline and 3-month follow-up using an isokinetic dynamometer. Results indicated that systemic isotretinoin did not significantly alter muscle strength, fatigue, and endurance.

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.

Vitamin D status in patients with rosacea.

BACKGROUND: Rosacea is a common chronic skin condition affecting the face. In recent years, significant evidence shows that vitamin D plays an important role in modulating the immune system. Vitamin D and its analogues via these mechanisms are playing an increasing role in the management of atopic dermatitis, psoriasis, vitiligo, acne and rosacea. OBJECTIVES: In our study, we aimed to investigate the relationship between serum vitamin D levels in patients with rosacea and analyze the association of vitamin D with clinical features. METHODS: Forty-four rosacea patients and 32 healthy control subjects were included into the study. 25-hydroxyvitamin D (25(OH)D), calcium and intact parathyroid hormone were measured. Deficiency of vitamin D is defined as the level of 25(OH)D being less than 20 ng/ml. RESULTS: Thirty-three female and 11 male patients were included in the study. The mean age of patients was 48.6 ± 11.5. The mean levels of vitamin D levels were found as 21.4 ± 9.9 and 17.1 ± 7.9 in patients and controls, respectively. The difference was statistically significant (p = 0.04). The prevalence of vitamin D deficiency in patients with rosacea was 38.6% and 28.1% in healthy controls (p = 0.34). CONCLUSIONS: To the best of our knowledge, our study is the first study for evaluating serum vitamin D levels of patients with rosacea in the literature. Patients with rosacea have relatively high serum vitamin D levels compared to control groups. The result of our study suggests that increased vitamin D levels may lead to the development of rosacea. To confirm status of vitamin D levels in patients with rosacea, larger epidemiological studies are needed.

Mean platelet volume and eosinophilia relationship in patients with bullous pemphigoid.

INTRODUCTION: Bullous pemphigoid (BP) is an autoimmune skin disease that is characterized by the formation of blisters on normal or erythematous skin. In patients with BP, eosinophils are highly represented in the inflammatory infiltrate of the lesional skin and their levels are often increased in peripheral blood. It is known that eosinophils are the major intravascular source of tissue factor (TF), an initiator of the extrinsic coagulation pathway. Patients with BP are also three times more likely to develop pneumonia and pulmonary embolism than the matched controls. We hypothesized that there might be an association between the eosinophil level and mean platelet volume (MPV) in these patients. PATIENT AND METHOD: A total of 19 patients with BP and age-sex match 22 healthy controls were included in this study retrospectively. MPV before treatment, MPV after treatment, platelet, eosinophil count before treatment, eosinophil count after treatment, white blood cell, glucose, C reactive protein and sedimentation rate were evaluated in BP patients and the control group. RESULTS: The MPV value (8.32 fl ± 1.8) and eosinophil count (1.03 × 10(3) µL(-1) ± 0.36) in patients with BP was significantly higher than that of control subjects (p=0.036) and (0.22 × 10(3)µL(-1) ± 0.29) (p=0.002) (p<0.05, Mann-Whitney U-test). CONCLUSION: In this study high levels of MPV and eosinophil levels have been detected. MPV may be a useful indicator of the risk of vascular events. Prospective studies are needed to compare disease activity, thromboembolic events and MPV in BP patients.

Mean platelet volume in recurrent aphthous stomatitis and Behçet disease.

Behcet disease (BD) and recurrent aphthous stomatitis (RAS) are systemic inflammatory diseases, but the exact pathogenesis of both the diseases is unknown. Mean platelet volume (MPV) is an indicator of platelet activation. The aim of this study was to investigate the MPV levels in patients with BD, RAS, and healthy participants. A total of 61 patients with BD, 60 patients with RAS, and 60 healthy controls were included in this study. The MPV levels and erythrocyte sedimentation rate in patients with BD and RAS groups were significantly higher than the control groups (P < .001). In the BD group as well as in the RAS group, the disease activity does not affect the levels of MPV. The MPV levels may be used as a cheap and feasible diagnostic marker in patients with BD and RAS. Nevertheless, the MPV does not have a predictive value in differentiating the diagnosis of BD and RAS.

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.

Neutrophil to lymphocyte ratio as a measure of systemic inflammation in psoriasis.

OBJECTIVE: Psoriasis is a chronic systemic inflammatory disorder. The neutrophil to lymphocyte ratio (N/L ratio) has been used as a marker for systemic inflammatory status. In our study, we aimed to evaluate N/L ratio in patients with psoriasis. METHODS: This cross-sectional study population consisted of 138 patients with psoriasis and 120 age- and sex-matched control subjects. RESULTS: The patients had significantly higher neutrophil counts and lower lymphocyte counts than the controls. The N/L ratios and high sensitivity C reactive protein (hs-CRP) levels were also significantly higher in patients. The N/L ratios and hs-CRP levels were increasing with increasing in Psoriasis Area and Severity Index score. Furthermore, the N/L ratios and hs-CRP levels of patients were found to be positively correlated. CONCLUSIONS: Our data show that the N/L ratio to be a simple, inexpensive and easily assessable marker of systemic inflammation in patients with psoriasis.

Narrow-band ultraviolet B phototherapy in childhood.

BACKGROUND: Narrow-band ultraviolet B (UVB) has been used for skin diseases in children. However, the use of phototherapy in childhood has limited due to the possible risk of skin cancer. The aim of this study is to evaluate the efficacy and safety of the narrow-band UVB phototherapy in children for the treatment of various skin diseases. METHODS: The data of the children aged 16 years or under who were treated with narrow-band UVB in our clinic's phototherapy unit were analyzed, retrospectively. RESULTS: The study included 77 children (42 girls, 35 boys) aged 5-16 years (mean 12.18 ± 3.53) who were treated with a total of 81 courses of narrow-band UVB phototherapy in the last 4.5 years. The majority of patients had vitiligo (47%) and psoriasis (39%). Thirty-four (44.2%) patients showed complete response, 15 (19.5%) good response, 12 (15.6%) partial response, 5 (6.5%) poor response and 11(14.3%) no response. Acute side effects of phototherapy were observed only in 11 (14.3%) patients. CONCLUSIONS: Narrow-band UVB phototherapy is an effective and well-tolerated treatment in childhood.