Ayla Gülekon

A retrospective analysis of treatment responses of palmoplantar psoriasis in 114 patients

Background  Treatment options remain unsatisfactory for patients with palmoplantar psoriasis (PP) and palmoplantar pustular psoriasis (PPP).

Natural cellular cytotoxicity in Behçet's disease.

This study evaluated the cytotoxic activity of natural killer cells in the active and inactive stages of Behçets disease (BD) and attempted to develop a new explanation for its immuno‐pathogenesis. Blood samples were taken from 16 BD patients and compared with 11 healthy individuals. The lymphocyte fraction was separated and diluated in RPMI‐1640. Candida as a target cell (T) was mixed with lymphocytes (E) (effector cells) in ratios of T:E 1/5 and T:E 1/25. After the numbers of colonies were counted with controls, the anticandidal index (natural cytotoxicity) was calculated. Natural cytotoxicity relatively decreased in the active stage and increased in the inactive stage of BD. Although the difference between the mean value of natural cytotoxicity in the active stage and in the inactive stage was significant, the difference between the averages of active stage and the control group was insignificant. However, the difference between inactive stage and the control group was remarkable. The increase of the natural cytotoxic activity in the inactive period of the disease may play a role together with other immune mechanisms in the aetiopathogenesis of BD.

The effects of calcipotriol and methylprednisolone aseponate on bcl‐2, p53 and ki‐67 expression in psoriasis

Objective  The decrease of physiological apoptosis in the psoriatic lesions is thought to be involved in the pathogenesis of psoriasis, and induction of apoptosis was shown to contribute to the regression of psoriatic hyperplasia. In the present study, we compared the effects of calcipotriol and methylprednisolone aseponate (MPA) treatments on bcl‐2, p53 and ki‐67 expressions in psoriatic patients in order to define a relationship between regulation of apoptosis and healing process in psoriasis.

Natural killer cell activity, serum immunoglobulins, complement proteins, and zinc levels in patients with psoriasis vulgaris.

The role of the immune system in patients with psoriasis vulgaris (PV) was investigated. The genetic and immunological basis for psoriasis is still unknown. Because of the reports of immunological defects in this disease, we investigated serum levels of immunoglobulins IgG, IgM, IgA, complement proteins C3, C4, serum zinc (Zn) levels and natural killer (NK) cell activities. Skin lesions of the psoriatic patients involved in the study comprised less than 10 % of the total body and the disease was in a stationary period. Zn levels were measured by atomic absorption spectrophotometry. NK cell activity was measured by 51Cr (Na2 51CrO4). IgG, IgA, IgM, C3 and C4 assays were done by liquidphase immunoprecipitation assay with nephelometric endpoint detection. IgG, IgA, C3 and C4 levels were significanty higher in patients with PV than in healty controls (p < 0.05). However, NK cell activity, serum Zn and IgM levels did not show significant differences between these two groups. There are changed immunological responses, which may play an important role in the pathogenesis of the disease. Many controversial results have been related to immunological parameters in psoriatic patients. Therefore, more detailed studies in this field need to be done to determine the relationship between psoriasis and the immune system.

Arachidonic acid metabolites and colchicine in Behçet's disease (BD)

Vasculitis is accepted to be the basis of Behçets disease (BD) which is a multisystem disease, and the arachidonic acid(AA) metabolites acting as balancing mediators in the organism are accepted to be responsible for the vasculitis. In this study, we examined the prostaglandin E2 (PGE2) and leukotriene C4 (LTC4) levels of the patients with BD before and after colchicine therapy. We found a statistical decrease in the PGE2 and LTC4 levels after colchicine therapy compared to the previous levels, concluding that colchicine inhibits the inflammation and the polymorphonuclear leukocyte (PML) chemotaxis by inhibiting the cyclooxygenase and lipoxygenase pathways.

Hypopigmented mycosis fungoides in an adolescent Turkish boy.

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Kadın Olgularda Yaygın Saç Kaybı ve Eşlik Eden Bulgular

Yaygin sac kaybi, bircok hormonal, besinsel faktore, cesitli kimyasal maddelere, ilaclara, sistemik/kutanoz hastaliklara ve emosyonel strese bagli olarak ortaya cikabilir. Bu birlikteliklerden bazilari oldukca iyi tanimlanmissa da bazilari cogu kez suclanmakla birlikte daha az tanimlanabilmislerdir. Bu calismanin amaci, altta yatan nedenler belirlenip, dislandiginda oldukca iyi bir prognoza sahip olan yaygin sac kaybi hastalarinda saptanan sistemik bulgularin ve eslik eden hastaliklarin incelenmesidir. Ocak 2000-Nisan 2007 tarihleri arasinda, Gazi ve Yeditepe Universitesi Hastanesi Dermatoloji kliniklerine yaygin sac kaybi yakinmasi ile basvuran, dermatolojik muayene ve sorgulama sonucunda alopesi areata veya androgenetik alopesi dusunulmeyen 100 kadin olgu iliskili olabilecegi dusunulen hastaliklar ve bulgular acisindan geriye donuk olarak incelendi. Hastalarda, bakir (n=100), cinko (n=100), ferritin (n=100), serum demiri (n= 68), tam kan sayimi (n=100), serbest T3 (n=100), serbest T4 (n=100), tiroid uyarici hormon (TSH) (n=100), eritrosit sedimentasyon hizi (n=64), vitamin B12 (n=100) ve folik asit (n=100) yapilan biyokimyasal ve hematolojik incelemelerdi. Yapilan biyokimyasal ve hematolojik incelemeler sonucunda dikkati ceken bulgular; olgularin %4’unde bakir, %9’unda cinko, %36’sinda ferritin ve %22’sinde demir eksikligine rastlanmasi oldu. %10 oraninda saptanan aneminin sebebi olarak da demir eksikligi disinda patoloji saptanmadi. Hastalarin 5’inde helikobakter pilori (+) gastrit, 15’inde cesitli psikiyatrik bozukluklar, 18’inde ise tiroit fonksiyon bozukluklari ve otiroid guatr klinik tabloya eslik etmekteydi. Bu calismada yaygin sac kaybinda saptadigimiz laboratuar bulgulari ve eslik eden hastaliklar incelenerek konuyla ilgili literatur tartisilmistir. Calismamizda, serum bakir, cinko ve tiroit fonksiyon bozuklugu dusuk bir oranda saptanmistir. Bu sonuc, bu tetkiklerin rutin olarak istenmemesi konusunda bizleri uyarmaktadir. Bu tetkiklerin, ancak klinik olarak bir suphe veya uygulanan tedavilere direnc oldugunda istenmesinde yarar vardir. Bunun yani sira, ferritin duzeyi ve tam kan sayiminin bu hasta nufusunda istenmesinde fayda oldugu sonucuna varilmistir. Diffuse Hair Loss in Females and Associating Findings Diffuse hair loss depends on many chemicals, drugs, systemic/cutaneous diseases, emotional stres and hormonal/nutritional factors. Although a part of these associations has been demonstrated in detail, many suspected factors need to be investigated. The aim of this study is to investigate the laboratory findings and associating diseases in diffuse hair loss patients, which have a good prognosis when the underlying factors can be detected and eliminated. One hundred female diffuse hair loss patients were investigated in the view of related diseases and findings retrospectively, between January 2000- April 2007 in Gazi and Yeditepe University Hospital Dermatology clinics. Copper (n=100), zinc (n=100), ferritine (n=100), serum iron (n= 68), total blood count (n=100), free T3 (n=100), free T4 (n=100), thyroid stimulating hormone (TSH) (n=100), erhytrosyte sedimentation rate (n= 64), vitamine B12 (n=100) and folic acide (n=100) were the biochemical and haematologic investigations tested in the patient population. 4% copper, 29% zinc, 36% ferritine and 22% iron deficiency were detected with biochemical and hematological investigations. In the anemic patients- which are constituting the 10% of patients- the only etiological factor was iron deficiency. 5 patients had associating helicobacter pylori (+) gastritis, 15 patients had psychiatric disorders, 18 patients had thyroid function disorders and euthyroid guatr. We have evaluated the laboratory results and associating diseases in our study and discussed the literature related with these results. We detected copper, zinc and thyroid function defects in a low rate, in this study. This result warns us about not to ask for these laboratory tests routinly. We should ask these laboratory tests when there is a clinical suspicion or resistance to treatments. In addition, its been concluded that investigating serum ferritine level and total blood count is usefull in this patient population.

Serum β2-microglobulin levels in psoriatic patients

β2‐Microglobulin (β2‐M) is a low molecular weight protein forming the light chain of the class I major histocompatibility complex. It is found on the cell surface of all nucleated cells. Its serum concentration is found to be increased in kidney diseases, neoplasia, AIDS, chronic inflammation and autoimmune diseases. Inflammation plays an important role in the pathogenesis of psoriasis, especially psoriatic arthritis and immunological upset is one of the most implicated factors in the etiology of the disease. In this study, the sera β2‐M levels were evaluated in cases diagnosed as psoriasis vulgaris and psoriatic arthritis, and a statistically significant increase was found in cases of psoriatic arthritis compared to those of psoriasis vulgaris and the control group.