Basak Kandi

Clinical features and natural course of Behçet’s disease in 661 cases: a multicentre study

Background  Behçet’s disease (BD) is a systemic inflammatory disease with unpredictable exacerbations and remissions. The natural course of BD is not fully known.

Does autonomic dysfunction play a role in atopic dermatitis

Background  Atopic dermatitis (AD) is a chronic dermatitis characterized by intense itching and excessive skin dryness. The factor most commonly blamed for the pathogenesis of skin dryness in the disease is impaired barrier function of the stratum corneum. However, there are findings indicating that the autonomic nervous system, and the sympathetic nervous system in particular, is affected negatively in AD, and thus, autonomic dysfunction can be an important factor leading to skin dryness.

Pimecrolimus 1% cream, methylprednisolone aceponate 0.1% cream and metronidazole 0.75% gel in the treatment of seborrhoeic dermatitis: A randomized clinical study

Background: Seborrhoeic dermatitis is a common, chronic, papulosquamous dermatosis. Treatment of seborrhoeic dermatitis includes topical treatments such as corticosteroids, antifungals, metronidazole and pimecrolimus. Objective: This study aimed to compare and contrast the efficacy and tolerability of pimecrolimus cream 1%, methylprednisolone aceponate 0.1% cream and metronidazole 0.75% gel topical treatments in the treatment of facial seborrhoeic dermatitis. Methods: The study included a total of 64 (32 males and 32 females) consecutive patients with facial seborrhoeic dermatitis. Patients were randomized into three equal groups. One group applied pimecrolimus 1% cream, another group applied methylprednisolone aceponate 0.1% cream, and the third group applied metronidazole 0.75% gel to their facial lesions twice daily for 8 weeks. Assessment of the disease severity was performed at baseline and at weeks 2, 4, and 8. Clinical measures assessed were erythema, scaling and pruritus, which were evaluated using a four-point scale (0–3). Results: Of the 64 patients, 17 (80%) in the metronidazole group, 21 (100%) in the pimecrolimus group and 22 (100%) in the methylprednisolone aceponate group completed the study. Four patients in the metronidazole group left the study. All of the therapeutic agents were found to be effective; however, the efficacy of pimecrolimus was higher than those of metronidazole and methylprednisolone (p < 0.05). When side effects associated with pimecrolimus and metronidazole were compared, the latter was found to be associated with more side effects (p < 0.05). Conclusions: We suggest pimecrolimus to be a therapeutic option for seborrhoeic dermatitis cases that show an unfavourable response to methylprednisolone aceponate.

The comparison of treatment with clobetasol propionate 0.05% and topical pimecrolimus 1% treatment in the treatment of alopecia areata

Abstract Background: Alopecia areata (AA) is a non-scarring hair loss. Objective: We aimed the comparison of clobetasol propionate and pimecrolimus efficiency and tolerability in the treatment of AA. Methods: The study included a total of 100 consecutive patients with AA. Patients were randomized into four groups. 30 patients used 1% pimecrolimus cream, 30 patients used 0.05% clobetasol propionate cream, 20 patients used petrolatum as placebo. Scalp of 20 patients was divided into two equal areas and one area was treated with 1% pimecrolimus cream and the other area with 0.05% clobetasol propionate cream. Results: At week 12 of treatment, the recovery rate of the pimecrolimus group was 53.73 ± 44.49 and the recovery score was 3.63 ± 2.07; that of the clobetasol propionate group was 47.00 ± 44.80 and the recovery score was 3.33 ± 2.20; that of the placebo group was 35.50 ± 40.53 and the recovery score was 2.75 ± 1.88. There was no statistically significant difference among the groups in terms of the percentage of recovery and the recovery score (p < 0.05). Conclusion: In conclusion, we detected that topical pimecrolimus treatment is as effective as topical corticosteroids and is superior to topical corticosteroids in terms of side effects in the treatment of AA.

Vitamin levels in Behcet's disease

Objective: To determine the role of oxidative stress and the antioxidant defense mechanism in the etiopathogenesis of active and inactive Behçets disease. In line with this objective, the present study aimed to examine the levels of nitric oxide (NO) and malondialdehyde (MDA), which are the end products of oxidant stress, and vitamins, which are non‐enzymatic antioxidants, for the diagnosis and particularly the follow‐up of Behçets disease. Materials and methods: The study group consisted of a total of 60 individuals: 40 of whom were Behçets disease patients and 20 were healthy individuals. Of the 40 Behçets patients, 29 had the active and 11 had the inactive (stable) form of the disease. Results: Although plasma MDA and NO (its stable form nitrite) levels in the total patient group were statistically significantly higher than those in the control group (p<0.06), there was no statistically significant difference as such between inactive Behçets patients and the control group (p>0.05). Vitamin E, C, B1, B2 and flavin mononucleotide (FMN) values were significantly lower in the patient group in comparison with the control group (p<0.05). There was no statistically significant difference in other vitamin values. Discussion: It is contemplated that measurement of such oxidative stress factors as MDA and NO and an accompanying evaluation of the antioxidant defense system can be significant in the diagnosis and treatment follow‐up of Behçets disease.

Primary Cutaneous Rhabdomyosarcoma in an Adult

Rhabdomyosarcomas (RMSs) are primitive malignant mesenchymal tumors that have a strong tendency to differentiate into skeletal muscle. They have a predilection for the head and neck region, the genitourinary tract, the retroperitoneum, and the soft tissues of the extremities. They are the most common soft tissue sarcoma of childhood. Rarely, RMSs may present as dermal nodules, particularly on the head or neck, usually as a result of dermal extension of a lesion arising in the underlying soft tissues. Lesions of dermal origin are rare.

Investigation of attention deficit and hyperactivity disorder in adult patients with atopic dermatitis

Background. Atopic dermatitis (AD) is a common chronic inflammatory disease that is associated with significant psychosocial morbidity and a decrease in health-related quality of life. Attention deficit hyperactivity disorder may be present in atopic dermatitis patients. Objective. The present study aims to investigate the co-presence of ADHD in adult patients with AD. Material and method. The study registered 60 adult patients with AD (48 females and 12 males) and 50 non-atopic control subjects (38 females and 12 males). The AD patient group and the control group were assessed using the Turgay adult Attention-Deficit/Hyperactivity Disorder (ADD/ADHD) DSM-IV-Based Diagnostic Screening and Rating Scale (Turkish Version), which was studied by a team of psychologists and psychiatrists in Turkey for validity, reliability and norms. The scale covers three dimensions of the disease, namely inattention, hyperactivity and impulsivity, and associated features of ADHD. The groups were compared and contrasted in terms of their similarities and differences in ADD/ADHD symptoms. Results. Three sub-dimensions of ADD/ADHD scale (Attention Deficit, Hyperactivity/ Impulsivity and Problem subdivisions) in AD patients were found statistically significantly elevated relative to controls (P<0.001, P<0.001, P<0.001, respectively). Conclusions. In conclusion we established the co-presence of ADHD in AD patients in the adult age group.

An urticarial vasculitis case induced by glatiramer acetate

Urticarial vasculitis (UV) is a disease characterized clinically by urticarial skin lesions and histologically by leukocytoclastic vasculitis caused by immunocomplex accumulation in post‐capillary venules. Cases induced by various drugs such as cimetidine, diltiazem, potassium iodide, fluoxetine, and non‐steroid inflammatory drugs have been reported in the literature. A 48‐year‐old female who developed pruritus and rash on her body 3 months after starting glatiramer acetate (GA) treatment for multiple sclerosis was diagnosed with UV after clinical and histopathological examination. This report presents the first case in the literature of UV induced by GA.

The frequency and seasonal variations in juvenile outpatients treated in a dermatology polyclinic

Objective  This study was carried out to evaluate the frequency and seasonal characteristics of dermatological problems of juvenile outpatients in the dermatology polyclinic.

Pustular Bazex Syndrome with Flexural Localization Associated with Metastatic Lung Carcinoma: Case Report

ABS TRACT A 60-year-old male who had been diagnosed with metastatic lung carcinoma six years previously and had not accepted the a treatment was evaluated due to rash in his body. The patient’s history revealed that the rash started six months ago on the back of the hand and extended to the upper extremities and his ear. Dermatological examination of the patient revealed erythematoussquamous plaques spread on flexural areas, bilateral upper limbs and ears, and pustules with peripheral location around the plaques. Histopathologically, there was hyperkeratosis, focal parakeratosis, small pustular change and perivascular lymphocytic infiltrate in the papillary dermis. Based on the clinical manifestation, presence of carcinoma and histopathologic evaluation, the patient was diagnosed as Bazex syndrome. In the present study, we have reported a very rare atypical form of Bazex syndrome due to psoriasiform lesions with acral and flexural location, accompanied by numerous pustules. This is the first case of acrokeratosis paraneoplastica in the literature that associated with metastatic lung carcinoma.