Betül Demir

Effect of Oral Isotretinoin Treatment on Retinal Nerve Fiber Layer Thickness

Background: Oral isotretinoin treatment can cause ocular side effects. Objective: This study was performed to detect possible toxic effects of oral isotretinoin treatment on the retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL). Methods: The study population consisted of 54 eyes of 27 patients with nodulocystic acne who used oral isotretinoin (Roaccutane) treatment. Macular GCL and peripapillary RNFL thickness measurements were performed using spectral domain optical coherence tomography (OCT) before and after therapy. Results: Before and after treatment, a complete ophthalmologic examination was normal in all eyes. However, posttreatment lower temporal (TL) values were significantly lower (76.80 ± 16.31) than pretreatment TL values (84.96 ± 24.83) (p = .02). There was no statistically significant difference in the other OCT values, upper temporal, superotemporal, superonasal, upper nasal, lower nasal, inferonasal, and inferotemporal (p = .35, p = .40, p = .56, p = .95, p = .94, p = .93, p = .61, respectively). Also, there was no statistically significant difference between the right and left eyes and between genders for all parameters (p > .05). Conclusion: The use of oral isotretinoin treatment has increased in recent years. In addition, oral isotretinoin treatment has a broad adverse effect potential on the ocular system. The measurement of RNFL thickness, especially TL thickness, by OCT may be useful for detecting the possible toxic effect of oral isotretinoin therapy on RNFL.

Efficacy of topical tacrolimus for the treatment of persistent pruritus ani in patients with atopic dermatitis

Background: Pruritus ani (PA) is defined as intense chronic itching affecting perianal skin. Objective: We aimed to determine the efficacy of topical tacrolimus treatment in atopic dermatitis (AD) patients who have PA. Methods: The study included 32 patients with AD who were suffering PA. Patients were randomized into two groups. In total, 16 patients used 0.03% tacrolimus ointment and 16 patients used vaseline as placebo. All groups applied topical treatments to their perianal area twice daily for 4 weeks. The treatments were then reversed for 4 weeks after a 2 weeks wash out period. Results: In total, 32 patients with AD who had refractory anal itching were enrolled in this study. None of the patients had obtained successful results with previous treatments. There was a statistically significant decrease in the recorded EASI, DLQI and itching scores for the tacrolimus group compared to the placebo group at weeks 4 and 6 of treatment (p < 0.05). Conclusion: Topical tacrolimus treatment was well tolerated and effective in controlling persistent PA in AD patients.

Does hepcidin play a role in the pathogenesis of aphthae in Behçet's disease and recurrent aphthous stomatitis?

Aphthae constitute one of the major signs in Behçets disease (BD) and recurrent aphthous stomatitis (RAS). No scientific study has yet explored the relationship of hepcidins, which have antimicrobial effects, with RAS and BD.

Evaluation of ovarian reserve and function in female patients treated with oral isotretinoin for severe acne: an exploratory study

Abstract Background: Isotretinoin affects the levels of female hormones and ovaries in patients with severe acne. Objective: This study evaluated the effects of isotretinoin on the ovarian reserve and levels of female hormones in patients with severe acne. Methods: Thirty-two female patients with severe acne were enrolled. All the patients were treated with oral isotretinoin 0.5–2 mg/kg/d. The total cumulative dose for a full course was 120–135 mg/kg. The treatment duration ranged from 5 to 8 months. The serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) levels and antral follicle count (AFC) and ovarian volume (OV) were evaluated before and after treatment. Results: After treatment, the mean FSH, LH, and E2 levels were significantly lower than before treatment. In addition, the mean AFC and OV decreased after treatment, although the difference was not significant. Conclusion: The results of this exploratory study do not demonstrate that oral isotretinoin has an impact in ovarian function. In contrast, isotretinoin affects levels of female hormones in patients with severe acne.

Prognostic factors that affect the response to topical treatment in patchy alopecia areata

Background  Alopecia areata (AA) is an organ‐specific, T‐cell‐mediated autoimmune disease that is characterized by non‐scarring hair loss.

Changes in serum desnutrin levels in patients with acne vulgaris

BackgroundAndrogens and insulin may contribute to increased sebum production in the pathogenesis of acne vulgaris.ObjectiveWe investigated the association between serum desnutrin levels and acne vulgaris in the pathogenesis of insulin resistance.Material and methods25 patients presenting with acne vulgaris and 25 control subjects participated in this study. Fasting blood glucose, triglycerides, LDL, VLDL, HDL, total cholesterol, insulin, C-peptide and thyroid function tests were measured. The homeostasis model assessment of insulin resistance (HOMA-IR) was used to calculate insulin resistance. Desnutrin levels were determined by enzyme-linked immunosorbent assay (ELISA) according to the manufacturer’s protocol.ResultsPatients with acne vulgaris had a mean serum desnutrin level of (8.83 ± 1.13 μIU/mL), which was statistically significantly lower in the control group (10:58 ± 3.43 μIU/mL). In patients with acne vulgaris the serum glucose levels, insulin levels and HOMA-IR values (87.92 ± 7:46 mg/dL, 11.33 ± 5.93 μIU/mL, 2.49 ± 1.40, respectively) were significantly higher than the control group (77.36 ± 9.83 mg/dL, 5.82 ± 2.68 μIU/mL, 1.11 ± 0.51, respectively) (p = 0.01, p<0.001, p<0.001, p<0.001, respectively).ConclusionFull cohort (patients and controls) evaluation revealed a negative correlation between the serum glucose and desnutrin levels (r = −0.31, p<0.05).Apositive correlationwas found between insulin and desnutrin levels (r = 0.42, p<0.001). In patients with acne vulgaris, as a result of increased levels of serum glucose and insulin, the function of desnutrin was suppressed, perhaps contributing to insulin resistance.

Intralesional Vitamin D Injection May Be an Effective Treatment Option for Warts

Background: Plantar warts are typically resistant to treatment. In recent years, treatments have included administration of intralesional tuberculin; measles, mumps, rubella vaccine; and Candida albicans antigen immunotherapy. To the best of our knowledge, there are no reports of intralesional vitamin D administration for the treatment of warts. Aim: To evaluate the efficacy and safety of intralesional vitamin D treatment for plantar warts. Methods: Twenty patients with single or multiple plantar warts were included in this study. Vitamin D3 (0.2 mL, 7.5 mg/mL) was injected into the base of the warts after prilocaine (0.1 mL, 20 mg/mL) injection. A maximum of 5 warts were treated in 1 session, with at maximum 2 injections performed at 4-week intervals. Results: In total, 16 of 20 patients (80%) showed complete resolution of warts, and 1 patient showed partial resolution. Three patients failed to show any response. No recurrence or serious adverse effects were observed. Conclusion: Intralesional vitamin D3 may be an effective treatment option for warts.

Audiological abnormalities in patients with alopecia areata.

Audiological abnormalities seen in various autoimmune disorders raises the question of whether such abnormalities also exist in alopecia areata.

Serum salusin-α and salusin-β levels in patients with Behcet's disease

BackgroundBehcet’s disease (BD) is a chronic, relapsing, systemic vasculitis of unknown etiology. There is an increased predisposition to insulin resistance and metabolic syndrome (MetS) in BD patients.ObjectiveThe aim of this study was to determine serum salusin-α and salusin-β levels in BD patients and healthy controls and to investigate their association with MetS.Patients and MethodsTwenty-five BD patients and 25 healthy controls were included in the study. Salusin-α and salusin-β levels were measured in blood samples using ELISA. In addition, BD patients and healthy controls were evaluated in terms of MetS.ResultsThe mean serum salusin-α level in BD patients was significantly lower compared to healthy controls (p = 0.03), whereas the mean serum salusin-β level in BD patients was significantly higher compared to healthy controls (p = 0.03). The mean serum salusin-α level was significantly lower in BD patients with MetS compared to BD patients without MetS (p = 0.04).ConclusionsSerum salusin-α level (an anti-atherogenic molecule) was lower, while serum salusin-β level (a pro-atherogenic molecule) was higher in BD patients. We consider that the decrease in salusin-α and the increase in salusin-β levels contribute to the development of MetS.

Metabolic Changes and Serum Ghrelin Level in Patients with Psoriasis

Background. Serum ghrelin levels may be related to metabolic and clinical changes in patients with psoriasis. Objective. This study was performed to determine the possible effects of serum ghrelin in patients with psoriasis. Methods. The study population consisted of 25 patients with plaque psoriasis. The patients were questioned with regard to age, gender, age of onset, duration of disease, height, weight, and body mass index (BMI). In addition, fasting blood sugar, triglyceride, cholesterol levels, insulin, and ghrelin levels were measured. Results. The mean serum ghrelin level was 45.41 ± 22.41 in the psoriasis group and 29.92 ± 14.65 in the healthy control group. Serum ghrelin level was significantly higher in the psoriasis group compared with the controls (P = 0.01). The mean ghrelin level in patients with a lower PASI score was significantly higher than in those with a higher PASI score (P = 0.02). Conclusion. The present study was performed to determine the effects of ghrelin in psoriasis patients. We found a negative correlation between severity of psoriasis and ghrelin level. Larger and especially experimental studies focusing on correlation of immune system-ghrelin levels and severity of psoriasis may be valuable to clarify the etiopathogenesis of the disease.