Didem Didar Balci

Increased carotid artery intima‐media thickness and impaired endothelial function in psoriasis

Background  Psoriasis is associated with an increased risk of atherosclerosis. This study compared subclinical atherosclerosis of the carotid and brachial arteries in psoriasis vulgaris patients and healthy controls using high‐resolution ultrasonography.

High prevalence of Staphylococcus aureus cultivation and superantigen production in patients with psoriasis

The aim of this study was to evaluate the association of Staphylococcal enterotoxins (se) a through e, exfoliative toxin (et) a and b, toxin and toxic shock syndrome toxin (tst) and mecA with psoriasis. We also investigated the distribution of Staphylococcus aureus (S. aureus) in the skin and nares. Fifty consecutive patients with chronic plaque-type psoriasis and 50 sex- and age-matched healthy controls were included in this study. There was a statistical difference in cultivation of S. aureus between lesional (64%) and non-lesional skin (14%) in patients with psoriasis (p = 0.037). S. aureus was cultivated from the nares in 25 (50%) of 50 patients with psoriasis and in 17 (34%) of 50 healthy controls (p > 0.05). In psoriasis patients, 31 (96.8%) out of the 32 strains isolated from the lesional skin and 3 (42.3%) out of the 7 strains isolated from the non-lesional skin were toxigenic (p = 0.01). Isolated strains from the nares were toxigenic in 96% (24/25) for patients with psoriasis and in 41.2% (7/17) for healthy controls, respectively (p = 0.006). Patients with cultivation-positive in lesional skin had a significantly higher PASI score than patients who were cultivation-negative in lesional skin (8.28 +/- 3.97 vs. 5.89 +/- 2.98, p = 0.031). Our results confirm that S. aureus colonization and its toxigenic-strains are associated with psoriasis. According to our findings, non-classical superantigens such as methicillin resistance gene (mecA), see and etb may also be associated with psoriasis.

Is androgenetic alopecia a risk for atherosclerosis

Background   Several studies have demonstrated the presence of an association between androgenetic alopecia (AGA) and cardiovascular disease. The aim of this study was to evaluate subclinical atherosclerosis in patients with AGA and healthy controls by the incorporation of carotid intima‐media thickness (IMT) and high‐sensitive C‐reactive protein (hs‐CRP) along with echocardiography (ECHO) and exercise electrocardiography (ExECG).

Increased amount of visceral fat in patients with psoriasis contributes to metabolic syndrome.

Background: Psoriasis is associated with obesity and metabolic syndrome. Metabolic syndrome is associated with visceral fat accumulation. There is no study on the accumulation of visceral fat in patients with psoriasis. Objective: The aim of this study was to compare the visceral fat accumulation in patients with psoriasis and controls. Subjects and Methods: 46 patients with psoriasis and 46 sex- and age-matched control patients were included in this study. The abdominal fat area [visceral fat area (VFA), subcutaneous fat area (SFA) and total fat area (TFA)] at the level of the umbilicus was evaluated by computed tomography. Results: The mean VFA value and VFA/SFA ratio of the psoriasis patients were significantly higher compared with the control patients (123.4 ± 80.3 vs. 81.2 ± 59.8 cm2 and 0.734 ± 0.593 vs. 0.491 ± 0.336; p = 0.005 and p = 0.017, respectively). Fasting blood sugar levels were also found to be significantly higher in psoriasis patients, compared with the control patients (101.8 ± 43.5 vs. 83.4 ± 9.1 mg/dl; p = 0.005). Multiple linear regression analysis indicated that waist-to-hip ratio, age, body weight, the presence of psoriasis and metabolic syndrome were significantly associated with VFA. Conclusion:Psoriasis patients had a higher amount of VFA, compared with the control patients.

DLQI scores in patients with keloids and hypertrophic scars: a prospective case control study

Background: Keloids and hypertrophic scars (HTS) can cause functional impairment and psychosocial burdens, both of which affects quality of life (QoL). Our aim was to compare Dermatology Life Quality Index (DLQI) scores in patients with keloids and HTS to those of psoriasis patients and normal controls.

Dermatology life quality index scores in children with vitiligo: comparison with atopic dermatitis and healthy control subjects

Vitiligo and atopic dermatitis (AD) are two major cutaneous diseases that affect quality of life (QoL) by causing functional and psychosocial disorders. Our objective was to calculate Children’s Dermatology Life Quality Index (CDLQI) scores in children with vitiligo and to compare these values with those in AD patients and healthy control subjects. The CDLQI was completed for 50 vitiligo and 50 AD patients presenting at the dermatology polyclinic, as well as for 50 age‐ and sex‐matched healthy controls. All subgroups in the vitiligo patient group had significantly higher total CDLQI scores than healthy controls. Vitiligo patients were found to have increased scores on all parameters, except itch, clothes/shoes, and sleep, compared with the AD patient group. Scores on itch and sleep were significantly higher in the AD group than in the vitiligo patients. Quality of life in children with vitiligo is substantially lower than in children with AD. This decline in QoL is critical in the psychosocial development of the former group.

Patients with psoriasis have an increased amount of epicardial fat tissue

Psoriasis is associated with coronary artery disease, and ischemic heart disease is associated with increased amounts of epicardial fat tissue (EFT). There has as yet been no study published on the accumulation of EFT in patients with psoriasis.

Sulfasalazine-induced hypersensitivity syndrome in a 15-year-old boy associated with human herpesvirus-6 reactivation

Drug-induced hypersensitivity syndrome (DIHS) is characterized by high fever, facial edema, diffuse maculopapular eruption, and multiorgan involvement. Human herpesvirus (HHV)-6 reactivation is an accepted criterion for the diagnosis of DIHS and has prognostic importance. We report a 15-year-old boy with juvenile rheumatoid arthritis who developed DIHS due to sulfasalazine, associated with reactivation of HHV-6.

Impaired Pulmonary Function in Patients with Psoriasis

Background: Psoriasis is associated with chronic obstructive pulmonary disease. There is no study on the spirometric pulmonary function testing in patients with psoriasis. Objective: The aim of this study was to compare the spirometric parameters in patients with psoriasis and controls. Methods: Ninety-six patients with psoriasis and 60 sex- and age-matched control subjects were included in this study. Spirometric pulmonary function testing, including percent forced vital capacity (FVC%), percent forced expiratory volume in the 1st second (FEV1%), forced expiratory flow at 25-75% of FVC (FEF25-75%), and FEV1/FVC ratio, was performed in all study subjects. Results: The mean FEV1/FVC ratio and FEF25-75% were significantly lower in the psoriasis patients than in the controls (82.4 ± 6.3 vs. 90.7 ± 10.7, p < 0.001, and 86.7 ± 24.2 vs. 94.8 ± 23.0, p = 0.04, respectively). Both FEV1/FVC ratio and FEF25-75% were significantly associated with the presence of psoriasis (p < 0.001 and p = 0.029, respectively). Conclusion: Psoriasis patients had lower mean FEV1/FVC ratios and FEF25-75%, compared with the control subjects. FEV1/FVC and FEF25-75% are independently associated with the presence of psoriasis.

Coexistence of Acral Syringomas and Multiple Trichoepitheliomas on the Face

Background: An extremely rare variant of syringoma is an acral form, which affects the upper extremities as an isolated finding. The acral syringomas may also be associated with syringomas on the feet or usual distribution around the eyelids. Of the eight previously documented cases of acral syringomas, all were located on the dorsal aspect of the upper extremities (fingers, hand, wrist, or forearm) dominantly. Objective: We report a 41-year-old woman who presented with multiple flesh-colored to reddish brown papules on the inner aspect of the forearms and many pearly, small papules on the periorbital regions. Results: The clinical picture and histopathology indicated the coexistence of acral syringomas and multiple trichoepitheliomas on the face. Conclusion: To the best of our knowledge, this is the first case of acral syringomas coexisting with multiple trichoepitheliomas.