Gonca Elçin

The Effect of Neodymium: Yttrium Aluminum Garnet and Fractional Carbon Dioxide Lasers on Alopecia Areata: A Prospective Controlled Clinical Trial.

BACKGROUND Effective treatment options for alopecia areata (AA) are missing. Whether lasers might be effective is a topic of debate. OBJECTIVE We aimed to evaluate whether neodymium: yttrium aluminum garnet (Nd:YAG) or fractional carbon dioxide lasers might stimulate the development of new hair. MATERIALS AND METHODS Thirty-two patients who had long-standing and treatment refractory diseases were recruited for the study. Three different patches on the scalp were selected, 1 of which served as control. The mean outcome measure was the hair count, which was calculated with the digital phototrichogram. Response was defined as at least 25% increase in the mean hair count at the treated patch compared with the control patch. RESULTS At the end of the study, there was no statistically significant difference in the mean hair count for the 3 patches. In 7 of 32 patients (22%), an increase in the mean hair count was observed on the whole scalp including the control patch, which resulted in an improved Severity of Alopecia Tool (SALT) score. CONCLUSION We have observed that Nd:YAG or fractional carbon dioxide lasers did not increase the mean hair count on the treated AA patches when compared with the control patch. However, an SALT score improvement in 22% of the patients suggested spontaneous remission.

Fractional carbon dioxide laser for facial rejuvenation: A prospective study to evaluate the efficacy and the safety

ABSTRACT Background: The aim of this study was to evaluate the efficacy and safety of the fractional ablative carbon dioxide laser for facial rejuvenation. Materials and Methods: Twenty-nine female who have the complaint of facial aging were recruited for the study. Participants received a maximum of three laser treatment sessions with one-month intervals and were scored using a 5-point scale on seven categories for facial aging before and after the treatment by the physicians. Self-assessments by participants were done at the last month of follow-up period and 3 years after the last session. Results: Mean facial aging score before the treatment was 11,24 ± 4,30 and after the treatment was 10,51 ± 3,86 (p = 0.003). The decrease in the score was mild in 18 (62,1%) participants, whereas it was moderate in only 1 (3,4%) participant. None of the participants had significant or perfect improvement. When the seven categories were analyzed seperately, the only statistically significant alteration in the score was found in the skin tone category (p = 0.0001). Conclusion: Results show that rejuvenation with the fractional ablative carbon dioxide laser decreases mildly the symptoms of facial aging in more than half of the patients.

Is there a role of food additives in recurrent aphthous stomatitis? a prospective study with patch testing

Recurrent aphthous stomatitis (RAS) is a common disease of the oral mucosa with an unknown etiology. This study aimed to determine if food additives play a role in the etiology of RAS as well as to determine if patch testing can be used to detect which allergens cause RAS.

Long-term follow-up of early mycosis fungoides patients treated with narrowband ultraviolet B phototherapy

Background: Narrowband ultraviolet B (UVB) provides complete response (CR) in 54–91% of early mycosis fungoides (MF) patients. Data concerning relapse rate and relapse-free interval after discontinuation of therapy need clarification. The purpose of this study was to evaluate the relapse rate and the relapse-free intervals of early MF patients after achieving complete response with narrowband UVB phototherapy. Methods: Retrospective evaluation of data, which belong to early MF patients treated with narrowband UVB phototherapy between May 2000 and July 2010, and followed-up until May 2012 in a single institution, for the occurrence of relapse and the time to relapse. Results: Of 31 patients, who were followed-up for a mean of 56.5 ± 30.2 months (median 55 months, range 20–120 months), relapse was observed in 11 (35.5%) patients, within a mean of 28.8 ± 18.2 months (median 33 months, range 4–59 months), whereas 20 (64.5%) patients stayed relapse-free for a mean of 54.2 ± 28.8 months (median 55.5 months, range 20–119 months). Patients received maintenance phototherapy with a median duration of 12 months (range 1–30 months) after achieving complete response. Conclusion: Results indicate that narrowband UVB phototherapy may induce low relapse rates and long relapse-free intervals for early MF.

Insulin sensitivity, androgens and isotretinoin therapy in women with severe acne

Background: Androgens appear to play a role in the development of acne, and presence of acne is a potential marker of hyperandrogenism. Objective: The authors evaluated androgens and insulin sensitivity markers before and after treatment with isotretinoin in women with post-adolescent severe acne who do not have hirsutism and/or ovulatory dysfunction. Methods: Androgens, lipids, glucose and insulin levels were measured in 26 patients and 21 controls during oral glucose tolerance test. Homeostasis model assessment for insulin resistance, area under curve (AUC)glucose and AUCinsulin were calculated. Twenty patients completed a minimum of 6-month isotretinoin treatment. Results: All studied parameters were similar in patients and controls at baseline. Isotretinoin therapy increased body mass index and triglyceride levels without any effect on androgens or insulin sensitivity. Conclusion: Severe acne itself is not associated with hyperandrogenemia and/or insulin resistance. Isotretinoin treatment does not alter serum androgens or insulin sensitivity, although it increases body weight and serum triglycerides.

Suppressed Adiponectin Levels and Increased Adiponectin Response to Oral Glucose Load in Lean Women with Severe Acne Normalizes after Isotretinoin Treatment

Background/Aim: Isotretinoin, the drug of choice for severe acne, might be associated with a decrease in insulin sensitivity. Adiponectin is an adipose tissue-derived protein that increases insulin sensitivity. In this study, we aimed to investigate adiponectin levels in postadolescent severe acne and the effect of isotretinoin on adiponectin levels. Methods: Participants included 18 female patients with severe acne and 18 healthy women matched for age and body mass index (BMI). Acne patients completed a 6-month isotretinoin treatment. Anthropometric measurements, serum adiponectin, lipids, fasting glucose, fasting insulin, and homeostatic model assessment for insulin resistance (HOMA-IR) were determined, and a standard 2-h oral glucose tolerance test (OGTT) was performed in healthy women once and in patients with acne before and after treatment. Results: At baseline, patients with acne had significantly lower serum adiponectin levels than controls. Isotretinoin treatment resulted in a significant increase in weight, BMI, and triglyceride and adiponectin levels. Glucose metabolism markers in patients with acne and controls were similar at baseline and did not change after treatment. Baseline OGTT in acne patients revealed an increased adiponectin response at 2 h, which was not present in healthy controls. Remarkably, this OGTT-induced adiponectin increment in acne patients was diminished after isotretinoin treatment. Conclusion: Adiponectin levels are differently regulated in women with severe acne and healthy controls in that circulating basal levels in patients are suppressed and show an increase in response to oral glucose load. Suppression of baseline adiponectin ameliorates after 6 months of isotretinoin treatment, reaching levels similar to those of healthy controls.

Autoimmune estrogen dermatitis in an infertile female

Abstract Autoimmune estrogen dermatitis is a cyclical cutaneous eruption that occurs premenstrually and goes to the rapid resolution within a few days of menstrual cycles. The disorder has variable clinical manifestations consisting of macules, papules, vesicles, urticarial lesions, bullae, eczematous plaques, and erythema multiforme-like lesions. Herein, we present a case of a 30-year-old woman with attacks of edema and erosions involving the oral and genital mucosal sites on every first day of her menstruation period. She had also multiple endocrinological problems such as hypotroidism and infertility. To determine the sex hormon sensitivity, intradermal skin tests were performed. Based on her personal history and skin test findings, a diagnosis of autoimmune estrogen dermatitis was made. After the oophorectomy, she was free from the skin and mucosal symptoms. We propose that it is important to suspect the diagnosis of autoimmune estrogen dermatitis in patients who present with recurrent cylic eruptions and it must be kept in mind that these patients might have a concomitant infertility.

Comparison of adrenocortical steroidogenesis in women with post‐adolescent severe acne and polycystic ovary syndrome

Increased adrenocortical production appears to be associated with acne and hirsutism in acne and polycystic ovary syndrome (PCOS). However, the aetiological role of androgens in the pathogenesis of acne per se is far from being clear.

Primary Lymphocytic Cicatricial Alopecia: A Retrospective Analysis of 36 Patients

Cicatricial alopecias (CAs) are a group of diseases that cause irreversible loss of hair follicles (1). The folliculocentric attack is common in all CAs, which can be divided into 2 groups as primary and secondary CAs. While the hair follicle is targeted and damaged mainly in primary CAs, the primary event in secondary CAs is cutaneous, and when cutaneous inflammation involves the hair follicles, the follicle is damaged; in other words, they are not specifically folliculocentric. According to the predominant inflammatory cell type, primary CAs are divided into four subgroups as lymphocytic, neutrophilic, mixed inflammatory, and nonspecific (2). Infections, severe burns, tumors, and exposure to radiation are among the causes of secondary CAs. As a result, the hair follicles are permanently damaged irrespective of whether they are primary or secondary; CAs are clinically characterized by the loss of follicular ostium and histopathologically by the loss of hair follicles, which are substituted with fibrous tissue (3).

Venous ulcerations due to inherited fibrinogen disorder in two male siblings

Türkderm-Deri Hastalıkları ve Frengi Arşivi Dergisi, Galenos Yayınevi tarafından basılmıştır. Turkderm-Archives of the Turkish Dermatology and Venerology, published by Galenos Publishing. Inherited fibrinogen disorders are a group of diseases for which decreased fibrinogen levels and/or decreased activity or abnormal functional activity are responsible. These diseases can be asymptomatic or manifesting as bleeding or thrombosis. Although hypercoagulopathic conditions are listed as causes of lower leg ulcerations, inherited fibrinogen disorders are rarely reported as causes of lower leg ulcerations in the literature. Here, we describe two siblings who had recurrent lower leg ulcerations due to inherited fibrinogen disorder. In cases of recurrent venous ulcerations which are not due to common etiologies and have familial history, it should be kept in mind that there may be an underlying inherited fibrinogen disorder as a rare reason for the hypercogulopathic condition.