Ilker Erden

Enoxaparin-induced hemorrhagic bullous dermatosis in a leprosy patient

Abstract Enoxaparin is a low-molecular-weight heparin that has been used widely to prevent and treat thromboembolic disorders for at least 30 years. The most common adverse skin reactions to enoxaparin are ecchymosis and skin necrosis due to vasculitis, urticaria, angioedema and erythema. Side effects from heparin administration are rare and usually located at the injection site. However, recent reports have suggested that they can also occur at a distance from the site of injection. Moreover, the etiopathogenesis has not been fully explained. In this article, we present a case of hemorrhagic bullous dermatosis associated with enoxaparin for the treatment of ischemic heart disease that developed in a patient with a past history of lepromatous leprosy.

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.

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.

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.

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.

Serum salusin-α and salusin-β levels in patients with psoriasis

Salusin is a bioactive peptide, discovered by Shichri et al.[1] in 2003. This multifunctional bioactive peptide is present in blood, urine and tissues in two forms: salusin-α and salusin-β. Salusins have important effects on the cardiovascular system. In particular, salusin-β is the most potent hypotensive peptide and has a vasodilator effect. This peptide induces hypotension, bradycardia and cardiac dysfunction through a cholinergic mechanism. Human salusins cause hypertrophy in vascular smooth [...]

Ghrelin in the pilosebaceous unit: alteration of ghrelin in patients with acne vulgaris

BackgroundGhrelin in the pilosebaceous tissues of human skin and ghrelin levels in patients with acne vulgaris have not yet been investigated.ObjectiveThe purpose of this study was to screen ghrelin immunoreactivity by immunohistochemistry in human pilosebaceous tissues of human skin and also to determine the quantities of ghrelin in the serum of the patients with acne vulgaris.Methods30 patients presenting with acne vulgaris and 30 control subjects participated in this study. Ghrelin levels were determined by enzyme linked immunosorbent assay (ELISA). Human hair follicles and sebaceous glands were immunohistochemically examined.ResultsImmunohistochemistry results showed that there is a strong ghrelin immunoreactivity in the hair follicles and sebaceous glands in sections of human skin. The mean serum ghrelin levels (27.58 ± 15.44 pg/mL) in patients with acne vulgaris was significantly lower than those of controls (35.62±20.46 pg/mL).ConclusionsGhrelin produced in hair follicles and sebaceous glands of the skin might participate in the pathogenesis of acne vulgaris and also acne vulgaris in humans might be associated with decreased serum ghrelin.

Serum Preptin and Amylin Values in Psoriasis Vulgaris and Behçet's Patients

Insulin resistance is found in both psoriasis and Behçets disease. No study has yet explored whether preptin and amylin, two hormones associated with insulin resistance, are involved in the insulin resistance observed in patients with psoriasis and Behçets disease.

Quality of life in patients with calluses

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