Kıymet Baz

Disease‐specific quality of life is associated with anxiety and depression in patients with acne

Objective  We aimed to evaluate the relationships between acne severity, anxiety, depression and disease‐specific quality of life in patients with acne.

The prevalence of pediculosis capitis in schoolchildren in Mersin, Turkey

Background  Pediculosis capitis is an endemic parasitosis affecting many countries of the world. The aim of this study was to investigate the incidence of head lice infestation in Mersin, Turkey.

Serum Levels of IL-4, IL-10, IL-12, IL-13 and IFN-gamma in Behçet's disease.

Behçets disease (BD) is an inflammatory disease of unknown etiology. Although its pathogenesis is not fully understood, recent studies have suggested that immunological abnormalities and neutrophil hyperfunction may be involved in its etiology and pathophysiology. The immune system in BD can be characterized as a divergent cytokine production profile of the mixed Th1/Th2 cell type. In this study, we investigated the levels of interleukin (IL)‐4, IL‐10, IL‐12, IL‐13 and interferon‐γ in the sera of patients with BD, in comparison with recurrent aphthous stomatitis and healthy controls, to determine the Th1/Th2 profile of the disease. The levels of IL‐4, IL‐10 and IL‐13 were found to be high in active BD patients, and IL‐12 and interferon‐γ levels were lower in active BD patients than in inactive BD, recurrent aphthous stomatitis, and control patients.

Reliability of Web-based teledermatology consultations

We studied the reliability of teledermatology diagnoses made using a Web-based system. Clinical photographs and information relating to 125 patients were placed on a Web server. Three dermatologists made the most likely diagnosis via a Web interface. The reference diagnosis was made in a face-to-face consultation with a fourth dermatologist; where appropriate it was confirmed histologically. The teledermatologists were correct in 57% of cases when viewing the images alone. Their diagnostic accuracy improved to 70% when additional clinical information was available. The rate of agreement between the teledermatologists ranged from 44% to 70% (kappa= 0.22–0.32). Seventy-seven per cent of the patients were correctly diagnosed by at least two dermatologists when clinical information was provided. A Web-based system appears to be reliable for teledermatology. A single well trained teledermatologist may give better results than a group of less well trained clinicians.

The changes in expression of ICAM-3, Ki-67, PCNA, and CD31 in psoriatic lesions before and after methotrexate treatment

Although the effectiveness of methotrexate (MTX) in the treatment of psoriasis is very well established, the mechanism of action is poorly understood. It was suggested that the therapeutic effect of MTX in psoriasis might be mediated by inhibition of adhesion molecule expression. The aim of our study was to investigate the different effects of MTX treatment on cell proliferation, inflammatory infiltrate, adhesion molecules, and angiogenesis in psoriasis, and to clarify the mechanism by which MTX exerts its therapeutic effects. Clinical response, the morpho–phenotypic changes, epidermal thickness, and mitosis count were analyzed and the expression of CD31 and ICAM-3, proliferative markers such as Ki-67, PCNA, were evaluated by immunohistochemical techniques in lesional psoriatic epidermis, before and after the treatment with MTX in ten patients. In posttreatment biopsies a decrease in the degree of epidermal hyperplasia and a significant reduction in the severity of the inflammatory infiltrate (P<0.05) were observed. In addition, CD31 and ICAM-3 expression was significantly decreased on dermal cellular infiltrate, (respectively; P<0.05, P<0.01). Ki67 and PCNA expression were suppressed concurrently in about 90% of cases (P<0.01). We suggest that MTX may have an inhibitory effect on an initial integral component of the pathways that lead to psoriasis. Immunopharmacologic intervention in adhesion event has the potential to improve psoriasis. Inhibition of revascularization may be another mechanism of action of MTX.

Plasma reactive oxygen species activity and antioxidant potential levels in rosacea patients: correlation with seropositivity to Helicobacter pylori

Background  Recent studies have suggested that there might be an etiologic role for Helicobacter pylori (HP) in rosacea. HP is a Gram‐negative bacterium that colonizes the gastric mucosa, increases the generation of reactive oxygen species (ROS), and decreases plasma antioxidants such as ascorbic acid.

Neutrophilic dermatosis of the hands (localized Sweet's syndrome) in association with chronic hepatitis C and sarcoidosis

Summary We report a case of recurrent localized Sweets syndrome (SS) with pulmonary sarcoidosis and hepatitis C virus infection. Hepatitis C may be the triggering factor for both Sweets syndrome and sarcoidosis through stimulation of T helper 1 immune responses involved in the pathogenesis of both diseases.

Celecoxib-induced photoallergic drug eruption.

Photoallergic dermatitis is caused by a photosensitizing substance plus sunlight exposure in a sensitized person. If the photosensitizer is delivered internally, it is called a photoallergic drug reaction. Celecoxib is a new generation non‐steroidal anti‐inflammatory drug and sulfonamide derivative. We report a photoallergic drug eruption associated with the introduction of celecoxib. To our knowledge, this is the first report of photoallergic drug reaction associated with celecoxib.

Isolated lip involvement in psoriasis

A 22-year-old woman presented with a 5-year history of scaling and cracking of the lips. The lesions involved both lips completely, but the surrounding skin remained uninvolved during this period and she had no skin lesions. She complained of a burning sensation on her lips and severe discomfort during eating and speaking. She had been prescribed various medications including emollient creams and topical steroids, with no effective improvement and short remission time. Dermatological examination revealed diffuse mild erythema, adherent silvery scales and fissuring on both upper and lower lips, with minimal extension over the vermilion border (Fig. 1). The remaining oral mucosa and surrounding skin appeared normal. She had no psoriatic or any other skin lesions, and was otherwise in good general health. Routine laboratory examinations were normal. There was no personal or family history of psoriasis or any other dermatological conditions, and no history of smoking. Because of the chronic nature of the lesions and failure of multiple therapies, an incisional biopsy was taken from the lower lip. On histological examination, lamellar hyperkeratosis, parakeratosis and squamous epithelium with psoriasiform hyperplastic rete pattern, and intracorneal pustules consistent with psoriasiform dermatitis were detected. Periodic-acid–Schiff stain for fungal hyphae was negative. Based on these findings and the clinicopathological correlation, a diagnosis of isolated lip psoriasis was made. An emollient cream and a mometasone furoate 0.1% ointment once a day were prescribed and the patient followed up at 2-weeks intervals. The lesions had cleared by the end of the second week and topical steroid treatment was stopped. Two months later, the patient presented with typical psoriatic skin lesions on her palms and soles. The results of the histopathological examination of the skin biopsy taken from the right palm were consistent with psoriasis. Psoriasis rarely involves the oral mucosa and is usually associated with cutaneous lesions. Oral lesions may present on the buccal mucosa, tongue, gingiva, palate, and very rarely the lips and ⁄ or perioral area. Because neither the clinical nor the histological changes are absolutely specific for psoriasis, particularly if cutaneous lesions are absent, diagnosis is difficult. Moreover, the existence of true psoriatic lesions of the oral mucosa is disputed. However, there is some agreement that oral psoriasis, although rare, does occur and the diagnosis is best made when the clinical course of the oral lesions parallels that of skin lesions and is supported by histological examination. Some additional criteria for the diagnosis of oral psoriasis such as a positive family history and human leucocyte antigen (HLA) typing have also been considered important in supporting a diagnosis of oral psoriasis. In our case, oral biopsy showed a psoriasiform pattern. Additionally, some features such as the chronicity and clinical appearance of the lesions characterized by silvery scales also suggested a diagnosis of isolated lip psoriasis. Weighing against this diagnosis were the absence of skin lesions, lack of a family history of psoriasis and the absence of HLA typing. Thus, although some criteria for the diagnosis of mucosal psoriasis have been suggested, diagnosis of isolated lip psoriasis was made only by the histopathological and clinical findings in our case. However, 2 months after the diagnosis, appearance of skin lesions with typical clinical and histopathological features of psoriasis confirmed the initial diagnosis. Lip psoriasis can be clinically confused with chelitis, chronic eczema, actinic dermatitis, chronic candidiasis and leucoplakia. In our case, these were not supported histologically. Most cases of oral psoriasis reported in the literature have been associated with skin disease and ⁄ or intraoral Figure 1 Mild erythema, adherent silvery scales and fissuring on lips. Viewpoints in dermatology • Correspondence

Cytochrome P450 polymorphisms in patients with Behcet's disease

Objectives  Although the etiopathogenesis of Behcets disease (BD) remains unknown, increased neutrophil functions such as chemotaxis, phagocytosis and excessive production of reactive oxygen species, including superoxide anion, may be responsible for the oxidative tissue damage observed in BD. Cytochrome P‐450 are a multigene family of enzymes involved in the detoxification and occasional activation of a wide variety of chemicals. Our aim was to investigate CYP2C9 and CYP2C19 polymorphisms in patients with BD.