Müge Güler Özden

Nitric Oxide Levels in Patients with Psoriasis Treated with Methotrexate

Psoriasis is a chronic, recurrent, inflammatory, and hyperproliferative disease. Recently there have been studies regarding increases in the levels of NO in inflammatory dermatoses including psoriasis. In this study, 22 patients with psoriasis were scored with PASI (psoriasis area and severity index) and the levels of serum nitrite-nitrate were evaluated before and after therapy with methotrexate (Mtx). The results were compared with age- and sex-matched healthy volunteers. The relation of the results with the clinical severity and the cumulative Mtx dose were also evaluated. The serum levels of nitrite-nitrate of the psoriatic patients with active lesions were found to be significantly higher than the levels of the healthy volunteers and the patients after therapy. The elevated nitrite-nitrate serum levels in the inflammatory period may suggest the possible role of this mediator in the etiopathogenesis of psoriasis and the potential future use of No inhibitors in the treatment of psoriasis.

Evaluation of 532-nm KTP laser treatment efficacy on acne vulgaris with once and twice weekly applications

Abstract Background: Light-based therapies and lasers have been proposed for the treatment of acne vulgaris but the efficacy and application periods of 532-nm KTP laser treatment are not clear. Objective: To evaluate the efficacy and safety of 532-nm KTP laser and compare the effects of once and twice weekly applications in the treatment of mild to moderate acne vulgaris. Methods: Totally 38 patients were treated once weekly and twice weekly in group I and in group II respectively. One half of the face of each patient was treated with 532-nm KTP and the other half was remained as untreated. Patients were evaluated at the beginning, one and four weeks after the last treatment session with Michaëlsson acne severity grading score (MASS). Results: Statistically significant improvement was found at second control (p = 0.005) in group I, and at the first (p = 0.004), and second (p < 0.001) controls in group II for treated sides. For both groups, changes of MASS were insignificant for untreated sites. Improvement of MASS of treated sides was not statistically significant between two treatment groups for both controls. Conclusion: 532-nm KTP laser treatment may be an alternative method in selected acne vulgaris patients. No significant difference was noted between once and twice weekly applications.

Serum galectin-3 levels in patients with Behçet's disease: association with disease activity over a long-term follow-up.

Backgroundu2002 There is a need for a laboratory marker that correlates with the clinical activity of Behçet’s disease (BD).

Topical Pimecrolimus 1% Cream for Resistant Seborrheic Dermatitis of the Face: An Open-Label Study

AbstractBackground: Treatment options for seborrheic dermatitis are numerous, including both topical and systemic agents (e.g. topical corticosteroids, oral antifungals, and psoralen plus UVA). However, long-term use of topical corticosteroids may lead to adverse effects. Pimecrolimus 1% cream is an effective and well tolerated treatment for seborrheic dermatitis.n Objective: To explore the efficacy of pimecrolimus 1% cream for the treatment of seborrheic dermatitis lesions resistant to conventional treatments.n Methods: Sixteen patients with resistant seborrheic dermatitis of the face applied pimecrolimus 1% cream twice daily for 2 weeks. The lesions were assessed clinically and the severity of the signs were assessed using a 4-point score. Additionally, the scores of all affected regions (paranasal, forehead, and eyebrows) were evaluated separately to assess whether different results would be obtained in different regions of the face. Also, patients completed self-assessments on a 100 mm Visual Analogue Scale (VAS) at each visit.n Results: Statistically significant reductions in the scores of all parameters were observed at day 7 and day 14 of the study. There were no significant differences between the responses on the three regions of the face. No adverse effects were reported except for temporary pruritus immediately after the application of pimecrolimus 1% cream in one patient.n Conclusion: Although the interpretation of efficacy was limited by the open-label, non-controlled study design and the small number of patients, this trial suggests that pimecrolimus 1% cream may be a successful treatment choice for patients with resistant seborrheic dermatitis of the face.

Treatment of melasma with a depigmentation cream determined with colorimetry

Abstract Background. Melasma is a pigmentary disorder often recalcitrant to treatment. Few studies have objectively evaluated the efficacy of treatment colorimetrically. Aim. To evaluate the safety and efficacy of a depigmentation cream, including mainly glycolic acid and Rumex occidentalis. Method. Twenty-seven patients applied the cream twice daily for the first 3 months and twice weekly for the following 3 months. L*, C* and h* values of the target lesions and the perilesional area were analyzed at baseline, 12 and 24 weeks colorimetrically. The physician and patient evaluated the clinical response rate. These results were compared statistically between the lesional and perilesional area. Results. There was a significant difference between 0–12, 0–24 (L*, C* and h* values) and 12–24 weeks (L* value) (p <0.001). For C* and h* values, the difference was not significant between 12 and 24 weeks (p = 0.464 and 0.151, respectively). Statistical significance was detected only between 3 and 6 months for C* value (p < 0.05) for the lesional and the perilesional areas. Clinical response rate was significant (p < 0.05). Conclusion. Our depigmentation cream is a moderate effective agent, well tolerated and can be considered as an alternative treatment of melasma. Twice-daily application may enhance the efficacy of treatment instead of twice-weekly application in the maintenance period.

Nailfold capillaroscopy in Behçet disease, performed using videodermoscopy.

Nailfold capillaroscopy is used for the identification of microvascular involvement in many rheumatic and extrarheumatic diseases.

Lichen planus pigmentosus presenting as generalized reticulate pigmentation with scalp involvement.

patient normally had > 100 lesions at a time, with each lesion lasting for 1–3 months, in keeping with the typical nature of LP of sudden appearance and spontaneous regression. Most of these lesions healed with varioliform scars. The lesions did not show any signs of malignant evolution; none were > 30 mm in diameter, all regressed spontaneously and there was no associated lymphadenopathy. The conventional treatments for LP described in the literature include photochemotherapy, antibiotics, topical corticosteroids and low-dose oral methotrexate. Other anecdotal reports include topical methotrexate, subcutaneous interferon-a and irradiation. The patient was given various treatments, including oral antibiotics, topical corticosteroids, ultraviolet light and tacrolimus, but none proved particularly effective. She was offered methotrexate but declined. The patient was started on HRT in 2001 for postmenopausal symptoms. She was noted to have a flare after stopping HRT in 2004. She was restarted on HRT and noticed a marked improvement in the LP lesions in December 2005. In December 2006, she was accidentally given twice the dose of HRT (Prempak-C 1.25 mg; Wyeth Medica Ireland, Little Connell, Newbridge, Co. Kildare, Ireland) and her LP cleared completely for the first time since starting treatment in 1980. After the HRT was reduced to the correct dose, the LP returned, but was noted to be much less severe than previously. There are no documented reports of clearance of LP with HRT in the literature. HRT resulted in complete suppression of our patient s LP at the higher dose of HRT and some suppression at the lower dose.

Narrow‐band ultraviolet B as a potential alternative treatment for resistant psychogenic excoriation: an open‐label study

Narrow‐band ultraviolet therapy has been used successfully for the treatment of inflammatory skin disorders and generalized pruritus. We have prospectively evaluated seven consecutive patients with resistant psychogenic excoriation (PE) treated with narrow‐band ultraviolet B (NB‐UVB). Approximately 70% of all patients showed improvement in their condition. NB‐UVB therapy was well tolerated, with no serious side effects. We may conclude that, when treating a patient with PE, NB‐UVB in combination with other approaches may provide extra benefit in resistant cases.

Different application techniques of pathergy testing among dermatologists

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