Mustafa Arica

Serum Cytokine Levels in Behçet's Disease

The aim of this study is to investigate and compare the serum levels of various cytokines in patients with Behçets Disease and healthy controls.

Clinical and dermoscopic evaluation of cutaneous leishmaniasis

Dermoscopy is a method to aid in the visualization of the epidermis and dermis. In recent years, the use of dermoscopy in the diagnosis of non‐melanocytic lesions such as those of leishmania cutis has increased.

Comparative study of 5% and 2.5% potassium hydroxide solution for molluscum contagiosum in children

Abstract Background: Molluscum contagiosum (MC) is a pediatric viral infection that is fairly contagious. Although various treatment methods are available, the presence of facial lesions limits options of therapy. Aim: We aimed to test an alternative treatment consisting of application of two different concentrations of potassium hydroxide (of KOH 5% solution and of KOH 2.5% solution) aqueous solution. Methods: In this study we evaluated the effectiveness and side-effects of daily applications of potassium hydroxide (KOH) aqueous solution at 2.5% and 5% concentrations, twice daily in 29 children with MC. Out of a total of 29 patients with molluscum contagiosum included in the study, 13 patients in the 2.5% KOH group and 12 patients in the KOH 5% group completed the study. Families were instructed to apply potassium hydroxide twice a day. The assessment of response and side-effects were performed on days 0, 15, 30, 45 and 60 (visits were numbered 1, 2, 3, 4 and 5, respectively) and one month after. Results: We had a total of 11 (44%) patients who completely recovered after the fifth visit. While eight (66.7%) of these 11 patients were in the 5% treatment group, three (23.1%) patients were in the 2.5% treatment group, and there was a statistically meaningful difference (p < 0.047). Patients with fewer lesions remitted better (p < 0.05). When number of lesions were taken into consideration, difference between the two treatment groups appeared after the fourth visit (p < 0.001). There were no statistical differences between the two groups with respect to side-effects (p = 0.682). Conclusions: Potassium hydroxide solution at a concentration of 5% was more effective than 2.5% in our patients. The treatment was well-tolerated on the face with the advantage of administration of lower concentrations. This study suggests potassium hydroxide may be a more preferable mode of treatment for molluscum contagiosum lesions on the face.

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.

Expression of interleukin-17 in lesions of erythema multiforme may indicate a role for T helper 17 cells.

Introduction The aim of this study was to evaluate levels of interleukin (IL)-2, IL-6, IL-8, IL-10, IL-17A and interferon γ (IFN-γ) in the serum of patients with erythema multiforme (EM) and to search for the presence of IL-17-expressing cells in lesional samples of EM. Material and methods A total of 32 patients (22 females and 10 males) diagnosed with EM of the minor or major type were included in the study. Levels of IL-2, IL-6, IL-8, IL-10, IL-17A and IFN-γ in the serum were determined and compared with healthy controls. Biopsy specimens were stained with haematoxylin and eosin (HE) and monoclonal antibodies to CD4, CD8 and IL-17 for immunohistochemical examination. Results IL-2, 6, 8 and 17A were significantly higher in the patient group (p = 0.016, p = 0.001, p = 0.004, p = 0.006, respectively) and levels of IL-10 were significantly lower than in the control group (p = 0.046). The cellular infiltrate in lesions of EM was composed mainly of CD4+ T lymphocytes. The presence of IL-17-expressing cells, at proportion of 5 to 50%, was observed in the infiltrate. Conclusions The demonstration of IL-17-expressing cells in lesions of EM in this study has brought forth the assumption that Th17 cells may be involved in the pathogenesis of EM.

Immune mechanisms and the role of oxidative stress in intrahepatic cholestasis of pregnancy

Introduction The purpose of this study was to investigate levels of inflammatory cytokines such as interleukin 6 (IL-6), tumor necrosis factor α (TNF-α) and neopterin and oxidative stress status in patients with intrahepatic cholestasis of pregnancy (ICP) as well as their potential role in the pathophysiology. Material and methods Thirty patients with ICP (Group 1) and 30 healthy pregnant women (Group 2) were included in this prospective case-control study. Levels of IL-6, TNF-α and neopterin were determined in both of the groups. Total anti-oxidant status (TAS) and total oxidative stress (TOS) levels were determined by means of a fully automated Erel method. Oxidative stress index (OSI) was calculated as the ratio of TOS to TAS. Results There was no significant difference between the groups in IL-6 and TNF-α levels (p = 0.105 and p = 0.722, respectively). The mean neopterin level was significantly higher in Group 1 compared to Group 2 (2.34 ±0.77 and 1.57 ±0.38, respectively, p = 0.001). In addition, TAS, TOS and OSI levels were significantly higher in Group 1 (p = 0.004, p = 0.001 and p = 0.001, respectively) compared to Group 2. Discussion Intrahepatic cholestasis of pregnancy is an inflammatory disorder in which maternal immune reaction may play a role. Interleukin 6 and TNF-α, which are some of the markers of humoral reaction, act as an indicator of abnormal reaction rather than acute-phase reaction in ICP. Further clinical trials and supportive placental findings are needed on the role of cytokines in cellular and humoral immune reactions during the symptomatic period and delivery to better understand the role of immune mechanisms in the aetiology of ICP.

Investigation of dermatology life quality index and serum prolactin and serum dehydroepiandrosterone sulphate levels in patients with chronic urticaria.

BACKGROUND Chronic urticaria (CU) is known to be one of the most disturbing diseases which significantly affect the quality of life. Prolactin (PRL) and DHEA-S (dehydroepiandrosterone sulfate) are stress-associated hormones in chronic urticaria. OBJECTIVE In the present study, we measured DHEA-S and prolactin levels of CU patients, compared them with healthy subjects and evaluated the association between disease status and serum levels. METHODS Plasma DHEA-S and serum PRL concentrations were measured in 48 CU patients and 31 healthy subjects. CU activity was assessed with the use of the symptom scores recommended with EAACI/GALEN/EDF guidelines. All the patients participating in this study were evaluated by means of Dermatology Life Quality Index (DLQI). With respect to DLQI and clinical activity scores, plasma DHEA-S and serum prolactin levels were compared. RESULTS Median plasma concentration of DHEA-S was significantly lower in CU patients as compared with healthy subjects (p = 0.026). DHEA-S levels of females were significantly lower than males (p = 0.001). Mean PRL values of the patients were higher than the controls, but not statistically significant (p = 0.619) and there was a statistically signifcant inverse correlation with DHEA-S levels (p = 0.04, r = -0.298). Therewas a significant correlation between DLQI and clinical disease activity (p < 0.001, r = 0.748). CONCLUSIONS The exact relation of hormones to CU pathogenesis remains to be determined by further clinical studies. In addition, therapies aiming to increase DHEA-S and decrease PRL may be subject to trial in CU.

Epidemiological and clinical characteristics of malignant melanoma in Southeast Anatolia in Turkey

Introduction The present study aimed to establish the epidemiological and clinical characteristics of patients who were histopathologically diagnosed with malignant melanoma (MM). Methods The present study retrospectively analyzed the data of 78 patients who were histopathologically diagnosed with MM in Dicle University Medical Faculty, Dermatology and Medical Oncology departments between 2005 and 2014. Results The study included 78 patients in total with 44 (56.4%) male and 34 (43.6%) female. Median age of the patients was 62.50 years (range: 27 - 84 years). Of the patients, 78.2% (n = 61) had cutaneous melanoma, 8.9% had solid organ melanoma, and 2.5% had ocular and mucosal melanoma. The most common tumor localization among the patients was the lower extremities with 29.4% (n = 23). The most common histopathological type was nodular malignant melanoma with 35.8% (n = 28). Based on TNM, Clark and Breslow classifications, 26.9% (n = 21) of the patients were stage 4, 26.9% (n = 21) were Clark stage 4, and 37.1% (n = 29) were Breslow stage 4. Median overall survival in all patients was 14.9 months (95% CI 10.9 - 18.8 months). In the multivariate Cox analysis, only stage statistically significantly affecting survival [odds ratio (OR): 0.54; (95% CI 0.16-1.82, p = 0.02)]. Conclusion Malignant melanoma data are also important for the optimal utilization of effective methods and healthcare resources to prevent the disease. In order to minimize MM mortality and morbidity, not only the society but also physicians from primary and secondary care hospitals should become familiar with melanoma.

Effects of hyperbaric oxygen therapy on rat facial skin.

Introduction: We used immunohistochemistry to investigate the histopathologic effects of hyperbaric oxygen (HBO) on the facial skin of rats. Material and methods: Rats in the HBO group (n = 6) were placed in a 20 L HBO chamber at 2.5 atmospheres absolute at 25–26°C with 100% oxygen for 90 min/day for 7 days. Following euthanasia, sections of facial skin were removed for examination. Results: Epidermal hyperplasia and degeneration, basal-cell hypertrophy, subepithelial fibrosis, and increased connective tissue were observed in the HBO group. E-cadherin expression was reduced in the epidermis, hair follicles, and sebaceous glands in HBO-treated rats relative to control animals. HBO treatment was associated with vimentin immunoreactivity in fibroblasts, endothelial cells, and the bulbus pilorum of a subset of hair follicles. It also resulted in increased type IV collagen expression within the connective tissue in the hair follicles and sebaceous glands. Conclusion: The HBO group demonstrated epidermal hyperplasia and degeneration, basal-cell hypertrophy, and subepithelial fibrosis. In addition, HBO decreased E-cadherin expression, which suggests that HBO may impair intracellular adhesion. Expression of vimentin and type IV collagen was also observed in the dermis. Increased connective tissue, hemorrhage, and mononuclear cell infiltration were observed in the dermis of HBO-treated animals. Thus, HBO has effects on the structures of the epidermis and dermis.

Psoriazis ve Eşlik Eden Hastalıklar

Psoriazis kronik inflamatuar bir hastaliktir. Psoriazis ile ilgili yapilan calismalarda bu inflamatuar durumun klinik yansimasinin artik deriye sinirli olmadigi, eslik eden bazi inflamatuar hastaliklarin psoriaziste normalde beklenenden farkli sayida oldugu fark edilmistir. Psoriazisle iliskili eskiden beri bilinen depresyon ve yasam kalitesi, psoriatik artrit, malignensi gibi bazi komorbiditelere ek olarak kardiovaskuler hastalik, metabolik sendrom, inflamatuar barsak hastaliklari, uyku apne sendromu gibi yeni arastirilan komorbiditeler tanimlanmistir. Bu derlemede sik gorulen komorbiditelerin ve konu ile alakali yapilmis calismalardan bahsedilecektir.