Mustafa Atasoy

Oxidant/antioxidant status in men with Behçet’s disease

Behçet’s disease (BD) is a chronic, progressive disorder that affects many systems of the body including the eye. The aim of this study was to assess whether the increase in oxidative stress in the affected tissues is reflected by lipid peroxidation and to check for alterations in antioxidants and antioxidant enzyme activities in patients with BD. Erythrocyte antioxidant potential (AOP), glutathione (GSH) and GSH-dependent enzymes (glutathione peroxidase (GSH-Px), glutathione reductase (GRD) and glutathione-S-transferase (GST), catalase (CAT), Cu–Zn superoxide dismutase (Cu–Zn SOD) activities, malondialdehyde (MDA) and some trace elements (zinc, Zn; copper, Cu; manganese, Mn) levels in men with BD. Erythrocyte CAT, GSH-Px activities, MDA, GSH, AOP and serum Zn values were significantly lower in patients with BD than in the control group. However, erythrocyte Cu–Zn SOD, GRD activities, erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP) and Cu values were significantly higher in patients with BD than in the control group, but GST activity and serum Mn values were unchanged. In conclusion, our results confirm the presence of oxidative stress in patients with BD and suggest that the severity of BD may arise from impaired antioxidant mechanisms. Therapy with antioxidants may lead to the increase in the antioxidant defense system and thus improvement in clinical symptoms.

Increased Serum Levels of Tumor Necrosis Factor Alpha in Lichen planus

Background: Lichen planus (LP) is a common, pruritic, inflammatory mucocutaneous disease. There are several opinions and approaches to the etiopathogenesis of LP. Immunologic mechanisms almost certainly mediate its development. T-cell-mediated immunity plays the major role in triggering the clinical expression of the disease. The cytokines that are produced by lymphocytes also play an important role in the development of LP. Objective: The goal of our study was to investigate the possible role of tumor necrosis factor α (TNF-α) in the pathogenesis of LP. Methods: Serum TNF-α levels were determined with the enzyme-linked immunosorbent sandwich assay method in the sera of 40 patients suffering from LP and in those of 40 healthy controls. Results: The serum levels of TNF-α were found to be significantly higher in the patient group compared to the healthy controls (patients: 35.64 ± 9.59 pg/ml, controls: 15.6 ± 3.97 pg/ml, p < 0.001). Conclusion: Our results revealed that TNF-α might play a major role in the pathogenesis of LP.

Inflammation and peripheral 5-HT7 receptors: The role of 5-HT7 receptors in carrageenan induced inflammation in rats

The aim of this study was: (1) to investigate possible role for 5-HT7 receptors in carrageenan induced inflammatory paw oedema in rats; (2) to determine the presence of 5-HT7 receptors in rat paw tissue; (3) to observe the effects of 5-HT7 receptor agonist and antagonist administration on inflammation; and (4) to determine a unique mechanism for inflammatory processes via 5-HT7 receptors. Effects of 5-HT7 receptor agonist, antagonist and indomethacin were investigated in carrageenan induced paw oedema in rats. Blood and tissue samples were collected and evaluated biochemically for serum cytokine levels, tissue oxidant-antioxidant balance and histopathologically for inflammatory cell accumulation. We performed Real Time PCR analyses for tissue 5-HT7 receptor and COX mRNA expressions. The 5-HT7 receptor agonist AS-19 exerted significant anti-inflammatory effect both alone and in combination with indomethacin. Antagonist, SB269970, did not affect inflammation alone but decreased the effects of agonist when co-administered. 5-HT7 mRNA levels were higher in the carrageenan group than healthy control. Carrageenan+indometacin group decreased the mRNA expression of 5-HT7 when compared to carrageenan group. While agonist administration decreased 5-HT7 mRNA expression when compared to carrageenan group. Agonist decreased paw COX expression. Agonist also decreased serum cytokine levels and tissue oxidative stress. In conclusion, this study demonstrated for the first time that 5-HT7 receptors are expressed in rat paw tissue and that this expression responds to inflammatory stimuli. The 5-HT7 receptor may be a promising new therapeutic target for prevention of inflammation and inflammatory disorders and may also provide a new glimpse into inflammation pathophysiology.

HLA Class I and Class II Genotyping in Patients with Chronic Urticaria

Objectives: Chronic urticaria (CU) is a common disease in which pathogenesis is unclear and which is resistant to therapy. Recent investigations have indicated that autoimmunity plays a role in nearly one third of CU patients. The present study aimed to investigate the relationship between human leukocyte antigen (HLA) class I and class II antigens and immune pathogenesis of CU. Methods: HLA class I and class II antigens were investigated in 40 patients diagnosed with CU, utilizing serologic techniques and polymerase chain reactions. The study was performed between October 2005 and May 2006. Further HLA typing in patient subsets was done depending on the response of patients to intradermal injection of autologous serum. About 30 healthy and genetically unrelated individuals formed the control group for evaluation. Results: The results revealed that HLA-B44 frequency was significantly higher (25%) in the patient group as compared with the matched control group (3.33%) (p = 0.033, OR = 9.667). There was no significant difference in HLA-A allelic distribution between the patient and control groups. In the genotyping of class II HLA alleles, HLA-DRB1*01 (25%) (p = 0.033, OR = 9.667) and HLA-DRB*15 (25%) (p = 0.033, OR = 9.667) were predominant alleles in the patient group. Conclusion: The association ofHLA-B44, HLA-DRB1*01 and HLA-DRB*15 alleles with idiopathic CU suggests that there is a genetic component in the pathogenesis of CU.

Linear atrophoderma of Moulin together with leuconychia: a case report.

Linear atrophoderma of Moulin has a distinctive disease pattern characterized by hyperpigmented atrophoderma and was described originally in 1992. It follows the line of Blaschko, and occurs without preceding inflammation, subsequent induration or scleroderma. The lesions usually develop during childhood or adolescence, and the prognosis is good. The diagnosis is made clinically and histopathologically. In our 18‐year‐old male patient, there were atrophic plaques unilaterally located on the trunk and arm, and white discoloration on all finger nails. Histopathological examination revealed epidermal atrophy together with disruption of collagen fibres.

Xanthoma Disseminatum with Hepatic Involvement in a Child

Abstract: Xanthoma disseminatum is a rare, usually self‐healing dermatologic disease of unknown etiology. Involvement of other organs and tissues including bone marrow, bone, and brain may be seen rarely in children. However, to date, hepatic involvement has not been reported. We describe a child with xanthoma disseminatum who had hepatic involvement, and discuss his course and treatment with steroid and azathioprine.

A case of acute generalized exanthematous pustulosis (AGEP) possibly induced by iohexol.

Acute generalized exanthematous pustulosis (AGEP) is an uncommon disease manifested as an erythematous pustular eruption. It is usually caused by systemic medication. We describe a patient with acute generalized pustular eruption induced by iohexol. A 52‐year‐old woman developed fever and a generalized pustular eruption on the neck, trunk and extremities three days after taking iohexol. The culture from pustules was sterile. Other systemic and laboratory examinations were normal. A skin biopsy from a lesion on the trunk showed the features of a drug‐induced pustular eruption as a subcorneal blister including neutrophils and eosinophils, mild spongiosis, and a sparse infiltrate at neutrophils and eosinophils in the papillary dermis. The patient had no history of psoriasis. The lesions resolved with systemic corticosteroid therapy within one week and did not relapse. According to our investigation, iohexol‐induced AGEP has not been previously reported. We present an interesting case.

Treatment of Confluent and Reticulated Papillomatosis with Azithromycin

Confluent and reticulated papillomatosis (CRP) is a relatively rare disorder of unknown origin, mostly affecting young female adults. We here present the case of a 21‐year‐old male patient with confluent and reticulated papillomatosis. Skin examination revealed brownish, verrucous, hyperkeratotic, 2 to 5 mm papules, which formed confluent patches and plaques with a reticulate network on the interscapular area. The patient was initially treated with ketoconazole cream for two weeks without improvement. The disease can be rather persistent and resistant to topical therapy. Our case showed a satisfactory response to treatment with azithromycin. Although this treatment is known to be effective in some cases, the action mechanism of azithromycin on CRP is not fully understood.

Comedonal, cornifying and hypertrophic Darier's disease in the same patient: a Darier combination.

Our 42‐year‐old patient had comedonal Dariers disease (DD) on the face, comedonal cornifying DD on the upper back, and hypertrophic DD on both legs. Biopsies taken from face, upper back and medial sides of the legs were found to be compatible with these clinical subtypes. The comedonal type was in the classical place, but the hypertrophic and cornifying types were not in the usual sites. In addition to the classic histopathology of DD, we noted multiple, warty dyskeratoma‐like structures in the comedonal type, marked compact hyperkeratosis in the cornifying type, and marked papillomatosis in the hypertrophic type.

Pyogenic granuloma with multiple and satellite involvement after a burn in a 5-year-old child

Dear Editor, Pyogenic granuloma (PG) is a common vascular hyperplasia of the skin and mucous membranes. PG usually occurs in children and young adults, and is usually seen on the face, trunk and limbs. There are also subcutaneous and intravenous variants. PG is often solitary, but multiple satellite lesions may occur.1 Although there are many cases with different etiologies in the published work, PG secondary to a burn is rare.2 We have found only five cases in the published work of the last 25 years.2–4 For these reasons, we report a case of a child with PG that developed on the area of a second degree burn. A 5-year-old female patient was brought to our Dermatology Clinics from a rural area for a burn on her upper arm. The child had no congenital etiology. The patient came to us 15 days after the burn. The patient’s medical history was unremarkable, and there was no personal or family history of skin disease. On dermatological examination, there were two big lesions (5 and 3 cm in diameter) surrounded by multiple small lesions on the hypopigmented area secondary to the burn injury, extending from left ankle to shoulder (Fig. 1). The big lesions had irregular borders and slight surface bleeding, were elevated from skin, and were polypoid and soft. The small lesions surrounding the big ones were red papules of varying sizes (0.25–0.5 cm in diameter). Laboratory tests were within normal limits. Serology for Venereal Disease Research Laboratory (VDRL) and HIV antibody was non-reactive/negative. Fungal and standard bacterial cultures from the lesions were negative. An incisional biopsy was performed before surgery. In histopathological examination, widelydilated, blood-filled vascular channels surrounded by small proliferating capillary buds were observed (Fig. 2). Nodularity surrounded by fibrous septa was also observed. These findings were consistent with the diagnosis of PG. The lesions were treated by total excision and primary closure. There were no recurrences at the end of a 6-month follow up. Pyogenic granuloma nodules may have a propensity to develop at sites of microscopic arteriovenous anastomoses. Consistent with this idea is the observation that the frequency of PG and the density of