Nilgün Solak Tekin

Accumulation of Oxidized Low-Density Lipoprotein in Psoriatic Skin and Changes of Plasma Lipid Levels in Psoriatic Patients

Background. Psoriasis is a chronic inflammatory skin disease characterized by an accelerated turnover of epidermal cells and an incomplete differentiation in epidermis with lesion. However, the exact etiology of psoriasis is unknown. Abnormalities in essential fatty acid metabolism, free radical generation, lipid peroxidation, and release of lymphokines have been proposed. Objective. Our purpose was to evaluate the plasma lipids and oxidized low-density lipoprotein accumulation in psoriatic skin lesion in order to ascertain the possible participation of oxidative stress and oxidative modification of lipids in pathogenesis of psoriasis. Methods. The study group included 84 patients with psoriasis, and 40 sex- and age-matched healthy volunteers. Blood lipid profile was determined. Psoriatic and nonlesional skin samples of psoriatic patients were evaluated for the presence of oxidized low-density lipoprotein by using an immune-fluorescent staining method. Results. The mean levels of lipids (total cholesterol, triglyceride, and LDL cholesterol) in patients with psoriasis were found to be significantly higher than those of healthy subjects. Psoriatic skins were shown positive oxidized low-density lipoprotein staining. There was no staining in nonlesional skin samples of the same individuals. Conclusion. Lipid peroxidation mediated by free radicals is believed to be one of the important causes of cell membrane destruction and cell damage. This study shows for the first time the accumulation of oxidized low-density lipoprotein in psoriatic skin lesion. We believe that accumulation of ox-LDL in psoriatic skin may have an important role in the immune-inflammatory events that result in progressive skin damage.

Adapalene vs. metronidazole gel for the treatment of rosacea

Background  Rosacea is a common, chronic dermatosis that requires long‐term therapy. Oral isotretinoin and topical and/or oral antibiotics are effective, but their usage may be limited due to side‐effects.

Oxidative stress in acne vulgaris

Background  Acne vulgaris is one of the common dermatological diseases and its pathogenesis is multifactorial. In this study, we aimed to determine the effects of oxidative stress in acne vulgaris.

Unnoticed dysautonomic syndrome of the face: Harlequin syndrome

Harlequin sign and harlequin syndrome, which are used interchangeably in the literature, are characterized by sudden onset of hemifacial sweating and flushing, induced by exercise and heat. Hemifacial sweating and flushing with normal ocular sympathetic innervation, known as harlequin syndrome, is rarely associated with tonic pupils, parasympathetic oculomotor lesion and pre- or postganglionic sudomotor sympathetic deficit. In the literature, hemifacial sweating and flushing in patients with apparently abnormal ocular sympathetic innervation has been defined as harlequin sign. To date, a few reports of excessive hemifacial sweating and flushing in structural lesion have been documented. Herein, we report five patients with excessive hemifacial sweating and flushing, two of whom had a syrinx. In presenting the patients, we have attempted to distinguish harlequin syndrome from harlequin sign. With this in mind, Case 1 can be described as harlequin syndrome resembling Ross syndrome, Case 2 as harlequin syndrome with normal ocular sympathetic innervation, Case 3 as harlequin sign with congenital Horner syndrome, Case 4 as harlequin sign with sympathetic and parasympathetic denervation sensitivity, and Case 5 as harlequin syndrome associated with occult sympathetic denervation sensitivity. These cases are discussed together with a review of the literature.

Dissecting cellulitis in a white male: response to isotretinoin

A 22-year-old white male with a one-year history of dissecting cellulitis of the scalp was successfully treated with oral isotretinoin. Complete healing was seen after z months and the treatment was discontinued after a course of 9 months. The patient is still in remission 3 months after cessation of the therapy.

Sleep disorders in Behçet's disease, and their relationship with fatigue and quality of life.

Behçet’s disease, a systemic vasculitis, can cause varying degrees of activity limitation, fatigue and quality of life impairment. To date, there have been no studies regarding sleep disturbance and its relationship with fatigue and life quality in Behçet’s disease. We aimed to evaluate sleep disorders and polysomnographic parameters, and to determine their relationship with fatigue and quality of life in Behçet’s disease. Fifty‐one patients with Behçet’s disease without any neurological involvement were interviewed regarding sleep disorders. Twenty‐one subjects with no sleep complaints were included as the control group. Sleep‐related complaints were evaluated in a face‐to‐face interview. Sleep quality, excessive daytime sleepiness, fatigue, depression, anxiety, disease activity/severity, and quality of life questionnaires and an overnight polysomnography were performed. Prevalences of restless legs syndrome (35.3%) and obstructive sleep apnea syndrome with/without other sleep disorders (32.5%) were higher than in the control group and the general population. Fatigue was higher in patients with restless legs syndrome and obstructive sleep apnea syndrome, and in those with lower minimum oxygen saturation; hence, only patients with restless legs syndrome had quality of life impairment. Sleep efficiency index and sleep continuity index were lower, and wake after sleep onset, respiratory disturbance index and apnea–hypopnea index were higher than in controls (P < 0.01). Neither sleep disorders nor polysomnographic parameters were related to disease activity and severity. In conclusion, it is important to question sleep disorder followed by a polysomnography, if necessary, in order to improve quality of life and fatigue in Behçet’s disease.

Bone mineral density and bone turnover markers in patients receiving a single course of isotretinoin for nodulocystic acne

Background  High‐dose isotretinoin has been reported to have adverse effects on bone mineral density (BMD); however, studies evaluating changes in BMD with isotretinoin therapy at different dosages and with varying treatment durations have produced conflicting results.

The association of FOXO3A gene polymorphisms with serum FOXO3A levels and oxidative stress markers in vitiligo patients

Vitiligo is an acquired epidermal pigment loss the skin with destruction of melanocytes. Oxidative stress is one of the major theories in the pathophysiology of vitiligo. FOXO3a is the forkhead members of the class O (FOXO) transcription factors, and plays important role in cell cycle regulation, apoptosis, oxidative stress, and DNA repair. The aim of our study was to investigate, for the first time, FOXO3a gene polymorphisms and FOXO3a protein levels, activities of superoxide dismutase (SOD) and catalase antioxidant enzymes in vitiligo patient and healthy controls. Moreover, plasma advanced oxidation protein products (AOPP) levels in subjects was evaluated to understand the possible role of protein oxidation in disease etiology. Studies groups included 82 vitiligo patients and 81 unrelated healthy controls. FOXO3a polymorphisms were determined using polymerase chain reaction-restriction fragment length polymorphism method. FOXO3a levels and catalase activity were measured by ELISA whereas AOPP levels and SOD activity were measured spectrophotometric analyses. We found a significant relationship between rs4946936 polymorphism of FOXO3a gene and vitiligo/active vitiligo patients (p=0.017; p=0.019 respectively), but not for rs2253310 (p>0.05). SOD activity and AOPP levels of vitiligo patient were increased compared with control group, whereas FOXO3a levels and catalase enzyme activity of vitiligo patient were decreased compared with control group (p<0.05). Our study indicates that rs4946936 of FOXO3a gene may associate susceptibility of vitiligo, especially active vitiligo. Moreover, our results confirm that oxidative stress may play a role in the pathophysiology of vitiligo. Further studies with larger samples are required to elucidate the role of FOXO3a in vitiligo.

Bone mineral density and bone turnover markers of patients with Behçet's disease.

Background  Behçets disease (BD) is a systemic inflammatory disease of unknown aetiology. The pathogenesis of rheumatological findings and the status of bone metabolism in this disease are unknown. Inflammatory diseases may predispose to a decrease in bone mineral density (BMD) and there are many studies concerning osteoporosis in chronic inflammatory diseases.

Isolated plantar collagenoma: a case report.

Collagenoma is a hamartomatous lesion consisting of proliferation of normal collagen tissue. We describe a 19‐year‐old girl with a firm, elastic 3 × 2 cm nodule located on her right plantar fossa. Histopathologically, dense, coarse, thick collagen fibers were located in the dermis. In addition, the number of elastic fibers was slightly decreased. Based on these findings, the case was diagnosed as isolated plantar collagenoma.