Nuran Alli

A comparative evaluation of quality of life and life satisfaction in patients with psoriatic and rheumatoid arthritis

Both rheumatoid arthritis (RA) and psoriatic arthritis (PsA) have a negative impact on patients’ quality of life (QOL). The aim of this study was to compare QOL and life satisfaction in patients with RA and PsA. Forty patients with PsA, 40 patients with RA, and 40 healthy control subjects were included in the study. Demographic data and clinical characteristics including age, sex, disease duration, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), peripheral pain assessed by visual analog scale (VAS) and Larsen scores of hand X-rays were recorded. Nottingham Health Profile (NHP) was used to evaluate QOL, and Life satisfaction index (LSI) was used to measure psychological well-being in both groups. The demographic data of the subjects were similar between the groups. The scores of all NHP subscales were significantly higher and the scores of LSI were significantly lower in PsA and RA patients than in control subjects. The inflammation markers including ESR, CRP, pain by VAS and Larsen scores were found to be significantly higher in RA patients. The scores of LSI were similar between the groups. Although the scores of physical domains of NHP (pain and physical disability) were statistically higher in RA patients (p<0.05), the scores of psychosocial subgroups of NHP were similar between RA and PsA patients (p>0.05). Both PsA and RA patients had disturbed QoL and decreased life satisfaction. In conclusion, peripheral joint damage, inflammation, and physical disability are significantly greater in RA but psychosocial reflection of QOL and life satisfaction are the same for both groups which can be explained by the additional impact of skin disease in patients with PsA.

Prevalence of skin diseases among pediatric patients in Turkey

The pediatric population is composed of persons under 16 years of age, and few studies are available on the dermatological diseases of this group. In the present study, data on a total of 6300 pediatric patients admitted between the years 2004–2006 were analyzed. Hospital‐based patient registry records were used for data collection. The data were analyzed according to age, sex and time of admittance. A female preponderance (53%) was observed, and adolescents (12–16 years old) constituted the largest group within the patient population (47.6%). A total of 125 dermatoses were recorded. Acne vulgaris was the most prevalent dermatosis (12.4%), followed by atopic dermatitis (11.8%), contact dermatitis (11.3%), warts (9.5%), seborrheic dermatitis (4.3%) and impetigo (4.1%). Atopic dermatitis was the most frequently seen dermatosis in both infants and preschool‐age children, whereas contact dermatitis was more prevalent in school‐age children, and acne vulgaris was more prevalent in the adolescent group. The frequencies of some diseases showed seasonal variations. Acne vulgaris, atopic dermatitis, contact dermatitis, psoriasis, xerosis and alopecia areata were more common in winter. In contrast, insect bites, vitiligo, dyshidrotic eczema, impetigo and tinea corporis were more common in summer. Studies of the pediatric population, which constitutes the cornerstone of the community, can play an important role in determining the policies of protective medicine and public health. New studies will help us to better understand the frequency of dermatological diseases in the pediatric population according to age, gender and season, and take precautions with regard to these conditions.

Serum interleukin-8 as a serologic marker of activity in Behçet's disease.

Background  Immune dysregulation has been shown to be one of the major aspects of the yet unknown pathogenesis of Behçets disease. Interleukin‐8 (IL‐8), a major chemokine with pivotal effects concerning leukocytes and endothelial cells, has been found to be elevated in patients with Behçets disease.

Protein C and protein S activities in Behçet's disease as risk factors of thrombosis

Background

Acquired aquagenic papulotranslucent acrokeratoderma

Aquagenic papulotranslucent acrokeratoderma (APA) is an acquired, unusual condition characterized by bilateral, symmetric, translucent-to-white papules located on the hands and feet. These lesions are accentuated following a short period of water exposure. Since its first description in 1973 as hereditary papulotranslucent acrokeratoderma, only a few cases of APA have been reported. We report two cases of teenage girls with APA. Both patients responded well to 5% salicylic acid ointment but recurrence of lesions still occurred. The close temporal proximity of presentation of these two cases may indicate that APA is not as rare as previously thought.

Generalized pruritus: a prospective study concerning etiology.

AbstractBackground:Generalized pruritus can often be the primary manifestation of systemic disease. Objective:To determine how frequently generalized pruritus had a systemic etiology in an outpatient population seen in a dermatology department and whether any identifiable patient characteristics meant a systemic explanation of generalized pruritus was more likely. Methods:A prospective controlled study of 55 patients with generalized pruritus and 41 healthy age- and sex-matched control subjects. Clinical data were collected from patients and laboratory parameters investigated in both patients and healthy control subjects to determine the frequency of systemic disease in each group. Results: Of 55 patients, 12 had a systemic cause of pruritus. Pruritus was the initial symptom of systemic disease in eight of these patients. The underlying diseases included hypothyroidism, chronic lymphocytic leukemia, hepatitis C, hepatitis B, diabetes mellitus, lung cancer, uremia, and iron deficiency anemia. Of these, iron deficiency anemia was the most common cause. Compared with the control group, mean serum hemoglobin, iron, and cyanocobalamin (vitamin B12) levels in patients with generalized pruritus were lower. No other patient characteristics were statistically associated with systemic causes of pruritus. Conclusion:Generalized pruritus was the initial symptom of a systemic disease in 8 of 55 patients presenting to a dermatology outpatient clinic with this complaint. A number of underlying diseases were identified, of which the most common was iron deficiency anemia.

Patient characteristics in Behçet disease: a retrospective analysis of 213 Turkish patients during 2001-4.

AbstractBackground: Behçet disease (BD) is a chronic, inflammatory, multisystemic vasculitic disorder with a wide spectrum of clinical presentations. The highest prevalence is seen in Turkey. Specific diagnostic tools are yet to be discovered; thus, the diagnosis relies on physicians being acquainted with the symptoms and signs of the disease. Objective: To investigate the epidemiologic characteristics of BD and to emphasize the typical clinical and laboratory characteristics. Methods: This was a retrospective analysis of all the BD patients attending the Ankara Numune Education and Research Hospital throughout the years 2001–4. Diagnosis of BD was made according to the International Study Group criteria. A total of 213 patients were evaluated with respect to family history, clinical features, pathergy test, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), antistreptolysin O, and ferritin levels. When assessing disease activity, the active clinical manifestations on the day of the examination were taken into account. Correlations were analyzed between sex and age distribution, age of onset, disease duration, and family history; and between family history and age of onset, pathergy, clinical manifestations, and laboratory parameters. Correlations were also evaluated between pathergy positivity and clinical manifestations, and laboratory parameters. Correlations between activity scores and age of onset, duration, sex, family history, and laboratory data were also analyzed. Results: The female : male ratio was 1.04, and the mean age of onset was 27 years. Family history did not affect age of onset or disease severity. Men presented with more active disease, and there was a weak but positive correlation between disease activity and CRP. No correlation was observed between duration and age of disease onset. The most common clinical presentations were oral aphthous lesions, genital ulcers, and skin lesions. Men more commonly presented with papulopustular lesions, pathergy positivity, and vascular, eye, and renal involvement, and women presented with arthritis/arthralgia more commonly than men. Vascular lesions, ESR, and CRP showed significant relationships with pathergy reaction. Eye involvement was not affected by age of onset. Conclusions: We believe our results indicate that the pathogenesis of BD is multifactorial. Hormonal factors seem to be of some influence, while genetic background and environmental factors seem to be the major contributors. Infections seem to be among the triggering environmental factors. Predisposing genes may affect the influence of environmental factors. Prevalence studies should be carried out periodically in those countries with a high prevalence ofBDto keep up with the changing dynamics of the disease, which may also shed light on the as-yet unknown pathogenesis of BD.

Comparison of nickel patch test reactivity in phases of the menstrual cycle

Background In earlier studies, it has been shown that severity of some diseases varies with menstrual cycle. Severity of skin diseases such as atopic dermatitis, lupus erythematosus, infections due to herpes virus, urticaria and acne were also reported to increase in the premenstrual phase. Effect of estradiol on the cellular immune system was investigated and it was found to depress the cellular immune response. In our study, we investigated whether nickel patch test reactivity was different during phases of the menstrual cycle and whether there was an increase in sensitivity to nickel during the premenstrual cycle in nickel‐sensitive women.

Prevalence of Hepatitis C Virus Antibodies and Cryoglobulinemia in Patients with Leukocytoclastic Vasculitis

Background: Several dermatologic manifestations of hepatitis C virus (HCV) infection have been described. The association of HCV infection, essential mixed cryoglobulinemia and leukocytoclastic vasculitis (LV) have been published mainly in case reports. Objective: The aim of the present study was to determine the prevalence of HCV infection and cryoglobulinemia in patients with LV. Methods: Twenty-five cases of LV were tested for anti-HCV antibodies by means of a third-generation enzyme-linked immunosorbent assay, and cryoglobulins were detected by the precipitation method. Thirty healthy volunteers served as control group. Results: Anti-HCV antibodies were detected in 2/25 patients with LV (8%) and none of the control group. Cryoglobulinemia was detected in 1 patient with LV and none in the control group. Conclusion: Although no significant difference between patients and the control group was detected, the prevalence of anti-HCV antibodies in LV patients is as high as 8%. Considering this, it seems reasonable to investigate the presence of HCV in unexplained cases of LV.

Bonbon toffee sign: a new dermatoscopic feature for sebaceous hyperplasia

Introduction  Sebaceous hyperplasia is a benign proliferation of the sebaceous gland. In this study, we tried to define the dermatoscopic features of sebaceous hyperplasia, which will help to minimize misdiagnoses.