Rafet Koca

Oxidant-antioxidant enzymes and lipid peroxidation in generalized vitiligo

Vitiligo is a common pigmentary disorder of the skin with selective destruction of melanocytes. The pathogenetic mechanisms in vitiligo have not been completely clarified. The aim of our investigation was to evaluate the oxidative stress in the pathogenesis of generalized vitiligo. Twenty‐seven patients with generalized vitiligo and 24 phototype‐, age‐, and sex‐matched healthy controls were included in this study. We analysed serum levels of malondialdehyde (MDA), nitric oxide (NO), and serum activities of superoxide dismutase (SOD) and xanthine oxidase (XO) in the patients with vitiligo and in the controls. We found significantly higher levels of MDA and XO activity (P < 0.001 and P < 0.05, respectively), and a significantly lower level of serum SOD activity (P < 0.05) in patients with vitiligo compared with the controls. However, the increase in the level of serum NO was insignificant (P > 0.05). These results suggest that lipid peroxidation of cellular membrane of melanocytes by free radicals may have a significant role in the pathogenesis of generalized vitiligo.

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.

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.

Peripheral nervous system involvement in patients with Behçet disease.

Background:Central nervous system involvement in Behçet disease (BD) has been well documented, but studies evaluating peripheral nervous system involvement are relatively uncommon. Objective:The aim of this study is to evaluate the frequency and characteristics of peripheral nervous system involvement in BD. Methods:Sixty-nine BD patients (36 women, 33 men) followed by neurology and dermatology outpatient clinics between October 1999 and October 2004 were enrolled into study. A careful history was taken and physical and neurologic examinations were done. All other medical causes that may be related to peripheral nervous system involvement were studied. All patients underwent nerve conduction studies using standard electrophysiologic procedures. Results:Peripheral nervous system involvement was detected in 13 patients. There was no sign and symptom related to peripheral nervous system involvement in these patients. Causes other than BD were found in 5 patients with polyneuropathy. Asymptomatic delay in conduction velocities of the median nerves was detected in 3 patients. In 5 patients with clinically evident peripheral nerve involvement due to BD, 3 had sensorimotor and 2 had sensory axonal neuropathies. Conclusion:Axonal type polyneuropathy may be seen in BD patients. Peripheral involvement may be detected by electrophysiological examinations in asymptomatic BD patients.

Is topical metronidazole effective in seborrheic dermatitis? A double-blind study

Background Seborrheic dermatitis is a common, chronic, papulosquamous dermatosis. Although several types of treatment have been developed, repetitive treatment courses are often necessary.

A comparison of metronidazole 1% cream and pimecrolimus 1% cream in the treatment of patients with papulopustular rosacea: a randomized open-label clinical trial

Background.  There are various treatment options available for rosacea, depending on the subtype, but treatment is still generally unsatisfactory. Some reports have indicated beneficial effects of topical pimecrolimus.

Digital Block With and Without Epinephrine During Chemical Matricectomy with Phenol

BACKGROUND Digital block with epinephrine is safe in selected patients. Chemical matricectomy with phenol is a successful, cheap, and easy method for the treatment of ingrown nails. OBJECTIVE To determine the effect of digital block with epinephrine in chemical matricectomy with phenol. MATERIAL AND METHODS Forty‐four patients with ingrown toenail were randomly divided into two groups. The plain lidocaine group (n=22) underwent digital anesthesia using 2% plain lidocaine, and the lidocaine with epinephrine group (n=22) underwent digital anesthesia with 2% lidocaine with 1:100,000 epinephrine. In the postoperative period, the patients were evaluated for pain, drainage, and peripheral tissue destruction and were followed for up to 18 months for recurrence. RESULTS The mean anesthetic volume used in the epinephrine group (2.2±0.4 mL) was significantly lower than the plain lidocaine group (3.1±0.6 mL). There was no statistically significant difference in postoperative pain and recurrence rates, but duration of drainage was significantly shorter in the epinephrine group (11.1±2.5 days) than in the plain lidocaine group (19.0±3.8 days). CONCLUSION Digital block with epinephrine is safe in selected patients, and epinephrine helps to shorten the postoperative drainage period. The authors have indicated no significant interest with commercial supporters.

Sleep disturbance in patients with lichen simplex chronicus and its relationship to nocturnal scratching: A case control study.

Background: Lichen simplex chronicus (LSC) is a common pruritic disorder resulting from repeated rubbing and scratching. Nighttime pruritus is a common feature in LSC and may disrupt the sleep pattern. The aim of this study is to determine whether there are sleep abnormalities in patients with LSC. Patients and Methods: Fifteen patients with LSC and 15 age-, sex- and body mass index-matched control subjects were enrolled in the study. No participant had any other medical or psychiatric illness. All subjects were evaluated by overnight polysomnography, scratch electrodes, Epworth sleepiness scale and a general questionnaire for demographic data and sleep problems. Results: There were no significant differences in the groups for total sleep time, sleep efficiency, sleep latency, rapid eye movement (REM) latency, percentage of stage 1 non-REM sleep and REM sleep. The percentage of stage 2 non-REM sleep was higher (P < 0.05) and the percentage of slow wave sleep (stages 3 and 4) was lower in the study group (P < 0.05) than in the controls. The patient group had a mean of 15.9 ± 7.5 arousal index and 22.8 ± 14.1 awakenings compared with 9.5 ± 3.1 and 10.4 ± 3.9, respectively, in the controls (P < 0.05, P < 0.01, respectively). Arousals of patients were mainly observed in non-REM sleep. The number of scratching bouts ranged from 6 to 20 per night. Scratching episodes were observed frequently during stage 2 non-REM sleep. Conclusion: Polysomnographic findings of patients with LSC demonstrated that sleep structure is disturbed by arousals and awakenings related to scratching bouts during sleep.

Guttate psoriasis-like lesions following BCG vaccination.

A 7-year-old boy presented to our clinic with a 1-week history of guttate psoriasis-like lesions after BCG vaccination. Although the patient did not have any history of psoriasis, his father and uncle had a history of psoriasis vulgaris. He was treated successfully with topical corticosteroid. Complete healing was seen after 3 weeks and the patient was still in remission 4 months after the cessation of the therapy. We proposed that patients who have psoriasis or predisposition to psoriasis must be carefully followed after BCG vaccination.