Serap Utaş

Helicobacter pylori eradication treatment reduces the severity of rosacea

BACKGROUND A higher prevalence of Helicobacter pylori infection in rosacea patients than in healthy controls has been reported. OBJECTIVE The aim of this study was to investigate the effect of H. pylori eradication therapy in patients with rosacea. METHODS Twenty-five rosacea patients and 87 age- and sex-matched healthy controls were included in this study. We detected IgG and IgA antibodies against H. pylori in both groups. An upper gastrointestinal endoscopy and a rapid urease test were performed on the 13 patients with rosacea who accepted this procedure. Amoxicillin 500 mg 3 times daily, metronidazole 500 mg 3 times daily, and bismuth subcitrate 300 mg 4 times daily were administered to patients positive for H. pylori. The severity of rosacea was scored before and after treatment. RESULTS There was no statistical difference in seropositivity in either group. In H. pylori-positive rosacea patients there was a significant decrease in the severity of rosacea at the end of the treatment as compared with the initial scores. CONCLUSION Our findings suggest that H. pylori may be involved in rosacea and that eradication treatment may be beneficial.

A pilot study evaluating anxiety and depressive scores in acne patients treated with isotretinoin

BACKGROUND: Isotretinoin therapy and its alleged adverse psychiatric effects have received considerable media attention during the past years. The aim of this pilot study was to investigate whether there was any association between isotretinoin therapy and anxiety, depression or suicidal ideation. METHODS: Forty‐five patients with severe recalcitrant acne were enrolled in this study. Isotretinoin was administered at a dose of 0.5–1 mg/kg per day in two divided doses with food for 16 weeks. All patients received a complete dermatological examination and the severity levels of their acne were scored according to the Leeds Revised Acne Grading system at baseline (before isotretinoin treatment) and follow‐up assessments at weeks 4, 8 and 16 of the treatment. Severity of anxiety and depressive symptoms were assessed with the Clinical Anxiety Scale and Montgomery‐Asberg Depression Rating Scale before and upon completion of the 16‐week isotretinoin treatment. RESULTS: Twenty‐three patients completed the final assessment. There was a statistically significant decrease in anxiety scores. Depression scores also decreased but were not statistically significant. No patient committed or attempted suicide. CONCLUSIONS: This pilot study was unable to detect an association between the use of isotretinoin and an increased risk for anxiety, depression, or suicidal thoughts.

Antioxidant potential of propylthiouracil in patients with psoriasis.

OBJECTIVE There is growing evidence supporting the reactive oxygen species (ROS) in the pathogenesis of psoriasis. Propylthiouracil(PTU), an antithyroid drug, has been shown to have beneficial effects on psoriasis. The aim of this study was to investigate both disturbances in oxidant/antioxidant system in psoriasis and whether PTU, shown to have immunomodulatory effects and antioxidant potential, has effects on oxidant/antioxidant system and clinical improvement in psoriatics. DESIGN AND METHODS Malondialdehyde (MDA), end product of lipid peroxidation, superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), and antioxidant enzymes were measured in plasma, erythrocytes and skin biopsies of psoriatics who were resistant to conventional therapy before and after 8 weeks of oral treatment with PTU (300 mg/day) or PTU/thyroxine (25 microg/day- to prevent possible hypothyroidism). The same parameters were also studied in healthy controls. Psoriasis Area and Severity Index (PASI) scores were used to evaluate the severity of the disease, and routine analyses and thyroid function tests were measured during the study. RESULTS Increased baseline MDA in all samples were found to be lower. In addition baseline SOD and GSH-Px in skin and erythrocytes were also lower. The increased plasma SOD levels in skin and erythrocytes of the study groups was found to be higher and lower,respectively in all patients after the treatment. No tissue parameters or erythrocyte GSH-Px were different from control levels at the end of the study. Significant clinical improvement and decreased PASI scores were observed in all patients. Post treatment TSH levels were higher in all patients, but these levels were within the reference range and none had clinical hypothyroidism. CONCLUSION These findings may provide some evidence for a potential role of increased lipid peroxidation and decreased antioxidant activity in psoriasis. PTU may be considered as treatment model in psoriasis, in particular for resistant cases, because of its antioxidant potential, and also antiproliferative and immunomodulatory effects.

Rosacea fulminans in pregnancy : Case report and review of the literature

Rosacea fulminans is a rare disease of unknown cause which occurs exclusively in women years after adolescence. Although the etiology is unknown, immunologic, hormonal, and vascular factors have been suggested. When rosacea fulminans occurs during pregnancy and in women taking oral contraceptive pills, hormonal factors may be a trigger. Rosacea fulminans is localized specifically to the face, with the chin, cheeks, and forehead bearing the brunt of the attack. A dull red, cyanotic erythema of all involved facial areas, extending beyond the inflammatory nodules, is typical.We present the case of a 31-year-old pregnant woman who had rosacea fulminans during the first trimester of her second pregnancy. She had multiple erythematous papules, pustules, nodules, and purulent discharging cysts on the face. Conventional therapeutic approaches with systemic corticosteroids were associated with clear improvement within 2 months, and subsequently only 0.75% metronidazole topical cream was used during the second trimester.

Patients with vulval pruritus: patch test results.

Background:  Persistent vulval pruritus is a frequent problem and patients may not show signs of a primary vulval dermatosis. Allergic contact sensitivity is an important factor in such patients but may also occur as a secondary event in women with vulval dermatoses.

Investigation of the skin characteristics in patients with severe GH deficiency and the effects of 6 months of GH replacement therapy: a randomized placebo controlled study

Objective  The presence of GH receptor in human skin and its appendages suggests a direct effect of GH on skin characteristics. The skin is usually thin and dry in patients with GH deficiency (GHD). Sheehans syndrome classically refers to postpartum hypopituitarism and GH is one of the earliest pituitary hormones lost. While severe GHD is a well‐established feature of Sheehans Syndrome, skin characteristics and the effects of GH replacement therapy (GHRT) have been investigated neither in Sheehans syndrome nor in other disorders of GHD. The aim of this study was to investigate the skin characteristics, including the sebum content, hydration (skin capacitance), transepidermal water loss (TEWL), pH and skin temperature, and particularly the effects of 6 months of GHRT on these parameters in GH deficient patients with Sheehans syndrome.

Composite cutaneous haemangioendothelioma treated with interferon

© 2007 The Authors 503 JEADV 2008, 22 , 499–527 Journal compilation

Clinical Evaluation of Roxithromycin: A Double-Blind, Placebo-Controlled and Crossover Trial in Patients with Acne Vulgaris

We clinically evaluated roxithromycin (ROM) in a double blind, placebo‐controlled, and crossover trial in patients with inflammatory acne. Patients with inflammatory acne who were attending our outpatient clinic for treatment and who had not received topical or systemic treatment for the previous month were enrolled in this study. Patients were randomly separated into two groups. Group I consisted of 26 patients. The patients received 2 × 150 mg/day ROM orally in the first period and 2 × 1 placebo tablets/day in the second period. Group II consisted of 20 patients. These patients received 2 × 1 placebo tablets/day in the first period and 2 × 150 mg/day ROM orally in the second period. The first period was the first four weeks, and then there was a washout period of two weeks (5th and 6th). The second period was the next four weeks (7th to 10th weeks) after the washout period. Median acne scores had clearly decreased in both groups at the end of the study. Differences of median acne scores were statistically significant in both groups between at baseline and at the end of the study (p< 0.001). The results showed that ROM is a safe and effective alternative in the treatment of inflammatory acne with few side effects and good compliance.

The effects of severe growth hormone deficiency on the skin of patients with Sheehan's syndrome

Background  Growth hormone (GH) may play an important role in the content and appearance of the skin. Dry, thin and pale skin has been described in hypopituitarism. Sheehans syndrome is characterized by anterior pituitary dysfunction due to postpartum pituitary necrosis and GH is one of the hormones lost first.

Ocular Side Effects Associated with Systemic Isotretinoin

Purpose. To evaluate ocular side effects associated with systemic isotretinoin. Patients and Method. Thirty‐five patients with severe recalcitrant acne were enrolled in this prospective study. Isotretinoin was administered at a dose of 0.5–1 mg/kg/day in two divided doses with food for 16 weeks. In all patients, visual acuity, anterior segment examination, intraocular pressure (IOP) measurement, Schirmer I test, tear film break‐up time (BUT), and color vision by Farnsworth‐Munsell (FM) 100 Hue color test were evaluated and microbiological investigation of conjunctival flora and anterior nares were performed. All these eye examinations were repeated before, during, and after treatment with isotretinoin by the same examiner. Results. There was no difference in visual acuity, and fundus examination in any of the cases after administration of the drug. No statistically significant difference was found between averages of IOP measurements and refraction (NS). On the other hand, the differences between FM 100 Hue test scores, Schirmer values, and BUT measurements that were evaluated before and during treatment were statistically significant (p < 0.05). Subjective symptoms such as dryness, itching, and contact lens intolerance occurred in 34% of the patients. Colonization of the conjunctiva and anterior nares by Staphylococcus increased significantly during treatment. All abnormal findings disappeared 1 month after stopping therapy. Conclusion. There are ocular side effects of isotretinoin that are treatable and they disappear after discontinuation of therapy.