Serpil Sener

Subclinical left ventricular dysfunction in Behcet's disease assessed by two-dimensional speckle tracking echocardiography

AIMS The aim of this study was to evaluate the left ventricular (LV) systolic strain by speckle tracking echocardiography (STE) in order to provide the early detection of myocardial dysfunction in patients with Behcets disease (BD). We also aimed to examine the relationship between LV systolic strain and N-terminal pro-B type natriuretic peptide (NT-proBNP), which is a cardiac biomarker of ventricular dysfunction. METHODS AND RESULTS Longitudinal and circumferential systolic strain assessed by STE was obtained in 32 BD patients and 27 age-matched controls. NT-proBNP levels were also measured in all subjects. Regional and mean longitudinal strain (-17.8 ± 2.7 vs. -20.5 ± 1.8%; P < 0.0001) was significantly lower in BD patients when compared with the healthy controls. Whereas regional and mean circumferential strain values (-22.0 ± 1.6 vs. -22.2 ± 2.3%; P = 0.62) did not reveal a significant difference between the patients and the controls. NT-proBNP was significantly higher in the patients than in the controls (65.18 ± 84.51 vs. 30.84 ± 14.75 pg/mL; P = 0.003). Linear regression analyses revealed only NT-proBNP as the independent correlate of mean LV longitudinal strain (R = 0.603, P = 0.001). CONCLUSION Longitudinal myocardial systolic function assessed by STE, which is a sensitive marker of subclinical ventricular dysfunction is impaired in BD. Increased NT-proBNP levels may be a sign of subclinical ventricular dysfunction in these patients.

The risk of coronary heart disease in men with androgenetic alopecia.

The meaningful association of androgenetic alopecia and coronary heart disease has been well documented, but few studies have focused on the importance of lipid parameters, such as total cholesterol, triglycerides, high density lipoprotein‐cholesterol, low density lipoprotein‐cholesterol, lipoprotein (a), apolipoprotein Al and apolipoprotein B in patients with androgenetic alopecia.

Cutaneous changes in patients with chronic renal failure on hemodialysis.

Context: A number of skin diseases can be observed in chronic renal failure (CRF). Their incidence have changed in different series. Objective: To compare the prevalence of cutaneous changes in CRF undergoing hemodialysis (HD) with healthy persons and to study the potential relationship with various parameters in the patients. Materials and methods: The study comprised one hundred patients with CRF under regular HD as well as one hundred healthy control subjects of matched age and sex. Both groups were subjected to full history and thorough skin examination. Results: Numerous skin lesions (at least one in each patient) were detected in all patients examined. Of these patients, nail abnormalities were observed in 92%, xerosis in 87%, fungal infection in 68%, hyperpigmentation in 62%, pruritus in 51%, and paleness in 51%. The nail changes included absence of lunula (55%), half and half nail (51%), splinter hemorrhages (36%), subungual hyperkeratosis (34%), onychomycosis (31%), koilonychia (19%), and onycholysis (9%). Oral changes were oral candidiasis (50%), xerostomia (40%), angular cheilitis (27%), and ulcerative stomatitis (18%). Specific cutaneous findings such as acquired perforating dermatosis, pseudoporphyria cutanea tarda, calciphylaxis, calcinosis cutis, and nephrogenic fibrosing dermopathy were not detected in any of the patients. In our study, when the patients were evaluated on the relationship between xerosis and pruritus, pruritus was found to be significantly increased parallel to the increase in the severity of xerosis. Conclusions: Xerosis and pruritus are common problems in HD-dependent patients. The early recognition of cutaneous signs can relieve suffering and decrease morbidity.

Detecting the Shape Differences of the Corpus Callosum in Behçet's Disease by Statistical Shape Analysis

The aim of this study was to assess the shape differences of the corpus callosum (CC) in patients with Behçets disease using statistical shape analysis (SSA). Additionally, an attempt was made to investigate the changes in CC size according to disease duration. Twenty‐five adults with clinically diagnosed Behçets disease and 25 age‐ and gender‐matched controls were examined by high‐resolution structural magnetic resonance imaging. The data obtained from the coordinate of landmarks were analyzed with Euclidean distance matrix analysis and a thin‐plate spline analysis. SSA and growth curve models were performed to investigate group differences and to fit the curves. A significant difference was determined between CC shape of Behçet patients and controls (P = 0.006). Based on the analysis, a decrease occurred in the CC size of the Behçet patients as the duration of disease increased. Maximum deformations were determined in the landmarks of interior notch of the splenium, inferior tip of the splenium, posterior‐most point of the CC, and topmost point of the CC. Similarly, the landmark of anterior‐most point of the CC was identified as having the minimum deformation. Behçet patients had significantly different CC shapes from control subjects. The results suggest that SSA is a promising tool for distinguishing Behçet patients from normal subjects, and that it can give useful information to assist clinicians. Additionally, SSA might be applied to detect shape differences in anatomical structures that are affected by a broad range of neurological diseases. Anat Rec, 2011.

Periocular allergic contact dermatitis following topical Mitomycin C eye drop application.

A 63-year-old women had an extensive limbal papilliform tumoural lesion of her left eye. Mitomycin C (MMC) was applied to thearea at a dose of 0.2 mg/ml after total surgical excision of the lesion. The lesion was diagnosed as invasive squamous cell carcinoma on histopathology and topical 0.02% MMC was prescribed four times daily to the left eye. A severe periocular contact dermatitis of the left eye developed two days after starting MMC. The patch test result was positive. The periocular dermatitis resolved after discontinuation of the topical MMC and treatment with a topical corticosteroid.

Changes in Anterior Chamber Parameters with the Pentacam Rotating Scheimpflug and Axial Length Measurements by Ultrasound in Patients Who Use Isotretinoin

Purpose: Evaluation of changes in anterior chamber parameters with the Pentacam rotating Scheimpflug and axial length measurements (Alx) by ultrasound in patients who use isotretinoin for the treatment of acne vulgaris. Methods: Twenty-nine eyes of 29 patients (15 men, 14 women) were evaluated with the Pentacam before the treatment, and at the 3rd and 6th months of treatment. The axial length was evaluated by ultrasound biometry. The non-parametric paired t-test was used to compare pretreatment and 3rd and 6th month anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA) width, central corneal thickness (CCT), lens thickness (LT), pupil size, axial length measurement (Alx) and mean keratometry values (K). Results: The mean age of the patients was 21.82 ± 4.14 years. The differences between the pretreatment and 3rd and 6th month ACD, ACV, CCT, Alx, LT and mean K values were statistically significant (p < 0.05). The differences between the pretreatment and 3rd and 6th month pupil size measurements were not statistically significant (p > 0.05). The differences between the pretreatment and 3rd month ACA measurements were statistically significant (p > 0.05), but there was no statistically significant difference with 6th month values (p < 0.05). Conclusions: Isotretinoin treatment causes statistically significant changes in most anterior segment parameters during treatment.

Rare presentation of human orf as multiple lesions

case of a responder to topical pimecrolimus. Such topical treatment may be patient-friendly, but topical pimecrolimus is not approved in Japan. Together with our report, it is assumed that treatment strategy targeting calcineurin might be effective for topical corticosteroid-resistant cases of LA. Psoralen-ultraviolet A (PUVA) therapy also has been reported to improve LA, possibly via its immunosuppressive action. Thus, the immune system might be a therapeutic target for LA, and our case suggests that topical tacrolimus might be a candidate therapeutic agent.

The incidence of Demodex species in skin biopsy specimens diagnosed as actinic keratosis and nonmelanoma skin cancer

Background: The most common types of skin cancers include basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), which are grouped as non-melanoma skin cancers. Actinic keratosis (AK) is a precancerous lesion that may develop into SCC. The pilosebaceous follicle mites, Demodex folliculorum and Demodex brevis, inhabit most commonly and densely certain facial skin areas where BCC and SCC also develops most frequently. Objective: Determine the prevalence of Demodex species in skin biopsy specimens diagnosed as SCC, BCC, and AK. Method: Specimens of the patients whose reports were available were studied in terms of Demodex. The specimens were stained using Hematoxylin and Eosin, and evaluated for Demodex species positivity. Results: There were Demodex species in seven (38.9%) out of 18 AK cases, 12 (31.6%) out of 38 SCC cases, and 26 (44.8%) out of 58 BCC cases of this study. The rate of Demodex species in patients diagnosed SCC, BCC, and AK was found to be rather high. Conclusion: Demodex species should also be evaluated in the follow-up of the treatment of patients in SCC, BCC, and AK group.

A case of sporotrichosis treated with itraconazole

Lymphocutaneous sporotrichosis is caused by Sporothrix schenckii, a dimorphic fungus commonly existing on decaying plants and in the soil. The fungus has a worldwide distribution but is more prevalent in temperate and tropical climates. Infection may result from traumatic inoculation of contaminated material such as soil, hay, moss, plant debris, splinters, thorns and barbs. Inoculation is also possible through some animal scratches and bites. We describe a typical case of lymphocutaneous sporotrichosis, which was confirmed by clinical, histological and microbiological features. The patient was successfully treated with 400 mg daily systemic itraconazole for 4 months.

The Evaluation of Vertebrobasilar Artery System in Neuro-Behçet and Behçet Disease using Magnetic Resonance Angiography

The aim of this study is the evaluation of the vertebrobasilar artery system in patients with Behçets and Neuro‐Behçets disease. For this aim; 20 adults with clinically diagnosed Behcets disease, 20 adults with Neuro‐Behçets disease, and 19 age‐ and gender‐matched controls were examined by magnetic resonance angiography (MRA). During MRA, diameters of left vertebral artery (LVA), right vertebral artery (RVA), basilar artery (BA), and proximal segment (P1) of posterior cerebral artery between origin and junction with the posterior communicating artery were measured. In all groups, LVA was dominant than RVA (P < 0.05). The diameters of BA and right P1 of Neuro‐Behçets disease were larger than the other groups (P < 0.05). In addition, the diameters of left P1 of Neuro‐Behçets disease were larger but not statistically significant. There is no difference between the groups in terms of gender. Behçets disease can affect vascular structures; therefore vertebrobasilar artery system should be examined in patients with Behçets and Neuro‐Behçets disease. Anat Rec, 297:1302–1305, 2014.