Şevki Özdemir

HLA Class I and Class II Genotyping in Patients with Chronic Urticaria

Objectives: Chronic urticaria (CU) is a common disease in which pathogenesis is unclear and which is resistant to therapy. Recent investigations have indicated that autoimmunity plays a role in nearly one third of CU patients. The present study aimed to investigate the relationship between human leukocyte antigen (HLA) class I and class II antigens and immune pathogenesis of CU. Methods: HLA class I and class II antigens were investigated in 40 patients diagnosed with CU, utilizing serologic techniques and polymerase chain reactions. The study was performed between October 2005 and May 2006. Further HLA typing in patient subsets was done depending on the response of patients to intradermal injection of autologous serum. About 30 healthy and genetically unrelated individuals formed the control group for evaluation. Results: The results revealed that HLA-B44 frequency was significantly higher (25%) in the patient group as compared with the matched control group (3.33%) (p = 0.033, OR = 9.667). There was no significant difference in HLA-A allelic distribution between the patient and control groups. In the genotyping of class II HLA alleles, HLA-DRB1*01 (25%) (p = 0.033, OR = 9.667) and HLA-DRB*15 (25%) (p = 0.033, OR = 9.667) were predominant alleles in the patient group. Conclusion: The association ofHLA-B44, HLA-DRB1*01 and HLA-DRB*15 alleles with idiopathic CU suggests that there is a genetic component in the pathogenesis of CU.

Nitric oxide levels in atopic dermatitis

AbstractAtopic dermatitis (AD) is a chronic or chronically relapsing inflammatory skin disease characterized by typically distributed eczematous skin lesions with lichenification, pruritic excoriations, dry skin and a susceptibility to skin infections. Nitric oxide is a molecule which is produced in endothelial cells, neuronal cells, fibroblasts, platelets, macrophages and neutrophils by nitric oxide synthetase, which plays a role in important biological and pathological processes. Nitric oxide, whose release is induced by cytokines and endotoxins, is produced in excessive amounts in acute, chronic inflammatory as well as infectious conditions.The purpose of our research was to determine nitric oxide (NO˙ ) values in patients with atopic dermatitis through spectrophotometric analysis. Data obtained from 22 atopic dermatitis patients and from 16 healthy controls were compared. The disease was mild (mild group), moderate (moderate group) and severe (severe group). Mean serum NO˙ levels were significantly hi...

Association of lupus vulgaris and multifocal tuberculous dactylitis and arthritis with multiple tuberculous scars.

Dear Editor, Lupus vulgaris is usually the result of dissemination from an endogenous focus during a period of lowered resistance and mycobacterium tuberculous bacillemia in a previously sensitized host with a strongly positive delayed hypersensitivity to tuberculin. The spread is mostly hematogenous or lymphatic. Approximately 2–3% of osteoarticular tuberculous (TB) is tuberculous osteomyelitis which is commonly seen in the short bones such as metacarpals, metatarsals and phalanges. The infection starts insidiously in the diaphysis with a fusiform painful swelling that may clinically resemble some of the inflammatory arthropathies so there may be diagnostic confusion. Multifocal TB dactylitis may be seen in debilitated children. As far as we could find in the English published work, lupus vulgaris and multifocal tuberculous dactylitis and arthritis, together, was reported in only two cases: one from the pediatric age group and one from the adult age group. To our knowledge, we present the second pediatric case in the published work. According to the parent’s history, fistulized abscess occurred on several fingers when she was 1 year old. After 2–3 months from the first lesions, the same kind of lesions occurred on feet but they healed within 2 months. Two year later, the same lesions occurred on the face and also healed in 2 months. During this period, some of the lesions on the hand healed but new ones occurred and there were always lesions on hand. There was no remarkable family history. Upon dermatological examination; an ellipsoid plaque which is pink in color, atrophic in center, peripherally hypertrophic, 6 cm × 8 cm in size was seen on the lateral side of knee. The left third finger was shortened and there was swelling of the proximal interphalangeal joint. There was also swelling of the second proximal interphalangeal joint so the second finger was also shortened. The right third finger had fixed flexion deformity with redness and swelling of the proximal and distal interphalangeal joint. The fourth finger’s distal interphalangeal joint had deformity and so the fourth finger had fixed flexion deformity. The index finger of the right hand was completely ulnar deviated from the metacarpophalangeal joint because of the deformity of the metacarpophalangeal and proximal interphalangeal joint and the whole phalanx of the finger had osteomyelitis. There was a discharging sinus in the fourth interdigital cleft (Fig. 1). The right and left feet had five atrophic scars on the extensor surface. There were many atrophic scars on the face