Sibel Berksoy Hayta

Metabolic syndrome may be an important comorbidity in patients with seborrheic dermatitis

Introduction Seborrheic dermatitis is a chronic inflammatory skin disease. One of the components of metabolic syndrome is inflammation, and many inflammatory cytokines play a critical role in the disease. The aim of this study is to investigate metabolic syndrome and to evaluate the relationship between the parameters of the disease and disease severity in patients with seborrheic dermatitis. Material and methods Forty-seven patients with seborrheic dermatitis and 36 healthy controls were included in the study. The parameters of metabolic syndrome were recorded in both groups. In the patient group, disease severity was determined with the seborrheic dermatitis area and severity index (SDASI). All the venous blood samples were taken at 8 a.m. after 10 h of fasting. Results High-density lipoprotein (HDL) levels in the patient group were statistically significantly lower than in the controls. There was no significant difference between groups according to other parameters. In terms of history of metabolic disease in first degree relatives (diabetes mellitus, cardiovascular disease, and dyslipidaemia), 78.7% of those in the patient group (n = 37) and 55.6% of those in the control group (n = 20) had a history of metabolic disease in their families, and the difference between the patient and control groups was found to be statistically significant (p < 0.05). There was a significant correlation between disease severity and plasma HDL levels (p = 0.033, r = –0.312). Conclusions The presence of seborrheic dermatitis may be a predictive factor for metabolic syndrome.

The reduction in inflammation and impairment in wound healing by using strontium chloride hexahydrate

Abstract Background: Numerous growth factors, cytokine, mitogen and chemotactic factors are involved in wound healing. Even though inflammation is important for the stimulation of proliferative phase, excessive inflammation also causes impairment in wound healing. Strontium salts suppress keratinocyte-induced TNF-alpha and interleukin-1 and interleukin-6 in in vitro cultures. This study was conducted to determine the effects of administration of topical strontium chloride hexahydrate on wound healing through TNF-alpha and TGF-beta in surgical wound healing model of in-vivo rat skin. Material and methods: Twenty-four rats were used in the study. After approximately 2 cm cutaneous–subcutaneous incision was horizontally carried out on the mid-neckline of the rats, the incision was again closed using 2.0 vicryl. The rats were assigned into three groups including eight rats in each group. Placebo emollient ointment and also the ointments, which were containing 5% and 10% strontium chloride hexahydrate and were prepared at the same base with placebo ointment, were administered to the groups by a blind executor twice a day for a week. At the end of seventh day, the rats were sacrificed and cutaneous and subcutaneous tissue of their wound site was resected for histopathological examination. Scoring of histopathological wound healing and scoring of tissue TNF-alpha and TGF-beta level with immunohistochemical staining were performed. Results: The groups, to which both 5% and 10% strontium chloride hexahydrate was administered, had lower immunohistochemical TNF-alpha levels and histopathological wound scores compared to controls, which was statistically significant (p < 0.05). Conclusion: Strontium chloride hexahydrate can lead to impairment in wound healing by suppressing inflammation through TNF-alpha.

Increased expressed emotion in patients with psoriasis

Aim of the study: The aim of this study was to determine whether patients with psoriasis are affected by expressed emotion in their family environment. Material and methods: Participants included 62 patients with psoriasis and 83 healthy controls and their biological parent, wife or husband, or adult child as a key relative. Sociodemographic data were recorded. Psoriasis area severity index was used to evaluate psoriasis severity. Hamilton depression and anxiety scales and the Expressed Emotion Questionnaire form were used to evaluate depression, anxiety, and expressed emotion. Results: The levels of expressed emotion and its subgroups in the patient group were higher than in the group of healthy controls (p < 0.05). Gender, disease duration, disease severity, and key relatives did not affect the levels of expressed emotion (LEEtotal) in the patients with psoriasis (p > 0.05). The LEEtotal of those with low educational level in the patient group was statistically significantly higher than those with higher educational level (p < 0.05). There was no correlation between the presence depression or anxiety and expressed emotion (p > 0.05). There was a negative correlation between age and the levels of expressed emotion in the patient group (p < 0.05). There was a negative correlation between age and intrusiveness in healthy controls (p < 0.05). Conclusions: Although decreasing with age, expression of emotion in patients with psoriasis is high, and psychosocial support should be provided to these patients.

Therapeutic and prophylactic effects of strontium on radiotherapy-induced skin toxicity in rats

Amaç: Bu çalışmada %5’lik stronsiyum (Sr) klorür hekzahidratın radyoterapiye (RT) bağlı gelişen deri toksisitesini önleyici ve/veya tedavi edici etkisinin olup olmadığının araştırılması amaçlandı. Gereç ve Yöntem: Dört buçuk-beş aylık, 200-210 gram ağırlığında 64 adet, dişi Wistar albino sıçan kullanıldı ve sıçanlar her bir grupta 8 sıçan olacak şekilde rastgele 8 gruba ayrıldı. Bulgular: Radyo Terapi Onkoloji Grubu Akut Radyasyon Morbidite Puanlama Kriterleri (RTOG) ve histopatolojik bulgulara göre karşılaştırma yapıldığında kontrol grubu ile diğer gruplar arasındaki fark istatistiksel olarak anlamlıydı (p<0,05). Fakat RT grubu ile diğer tedavi grupları arasında istatistiksel olarak fark yoktu (p>0,05). Ayrıca tedavi grupları arasında anlamlı farklılık yoktu (p>0,05). Gruplar transforme-edici büyüme faktörü-β’nın immünohistokimyasal değerlendirmesine göre karşılaştırıldığında istatistiki sonuçlar: Grup 1 ve 4 (p=0,015), grup 1 ve 5 (p=0,014), grup 1 ve 6 (p=0,035), grup 1 ve 8 (p=0,046), grup 2 ve 6 (p=0,047), grup 4 ve 6 (p=0,031) şeklindeydi. Gruplar tümör nekroz faktörü-α’nın immünohistokimyasal değerlendirmesine göre karşılaştırıldığında istatistiki sonuçlar: Grup 1 ve 2 (p=0,024), grup 1 ve 8 (p=0,045) şeklindeydi. Sonuç: Topikal olarak kullanılan %5 konsantrasyondaki Sr RT’nin deri üzerinde yan etkilerini önlemek için yeterli değildir. Bu sonuç RTOG puanlama, histopatolojik bulgular ve immünolojik belirteçlerle desteklenmiştir. Anahtar Kelimeler: Stronsiyum, dermatit, radyasyon, deri toksisitesi Background and Design: This study aimed to investigate whether 5% strontium (Sr) chloride hexahydrate has preventive or therapeutic effects on the radiotherapy (RT)-induced adverse skin effects. Materials and Methods: Sixty-four female Wistar albino rats weighing 200-210 g, aged 4.5-5 months were divided into eight groups. Results: There were significant differences between control group and the other groups according to the Radiation Therapy Oncology Group Acute Radiation Morbidity Scoring Criteria (RTOG) and histopathological findings (p<0.050). However, there were no significant differences between RT group and treatment groups (p>0.05). In addition, there were no significant differences among treatment groups (p>0.05). Statistical results were as follows according to the immunohistochemical evaluation of transforming growth factor-β: group 1 and 4 (p=0.015), group 1 and 5 (p=0.014), group 1 and 6 (p=0.035), group 1 and 8 (p=0.046), group 2 and 6 (p=0.047), group 4 and 6 (p=0.031); and according to the immunohistochemical evaluation of tumor necrosis factor-α: group 1 and 2 (p=0.024), group 1 and 8 (p=0.045). Conclusion: Topical treatment with Sr at a concentration of 5% is insufficient to prevent the side effects of RT involving the skin, as assessed by the RTOG scoring, histopathological findings, and immunological markers.

Bir yaşlanma modeli olarak Caenorhabditis elegans bireylerinde kalsinörin inhibisyonu ile ortaya çıkan değişiklikler

Mustafa Tosun, Sibel Berksoy Hayta, Melih Akyol, Sedat Özçelik 1 Dermatology Department, Sivas Numune Hospital, Sivas, Turkey 2 Cumhuriyet University School of Medicine, Dermatology Department, Sivas, Turkey Corresponding author: Mustafa Tosun, Dermatology Department, Sivas Numune Hospital, Sivas, Turkey E-mail: doktor699@hotmail.com Received/Accepted: September 05, 2015 / September 06, 2017 Conflict of interest: There is not a conflict of interest.

Supression of sweating in palmar hyperhydrosis with 5% strontium chloride hexahydrate.

A 18-year-old boy who complained palmoplantar hyperhydrosis was admitted to our clinic. He had hyperhydrosis for 3 years. He had been used some topical medications and antiperspirants, including aluminium chlorohydrate. He expressed that he used a topical product composed of strontium chloride hexahydrate (VR Nocicept dysesthesia cream, Gelişim M€ uh. Ltd. Şti, Sivas, Turkey) to calm his pruritus due to insect bite on his hand and that this product decreased his palmar hyperhydrosis. To test the effect of strontium chloride hexahydrate (Sigma) on sweating, we made an iodine-starch test in our patient. His right hand in tap water and his left hand in a solution with 5% strontium chloride hexahydrate were kept for 15 minutes and iodine-starch test was made. A decrease of sweating on the hands treated 5% strontium chloride hexahydrate was detected (FIG. 1). The case was invited once again to make a gravimetric test for his hyperhydrosis. Gravimetric test was made after 15 minutes’ rest in sitting position in standardized temperature (24–25 C) and humidity 15–17%. After drying the surface, a preweighed filter paper was applied to the palms and plantars for a period of 1 minute. The paper was then weighed and the rate of sweat production was calculated in mg/min (1). Gravimetric intensity of sweating in this case prior to any topical application was 82 and 73 mg/min for right and left palms (respectively) and 67 and 55 mg/min right and left plantars (respectively). We recommended him to use a topical preparation including 5% strontium chloride hexahydrate (VR Nocicept dysesthesia cream) twice a day for 2 weeks period. Eight hours after the last use of topical preparation, gravimetric test was carried out again. The intensity of sweating was 30 and 33 mg/min for right and left palms, respectively, and 35 and 28 mg/min for right and left plantars, respectively. Strontium salts (e.g., chloride, nitrate) block the activation of cutaneous type C nociceptors and can effectively suppress sensory irritation and pruritus (2). Depending on their effects, strontium chloride hexahydrate (VR Nocicept dysesthesia cream) can be used in dermatological diseases accompanied by pruritus and irritation as an adjunctive therapy agent. Topical aluminium chloride hexahydrate is a well-established therapy for hyperhidrosis and the mechanism of action of aluminum chloride hexahydrate is the blockage of the distal acrosyringium, which leads to functional and structural degeneration of the Address correspondence and reprint requests to: Melih Akyol, MD, Dermatology Department, Cumhuriyet University School of Medicine, 58140 Sivas, Turkey, or e-mail: melakyol@gmail.com

Seboreik keratozun dermatoskopik görüntüleri ile histopatolojik alt tipleri arasında korelasyon

Amac. Seboreik keratoz daha cok yaslilarda gorulen benign karakterli epidermal bir tumordur. Akantotik, hiperkeratotik, irrite, retikuler, klonal tip ve melanoakantoma olmak uzere 6 farkli histopatolojik alt tipi vardir. Dermatoskopi (epiluminans mikroskopi) pigmente deri lezyonlarinin ciplak goz ile gorulemeyen klinik morfolojik ozelliklerini gosteren in vivo, non-invaziv bir tekniktir. Bu calismadaki amacimiz seboreik keratozun dermatoskopik ozelliklerinin, histopatolojik alt gruplari ile korelasyonu olup olmadigini saptamakti. Yontem. Calismaya alinan 53 hastanin toplam 80 adet SK lezyonu alindi. Dermatoskopik bulgular tanimlandi. 77 lezyondan insizyonel biyopsi alinirken uc lezyona total rezeksiyon yapildi ve histopatolojik alt tipler velirlendi. Bulgular. SK alt tipleri; komedon benzeri acikliklar, mila benzeri kistler, fissur, polimorf damar, ekzofitik papiller, dot/globul ve mavi beyaz yapi acisindan degerlendirildiklerinde istatiksel olarak aralarindaki fark onemsiz bulunmustur (p>0,05). Alt tiplerde sosis parmak hiperkeratotik tip ve irrite tip SK’da, milia-bulut irrite tip SK en fazla gozlenirken (p<0,05), psodostreaks ve psodoretikuler patern en cok retikuler tip SK’da saptanmistir (p<0,05). Sonuc. Dermatoskopi, seboreik keratoz olgularinda histopatolojik alt tiplerin belirlenebilmesine yardimci bir tani araci olarak kullanilabilir.

Gecikmiş tanısıyla Hallopeau tipi akrodermatitis kontinua olgusu

1. Braun-Falco O, Plewing G, Wolf HH, Burgdorf WHC. Acrodermatitis continua suppurativa. Dermatology. Third Edition. Springer-Verlag, Berlin, 2009: 521. 2. Weisshaar E, Diepgen TL. Successful etanercept therapy in therapy refractory

Psoriyaziste demir metabolizması ve kortizol: Bir ön çalışma

Ozet Amac. Psoriyazis, kronik, tekrarlayici, inflamatuar bir deri ve eklem hastaligidir. Etyopatogenezi konusunda bugune kadar en cok calisilan hastaliklardan biri olmasina ragmen, tam aciklik kazanmamistir. Psoriyazise yonelik son 20 yilda yapilan deneysel calismalar hastaligin etiyolojisinde psikoloji, noroendokrinoloji ve immunolojinin birlikteligine dikkat cekmektedir. Bu calismanin amaci psoriyazis vulgarisli olgularda demir metabolizmasi, C- reaktif protein (CRP), kortizol degerleri arasindaki iliskiyi ortaya koymaktir. Yontem. Calismaya psoriyazis vulgaris tanisi alan 12’si kadin 16’si erkek toplam 28 olgu alindi. Olgularin yas, cinsiyet, hastalik suresi kaydedildi. Olgularda serum demiri, demir baglama kapasitesi (TIBC), ferritin, CRP, tam kan ve bazal kortizol degerleri olculdu. Bulgular. Olgularda demir degerleri ile CRP degerleri arasinda kuvvetli korelasyon, TIBC degerleri ile kortizol degerleri arasinda orta derecede korelasyon saptandi. Sonuc. Psoriyazis vulgarisli hastalarda demir metabolizmasi gozardi edilmemelidir. Ozellikle inflamatuar donemde uygulanabilecek parenteral demir uygulamasi gibi yontemlerin gelistirilebilmesi, hastaligin kontrol edilmesini kolaylastirabilecektir. Anahtar sozcukler: Psoriyazis, C-reaktif protein, kortizol, TIBC Abstract Aim. Psoriasis is a disease of the skin and joints, which is chronic, recurrent, and inflammatory. Although etiopathogenesis is a disease on which one of the most studied was made so far, it wasn’t gain a complete clearness. Experimental studies made about Psoriasis for the last 20 years, draws attention to coexistence psychology, neuroendocrinology, and of immunology in the etiology of the disease. The purpose of this study,is to emerge the relationship between ferrous metabolism, C-reactive protein (CRP), cortisol values in patients with psoriasis vulgaris. Method. 12 women and 16 men who were diagnosed with psoriasis vulgaris were included in a total of 28 patients who were diagnosed with psoriasis vulgaris were included in the study. Age of patients, gender, and duration of disease were recorded. The patients serum ferrous, total iron binding capacity (TIBC), ferritin, CRP, whole blood and basal cortisol levels were measured. Results. It was observed that a strong correlation between Patients with ferrous values, CRP levels, and a moderate correlation between cortisol levels and TIBC values. Conclusions. Ferrous metabolism in patients with Psoriasis vulgaris should not be ignored. Especially the improvement of methods such as parenteral ferrous application which can apply to the period of inflammatory will make easy to control illness. Keywords: Psoriasis, C-reactive protein, cortisol, TIBC