Süleyman Pişkin

Effects and side-effects of spironolactone therapy in women with acne

Background and aims  Androgen hormones play an important role in the pathogenesis of acne. Despite the demonstrated effects, spironolactone, an androgen receptor blocker, is not commonly used to treat acne. We planned an open‐labelled, prospective study to evaluate the effects and side‐effects of spironolactone therapy in women with acne.

Benzoyl peroxide, adapalene, and their combination in the treatment of acne vulgaris.

Benzoyl peroxide and adapalene are among the most effective topical agents used in the treatment of acne. We planned an open‐labeled, prospective study to compare the effects and side effects of these two drugs alone and in combination in the treatment of acne vulgaris. One hundred and five consecutive patients (30 men and 75 women) with acne vulgaris were included in this study. The patients were randomly divided into three groups with 35 patients in each. The groups were randomly assigned to 0.1% adapalene gel, 5% benzoyl peroxide lotion, or combination of 0.1% adapalene gel +5% benzoyl peroxide treatment. Acne lesions were classified as noninflammatory (open and closed comedones) and inflammatory (papule, pustule, nodule, cyst), and the lesions on the face were counted before the therapy, during the control visits, and after the treatment. Erythema, dryness, burning, and other side effects were recorded during the treatment. The mean age of the patients was 18.44 ± 3.75 years. Eight patients were excluded because of noncompliance with the treatment regimen or the follow‐up schedule, and four patients were excluded due to allergic contact dermatitis. The study revealed that all three therapy protocols were effective in treating noninflammatory and inflammatory lesions in acne vulgaris (p<0.05) and that there was no significant difference between the groups in efficacy or side effects (p>0.05). Adapalene and benzoyl peroxide are effective and well tolerated agents for acne vulgaris; combination therapy has no superiority over adapalene or benzoyl peroxide alone.

Cutaneous findings in patients with primary Sjogren’s syndrome

Sjogren’s syndrome (SS) is an autoimmune disease that is characterized by exocrine gland involvement. It is reported that the skin is affected in nearly half of SS patients. Cutaneous manifestations consist of xerosis, angular cheilitis, eyelid dermatitis, pruritus, cutaneous vasculitis (frequently manifesting as palpable purpura), and erythema annulare. Most of them are nonspecific and less severe than the oral, ocular, or musculoskeletal symptoms. We present two patients with primary SS who have many cutaneous manifestations including erythema annulare and pernio-like lesions and review the literature about this topic.

Susceptibility to Atherosclerosis in Patients With Psoriasis and Psoriatic Arthritis as Determined by Carotid-Femoral (Aortic) Pulse-Wave Velocity Measurement

INTRODUCTION AND OBJECTIVES In this study we analyzed the susceptibility to atherosclerosis of patients with psoriasis and psoriatic arthritis (PsA) by determining the femoral-carotid pulse wave velocity (PWV), which is a measure of the viscoelastic properties of blood vessels. METHODS The study included 25 patients with psoriasis (age 18-63 years; 13 male), of whom nine had arthritis, as well as 39 sex- and age-matched healthy control subjects (age 24-70 years, 25 male). The systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate, body mass index (BMI) and waist-to-hip ratio (WHR) of all participants were recorded and, in patients, skin lesions were assessed using the psoriasis area and severity index (PASI). Arterial distensibility was determined by automatic carotid-femoral PWV measurement using the Complior Colson device. RESULTS Mean PWV, SBP and DBP were significantly higher in psoriatic patients than in control subjects (P=.036, P< .001, and P=.005, respectively). In PsA patients, the mean WHR, SBP, DBP and PWV were all significantly higher than in control subjects (P=.001, P=.031, P=.001, and P=.014, respectively). CONCLUSIONS The carotid-femoral PWV is increased in patients with psoriasis and PsA.

The treatment of common warts with infrared coagulation.

Treatment of warts can involve medical and surgical methods. Infrared coagulation is a surgical method very rarely used in the treatment of warts. We planned an open‐labeled prospective study to research the effect of infrared coagulation in the treatment of common warts, comparing it with electrocoagulation, and discussing its applicability as an alternative therapy regimen. Eighteen patients with common warts were included in this study. There were 49 warts of various sizes (1 mm to 1 cm) in these 18 patients. Twenty‐seven warts were treated with infrared coagulation, and 22 warts were treated with electrocoagulation. Sixteen patients were treated with both infrared coagulation and electrocoagulation; two patients were treated with only infrared coagulation. The patients were followed‐up for six months after treatment. Changes in sizes of warts, healing times, and cure rates were compared by Mann‐Whitney U test. The mean healing time was 35.5 ± 5.7 days with infrared coagulation and 32.9 ± 4.0 days with electrocoagulation. There was not any significant difference between healing times (p>0.05). Bacterial infection was seen on seven (31.8%) warts treated with electrocoagulation, but no side effects were seen with infrared coagulation. There was a significant difference between side effect rates in two groups (p<0.01). Nine (33.3%) of the warts treated with infrared coagulation and seven (31.8%) of the warts treated with electrocoagulation recurred in the six‐month follow‐up period. The overall cure rates at the end of the follow‐up period were 66.7% and 68.2% respectively. There was not any significant difference between the cure rates in the two groups (P>0.05). We conclude that infrared coagulation is a safe and cheap method and should be kept in mind as an alternative modality for the treatment of common warts.