Teoman Erdem

Omentin serum levels and omentin gene Val109Asp polymorphism in patients with psoriasis

Psoriasis is a chronic inflammatory disease of uncertain pathogenesis. Omentin is a new adipokine with anti‐inflammatory properties; however, the relationship between psoriasis and omentin has not been fully established yet.

Associations between Demodex species infestation and various types of cancer

Tumor-associated immune system cells secrete protease and cytokines that can inhibit the immune response. In particular, T-cell effector functions could be inhibited, potentially causing an increase in parasitic infestations. Demodex species are common inhabitants of normal hair follicles. Humans are the specific host for two species Demodex folliculorum and D. brevis. The aim of this study was to investigate the incidence and infestation of D. folliculorum and D. brevis in patients with cancer. In the present study, 101 patients with cancer were selected from among patients who were diagnosed and treated for cancer. The cancer patients were divided into four groups according to cancer type. Slides were examined for parasites using light microscopy at magnifications of ×40 and ×100. Infestation was defined as having at least five living parasites/cm2 of skin. The ages of the patients with cancer ranged between 38 and 82 years, with a mean of 65.5±10.1 years. It was determined that 77 of the 101 (76.2%) cancer patients were positive for Demodex species. Infestation was positive in 18 (47.4%) of the 38 cases in the breast cancer group, 7 (29.2%) of the 24 cases in the lung cancer group, 5 (18.5%) of the 27 cases in the gastrointestinal system cancer group, and 2 (16.7%) of the 12 cases in the urogenital system cancer group. Results showed that the rate of Demodex species infestation was higher in patients with breast cancer. Thus, cancer — and particularly breast cancer — is a risk factor for Demodex species infestation.

Aeroallergen Prick Skin Test and Autologous Serum Skin Test Results in Patients with Chronic Urticaria and Their Comparison

Dear Editor: The etiology of chronic urticaria (CU) cannot be identified in more than 75% of patients, even after an exhaustive search. The autologous serum skin test (ASST) based on the intradermal injection of autologous serum is a simple screening diagnostic procedure used in CU. Studies have shown that ASST is positive in almost half of patients with CIU1. Aeroallergen prick skin test (ASPT) can provide useful confirmatory evidence for immediate type I hypersensitivity2. The purpose of our study was to assess the prevalence of positivity of ASST and ASPT, and their relevance in patients with CU. Fifty CU patients (female/male: 35/15, mean age: 33.32±9.42 years) and 50 controls (female/male: 20/30, mean age: 36.84±13.13 years), who were classified according to age and gender, were included in the study. In all of the patients, physical urticaria, food and drug allergies, as well as urticarial vasculitis, were ruled out after taking a detailed history and performing relevant laboratory investigations. Clinical and laboratory details of all of the patients were recorded, using a standard format. The ASST and the ASPT were performed intradermally. The aeroallergen, used for ASPT, were Dermatophagoides farinae, D. pteronyssinus, betulecea (alder, birch, hazel, hornbeam), salicacea (poplar, willow), mixture of 4 cereals (barley, maize, oat, wheat), mixture of 5 grasses (cocksfoot, rye-grass timothy meadow grass, sweet vernal-grass), mixture of 12 grasses (cocksfoot, rye-grass timothy meadow grass, sweet vernal grass, oat grass, wild oat, meadow fescue, bent grass, yorkshire fog bermuda grass, bromus), compositae (golden rod, dandelion, cocklebur, ox-eye daisy), feathers mixture (duck, goose, hen), and cat. Data were analyzed by using SPSS 11.5 software (SPSS Inc., Chicago, IL, USA). Ki kare test was used for the statistical analytical approach, and t test was used for other variables. There was a significant difference between patients (27 patients, range: 34%) and controls (5 controls, range: 10%), according to ASST positivity (p 0.5). The most prevalent aeroallergens in the patients were D. farinae (16% of patients). Sixteen percent of the patients reacted to a mixture of 4 cereals, 12% reacted to a mixture of 5 grasses and 12% reacted to a mixture of 12 grasses. The difference, according to the controls, was not meaningful (p>0.05). ASST has been suggested as a screening test for CIU. In our study, based on the disease duration, there was no significant difference between the ASST positive and negative groups, similarly, the studies of Kultanan et al.2 and Nettis et al.3 Grattan et al.4 reported a 35% positive ASST result in patients with CU. Coban et al.5 found a positive ASST in 25 of 40 patients (62.5%) with CC. Our findings are similar to those reported in those studies. CIU can be provoked by a number of known and unknown factors and allergens. Some of these allergens can be identified by prick tests. In our study, the most positive reactions were seen with house dust mites. Caliskaner et al.6 prick tested 259 patients with CU with common aeroallergens. Seventy-one of the patients had positive reactions to one or more allergens. The most common allergens were house dust mites, followed by pollens, cockroaches and moulds. Tezcan et al.7 prick tested 5,055 patients, 556 of whom had CU. According to this study, 42% of patients reacted to house dust mites, 54% reacted to grass pollen and 45% reacted to cereal pollen. In our study, ASPT positivity was not high because the living area is not mouldy. In addition, both the number and species of plants and pollens are scarce. In our setting, ASST is the only available test for the diagnosis of autoimmune urticaria. It is a simple and inexpensive, semi-invasive and easy-to-perform test, which can be undertaken by a dermatologist to determine whether the patients CIU is autoimmune in origin. As conventional approaches to management may be unsuccessful, ASST is especially important from the therapeutic point of view, as it can help the dermatologist to determine whether to initiate immunosuppressive therapy in CIU patients. When investigating the etiology of patients with CIU, the ASPT should be made with anamnesis.

Impact of Elevated Serum Uric Acid Levels on Systemic Inflammation in Patients With Psoriasis.

Patients with psoriasis have increased systemic inflammation and serum uric acid (SUA) levels compared with the general population. However, the role of SUA in modulating inflammation in these patients is not known. We evaluated the associations of SUA with inflammation and psoriasis severity; 199 patients with psoriasis and 54 healthy volunteers were included in the study. Demographic features, Psoriasis Area and Severity Index (PASI) scores, and laboratory data including SUA, C-reactive protein (CRP), and neutrophil to lymphocyte ratio (NLR) were collected. Patients with psoriasis had higher fasting blood glucose, body mass index (BMI), CRP, SUA, white blood cell (WBC) count, neutrophil count, and NLR compared with controls. The PASI score positively correlated only with CRP (r = .185, P = .012) and NLR (r = .313, P < .001). The BMI, WBC count, PASI score, and CRP, but not SUA, appeared as independent associates of NLR in patients with psoriasis in linear regression analysis. Neutrophil to lymphocyte ratio and SUA were significantly increased in patients with psoriasis compared with controls. Neutrophil to lymphocyte ratio and CRP were independent predictors of PASI score, whereas SUA was not. Serum uric acid seemed not to modulate the inflammation seen in patients with psoriasis in our cohort.

The relationship between ABO blood groups and acne vulgaris

Background and Aim: Studies of associations between various cancers and the ABO blood groups have shown elevated relative risks for some categories of disease. There has so far been no report of an evaluation of the relationship between the ABO blood groups and acne vulgaris. To investigate this association, we conducted a retrospective study of acne vulgaris diagnosed in Turkey. Material and Methods: All cases were clinically confirmed. Blood information was obtained on 498 individuals with acne vulgaris, and the distribution of ABO and Rh blood type for cases was compared with that of 419 healthy blood donors from the same geographic area. Results: Patients with group A and B blood groups ratios were higher than the control group, but not statistically significant (P = 0.325 and P = 0.138). The ratio of the patient group with AB blood group was significantly higher than in the control group (P < 0.01). The ratio of blood group O of patient group was significantly lower than in the control group (P < 0.01). There were no statistically significant differences between the patient and control groups in the distribution of Rh factor. Conclusion: Our study showed a significant association of AB and O blood groups with acne vulgaris. Further studies in a larger series on blood group antigens are needed to shed some light on the relationship between these antigens and skin cancer.

DRESS syndrome potentially induced by allopurinol and triggered by influenza vaccine

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome, also known as drug-induced hypersensitivity syndrome (DHIS), is an acute, potentially life-threatening disease that includes skin rash, fever, haematological abnormalities and multiorgan involvement. Although its aetiopathogenesis is not exactly known, it is thought that inefficient drug detoxification leading to the accumulation of drug reactive metabolites causes autoimmune responses in skin and some internal organs, alters immune responses and induces reactivation of viral infections in people who have genetic predisposition. To the best of our knowledge, only one case of DRESS syndrome has been reported after delivery of the influenza vaccine, but the drug that induced the reaction in that case was sulfasalazine. We report a case of a 64-year-old woman, receiving allopurinol, who developed DRESS syndrome after taking the influenza vaccine.

Terra firma-forme dermatosis: wipe first

References 1 Spellberg B, Edwards J Jr, Ibrahim A. Novel perspective on mucormycosis: pathophysiology, presentation, and management. Clin Microbiol Rev 2005; 18: 556–569. 2 Rickerts V, Mousset S, Lambrecht E, et al. Comparison of histopathological analysis, culture, and polymerase chain reaction assays to detect invasive mold infections from biopsy specimens. Clin Infect Dis 2007; 44: 1078– 1083. 3 Hammond SP, Bialek R, Milner DA, et al. Molecular methods to improve diagnosis and identification of mucormycosis. J Clin Microbiol 2011; 49: 2151–2153. 4 Prevoo RL, Starink TM, de Haan P. Primary cutaneous mucormycosis in a healthy young girl. J Am Acad Dermatol 1991; 24: 882–885. 5 De Oliveira-Neto MP, Da Silva M, Fialho Monteiro PC, et al. Cutaneous mucormycosis in a young, immunocompetent girl. Med Mycol 2006; 44: 567–570.

The effectiveness of matrix cauterization with trichloroacetic acid in the treatment of ingrown toenails.

Ingrown toenail is an often painful clinical condition that usually affects the big toe. Chemical matricectomy with phenol has a low recurrence rate and good cosmetic results. However, it produces extensive tissue destruction that can result in drainage and delayed healing. Alternatives such as sodium hydroxide and trichloroacetic acid (TCA) have therefore come into vogue. A total of 39 patients with 56 ingrown toenail edges underwent chemical matricectomy with 90% TCA after partial nail avulsion. In most of the patients, adverse effects such as postoperative pain and drainage were minimal. One patient who underwent matricectomy had recurrence in a single nail edge (1.8%) at 12 months follow-up. No recurrence was observed among 38 patients during the mean follow-up period. This was considered to be statistically significant (P < 0.001). Partial nail avulsion followed by TCA matricectomy is a safe, simple, and effective method with low rates of postoperative morbidity and high rates of success.

Dyshidrotic eczema associated with the use of IVIg

Intravenous immunoglobulin (IVIg) treatment is highly effective for autoimmune diseases including myasthenia gravis. Recovery is observed at approximately. 75% of myasthenia gravis patients through IVIg treatment. As a result of many clinical studies, the recommended dose is determined as 0.4 g/kg for 5 days (maximum total dose at 2 g/kg body weight). If an additional immunomodulatory treatment is not administered, IVIg maintenance treatment is needed mostly. However, some side effects may inhibit long-term treatment. For this reason, it is important to know the effect profile well and when the treatment should be discontinued. A female myasthenia gravis patient case is presented here, where dyshidrotic eczema has occurred after the second dose of intravenous Ig medication and whose treatment is despite further IVIg therapy.

Various simultaneous nail changes due to valproic acid use

Abstract There are only a few case reports about nail changes due to valproic acid in the literature despite its widespread use. We present a 50-year-old man who had onycholysis, roughness of the nail surface and brownish-yellow discoloration of both fingernails and toenails, which remarkably ameliorated upon cessation of valproic acid.