Yunus Saral

The relationship between severity of the disease and circulating nucleosomes in psoriasis patients

Psoriasis was initially considered to represent a disease of abnormal epidermal keratinocyte proliferation. Proliferation of keratinocytes is restricted by apoptotic cell death to maintain a constant thickness of epidermis. Nucleosomes are mainly released by apoptotic cells. Tumor necrosis factor-α (TNF-α) is an important factor affecting the apoptosis. In the present study, the relationship between TNF-α, nucleosome and the Psoriasis Area and Severity Index (PASI) score was investigated. The patients were divided according to PASI score into three groups (mild, moderately, severe). Serum TNF-α and nucleosome levels were measured using Enzyme-linked immunosorbent assay (ELISA) method. Our findings show a correct relationship between PASI scores and TNF-α and an inverse relationship between nucleosome and PASI score. According to the results obtained from the study, we believe that serum nucleosome levels can be used as a new indicator in follow-up of patients with psoriasis and monitoring of the effectiveness of drugs which used in the treatment of psoriasis.

Cutaneous leiomyoma in a child: A case report

Leiomyoma is a benign tumour commonly encountered in the genitourinary and gastrointestinal organs in adults. Cutaneous leiomyomas are rare benign tumors arising from the arrector pili muscle of hair follicles. Cutaneous leiomyomas are more likely to occur in adults than in children. We describe a case of a 10-year-old female who presented with multiple, firm, red-brown masses on the back. A punch biopsy was performed. Under high-power examination, spindle cells with an eosinophilic cytoplasm were observed and immunohistochemical studies were performed; the cells stained strongly positive for smooth muscle actin (SMA). The patient was subsequently diagnosed with pilar leiomyoma and referred to a plastic surgeon for surgical treatment. Although cutaneous leiomyoma is a rare disorder, we identified a case of pilar leiomyoma in a young female. A careful clinical assessment led to the correct diagnosis and therapy in the present case. We propose that leiomyoma ought to be considered in the differential diagnosis of any cutaneous or mucosal mass in children.

Hepcidin expression in psoriasis patients.

Background: Iron is an essential nutrient for mammals. Accelerated loss of nutrients through hyperproliferation and desquamation from the skin in psoriasis is known. Hepcidin is an important and recently discovered regulator of iron homeostasis. Aims and Objectives: The present study was undertaken to investigate the hepcidin expression in psoriasis patients. Materials and Methods: We examined peripheral blood cell counts, serum Fe, ferritin, interleukin-6 (IL-6) and hepcidin levels using respectively automated hematology analyzer, Iron assay on the AEROSET system, chemiluminescent microparticle immunoassay with automated analyzer, and enzyme-linked immunosorbent assay. Results: The independent comparison of Fe, ferritin, IL-6 and hepcidin levels in psoriasis patients and control group (healthy volunteers) revealed lower Fe and higher IL-6, hepcidin levels in psoriasis patients. No significant difference was seen in the ferritin level between the psoriasis and the control group. Conclusions: We think that studies on hepcidin expression in psoriatic plaques will contribute to our understanding the role of iron and hepcidin in the pathogenesis of psoriasis.

Epidermoid Cyst on the Nipple: A Rare Location

lateral section of the ascending aorta (Fig. 2a and b). Following these findings, a positron-emission tomography and a computed tomography scan were taken, which showed an increased metabolism in the lesion with standardized uptake values of 2.5 and suggested an active disease (Fig. 2c). After thorough consultation with a patient, a left side thoracotomy and resection of lesion was performed along with a resection of pericardium and diaphragm. Histopathologic finding showed that the lesion was a metastasis from a primary ILC (Fig. 3). She is currently undergoing her 18 month of treatment with capecitabine therapy and tolerating it well. Although metastatic breast cancer is considered as an incurable disease, a small number of patients remain disease-free for a long time. This is the first imaging report of breast cancer metastasis in the retrosternal fat tissue. The management of patients who have metastatic cancer is a systemic treatment, and the role of breast cancer metastasectomy is still unclear. The evidence of improved survival outcomes when systemic therapy is combined with local therapy (surgery or radiation), should raise up a possibility of incorporating other imaging modalities in standard for breast cancer follow-up, emphasizing the importance to recognize breast cancer metastasis at the time of suggestive symptoms.

Eosinophilic panniculitis presenting with Kaposi’s sarcoma-like plaques in a patient who is human immunodeficiency virus positive: a case report

IntroductionEosinophilic panniculitis is an unusual type of panniculitis characterized by a prominent infiltration of subcutaneous fat with eosinophils without an exact etiopathogenesis. To the best of our knowledge, up to now eosinophilic panniculitis has been described in only one previous case with human immunodeficiency virus disease in the literature.Case presentationHere we report the case of a 44-year-old Caucasian man, who is human immunodeficiency virus positive, diagnosed with eosinophilic panniculitis. A dermatological examination revealed multiple, confluent Kaposi’s sarcoma-like purple colored, deep plaques and nodules on his right gluteal area and right thigh. The presence of the mixed inflammatory infiltrate of lymphocytes, macrophages, and numerous eosinophils involving both septa and lobules of the subcutis were noted on the histopathological examination. On the basis of all these clinical and histopathological findings the patient was diagnosed with eosinophilic panniculitis. He was given intravenous 60mg/day methylprednisolone for 3 consecutive days a week for 6 months. The lesions resolved almost completely after 6 months.ConclusionThe predominance of T helper-2 subset of T helper cells and the consequential increase in interleukin-5 cytokines accompanying peripheral eosinophilia and high serum immunoglobulin E levels may all be blamed for the development of eosinophilic panniculitis in our case study. As a result, we aim to emphasize that eosinophilic panniculitis should be kept in mind in the differential diagnosis of subcutaneous nodular lesions in patients who are human immunodeficiency virus positive. We also focus on the requirement of histopathological examination for the definitive diagnosis because the clinical features of eosinophilic panniculitis may easily be confused with Kaposi’s sarcoma.

Endokrin Hastalıklarda Deri Bulguları

OZET Bircok endokrin hastaligin seyri sirasinda deri bulgulari olabilmektedir. Bu deri lez¬yonlarinin taninmasi endokrin hastaliklarin teshisinde ve tedavisinde cok onemli bir yere sahiptir. Bu calismada endokrin hastaligi tanisi almis olan 272 hastanin dermato¬lojik hastaliklarin sikliginin belirlenmesi, ayni hastalardaki dermatolojik bulgularin ve semptomlarin yas ve cinsiyete gore dagiliminin arastirilmasi amaclanmistir. Calismaya 203’u kadin 69’u erkek toplam 272 hasta alindi. Yapilan istatistiksel analiz sonucunda endokrin hastaliklarin hastalarin yas ve cinsiyetlerine gore dagiliminda anlamli farklilik¬lar bulundu (p<0.00). Hastalarin yapilan muayenelerinde 94’unde (%34,6) sac hastaligi, 80’inde (%29,4) tirnak hastaligi, 48’inde (%17,6) deri enfeksiyonu, 43’unde (%15,8) kronik gunes hasari, 36’sinda (%13,2) keratozis pilaris, 61’inde (%22,4) akne vulgaris, 74’unde (%27,2) kseroderma, 83’unde (%30,5) pruritus, 61‘inde (%22,4) skin tag ve 28’inde (%10,3) akantozis nigrikans mevcuttu. Deri enfeksiyonlarin yasla birlikte arttigi (p<0,00) ve 4. dekatta en fazla oldugu, tirnak hastaliklarinin da yasla birlikte arttigi belir¬lendi (p<0,00). Ancak, acne vulgarisin erken yaslarda fazla oldugu, ileri yaslarda azaldigi belirlendi (p<0,00). Akne vulgaris tanisi alanlarin agirlikli olarak hirsutismus grubunda olmasi istatistiksel olarak anlamli bulundu (p<0,00). Elde ettigimiz bu veriler sonucunda endokrin hastalarin duzenli olarak dermatolojik muayenelerinin yapilmasi gerektigi kanaatine varilmistir. Cutaneous manifestations of endocrine disorders ABSTRACT During the course of endocrine diseases, skin symptoms may be seen. Recognition of en¬docrin skin lesions have very important role in the diagnosis and treatment of endocrine diseases. In this study, we aimed to investigate the frequency of dermatological diseases and distribution of dermatological signs and symptoms according to age and sex in 272 patients diagnosed with endocrine disease. Total 272 patients were included in the study; 203 women, 69 men. Significant differences were seen at result of the statistical analysis of endocrine diseases according to age and sex (p<0.00). In examination of patients 94 (34.6%) hair disease, 80 (29.4%) nail disease, 48 (17.6%) skin infection, 43 (15.8%) chronic sun damage, 36 (13.2%) keratosis pilaris, 61 (22.4%) acne vulgaris, 74 (27.2%) xeroderma, 83 (30.5%) pruritus, 61 (22.4%) skin tag, 28 (10.3%) acanthosis nigricans were seen. Increased incidence with age in skin infections (the greatest 4. decade) and nail disease were seen (p<0.00). However, acne vulgaris is more in early age than elderly (p<0.00). Diagnosed patients with acne vulgaris were mainly in the fields of hirsutism group (p<0.00). As a result of these data, dermatological examinations should be per¬formed in endocrine disease patients regularly. J. Exp. Clin. Med., 2011; 28:45-48