Evaluation of contact sensitivity to topical drugs in patients with contact dermatitis

Background and Design: Topical drugs are an important group of contact allergens. The present study aimed to evaluate contact sensitivity to topical drugs in patients with contact dermatitis. Materials and Methods: Between 2003 and 2008, 129 patients were followed up at the Department of Dermatology at Ankara University School of Medicine with clinically suspected contact sensitivity to topical drugs. In this study, the patch test reactions to the European Standard Battery and topical drugs used by the patients and medicament patch test results were evaluated. Results: Positive patch test reaction to one or more allergens was found in 80 (62.0%) of 129 patients included in the study. Sixty-one of the 80 patients (61/129, 47.3%) had positive patch test reaction to medicaments. Medicament sensitivity was detected in 37.9% (49/129) of subjects. Nitrofurazone was found to be the most common allergen (18.6%). Discussion: The present study showed that topical drugs are a frequent cause of allergic contact dermatitis. Therefore, the probability of contact sensitivity to topical drugs should also be considered in patients with the clinical diagnosis of allergic contact dermatitis and, suspected cases should be evaluated further with patch testing in order to find the responsible allergens

Clinical and demographic characteristics of 165 patients with lichen planus

Objective: Lichen planus (LP), is a papulosquamous inflammatory disease, which involves the skin, mucous membranes, nails and scalp. The incidence varies according to geographical regions. In this study, it was aimed to detect the clinical and demographic characteristics of the patients with LP who have been under follow-up at our clinic. Methods: One hundred sixty five patients, who were diagnosed as LP in our clinic between 2010 and 2013, were enrolled to the study. The age, gender, disease duration, time of onset of disease, characteristics of involvement, associated systemic diseases, laboratory findings and treatment were recorded retrospectively. Results: In our study, 0.6% of all patients admitted to our clinic were diagnosed as LP. A total of 165 patients included in the study, 92 women (56%) and 73 men (44%), respectively. Patients’ ages ranged 8-78 (mean 44.7±16.7). Disease duration ranged from 1 month to 20 years (mean 15.6±29.7). One hundred thirty four patients (81.2%) had skin involvement, 51 (31%) had oral mucosal involvement, and 15 (9%) had genital involvement. Five (4.5%) of 111 patients with viral hepatitis tests were positive for hepatitis C virus. Hepatitis B virus positivity was seen in 4 (4%) patients. Conclusion: There is a need for further studies with more patients to better understand the epidemiological, clinical and pathological characteristics of LP. We believe that our study will contribute to the determination of our country’s data

Investigation into the frequency of helicobacter pylori infection with carbon 14 urea breath test in patients with vitiligo

Background/aim: Vitiligo is a common, acquired depigmenting skin disorder. The relationship between Helicobacter pylori (HP) infection and autoimmune dermatological disease has been previously reported. However, the frequency of HP infection in patients with vitiligo has not been reported. In this study, we aimed to investigate the frequency of HP infection with the carbon 14 (C14) urea breath test (UBT) in patients with vitiligo. Materials and methods: This study included 34 patients (18 males and 16 females) with vitiligo and 30 age- and sex-matched healthy controls. HP infection was diagnosed using the C14 UBT (Heliprobe). Statistical analysis was performed using SPSS 19. Results: The frequency of HP infection was 64.7% in the patient group and 33.3% in the control group according to the C14 UBT (chisquare test, P = 0.012). HP infection frequency is statistically significantly higher in patients with vitiligo. Conclusion: To the best of our knowledge, this is the first investigation of the frequency of HP positivity in patients with vitiligo. To better understand the role of HP in vitiligo as an etiological or initiating factor, further experimental and clinical studies with a greater number of patients are needed.Background/aim: Vitiligo is a common, acquired depigmenting skin disorder. The relationship between Helicobacter pylori (HP) infection and autoimmune dermatological disease has been previously reported. However, the frequency of HP infection in patients with vitiligo has not been reported. In this study, we aimed to investigate the frequency of HP infection with the carbon 14 (C14) urea breath test (UBT) in patients with vitiligo. Materials and methods: This study included 34 patients (18 males and 16 females) with vitiligo and 30 age- and sex-matched healthy controls. HP infection was diagnosed using the C14 UBT (Heliprobe). Statistical analysis was performed using SPSS 19. Results: The frequency of HP infection was 64.7% in the patient group and 33.3% in the control group according to the C14 UBT (chisquare test, P = 0.012). HP infection frequency is statistically significantly higher in patients with vitiligo. Conclusion: To the best of our knowledge, this is the first investigation of the frequency of HP positivity in patients with vitiligo. To better understand the role of HP in vitiligo as an etiological or initiating factor, further experimental and clinical studies with a greater number of patients are needed

Evaluation of patch test results in patients with contact dermatitis

ÖZET Amaç: Allerjik kontakt dermatit (AKD), deriye temas eden maddelere karşı gelişen bir aşırı duyar- lılık reaksiyonudur. AKD’ye neden olan allerjenlerin saptanması için yama testleri kullanılmaktadır. AKD’ye en sık neden olan maddeler coğrafik bölgelere göre değişiklik göstermektedir. Bu çalış- mada, kliniğimizde AKD ön tanısı ile yama testi yapılan hastalarda en sık rastlanan allerjenlerin saptanması ve elde edilen verilerin literatür ile karşılaştırması amaçlanmıştır. Gereç ve Yöntemler: Çalışmamıza Ocak 2010 ile Haziran 2013 tarihleri arasında kliniğimizde AKD tanısı konularak avrupa standart serisi ile yama testi uygulanan 148 hasta alındı. Hastaların yaş, cinsiyet, hastalık süresi, meslek, atopi varlığı, lezyon lokalizasyon bilgileri ve yama testi sonuçları retrospektif olarak kaydedildi. Bulgular: Çalışmaya alınan 89’u kadın, 59’u erkek, toplam 148 hasta alındı. Hastaların yaş ortala- ması 35,3±14,8 idi. Yama testi yapılan 148 hastanın 45’inde (%30,4) test yapılan allerjenlerden bir veya birden fazlasına karşı pozitif reaksiyon görüldü. En sık pozitif reaksiyon saptanan allerjenler sırasıyla nikel sülfat (%11,5), potasyum dikromat (%6,1), kobalt klorid (%4,7), paraben karışımı (%4,1), tiuram karışımı (%2,7), neomisin sülfat (%2,7) ve koku karışımı (%2,7) idi. Sonuç: Çalışmamızın ülkemizde en sık duyarlılığa neden olan kontakt allerjenlerin belirlenmesine katkıda bulunacağını düşünmekteyiz.Objective: Allergic contact dermatitis (ACD) is a hypersensitivity reaction which develops against substances contacting the skin. Patch tests are used for the detection the allergens that cause ACD. The most common substances that cause ACD vary based on geographic regions. In this study, detection of the most common allergens in patients who underwent patch testing with the diagnosis of ACD and comparison of the results with literature were aimed. Mateials and Methods: One hundred forty-eight patients, who underwent European standard patch test with the diagnosis of ACD in our clinic between January 2010 and June 2013, were enrolled in our study. The data about age, sex, duration of disease, occupation, the presence of atopy, localization of the lesion of the patients and patch test results were recorded retrospectively. Results: Eighty-nine females and 59 males, a total of 148 patients, were included in the study. The mean age of the patients was 35.3 ± 14.8. Positive reactions to one or more allergens were observed in forty-five (30.4%) of 148 patients who underwent patch test. The allergens that were the most common cause of positive reactions were nickel sulfate (11.5%), potassium dichromate (6.1%), cobalt chloride (4.7%), paraben mix (4.1%), thiuram mix (2.7%), neomycin sulfate (2.7%) and fragrance mix (2.7%), respectively. Conclusion: We believe that our study will contribute to the determination of contact allergens which is the most common cause of sensitization in our country

Diffuse involvement of ascending aorta and left main coronary artery with familial hypercholesterolemia : Case report

Ailesel hiperkolesterolemi (AH) ailesel geçiş gösteren, LDLkolesterol metabolizmasındaki bozukluk sonucu plazma LDL düzeyinde artışa neden olan genetik bir hastalıktır. Yüksek serum lipid düzeyi ve LDL-kolesterolün dolaşımdan temizlenememesi nedeniyle hızlı ateroskleroz gelişimi vardır. Bu da erken yaşta koroner arter hastalığı ve aterosklerotik aort oluşumuna neden olur. Aort kökündeki ateromatöz değişiklikler koroner osteal lezyonlara ve aort iç duvarında düzensizliklere yol açmaktadır. Biz de koroner osteal lezyonla birlikte asendan aorta da yaygın tutulumu olan AH'li bir vakayı sunuyoruz.Familial hypercholesterolemia (FH) is an inherited genetic disorder leading to increased plasma LDL levels due to defects in LDL-cholesterol metabolism. Atherosclerosis occurs early due to the high serum lipid levels and inability to eliminate LDL-cholesterol from circulation. This results in coronary artery disease and atherosclerotic aorta at early age. Atheromatous alterations in aortic root lead to coronary osteal lesions and irregularities in the inner aortic wall. We present an FH case with extensive involvement of ascending aorta with coronary ostial lesion

Sonographic evaluation of the nail plate and nail bed thickness in psoriasis patient with and without nail involvement

Amaç: Psoriazis toplumda %1-3 sıklıkta görülen deri, eklemler ve tırnakları, tutan eritemli skuamlı inflamatuar bir hastalıktır. Psoriazis hastalarında tırnak tutulumu sıklığı %15-% 69 arasında değişmektedir. Ankilozan spondilit ise psoriatik artrit gibi seronegatif spondilartritlerdendir. Ultrasonografi günümüzde yumuşak dokuları değerlendirmek için yaygın kullanılan non invaziv bir görüntüleme yöntemidir. Bu çalışmada tırnak tutulumu olan ve olmayan psoriazis hastalarında tırnak yatak ve tırnak plak kalınlıklarını ultrasonografik olarak ölçerek ankilozan spondilit hastaları ve kontrol grubu ile karşılaştırmayı hedefledik. Gereç ve Yöntem: Otuzyedi psoriazis, 39 ankilozan spondilit hastası ile 33 sağlıklı kontrol çalışmaya dahil edildi. Psoriazis hastaları ile ankilozan spondilit ve kontrol grubunun “tırnak plak kalınlığı” ve “tırnak yatak kalınlığı” hasta oturur pozisyonda ve sağ el masa üzerinde nötral pozisyonda iken gri skala ultrasonografi (LOGIQ5Pre, GE, 4-11- MHz lineer prob) ile aynı hekim tarafından sağ el ikinci parmak tırnağında(indeks tırnak) ölçüldü. Bulgular: Tırnak yatak kalınlıkları psoriazis, ankilozan spondilit ve kontrol grubunda sırasıyla 1.60,1.58,1.51 mm olarak ölçüldü. Tırnak plak kalınlıkları ise psoriazis, ankilozan spondilit ve kontrol grubunda sırasıyla 0.64,0.62,0.68 mm olarak ölçüldü. Psoriazis grubu ile ankilozan spondilit ve kontrol grupları arasında tırnak yatak ve tırnak plak kalınlıkları açısından istatistiksel olarak fark yoktu.(p=0.13,p=0.45)Tırnak yatak kalınlığı, sağ el ikinci parmak tırnağı tutulumu olan hastalarda, olmayanlara göre istatistiksel olarak daha yüksek ölçüldü. (p=0.030) Sonuç: Sonuç olarak çalışmamızda tırnak plak ve tırnak yatak kalınlıkları ultrasonografik olarak değerlendirildiğinde psoriazis grubu ile kontrol grubu ve ankilozan spondilit hastaları arasında fark bulunmadı. Ultrasonografik olarak ölçülen tırnak yatak kalınlıkları sağ el ikinci parmak tırnağı tutulumu olan hastalarda, olmayanlara göre istatistiksel olarak daha yüksekti.Objective: Psoriasis is an inflammatory and erythematousscaly disease which involve the skin, joint and nail. It’s prevalence is 1-3%. The incidence of nail involvement in psoriasis patient ranged between 15-69 %. Ultrasonography is a noninvasive imaging method widely using for assess the soft tissue image nowadays. In this study we aimed to assess the nail bed and nail plate thickness in psoriasis patient with and without nail involvement and compare with ankylosing spondylitis and control groups. Material and Methods: Thirty-seven patient with psoriasis, 39 patient with ankylosing spondylitis and 33 healthy control were included to the study. Nail bad and nail plate thicknesses was measured with grey scale USG(LOGIQ5Pre, GE, 4-11- MHz lineer prob) from the right hand’s second finger(index finger), when the patient seated with the hands in a neutral position over the table. Results: Nail bad thicknesses were measured as 1.60, 1.58, 1.51 mm respectively in psoriasis, ankylosing spondilytis and control groups. Nail plate thicknesses were 0.64,0.62 and 0.68 mm respectively in psoriasis, ankylosing spondylitis and control groups. Nail bad and nail plate thickness were not statistically different between psoriasis, ankylosing spondylitis and control groups.(p=0.13,p=0.45) Nail bad thicknesses were measured more in the psoriasis patient with righth and second finger nail involvement then without righth and second finger nail involvement. (p=0.030) Conclusion: Inconclusion when evaluated the nail plate thickness ultrasonographically there was no statistically significant difference between psoriasis, ankylosing spondylitis and control groups. Nail bed thickness was statistically higher in psoriasis patients with righth and second finger nail involvement compared to non

A case of atypical scleromyxedema mimicking angioedema which responded well to acitretin treatment

Otuz yedi yaşındaki erkek hasta göz kapaklarında, kulaklarında, boyun ön ve yan yüzleri ile ensesinde şişlik ve hafif kaşıntı şikayeti ile polikliniğimize başvurdu. Dermatolojik muayenesinde göz kapaklarında ve kulaklarında soluk eritem ve ödem; yüz derisinde kabalaşma ve alın bölgesinde oluklanmalar saptandı. Hastanın öyküsünden yaklaşık iki aydır ürtiker-anjioödem tanıları ile sistemik kortikosteroid, antihistaminik ve adrenalin tedavilerinin verildiği fakat bu tedavilerden hiç fayda görmediği öğrenildi. Klinik, histopatolojik ve laboratuvar bulgularının ışığında hastaya monoklonal gamopatisiz atipik skleromiksödem tanısı konuldu. Hastaya asitretin (35 mg/gün) tedavisi başlandı. İki ay sonra lezyonlarda belirgin düzelme gözlendiA 37-year-old male patient was admitted our clinic with the complaints of edema and mild pruritus of the eyelids, ears, and the neck. On dermatological examination, there were edema and pale erythema on the eyelids and ears as well as coarsening of the facial features and lines grooving the forehead. His medical history revealed that the patients received systemic corticosteroids, antihistamines and epinephrine treatments for about two months with the diagnosis of urticaria and angioedema, however, he did not benefit from these treatments. A diagnosis of atypical scleromyxedema without monoclonal gammopathy was established according to the clinical, histopathological and laboratory findings. Acitretin treatment with a dose of 35 mg/day was started. Marked regression in the lesions was observed two months later

Sonographic evaluation of the nail plate and nail bed thickness in psoriasis patient with and without nail involvement

Amaç: Psoriazis toplumda %1-3 sıklıkta görülen deri, eklemler ve tırnakları, tutan eritemli skuamlı inflamatuar bir hastalıktır. Psoriazis hastalarında tırnak tutulumu sıklığı %15-% 69 arasında değişmektedir. Ankilozan spondilit ise psoriatik artrit gibi seronegatif spondilartritlerdendir. Ultrasonografi günümüzde yumuşak dokuları değerlendirmek için yaygın kullanılan non invaziv bir görüntüleme yöntemidir. Bu çalışmada tırnak tutulumu olan ve olmayan psoriazis hastalarında tırnak yatak ve tırnak plak kalınlıklarını ultrasonografik olarak ölçerek ankilozan spondilit hastaları ve kontrol grubu ile karşılaştırmayı hedefledik. Gereç ve Yöntem: Otuzyedi psoriazis, 39 ankilozan spondilit hastası ile 33 sağlıklı kontrol çalışmaya dahil edildi. Psoriazis hastaları ile ankilozan spondilit ve kontrol grubunun “tırnak plak kalınlığı” ve “tırnak yatak kalınlığı” hasta oturur pozisyonda ve sağ el masa üzerinde nötral pozisyonda iken gri skala ultrasonografi (LOGIQ5Pre, GE, 4-11- MHz lineer prob) ile aynı hekim tarafından sağ el ikinci parmak tırnağında(indeks tırnak) ölçüldü. Bulgular: Tırnak yatak kalınlıkları psoriazis, ankilozan spondilit ve kontrol grubunda sırasıyla 1.60,1.58,1.51 mm olarak ölçüldü. Tırnak plak kalınlıkları ise psoriazis, ankilozan spondilit ve kontrol grubunda sırasıyla 0.64,0.62,0.68 mm olarak ölçüldü. Psoriazis grubu ile ankilozan spondilit ve kontrol grupları arasında tırnak yatak ve tırnak plak kalınlıkları açısından istatistiksel olarak fark yoktu.(p=0.13,p=0.45)Tırnak yatak kalınlığı, sağ el ikinci parmak tırnağı tutulumu olan hastalarda, olmayanlara göre istatistiksel olarak daha yüksek ölçüldü. (p=0.030) Sonuç: Sonuç olarak çalışmamızda tırnak plak ve tırnak yatak kalınlıkları ultrasonografik olarak değerlendirildiğinde psoriazis grubu ile kontrol grubu ve ankilozan spondilit hastaları arasında fark bulunmadı. Ultrasonografik olarak ölçülen tırnak yatak kalınlıkları sağ el ikinci parmak tırnağı tutulumu olan hastalarda, olmayanlara göre istatistiksel olarak daha yüksekti.Objective: Psoriasis is an inflammatory and erythematousscaly disease which involve the skin, joint and nail. It’s prevalence is 1-3%. The incidence of nail involvement in psoriasis patient ranged between 15-69 %. Ultrasonography is a noninvasive imaging method widely using for assess the soft tissue image nowadays. In this study we aimed to assess the nail bed and nail plate thickness in psoriasis patient with and without nail involvement and compare with ankylosing spondylitis and control groups. Material and Methods: Thirty-seven patient with psoriasis, 39 patient with ankylosing spondylitis and 33 healthy control were included to the study. Nail bad and nail plate thicknesses was measured with grey scale USG(LOGIQ5Pre, GE, 4-11- MHz lineer prob) from the right hand’s second finger(index finger), when the patient seated with the hands in a neutral position over the table. Results: Nail bad thicknesses were measured as 1.60, 1.58, 1.51 mm respectively in psoriasis, ankylosing spondilytis and control groups. Nail plate thicknesses were 0.64,0.62 and 0.68 mm respectively in psoriasis, ankylosing spondylitis and control groups. Nail bad and nail plate thickness were not statistically different between psoriasis, ankylosing spondylitis and control groups.(p=0.13,p=0.45) Nail bad thicknesses were measured more in the psoriasis patient with righth and second finger nail involvement then without righth and second finger nail involvement. (p=0.030) Conclusion: Inconclusion when evaluated the nail plate thickness ultrasonographically there was no statistically significant difference between psoriasis, ankylosing spondylitis and control groups. Nail bed thickness was statistically higher in psoriasis patients with righth and second finger nail involvement compared to non