Trichostasis spinulosa confirmed by standard skin surface biopsy

Trichostasis spinulosa (TS) is a common but rarely diagnosed disease. For diagnosis, it's sufficient to see a bundle of vellus hair located in a keratinous sheath microscopically. In order to obtain these vellus hair settled in comedone-like openings, Standard skin surface biopsy (SSSB), a non-invasive method was chosen. It's aimed to remind the differential diagnosis of TS in treatment-resistant open comedone-like lesions and discuss the SSSB method in diagnosis. A 25-year-old female patient was admitted with a complaint of the black spots located on bilateral cheeks and nose for 12 years. In SSSB, multiple vellus hair bundles in funnel-shaped structures were observed under the microscope, and a diagnosis of ‘TS’ was made. After six weeks of treatment with tretinoin 0.025% and 4% erythromycin jel topically, the appearance of black macules was significantly reduced. Treatment had to be terminated due to her pregnancy, and the lesions recurred within 1 month. It's believed that TS should be considered in the differential diagnosis of treatment-resistant open comedone-like lesions, and SSSB might be an inexpensive and effective alternative method for the diagnosis of TS

Corticosteroid hypersensitivity in allergic rhinitis

Corticosteroid hypersensitivity in allergic rhinitis. Background: intranasal corticosteroid (IC) is the most effective treatment method in allergic rhinitis patients who are unresponsive to antihistamines. The literature reports an approximate 20% treatment failure for instances where IC is used for the treatment allergic rhinitis. Hypersensitivity reaction to corticosteroids may be one of the causes of this treatment failure. Objective: to discover the incidence and confounding factors of corticosteroid hypersensitivity in patients with allergic rhinitis. Methods: after 31 patients were excluded, 150 consecutive patients who were prospectively evaluated in our outpatient clinics with the diagnosis of allergic rhinitis and 50 age- and sex- matched healthy volunteers were included in this study. To diagnose allergic rhinitis, the symptoms of patients and a skin prick test were used. A skin patch test was used to determine corticosteroid hypersensitivity. Total IgE values and total eosinophil count were obtained for all patients. Total symptom scores were calculated for the severity of symptoms and to determine the response to therapy using intranasal corticosteroids. Results: the incidence of corticosteroid hypersensitivity determined via the skin patch test was 14.0% (21 out of 150 patients). A difference was observed for patch test positivity results between the study and control groups (14% vs. 0%, respectively). Serum IgE levels and total eosinophil count were higher among patients who had corticosteroid hypersensitivity (p:0.005 and p:0.004, respectively). Patients unresponsive to intranasal corticosteroids had a higher incidence of corticosteroid hypersensitivity (71.4% vs. 4.4%, p<0.001). Conclusion: our study is the largest to date investigating CH in patients with allergic rhinitis and patients with allergic rhinitis have been found to have a high incidence (14%) of corticosteroid hypersensitivity, which may affect the response of patients to intranasal corticosteroid treatment

High-resolution computed tomography and pulmonary function findings of occupational arsenic exposure in workers

Background: The number of studies where nonmalignant pulmonary diseases are evaluated after occupational arsenic exposure is very few. Aims: To investigate the effects of occupational arsenic exposure on the lung by high-resolution computed tomography and pulmonary function tests. Study Design: Retrospective cross-sectional study. Methods: In this study, 256 workers with suspected respiratory occupational arsenic exposure were included, with an average age of 32.9±7.8 years and an average of 3.5±2.7 working years. Hair and urinary arsenic levels were analysed. High-resolution computed tomography and pulmonary function tests were done. Results: In workers with occupational arsenic exposure, high-resolution computed tomography showed 18.8% pulmonary involvement. In pulmonary involvement, pulmonary nodule was the most frequently seen lesion (64.5%). The other findings of pulmonary involvement were 18.8% diffuse interstitial lung disease, 12.5% bronchiectasis, and 27.1% bullae-emphysema. The mean age of patients with pulmonary involvement was higher and as they smoked more. The pulmonary involvement was 5.2 times higher in patients with skin lesions because of arsenic. Diffusing capacity of lung for carbon monoxide was significantly lower in patients with pulmonary involvement. Conclusion: Besides lung cancer, chronic occupational inhalation of arsenic exposure may cause non-malignant pulmonary findings such as bronchiectasis, pulmonary nodules and diffuse interstitial lung disease. So, in order to detect pulmonary involvement in the early stages, workers who experience occupational arsenic exposure should be followed by diffusion test and high-resolution computed tomography

Antinociceptív neurotranszmitterek / modulátorok hatásmechanizmusa: homológ és heterológ receptor kölcsönhatások vizsgálata és új, endogén peptid-kötőhelyek azonosítása = Neurochemical studies on neurotransmitters in pain regulation: identification of novel peptide binding sites and investigation of homologous and heterologous receptor interactions

Az antinocicepcióban kulcsszerepet játszó mu opioid receptor endogén ligandumának tekintett endomorfinok (1 és 2) kötőhelyeit karakterizáltuk biokémiai és autoradiográfiás módszerekkel. Megállapítottuk, hogy az endomorfin 1 két kötőhelyet ismer fel, amelyek közül a kis affinitású a klasszikus mu receptortól részben eltérő lokalizációval, ligandspecificitással bír és regulációja nem követi az ismert reakció utakat. Új, konformációsan gátolt endomorfin analógok kifejlesztésével módosítható volt a peptidek affinitása, szelektivitása. Világossá vált, hogy akár kismértékű szerkezeti módosítások is jelentős funkcionális eltéréseket eredményezhetnek. Az opioid és kannabinoid rendszer összefüggéseit vizsgáltuk molekuláris biológiai és biokémiai módszerekkel in vitro és in vivo. A legmarkánsabb változásokat a mu opioid receptorok esetében kaptunk, legfőképpen az előagyi és az agytörzsi területeken. Mind endogén CB1 agonista, mind CB2 antagonista befolyásolta a mu opioid receptor expresszióját és regulációját. A kannabisz és opioid rendszer közötti interakciók pontos mechanizmusainak feltárásával új kapuk nyílhatnak meg a fájdalomcsillapítás terápiás alkalmazásában a távolabbi jvőben | The endomorphins (1 and 2) are putative endogenous ligands for mu opioid receptors, which play a major role in antinociception. It was found, that endomorphin1 labels two distinct sites with partially different localization, ligand selectivity profiles. The regulation of its binding is not identical to that of the classical opioid ligands. The recently developed endomorphin analogs with constrained structure show changes in affinity and selectivy. Relatively small chemical modifications might lead to major changes in functional consequences. We investigated the interaction of the opioid system with several others related to nociception/antinociception. Among them, the occurrence of possible changes in mRNA expression and in functional activity of opioid receptors after acute in vivo and in vitro treatments with cannabinoids were studied. Wild-type, CB1 knockout mice and CB2 receptor deficient animals were among the the subjects of the study. We examined the changes of opioid receptor?s mRNA levels by using real-time PCR, analyzed the capability of mu-, delta and kappa opioid agonists to activate G-proteins and investigated mu-opioid receptors binding properties by using competition assays. Our data show changes in the expression and functional integrity of mu opioid receptors in forebrain, cerebellum and brainstem after different cannabinoid treatments. A better knowledge of the observed interactions may lead to exciting therapeutic possibilities in a long term

Comparison of European Standard Patch Test Results of 330 Patients from an Occupational Diseases Hospital

Background and Aim. Contact dermatitis (CD) is the most prevalent occupational skin disease with a significant impact on quality of life. Patch testing is used for the identification of responsible allergens which may improve protective and preventive measures in the workplace. Herein, we aim to identify the demographic characteristics and occupation of patients with early diagnosis of occupational CD and compare patch test results. Materials and Methods. The study included 330 patients referred to our clinic between April 2009 and April 2011 and who were patch-tested with 28-allergen European Standard Test. Results. 126 (38%) patients were female and 204 (62%) were male with a mean age of 36.12 (±13.13) years. Positive allergic reactions were observed in 182 (55%) patients. Nickel sulphate (41/126) and potassium dichromate (39/204) were significantly the most common allergens in women and men, respectively (P<0.005). Additionally, the most common occupation in women was household activities (83/126) and in men was manufacturing (80/204). Conclusion. The allergens to which people become sensitized differ according to their working environment and occupation. Classification of occupations is important for identification of sensitization risks and monitoring of changes in allergen distribution of different occupations

A rare case of juvenile-onset Behcet's disease: Fournier's gangrene followed by intestinal involvement

Behcet's disease (BD) is a multisystemic, inflammatory disease with still unknown etiology and rarely seen in childhood. BD has worse prognosis in young, male patients. BD exacerbations may be triggered by viral, bacterial, and other undefined antigenic stimuli in genetically predisposed individuals. Fournier's gangrene (FG) is a rapidly progressive, necrotizing fasciitis of the genital and perineal regions with high morbidity and mortality. FG is usually seen in immunocompromised patients and may be triggered by local factors such as trauma, trombosis, and vasculitis. Here, we present a adolescent, male patient with juvenile-onset BD who developed FG and afterwards entero-Behcet. This unique assocation without any other underlying immunocompromised condition is discussed. (C) 2017 Annals of Pediatric Surgery

Alopesi areata, vitiligo ve sağlıklı kontrollerde otolog serum deri testi pozitifliği

Background and Design: Autologous serum skin test (ASST), the best in-vivo test displaying in vitro basophil histamin releasing activity, is used in the diagnosis of chronic autoimmune urticaria. Besides, it is cheap and is easy to perform. It has been found that in ASST-positive chronic urticaria patients, autoimmune thyroid disease especially and other autoimmune diseases were more common and the level of autoimmune markers were higher compared to others. Autoimmunity is accused in the pathogenesis of alopecia areata and vitiligo. In this study, we assessed ASST results in healthy controls and those with autoimmune diseases, and aimed to explore the effects of thyroid autoantibodies and other factors in ASST positivity. Materials and Methods: ASST was administered to 51 patients with alopecia areata, 53 patients with vitiligo and 51 healthy controls, and thyroid function tests and thyroid autoantibodies (anti-Tg, anti-TPO) were assessed. Results: ASST was positive in 64.7% of patients with in alopecia areata, 64.2% of those with vitiligo and in 45.1% of controls. There was no statistically significant difference between the groups in terms of ASST positivity. We observed that ASST positivity had no relationship with age, anti-Tg, anti-TPO and the presence of one or both autoantibody positivity. It was seen that the frequency of ASST positivity was higher in females than in men in all groups, but it was statistically significant in alopecia areata group only. Among the all study groups, the frequency of ASST positivity was statistically significantly higher in females than in men.Conclusion: The high rates of ASST positivity in individuals with alopecia areata and vitiligo as well as in healthy control, indicate that ASST positivity does not solely exist in chronic urticaria patients. With logical regression analysis, it was shown that, having alopecia areata and being female significantly increase the risk of having ASST positivity. Therefore, we assume that ASST positivity might indicate the autoimmune etiology for alopecia areata and susceptibility to autoimmune diseases in female gender

A rare case of juvenile-onset Behçet's disease: Fournier’s gangrene followed by intestinal involvement

Behçet's disease (BD) is a multisystemic, inflammatory disease with still unknown etiology and rarely seen in childhood. BD has worse prognosis in young, male patients. BD exacerbations may be triggered by viral, bacterial, and other undefined antigenic stimuli in genetically predisposed individuals. Fournier’s gangrene (FG) is a rapidly progressive, necrotizing fasciitis of the genital and perineal regions with high morbidity and mortality. FG is usually seen in immunocompromised patients and may be triggered by local factors such as trauma, trombosis, and vasculitis. Here, we present a adolescent, male patient with juvenile-onset BD who developed FG and afterwards entero-Behçet. This unique assocation without any other underlying immunocompromised condition is discussed.Keywords: Behçet's disease, colitis, Fournier’s gangrene, juvenile onse

Alopesi areata, vitiligo ve sağlıklı kontrollerde otolog serum deri testi pozitifliği

Background and Design: Autologous serum skin test (ASST), the best in-vivo test displaying in vitro basophil histamin releasing activity, is used in the diagnosis of chronic autoimmune urticaria. Besides, it is cheap and is easy to perform. It has been found that in ASST-positive chronic urticaria patients, autoimmune thyroid disease especially and other autoimmune diseases were more common and the level of autoimmune markers were higher compared to others. Autoimmunity is accused in the pathogenesis of alopecia areata and vitiligo. In this study, we assessed ASST results in healthy controls and those with autoimmune diseases, and aimed to explore the effects of thyroid autoantibodies and other factors in ASST positivity. Materials and Methods: ASST was administered to 51 patients with alopecia areata, 53 patients with vitiligo and 51 healthy controls, and thyroid function tests and thyroid autoantibodies (anti-Tg, anti-TPO) were assessed. Results: ASST was positive in 64.7% of patients with in alopecia areata, 64.2% of those with vitiligo and in 45.1% of controls. There was no statistically significant difference between the groups in terms of ASST positivity. We observed that ASST positivity had no relationship with age, anti-Tg, anti-TPO and the presence of one or both autoantibody positivity. It was seen that the frequency of ASST positivity was higher in females than in men in all groups, but it was statistically significant in alopecia areata group only. Among the all study groups, the frequency of ASST positivity was statistically significantly higher in females than in men.Conclusion: The high rates of ASST positivity in individuals with alopecia areata and vitiligo as well as in healthy control, indicate that ASST positivity does not solely exist in chronic urticaria patients. With logical regression analysis, it was shown that, having alopecia areata and being female significantly increase the risk of having ASST positivity. Therefore, we assume that ASST positivity might indicate the autoimmune etiology for alopecia areata and susceptibility to autoimmune diseases in female gender