Cicatricial Alopecias

Primary cicatricial alopecias (PCA) are a rare group of disorders in which the hair follicle is the main target of destructive inflammation resulting in irreversible hair loss with scarring of affected lesions. Inflammation may predominantly involve lymphocytes or neutrophils. Cicatricial alopecias that mainly involve lymphocytic inflammation include lichen planopilaris, discoid lupus erythematosus, pseudopelade (Brocq), central centrifugal alopecia, alopecia mucinosa, and keratosis follicularis spinulosa decalvans. Cicatricial alopecias that are due to predominantly neutrophilic inflammation include folliculitis decalvans and dissecting cellulitis of the scalp. Acne keloidalis, acne necrotica, and erosive pustular dermatosis are cicatricial alopecias with a mixed inflammatory infiltrate

Omalizumab is not just an anti-immunoglobulin E

Introduction and purpose The mechanism of omalizumab in urticaria is not literally known. Omalizumab may affect receptors on the mast cell surface in other ways, especially other than Fc epsilon RI. Materials and Methods Thirty patients who were treated with omalizumab with the diagnosis of chronic urticaria were included in the study. For serum vasoactive intestinal peptide (VIP), kallikrein (KAL), and substance p (SP) values, 5 mL of blood was taken from the patients. These bloods were centrifuged for 5 min and stored at −80° until the levels were measured. The changes in values measured at baseline, third month, and sixth month were analyzed by Friedman test. A value of p < 0.05 was considered statistically significant results. Results While SP, KAL, and VIP values increased continuously, it was observed that the D-dimer value decreased. Conclusion This study shows that omalizumab can affect mast cells other than IgE. To the best of our knowledge, this is the first study to show the relationship between omalizumab and VIP

Alopecia areata different view; Heavy metals

Background: Alopecia areata (AA) is a noncicatricial alopecia affecting any hair-bearing area. Although AA is considered to be an autoimmune disease, oxidative stress has been shown to be an important factor in the etiology of AA. Trace elements are highly essential for humans since they form the building blocks of large molecules, function as the cofactors of enzymes, and have some key biological functions. The aim of this study was to investigate serum levels of heavy metals like iron (Fe), zinc (Zn), manganese (Mn), copper (Cu), magnesium (Mg), cobalt (Co), cadmium (Cd), and lead (Pb) in patients with AA. Materials and Methods: The study included a patient group of 30 with AA and a control group of 31 healthy individuals. Serum levels of heavy metals were measured using atomic absorption spectrophotometry. Results: The 30 patients included 17 (56.7%) men and 13 (43.3%) women with a mean age of 33.8 (range, 19–48) years. Serum Zn and Mn levels were significantly lower and serum Cd, Fe, Mg, Pb, Co, and Cu levels were significantly higher in the patient group compared to that of the control group (P < 0.05 for all). Conclusion: The results indicated that low levels of Zn and Mn are associated with AA while other metals were normal. So Zn supplementation may have some beneficial effect in AA while Fe prescription is fruitless

Evaluation of 62 bullous pemphigoid patients

Bullous pemphigoid (BP) is an acquired autoimmune disease often manifesting with subepidermal bullae. Autoantibodies against hemidesmosomes constitute the main cause of BP. In this study, we aimed to evaluate the clinical and histopathological characteristics of BP patients and to discuss them in light of the studies conducted in Turkey and around the world. The retrospective study included 62 patients that were diagnosed with BP in our clinic between 2005 and 2017. Diagnosis of BP was established based on clinical, histopathological, and DIF microscopy findings. Age, gender, duration of disease, presence of pruritus, peripheral eosinophilia, significant histopathological findings, history of smoking, and family history were recorded for each patient. Patients under 18 years of age were excluded from the study. The 62 patients comprised 24 (38.7%) men and 38 (61.3%) women with a median age of 72.0 years. The male-to-female ratio was 1.5. The median age at disease onset was 67.0 (range, 50-75) years and the median duration of disease was 1.0 (0.5-3.0) years. Of the 62 patients, 35 (56.5%) had a history of smoking and mucosal involvement was found in 27 (43.5%) patients. BP is a disease of the elderly and more common in women than in men. Oral mucosa should be an integral part of the physical examination in BP patients. Pruritus is a significant clinical symptom and eosinophilia is an important laboratory marker in the diagnosis of BP, particularly in patients with difficult diagnosis. [Med-Science 2019; 8(2.000): 426-9

Effects of Omalizumab on Serum Levels of Substance P, Calcitonin Gene-Related Peptide, Neuropeptide Y, and Interleukin-31 in Patients with Chronic Spontaneous Urticaria

The mechanism of action of omalizumab in urticaria is still not literally known. This study examines the serum values of substance P (SP), calcitonin gene-related peptide (CGRP), neuropeptide Y (NPY), and interleukin-31 (IL-31) in patients using omalizumab. In this study, 30 patients with chronic spontaneous urticaria (CSU) who were going to be treated with omalizumab and 20 healthy volunteers took part. Demographic data, clinical data, and disease activity scores were noted. For serum SP, CGRP, NPY, and IL-31 values, 10 mL of blood were taken from the patients before starting the treatment, 3 months after the treatment, at the end of the 6th month, and from healthy volunteers all at once. The change in values measured at baseline, 3rd month, and 6th month was analyzed by the Friedman Test. The Mann–Whitney U test was used to compare the parameters obtained from the patients and control groups. The significance level was set at p=0.05. SP, CGRP, NPY, and IL-31 values were all statistically significantly lower in the CSU patient group compared to the control group. After treatment, the levels of SP and CGRP in the serum went up, and the levels of serum IL-31 went down. These changes were statistically significant. This study supports the view that omalizumab does not only affect IgE receptors but also affects mast cells through other mechanisms. According to our knowledge, this is the first study to show that omalizumab therapy and serum CGRP levels are related

Systemic comorbidities associated with rosacea: a multicentric retrospective observational study

WOS: 000472185200024PubMed ID: 30575019BackgroundOnce considered a disorder limited to the skin, rosacea is now known to be associated with systemic disorders. The aim of this study was to determine what systemic comorbidities accompany rosacea and to determine the relationship between the type, severity, and duration of rosacea, and the presence of and type of systemic comorbidities. MethodsThis retrospective multicenter study was conducted by the Turkish Society of Dermatology Acne Study Group. Thirteen dermatology clinics throughout Turkey participated in the study. A structured physician-administered questionnaire was used to collect patient demographics, clinical findings, and lifestyle data. The principal rosacea subtype, physician global assessment of severity, and duration of rosacea were recorded. Physicians recorded each participant's medical history, including current and past comorbidities, duration of any such comorbidity, and the use of medications to treat any comorbidities. ResultsThe study included 1,195 rosacea patients and 621 controls without rosacea aged 18-85years. As compared to the controls, more of the rosacea patients had respiratory tract, gastrointestinal system, and metabolic and hepatobiliary system disorders in a rosacea's severity- and duration-dependent manner. ConclusionClinicians must be aware of the potential for systemic comorbidities in rosacea patients, which becomes more likely as disease duration and severity increase