Effects of systemic isotretinoin treatment on hemogram, biochemical parameters, and inflammatory markers

Background and Design: Isotretinoin, a vitamin A derivative, is widely used to treat moderate and severe acne. Although the effect of systemic isotretinoin treatment on hemogram parameters has been demonstrated, the results are still controversial. In the present study, we investigated the effect of isotretinoin on biochemical parameters, hemogram, and inflammatory markers in the Black Sea Region. Materials and Methods: Medical data of 300 patients with moderate and severe acne vulgaris who received systemic isotretinoin treatment for at least three months were analyzed retrospectively. Hemogram parameters, serum creatinine levels, liver transaminase levels, serum lipid levels, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, and monocyte/high-density lipoprotein (HDL) ratios were evaluated before and three months after the treatment. Results: A significant decrease was found in leukocyte count, red blood cell count, neutrophil count, monocyte count, HDL levels, and NLR after three months of treatment compared to the baseline. A significant increase was found in platelet count, plateletcrit (PCT), platelet distribution width (PDW), red cell distribution width, hematocrit, mean erythrocyte hemoglobin, total cholesterol, low-density lipoprotein, triglyceride, and aspartate aminotransferase levels. Conclusion: According to our results, isotretinoin can affect several hemogram and biochemical parameters. In addition, this article is the only article demonstrating a decrease in monocyte count and an increase in PDW and PCT levels after the treatment of isotretinoin in the literature

A case of herpes zoster developing after COVID-19 vaccine and recurring after COVID-19 infection in the same dermatome

Coronavirus disease-2019 (COVID-19) is an ongoing infectious respiratory disease recognized worldwide as a pandemic, and it can affect many organs and systems, including the skin. Various cutaneous manifestations, including reactivation of varicella-zoster virus related to COVID-19 and COVID-19 vaccination have been reported. We would like to present a 46-year-old female, who developed herpes zoster (HZ) in the right C3 dermatome after m-RNA COVID-19 vaccine and was admitted to our clinic with recurrent HZ in the same dermatome following COVID-19 infection, two months after the vaccination

Psoriazis Hastalarında Kas-İskelet Sisteminin Elektrofizyolojik ve Ultrasonografik Olarak Değerlendirilmesi

Psoriasis is a chronic, relapsing, inflammatory dermatose which is accompanied by psoriatic arthritis (PsA) in 5-30% of the cases. Peripheral neuropathy is a term that can be used for almost every condition that affects peripheral nervous system. In most of the rheumatic conditions, polyneuropathy caused by pathogenesis and by the involvement of the disease or by the treatments, is reported. The main aim of this study was to see enthesopathy frequency using Glasgow Ultrasound Enthesitis Scoring Scale (GUESS) and to define the relationship between enthesopathy and clinical parameters as well as to find out the frequency of peripheral neuropathy in psoriasis patients by nerve conduction studies and the relation between clinical parameters. 74 psoriasis patients' Achilles, plantar aponeurosis, quadriceps, proximal and distal patellar entheses were evaluated by ultrasonography (USG) using GUESS. Sensory and motor nerve conduction studies in median and ulnar nerve of both upper extremities, motor nerve conduction study of peroneal and tibial nerves in lower right extremity and sensory conduction study on right sural nerve was performed in 25 psoriasis patients. In 172 of 730 (23,56%) entheses, USG found signs indicative of enthesopathy. Enthesopathy was statistically significantly more frequent in the cases with nail involvement compared to cases without nail involvement (p = 0,004). There was no statistically significant difference of enthesopathy frequency between symptomatic and asymptomatic patients (p>0,05). 7 (28%) of 25 patients had a pathology in nerve conduction studies. Bilateral ulnar and right tibial nerve distal motor latencies were shown to get longer (p = 0,001, p = 0,01, p = 0,019) whereas left ulnar nerve sensory conduction velocity gets slower (p = 0,033) with increasing GUESS scores. Nail involvement and enthesopathy is closely related. The patients with nail involvement should be reviewed for enthesopathy and screened for PsA development. Enthesial anomalies can also be seen in psoriasis patients without articular symptoms. Wide and long-term studies are necessary to research the importance of subclinical enthesopathy in the early diagnosis of PsA. Peripheral nerve dysfunction was frequently diagnosed in psoriasis patients and the possibility vii of a relationship between enthesopathy and peripheral nerve dysfunction was found. In order to clarify such relations, controlled studies with a wider patient population are necessary.Psoriazis, % 5-30 oranında psoriatik artritin (PsA) eşlik ettiği kronik, tekrarlayıcı, inflamatuvar bir dermatozdur. Entezit PsA?in major bulgularından biridir. Periferik nöropati periferik sinir sistemini tutan her hastalık için kullanılabilen genel bir terimdir. Birçok romatizmal hastalıkta gerek hastalık patogenezi veya tutulumu gerekse kullanılan tedavilere bağlı polinöropati varlığı bildirilmiştir. Bu çalışmada, psoriazisli hastalarda, ?Glasgow Ultrasound Enthesitis Scoring Scale? (GUESS) kullanarak entezopati sıklığını araştırmak ve entezopati ile klinik parametreler arasındaki ilişkiyi belirlemek, sinir iletim çalışmaları ile psoriazis hastalarındaki periferik nöropati sıklığını ve klinik parametreler ile ilişkisini araştırmak amaçlanmıştır. 74 psoriazis hastasının Aşil, plantar aponöroz, quadriseps, proksimal ve distal patellar entezleri GUESS kullanılarak ultrasonografi (USG) ile değerlendirilmiştir. 25 psoriazis hastasına her iki üst ekstremitede median ve ulnar sinirlere yönelik duyu ve motor iletim, sağ alt ekstremitede peroneal ve tibial sinirlere yönelik motor, sural sinir için de duyu iletim çalışması yapılmıştır. 74 hastada değerlendirilen 730 entezin 172 tanesinde (%23,56) entezopati tespit edilmiştir. Tırnak tutulumu olan hastalarda entezopati sıklığı, tırnak tutulumu olmayanlara göre istatistiksel açıdan anlamlı olarak daha yüksek saptanmıştır (p = 0,004). Entezopati sıklığı açısından semptomu olan hastalar ile olmayan hastalar arasında anlamlı fark tespit edilmemiştir (p > 0,05). 25 hastanın 7?sinde (%28) sinir iletim çalışmasında patoloji saptanmıştır. GUESS skoru arttıkça bilateral ulnar ve sağ tibial sinir distal motor latanslarının uzadığı (p = 0,001, p = 0,01, p = 0,019), sol ulnar sinir duyu ileti hızının ise azaldığı (p = 0,033) bulunmuştur. Tırnak tutulumu ile entezopati varlığı yakın ilişkilidir. Tırnak tutulumu olan psoriazis hastalarının entezopati açısından araştırılması ve PsA gelişimi açısından takip edilmesi gerekmektedir. Artiküler semptomu olmayan psoriazis hastalarında da entezeal anormallikler görülebilmektedir. Subklinik entezopatinin PsA erken tanısındaki önemini araştıran geniş ve uzun dönem takipli çalışmalara ihtiyaç vardır. Psoriazis hastalarında artmış sıklıkta periferik sinir disfonksiyonu saptanmış, entezopati ile periferik sinir disfonksiyonu arasında ilişki olabileceği tespit edilmiştir. Bu ilişkileri aydınlatabilmek için daha çok hastanın dahil edildiği kontrollü çalışmalara ihtiyaç duyulmaktadır

Polymyalgia rheumatica after herpes zoster

WOS: 000452898000017PubMed: 30874245Polymyalgia rheumatica (PMR) is a systemic disease associated with widespread body pain, in the elderly.1 Herpes zoster (HZ) is characterized by painful vesicular rash with dermatomal distribution.2 Although it causes many complications, to our knowledge, PMR secondary to HZ has not been previously reported

The effect of COVID-19 on development of hair and nail disorders: a Turkish multicenter, controlled study

© 2022 the International Society of Dermatology.Background: A broad spectrum of skin diseases, including hair and nails, can be directly or indirectly triggered by COVID-19. It is aimed to examine the type and frequency of hair and nail disorders after COVID-19 infection. Methods: This is a multicenter study conducted on consecutive 2171 post-COVID-19 patients. Patients who developed hair and nail disorders and did not develop hair and nail disorders were recruited as subject and control groups. The type and frequency of hair and nail disorders were examined. Results: The rate of the previous admission in hospital due to COVID-19 was statistically significantly more common in patients who developed hair loss after getting infected with COVID-19 (P < 0.001). Telogen effluvium (85%) was the most common hair loss type followed by worsening of androgenetic alopecia (7%) after COVID-19 infection. The mean stress scores during and after getting infected with COVID-19 were 6.88 ± 2.77 and 3.64 ± 3.04, respectively, in the hair loss group and were 5.77 ± 3.18 and 2.81 ± 2.84, respectively, in the control group (P < 0.001, P < 0.001). The frequency of recurrent COVID-19 was statistically significantly higher in men with severe androgenetic alopecia (Grades 4–7 HNS) (P = 0.012; Odds ratio: 2.931 [1.222–7.027]). The most common nail disorders were leukonychia, onycholysis, Beau's lines, onychomadesis, and onychoschisis, respectively. The symptoms of COVID-19 were statistically significantly more common in patients having nail disorders after getting infected with COVID-19 when compared to the control group (P < 0.05). Conclusion: The development of both nail and hair disorders after COVID-19 seems to be related to a history of severe COVID-19