Mycosis fungoides and vitamin D status: Analyses of serum 25-hidroxyvitamin D levels and single nucleotide polymorphisms in the vitamin D receptor gene

Various types of cancer, including melanoma and non-melanoma skin cancer, are associated with vitamin D receptor (VDR) polymorphisms. However, few studies have addressed VDR polymorphisms in patients with mycosis fungoides (MF), and previous studies have reported conflicting results. Aim of this case-control study was to assess the correlation between VDR single nucleotide polymorphisms (SNPs) Cdx2, Fok1, Apa1, Bsm1, and Taq1 and MF. Venous blood samples were collected from 41 patients with MF and 59 age- and sex-matched healthy controls. VDR genotypes of both groups were analyzed. Serum vitamin D levels of patients with MF were also analysed among varying stages and VDR genotypes. Vitamin D levels were significantly low (&lt;30 ng/mL) in 87.9% of the patients (P&lt;0.001). No associations were found between Apa1, Cdx2, Fok1, and Bsm1 SNPs and MF. However, Taq1 polymorphisms were higher in the healthy control group (P&lt;0.001). Our study supports the claim that vitamin D deficiency is common in patients with MF. On the other hand, our findings suggest that Taq1 polymorphisms may be associated with decreased susceptibility to MF. Therefore, VDRs may have complex and heterogeneous effects on the pathogenesis of MF. </p

Mycosis fungoides and vitamin D status: Analyses of serum 25-hidroxyvitamin D levels and single nucleotide polymorphisms in the vitamin D receptor gene

Various types of cancer, including melanoma and non-melanoma skin cancer, are associated with vitamin D receptor (VDR) polymorphisms. However, few studies have addressed VDR polymorphisms in patients with mycosis fungoides (MF), and previous studies have reported conflicting results. Aim of this case-control study was to assess the correlation between VDR single nucleotide polymorphisms (SNPs) Cdx2, Fok1, Apa1, Bsm1, and Taq1 and MF. Venous blood samples were collected from 41 patients with MF and 59 age- and sex-matched healthy controls. VDR genotypes of both groups were analyzed. Serum vitamin D levels of patients with MF were also analysed among varying stages and VDR genotypes. Vitamin D levels were significantly low (&lt;30 ng/mL) in 87.9% of the patients (P&lt;0.001). No associations were found between Apa1, Cdx2, Fok1, and Bsm1 SNPs and MF. However, Taq1 polymorphisms were higher in the healthy control group (P&lt;0.001). Our study supports the claim that vitamin D deficiency is common in patients with MF. On the other hand, our findings suggest that Taq1 polymorphisms may be associated with decreased susceptibility to MF. Therefore, VDRs may have complex and heterogeneous effects on the pathogenesis of MF. </p

Evaluation of the importance of immunological profile for pemphigus vulgaris in the light of necessity to modify compensation theory

According to the “desmoglein compensation theory,” anti-Dsg1 and anti-Dsg3 profiles are crucial for the clinical outcome of pemphigus vulgaris. However, recent studies have highlighted several cases with an incompatibility between the antibody profile and clinical manifestation. Data of 37 patients who had been diagnosed pemphigus vulgaris in our Department between January 2014-June 2016 were retrieved from our clinical database. Patients with ABSIS skin involvement scores, oral mucosa extent and severity scores, anti-Dsg1 and Dsg3 antibody profile were included in this retrospective study. Patients with discordance between clinical manifestations and immunological profile were considered as atypical clinical phenotype. Patients with missing data were excluded. In all 37 patients, Dsg1 and Dsg3 antibody titers at the baseline did not correlate with the concurrent ABSIS scores. At follow up, we detected statistically significant correlations between anti Dsg-1 profile and ABSIS skin involvement scores (p=0.006; r=0.588) and between anti-Dsg3 and ABSIS mucosal extent and severity scores (p=0.058; r=0.431). After treatment, the reduction of Dsg-1 antibody titers was statistically significant in remittent patients (p=0.027). We did not detect statistically significant reduction of Dsg-3 antibodies. Four subjects had incompatible antibody profile and clinical activity. Discordance between phenotype-antibody profile and clinical activity-Dsg titers support the idea that non-Dsg antigens may also be the target for pemphigus autoimmunity. </p

Generalized livedo reticularis like eruption induced Generalized livedo reticularis like eruption induced by trimethoprim/sulfamethoxazole: A case report with by trimethoprim/sulfamethoxazole: A case report with concomitant myelosuppression

Livedo reticularis is a reticular discoloration of the skin because of the vascular anatomy of the skin. The condition most commonly affects the legs. Drug induced livedo reticularis which is an acknowledged side effect of amantadine, tends to be widespread, asymptomatic, benign rash. There are also reports of livedoid eruption induced with drugs including dapsone, imatinibe, gefitinibe. We describe a case of livedo reticularis like eruption and haemotological toxicity with trimetophrim-sulfamethoxazole. The purpose of this report is to remind clinicians of this rare, benign side effect of the common prescribed medication

Data analysis of 287 patients present with erythema nodosum: A closer look at associations

Background: Erythema nodosum (EN) is the most common clinical variant of panniculitis. It may occur in association with a wide variety of causative stimuli. The aim of our study is to describe the possible etiologic factors associated with EN and compare them with the series previously reported in the literature. Materials and Method: This is a retrospective chart review of 287 patients who have presented to our clinic with tender erythematous nodular lesions and finally diagnosed as eythema nodosum between January 2010 and December 2015. Results: Our retrospective study included 239 females and 48 males (sex ratio, 5:1). Of the 287 EN patients, etiologic factor has been determined in 123 (42.85%) of the participants and this group was categorized as secondary EN. In secondary EN group the leading etiologic factor was infections (n=68, 23.69%). Other etiologic factors were Behcet’s Disease (n=18, 6.27%), connective tissue disease (n=8, 2.78%), tuberculosis (n=6, 2.09%) sarcoidosis (n= 5, %1.74), drugs (n=6, 2.09%), granulomatous mastitis (n=2, 0.69%), IBD (n=2,0.69%), malignancy (n=1, 0.34%) and food supplement (n=1, 0.34%). Conclusion: Our data confirm that viral and bacterial infections are the leading causative factors of EN, followed by Behcet’s Disease, pregnancy and connective tissue disease (CTD). These conditions should be investigated as part of systemic search

A rare case of trigeminal trophic syndrome with an extensive scalp, forehead, and upper eyelid ulceration in a patient with undiagnosed Alzheimer disease

Background: Trigeminal Trophic Syndrome (TTS) is a rare presentation of facial ulceration, which is characterized by the triad of anesthesia, paraesthesia, and damage of trigeminal sensory branches.Main observations: We report a unique case of TTS as an extensive forehead and scalp ulceration in a patient with undiagnosed Alzheimer disease.Conclusions: Treatment options for trigeminal trophic syndrome are limited and disappointing especially in older patients with dementia. Family education and behavioral modification therapies may be well tolerated option in this population

A rare case of trigeminal trophic syndrome with an extensive scalp, forehead, and upper eyelid ulceration in a patient with undiagnosed Alzheimer disease

Background: Trigeminal Trophic Syndrome (TTS) is a rare presentation of facial ulceration, which is characterized by the triad of anesthesia, paraesthesia, and damage of trigeminal sensory branches.Main observations: We report a unique case of TTS as an extensive forehead and scalp ulceration in a patient with undiagnosed Alzheimer disease.Conclusions: Treatment options for trigeminal trophic syndrome are limited and disappointing especially in older patients with dementia. Family education and behavioral modification therapies may be well tolerated option in this population

Factors Affecting The Etiology Of Intractable Pruritus In Hospitalized Patients Without Primary Skin Lesions

Introduction: Pruritus is a common symptom that has dermatologic, systemic, neurological, psychogenic, mixed, and unknown causes. The aim of this study was to identify the underlying origin of pruritus (UOP) in hospitalized patients having intractable pruritus and presenting with secondary scratch lesions (SSLs) and to assess the factors affecting UOP. Methods: Data of 95 patients (male/female: 47/48) presenting with SSLs were examined retrospectively. Demographic and clinical characteristics, diagnostic procedures, and treatment agents were recorded. UOP was defined as dermatological and non-dermatological factors. Results: The median (range) age and disease duration were 61 years (11-91) and 2 months (0.06-120), respectively. Pruritus was related to dermatological and non-dermatological reasons in 78% and 22% of patients. Univariate analysis revealed that factors showing an association between patients with and without underlying dermatological origin of [pruritus (UDOP)] were age, disease duration, disease onset, >= 3 months of continuous drug use, intake of drugs attributed to lead to pruritus, accompanying systemic diseases, polypharmacy, renal function tests, and the presence of sleep disorders (p=0.001, p=0.001, p=0.001, p=0.03, p=0.045, p=0.02, p=0.004, p=0.047 and p=0.01, respectively). Multivariate analyses revealed that acute onset of pruritus increased the risk of UDOP by 15.28 times (p=0.005, 95% confidence interval (CI): 2.30-101.67) compared to patients with chronic onset. The lack of sleep disorders increased the risk of UDOP by 8.22 times (p=0.01, 95% CI: 1.67-40.56) compared to patients who had sleep disorders. Conclusion: Acute onset of pruritus and lack of sleep disorders were independent predictors of UDOP in patients with SSLs. The remaining patients without UDOP should be directed to the relevant departments for accurate diagnosis and management.Wo

Assessment of Metabolic Profile and Ischemia-modified Albumin Level in Patients with Alopecia Areata: A Case-Control Study

Background: Alopecia areata (AA) is an autoimmune-mediated hair follicle disorder. In the literature, there is no study evaluating metabolic syndrome and levels of ischemia-modified albumin (IMA) which is proposed as an oxidative stress biomarker in patients with AA. Aims: The aim was to investigate the presence of metabolic syndrome and the levels of IMA, small dense low-density lipoprotein (sd-LDL), and visfatin levels in AA patients. Settings and Design: A hospital-based cross-sectional study was undertaken among AA patients and controls. Subjects and Methods: Thirty-five patients with AA and 35 sex-, age-, and body mass index-matched healthy controls were enrolled. Clinical and laboratory parameters of metabolic syndrome were examined in all participants. Furthermore, IMA, sd-LDL, and visfatin levels were assessed and analyzed with regard to disease pattern, severity and extent, severity of alopecia tool score, duration, and recurrence. Results: The median IMA and adjusted IMA levels were significantly increased compared with controls (P<0.05 and P=0.002, respectively). Patients with pull test positivity displayed higher levels of adjusted IMA levels (P<0.05). In AA group, there was a positive correlation between adjusted IMA and waist circumference (r=0.443, P=0.008), adjusted IMA and triglyceride levels (r=0.535, P=0.001), and adjusted IMA and sd-LDL levels (r=0.46, P<0.05). We observed no statistically significant difference in fasting blood glucose and lipid profile, sd-LDL, and visfatin levels of the patients and healthy controls. Conclusions: AA patients and controls have similar metabolic profile. Raised levels of adjusted IMA levels may be associated with antioxidant/oxidant imbalance and with risk of cardiovascular disease