Higher incidence of metabolic syndrome components in vitiligo patients: a prospective cross-sectional study

Background/objectives: To investigate the association between vitiligo and metabolic syndrome. Methods: A prospective cross-sectional study was conducted between 2014 and 2016. Study (n=155) and control groups (n=155) were evaluated for metabolic syndrome according to National Cholesterol Education Program Adult Treatment Panel III and the International Diabetes Federation criteria. Study group was divided into three groups according to their vitiligo area severity index and vitiligo disease activity score values (Group 1: 6.89 for VASI score, Group A: -1-0, Group B: 1-2 and Group C: 3-4 for vitiligo disease activity score respectively). MetS rates according to both criteria were compared between the vitiligo disease activity score and vitiligo area severity index groups. Results: Metabolic syndrome rates were 37.4% and 40% in the study group and 19.4% and 26.5% in the control group according to National CholesterolEducation Program Adult Treatment Panel III and International Diabetes Federation criteria, respectively (p<001 and p=0.011). Metabolic syndrome was more frequent in vitiligo area severity index Groups 2 and 3 compared to vitiligo area severity index Group 1, and in vitiligo disease activity score Group C compared to vitiligo disease activity score Groups A and B. Study limitations: Single center experience, absence of more specific oxidative-stress markers and lack of long-term follow-up of the patients. Conclusions: Frequency of metabolic syndrome was higher in patients with non-segmental vitiligo and the rate was higher in active/severe form of the disease

The utility of systemic-immune inflammation index for predicting the disease activation in patients with psoriasis

Objective: To evaluate the utility of systemic-immune inflammation index (SII) in themanagement of patients with psoriasis.Method: This retrospective case-control study was conducted on patients who wereadmitted to the dermatology outpatient clinic. Patients with psoriasis (n = 71) werecompared with a age and gender-matched control group (n = 70) with other non inflammatory dermatologic diseases. Study and control groups were compared interms of clinical characteristics and SII values (neutrophil X platelet/lymphocyte).Afterwards, 50th percentile value (4.5) for psoriasis area severity index (PASI) wascalculated for the study group. Two subgroups were formed according to PASI val ues: (1) PASI < 4.5 group (n = 36) and (2) PASI ? 4.5 (n = 35). Clinical characteristicsand SII values were also compared between these two subgroups. Furthermore, SIIvalues were compared according to the presence of scalp, joint, nail, and genital area involvement in the study group. Finally, a receiver operating characteristic (ROC)curve analysis was performed in order to assess the performance of SII in determin ing the activation of psoriasis in the study group.Results: Significantly higher SII values were found in patients with psoriasis.PASI ? 4.5 subgroup and patients with nail and genital involvement had also signifi cantly higher SII values (P < .05). A cut-off value of 575.8 was calculated with 66.7%sensitivity and 66% specificity for psoriasis activation.Conclusion: SII may be used for the prediction of psoriasis activation

Efficacy of systemic minoxidil and tofacitinib combination in treatment-resistant alopecia universalis

Alopecia areata (AA) is an autoimmune nonscarring alopecic disorder, which presents with varying amounts of hair loss, ranging from focal patchy loss to entire scalp and body hair loss. Treatment of AA is a challenging issue within dermatology practice. Although many treatment options are present, response to medications remains un satisfactory, especially in severe and recalcitrant cases. In this study, we present a case of treatment-resistant AU, which was successfully treated by the combination of tofacitinib and oral minoxidil

The utility of immunoglobulin A/complement 3 and immunoglobulin G/immunoglobulin M ratios in the assessment of disease activation in patients with Behcet disease

Objective: Pathogenesis of Behc¸et disease (BD) has not yet been clearly revealed and there is no ideal test for the estimation of disease activation at present. This study aimed to assess the efficiencies of IgG/IgM and IgA/C3 ratios in determining activation of BD. Method: This retrospective cohort study consisted of 140 patients with BD. Patients were divided into two groups: (1) active BD (n ¼ 89) and (2) inactive BD (n ¼ 51) and were compared in terms of demo graphic features, clinical characteristics and laboratory test results. IgA/C3 and IgG/IgM ratios were compared according to organ system involvement; receiver operating characteristic (ROC) curve ana lysis was performed in order to assess the performance of IgA/C3 and IgG/IgM ratios in determining patient disease status. Results: Significantly higher levels of erythrocyte sedimentation rate, C-reactive protein, IgA, G, C4, IgA/C3, IgG/IgM ratios (p ¼ .007 for IgA and p < .001 for others) and significantly lower levels of IgM and C3 were observed in patients with active BD (p < .001). The IgG/IgM ratio was significantly higher in patients with vascular involvement (p ¼ .017) and the IgA/C3 ratio was significantly higher in patients with arthritis (p ¼ .007). Cut-off values of 0.019 (70.8% sensitivity, 62% specificity) and 7.08 (84.3% sensitivity, 80% specificity) were determined for IgA/C3 and IgG/IgM ratios, respectively. Conclusion: IgA/C3 and IgG/IgM ratios may be used as additional parameters for the assessment of BD status

Perspectives of dermatology specialists and residents on COVID-19 vaccines: a questionnaire-based survey

AbstractBackground: To evaluate the perspectives of dermatology specialists and residents on coronavirus disease 2019 (COVID-19) vaccines.Methods: Present questionnaire-based study was conducted on dermatology resi dents and specialists between January 5 and 20. A non-validated online questionaryevaluating the attitude of the participants about the COVID-19 vaccine was per formed. In the first step of the study, data related to the demographic features, all par ticipants' clinical characteristics, and working conditions were recorded. Thereafter answers given to 12 specific questions were recorded. The study population was divided into two groups: dermatology residents (n = 138) and specialists (n = 159). Mentioned variables were compared between the two defined groups. Furthermore, a correlation analysis was performed to assess the relationship between vaccination acceptance and various study parameters.Results: Majority of the cases had positive attitudes against COVID-19 vaccines. However, there were significant differences between the resident and specialist groups related to the source of information, working conditions, degree of concern, and type of vaccines. Statistically significant negative, weak correlations were observed for age and duration of medical practice (r = -.128, P = .028; r = -.132, P = .041 respectively). Statistically significant positive weak correlations were observed for chronic diseases, level of knowledge about COVID-19 vaccines, number of information sources about COVİD-19, and previous COVİD-19 infection (r = .133, P = .021; r = .207, P < .001; r= .335, P < .001; r = .176, P = .002 respectively).Conclusion: The acceptance of COVID-19 vaccination may be affected by working conditions, medical experience, level of knowledge and the presence of risk factors for severe disease among dermatology residents and specialists

Abnormal foot angles has an association with ingrown toenail

Background: Onychocryptosis, frequently termed ‘‘ingrown toenail’’ is a common foot problem in routine dermatology and orthopaedic clinical practice which leads to pain and disability. Although the aetiology of ingrown toenail is not well understood various associated risk factors have been identified with the pathogenesis. Material and methods: This study was a retrospective investigation of 170 patients with hallux valgus and lateral border ingrown toenail of all stages. The patients were compared with a control group. The radiologic assessment in both groups included right hallux valgus angle, left hallux valgus angle, right first and second intermetatarsal angle, and left first and second intermetatarsal angle. Results: There were 121 female and 49 male patients in the case group and 68 female and 32 male in the control group. The mean age of the case group was 41.1 years and 41.1 years in the control group. A statistically significant difference was found between the case and the control groups in terms of the right hallux valgus angle variable. Conclusion: The abnormal hallux valgus angle and the abnormal intermetatarsal angle plays an important role in ingrown toenail aetiology. The X-rays of the feet should be performed to determine the susceptibility of the patients who are admitted to the hospital for ingrown toenail in order to prevent other toes ingrown toenail and for planning the treatment of the patients with an ingrown toenail

Efficacy of systemic minoxidil and tofacitinib combination in treatment‐resistant alopecia universalis

Alopecia areata (AA) is an autoimmune nonscarring alopecic disorder, which presents with varying amounts of hair loss, ranging from focal patchy loss to entire scalp and body hair loss. Treatment of AA is a challenging issue within dermatology practice. Although many treatment options are present, response to medications remains un satisfactory, especially in severe and recalcitrant cases. In this study, we present a case of treatment-resistant AU, which was successfully treated by the combination of tofacitinib and oral minoxidil