Objective Adherence is a problem in the topical treatment of acne. This study was designed to evaluate the efficiency of current topical treatment and adherence in patients. Methods Patients with acne vulgaris who had recently been prescribed a topical therapy were selected. A dermatologist-directed questionnaire was completed. Demographic data, acne severity, treatment and the manner of use, side effects, and reason for discontinuation were recorded. Results A total 250 patients were included, 178 female (71.2%) and 72 male (28.8%) participants, mean age was 18.6 ± 2.8 years. Of 250 patients, 114 (45.6%) had given up therapy for two reasons: unresponsiveness in 71 (62.3%) and side effects in 43 (37.7%) patients. For antibacterial treatments, the rate of unresponsiveness was higher but the rate of side effects was lower. Discontinuation owing to unresponsiveness was higher in patients with severe acne. Side effects were higher in patients with comedonal-type acne. The lowest rates of side effects and discontinuation were among every-other-night users. Conclusion In this study, patients with acne gave up treatment owing to side effects and unresponsiveness, which reduced the treatment efficiency.
As osteoporosis has multifactorial etiology, psoriasis may be among the triggering or facilitating factors for osteoporosis particularly in psoriatic women via several mechanisms such as low blood level of vitamin D and increased inflammation.
IntroductionThere are a few studies showing an increased risk of insulin resistance, metabolic syndrome, and oxidative stress in patients with vitiligo.AimTo investigate whether systemic inflammation is increased in vitiligo patients in a case-control study design.Material and methodsNonsegmental vitiligo patients who had been followed at the outpatient dermatology clinic of a university-affiliated teaching hospital, and healthy controls were enrolled in the study. Patients who were receiving systemic treatments and having a systemic disease such as diabetes mellitus and thyroiditis were excluded. Demographic features were recorded and peripheral blood samples were taken from all participants to study serum whole blood count, creatinine, and C-reactive protein (CRP).ResultsFifty patients with localized vitiligo, 43 patients with generalized vitiligo, and 50 healthy volunteers were enrolled in the study. Neutrophil to lymphocyte ratio and serum CRP levels were significantly higher in patients who have generalized vitiligo than those with localized vitiligo and healthy controls. However, there was no significant difference regarding neutrophil to lymphocyte ratio (NLR) and CRP between localized vitiligo and control groups.ConclusionsPatients with generalized vitiligo seem to have increased systemic inflammation compared with localized vitiligo and control subjects in our cohort. To the best of our knowledge, this is the first study in the literature showing increased NLR values in generalized vitiligo patients. Further studies with cardiovascular disease markers are required to elicit this association better.
Patients with psoriasis have increased systemic inflammation and serum uric acid (SUA) levels compared with the general population. However, the role of SUA in modulating inflammation in these patients is not known. We evaluated the associations of SUA with inflammation and psoriasis severity; 199 patients with psoriasis and 54 healthy volunteers were included in the study. Demographic features, Psoriasis Area and Severity Index (PASI) scores, and laboratory data including SUA, C-reactive protein (CRP), and neutrophil to lymphocyte ratio (NLR) were collected. Patients with psoriasis had higher fasting blood glucose, body mass index (BMI), CRP, SUA, white blood cell (WBC) count, neutrophil count, and NLR compared with controls. The PASI score positively correlated only with CRP ( r = .185, P = .012) and NLR ( r = .313, P < .001). The BMI, WBC count, PASI score, and CRP, but not SUA, appeared as independent associates of NLR in patients with psoriasis in linear regression analysis. Neutrophil to lymphocyte ratio and SUA were significantly increased in patients with psoriasis compared with controls. Neutrophil to lymphocyte ratio and CRP were independent predictors of PASI score, whereas SUA was not. Serum uric acid seemed not to modulate the inflammation seen in patients with psoriasis in our cohort.
In patients with vitiligo, the clinical and laboratory features of the disease may vary according to time of onset. This is addressed in the literature by only a few studies with conflicting results. The aim of this study was to determine the demographic and clinical features of patients with non-segmental vitiligo and to establish the association between vitiligo and autoimmune diseases with a focus on time of disease onset. A total of 224 vitiligo patients for whom complete medical records were available were evaluated retrospectively. Demographic data, scores on the Vitiligo Area Score Index (VASI), clinical features, vitiligo disease activity, repigmentation status, presence of any accompanying autoimmune disease, antinuclear antibody (ANA) titers, serum levels of glucose, thyroid-stimulating hormone (TSH), thyroxine (T4) hormone, anti-thyroid peroxidase (anti-TPO), and anti-thyroglobulin (anti-TG) were recorded. The prevalence of halo nevi was significantly higher (P < 0.001) among children than in other patient groups. The prevalence of leukotrichia was higher in adults with adult-onset disease than in either pediatric patients or adults with childhood-onset disease (P = 0.002). Both anti-TG and anti-TPO levels were significantly higher in adults with adult-onset disease than in pediatric patients and adult patients with childhood-onset disease. The prevalence of autoimmune disease was 22.2%. Anti-TG levels were significantly higher in patients with treatment-related repigmentation than in those without repigmentation. This study shows that clinical features and associations with autoimmune disease may vary according to the age of onset of vitiligo.
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