Objectives: This study aims to evaluate the clinical effects of isotretinoin (13-cis-retinoic acid), a derivative of retinoic acid, on the clinical features of chronic rhinosinusitis. Patients and Methods:The study group included 25 chronic rhinosinusitis patients (16 females, 9 males; mean age 25.2±6.8 years; range 15 to 25 years) who were on isotretinoin for acne treatment, while the control group consisted of 25 chronic rhinosinusitis patients (15 females, 10 males; mean age 25.2±6.8 years; range 15 to 25 years) who were not on isotretinoin treatment. The patients' symptom scores in visual analog scale (VAS), Lanza and Kennedy nasal endoscopic scores and Newman computed tomography (CT) scores were obtained in order to evaluate the their symptom, examination and radiological findings. These patients' symptom and examination results were evaluated first day, week two and at months 3-5 and 6-10. Paranasal sinus CT results were studied first day and at months 6-10. Results:In the group of patients being administered isotretinoin, no significant change in the mean symptom and examination scores was detected during the acute phase (week 2), while there was a significant regression in the longterm (months 3-5 and 6-10). There was a significant regression in the mean CT score after isotretinoin therapy. In the control group no significant change was seen in any of the scores. The number of acute sinusitis attacks were significantly lower in the isotretinoin group than in the control group. No significant difference was found between the two groups in terms of the duration of the healing period of acute sinusitis attacks. Conclusion:We conclude that the long-term administration of isotretinoin has positive effects on the clinical results of chronic rhinosinusitis.
Background Previous studies has shown that dry eye test abnormalities, meibomian gland dysfunction (MGD), may occur in psoriasis. Objectives The authors aimed to evaluate the dry eye disease (DED), MGD, in psoriasis patients with meibography which is a current, objective, noninvasive method for patients with meibomian gland diseases, to investigate the relationship between disease severity and ocular involvement. Methods This study included 50 participants with psoriasis and 50 healthy individuals. All subjects were examined by the same dermatologist and referred for ophthalmological examination including meibomian gland obstruction, lid margin alterations assessment, ocular surface disease index assessment, tear film break-up time test, Schirmer test, corneal conjunctival fluorescein staining assessment. Additionally, upper and lower lids were evaluated for meibomian gland loss with meibography. Results MGD (28%), meibomian gland loss (MGL) (29.5%), upper meiboscore (0.61 ± 0.81), lower meiboscore (0.46 ± 0.61), DED (22%) were significantly higher in the psoriasis group compared with the control group (p = 0.008, p < 0.001, p = 0.027, p = 0.041, p = 0.044, respectively). There was a significant relationship between MGD and psoriasis area severity index (PASI) (p = 0.015, Odds Ratio = 1.211). There was a significant positive relationship between MGL with PASI (p < 0.001, r = 608) and psoriasis duration (p < 0.001, r = 0.547). Study limitations Smaller study group and inability to detect quality changes of meibum with meibography were limitations of the study. Conclusions Psoriasis may affect the meibomian gland morphology, may cause structural changes in meibomian glands, and as a result of these may cause MGD and DED. Therefore, ophthalmologists and dermatologists should be aware of this situation and co-evaluate the patients in this respect.
Introduction: Sunlight is the major source of vitamin D, thus, the use of sunscreens could result in vitamin D insufficiency or deficiency. Objective: We aimed to assess serum vitamin D levels in healthy children aged 0-18 years in the winter and determine the association between sunscreen use and sun protection behaviors on vitamin D status. Methods: The demographic data, clothing style, skin type, history of sunburn, history of visiting seaside towns in summer, sun protection behaviors including sunscreen use, wearing sunglasses and hats, and further detailed information about sunscreen use were recorded. Vitamin D status was assessed by measuring blood levels of 25(OH)D during winter. Results: Three hundred seventy-six children (172 boys and 204 girls) with a mean age of 128.38±56.39 months were enrolled. The mean serum level of 25(OH)D was 15.32±8.64 ng/mL. The mean values of vitamin D were associated with age, sex, traditional clothing style, having a sunburn history, and sunscreen use (p<0.05). Adolescents and girls had vitamin D deficiency and inadequacy more than younger children and boys (p<0.05). Sunscreen use in the adequacy group was lower than in the inadequacy and deficiency groups (p=0.001). There was no significant difference between vitamin D status according to the sunscreen details (SPF, product source, season, and body areas) (p>0.05). Conclusions: Sunscreen use appears to reduce vitamin D levels measured in winter. Children, especially girls and adolescents, should be exposed to sufficient sunlight to maintain normal serum vitamin D levels. Vitamin D supplementation should be given to children, especially during winter.
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