The aim of the present study was to investigate the potential effects of isotretinoin on the biliary system in patients with acne vulgaris receiving isotretinoin therapy. This was a preliminary retrospective study involving 40 patients with severe acne vulgaris who attended the dermatology clinic and were administered different doses (20 or 30 mg/day) of isotretinoin. Serum levels of AST, ALT, ALP, GGT, total bilirubin, direct bilirubin, and indirect bilirubin at the beginning and at the first month of therapy were scanned, recorded, and statistically analyzed. Total and indirect bilirubin levels at the first month of treatment in 30 patients, receiving isotretinoin at a dose of 20 mg/day, were significantly lower compared to the baseline values (p = .02 and p = .03, respectively), whereas AST and GGT serum levels were significantly higher (p = .003 and p = .006 respectively). No significant reduction in total and indirect bilirubin levels was detectable at the first month of treatment in 10 patients receiving isotretinoin at a dose of 30 mg/day; however, AST, ALP, and GGT levels were significantly elevated in these patients (p = .023; p = .004; and p = .001, respectively). To our knowledge, there is no previous study investigating the effects of isotretinoin on the biliary system, and, therefore, the present study is a preliminary one. Our findings implicate that low dose (20 mg/day) isotretinoin therapy can potentially reduce total and indirect bilirubin levels. Long‐term, large‐scale, prospective studies with patients receiving different doses of isotretinoin may provide more reliable information regarding the bilirubin lowering effects of isotretinoin and optimum dosing for achieving this clinical effect.

ÖzAmaç: Bu çalışmayla dermatoloji polikliniğimize başvuran psöriasis hastalarının Tamamlayıcı ve Alternatif Tıp (TAT) yöntemleri hakkındaki bilgi ve yaklaşımları ile psöriasis hastalığının besinlerle olabilecek ilişkisini değerlendirmeyi amaçladık.Gereç ve Yöntem: Çalışmamız Mayıs 2018-Temmuz 2018 tarihleri arasında dermatoloji polikliniğine psöriasis nedeniyle başvuran 111 hasta ile anket çalışması olarak planlandı. Anket soruları hastalarla poliklinik ortamında yüz yüze soru-cevap şeklinde uygulandı.Bulgular: Çalışmamıza gönüllü olarak katılan 111 hastanın 58'i (%52,3) erkek, 53'ü (%47,7) kadın idi. Ankete katılanların 59'u(%53,2) herhangi bir TAT yöntemi kullanmadığını,52'si(%46,8) ise kullandığını bildirdi. Kullanan ve kullanmayanlar arasında cinsiyet, eğitim düzeyi, hastalık süresi, yaşadığı yer açısından istatistiksel olarak anlamlı farklılık saptanmadı. Ancak yaş olarak kullananların yaş ortalamasının kullanmayan gruptan anlamlı olarak düşük olduğu bulundu(t(109)=2.484; p=0.015<0,05). En sık kullanılan TAT yönteminin topikal uygulanılan bitkisel ürünler(%32,4) olduğunu belirledik. En sık kullanılan topikal bitkisel ürün kantoron yağı idi. TAT yöntemlerine en sık başvurma nedeninin yakın çevre (%63,5) olduğunu gözlemledik. %69,2'lik bir oranla sorulmadığı takdirde kullandığı TAT yöntemi ile ilgili doktora bilgi vermediği gözlendi. Hastaların %60,4'ü besinlerle hastalık arasında tespit ettikleri bir etkileşim olmadığından bahsetti.Sonuç: Katılımcıların sıklıkla bitkisel ürünleri tercih ettiği, bunları en sık yakın çevresinden duyduğu, kullandığı takdirde büyük çoğunluğunun bunu doktorundan gizlediği, TAT kullanmayan grubun psöriasis hastalığında daha yüksek olduğu ve besinlerle ilişkinin etyopatogenezde düşük bir olasılık olduğu sonuçlarına vardık.

No abstract

Introduction:  Psoriasis is an inflammatory disease that can cause cardiovascular comorbidities. Some recent studies have indicated that impaired gut microbiota and metabolites may be associated with inflammatory diseases. Objectives: In this study, the relationship between serum trimethylamine n-oxide (TMAO, a gut bacterial metabolite) level and carotid intima-media thickness (CIMT) and disease severity in psoriasis patients was investigated. Methods: Age- and gender-matched 73 patients and 72 healthy controls were included in the study. In both groups serum trimethylamine n-oxide(TMAO), oxidized low- density lipoprotein (ox-LDL), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride, total cholesterol, high-sensitivity C-reactive protein (hs-CRP), creatinine, aspartate aminotransferase (AST) and alanine aminotransferase(ALT) levels were recorded and the carotid intima-media thickness (CIMT) was measured by B-mode ultrasonography by a cardiologist.   Results: TMAO, hs-CRP, oxidized-LDL, triglyceride and CIMT levels were statistically higher in the patient group. HDL levels were statistically higher in the control group. There was no significant difference between the two groups in terms of total cholesterol and LDL-C levels. In partial correlation analyzes in the patient group, positive correlations were observed between TMAO and CIMT, LDL-C and total cholesterol levels. Linear regression analysis showed that TMAO levels positively predicted CIMT levels. Conclusions: This study confirmed that psoriasis is a risk factor for the development of cardiovascular disease and that elevated serum TMAO levels in these patients indicate the presence of intestinal dysbiosis. Furthermore, TMAO levels were found to be a predictor of the risk of developing cardiovascular disease in psoriasis patients.

Background: Infantile eosinophilic pustular folliculitis (I-EPF) is a rare disease characterized by pruritic vesicles and sterile pustules on the erythematous surface of the scalp and facial localization, usually seen in the neonatal period. It is essential to show the presence of dense eosinophils in the diagnosis of pustules. Histopathological examination of the hair follicles by eosinophils infiltration is determined.Aim: Here, we reported a 5-month-old baby boy diagnosed infantile eosinophilic pustular folliculitis. Patient:A 5-month-old baby boy was consulted to our polyclinic by his family because of pustules on the scalp, face, and neck developing in two week after birth. In dermatological examination, the pustular lesions of 1-2 mm in diameter on the scalp, face, and neck on an erythematous background were determined.Results: There was no growth in the culture taken from the pustule. In the laboratory tests of the patient; upon detection of eosinophilia in the hemogram. The eosinophil count at the patient's first admission was 1.48 K/μl. (0.05 0.50). Eosinophil count was 0.02 K/μl after treatment. It was decreased. The patient was evaluated for other pustular dermatoses. In the differential diagnosis of the patient; causing bacterial/nonbacterial pustulosis were included. Bacterial culture was negative. Conclusion: Eosinophilic folliculitis defines as a group of papulopustular diseases with unknown etiology characterized histologically by eosinophilic infiltrates. First, Ofuji reported a female patient with recurrent follicular pustules and peripheral eosinophilia as a variant of folliculitis in 1965. Its etiopathogenesis is not clearly known. In the differential diagnosis of EPF includes the other pustular lesions of the newborn such as erythematoxicum neonatarum, transient neonatal pustular dermatosis, infantile acropustulosis, scabies, dermatophytosis, and langerhans cell histiocytosis. Treatment options includes topical corticosteroids and calcineurin inhibitors, antihistamines, systemic antibacterial and anti-inflammatory agents, and dapson.