No abstract

Background: Metabolic syndrome and insulin resistance may accompany rosacea.Zinc-alpha-2 glycoprotein (ZAG) is an adipokine involved in lipid, glucose, and insulin metabolism and might be associated with metabolic syndrome and insulin resistance. Aims:To investigate the serum ZAG levels, presence of metabolic syndrome, insulin resistance, and the correlation between ZAG levels, rosacea severity, and metabolic syndrome in patients with rosacea.Patients/Methods: Seventy-nine patients with rosacea and 80 healthy volunteers were included. Anthropometric and demographic features, personal and family histories, clinical data, the subtype, severity, and duration of rosacea were recorded.Metabolic syndrome, insulin resistance, and dyslipidemia were evaluated in both groups. Fasting blood sugar, lipid panel, C-reactive protein, sedimentation rate, insulin, and serum ZAG levels were investigated.Results: Frequency of metabolic syndrome, systolic and diastolic blood pressures, and C-reactive protein levels were significantly higher in the rosacea group (p < 0.001 and p = 0.001, respectively). Frequency of dyslipidemia and insulin resistance did not significantly differ between the groups (p = 0.175 and 0.694, respectively). The mean serum ZAG levels were lower in the rosacea group, but no significant difference was evident. In rosacea patients with metabolic syndrome, serum ZAG levels were significantly lower (p = 0.043); however, serum ZAG levels, insulin, and the homeostasis model assessment-estimated insulin resistance values were significantly higher (p = 0.168, 0.013 and 0.001, respectively). Conclusion:Metabolic syndrome, high blood pressure, and high C-reactive protein levels were associated with rosacea indicating chronic systemic inflammation. ZAG levels were associated with metabolic syndrome in patients with rosacea but not associated with rosacea subtype and disease severity.

Psöriyazis hastalığında, psöriyatik plaklarda artış ile stres arasında ilişki olduğu gösterilmiştir. Psöriyazis, ayrıca yüksek aleksitimi düzeyleri ve stres ile de ilişkilidir. Depresyon ve çeşitli psikiyatrik hastalıklarda, ruminasyon ile hem hastalığın başlaması hem de süreğenleşmesi arasında ilişki olduğu bildirilmiştir. Bu çalışmada stresle ilişkili diğer bir faktör olan ruminasyon incelenmiştir. Yöntem: 96 psöriyazis hastası ve 93 sağlıklı kontrol çalışmaya alınmıştır. Katılımcıların tamamına Sosyodemografik Veri Formu, Toronto Aleksitimi Ölçeği, Stresle Başa Çıkma Tarzları Ölçeği, Ruminatif Düşünme Biçimi Ölçeği ve Hastane Anksiyete Depresyon Ölçeği uygulanmıştır. Hasta grubunda, psöriyatik plaklarda son 1 ayda artış olup olmadığı klinisyen tarafından kayıt altına alınmıştır. Bulgular: Hem hasta hem de kontrol grubunda ruminasyon puanları ile aleksitimi puanları (hasta grubu, r=0,47; p<0,01; kontrol grubu, r=0,38; p<0,01) ve çaresiz stresle başa çıkma tarzı puanları (hasta grubu, r=0,56; p<0,01; kontrol grubu, r=0,57; p<0,01) arasında anlamlı ilişki saptanmıştır. Depresyon ve anksiyete puanları kontrol edildiğinde hasta grubunda, ruminasyon puanları ile duyguları tanıma güçlüğü puanları (r=0,42; p<0,01), duyguları ifade güçlüğü puanları (r=0,25; p<0,05) ve çaresiz stresle başa çıkma becerileri puanları (r=0,41; p<0,01) arasında pozitif yönde anlamlı ilişki olduğu görülmüştür. Depresyon ve anksiyete puanları kontrol edildiğinde kontrol grubunda ise ruminasyon düzeyi ile duyguları tanıma güçlüğü puanları (r=0,27; p<0,05) ve çaresiz stresle başa çıkma becerileri puanları (r=0,42; p<0,01) arasında pozitif yönde anlamlı ilişki olduğu görülmüştür. Psöriyatik plaklarda son 1 ayda artış olan ve olmayan hastalar karşılaştırıldığında, ruminasyon puanları (p<0,01), duyguları ifade etmede güçlük puanları (p<0,05) ve toplam aleksitimi puanları (p<0,05) arasında anlamlı fark olduğu saptanmıştır. Sonuç: Psöriyaziste aleksitimi ve pasif stresle başa çıkma tarzlarının ruminasyon ile ilişkisi hastalık seyrini etkiliyor olabilir.

The aim of this study is to investigate the demographic and clinical characteristics of patients receiving biological therapy for psoriasis. All patients who received biological treatment for psoriasis were included in the study. Characteristics of patients and PASI responses' rates were evaluated at 6, 12, 16, 24, 36, and 52 weeks. One hundred and three patients enrolled. Of all, 28 patients were using adalimumab (27.2%), 26 were using secukinumab (25.2%), 22 were using infliximab (21.4%), 22 were using ustekinumab (21.4%), 5 were using ixekizumab (4.9%). PASI75 response rates at sixth and 52nd weeks; were 68.1% and 95% for infliximab, 64.3% and 100% for adalimumab, 77.3% and 100% for ustekinumab, 76.9% and 81.3% for secukinumab, respectively. The most common reason for biologic switching was secondary failure. Treatment failure was the main reason of switching therapies. In our study, no statistically significant difference was found between efficacies of biological drugs. It remains unclear in what order and how exactly biological agent switching should be done. There is a need for large-scale studies on the treatment response rates, and survival times of different biologics.

Background Isotretinoin has various effects on nails. However, the mechanism of how isotretinoin affects the nail plate is unknown. We aimed to investigate the effects of isotretinoin on morphology, growth rate, and thickness of the nail plate. Methods A total of 70 acne vulgaris patients treated with isotretinoin and a control group consisting of 68 healthy volunteers were included in the study. Isotretinoin treatment was started at a dose of 0.5 mg/kg per day. Nail changes were noted; length and thickness of the nail plate were measured in all participants every month. Results The medians of nail growth rates in the isotretinoin and control groups were 3.16 (2.87–3.57) mm/month and 2.89 (2.56–3.19) mm/month, respectively. The medians of nail thickness in the isotretinoin and control groups were 0.47 (0.38–0.53) mm and 0.50 (0.40–0.65) mm, respectively. Statistically significant differences were observed between the groups in terms of nail growth rate and thickness (P < 0.01, P = 0.02, respectively). Nail findings were observed in nine out of 70 patients (12.8%), mostly onychoschizia. Conclusion Isotretinoin gradually increases the nail growth rate and thins the nail plate over time during the course of isotretinoin treatment. Dermatologists prescribing isotretinoin should also consider the nail changes, which may impact the life quality of patients.