R ecent experimental and clinical studies have demonstrated the negative effects of nicotine on the viability of skin flaps (1-7). Nicotine induces vasoconstriction in peripheral vascular structures, and diminishes gas and nutrient exchange in peripheral tissues (8,9). Ischemia, venous congestion, the development of hematomas and other factors may influence skin flap viability. Necrotic skin flaps can result in significant complications, including delayed wound healing, dehiscence and wound contraction. The distal portions of skin flaps are more prone to necrotic damage. Chronic vasoconstriction can result in pathophysiological changes that impair the perfusion of oxygen into the skin flap. Tissues with absent or limited capillary blood flow will become necrotic over time (5,7,10). Smokers are at an increased risk of developing necrotic damage following skin flap surgery, which may result in additional risk to the patient and necessitate additional complex surgical procedures (11). However, pharmaceutical agents, including sympatholytics, vasodilators, calcium channel

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Amaç: Serum Lipokalin 2 (LCN2) seviyelerinin psoriasiste artmış inflamasyon için bir genel belirteç olduğu bilinmektedir. Bu çalışmada, LCN2'nin psoriatik lezyonlardaki reseptör düzeyini araştırmayı amaçladık. Yöntemler: LCN2 immünohistokimyasal ekspresyonu, 31 psoriasis hastası ve 31 kontrol grubuna ait deri biyopsi örneklerinde araştırılmış ve sonuçlar guruplar arasında karşılaştırılmıştır. Bulgular: Hasta grubunda 19 (%61,3) plak psoriasisli hasta vardı ve bunların tamamında orta ve kuvvetli boyanma şiddetinde üst epidermal tabakada LCN2 immünohistokimyasal ekspresyonu saptanmıştır. Geriye kalan 12 hastada (%38,7) patolojik bulgulara göre, erken evre psoriatik lezyonları olan ve kontrol grubu biyopsilerinde epidermal LCN2 immünohistokimyasal ekspresyonu görülmemiştir. Kıl folliküllerinin iç kök kılıfında, LCN2 immünohistokimyasal ekspresyonu her iki gurupta da görüldü ve ekspresyonlar arasında istatistiksel anlamlı fark bulunamamıştır (p=1,00). Sonuç: Çalışmamızda, plak psoriasisli hastalarda üst epidermiste orta ve kuvvetli boyanma şiddetinde LCN2 immünohistokimyasal ekspresyonu tespit edilmiştir. Fakat kontrol grubu deri biyopsilerinde LCN2 immünohistokimyasal ekspresyonu epidermisde görülmemiştir. Bu bulgular, LCN2'nin psoriasis patogenezindeki önemine işaret edebilir. Öte yandan erken evre psoriatik lezyonları olan hastalarda ekspresyon saptanmaması LCN2'nin psoriasis patogenezinin ileri dönemlerinde etkin olduğunu düşündürmektedir. Objective: Serum Lipocalin 2 (LCN2) levels are a general indicator for increased inflammation in the patients with psoriasis. In this study, we aimed to investigate the receptor levels of LCN2 in psoriatic lesions. Methods: Immunohistochemical expression of LCN2 was investigated in 31 skin biopsy samples of patients with psoriasis and 31 skin biopsies of control group and the results were compared between the groups. Results: Among patient group, 19 patients (61.3%) had plaque psoriasis and in all of these, medium to strong staining intensity of LCN2 immunohistochemical expression was detected in the upper epidermal layer. In remaining 12 patients (38.7%) with pathologically early stage psoriatic lesions and control group epidermal LCN2 immunohistochemical expression was not observed. LCN2 immunohistochemical expression was detected in the inner root sheath of the hair follicles in both groups without any statistically difference (p=1.00). Conclusion:In our study, medium to strong staining of LCN2 receptor was detected in the superficial epidermis of the psoriatic plaques. But LCN2 immunohistochemical staining was not observed in control skin biopsies. These findings may point out the significance of LCN2 in pathogenesis of psoriasis. On the other hand, absence of expression in patients with early psoriatic lesions imply that LCN2 may be active at the later stages of the pathology.