Melkersson-Rosenthal syndrome (MRS) is a rare, non-caseating chronic granulamatous neurocutaneous disease. MRS is frequently seen at the second or third decades of life. Classic triad was comprised of the recurrent facial nerve paralysis, orofacial edema and fissured dorsal tongue (lingua plicata). It is seen in 8-25% of the cases. The most important differential diagnosis of MRS is angioedema. Here we present two cases with MRS from our clinic. The first one is an example for the classic triad and the histopathological appearance is consistent with granulomatous cheilitis. The second case has an nonspesific histopathologic examination and was diagnosed clinically.

Behçet's disease (BD) is a chronic inflammatory disease. The etiopathogenesis of BD is not well understood and several cytokines and genetic factors have been investigated. Interleukin (IL)-37, which a member of IL-1 family is an anti-inflammatory cytokine. The aim of the study was to analyze serum IL-37 level and IL-37 gene polymorphisms to assess its possible role in BD. Two hundred twenty-three patients with BD and 80 healthy controls (HC) were enrolled. Serum IL-37 level was measured using an enzyme-linked immunosorbent assay (ELISA). Deoksiribo Nucleic acids (DNA) were extracted using a genomic DNA isolation kit. Single nucleotide polymorphism (SNP) of IL-37 gene (rs3811047) was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR/RFLP) methods. Serum IL-37 level was not significantly different in BD and HC (p > 0.05). Serum IL-37 level was not associated with the disease activity (p > 0.05). However, its level was higher in mucocutaneous involvement compared with systemic involvement (p = 0.002) and HC (p = 0.005). IL-37 gene polymorphisms were similar in BD and HC (p > 0.05). IL-37 may play a role in the etiopathogenesis of BD by contributing to manifestation with more moderate clinical symptoms.

We herein describe a new severe asthma endotype in connection with CSS. We suggest that physicians who deal with uncontrolled severe asthma cases should consider CSS in the presence of nasal polyps, aspirin hypersensitivity, and especially peripheral blood eosinophilia over 10%.

ÖZGiriş: Soğuk ürtikeri nadir görülen bir fiziksel ürtiker alt tipidir. Çalışmada soğuk ürtikerli hastaların özelliklerini, buz testinde provokasyon süresini uzatmanın testin tanısal değeri üzerindeki etkisini araştırmayı amaçladık. Gereç ve Yöntem:Merkezimizde son üç yıl içinde soğuk ürti-keri tanısı almış 29 hasta retrospektif olarak çalışmaya alındı. Hastaların demografik verileri, hastalık ile ilgili klinik özellikleri ve mevcut test sonuçları toplandı. Tüm olgularda buz testi uygulandı. Merkezimizde standart buz testi sırasında stimülasyon süresi 5 dakika olarak uygulanmaktaydı ve testin negatif bulunması durumunda kademeli olarak önce 10 dakikaya, ardından 20 dakikaya çıkarılmaktaydı. Buz testinde stimülasyon süresinin 20 dakikaya çıkarılmasının testin tanısal değeri üzerindeki etkisini araştırmak amacıyla kronik ürtikeri olan ancak soğuk ile tetiklenme tariflemeyen 20 hastaya stimülasyon süresi 20 dakika olacak şekilde buz testi uygulandı. Bulgular: Çalışmaya soğuk ürtikeri tanısı konan 29 hasta (K/E: 20/9, medyan (min-maks) yaş: 37 (17-57)) alındı. Hastaların hiçbirinde ilişkili olabilecek başka bir hastalık ya da neden saptanmadığından tüm hastalar idyopatik soğuk ürtikeri olarak sınıflandı. Atopi sıklığı %48.0 bulundu. Üç hastada (%10.3) lokalize soğuk ürtikeri saptandı. Sistemik reaksiyonların sıklığı %48.3 (14/29), anafilaksi sıklığı ise %10.3 (3/29) idi. Hastaların %41.4'ünde (12/29) ek olarak diğer ürtiker formları (en sık kronik spontan ürtiker ve semptomatik dermografizm) mevcuttu. Buz testinin duyarlılığı stimülasyon süresi 5 dakika olarak uygulandığında %58.6, stimülasyon süresi kademeli olarak 20 dakikaya uzatıldığında %69.0 bulundu. Kontrol olguların hiçbirinde stimülasyon süresi 20 dakika olacak şekilde uygulanan buz testinde pozitiflik saptanmadı. ABSTRACTObjective: Cold urticaria is an uncommon type of physical urticaria. We aimed to characterize the features of patients with cold urticaria, and to investigate the effect of increasing stimulation time on the diagnostic value of the ice cube test. Materials and Methods:Twenty-nine patients diagnosed with cold urticaria in the past three years were retrospectively included. Demographic and clinical data were collected. The ice cube test was performed in all patients. During the standard ice cube test procedure the stimulation time was five minutes, and if the result was negative it was gradually increased to ten and twenty minutes. To investigate the effect of increasing the stimulation time to twenty minutes on the diagnostic value, the test was performed in twenty patients with chronic urticaria in whom cold was not a triggering factor.Results: Twenty-nine patients (F/M: 20/9, median (min-max) age:37 (17-57)) with cold urticaria were included. No secondary causes were identified. The rate of atopy was 48.0%. Three patients (10.3%) had localised cold urticaria. The frequency of systemic reactions and anaphylaxis was 48.0% and 10.3%, respectively. Twelve patients (41.4%) also had other types of urticaria, most commonly chronic spontaneous ur...