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INTRODUCTION: Behcet's disease (BD) is a chronic, relapsing, systemic vasculitis of unknown etiology. AIM: To measure serum ghrelin levels in BD patients and healthy controls and to investigate its association with metabolic syndrome (MetS). MATERIAL AND METHODS: Thirty BD patients and 30 healthy individuals were enrolled in the study. Ghrelin levels were measured in blood samples using ELISA. RESULTS: The mean serum ghrelin level in BD patients (28.57 ±14.04) was significantly lower compared to healthy controls (40.72 ±23.21) (p = 0.01). The mean serum ghrelin level in BD patients who had MetS (24.18 ±12.73) was lower compared to BD patients who did not have MetS (30.77 ±14.45), but this difference was not significant (p > 0.05). CONCLUSIONS: Ghrelin levels were lower in BD patients compared to healthy controls. There was no association between reduced ghrelin levels and MetS; however, there was a negative correlation between ghrelin levels and disease activity.

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BACKGROUND: Insulin resistance is found in both psoriasis and Behçet's disease. No study has yet explored whether preptin and amylin, two hormones associated with insulin resistance, are involved in the insulin resistance observed in patients with psoriasis and Behçet's disease. OBJECTIVES: We aimed to explore how the amounts of preptin and amylin change in psoriasis and Behçet's disease and whether they are involved in the etiopathology of these two diseases, by comparing hormone levels in patients and healthy controls. METHODS: The study registered 30 patients with psoriasis, 30 patients with Behçet's disease, and 30 healthy volunteers (as a control group). Fasting blood sugar, triglyceride, LDL, VLDL, HDL, total cholesterol, HbA1c, C-peptide, insulin, and serum preptin and amylin levels were measured in all subjects. RESULTS: Serum preptin and amylin levels were significantly lower in the patients with psoriasis and Behçet's disease than in the control group (P < 0.001, P = 0.004, and P = 0.008, respectively). A comparison of the serum preptin and amylin levels between the patients with psoriasis and Behçet's disease did not reveal a statistically significant difference. Serum insulin level and The homeostasis model assessment of insulin resistance (HOMA-IR) index were significantly lower in the psoriasis patient group relative to the control group (P = 0.02 and P = 0.03, respectively), while the values for the Behçet's disease group did not differ significantly from those for the control group CONCLUSIONS: Serum levels of preptin and amylin were significantly lower in patients with psoriasis and Behçet's disease, indicating that these hormones may be a factor for development of metabolic syndrome in these two diseases.

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Enoxaparin is a low-molecular-weight heparin that has been used widely to prevent and treat thromboembolic disorders for at least 30 years. The most common adverse skin reactions to enoxaparin are ecchymosis and skin necrosis due to vasculitis, urticaria, angioedema and erythema. Side effects from heparin administration are rare and usually located at the injection site. However, recent reports have suggested that they can also occur at a distance from the site of injection. Moreover, the etiopathogenesis has not been fully explained. In this article, we present a case of hemorrhagic bullous dermatosis associated with enoxaparin for the treatment of ischemic heart disease that developed in a patient with a past history of lepromatous leprosy.

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BACKGROUND: Isotretinoin affects the levels of female hormones and ovaries in patients with severe acne. OBJECTIVE: This study evaluated the effects of isotretinoin on the ovarian reserve and levels of female hormones in patients with severe acne. METHODS: Thirty-two female patients with severe acne were enrolled. All the patients were treated with oral isotretinoin 0.5-2 mg/kg/d. The total cumulative dose for a full course was 120-135 mg/kg. The treatment duration ranged from 5 to 8 months. The serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) levels and antral follicle count (AFC) and ovarian volume (OV) were evaluated before and after treatment. RESULTS: After treatment, the mean FSH, LH, and E2 levels were significantly lower than before treatment. In addition, the mean AFC and OV decreased after treatment, although the difference was not significant. CONCLUSION: The results of this exploratory study do not demonstrate that oral isotretinoin has an impact in ovarian function. In contrast, isotretinoin affects levels of female hormones in patients with severe acne.

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BACKGROUND: Behcet's disease (BD) is a chronic, relapsing, systemic vasculitis of unknown etiology. There is an increased predisposition to insulin resistance and metabolic syndrome (MetS) in BD patients. OBJECTIVE: The aim of this study was to determine serum salusin-α and salusin-ß levels in BD patients and healthy controls and to investigate their association with MetS. PATIENTS AND METHODS: Twenty-five BD patients and 25 healthy controls were included in the study. Salusin-α and salusin-ß levels were measured in blood samples using ELISA. In addition, BD patients and healthy controls were evaluated in terms of MetS. RESULTS: The mean serum salusin-α level in BD patients was significantly lower compared to healthy controls (p = 0.03), whereas the mean serum salusin-ß level in BD patients was significantly higher compared to healthy controls (p = 0.03). The mean serum salusin-α level was significantly lower in BD patients with MetS compared to BD patients without MetS (p = 0.04). CONCLUSIONS: Serum salusin-α level (an anti-atherogenic molecule) was lower, while serum salusin-ß level (a pro-atherogenic molecule) was higher in BD patients. We consider that the decrease in salusin-α and the increase in salusin-ß levels contribute to the development of MetS.

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BACKGROUND: Androgens and insulin may contribute to increased sebum production in the pathogenesis of acne vulgaris. OBJECTIVE: We investigated the association between serum desnutrin levels and acne vulgaris in the pathogenesis of insulin resistance. MATERIAL AND METHODS: 25 patients presenting with acne vulgaris and 25 control subjects participated in this study. Fasting blood glucose, triglycerides, LDL, VLDL, HDL, total cholesterol, insulin, C-peptide and thyroid function tests were measured. The homeostasis model assessment of insulin resistance (HOMA-IR) was used to calculate insulin resistance. Desnutrin levels were determined by enzyme-linked immunosorbent assay (ELISA) according to the manufacturer's protocol. RESULTS: Patients with acne vulgaris had a mean serum desnutrin level of (8.83 ± 1.13 µIU/mL), which was statistically significantly lower in the control group (10:58 ± 3.43 µIU/mL). In patients with acne vulgaris the serum glucose levels, insulin levels and HOMA-IR values (87.92 ± 7:46 mg/dL, 11.33 ± 5.93 µIU/mL, 2.49 ± 1.40, respectively) were significantly higher than the control group (77.36 ± 9.83 mg/dL, 5.82 ± 2.68 µIU/mL, 1.11 ± 0.51, respectively) (p = 0.01, p<0.001, p<0.001, p<0.001, respectively). CONCLUSION: Full cohort (patients and controls) evaluation revealed a negative correlation between the serum glucose and desnutrin levels (r = -0.31, p<0.05). A positive correlation was found between insulin and desnutrin levels (r = 0.42, p<0.001). In patients with acne vulgaris, as a result of increased levels of serum glucose and insulin, the function of desnutrin was suppressed, perhaps contributing to insulin resistance.

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OBJECTIVES: To evaluate PSA (Prostate-specific antigen) parameters in patients with lepromatous leprosy (LL). DESIGN: In a retrospective study, 23 male patients with LL were evaluated. PSA parameters (serum total PSA (tPSA), free PSA (fPSA), free-to-total PSA ratio (f/tPSA), PSA Density (PSAD)) were assessed. PSA parameters were compared with a control group. RESULTS: The mean tPSA, fPSA, f/tPSA, prostate volume, and PSAD values of the patient group with LL were 1.87 +/- 0.81 ng/ml, 0.67 +/- 0.29 ng/ml, 0.36 +/- 0.11, 41.08 +/- 23.65 ml and 0.055 +/- 0.037, respectively. The mean tPSA, fPSA, f/tPSA, prostate volume, and PSAD values of the control group were 2.71 +/- 0.91 ng/ml, 0.80 +/- 0.34 ng/ml, 0.30 +/- 0.08, 65.0 +/- 28.73 ml and 0.049 +/- 0.028, respectively. The mean tPSA and prostate volume values were found to be significantly lower in the patient group with LL (p = 0.002 and 0.004, respectively). No significant difference was found between two groups in terms of mean fPSA and PSAD values (p = 0.18 and 0.5, respectively). The mean f/tPSA value was found to be significantly higher in the patient group with LL (p = 0.02). Testes in 16 (69%) patients with LL were bilaterally atrophic. CONCLUSIONS: Serum tPSA values and prostate volumes in the patients with LL were significantly reduced and f/tPSA values were significantly increased. Testicular atrophy in the lepromatous cases might be due to leprosy-related orchitis and associated with a reduction in prostatic volume.

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BACKGROUND: Oral isotretinoin treatment can cause ocular side effects. OBJECTIVE: This study was performed to detect possible toxic effects of oral isotretinoin treatment on the retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL). METHODS: The study population consisted of 54 eyes of 27 patients with nodulocystic acne who used oral isotretinoin (Roaccutane) treatment. Macular GCL and peripapillary RNFL thickness measurements were performed using spectral domain optical coherence tomography (OCT) before and after therapy. RESULTS: Before and after treatment, a complete ophthalmologic examination was normal in all eyes. However, posttreatment lower temporal (TL) values were significantly lower (76.80 ± 16.31) than pretreatment TL values (84.96 ± 24.83) (p  =  .02). There was no statistically significant difference in the other OCT values, upper temporal, superotemporal, superonasal, upper nasal, lower nasal, inferonasal, and inferotemporal (p  =  .35, p  =  .40, p  =  .56, p  =  .95, p  =  .94, p  =  .93, p  =  .61, respectively). Also, there was no statistically significant difference between the right and left eyes and between genders for all parameters (p > .05). CONCLUSION: The use of oral isotretinoin treatment has increased in recent years. In addition, oral isotretinoin treatment has a broad adverse effect potential on the ocular system. The measurement of RNFL thickness, especially TL thickness, by OCT may be useful for detecting the possible toxic effect of oral isotretinoin therapy on RNFL.

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Background. Serum ghrelin levels may be related to metabolic and clinical changes in patients with psoriasis. Objective. This study was performed to determine the possible effects of serum ghrelin in patients with psoriasis. Methods. The study population consisted of 25 patients with plaque psoriasis. The patients were questioned with regard to age, gender, age of onset, duration of disease, height, weight, and body mass index (BMI). In addition, fasting blood sugar, triglyceride, cholesterol levels, insulin, and ghrelin levels were measured. Results. The mean serum ghrelin level was 45.41 ± 22.41 in the psoriasis group and 29.92 ± 14.65 in the healthy control group. Serum ghrelin level was significantly higher in the psoriasis group compared with the controls (P = 0.01). The mean ghrelin level in patients with a lower PASI score was significantly higher than in those with a higher PASI score (P = 0.02). Conclusion. The present study was performed to determine the effects of ghrelin in psoriasis patients. We found a negative correlation between severity of psoriasis and ghrelin level. Larger and especially experimental studies focusing on correlation of immune system-ghrelin levels and severity of psoriasis may be valuable to clarify the etiopathogenesis of the disease.

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INTRODUCTION: One of the main problems in Behçet's disease is the lack of an original laboratory marker that can reflect clinical activity. In this study, laboratory parameters that could be used as indicators of active disease are investigated. MATERIALS AND METHODS: The study included a total of 40 patients with Behçet's disease, 25 of whom were active and 15 inactive, who applied to Firat University, Firat Medical Center Dermatology, Rheumatology, Physiotherapy, and Ophthalmology outpatient clinics and a control group composed of 30 healthy volunteers. Serum neopterin, C-reactive protein (CRP), and sedimentation rate (ESR) levels were determined in all patients and healthy controls. RESULTS: Serum neopterin, CRP, and ESR levels in active Behçet's disease patients were significantly higher than those in both the inactive group and healthy controls (p<0.001). CONCLUSIONS: It was contemplated that together with serum CRP and ESR, neopterin could be a useful laboratory parameter in patients in whom disease activation could not be determined.

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