Introduction: Topical dapsone has a level A recommendation for the treatment of papulopustular rosacea; however, its treatment efficacy has not been studied previously. The aim of this study is to evaluate the safety and efficacy of topical 7.5% dapsone gel applied once daily at night in the treatment of papulopustular rosacea.
Patients and methods: This is a prospective study including female papulopustular rosacea patients with a minimum IGA score of 2. The patients were recruited at two different outpatient clinics by two independent dermatologists. The patients were prescribed 7.5% dapsone gel (same brand) for once-daily use at night. No other topical or systemic treatment modalities were allowed to be used during the study except for a sun protection factor 50 sunscreen and an emollient face cream. The patients were evaluated with the total lesion counts and IGA scores at weeks 0, 4 and 8 by two independent dermatologists. The side effects of burning, stinging, pain, erythema, and exfoliation were questioned during the follow-up visits.
Results: All 32 recruited patients (18-70) completed the study. The mean lesion counts of the patients were 22.10 ± 8.95 on the initial visit, 11.90 ± 6.49 on the 4th week follow-up and 3.87 ± 3.76 on the 8th week follow up. The mean IGA scores of the patients were 3.06 ± 0.81 on the initial visit, 2.10 ± 0.87 on week 4 and 0.74 ± 0.73 on week 8. The decrease in the mean lesion count and IGA score of the patients in weeks 4 and 8 were statistically significant (p = 0.000 for all). This decrease was independent of the patient's age (p > 0.005). No side effects were reported.
Conclusions: The 7.5% topical formulation of dapsone is effective for papulopustular rosacea both on the first and second months of the treatment regardless of the age of the patient. Its safe side effect profile suits for a comfortable use in rosacea patients with a decreased skin tolerance.
Background: Lipid indices, particularly the triglyceride-glucose index (TyG index) and the triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio, are simple, reliable, non-insulin-based surrogate markers of insulin resistance that have recently gained prominence. The aim of this study was to evaluate the effect of isotretinoin treatment on surrogate markers of insulin resistance, in particular the TyG index, in patients with acne vulgaris (AV).
Materials and methods: This retrospective study reviewed the records of 200 patients who received isotretinoin treatment for acne vulgaris at the Department of Dermatology and Venereology between September 2023 and March 2024. Serum fasting glucose, fasting lipid profile [triglyceride (TG), total cholesterol (TC), very low-density lipoprotein cholesterol (VLDL-C), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C)] and other biochemical parameters were recorded. Triglyceride-glucose (TyG) index value was calculated with the formula Ln [fasting triglyceride (mg/dL) × fasting plasma glucose (mg/dL)/2]. Pre-treatment values were compared with values after 5 months of treatment.
Results: TyG index and TG/HDL, TC/HDL, and LDL/HDL ratios all increased statistically significantly (p < 0.001). In addition, a positive correlation was found between pre- and post-treatment TyG index values and pre- and post-treatment TC/HDL, LDL/HDL and TG/HDL ratio values (p < 0.001). Among lipid measurements, triglycerides, total cholesterol, VLDL-C, LDL-C increased statistically significantly (p < 0.001), while HDL-C decreased statistically significantly (p < 0.05).
Conclusion: The results of this study suggest that isotretinoin treatment may increase insulin resistance in AV patients by increasing surrogate biomarkers of insulin resistance. We also suggest that the TyG index and other lipid indices can be used in treatment follow-up.
Background: Recently, the use of natural products as skin photoprotective agents has been in increasing demand. This study investigated the bioactivity of phycocyanin (PC) extracted from Spirulina sp. on human skin fibroblast cell line (CCD-966SK), specifically focusing on apoptosis, necrosis, anti-inflammatory effects, and enzymatic reactions.
Methods: The first step of this study was cyanobacterial cell culture and the extraction and purification of PC. After that, CCD-966SK cell line was cultivated under normal and UV irradiation. The bioassays included the cytotoxicity measurement, cell viability assay, morphology determination, tumour necrosis factor-α and Interleukin 6 release assays, enzyme activity for superoxide dismutase and glutathione peroxidase as well as malondialdehyde content and the cell-free extract of cyanobacterial stains were assessed.
Results: The cell viability results showed that as the concentration of the PC increased, the viability of CCD-966SK cell line was reduced, which suggested that the effect of PC on the growth of fibroblast cells was dose dependent. The morphological results indicated that presence of PC in the fibroblast cell culture medium led to a transformation in cell morphology from spindle-shaped to spherical. PC released anti-inflammatory IL-6 and TNF-a cytokines, indicating high inflammation resistance. Furthermore, the findings revealed that PC dramatically reduced the release of superoxide dismutase, glutathione peroxidase, and malondialdehyde from inflammatory cells, with the reduction being more apparent at increasing doses.
Conclusions: In conclusion, the results indicated that PC inhibit the CCD-966SK cell line by membrane destructor, which led to the increase the leakage of cell constituent and increase enzymes activities.
Introduction: The effect of isotretinoin on inflammatory markers has been reported with conflicting results. No studies have been reported on the relationship between isotretinoin and lymphocyte/high-density lipoprotein cholesterol [HDL-C] ratio (LHR), neutrophil/HDL-C ratio (NHR), or platelet/HDL-C ratio (PHR) in acne patients.
Objectives: We aimed to investigate how isotretinoin affects the inflammatory markers, including LHR, NHR, and PHR, in acne vulgaris patients.
Methods: A total of 361 patients with moderate-to-severe acne vulgaris who received systemic isotretinoin for at least six months were included. Complete blood count and biochemical analyses, including monocyte/HDL-C ratio (MHR), NHR, LHR, PHR, neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR), the aggregate index of systemic inflammation (AISI), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI), obtained at the treatment onset and the end of the first, third, and sixth months of treatment were investigated.
Results: There was no significant difference in MHR and NHR levels between repeated measures. A significant increasing trend was seen in LHR and PHR (P = 0.001 and P = 0.011, respectively). HDL-C levels gradually and significantly declined during the six months (P < 0.001). Serum NLR, derived NLR, SII, SIRI, MLR, and AISI showed a significant decrease in line with clinical improvement in acne during the six months of therapy (P < 0.05).
Conclusions: Declining levels of NLR, MLR, SII, SIRI, and AISI may indicate the anti-inflammatory effects of isotretinoin on the pilosebaceous unit, whereas increasing levels of LHR and PHR may show systemic inflammatory activity of isotretinoin.
Purpose: To compare the thickness of the retinal nerve fibre layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), and choroid in healthy electronic cigarette smokers and non-smokers using spectral domain optical coherence tomography (SD-OCT).
Material and method: 25 healthy electronic cigarette smokers and 25 age- and gender-matched healthy non-smokers were included in the study. RNFL, GCL, IPL and choroidal thickness were measured by SD-OCT using an automated programme. After normality tests, an independent sample t-test was used to analyse the differences in RNFL, GCL, IPL, and choroidal thickness values between the groups.
Results: The mean age of electronic cigarette smokers and non-smokers was 33.68 and 33.64 years, respectively. The mean smoking history was 6.6 years (range 5-8 years). Most of the participants smoked 2-5 ml of e-liquid per day (52%), while 36% smoked more than 5 ml and 12% smoked less than 2 ml per day. The mean intraocular pressure in the electronic cigarette smoker group was 15.0 mmHg, while the non-smoker group was 15.32 mmHg. The mean axial length in the electronic cigarette smoker group and non-smoker group was 23.36 and 23.63 mm, respectively. No significant difference was observed regarding RNFL, GCL, IPL or choroidal thickness between both groups.
Conclusion: The thickness of the RNFL, GCL, IPL, and choroid was found to be similar in both the healthy electronic cigarette smokers and non-smokers groups.
Purpose: The diversity of skin diseases in patients with malignancies leads to diagnostic difficulties and complicate cancer treatment. Furthermore, the increasing use of chemotherapy drugs and novel treatment regimens raises the risk of the development of various cutaneous side effects and the need for dermatologists during cancer management. We investigated the skin diseases in patients with malignancies and the cutaneous side effects of cancer treatments.
Methods: Medical records of cancer patients evaluated in the Dermatology clinic between July 2018 and April 2023 were retrospectively reviewed.
Results: This study included 872 cancer patients, 374 females and 498 males. Acute myeloid leukaemia was the most common malignancy, followed by multiple myeloma and invasive ductal breast carcinoma. Graft versus host disease was observed in 89 (10.2%) patients after stem cell transplantation and radiodermatitis developed in 16 (1.8%) patients. Maculopapular drug eruption and hand foot syndrome were the most common cutaneous side effects of chemotherapy drugs. Capecitabine was the most common etiologic agent in hand foot syndrome. Cellulitis was the most frequent bacterial infection in cancer patients, whereas herpes zoster was the most frequent viral infection. Among the chemotherapy drugs that caused acneiform drug eruption, cetuximab and cytarabine were notable. Facial erythema was associated with cytarabine use in 27.3% of patients.
Conclusion: Identifying the common skin diseases in cancer patients and cutaneous side effects due to chemotherapy drugs may help to take preventive measures, develop specific and effective treatments, determine the most appropriate cancer treatment options, and increase patients' compliance with cancer treatment.
Antibody-drug conjugates (ADCs) are an emerging field of cancer treatments that are becoming more widespread in their use. However, there are potential ocular toxicities associated with these drugs that ophthalmologists need to be aware of to better maintain ocular health as patients undergo rigorous medical treatment for their conditions. While many ADCs have been approved by the Food and Drug Administration (FDA), many subsequent reports have been published regarding additional ocular side effects these drugs may cause. This review provides ophthalmologists with a practical guide on how to treat ocular toxicities associated with all FDA-approved ADCs to date. The potential pathophysiology of side effects is also discussed.
Objective: In this study, we aimed to compare choroidal vascular changes using the Choroidal Vascularity Index (CVI) between patients with inactive Thyroid Eye Disease (iTED) and healthy individuals, and to assess the relationship between CVI and choroidal thickness (CT), smoking history, and clinical parameters.
Methods: In this cross-sectional observational study, the eyes of 30 patients aged 18 to 45 with iTED were compared with the randomly selected eyes of 35 age and gender-matched healthy control individuals. Optical coherence tomography (OCT) scans were taken from all participants. The images were binarized using the ImageJ software, and the total choroidal area (TCA) and luminal area (LA) were measured. The ratio of the LA to the TCA was used to calculate the CVI. The relationships between these measurement parameters and clinical activity score (CAS), exophthalmometry, smoking status, and other clinical parameters were examined.
Results: In the iTED group, CT and CVI values were significantly higher compared to the control group (p < 0.001, p = 0.029). No significant effect of smoking on choroidal parameters was detected in the iTED group. Additionally, there was no statistical correlation between choroidal parameters and either exophthalmometry or CAS (p > 0.05). In the multivariate regression analysis, it was determined that CT showed a significant relationship with thyroid stimulating immunoglobulin (TSI) (p = 0.003).
Conclusions: This study found that CT and CVI were increased in the eyes of patients with iTED compared to healthy controls. The history of smoking did not appear to have any effect on CT and CVI in iTED patients.
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