Objective: The main purpose of this research was to crosscheck sleep quality in patients with psoriasis with that in healthy individuals and to evaluate a possible relationship between sleep quality and disease severity in these patients. Materials and Methods:Fifty-eight patients with plaque psoriasis and 58 age-and gender-matched healthy individuals were included. The Psoriasis Area and Severity Index (PASI) scoring method was used to assess the disease severity in patients with psoriasis. The sleep quality of the participants was evaluated by the Pittsburgh Sleep Quality Index (PSQI). The sleep quality scores of the patients with psoriasis were compared to those of healthy controls. Pearson' s correlation test and independent samples t-test and were used to interpret the data.Results: The mean disease duration was 11.1±7.4 years (mean±standard deviation), and the mean PASI was 14.1±5.3. In total, 60% of the patients with psoriasis (n=35) experienced poor sleep quality, and this frequency was considerably higher in the patients with psoriasis than in the healthy controls (p<0.000). Further, the mean PSQI in the patients with psoriasis (7.01±41.4) was higher than that in the healthy controls (4.18±2.76, p=0.000). The scores of daytime dysfunction, habitual sleep efficiency, and subjective sleep quality, which are the three components of sleep quality, were considerably higher in the patients with psoriasis than in the healthy controls (p=0.007, p=0.032, and p=0.034, respectively). Conclusion:Our results showing impaired sleep quality and its association with disease severity in patients with psoriasis may contribute to the management of psoriasis.Keywords: Psoriasis, sleep quality, psoriasis severity ÖZ Amaç: Sağlıklı kontrollerle, psöriazis hastalarında uyku kalitesini karşılaştırmak ve uyku kalitesi ve bu hastalarda hastalık şiddeti arasında olası bir ilişkiyi değerlendirmekti.Gereç ve Yöntem: Psöriazis hastalığı olan elli sekiz hasta yaş ve cinsiyet uyumlu 58 sağlıklı kontrol bu çalışmaya dahil edildi. Psöriazis alan ve şiddet indeksi (PASİ) hastalığın şiddetini değerlendirmek için kullanıldı. Katılımcıla-rın uyku kalitesi 'Pittsburgh uyku kalite indeksi' ile değerlendirildi. Psöriazis hastalığı olan hastaların uyku kalitesi puanları sağlıklı kontrol ile karşılaştırıldı. Bağımsız t testi ve Pearson korelasyon testi istatistiki değerlendirme için kullanıldı.Bulgular: Ortalama hastalık süresi 11,1±7,4 yıl (ortalama±standart sapma) ve ortalama PASI 14,1±5,3 olarak değerlendirildi. Psöriazis hastalarının %60'ında (n=35) uyku kalitesi düşüktü ve bu sıklık hastalarda sağlık-lı kontrollere göre anlamlı derecede yüksekti (p<0,000). Aynı zamanda hastalar için ortalama PSQI skoru (7,01±41,4) sağlıklı kontrollerden daha yüksekti (4,18±2,76; p=0,000). Uyku kalitesinin üç bileşeninin skorları; subjektif uyku kalitesi, alışılagelmiş uyku etkinliği ve günlük disfonksiyonu, psöriazisli hastalarda sağlıklı kontrollere göre anlamlı derecede yüksekti (sırasıyla p=0,034, p=0,032 ve p=0,007).Sonuç: Sonuç olarak, Psöriazi...
Behçet's disease (BD) is a chronic disorder characterized by mucocutaneous and multisystem manifestations. Fibromyalgia (FM) is characterized by widespread musculoskeletal pain and may be present concomitantly with several rheumatic diseases. Our aims were to investigate the prevalence of FM in patients with BD and to evaluate the possible relation of FM presence with BD disease activity. A total of 104 Behcet patients were included in this study. Age, sex, disease durations and the BD Current Activity Form (BDCAF) scores as disease activity evaluation were recorded. Presence of FM and the Fibromyalgia Impact Questionnaire (FIQ) scores was investigated. Also, ESR and CRP concentrations were determined in all patients. Mann-Whitney U test and Pearson's correlation tests were used for the statistical analysis. There were 60 female and 40 male patients with an age range of 19-51 years. Eighteen of 100 BD patients were diagnosed as FM. Although ages, disease duration and laboratory parameters did not differ between BD patients with and without FM, BD patients with FM were more frequently female (p < 0.000). The presence of FM did not differ significantly between patients with and without systemic manifestations. Also, oral-genital ulcers, erythema nodosum, thrombophlebitis, pustular lesions and doctor's impression of disease activity scores were not found to be different in BD patients with or without FM. However, there were significant differences in fatigue, headache, arthralgia and patient impression of disease activity (today and last 28 days) between these groups (p < 0.000; p < 0.01; p < 0.01; p = 0.021 and p = 0.027, respectively). Also, there were significant correlations between BDCAF and FIQ items that refer pain and fatigue (p < 0.01). FM is a common and important clinical problem that may represent an additional factor that worsens pain and physical limitations in patients with BD. The higher prevalence of FM in patients with BD seems to be affected by BD itself, rather than its severity.
Disease activity may be questioned as a possible related factor to depression in patients with rheumatoid arthritis (RA) and Behcet disease (BD). Our aims were to determine and compare the depression levels of patients with RA and BD and to investigate a possible association between disease activity and depression scores of the patients. A total of 30 RA and 30 BD patients were included in this study. In RA patients; pain, morning stiffness duration, systemic involvement, tender-swollen joints, the physician-patient global assessments and DAS28 scores were determined. In patients with BD, the BD Current Activity Form was assessed for disease activity. Beck depression inventory (BDI) was used for the evaluation of patient groups. BDI score above 13 was considered as cut-off point for depression. Pearson's correlation and Mann-Whitney U tests were used for statistical analysis. In RA patients, in spite of no correlation between disease activity and depression, a significant correlation between BDI scores and pain was determined (p < 0.000; r = 0.615). In BD group; positive correlations between BDI scores and patient's impression of disease activity and arthralgia were determined (p < 0.014 and p < 0.001, respectively). Number of BD patients with higher BDI scores than cut-off point was significantly more than those in RA group (p < 0.039). Pain in RA patients, and patient's impression of disease activity and joint involvement in BD patients were found as related factors to the depression scores. The greater ratio of BD patients with higher depression score than those in RA indicates the need for increased awareness of depressive symptoms in patients with BD.
IU/L) levels were observed (Fig. 1d). Based on the patient's clinical course, in which no treatments other than the scabies treatment were introduced, the improvement of his skin symptoms and reductions in his serum TARC and IgE levels were considered to have been due to the scabies treatment. There are two common subtypes of scabies: classic and crusted scabies. 1,5 The skin manifestations of classic scabies include burrows and erythematous papules/nodules. Severe and persistent pruritus is a hallmark of scabies. 6 Hashimoto et al. 6 reported that Th2 immunity predominates in human ordinary scabies lesions and is accompanied by the massive infiltration of interleukin (IL)-31 (+) M2 macrophages and epidermal expression of thymic stromal lymphopoietin and periostin (TSLP). Eosinophils are one of the first cell types attracted to tissue sites affected by localized allergic inflammation, and they secrete Th2-inducing cytokines (IL-4 and IL-13), which affect resident dendritic cells (DCs), enhancing DC activation and promoting a Th2-inducing phenotype. 7,8 In our case, a histological examination revealed the massive infiltration of eosinophils and indicated that Th2 immunity was involved in upregulating the patient's serum TARC levels. Interestingly, his serum TARC levels decreased more markedly than his serum IgE levels after treatment. Serum TARC levels might reflect treatment efficacy more closely than serum IgE levels and, hence, could be considered as a potential biomarker. Further, as scabies is frequently misdiagnosed as AD or PN and treated with topical corticosteroids, which masks the condition, elevated serum TARC levels could further delay diagnosis. Thus, clinicians must consider scabies when examining patients with pruritic nodules who exhibit elevated serum TARC levels, and the serum TARC level might be a useful marker of the efficacy of treatments for scabies. Acknowledgement The patients in this manuscript have given written informed consent to publication of their case details.
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