Recurrent aphthous ulceration (RAU) is a common oral mucosal disorder characterized by recurrent, painful oral aphthae. Although the exact cause of RAU is not known, local trauma, microorganisms, nutritional deficiencies, hormonal changes, genetics, and immunological factors have been suggested to contribute to its pathogenesis. The aim of this study was to assess the level of lipid peroxidation and status of antioxidant vitamins in patients with RAU. Thirty patients with RAU and 20 healthy controls were recruited. Vitamins A, E, and C and malondialdehyde (MDA) levels were measured in both serum and saliva of patients with RAU and control subjects by high performance liquid chromatography. Levels of vitamins A, E and C in both fluids were significantly lower (p < 0.05 for vitamins A and E, and p < 0.005 for vitamin C, respectively) in patients with RAU than in healthy control subjects. Conversely, the levels of MDA in serum and saliva were significantly higher (p < 0.005) in patients with RAU than in the control group. Furthermore, strong and highly significant correlation was found between serum and salivary levels of vitamins A, E and C, and MDA in patients with RAU (r 0.90, p < 0.0001). The present study demonstrates that the serum and saliva levels of selected antioxidant vitamins are lower, while the degree of lipid peroxidation, as judged by the MDA levels, is higher in patients with RAU than in the control subjects. This is the first to measure specific antioxidant levels in both saliva and blood in the same patients, and indicates that the non-enzymatic anti-oxidant ability is impaired in patients with RAU. recurrent aphthous ulceration; antioxidant vitamins; MDA; nonenzymatic defense system; saliva

Background:The clinical features, therapy and outcome of anthrax cases from the Elazig province (the eastern Anatolian region) of Turkey seen in our clinic over an 8-year period were reviewed. Patients and Methods: The records of 25 anthrax cases observed in our clinic during the period January 1994 to April 2002 were examined. Results: All cases were cutaneous; 18 (72%) patients exhibited malignant pustules and seven (28%) malignant edema. Three of the patients with a malignant pustule developed anthrax sepsis when admitted to our clinic. All cases were treated with penicillin. One patient who had penicillin allergy was treated with ciprofloxacin. In addition, patients with malignant edema were also treated with systemic corticosteroids (methylprednisolone or dexamethasone). Two patients died due to anthrax sepsis; one case with anthrax sepsis recovered. The mortality rate was 8%. Discussion: Anthrax is still a reality in Turkey. Cutaneous anthrax should be considered in any patient with a painless ulcer with vesicles, edema and a history of exposure to animals or animal products. In our series, penicillin and ciprofloxacin were effective in treatment of anthrax. Our anthrax sepsis case demonstrates that anthrax sepsis is not always fatal if antibiotic treatment is given early after diagnosis.

Objective: Alopecia areata (AA) is a disease characterized by patchy hair loss. Although the etiopathogenesis of AA is still unclear, it has been hypothesized that immune system dysfunction and stress are involved. The aim of this study was to evaluate possible associations between AA and depression, anxiety and serum levels of cytokines interleukin (IL)-1β, IL-6, IL-8 and IL-10. Materials and Methods:Forty-three patients who were diagnosed with AA were prospectively enrolled into the study. Thirty age-and sex-matched healthy individuals were included as the control group. The Hamilton Rating Scale for Depression and the Hamilton Rating Scale for Anxiety were used. For children between the ages of 7 and 16, the Children's Depression Inventories was completed. Serum levels of the cytokines IL-1 β, IL-6, IL-8, and IL-10 were analyzed by ELISA.Results: No significant differences were observed between patients and controls with respect to serum cytokine levels (p>0.05). Depression rates were found to be 50% and 30% in AA patients and controls, respectively (p<0.05). Similarly, anxiety rates were found to be 63% and 23.3% in AA patients and controls, respectively (p<0.05). Conclusion:Depression and anxiety were found more frequent in AA patients than healthy individuals. Therefore, when considering management therapy, an entire psychiatric evaluation should also be performed. However, no differences were found in serum cytokine levels of patients and controls.

These findings demonstrate that the sudomotor activity controlled by the sympathetic nervous system, as well as unmyelinated fibres that play a role in this activity are affected in patients with AD. We think that the involvement of sudomotor activity may be one of the causes that leads to dysfunction in sweat glands and skin dryness.

Granulomatous cheilitis (GC) is a chronic edema which frequently affects the upper lip due to granulomatous inflammation. Its etiology is currently unknown. This rare disease is generally accompanied by Melkersson-Rosenthal syndrome (MRS), characterized by scrotal tongue, orofacial edema and facial paralysis. However, it is also known to develop only with orofacial edema. Granulomatous cheilitis is a difficult disease to treat because of recurrences. There are contradictory reports about the results of treatment without surgical intervention and the rates of recurrence. Our case was a 57-year-old female patient who was characterized by orofacial edema only. The edema and erythema had persisted for 1 year before admission. In the present case, application of intralesional corticosteroid treatment as a total of three injections over 3 consecutive months (one injection per month) and the accompanying metronidazole treatment brought about successful results. No recurrence was observed in the follow-up.

IntroductionHistological changes of psoriasis include invasion of neutrophils into the epidermis and formation of Munro abscesses in the epidermis. Neutrophils are the predominant white blood cells in circulation when stimulated; they discharge the abundant myeloperoxidase (MPO) enzyme that uses hydrogen peroxide to oxidize chloride for killing ingested bacteria.AimTo investigate the contribution of neutrophils to the pathogenesis of psoriasis at the blood and tissue levels through inducible nitric oxide synthase (iNOS) and MPO.Material and methodsA total of 50 adult patients with a chronic plaque form of psoriasis and 25 healthy controls were enrolled to this study. Serum MPO and iNOS levels were measured using ELISA method. Two biopsy specimens were taken in each patient from the center of the lesion and uninvolved skin. Immunohistochemistry was performed for MPO and iNOS on both normal and psoriasis vulgaris biopsies.ResultsWhile a significant difference between serum myeloperoxidase levels were detected, a similar statistical difference between participants in the serum iNOS levels was not found. In immunohistochemistry, intensely stained leukocytes with MPO and intensely staining with iNOS in psoriatic skin was observed.ConclusionsNeutrophils in psoriasis lesions are actively producing MPO and this indirectly triggers the synthesis of iNOS. Targeting of MPO or synthesis of MPO in the lesion area may contribute to development of a new treatment option.

Sporotrichosis is rare in Turkey. We report a 40-year-old woman who had subcutaneous sporotrichosis caused by sporothrix schenckii that was successfully treated with terbinafine (250 mg, twice a day) for a period of 6 months. She received a saturated solution of potassium iodide orally for two months. Terbinafine and potassium iodide are suggested to be the agents of choice for treatment of subcutaneous sporotrichosis.

Aim To investigate, retrospectively, psychiatric consultation results of inpatients staying in Fırat University Dermatology Clinic. Materials and method Records of 520 inpatients who were treated in Fırat University Dermatology Clinic between May 2000 and May 2003 were examined and their psychiatric consultation reports were retrospectively evaluated. Results Of the 520 patients who were included in the study, 272 were female and 248 were male. Ninety-two patients were asked to have psychiatric consultation and when consultation results of these patients were examined it was seen that 67 of them (61.7%) were given a psychiatric diagnosis. Of the 67 patients who were given a psychiatric diagnosis, 34 (50.7%) were female and 33 (49.3%) were male. Mean age of the patients was 39.4 (the youngest being 24 and the oldest 63). It was established that 35.9% of patients (24 individuals) were diagnosed as depressive disorder, 29.8% (20 individuals) as anxiety disorder, 13.4% (nine individuals) as mixed depressive anxiety disorder, 13.4% (nine individuals) as borderline personality disorder and 7.5% (five individuals) as obsessive-compulsive disorder, and that psychiatric treatment was started in 91% of patients. Dermatological diagnoses of patients who were given psychiatric diagnoses were as follows in order of frequency: psoriasis in 22 patients (32.9%), urticaria in 31 patients (46.2%), prurigo nodularis in five patients (7.4%) and others in nine patients (13.5%), respectively. Conclusions Dermatological diseases and psychiatric disorders frequently go together. Psychiatric treatment was started in a high number of patients who were given psychiatric diagnoses and had dermatological problems in the present study. Referring patients with chronic dermatological problems to the psychiatry clinic with a view to supporting their dermatological treatments, we believe, will increase the success rate of dermatosis treatment.