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    Analysis of 3702 patients with acne vulgaris and concomitant comorbidities in Turkey: a multi-centered, prospective, controlled study
    (Wiley, 2021) Unal, Emine; Karadag, Ayse Serap; Akturk, Aysun Sikar; Namdar, Nazli Dizen; Kelekci, Kiymet Handan; Aksoy, Berna; Balta, Ilknur
    Background Acne vulgaris is a chronic inflammatory skin disease that affects the pilosebaceous unit. Although it is considered to be a skin-limited disease, different clinical studies have recently been published in which the disease is accompanied by systemic symptoms. In this study, systemic comorbidities accompanying acne vulgaris and the relationship between existing comorbidities and disease severity are investigated. Methods This prospective multicenter study was conducted by the Turkish Society of Dermatology Acne Study Group. Twelve dermatology clinics and 14 clinicians throughout Turkey participated in the study. A structured physician-administered questionnaire was used to collect patient demographics, clinical findings, and lifestyle data. Physicians recorded each participant's medical history, including current and past comorbidities, duration of any comorbidity, smoking, and drinking. Body mass index (BMI) was calculated. Results There were 3022 patients in the adolescent acne group and 897 in the control group. The incidence of nonmigraine headache in adolescents with acne was significantly higher than in the nonacne group (P = 0.019). There were 680 patients in the postadolescent acne group and 545 in the control group. In the postadolescent group, incidence of metabolic disease was lower than the control group (P = 0.003). In the postadolescent group, premenstrual syndrome (P < 0.001) and PCOS (P = 0.007) were more common than the control group. Conclusions In this study, we observed that acne vulgaris does not cause systemic comorbidities. There is also a need for new studies involving a large number of patients to illuminate systemic diseases accompanying acne vulgaris.
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    Introduction of a novel quantitative scoring system for acanthosis nigricans and its validation in a pilot study
    (Wiley, 2020) Karadag, Ayse Serap; Uzuncakmak, Tugba Kevser; Ozlu, Emin; Takir, Mumtaz; Karadag, Remzi; Kostek, Osman; Chen, WenChieh
    Inconsistent data exist regarding the diagnostic value of acanthosis nigricans (AN) or skin tags as clinical markers for obesity or diabetes. In an outpatient department-based prospective study, we designed a scoring for AN severity (SCANS) to evaluate AN and skin tags, their correlation with obesity or diabetes. Quantification of AN in six anatomic sites, in consideration of the affected skin surface areas, texture changes, number of skin tags, leads to a total severity score between 0 and 46. Among 336 adult patients (aged >= 18 years) with AN, a higher BMI was associated with AN (r = 0.299, P < .001), but not with diabetes (P = .43), as compared with 243 age- and sex-matched controls without AN. Among nondiabetics, AN scores were significantly correlated with waist circumference (r = 0.131, P = .024) and total cholesterol levels (r = 0.155, P = .04). Skin tags alone in the absence of AN were not associated with obesity (P = .333) or diabetes (P = .164). The total AN scores were positively correlated with the presence of skin tags (r = 0.132, P < .001), and the involvement of anterior neck (r = 0.668, P < .001) and axilla (r = 0.793, P < .001). Knuckles and groins were unaffected in our series. Our results indicate that combination of AN with skin tags can be used as clinical marker for obesity, but not for diabetes. Large-scale studies on patients of different ethnic background are required to further validate our proposed scoring.
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    A Psoralen and Ultraviolet A?Aggravated Dermatosis: Grover’s Disease
    (2020) Ozlu, Emin; Karadag, Ayse Serap; Uzuncakmak, Tugba Kevser; Ozkanlı, Seyma; Erdem, Aysegul; Akdeniz, Necmettin
    Grover’s disease (GD) is an acquired dermatosis called transient acantholytic dermatosis. The exact cause is unknown, but the factors blamed for the etiology include ultraviolet (UV), sweating, temperature rise, radiation, medications, and malignancies. Topical corticosteroids, topical retinoids, and topical calcipotriol are usually sufficient for treatment, and systemic retinoids, systemic steroids, phototherapy, and methotrexate are rarely used. The current report describes the case of GD in a female patient, which was aggravated by the psoralen and UVA phototherapy.
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    Tissue expression of glutathione S transferase isoenzymes in vitiligo
    (Taylor & Francis Ltd, 2021) Uzuncakmak, Tugba Kevser; Ozkanli, Seyma; Kocdogan, Arzu Kaya; Oguztuzun, Serpil; Karadag, Ayse Serap; Ozlu, Emin; Akdeniz, Necmettin
    The association of glutathione S-transferase (GST) enzymes with vitiligo is inconclusive. To evaluate tissue expressions of GST isoenzymes in vitiligo patients and to compare these expressions with healthy controls, we used 26 active depigmented patches on the trunk of vitiligo patients and 20 healthy sex and age matched controls. Punch biopsies were taken from the lesioned or normal skin. Tissue expression of GST isoenzymes were analyzed immunohistochemically. Tissue expression of GSTT1, GSTA1 and GSTP1 was significantly higher in the patient group than controls. Tissue expression of GSTM1 was not significantly different between the two groups. The increased tissue expression of GSTT1, GSTA1 and GSTP1 may represent a response to excess free radical formation in vitiligo and may support the role of oxidative stress in the pathogenesis of vitiligo.