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Background: Pyoderma Gangrenosum (PG) is a chronic disease characterized by recalcitrant skin ulcers., Objective: We aimed to evaluate the demographic, clinical characteristics, treatments and factors affecting the treatment responses of patients with PG., Methods: We performed a multicenter study of 12 tertiary care centers. We analyzed the data of the patients who were followed up with a diagnosis of PG between the years 2012‒2022 retrospectively., Results: We included a total of 239 patients of whom 143 were female and 96 were male, with an average age of 54.2 ± 17.4 years. The most common treatment was systemic steroids (n = 181, 75.7%). Among these patients, 50.8% (n = 92) used systemic steroids as the sole systemic agent, while 49.2% (n = 89) used at least one adjuvant immunosuppressive agent. The independent factors determined in regression analysis to influence response to systemic steroids positively were disease onset age ≥ 30-years, negative pathergy, absence of leukocytosis, negative wound culture, presence of a single lesion, and absence of upper extremity involvement. Biological agents were used in 18.4% (n = 44) of the patients in the present study. We also analyzed pathergy positive PG and early onset (onset age < 30) PG separately due to their distinct clinical features which were revealed during statistical analysis., Study Limitations: Retrospective nature of the present study., Conclusions: Analyses of the factors influencing treatment responses are addressed in this study. Also, we concluded that investigation for accompanying autoinflammatory diseases of pathergy positive PG and early onset PG is necessary and the patients in these two groups are more resistant to treatment, necessitating more complicated treatments., (Copyright © 2024 Sociedade Brasileira de Dermatologia. Published by Elsevier España, S.L.U. All rights reserved.)

Background: The fit of a metal-ceramic restoration is essential to its long-term durability. Regarding marginal and internal fit, there is not enough information about the technologies used in the production of metal-ceramic restorations. The aim of this in vitro study is to compare, both before and after porcelain firing, the marginal, axial, axio-occlusal, and occlusal fit of metal-ceramic restorations manufactured using casting, additive or subtractive computer-aided design, and computer-aided manufacturing techniques (CAD/CAM)., Methods: CAD/CAM were used to create 50 prepared maxillary first molar-shaped Co-Cr die models, which were randomly divided into 5 groups (n = 10). Cobalt-chrome copings were produced by casting (C), hard metal milling (HM), soft metal milling (SM), selective laser melting (SLM), and selective laser sintering (SLS) techniques. Before and after porcelain firing, discrepancies of the copings were measured using the silicone replica technique. The data obtained by measurements with a stereomicroscope at x80 magnification were analyzed statistically in the SPSS program. The ROBUST three-way analysis of variance (ANOVA) method was used to compare the discrepancy values., Results: There were statistically significant differences among fabrication methods (P < .001). The HM method showed the highest discrepancy (90.1 μm), and the C (63 μm) method showed the lowest discrepancy in terms of the die model- crown fit. The C, SLS, and SM methods (63 μm; 61.6 μm; 67.7 μm) were statistically similar (P > .001). The highest discrepancy was observed on the occlusal area (87.1 μm), and the lowest discrepancy was observed on the axial area (47.7 μm) of the coping. Porcelain firing had a decrease in the discrepancy values (P = .001)., Conclusion: All CAD/CAM techniques are appropriate for clinical use; selective laser sintering and soft milling can be the more recommended methods for the compatibility of metal-porcelain restorations, as they have lower discrepancy values than the SLM and HM methods., (© 2024. The Author(s).)

Melasma is a common acquired hyperpigmentation disorder that affects mostly women and individuals with darker skin types. Oxidative stress may play a role in the pathogenesis of melasma. Dynamic thiol/disulfide homeostasis is one of the most important indicators of oxidative stress. This study aimed to investigate the presence of oxidative stress in patients with melasma by evaluating thiol/disulfide homeostasis. Sixty-seven patients with melasma and 41 healthy age- and sex-matched controls were included in the study. Disease severity was evaluated using the modified melasma area and severity index (mMASI). Thiol/disulfide homeostasis parameters of the melasma and control groups were measured using a novel, fully automated spectrophotometric method. Our data indicated the presence of oxidative stress in melasma, which may be correlated with disease severity. Because research on the presence of oxidative stress in melasma is limited, further studies are needed to support these conclusions.

Introduction: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening acute mucocutaneous disorders usually triggered by drugs. In this study, we aimed to evaluate the factors affecting mortality in patients with SJS-TEN., Methods: Our study is a retrospective cohort study, analyzing data collected from a total of 12 tertiary care centers between April 2012 and April 2022., Results: The study included 59 males and 107 females, a total of 166 patients, with an average age of 50.91 ± 21.25 years. Disease classification was TEN in 50% of cases, SJS in 33.1%, and SJS-TEN overlap in 16.9%. The average SCORTEN within the first 24 h was 2.44 ± 1.42. Supportive care was provided to 99.4% of patients. The most commonly used systemic immunomodulatory treatments were systemic steroids (84.3%), IVIG (intravenous immunoglobulin) (49.3%), and cyclosporine (38.6%). Plasmapheresis was administered to five patients. While 66.3% of patients were discharged, 24.1% resulted in exitus. Our comparative analysis of survivors and deceased patients found no effect of systemic steroids, IVIG, and cyclosporine treatments on mortality. Univariate analysis revealed that the SCORTEN scores on days 1 and 3 as well as the rates of detachment at the onset and during follow-up were significantly higher in deceased patients compared to survivors. The rates of fever, positive blood cultures, and systemic antibiotic use were higher in deceased patients compared to survivors. The presence of comorbidities, diabetes, and malignancy were significantly more common in deceased patients. Multivariate regression analysis indicated that over SCORTEN 2, the mortality risk exponentially rose with each SCORTEN increment, culminating in an 84-fold increase in mortality at SCORTEN 5-6 (odds ratio [95% confidence interval]: 13.902-507.537, p < 0.001) compared to SCORTEN 0-1. Additionally, the utilization of plasmapheresis was associated with a 22-fold increase in mortality (odds ratio [95% confidence interval]: 1.96-247.2, p = 0.012)., Conclusion: Our study found that a high SCORTEN score within the first 24 h and the use of plasmapheresis were related to increased mortality, while systemic steroids, IVIG, and cyclosporine treatments had no impact on mortality. We believe that data gathered from one of the most comprehensive studies which we conducted on SJS-TEN will enrich the literature, although additional research is warranted., (© 2024. The Author(s).)

Methotrexate (MTX) is commonly used as first-line systemic treatment agent in psoriasis. We aimed to evaluate the clinical characteristics and treatment responses of patients with psoriasis undergoing MTX monotherapy. Data from adult patients with plaque psoriasis who received MTX monotherapy for at least 3 months between April 2012 and April 2022 were retrospectively evaluated in 19 tertiary care centers. Our study included 722 female and 799 male patients, a total of 1521 participants. The average age of the patients was 44.3 ± 15.5 years. Mode of treatment was oral in 20.4% of patients while in 79.4% it was subcutaneous. The median treatment duration was 8 months (IQR = 5-15). The median weekly dose was 15 mg (IQR = 11-15). 1448 (95.2%) patients were taking folic acid supplementation. At week 12, 16.3% of the patients achieved PASI (Psoriasis Area and Severity Index) 90 response while at week 24, 37.3% achieved it. Logistic regression analysis for week 12 identified the following independent factors affecting PASI 90 achievement positively: median weekly MTX dose ≤ 15 mg (P = 0.011), subcutaneous administration (P = 0.005), no prior systemic treatment (< 0.001) and folic acid use (0.021). In logistic regression analysis for week 24; median weekly MTX dose ≤ 15 mg (P = 0.001), baseline PASI ≥ 10 (P < 0.001), no prior systemic treatment (P < 0.004), folic acid use (P = 0.001) and absence of comorbidities (P = 0.009) were determined as independent factors affecting the achievement of PASI 90. Adverse effects were observed in 38.8% of the patients, with nausea/vomiting (23.9%) and transaminase elevation (13%) being the most common. The most common reasons for interruptions (15.3%) and discontinuations (27.1%) of the treatment were patient related individual factors. The use of MTX as the first systemic treatment agent, at doses ≤ 15 mg/week and concurrent folic acid application are positive predictive factors for achieving the target PASI response both at weeks 12 and 24. In our study, which is one of the most comprehensive studies on MTX treatment in psoriasis, we observed that MTX is an effective and safe treatment option., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: Vitiligo is a chronic skin disorder in which immune dysregulation has been reported as one of the major etiopathological factors. Interleukin-12 (IL-12), IL-23 and IL-27 of IL-12 cytokine family were identified as critical cytokines in the pathogenesis of many autoimmune and inflammatory skin diseases including vitiligo. IL-35 is one of the newest member of IL-12 cytokine family., Objectives: The purpose of our study was to examine serum IL-35 levels in addition to serum IL-12, IL-23, IL-27 levels in the vitiligo patients and control group, and to investigate the relationship of these cytokines with the characteristics of vitiligo., Methods: Serum IL-12, IL-23, IL-27 and IL-35 levels of 87 vitiligo patients and 70 healthy volunteers were analyzed using the enzyme-linked immunosorbent assay (ELISA). We compared the IL-12 cytokine family levels in the patient and control groups, and investigated the relationship of these levels with the characteristics of vitiligo., Results: Patients had higher levels of IL-12 (31.2 versus 20.1, P < 0.001) and IL-35 (9.6 versus 8.1, P = 0.031). Patient and control groups had similar levels of IL-23 (P = 0.78) but were correlated with the Vitiligo Area Scoring Index (VASI) (P = 0.022, r = 0.35). Patients had lower levels of IL-27 (207.6 versus 258.7, P < 0.001). In addition, the levels of serum IL-27 were correlated negatively with the Vitiligo Disease Activity (VIDA), and positively with disease duration (P = 0.007, r = 0.30)., Conclusions: Differences of serum levels between Vitiligo patients and healthy controls, significant relationships with the characteristics of vitiligo suggest that the IL-12 cytokine family may play a role in the pathogenesis of vitiligo.

Introduction: Morphea localized scleroderma (LS) is a rare skin disease with unknown pathogenesis, which causes sclerosis of the dermis and subcutaneous tissue., Objectives: It was aimed to compare the characteristics of patients with pediatric and adult-onset morphea., Methods: A retrospective analysis was performed on the records of 183 adult morphea patients. The demographics, clinical and laboratory characteristics, and treatment options of the patients were recorded. Adult patients with morphea over the age of 18 were divided into two groups according to the age of onset and compared., Results: Twenty-two percent (N = 41) of the patients had pediatric-onset morphea (POLS) and 77.6% (n=142) had adult-onset morphea (AOLS). While POLS had a higher head-neck involvement, AOLS had a higher breast involvement (P < 0.001 and P = 0.043). Patients with linear morphea were younger, and more frequently had at least one laboratory anomaly (P = 0.016 versus 0.024). Anti-dsDNA positivity and low hemoglobin (Hb) were observed more frequently in patients with breast involvement. Patients with inguinal involvement, on the other hand, had lower Hb and a higher rate of diabetes, and those patients were older (P = 0.042, 0.040, and 0.012, respectively)., Conclusions: Clinical characteristics and accompanying laboratory anomalies of the patients with morphea depend on the age of onset, involvement areas and the types of morphea, having such data readily available should guide the holistic approach for, and the monitoring process of, the disease.

Background: This study aimed to investigate different surface treatments thought to increase the bond strength between zirconia ceramic and adhesive resin cement., Methods: The samples were prepared in 15 × 10 × 2 mm dimensions by cutting off monolithic zirconia ceramic blocks (Incoris TZI; Sirona, Germany). Surface roughness measurements were made with a profilometer, the average surface roughness (Ra1) was recorded, and five different surface treatments were applied. Group 1: Control group. No surface treatment was applied. Group 2: Sandblasted with Al 2 O 3 under pressure of 50 μm. Group 3: Sandblasted with 30 μm Al 2 O 3 - SiOx under pressure, then tribochemical silica coating, silane bonding agent, and ceramic primer were applied. Group 4: Samples were etched in a hot acid solution containing methanol, HCl, and chloride at 100 °C. Group 5: Samples were coated in a solution containing Grade C Aluminum Nitrite at 75 °C for 15 Sects. 12,000 thermal aging was carried out to all samples. Then, samples were bonded to a composite surface (Filtek Z250) with two different types of adhesive cement (Panavia F 2.0, Rely X U200) (n = 10). A load was applied to the samples attached to the Universal Test Device for the SBS, and the SBS was recorded. The surface roughness measurements of all samples were made again, and the average surface roughness Ra2 was recorded. The data was analyzed with a two-way ANOVA test. Bonferroni correction was used for multiple comparisons of the groups. p = 0.005 was accepted as the statistically significant value., Results: There was no statistically significant difference between the groups in the Ra1 measurements (p = 0.031). There was a statistically significant difference between the Ra2 values of Groups 4 and 5 and the Ra2 values of Groups 1,2 and 3 in the Ra2 measurements (p < 0.001). There was no statistically significant difference between the SBS values of the groups (p > 0.005). Also, there was no statistically significant difference in the SBS values of all groups for the two different cements tested (p > 0.005)., Conclusions: None of the surface treatments applied to monolithic zirconia ceramic samples increased the SBS between ceramic and adhesive resin cement., (© 2023. The Author(s).)

Objective: Seborrheic dermatitis is a common papulosquamous skin disease with unknown pathogenesis. The aim of our study was to determine the serum level of 25-hydroxy vitamin D in patients with seborrheic dermatitis SD., Methods: A total of 53 patients and 60 healthy controls were included in the study. Serum vitamin D, calcium, phosphorus, and parathormone levels were measured in the patient and control groups, and a comparison was made between the two groups regarding these parameters., Results: Severe vitamin D deficiency was more frequent among patients with seborrheic dermatitisSD compared to controls (52.8 vs. 25.8%, p=0.003). In patients with severe vitamin D deficiency, seborrheic dermatitis SD was detected more frequently at an early age (p=0048) and in women (p=0.015). No correlation was found between the seborrheic dermatitis skin involvement site and vitamin D level., Conclusion: The fact that vitamin D levels decreased in patients with seborrheic dermatitis SD and patients with severe vitamin D deficiency develop seborrheic dermatitis SD earlier suggests that the low levels of vitamin D are related to seborrheic dermatitis.

Background: Vitiligo, a multifactorial, depigmented skin disease, is characterised by selective loss of functional melanocytes leading to pigment reduction in the affected areas of the skin., Aim: We aimed to examine thiol-disulphide homeostasis, IMA, copper, zinc, selenium, vitamin A and vitamin C levels in vitiligo patients., Materials and Methods: The study included 83 vitiligo patients and 72 healthy controls. Copper, zinc, and selenium levels were measured by atomic absorption spectrophotometer; vitamin A and E levels were measured by high-performance liquid chromatography. Ischemia-modified albumin and native/total thiol levels were measured by colourimetric method., Results: Serum native and total thiol levels were significantly lower in vitiligo patients ( P < 0.001, for all). Zn levels were significantly higher in vitiligo patients than in the control group ( P = 0.004). There was no statistical difference in terms of Cu, Se, vitamin A and vitamin E levels., Conclusions: All thiol-disulphide homeostasis parameters (the most important antioxidant-oxidant system in circulation), trace elements, and vitamins together were evaluated in the present study in vitiligo patients. It can be concluded that vitiligo patients have increased oxidative stress status, and also the increase in the dissemination of the disease also increases the oxidative stress in the body., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Indian Journal of Dermatology.)

Introduction: Psoriasis is an immune-mediated, chronic and inflammatory disease whose pathogenesis is affected by the interactions of several immune cells and cytokines. PD-1 is an inhibitor receptor that is expressed to a large extent in T lymphocytes and responsible for regulating autoimmunity and self-tolerance., Objectives: In this study, we aimed to investigate the expression of PD-1/PD-L molecules in the lesioned skins of psoriasis patients., Methods: The study included 30 psoriasis patients, and 15 healthy volunteers as the control group. Anti PD-1 and PD-L1 antibodies were applied to the skin biopsy samples that were collected from the patient and control groups. Cytoplasmic and membranous staining of PD-1 and PD-L1 were considered positive. The number of stained immune cells that was examined for each case., Results: The percentage of the tissues with high PD-1 (+) and PDL-1 (+) immune cell counts were significantly higher in the psoriasis patients compared to healthy controls (P values = 0.004 and 0.002, respectively). A negative and statistically significant correlation was detected between PDL-1(+) immune cell numbers and PASI scores (P = 0.033, r=-0.57)., Conclusions: In the lesioned skin samples of psoriasis patients, the PD-1 and PD-L1 expressions were significantly higher in immune cells than that in the skin samples of the healthy controls. This study was the first investigation of the expression of PD-1/PD-L molecules in the immune cells in found the lesioned skins of psoriasis patients.

Competing Interests: There are no conflicts of interest.

Introduction: Atopic dermatitis (AD) is a chronic, recurrent, and inflammatory skin disease experienced mostly in childhood. Chronicity of the disease, relapses, constant need of regular skin care causes seeking for alternative treatments., Aim: The aim of this study is to evaluate the complementary and alternative treatments (CAT) used by parents' caregivers in pediatric patients diagnosed with AD, and the association between CAT use and patient characteristics., Materials and Methods: A questionnaire questioning the sociocultural and demographic characteristics of the family, the clinical findings of the patients, their treatments and CAT applications was recorded., Results: Eighty-three patients were included in the study. 68.7% of the patients used at least one type of CAT. Vitamins and oils were the most commonly used CAT (48.8% and 47%, respectively) and 73.3% of the patients using CAT continued normal AD treatment while using CAT. The biggest factor affecting CAT choice was the advice of the immediate circle (75%), and 40.6% of the patients stated that they benefited from the complementary therapy., Conclusions: CAT are widely used in AD. Physicians should know the socio-cultural structure of the region they are in, the CAT used and their side effects, and inform the families.

Background: Seborrheic dermatitis (SD) is a common, chronic inflammatory disease with relapses and remissions., Objectives: So we planned to investigate the relationship between SD and metabolic syndrome (Mets)., Methods: 54 patients over 18 years of age without known diabetes mellitus, hypertension, coronary artery disease who were clinically diagnosed with SD in our clinic and 47 healthy controls were included in the study. Body mass index (BMI) was calculated of all participants. Complete blood count, fasting blood sugar (FBG), triglyceride (TG), total cholesterol, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) were examined. The relationship between the presence of MetS, disease severity, and duration was investigated., Results: Average age of patients was 35.4 (sd: 12). Average age of controls was 32.9 (sd: 10.7). MetS was detected in 35.2% (n = 19) of the patient group and 10.6% (n = 5) of the control group. The presence of MetS was higher in SD patients than in the control group (p = 0.004). The rate of people with high TG was significantly higher in the SD group than the controls (p = 0.015). HDL level was significantly lower in the patient group (p = 0.050). Systolic and diastolic blood pressure were high in patients (p = 0.016, p = 0.029)., Conclusions: Seborrheic dermatitis should be considered as a MetS marker and the presence of MetS should be examined in this group of patients. This can be helpful for the early diagnosis of a systemic disease complex with numerous complications. Also, treatment of MetS can also improve SD lesions., (© 2022 Wiley Periodicals LLC.)

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. The pathogenesis of HS is not clear, and the triggering mechanism for the initiation of the disease is still a controversy., Aims: The present study aims to investigate the relationship between thiol-disulfide homeostasis (TDH), ischemia-modified albumin (IMA), and HS. To our knowledge, this will be the first report evaluating TDH and IMA status in HS., Patients/methods: The study included 30 patients with HS as the patient group and 30 healthy individuals as the control group. For determination of HS severity, Hurley and Hidradenitis suppurativa physician global assessment (PGA) scores were used. One tube venous blood specimen from every participant was obtained. IMA and TDH tests were analyzed in sera of participants. The results were evaluated statistically., Results: Disulfide (p < 0.001), Index I (p = 0.001), and Index II (p = 0.001) levels in HS group were significantly higher than control group. IMA levels in patients with higher Hurley scores are significantly higher (p = 0.032, r = 0.39). A positive correlation was observed between IMA level and disease duration (p = 0.021, r = 0.42)., Conclusions: The shift in thiol/disulfide balance toward disulfide and significant increase in IMA levels put out the importance of oxidation status in HS etiopathogenesis., (© 2022 Wiley Periodicals LLC.)

Background: Androgenetic alopecia (AGA) is the most common cause of hair loss in men. In addition to genetic and hormonal factors, oxidative stress (OS) is suggested as a factor in the etiology., Aim: In this study, we aimed to investigate the presence of OS due to thiol disulfide balance deterioration in male patients with AGA., Materials and Methods: A total of 45 male AGA patients and 42 healthy male controls were included in the study. Native thiol, disulfide, and total thiol levels were assessed through automated spectrophotometry. The relationship between total protein, albumin, native thiol, disulfide, and total thiol levels in addition to demographic and clinical characteristics of the patients were examined., Results: The mean age of the patients was 32.6 ± 10 years, and the median AGA duration in the patients was 3 years. There was no statistically significant difference in terms of native thiol, disulfide, total thiol levels, disulfide/total thiol, disulfide/native thiol, and native thiol/total thiol ratios between AGA patients and controls. Native thiol and total thiol levels negatively correlated with age and AGA duration, while disulfide levels only correlated with age.Albumin and native thiol levels were significantly lower in patients with low vitamin D levels (p = 0.040 and p = 0.021, respectively); however, total thiol and native thiol/total thiol ratio values were significantly higher., Conclusion: According to this study, thiol disulfide homeostasis is in balance in male patients with AGA. In patients with emotional stress and vitamin D deficiency, the balance appears to be shifted in favor of oxidative stress., (© 2021 Wiley Periodicals LLC.)

Background: Telogen effluvium (TE) is a common form of non-scarring alopecia, characterized by excessive shedding of telogen club hairs., Objectives: The aim of the present study was to investigate patient characteristics, laboratory parameters, and treatment strategies in TE., Methods: Electronic records of 3028 patients were retrospectively analyzed. Demographic and clinical data, as well as serum parameters screening for iron, vitamin B12, vitamin D, folate and zinc deficiencies, thyroid function, and ANA titers, were evaluated., Results: In the study group, the most frequently performed test type was serum ferritin level (82.3%), followed by complete blood count (81%), both of which revealed that 6.2% of the patients had iron deficiency anemia. 4.6% of the patients had thyroid dysfunction. In screened patients, vitamin and mineral deficiencies were as follows: vitamin D (72.2%), vitamin B12 (30.7%), folate (4.4%), and zinc (2.1%). Women were more likely to be prescribed vitamin D replacement therapy. Iron replacement was the most frequently ordered treatment, comprising 37.5% of total prescriptions., Conclusion: To the best of our knowledge, this is the most comprehensive retrospective study having the largest number of patients with TE. Our results will not only help to augment knowledge about TE, but also provide a diagnostic algorithm for the laboratory and clinical workup of patients with TE., (© 2021 Wiley Periodicals LLC.)

Background: Alopecia areata (AA) is an autoimmune disease where autoimmune dysregulations along with genetic susceptibility are hypothesized to play a role in pathogenesis., Objective: The aim of this study in to evaluate HLA-A, HLA-B, HLA-C, HLA-DQB1, and HLA-DRB1 profile and its relationship with clinical features in AA patients., Materials and Methods: Ninety-eight patients with AA and 100 healthy controls were included in the study. HLA-A, HLA-B, HLA-C, HLA-DQB1, and HLA-DRB1 frequencies were analyzed using polymerase chain reaction-sequence specific primers (PCR-SSP)., Results: HLA-B*39 and HLA-HLA-DRB1*15 allele frequencies were increased ( p  = .022 and p  = .023, respectively), HLA-A*11 and HLA-B*35 frequencies were decreased ( p  = .006 and p  = .014, respectively) in AA patients. HLA-B*13 and HLA-DRB1*11 were associated with poor prognostic factors. A class I allele, HLA-B*13 was associated with recurrence ( p  = .023) and presence of nevus flammeus ( p  = .022), while the class II allele HLA-DRB1*11 was associated with widespread hair loss (diffuse or universal alopecia) ( p  = .026), presence of ophiasis ( p  = .049) and juvenile onset ( p  = .018)., Conclusion: Belonging to two different classes of HLA family, HLA-B*13 and HLA-DRB1*11 alleles identified separate set of risk factors. In addition to increasing the risk of AA, HLA alleles may affect the prognosis of the disease.

Background: Venous hypertension causes many different cutaneous findings such as varicosities, telangiectasia, edema, and pigmentation, dermatitis, and venous ulcers on the skin., Objective: This study aims to investigate the cutaneous signs and symptoms of chronic venous insufficiency (CVI) and to examine their contribution to early diagnosis., Methods: A total of 150 patients were included in the study who applied to the dermatology outpatient clinic and were diagnosed with skin disease related to CVI or had skin findings. Patient's age, gender, complaints, occupation, additional diseases, drug usage, history of prolonged standing and travel, smoking habit, number of pregnancies, history of varicose veins in the family, dermatological diagnosis/findings, and venous Doppler ultrasonography reports were examined retrospectively., Results: 56% of patients were women. Mean age was 56.69 ± 13.6 years. Overall, 82.7% of total patients had at least one skin finding. The most frequent skin findings except varicose veins were insufficiency dermatitis accounted for 32.7% of patients, telangiectasia, and pigmentation which were comprised 25.3%, 19.3% of the total number of patients respectively. In addition to this, 48.7% of patients had itching problems and 32.7% had pain. Moreover, 46% of patients presented superficial vein insufficiency, while 8.7% had deep vein insufficiency. For 47.3% of patients, vein diameter dilation was observed and 11.3% suffered from perforating vein insufficiency. In terms of Clinical-Etiologic-Anatomic-Pathophysiologic (CEAP) classification, scores of 52% of the patients were C3 and lower, while scores of 48% of total patients were C4a and higher., Conclusions: Early diagnosis and treatment of chronic venous insufficiency could prevent further chronic processes such as venous ulceration which is an advanced CVI finding. Thus, assessing the early skin findings might be important to identify the underlying venous insufficiency disease., (© 2021 Wiley Periodicals LLC.)

Objectives: The present study aims to evaluate the relationship between Behçet's uveitis and lymphangiogenesis by determining levels of Vascular endothelial growth factor-C (VEGF-C, its receptors sVEGFR-2, sVEGFR-3 and lymphangiogenesis markers podoplanin (PDPN) and lymphatic vessel endothelial hyaluronan receptor 1(LYVE-1), and C-type lectin domain family 1 member B (CLEC2)., Materials and Methods: 55 patients with BD uveitis and 31 healthy control subjects were enrolled in the study., Results: sVEGFR-2, sVEGFR-3, VEGF-C/sVEGFR-2 ratio, PDPN and LYVE-1 levels were higher in the patient group. A positive correlation was found between LYVE-1 and hsCRP levels. PDPN had a strong predictive value for progression with a cut-off value of 2 pg/mL, with 69% sensitivity and 68% specificity (p = 0.001)., Conclusion: LYVE-1 and PDPN can be good representatives of the ongoing inflammatory processes in BD uveitis and point out that the disease can be related to lymphangiogenesis.

Background: Psoriasis is a chronic inflammatory disease in which T helper 1 (Th1) and Th17 cells play a major role in its pathogenesis. Studies have shown that keratinocytes in psoriatic tissue are resistant to apoptosis and have a high proliferation rate. Survivin is a multifunctional protein belonging to an apoptosis inhibitor family, which has significant effects on the immune system, such as activation of dendritic cells and T cells and immunomodulation., Objectives: To investigate a possible relationship between serum survivin levels and psoriasis disease characteristics and severity., Materials and Methods: The present study included 84 patients with psoriasis who did not receive any systemic treatment for psoriasis in the last three months and 84 volunteers without psoriasis. Demographic data, smoking status, and alcohol consumption of the participants were questioned, and body mass index (BMI) was calculated. In the patient group, disease duration, family history, accompanying arthritis, and nail involvement were questioned and psoriasis area severity index (PASI) scores were calculated. Serum survivin levels were measured in all subjects., Results: Serum survivin level was significantly higher in the patients compared to the controls (p = 0.008). There was no relationship between serum survivin level and disease duration, family history, joint involvement, nail involvement, BMI, and PASI score (all p-values > 0.05). Serum survivin levels were significantly higher in smokers than non-smokers and in alcohol consumers than patients that did not drink alcohol in the psoriasis group (p = 0.034 and p = 0.006, respectively)., Conclusion: Serum survivin levels were higher in psoriasis patients than the control group. This finding suggests that this molecule, which is both immunomodulatory and an apoptosis inhibitor, may play a role in the pathogenesis of psoriasis. Significantly high serum survivin level in psoriasis patients who smoke suggests that smoking may act through survivin. More comprehensive studies are needed to evaluate the role of survivin in the pathogenesis of psoriasis and its relationship with smoking., (© 2021 Wiley Periodicals LLC.)

Background: Behçet's disease (BD) is a chronic inflammatory vasculitis affecting multiple organs. Uveitis is frequently seen in patients with BD, especially in Turkish population., Objectives: To investigate vascular endothelial growth factor (VEGF) gene polymorphisms along with the levels of VEGF and VEGF receptors in patients with Behçet's uveitis (BU)., Material and Methods: Fifty-five BD-associated uveitis patients and 30 ageand sex-matched controls were included in this case-control study. The genotypes of the single nucleotide poymorphisms (SNPs): rs2010963 (+405G), rs3025039 (+936T) and rs699947 (-2598A) of the VEGF-A gene were determined using real-time polymerase chain reaction (RT-PCR) and serum levels of VEGF and VEGF receptors were measured using enzyme-linked immunosorbent assay (ELISA)., Results: No associations of the VEGF gene polymorphisms were observed in BD uveitis patients, but arthritis was present in 53.3% of patients not possessing CT genotype in C3025039→T polymorphism (p = 0.024). Although there were no statistically significant differences in serum VEGF-A, VEGF-C and soluble vascular endothelial growth factor receptor-3 (sVEGFR-3) levels (p < 0.05), serum vascular endothelial growth factor receptor-1 (VEGFR-1) and sVEGFR-3 levels were significantly higher in the BD group (p < 0.001 and p = 0.001, respectively). In addition, VEGF-C/soluble vascular endothelial growth factor receptor-2 (sVEGFR-2) ratio was significantly higher (p < 0.001), while VEGF-A/VEGFR-1 and VEGF-C/sVEGFR-3 ratios were significantly lower (p < 0.001 and p = 0.033, respectively) in BD patients compared to controls. Also, VEGF-C/sVEGFR-3 (p = 0.024, r = 0.37) and VEGF-C/sVEGFR-2 (p = 0.020, r = 0.38) ratios were positively correlated with disease duration., Conclusions: The significant changes in sVEGFR-3 levels and VEGF-C/sVEGFR-3 ratio has shown that lymphangiogenesis processes might take place in the pathogenesis of BD uveitis, and these parameters can be important indicators of evaluation of BD patients with uveitis together with disease duration.

Background: Rosacea is a chronic inflammatory skin disease characterized with increased serum and tissue inflammatory mediators. IL-17 is a well-known inflammatory mediator that plays important roles in pathogenesis of inflammatory skin diseases. Previous studies reported that Th17 pathway is activated in rosacea and IL-17, one of Th17 signature cytokines, is elevated in tissue samples of rosacea patients., Objectives: The aim of this study was to investigate serum IL-17 levels in rosacea patients and to study its relationship with disease characteristics., Methods: Sixty patients diagnosed with rosacea and 60 healthy controls were included in the study. Serum IL-17 concentrations were measured using enzyme-linked immunosorbent assay (ELISA)., Results: The mean serum IL-17 level was 8.03 pg/mL (SD = 1.47) in rosacea patients and 7.37 pg/mL (Sd = 1.19) in controls. Serum IL-17 levels were significantly higher in rosacea (p = 0.002). Serum IL-17 levels were similar among patients with erythematotelangiectatic (ET) and papulopustular (PP) rosacea (8.02 vs 8.06, p = 0.83). Serum IL-17 levels did not correlate with rosacea severity (p = 0.59, r = 0.07 in ET rosacea; p = 0.88, r = 0.02 in PP rosacea), age of onset (p = 0.58, r = -0.07), and disease duration (p = 0.37, r = -0.11). Primary features and global assessments did not correlate with serum IL-17 levels (all p > 0.05). Among secondary features, edema showed a significant negative correlation with serum IL-17 concentrations (p = 0.037, r = -0.26)., Conclusions: Our study showed increased serum IL-17 levels in rosacea patients and a significant correlation between IL-17 concentrations and secondary features of the disease suggesting IL-17 may contribute to pathogenesis of rosacea and may be a new target for rosacea treatment., (© 2021 Wiley Periodicals LLC.)

Introduction: Galectin-3 is a β-galactoside-binding lectin associated with cellular proliferation, inflammation and angiogenesis, which are the major characteristics of psoriatic skin., Objectives: To investigate serum galectin-3 levels in psoriasis patients compared with healthy controls and to study its relationship with disease characteristics., Methods: Seventy-eight patients diagnosed with psoriasis and 78 age- and sex-matched healthy volunteers were included in the study. Serum galectin-3, IL-17, IL-6 and TNF-α levels were measured using Enzyme-linked immunosorbent assay (ELISA)., Results: Serum Galectin-3, IL-17, IL-6 and TNF-α levels were significantly higher in psoriasis patients compared with control group (P < .001, P = .003, P < .001 and P < .001, respectively). A cut-off value of 10 ng/mL for galectin-3 was set after receiver operating characteristic analysis. A serum galectin-3 level >10 ng/mL increased the risk of psoriasis by 14.5 times (95% CI: 6.6-32.3, P < .001) and a serum galectin-3 level >10 ng/mL predicted psoriasis with 83.3% sensitivity and 74.3% specificity. No statistically significant association was observed between serum galectin-3 concentrations and disease characteristics including disease severity, presence of psoriatic arthritis, nail involvement and psoriatic comorbidity. No statistically significant correlation was observed between serum galectin-3 level and serum IL-17, IL-6 and TNF-α levels (all three P values > .05)., Conclusions: Elevated serum galectin-3 levels in psoriasis patients may indicate a possible role of galectin-3 in pathogenesis of psoriasis., (© 2021 John Wiley & Sons Ltd.)

Aim: Immunoglobulin A vasculitis (IgAV) is classified as a leukocytoclastic vasculitis characterized by immune deposits in endothelial walls of small vessels causing vascular endothelial injury. The aim of the present study is to evaluate levels of vascular endothelial growth factor-A (VEGF-A) and VEGF receptor-1 (VEGFR-1) levels in adult IgAV patients., Method: Thirty-seven adult IgAV patients admitted to the Rheumatology Clinic meeting the IgAV American College of Rheumatology (ACR) criteria and 32 control subjects were enrolled in the study. Disease activity was categorized as "remission" or "active" according to Birmingham Vasculitis Activity Score (BVAS). Serum VEGF-A, VEGFR-1 levels and VEGFR-1/VEGF-A ratio were evaluated in patient and control groups., Results: Serum median VEGF-A, VEGFR-1 and VEGFR-1/VEGF-A ratios were significantly higher in the patient group when compared to controls (235.9 [155-308.4] pg/mL vs. 78.8 [29.7-210.3] pg/mL, 400 [277.2-724.3] pg/mL vs. 31.5 [12.5-214.4] pg/mL and 1.85 [0.57-2.97] vs. 0.46 [0.38-0.63] respectively, all P values <.001). VEGFR-1 had the strongest predictive value with a cut-off value of 0.6 with 75% sensitivity and 73% specificity (P < .001)., Conclusion: This study is the first report indicating elevated serum VEGF-A, VEGFR-1, and more importantly VEGFR-1/VEGF-A ratio can be good representatives of the inflammatory processes together with vascular endothelial injury in adult IgAV patients. VEGFR-1 seems to be a more important indicator of the ongoing inflammation., (© 2021 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.)

Background: Vitiligo is an autoimmune disease characterised by acquired loss of melanocytes. Although the pathogenesis of vitiligo remains unknown, oxidative stress and autoimmune dysregulations are considered to play a role., Objective: The aim of this study was to evaluate the HLA profile and total antioxidant capacity (TAC) and their relationship to clinical characteristic of vitiligo patients., Methods: Ninety-one vitiligo patients and 100 healthy controls were included in the study. We analysed HLA allele frequencies using sequence-specific oligonucleotide Prob (SSOP) method. Serum total antioxidant capacity (TAC) levels were measured and compared between vitiligo patients and controls., Results: HLA-A*02 allele frequency was increased (OR = 1.6, CI = 1.12-2.24, P = .009), HLA-A*11 (OR = 0.46, CI = 0.32-0.91, P = .019) and HLA-DRB1*01 (OR = 0.39, CI = 0.16-0.92, P = .029) frequencies were decreased in vitiligo patients. HLA-A*02 allele especially increased the risk of late onset (Vitiligo onset >30 years of age) vitiligo (OR:3.67, 95% CI: 1.63-8.26, P = .002). Serum TAC levels were similar between vitiligo patients and healthy controls but TAC levels were significantly lower in patients who did not have an HLA-DRB1*01 allele (1.52 vs 1.61, P = .033)., Conclusion: Our study showed that HLA-A*02 increases, HLA-A*11 and HLA-DRB1*01 decreases vitiligo susceptibility in Turkish patients as well as a possible relationship between HLA and TAC., (© 2021 John Wiley & Sons Ltd.)

Background: Acne Vulgaris is a chronic inflammatory disease that requires long-term treatment. Adherence to treatment is a problem in chronic diseases and may affect treatment outcomes. Objective: We aim to investigate treatment adherence and satisfaction of patients with acne and identify independent factors that affect them. Methods: Five hundred patients with acne were included in this cross-sectional study. Demographic and clinical characteristics of the patients were recorded. Severity of acne was assessed using the Investigator Global Assessment (IGA) scale, and a five-point Likert scale was used to assess patients' satisfaction and adherence. Results: Adherence to treatment was poor in 64.4% of the patients. Multivariate logistic regression analysis showed that using oral isotretinoin (OR: 4.1, 95% CI 2.44-6.92, p  < .001) and satisfaction with treatment (OR: 2.1, 95% CI 1.31-3.43, p  = .002) were independent factors that affect adherence in patients. 51.8% of the patients were satisfied with their treatments and treatment satisfaction was higher in females (OR: 2.2, 95% CI 1.3-3.8, p  = .004) and patients using oral isotretinoin (OR: 14.8, 95% CI 9.4-23.2, p  < .001). Conclusions: Treatment adherence is poor among patients with acne. Identifying the factor that affects adherence may help the dermatologist recognize non-adherent patients and develop strategies to improve adherence.

Background: Psoriasis is a multifactorial, chronic inflammatory skin disease where genetic and environmental factors play a role in the pathogenesis. Smoking is one of the critical environmental factors triggering psoriasis., Objective: The purpose of the present study was to analyse the smoking habits of patients with psoriasis and the effect of smoking on disease characteristics., Methods: One hundred and thirty-three patients who applied to the department of Dermatological and Venereal Diseases, Ankara Numune Education and Research Hospital, between May 2018 and May 2019 and were diagnosed with psoriasis participated in the study. Clinical, demographical, and treatment-related characteristics, and smoking habits of patients were recorded., Results: Sixty-seven point six percent of psoriasis patients were smokers. The presence of moderate to severe psoriasis (P = .028), nail involvement (P = .004), administration of systemic treatment (P = .024) and additional cardiovascular disease (P = .038) frequencies was higher in smokers compared to non-smokers. Besides, a positive correlation was observed between the amount of smoking and psoriasis area and severity index (PASI) (P = .003; r = .32)., Conclusions: Smoking has many negative effects on patients with psoriasis including higher PASI levels, increased frequency of nail involvement, and cardiovascular diseases. Questioning cigarette smoking in psoriatic patients and supporting smoking cessation may contribute to reducing the adverse impact of smoking on psoriasis., (© 2020 John Wiley & Sons Ltd.)

The 14 authors of the first review article on hidradenitis suppurativa (HS) pathogenesis published 2008 in EXPERIMENTAL DERMATOLOGY cumulating from the 1st International Hidradenitis Suppurativa Research Symposium held March 30-April 2, 2006 in Dessau, Germany with 33 participants were prophetic when they wrote "Hopefully, this heralds a welcome new tradition: to get to the molecular heart of HS pathogenesis, which can only be achieved by a renaissance of solid basic HS research, as the key to developing more effective HS therapy." (Kurzen et al. What causes hidradenitis suppurativa? Exp Dermatol 2008;17:455). Fifteen years later, there is no doubt that the desired renaissance of solid basic HS research is progressing with rapid steps and that HS has developed deep roots among inflammatory diseases in Dermatology and beyond, recognized as "the only inflammatory skin disease than can be healed". This anniversary article of 43 research-performing authors from all around the globe in the official journal of the European Hidradenitis Suppurativa Foundation e.V. (EHSF e.V.) and the Hidradenitis Suppurativa Foundation, Inc (HSF USA) summarizes the evidence of the intense HS clinical and experimental research during the last 15 years in all aspects of the disease and provides information of the developments to come in the near future., (© 2020 The Authors. Experimental Dermatology published by John Wiley & Sons Ltd.)

Background: Psoriasis is a common chronic inflammatory dermatosis. Systemic immune inflammation index (SII) is an inflammation-based biomarker, which has been shown to be an effective prognostic factor in diseases with an inflammation-related etiology., Objectives: The aim of the present study was to investigate the potential efficacy of SII as a prognostic factor in patients with psoriasis and psoriatic arthritis., Materials and Methods: This is a study developed based on the analysis of the medical records of patients with psoriasis. The study retrospectively evaluated the records of the participants for complete blood count results. The SII was calculated by the formula: neutrophil x platelet/lymphocyte. Neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR) and platelet-lymphocyte ratio (PLR) were determined., Results: SII was significantly higher in patients with psoriasis than in controls (578.1 vs. 396, p<0.001). The differences between the median NLR (2.2 vs. 1.5, p<0.001), MLR (0.25 vs. 0.21, p<0.001) and the mean red cell distribution width coefficient of variation (13.8 vs. 12.8, p<0.001) values of patient and control group were significant. SII was higher in patients with moderate/severe psoriasis than patients with mild psoriasis (687.3 vs. 506.6, p=0.034). A positive correlation was observed between SII and PASI (p<0.001; r=0.37). SII was higher in patients with arthritis than patients without (672.1 vs. 548.2, p=0.018)., Conclusion: This is the first study to prove that SII might serve as an independent prognostic indicator for patients with psoriasis and psoriatic arthritis., Competing Interests: None to declare., (Copyright © 2014, Medical University Publishing House Craiova.)

Purpose: The present study aimed to evaluate the clinical applicability of monolithic zirconia (MZ) crowns of different thickness via determination of fracture resistance and marginal fit., Materials and Methods: MZ crowns with 0.5, 0.8, 1.0, and 1.5 mm thickness and porcelain fused to metal (PFM) crowns were prepared, ten crowns in each group. Marginal gaps of the crowns were measured. All crowns were aged with thermal cycling (5 - 55℃/10000 cycle) and chewing simulator (50 N/1 Hz/lateral movement: 2 mm, mouth opening: 2 mm/240000 cycles). After aging, fracture resistance of crowns was determined. Statistical analysis was performed with one-way ANOVA and Tukey's HDS post hoc test., Results: Fracture loads were higher in the PFM and 1 mm MZ crowns compared to 0.5 mm and 0.8 mm crowns. 1.5 mm MZ crowns were not broken even with the highest force applied (10 kN). All marginal gap values were below 86 µm even in the PFM crowns, and PFM crowns had a higher marginal gap than the MZ crowns., Conclusion: The monolithic zirconia exhibited high fracture resistance and good marginal fit even with the 0.5 mm thickness, which might be used with reduced occlusal thickness and be beneficial in challengingly narrow interocclusal space., (© 2020 The Korean Academy of Prosthodontics.)

Background: Cytochrome P450 2J2 is mostly expressed in extrahepatic tissues; it metabolizes arachidonic acid to epoxyeicosatrienoic acids, with various cardio protective and anti-inflammatory effects. CYP2J2 polymorphism has been identified as a risk factor for cardiovascular diseases, but its association with psoriasis remains unknown., Objective: To evaluate CYP2J2 polymorphism as a risk factor for psoriasis in the Turkish population., Methods: There were 94 patients with psoriasis and 100 age- and sex-matched healthy controls included in the study. Detailed demographic and clinical characteristics were recorded, and Psoriasis Area and Severity Index (PASI) scores were calculated for psoriasis patients. Venous blood samples were collected from all the participants and CYP2J2 50G>T (rs890293) polymorphism was analyzed using polymerase chain reaction (PCR)., Results: Both T allele and TT+GT genotype frequencies were increased in psoriasis vulgaris patients compared to the control group (p=0.024 and p=0.029 respectively, OR=2.82, 95% CI: 1.11-7.15) No association between CYP2J2 polymorphism and clinical features of psoriasis was identified., Study Limitations: A limited number of patients were included in the study., Conclusion: CYP2J2 50G>T (rs890293) polymorphism was associated with an increased risk for PsV in the Turkish population., (Copyright © 2019 Sociedade Brasileira de Dermatologia. Published by Elsevier España, S.L.U. All rights reserved.)

Backround: Despite extensive usage of systemic isotretinoin in patients with acne for many years, laboratory monitoring protocols for adverse effects depend on the centers and there is no standardized practice for frequency and type of laboratory testing. We aimed to decrease unnecessary monitoring and to standardize our general clinical practice of our department as well as to provide patient comfort and cost saving. Materials and methods: The medical charts of 704 acne patients treated with systemic isotretinoin were reviewed retrospectively. The National Cancer Institute common terminology criteria for adverse events v3.0 grading system was used in order to categorize the laboratory abnormalities of liver functions and lipid levels. Results: All laboratory abnormalities were grade I. Abnormal liver function was seen in 7.2% of the patients ( n  = 51), maximum values were ALT: 87 IU/L, AST: 97 IU/L (normal values, ALT: 5-41 IU/L, AST: 5-40 IU/L) and median time of the abnormalities in liver function tests was in the second month. Lipid profile abnormalities were detected in 58% of the patients ( n  = 401). Maximum values during the laboratory monitoring were T g : 481 mg/dL CHOL: 314 mg/dL, LDL: 259 mg/dL (normal values, T g : 0-200 mg/dL, CHOL.: 0-200 mg/dL, LDL: 0-100 mg/dL). The median time of lipid abnormalities was in the first month (1-3 months). Abnormalities related to CBC were seen in 8.2% of the patients ( n  = 58). The median time of CBC abnormality was the second month of treatment. Anemia, leukopenia and thrombocytopenia were seen in 3.4%, 3.7%, and 1.6% of the patients respectively. Conclusion: Clinically insignificant and reversible CBC abnormalities, mild to moderate elevation of liver transaminases and serum lipids are the most common laboratory abnormalities in patients with acne treated with oral isotretinoin. Due to these abnormalities are reversible even the isotretinoin therapy continued, and generally there is no need to discontinuation of treatment due to laboratory abnormalities, frequent biochemical monitoring is not recommended.

Background: Rosacea may result in emotional distress and anxiety. However, data on the presence of generalized anxiety disorder in rosacea patients are scarce., Objective: The aim of the study was to detect the frequency and level of anxiety and depression in patients with rosacea., Methods: A total of 194 consecutive rosacea patients and 194 age- and sex-matched controls were enrolled. Severity of rosacea was assessed in patients according to the criteria of the National Rosacea Society Ethics Committee. Both patients and controls were evaluated by the Generalized Anxiety Disorder 7-item scale, and severity was measured by the Generalized Anxiety Disorder-Adult., Results: Individuals who were diagnosed with an anxiety and/or depressive disorder were more common in patient group (24.7% vs. 7.2%, p<0,01). Female patients were particularly at risk for having generalized anxiety disorder (OR=2.8; 95% CI 1.15-7.37; p=0.02)., Study Limitations: Single center study and limited sample size., Conclusions: Rosacea patients show greater risk of having anxiety disorders, including generalized anxiety disorder. Female patients, those with lower educational levels, those with phymatous subtype, untreated patients, and patients with prior psychiatric morbidity may be at particular risk for anxiety. It is essential to consider the psychological characteristics of patients to improve their well-being., (Copyright © 2019 Sociedade Brasileira de Dermatologia. Published by Elsevier España, S.L.U. All rights reserved.)

Background: Rosacea is a chronic disease that is characterized by facial skin inflammation and vascular abnormality. Vascular endothelial growth factor (VEGF) is a potent mediator of vascular permeability and inflammation that might play a role in the pathogenesis of rosacea., Objective: This study aimed to determine the association between VEGF gene polymorphisms and rosacea., Methods: A case-control study design was used to compare 100 patients with rosacea and 100 age- and gender-matched control subjects in terms of VEGF polymorphisms based on polymerase chain reaction and the serum level of VEGF and VEGF receptors based on enzyme-linked immunosorbent assay., Results: Heterozygous and homozygous +405C/G polymorphism of the VEGF gene was observed to increase the risk of rosacea 1.7-fold (95% confidence interval 1.2-4.2) and 2.3-fold (95% confidence interval 1.2-4.2), respectively. There was a significant positive correlation between the severity of rosacea and +405C/G polymorphism of the VEGF gene in patients with erythematotelangiectatic rosacea., Limitations: Serum VEGF and VEGF receptor levels were measured in the limited number of patients., Conclusion: The present findings indicate that +405C/G polymorphism of the VEGF gene increases the risk of rosacea., (Copyright © 2019 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

To improve the flexural strength and flexural modulus of polymethyl methacrylate (PMMA), copolymerization of PMMA with 10, 20, 30, and 40% (v/v) of either ethyl-methacrylate, butyl-methacrylate (BMA), or isobutyl-methacrylate (IBMA) was carried out. Test specimens were fabricated from heat-cured resin. The flexural strength was measured using a 3-point bending test. The chemical characterization and the copolymerization mechanisms of the copolymer resins were confirmed by 1 H-NMR and FTIR. The flexural strength data were analyzed by applying two-way variance analysis. PMMA was reinforced by ethyl-methacrylate, BMA and IBMA copolymerization. Flexural strengths of the BMA and IBMA copolymers were significantly higher than those of the control group. Maximum flexural strength and modulus resulted from a 40% concentration of IBMA. The flexural strength and modulus values of all copolymer groups were found to be higher than those of the control group. The flexural moduli of the BMA and ethyl-methacrylate groups were similar to those of the control.