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   Table of Contents - Current issue
Coverpage
January-March 2021
Volume 15 | Issue 1
Page Nos. 1-16

Online since Tuesday, March 30, 2021

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ORIGINAL ARTICLES  

Elevated serum creatine kinase levels in acne vulgaris patients treated with isotretinoin: A retrospective single-center study p. 1
Sıla Kılıç Sayar
DOI:10.4103/tjd.tjd_2_21  
Background: Oral isotretinoin is a highly effective and widely used therapeutic agent for acne; however, it requires close follow-up due to its potential to produce various side effects. Slightly increased levels of serum creatine kinase (CK) that are either associated or not associated with musculoskeletal symptoms have been commonly reported and are typically considered innocuous. Objectives: The aims of the study are to investigate the frequency of our acne vulgaris patients with elevated serum CK levels during isotretinoin treatment, to analyze their course, and to determine the potential risk factors. Materials and Methods: Data of the patients in an outpatient clinic who were treated with isotretinoin due to acne vulgaris were retrospectively analyzed. Results: A total of 154 patients with at least 3 months of follow-up were included in the study. Elevated serum CK levels were found in 31 patients, and two patients had elevated levels over 1000 IU/l. While male sex was found to be a significant risk factor of CK elevation (P < 0.001), the mean age during the therapy was not found to be significantly different between the two groups. Of the patients with elevated serum CK levels, 16.2% were symptomatic and 29% had a recent history of physical exercise. Conclusions: Although mild elevation of serum CK has a benign course and is not uncommon among acne vulgaris patients who are treated with isotretinoin, remarkable elevations and symptomatic cases are relatively rare. Even CK elevations of more than 1000 IU/l may occur without symptomatic rhabdomyolysis if they are triggered by strenuous physical exercise or other causes during isotretinoin treatment. Further investigation of whether an agreed upon and not currently recommended upper limit for CK level that is tolerable can ensure safer follow-up during isotretinoin treatment is needed.
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The eating attitudes, sleep and personality characteristics, and effects of on acne severity in adolescents with acne vulgaris p. 5
Öznur Bilac, Cemal Bilaç, Akın Tahıllıoğlu, Aylin Deniz Uzun, Merve Dilcan, Arif Önder, Canem Kavurma, Gülçin Uzunoğlu
DOI:10.4103/tjd.tjd_6_21  
Background: Acne vulgaris (AV) is a very common dermatological problem during adolescence. It is reported that it has a multifactorial etiology and nutritional attitudes, insufficient and poor-quality sleep may cause increased severity of AV. Aim: We aimed to investigate the sleep, eating attitudes and personality traits, and their effects on acne severity in adolescents with acne. Methods: The study sample was formed of 37 adolescent girls aged 12–18 years who presented at the University Dermatology Clinic and were diagnosed with AV and 37 adolescents without AV-matched age and gender. Eating attitude test, Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) Personality Inventory Child Form, and child and parent forms of DSM-5 Level 2 Sleep Disorders were applied to in both groups. The AV severity assessed by using the Global Acne Grading Scale (GAGS). Psychiatric diagnosis was excluded with clinical interview according to the Schedule for Affective Disorders and Schizophrenia for school-aged children: Present and Lifetime Version (K-SADS-PL-DSM-5-T). Results: The mean age of adolescents with and without AV was 15.3 (standard deviation [SD] = 1.7), 15.4 (SD = 1.8), respectively. The mean disease duration of adolescents with AV was 20.4 (SD = 15.2) months, and the mean GAGS score was 23.24 (SD = 9.4). It was determined that eating attitudes, sleep, and personality characteristics of adolescents were similar in both groups. Eating attitudes, sleep, and personality characteristics had no direct effect on acne severity. Conclusion: Although this study demonstrates that eating attitudes, sleep, and personality characteristics were similar in adolescents with and without AV and these variables had no effect on acne severity, these results may have been obtained because of the severity scores of adolescents with AV were “moderate.” There is a need for researches examining these variables in adolescents with “severe” AV.
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A clinical and histopathological study comparing efficacy of microneedling versus cryoroller liquid nitrogen therapy in the treatment of striae distensae p. 11
Vrushali Salve, Hari Pathave, Chitra Nayak
DOI:10.4103/tjd.tjd_12_21  
Background: Striae distensae (SD) are visible linear scars in areas of dermal damage due to excessive stretching of the skin. Striae can cause cosmetic morbidity and psychological distress, particularly in women. In spite of several advances, no definitive treatment has emerged. Aim: The aim of this study was to evaluate the efficacy of microneedling versus cryoroller liquid nitrogen therapy in the management of striae distensae both clinically and histopathologically. Methodology: Striae of all 27 patients were treated with needling and cryoroller liquid nitrogen therapy on two different sides of each patient. Digital photography and skin biopsy were done to assess clinical and histopathological improvement. Results: On the evaluation of clinical response, poor clinical response (≤2%) was seen in 92.6% (n = 25) of patients on the dermaroller side, followed by moderate clinical response and on the cryoroller side, poor clinical response was seen in all 27 patients. Comparing the two sides, on the dermaroller side, 77.8% (n = 21) were satisfied and on the cryoroller side, 55.6% (n = 15) of the patients were slightly satisfied and 29.6% (n = 8) were satisfied. The histopathological improvement was almost similar on both dermaroller and cryoroller sides. Conclusion: Both microneedling with dermaroller and liquid nitrogen cryoroller were found to be safe and partially effective methods to treat striae. Patients were more satisfied with microneedling than cryoroller.
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Surgical pearl: Noncorrosive chemical fountain pen for cautery p. 16
Muhammed Mukhtar
DOI:10.4103/tjd.tjd_128_20  
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