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Sarıkaya Solak S, Kara Polat A, Kilic S, Oguz Topal I, Saricaoglu H, Karadag AS, Canpolat F, Kartal SP, Deveci BN, Kacar N, Polat Ekinci A, Guner R, Polat M, Dogan G, Guler Ozden M, Bulbul Baskan E, Ozaydin Yavuz G, Adisen E, Gulekon A, Tanribilir ME, Yilmaz O, Akman Karakas A, Ozturk P, Didar Balci D, Gonulal M, Yondem H, Turel Ermertcan A, Sendur N, Topyildiz H, Korkmaz S, Alpsoy E. Clinical characteristics, quality of life and risk factors for severity in palmoplantar pustulosis: a cross-sectional, multicentre study of 263 patients. Clin Exp Dermatol 2021; 47:63-71. [PMID: 34236713 DOI: 10.1111/ced.14829] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 07/06/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Palmoplantar pustulosis (PPP) is a rare, chronic, inflammatory skin disease characterized by sterile pustules on palmar or plantar areas. Data on PPP are scarce. AIM To investigate the clinical characteristics and risk factors for disease severity in a large cohort of Turkish patients with PPP. METHODS We conducted a cross-sectional, multicentre study of patients with PPP recruited from 21 tertiary centres across Turkey. RESULTS In total, 263 patients (165 women, 98 men) were evaluated. Most patients (75.6%) were former or current smokers. The mean Palmoplantar Pustulosis Area and Severity Index (PPPASI) was 8.70 ± 8.06 and the mean Dermatology Life Quality Index (DLQI) score was 6.87 ± 6.08, and these scores were significantly correlated (r = 0.52, P < 0.001). Regression analysis showed that current smoking was significantly associated with increased PPPASI (P = 0.03). Coexisting psoriasis vulgaris (PsV) was reported by 70 (26.6%) patients. Male sex prevalence, PPP onset incidence, disease duration, DLQI, and prevalence of nail involvement and psoriatic arthritis (PsA) were significantly increased among patients with PPP with PsV. Of the 263 patients, 18 (6.8%) had paradoxical PPP induced by biologic therapy, and these patients had significantly increased mean DLQI and prevalence of PsA (r = 0.03, P = 0.001). CONCLUSION Our data suggest that smoking is a risk factor for both PPP development and disease severity. Patients with PPP with PsV present distinct clinical features and patients with biologic therapy-induced paradoxical PPP have reduced quality of life and are more likely to have PsA.
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Affiliation(s)
- S Sarıkaya Solak
- Departments of Dermatology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - A Kara Polat
- Medical Biostatistics, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - S Kilic
- Department of Dermatology, Istanbul Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - I Oguz Topal
- Department of Dermatology, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - H Saricaoglu
- Department of Dermatology, Prof Dr Cemil Tascioglu City Hospital, University of Health Sciences, Istanbul, Turkey
| | - A S Karadag
- Department of Dermatology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - F Canpolat
- Department of Dermatology, Memorial Atasehir Hospital, Istanbul, Turkey
| | - S P Kartal
- Department of Dermatology, Memorial Atasehir Hospital, Istanbul, Turkey
| | - B N Deveci
- Department of Dermatology, Memorial Atasehir Hospital, Istanbul, Turkey
| | - N Kacar
- Department of Dermatology, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey
| | - A Polat Ekinci
- Department of Dermatology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - R Guner
- Department of Dermatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - M Polat
- Department of Dermatology, Faculty of Medicine, Sivas Cumhuriyet University, Sivas, Turkey
| | - G Dogan
- Department of Dermatology, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - M Guler Ozden
- Department of Dermatology, Faculty of Medicine, Mugla, Mugla Sitki Kocman University, Mugla, Turkey
| | - E Bulbul Baskan
- Department of Dermatology, Prof Dr Cemil Tascioglu City Hospital, University of Health Sciences, Istanbul, Turkey
| | - G Ozaydin Yavuz
- Department of Dermatology, Faculty of Medicine, Samsun Ondokuz Mayis University, Samsun, Turkey
| | - E Adisen
- Department of Dermatology, Faculty of Medicine, Van Yuzuncu Yil University, Van, Turkey
| | - A Gulekon
- Department of Dermatology, Faculty of Medicine, Van Yuzuncu Yil University, Van, Turkey
| | - M E Tanribilir
- Department of Dermatology, Faculty of Medicine, Van Yuzuncu Yil University, Van, Turkey
| | - O Yilmaz
- Department of Dermatology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - A Akman Karakas
- Department of Dermatology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - P Ozturk
- Department of Dermatology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - D Didar Balci
- Department of Dermatology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - M Gonulal
- Department of Dermatology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - H Yondem
- Departments of Dermatology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - A Turel Ermertcan
- Department of Dermatology, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - N Sendur
- Department of Dermatology, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - H Topyildiz
- Department of Dermatology, Medicana International Hospital, Izmir, Turkey
| | - S Korkmaz
- Department of Dermatology, Faculty of Medicine, Aydin Adnan Menderes University, Aydin, Turkey
| | - E Alpsoy
- Department of Dermatology, Faculty of Medicine, Gazi University, Ankara, Turkey
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Canpolat Kirac B, Adisen E, Bozdayi G, Yucel A, Fidan I, Aksakal N, Gurer MA. The role of human herpesvirus 6, human herpesvirus 7, Epstein-Barr virus and cytomegalovirus in the aetiology of pityriasis rosea. J Eur Acad Dermatol Venereol 2008; 23:16-21. [PMID: 18713231 DOI: 10.1111/j.1468-3083.2008.02939.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To identify the role of human herpesvirus 6 (HHV-6), HHV-7, Epstein-Barr virus (EBV) and cytomegalovirus (CMV) in the pathogenesis of pityriasis rosea (PR). MATERIAL Polymerase chain reaction with specific primers for HHV-6 and HHV-7 DNA sequences was performed on the blood and tissue samples of 25 patients with PR and on the blood samples of age- and sex-matched healthy controls. HHV-6, EBV, CMV immunoglobulin M (IgM) and IgG were analysed by enzyme-linked immunosorbent assay, HHV-7 IgM and IgG were analysed by indirect immunofluorescence on the serum samples of the study population. In the patient group, the values were studied 2 weeks later again (second control). RESULTS There were no differences between the first and second controls of the patients and healthy subjects regarding HHV-6 IgM, HHV-7 IgM, CMV IgM, EBV IgM results. There were significant differences between the first [HHV-6 DNA (2 of 25), HHV-7 DNA (6 of 25)] and second control [HHV-6 DNA (1 of 25), HHV-7 DNA (11 of 25)] of the patients for the blood samples in favour of HHV-7. PR patients showed higher amounts of HHV-6 and HHV-7 DNA positivity when compared with that of healthy subjects. HHV-7 seemed to be more important regarding tissue samples [HHV-6 DNA (7 of 25), HHV-7 DNA (12 of 25) first control, HHV-6 DNA (6 of 25), HHV-7 DNA (12 of 25) second control] as well as blood samples. CONCLUSION Though our results failed to support a causal relationship among EBV, CMV and PR, they indicated a possible role for HHV-6 and especially HHV-7 in a group of Turkish patients but other aetiological factors may exist.
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Affiliation(s)
- B Canpolat Kirac
- Department of Dermatology, Gazi University, Besevler, Ankara, Turkey.
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