Background: Nociplastic-like pain features are increasingly recognized as significant contributors to chronic pain and reduced quality of life in patients with rheumatoid arthritis (RA). However, their clinical correlates and relationship with disease activity remain incompletely understood. Objective: To evaluate the prevalence of nociplastic-like pain features in patients with RA and to investigate their associations with disease activity, pain intensity, fatigue, sleep quality, and health-related quality of life. Methods: In this cross-sectional study, 160 patients with RA were enrolled. Nociplastic-like pain features were assessed using the PainDETECT questionnaire. Disease activity was evaluated using the Disease Activity Score in 28 joints (DAS28). Pain intensity, fatigue, sleep quality, and health-related quality of life were assessed using the visual analog scale (VAS), Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F), Pittsburgh Sleep Quality Index (PSQI), and Short Form-36 (SF-36), respectively. Continuous variables were compared using t-tests or Mann–Whitney U tests according to data distribution. Stepwise multivariate linear regression analysis was performed to identify independent factors associated with PainDETECT scores. Results: Pain patterns suggestive of nociplastic-like features were identified in 22.5% of patients. These patients had significantly higher pain intensity, greater fatigue (lower FACIT-F scores), poorer sleep quality (higher PSQI scores), and lower SF-36 scores across all domains compared with patients without these features (all p < 0.001). PainDETECT scores showed a strong positive correlation with VAS pain intensity (r = 0.679, p < 0.001) and a moderate correlation with DAS28 (r = 0.536, p < 0.001). PainDETECT scores were negatively correlated with FACIT-F (r = −0.512, p < 0.001) and several SF-36 domains. In stepwise multivariate regression analysis, pain intensity, tender joint count, and education level emerged as independent predictors of nociplastic-like pain features, whereas inflammatory markers (CRP, ESR) and DAS28 were excluded from the model. Conclusions: Nociplastic-like pain features are common in RA and are independently associated with pain intensity, joint tenderness, and psychosocial factors rather than inflammatory activity alone. Routine assessment of these features is essential for personalized pain management and underscores the importance of considering potential central sensitization mechanisms in addition to traditional anti-inflammatory therapies.

This study aimed to evaluate how systemic antimony treatment in cutaneous leishmaniasis (CL) patients affects biochemical, hematological, and inflammatory parameters in child and adult patient groups. A total of 50 patients (29 adults, 21 children) who received systemic meglumine antimonate (MA) treatment in the skin and venereal diseases clinic between September 2022 and January 2024 and were diagnosed with CL by microscopic examination were included in the study. The medical records of the patients were examined retrospectively. Before and after treatment, neutrophil count, leukocyte count, lymphocyte count, hemoglobin concentration, platelet count, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), mean platelet volume (MPV), amylase, lipase, alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen and serum creatinine levels were recorded. In the children group, lymphocyte and platelet values decreased statistically significantly; and lipase value increased statistically significantly after treatment. In the adult group; hemoglobin, neutrophil, lymphocyte and leukocyte values decreased statistically significantly; ALT, AST, amylase, lipase, NLR and PLR values increased statistically significantly after treatment. Based on the data in our study, it was stated that systemic meglumine antimonate treatment may lead to an increase in pancreatic enzymes and transaminases and bone marrow suppression. We also think that patients in the adult age group should be followed more closely regarding pancreatic enzymes and kidney function tests than the pediatric age group.

BackgroundLipid indices, particularly the triglyceride-glucose index (TyG index) and the triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio, are simple, reliable, non-insulin-based surrogate markers of insulin resistance that have recently gained prominence. The aim of this study was to evaluate the effect of isotretinoin treatment on surrogate markers of insulin resistance, in particular the TyG index, in patients with acne vulgaris (AV). Materials and methodsThis retrospective study reviewed the records of 200 patients who received isotretinoin treatment for acne vulgaris at the Department of Dermatology and Venereology between September 2023 and March 2024. Serum fasting glucose, fasting lipid profile [triglyceride (TG), total cholesterol (TC), very low-density lipoprotein cholesterol (VLDL-C), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C)] and other biochemical parameters were recorded. Triglyceride-glucose (TyG) index value was calculated with the formula Ln [fasting triglyceride (mg/dL) x fasting plasma glucose (mg/dL)/2]. Pre-treatment values were compared with values after 5 months of treatment. ResultsTyG index and TG/HDL, TC/HDL, and LDL/HDL ratios all increased statistically significantly (p < 0.001). In addition, a positive correlation was found between pre- and post-treatment TyG index values and pre- and post-treatment TC/HDL, LDL/HDL and TG/HDL ratio values (p < 0.001). Among lipid measurements, triglycerides, total cholesterol, VLDL-C, LDL-C increased statistically significantly (p < 0.001), while HDL-C decreased statistically significantly (p < 0.05). ConclusionThe results of this study suggest that isotretinoin treatment may increase insulin resistance in AV patients by increasing surrogate biomarkers of insulin resistance. We also suggest that the TyG index and other lipid indices can be used in treatment follow-up.

Background: Facial aesthetic assessment is inherently subjective, leading to significant inter‐observer variability in treatment planning. Artificial intelligence (AI) offers a potential framework for standardized morphometric reporting. Objective: To evaluate whether AI‐augmented morphometric reports improve the consistency of simulated aesthetic treatment plans among dermatologists. Methods: Six dermatologists (3 experts, 3 residents) proposed treatment plans (neurotoxin units and filler volumes) for 76 standardized frontal images from the Chicago Face Database. In Phase I (Baseline), raters used visual intuition. In Phase II (AI‐Augmented), raters were provided with objective morphometric reports. The primary outcome was the change in inter‐rater reliability, measured by the Intraclass Correlation Coefficient (ICC(2,1)). Results: Significant baseline asymmetry (> 1.5 scaled units) was present in 58.4% of cases. The overall ICC(2,1) improved from 0.62 (95% CI: 0.54–0.69) to 0.88 (95% CI: 0.81–0.93) following AI augmentation. The most substantial improvement was observed in the resident group (ICC: 0.46 to 0.84). The mean absolute deviation from the expert‐group mean declined from 0.34 to 0.12 scaled units. Conclusion: AI‐augmented morphometric reporting was associated with improved inter‐rater agreement and reduced variability in simulated facial aesthetic treatment planning, particularly among less experienced raters. However, improved agreement does not necessarily reflect improved clinical accuracy, and future validation against clinical outcomes is warranted. The AI system functioned as a decision‐support tool rather than a replacement for clinician judgment.

Behçet's disease (BD) is a multisystem autoinflammatory disorder that may present during childhood. Pediatric BD is challenging to diagnose due to heterogeneous clinical manifestations and the lack of standardised pediatric classification criteria. This study aimed to evaluate the association between systemic inflammatory biomarkers-including the neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), and C-reactive protein (CRP)/albumin ratio-and systemic organ involvement in children with BD. To our knowledge, no prior study has investigated these markers in pediatric BD. In this retrospective study, 41 pediatric patients diagnosed with BD according to the 2015 PEDBD criteria and followed jointly by dermatology and rheumatology departments were included. Age- and sex-matched healthy controls (n = 41) undergoing elective surgery were also enrolled. Inflammatory indices (NLR, SII, PIV, CRP/albumin) were calculated from pre-treatment blood samples. Cut-off values for systemic involvement were determined via ROC analysis. Statistical analyses included the Kolmogorov-Smirnov test, independent t-test or Wilcoxon test, Chi-square and McNemar tests, correlation analysis, logistic regression, and ROC analysis. Systemic involvement was observed in 28 (68.3%) patients, including neurological involvement in 4 (9.8%), vascular involvement in 5 (12.2%), and other major organ involvement in 19 (46.3%). Inflammatory indices-PIV, SII, NLR, and CRP/albumin-were significantly higher in patients with systemic, neurological, and vascular involvement (all p < 0.05). Optimal cut-off values for each index were established based on systemic involvement. Systemic inflammatory biomarkers such as NLR, SII, PIV, and CRP/albumin ratio may serve as useful indicators of systemic organ involvement in pediatric BD. Routine assessment of these markers could facilitate earlier recognition and more targeted management of systemic manifestations in this population.

Background: Neuropathic pain is increasingly recognized as a significant con-tributor to chronic pain and reduced quality of life in patients with rheumatoid arthritis (RA). However, its clinical correlates and relationship with disease ac-tivity and patient-reported outcomes in RA remain incompletely understood. Objective: To evaluate the prevalence of likely neuropathic pain features in RA patients and to investigate their associations with disease activity, pain intensity, fatigue, sleep quality, and health-related quality of life. Methods: In this cross-sectional study, 160 RA patients were enrolled. Neuro-pathic pain features were assessed using the PainDETECT questionnaire. Dis-ease activity was evaluated with the Disease Activity Score in 28 joints (DAS28). Pain intensity, fatigue, sleep quality, and health-related quality of life were as-sessed using the visual analog scale (VAS), Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F), Pittsburgh Sleep Quality Index (PSQI), and Short Form-36 (SF-36), respectively. Group comparisons, correlation analyses, and multivariate linear regression models were performed to identify factors associated with neuropathic pain. Results: Likely neuropathic pain was identified in 22.5% of patients. Patients with neuropathic pain had significantly higher pain intensity, greater fatigue, poorer sleep quality, and lower SF-36 scores across all domains compared with patients without neuropathic pain (all p < 0.001). Although DAS28 scores were higher in patients with neuropathic pain, PainDETECT scores correlated more strongly with VAS pain in-tensity (ρ = 0.679, p < 0.001) than with DAS28 (ρ = 0.536, p < 0.001). PainDETECT scores were negative-ly correlated with FACIT-F (ρ = −0.512, p < 0.001) and multiple SF-36 domains, indicating substantial quality-of-life impairment. In multivariate regression analysis, only pain intensity independently predicted neuropathic pain features. Conclusions: Neuropathic pain is common in RA and is more closely associated with pain intensity and patient-reported outcomes than with inflammatory activ-ity alone. Routine assessment of neuropathic pain features may facilitate more personalized and effective pain management strategies in RA, highlighting the clinical relevance of targeting neuropathic mechanisms alongside inflammation.