Objective: Although the etiopathogenesis of acne rosacea has not yet been clearly elucidated, it has been discussed over the years that autoimmunity may play a role. Genetic and environmental factors are known to have combined effects in the background of autoimmunity, but it has recently been emphasized that an impaired intestinal barrier system is also involved in the development of the disease. Zonulin is a protein that reversibly increases intestinal permeability. This study aimed to evaluate the zonulin levels in acne rosacea. Methods: A total of 61 individuals, 30 diagnosed with acne rosacea and 31 healthy controls, were included in this study. There was no difference between the two groups in terms of age, gender, and body mass index. Zonulin was studied using the enzyme-linked immunosorbent assay. Results: The serum zonulin levels were found to be significantly higher in the patient group than in the control group (18.5 ± 2.9 ng/ml and 13.2 ± 2.7 ng/ml, respectively; p < 0.001). Conclusion: This is the first study in the literature to demonstrate that the serum zonulin levels are increased in patients with acne rosacea.

Ünal A, et al. Ann Dermatol. 2024 Aug;36(4):231-235. https://doi.org/10.5021/ad.24.020

Background: This paper aimed to determine the prevalence of 25-hydroxy vitamin D (25(OH)D) deficiency in healthy adult patients who presented to our hospital in Istanbul province and to present the difference between vitamin 25(OH)D levels by gender, age group, season, and month. Methods: The vitamin 25(OH)D levels of 9,778 adults who presented to our hospital's internal medicine checkup outpatient clinic between January 2022 and December 2023 were analyzed retrospectively. Individuals with chronic disorders were excluded from the study. The adult patients included in the study were divided into two groups by age (18-50 and 51-65 years). Serum 25(OH)D levels were measured using the electrochemiluminescence immunoassay method. A serum 25(OH)D level was considered deficient if below 20 ng/mL, insufficient if 20-30 ng/mL, and sufficient if above 30 ng/mL. The patients' 25(OH)D levels were investigated by age, gender, season, and month. Results: After measurement, vitamin D levels were deficient in 57.2% of the patients (n=5,592), insufficient in 28.2% (n=2,756), and sufficient in 14.6% (n=1,430). The mean vitamin D level of the 18-50 age group was significantly lower than that of the group 51-65 age group (p=0.001; p0.05). The mean vitamin D levels were 17.99±10.88 ng/mL in winter, 18.11±12.69 ng/mL in spring, 22.08±11.58 ng/mL in summer, and 21.67±10.82 ng/mL in fall. There were statistically significant differences according to the season and month of hospital presentation (p=0.001; p<0.01). Conclusions: The prevalence of vitamin D deficiency (below 20 ng/mL) in healthy adults aged 18-65 years in Istanbul was 57.2%. That prevalence varied across seasons and months, indicating that sunlight was not used sufficiently. Vitamin D deficiency in Istanbul presents a major problem that needs to be remedied.