1
|
Turk CB, Baykara Ulusan M, Döş YM, Manav Baş V, Sarikaya Tellal E, Koku Aksu AE. The Effects of Oral Isotretinoin on Atrophic Acne Scars Measured by Shear-wave Elastography: An Observational, Single-center Study. J Clin Aesthet Dermatol 2023; 16:46-51. [PMID: 37720196 PMCID: PMC10503936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
Background Although the effects of oral isotretinoin (OI) on acne vulgaris and preventing further acne scars have been well-documented, the specific impact of OI alone on pre-existing atrophic acne scars (AAS) remains unclear. No clinical study has objectively evaluated the effect of OI on AAS yet. Objective We sought to investigate the OI effect on AAS quantitatively and reliably by shear-wave elastography (SWE). Methods This work is a single-center, prospective and observational study. Thirty patients with moderate and severe acne vulgaris accompanied by AAS were included. We started the OI with a standard dose regime. On Days 0 and 90 of treatment, patients' global acne grading system (GAGS) and the Goodman and Baron's Qualitative Global Scar Rating System (GSRS) were evaluated. The dermal thickness, subcutaneous tissue thickness, scar size, and scar and subcutaneous tissue's elastic modules were measured on both cheeks of each patient by SWE. Results The improvement in GSRS stages and GAGS scores in 90 days were statistically significant (respectively; p=0.029, <0.001). Scar size and dermal thickness decreased, while the subcutaneous tissue thickness and the elastic modulus of scar and subcutaneous tissue increased in bilateral cheeks. The thickness changes in the right side dermis, and subcutaneous tissue on both sides were noteworthy (p<0.05). Conclusion Besides its well-known effect on acne vulgaris, OI also could be an effective treatment option for reducing scar size and severity while improving skin elasticity. SWE may help follow skin and scar properties.
Collapse
Affiliation(s)
- Cemre Busra Turk
- Dr. Turk is with the Wellman Center for Photomedicine at Massachusetts General Hospital in Boston, Massachusetts
- Additionally, Dr. Turk is with the Department of Dermatology at Harvard Medical School in Boston, Massachusetts
| | - Melis Baykara Ulusan
- Dr. Baykara Ulusan is with the University of Health Sciences Istanbul Training and Research Hospital's Radiology Clinic in Istanbul, Turkey
| | - Yusuf Mert Döş
- Drs. Döş, Manav Baş, Sarıkaya Tellal, and Koku Aksu are with the University of Health Sciences Istanbul Training and Research Hospital's Dermatology Clinic in Istanbul, Turkey
| | - Vildan Manav Baş
- Drs. Döş, Manav Baş, Sarıkaya Tellal, and Koku Aksu are with the University of Health Sciences Istanbul Training and Research Hospital's Dermatology Clinic in Istanbul, Turkey
| | - Ebru Sarikaya Tellal
- Drs. Döş, Manav Baş, Sarıkaya Tellal, and Koku Aksu are with the University of Health Sciences Istanbul Training and Research Hospital's Dermatology Clinic in Istanbul, Turkey
| | - Ayse Esra Koku Aksu
- Drs. Döş, Manav Baş, Sarıkaya Tellal, and Koku Aksu are with the University of Health Sciences Istanbul Training and Research Hospital's Dermatology Clinic in Istanbul, Turkey
| |
Collapse
|
2
|
Sarıkaya Tellal E, Ilhan Erdil D, Gore Karaali M, Aksu AEK, Erdemir VA, Polat AK, Leblebici C. Interstitial Granulomatous Dermatitis and Palisaded Neutrophilic Granulomatous Dermatitis: Retrospective Clinicopathological Analysis of 16 Cases. Dermatol Pract Concept 2023; 13:e2023129. [PMID: 37557159 PMCID: PMC10412059 DOI: 10.5826/dpc.1303a129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2022] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION Reactive granulomatous dermatitis (RGD) is a new entity, which is highly associated with systemic disorders. There is scarce data regarding interstitial granulomatous dermatitis (IGD) and palisaded neutrophilic granulomatous dermatitis (PNGD). OBJECTIVES We aimed to evaluate clinical and histopathological characteristics of IGD and PNGD as unified entities under the term of RGD. METHODS Observational, retrospective, single-center study of patients diagnosed with IGD and PNGD between 2012 and 2021 were included in the study. RESULTS Of 16 patients (14 females and 2 males) with RGD, 13 had IGD and 3 had PNGD with a mean age of 62.5 years. The most common clinical presentation was plaques 37.5% (N=6), followed by patches 25% (N=4). The most common localization of involvement was lower extremity 75% (N=12), followed by trunk and upper extremity. Multiple localization of involvement was determined in 75% (N=12) of patients. None of the patients had rope sign. Associated comorbidities such as autoimmune diseases and malignancies were detected in 68.7% (N=11) of patients. In majority of biopsies (87.5%; N=14), there were lymphohistiocytic cell infiltration. Other accompanying cells were scarce neutrophils 31.2% (N=5) and eosinophils 31.2% (N=5). All of the biopsies had interstitially located lymphohistiocytic cell infiltration surrounding with swollen and degenerated collagen. Palisaded pattern was determined in 18.7% (N=3) of patients and floating sign was seen in 18.7% (N=3) of biopsies. CONCLUSIONS RGD is a rare entity and most patients with RGD had associated disorders such as autoimmunity or malignancy. There is overlapping between IGD and PNGD, therefore supporting the usage of umbrella term as reactive granulomatous dermatitis is compatible with the literature.
Collapse
Affiliation(s)
- Ebru Sarıkaya Tellal
- Department of Dermatology, University of Health Science (HSU) Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Dilara Ilhan Erdil
- Department of Dermatology, University of Health Science (HSU) Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Muge Gore Karaali
- Department of Dermatology, Irmet International Hospital, Tekirdag, Turkey
| | - Ayse Esra Koku Aksu
- Department of Dermatology, University of Health Science (HSU) Istanbul Training and Research Hospital, Istanbul, Turkey
| | - VA Erdemir
- Department of Dermatology, Göztepe Training and Research Hospital, Medeniyet University, Istanbul, Turkey
| | - Asude Kara Polat
- Department of Dermatology, University of Health Science (HSU) Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Cem Leblebici
- Department of Pathology, University of Health Science (HSU) Istanbul Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|
3
|
Inan Yuksel E, Kara Polat A, Gore Karaali M, Koku Aksu AE, Gurel MS. Effect of the varicella vaccination implementation on the development of herpes zoster in children and adolescents. Dermatol Ther 2021; 34:e14995. [PMID: 34031954 DOI: 10.1111/dth.14995] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 05/19/2021] [Indexed: 11/29/2022]
Abstract
Herpes zoster (HZ) is an infectious disease caused by latent varicella-zoster virus reactivation. There are conflicting reports on the varicella vaccine's effect on the incidence of HZ in children and adolescents. This study aimed to determine the impact of the single dose of varicella vaccination on HZ prevalence during childhood and adolescence. The study included children and adolescents aged <18 years who presented to the dermatology outpatient clinic between 2005 and 2019 and were diagnosed with HZ. Considering that the universal vaccination program started to be implemented in Turkey in 2013, non-vaccinated cases in the prevaccination period, vaccinated cases in the postvaccination period, and non-vaccinated patients in the postvaccination period were compared in terms of HZ prevalence and demographic features. After the initiation of the varicella vaccination program, the prevalence of HZ was found to decrease by 24.7% in all. The HZ prevalence was significantly reduced in vaccinated children, while the rate of decrease in non-vaccinated children was low (58.6% and 16.4%, respectively). The median age of the non-vaccinated cases in the postvaccination period (10 [min 0.5-max 17] years) was significantly higher compared to the other groups (p < 0.001). The number of cases aged <2 years was the highest in the vaccinated group (p < 0.001). Administration of a single dose of varicella vaccine was insufficient to decrease the prevalence of HZ <18 years of age. In the post-vaccination period, the frequency of HZ in unvaccinated cases increased in adolescence. In vaccinated children, HZ seems to develop at an earlier age.
Collapse
Affiliation(s)
- Esma Inan Yuksel
- Department of Dermatology, Firat University Faculty of Medicine, Elazıg, Turkey
| | - Asude Kara Polat
- Department of Dermatology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Muge Gore Karaali
- Department of Dermatology, Erzincan Binali Yıldırım University Faculty of Medicine, Mengücek Gazi Training and Research Hospital, Erzincan, Turkey
| | - Ayse Esra Koku Aksu
- Department of Dermatology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Salih Gurel
- Department of Dermatology, Medeniyet University, Faculty of Medicine, Istanbul, Turkey
| |
Collapse
|
4
|
Gore Karaali M, Koku Aksu AE, Cin M, Leblebici C, Kara Polat A, Gurel MS. Tissue eosinophil levels as a marker of disease severity in bullous pemphigoid. Australas J Dermatol 2021; 62:e236-e241. [PMID: 33748980 DOI: 10.1111/ajd.13547] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/05/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Eosinophils play an important role in bullous pemphigoid (BP) pathogenesis. Although tissue infiltration with eosinophils has been known for a long time, there is a lack of knowledge about the relationship between tissue eosinophil levels and disease severity and clinical characteristics of the patients. METHODS Fifty-nine patients diagnosed with BP between January 2008 and December 2018 were reviewed. Haematoxylin-Eosin (H&E)-stained preparations were re-evaluated in terms of tissue eosinophil levels. For disease severity, Bullous Pemphigoid Disease Area Index (BPDAI) was used. The relationship between tissue eosinophil levels and disease severity and clinical features were evaluated. RESULTS Erosion/blister and urticaria/erythema BPDAI scores were higher in the group with high tissue eosinophil level than the group with low tissue eosinophil level. Tissue and peripheral blood eosinophil count were correlated with total urticaria/erythema BPDAI scores. There was no correlation between blood and tissue eosinophil count. The mortality rate was 64.7% vs 44.0% in the high vs low tissue eosinophil groups. Tissue eosinophil levels were high in patients with BP accompanying neurological disease. CONCLUSIONS Tissue eosinophil count and peripheral blood eosinophil count were correlated with disease severity in BP. Tissue eosinophil levels were also high in patients with BP accompanying neurological disease.
Collapse
Affiliation(s)
- Muge Gore Karaali
- Department of Dermatology, Mengücek Gazi Training and Research Hospital, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - Ayse Esra Koku Aksu
- Department of Dermatology, University of Health Science (HSU) Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Merve Cin
- Department of Pathology, University of Health Science (HSU) Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Cem Leblebici
- Department of Pathology, University of Health Science (HSU) Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Asude Kara Polat
- Department of Dermatology, University of Health Science (HSU) Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Salih Gurel
- Department of Dermatology, Göztepe Training and Research Hospital, Medeniyet University, Istanbul, Turkey
| |
Collapse
|
5
|
Kara Polat A, Oguz Topal I, Aslan Kayıran M, Koku Aksu AE, Aytekin S, Topaloglu Demir F, Ozkok Akbulut T, Kıvanc Altunay I, Ozkur E, Karadag AS. Drug survival and safety profile of acitretin monotherapy in patients with psoriasis: A multicenter retrospective study. Dermatol Ther 2021; 34:e14834. [PMID: 33527603 DOI: 10.1111/dth.14834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/22/2021] [Accepted: 01/23/2021] [Indexed: 12/01/2022]
Abstract
Acitretin is a nonimmunosuppresive systemic agent used in the treatment of psoriasis. Despite its frequent use, research on drug survival and adverse effects is limited. This study aims to evaluate drug survival, factors associated with survival, and adverse effects. Database of the six tertiary referral center for psoriasis patients treated with acitretin between November 2014 and April 2020 were retrospectively analyzed. Demographics of patients, adverse effects, and also drug survival were analyzed. Of 412 patients, 61.2% were male, and 38.8% were female. Common clinical adverse effects were cheilitis (71.4%), dry skin (62.5%), and palmoplantar skin peeling (37.2%). High triglyceride and high total cholesterol levels were observed in 50.0% and 49.5% of patients, respectively. Median survival time (95% confidence interval [CI]) was 18 (13.6-22.4) months. Statistically significant risk factors affecting drug discontinuation were having psoriatic arthritis, age under 65, and receiving previous systemic treatment. Drug survival rates were 56.6%, 25.9%, and 19.8% at 1, 5, and 8 years, respectively. Although mucocutaneous adverse effects of the acitretin were quite frequent, severe, life-treatining ones were infrequent. This old, relatively inexpensive and safe treatment remains a good alternative for the treatment of psoriasis.
Collapse
Affiliation(s)
- Asude Kara Polat
- Department of Dermatology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Ilteris Oguz Topal
- Department of Dermatology, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, Turkey
| | - Melek Aslan Kayıran
- Department of Dermatology, Istanbul Medeniyet University, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Ayse Esra Koku Aksu
- Department of Dermatology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Sema Aytekin
- Department of Dermatology, University of Health Sciences, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey
| | - Filiz Topaloglu Demir
- Department of Dermatology, Istanbul Medipol University, Faculty of Medicine, Istanbul, Turkey
| | - Tugba Ozkok Akbulut
- Department of Dermatology, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Ilknur Kıvanc Altunay
- Department of Dermatology, University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Ezgi Ozkur
- Department of Dermatology, University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | | |
Collapse
|
6
|
Kara Polat A, Oguz Topal I, Karadag AS, Aksoy H, Koku Aksu AE, Ozkur E, Ozkok Akbulut T, Topaloglu Demir F, Engin B, Uzuncakmak TK, Kıvanc Altunay I. The impact of COVID-19 in patients with psoriasis: A multicenter study in Istanbul. Dermatol Ther 2020; 34:e14691. [PMID: 33351215 PMCID: PMC7883044 DOI: 10.1111/dth.14691] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 12/14/2020] [Accepted: 12/16/2020] [Indexed: 12/19/2022]
Abstract
There is widespread concern about treatment of psoriasis in COVID‐19 pandemic. We aimed to evaluate the epidemiological data, clinical characteristics, treatment features of the psoriasis patients during the pandemic period. We conducted a study in dermatology clinics of seven different tertiary centers. All adult psoriasis patients who were followed up between 11 March 2020 and 28 June 2020, were phone called or questioned in their visit to their follow‐up clinics. A semistructured questionnaire was applied and patients' demographics and disease characteristics were recorded. Of 1322 patients, 52.4% were male, and 47.6% were female. According to the questionnaire responses, 964 (72.9%) of these patients could not communicate with their physician during this period, remained 358 (27.1%) patients contacted the physician by phone, email, or hospital visit. From the patients diagnosed as probable/confirmed COVID‐19, 14 were female, and 9 were male. Nine of 23 (39.1%) patients were using biologic treatment. There was no statistically significant difference in terms of hospitalization from COVID‐19 between the patients using biologics (n = 9) and those who did not (n = 14) (P = 1.00). No mortality was observed among them. Obesity, smoking, age, and accompanying psoriatic arthritis were not among the risk factors affecting the frequency of COVID‐19. We only encountered an increased risk in diabetic patients. Also, an exacerbation of psoriasis was observed with the infection. No difference was found in patients with psoriasis in terms of COVID‐19 infection in patients who use biologics and those who don't.
Collapse
Affiliation(s)
- Asude Kara Polat
- Department of Dermatology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Ilteris Oguz Topal
- Department of Dermatology, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, Turkey
| | - Ayse Serap Karadag
- Department of Dermatology, Istanbul Medeniyet University, Faculty of Medicine, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Hasan Aksoy
- Department of Dermatology, Istanbul Medeniyet University, Faculty of Medicine, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Ayse Esra Koku Aksu
- Department of Dermatology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Ezgi Ozkur
- Department of Dermatology, University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Tugba Ozkok Akbulut
- Department of Dermatology, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Filiz Topaloglu Demir
- Department of Dermatology, Istanbul Medipol University, Faculty of Medicine, Istanbul, Turkey
| | - Burhan Engin
- Department of Dermatology, Istanbul University-Cerrahpasa, Faculty of Medicine, Istanbul, Turkey
| | - Tugba Kevser Uzuncakmak
- Department of Dermatology, Istanbul University-Cerrahpasa, Faculty of Medicine, Istanbul, Turkey
| | - Ilknur Kıvanc Altunay
- Department of Dermatology, University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|
7
|
Gore Karaali M, Erdil D, Erdemir VA, Gurel MS, Koku Aksu AE, Leblebici C. Evaluation of clinicopathological and treatment characteristics of 80 patients with acquired perforating dermatosis. Dermatol Ther 2020; 33:e14465. [PMID: 33112028 DOI: 10.1111/dth.14465] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 10/13/2020] [Accepted: 10/23/2020] [Indexed: 12/22/2022]
Abstract
Acquired perforating dermatosis (APD) is a group of a rare dermatological disorder characterized by elimination of dermal connective tissue through epidermis. We aimed to evaluate the characteristics of patients diagnosed with APD and to determine the differences in comorbidities according to subtypes of APD. A retrospective, observational, cross-sectional study was designed. Patients diagnosed with APD between January 2008 and January 2019 were reviewed. Eighty patients were included in the study. 61.2% (n = 49) of the patients were female and 38.8% (n = 31) were male with a mean age of 58.4 ± 12.5 years. 82.5% (n = 66) of the patients were diagnosed with reactive perforating collagenosis (RPC) and 17.5% (n = 14) of perforating folliculitis (PF). The most common concomitant disease was diabetes mellitus (82.5%). 5.0% of the patients had malignancy. The comorbidity rate in RPC group was higher than PF (P < .05). Topical steroid was the most frequently (90.0%) used treatment. Complete response was obtained 55.0% of patients. Exitus was observed in 23.8% (n = 19) of patients in a mean 17.6 ± 25.7 months follow-up period. APD may be associated with many diseases. Comorbidities are more frequent in RPC group. This situation warns us to evaluate patients with RPC in more detail for underlying diseases. High mortality rate related to the underlying systemic diseases suggests being careful in terms of mortality in patients diagnosed with APD.
Collapse
Affiliation(s)
- Muge Gore Karaali
- Department of Dermatology, Mengücek Gazi Training and Research Hospital, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - Duygu Erdil
- Department of Dermatology, University of Health Science (HSU) Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Vefa Aslı Erdemir
- Department of Dermatology, Göztepe Training and Research Hospital, Medeniyet University, Istanbul, Turkey
| | - Mehmet Salih Gurel
- Department of Dermatology, Göztepe Training and Research Hospital, Medeniyet University, Istanbul, Turkey
| | - Ayse Esra Koku Aksu
- Department of Dermatology, University of Health Science (HSU) Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Cem Leblebici
- Department of Pathology, University of Health Science (HSU) Istanbul Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|
8
|
Kara Polat A, Gore Karaali M, Esra Koku Aksu A, Asli Turgut Erdemir V, Leblebici C, Salih Gurel M. A rare cutaneous tuberculosis form, erythema induratum of Bazin: 6 years’ experience. Acta Dermatovenerologica Alpina Pannonica et Adriatica 2020. [DOI: 10.15570/actaapa.2020.26] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
9
|
Kara Polat A, Gore Karaali M, Esra Koku Aksu A, Asli Turgut Erdemir V, Leblebici C, Salih Gurel M. A rare cutaneous tuberculosis form, erythema induratum of Bazin: 6 years' experience. Acta Dermatovenerol Alp Pannonica Adriat 2020; 29:123-128. [PMID: 32975298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Erythema induratum of Bazin (EIB) is a rare tuberculid form characterized by hypersensitivity to Mycobacterium tuberculosis antigens. There are a few case series related to EIB in the literature. We evaluated the demographic, clinical, treatment, and follow-up characteristics of patients diagnosed with EIB. METHODS Demographic, clinical, histopathologic, and imaging findings as well as treatment and follow-up properties were evaluated in 22 patients retrospectively diagnosed with EIB between January 2013 and December 2018. RESULTS Of the 22 patients,90.9% were female and 9.1% were male. The mean age was 57.2 ± 12.9 years. Ten of the patients had a history of contact with tuberculosis, and one had a history of active pulmonary tuberculosis. The purified protein derivate (PPD) test average was 18.1 mm. The lesions were located in the lower extremity in all patients and in the upper extremity in 31.8% of patients. Histopathologically, 22.7% had vasculitis, 27.3% were treated with four tuberculosis drugs, and 72.7% were followed without tuberculosis treatment. Treatment was continued for two patients, and 75.0% of the patients treated with a four-drug regimen recovered. Relapse was observed in one of the patients after 36 months. The recovery rate was found to be 87.5% in patients that did not receive tuberculosis treatment, and there were no relapses in the follow-up. CONCLUSIONS EIB's etiopathogenesis is unknown. In total, 75.0% of the patients receiving tuberculosis treatment and 87.5% of the patients without tuberculosis treatment recovered in our study. The role of tuberculous therapy in the management of EIB is controversial. The selection of appropriate treatment for EIB continues to be an area of debate, and further studies are needed.
Collapse
Affiliation(s)
- Asude Kara Polat
- Department of Dermatology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Muge Gore Karaali
- Department of Dermatology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Ayse Esra Koku Aksu
- Department of Dermatology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Vefa Asli Turgut Erdemir
- Department of Dermatology, Medeniyet University, Göztepe Training and Research Hospital, Istanbul, Turkey
| | - Cem Leblebici
- Department of Pathology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Salih Gurel
- Department of Dermatology, Medeniyet University, Göztepe Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|
10
|
Kara Polat A, Akin Belli A, Ergun EZ, Manav Bas V, Erdil D, Koku Aksu AE, Gurel MS. Knowledge levels and concerns about oral isotretinoin treatment in the parents of adolescent acne patients. Dermatol Ther 2020; 33:e13669. [DOI: 10.1111/dth.13669] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/18/2020] [Accepted: 05/21/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Asude Kara Polat
- Department of Dermatology University of Health Sciences, Istanbul Training and Research Hospital Istanbul Turkey
| | - Asli Akin Belli
- Department of Dermatology Çakmak Erdem Hospital Istanbul Turkey
| | - Ecem Zeliha Ergun
- Department of Dermatology University of Health Sciences, Istanbul Training and Research Hospital Istanbul Turkey
| | - Vildan Manav Bas
- Department of Dermatology University of Health Sciences, Istanbul Training and Research Hospital Istanbul Turkey
| | - Duygu Erdil
- Department of Dermatology University of Health Sciences, Istanbul Training and Research Hospital Istanbul Turkey
| | - Ayse Esra Koku Aksu
- Department of Dermatology University of Health Sciences, Istanbul Training and Research Hospital Istanbul Turkey
| | - Mehmet Salih Gurel
- Department of Dermatology Medeniyet University, Göztepe Training and Research Hospital Istanbul Turkey
| |
Collapse
|
11
|
Gore Karaali M, Polat AK, Sarı Y, Koku Aksu AE, Leblebici C, Gurel MS. Proliferative Actinic Keratosis: An Invasive Squamous Cell Carcinoma or not? Acta Dermatovenerol Croat 2019; 27:75-80. [PMID: 31351500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Actinic keratoses have variants that differ clinically and pathologically. Proliferative actinic keratoses (PAK) are known to be resistant against standard therapies and to create a tendency for the development of invasive squamous cell carcinoma (SCC). This study retrospectively reviewed the medical records of 50 patients with 51 PAK lesions. Fifty patients (40 male, 10 female) with a mean age of 68.5 were included in the study. Thirty-two (63%) PAK lesions were clinically selected for total excision but only 27 of them could be totally excised. Among the excised lesions, 13 were reported to be PAK, 13 were SCC, and 1 was keratoacanthoma. There was no significant difference between the PAK and SCC groups. Overall, the groups with excised and unexcised lesions were statistically similar with respect to age, sex, lesion duration, localization, size, and surface features, but induration was more common in the SCC group. The mean follow-up time was 19.7 and 17.0 months in the PAK and SCC group, respectively. In conclusion, 25% (13/51) of lesions diagnosed as PAK were invasive SCC, which is of clinical and histopathological significance. Our results suggest that the definition of PAK should be histopathologically revised and that total excisional biopsy instead of punch biopsy should be considered, especially for lesions with a proliferative appearance.
Collapse
Affiliation(s)
- Muge Gore Karaali
- Muge Gore Karaali, MD, Istanbul Training and Research Hospital , Department of Dermatology, Kasap İlyas Mah. Org. Abdurrahman , Nafiz Gürman Cd., PK: 34098, Istanbul, Turkey;
| | | | | | | | | | | |
Collapse
|
12
|
Karaali MG, Polat AK, Koku Aksu AE, Leblebici C, Gurel MS. Solitary noninfiltrating angiolipoma on the finger, an unusual localization. Dermatol Online J 2019; 25:13030/qt72p1g8g4. [PMID: 30865409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 02/28/2019] [Indexed: 06/09/2023] Open
Abstract
Angiolipoma, a subtype of lipoma, is a benign adypocytic soft tissue tumor composed of mature adipose tissue and small vascular proliferations. This entity makes up 5-17% of all lipomas. The diagnosis is made by clinical and pathological examination, ultrasonography, and/or magnetic resonance imaging (MRI). It is generally an encapsulated tumor (noninfiltrative), but rarely has an infiltrative form. Angiolipoma mostly occurs on the trunk and extremities with male predominance. The forearm is the most frequent location for angiolipomas. It is very rarely seen on the fingers. Herein, we report a patient with solitary noninfiltrating angiolipoma on a finger. The patient was treated with surgical excision and no recurrence has been noted over one year of observation.
Collapse
Affiliation(s)
- Muge Gore Karaali
- Department of Dermatology, Health and Science University Istanbul Training and Research Hospital, Istanbul.
| | | | | | | | | |
Collapse
|
13
|
Karaali MG, Polat AK, Koku Aksu AE, Leblebici C, Gurel MS. Solitary noninfiltrating angiolipoma on the finger, an unusual localization. Dermatol Online J 2019. [DOI: 10.5070/d3252042914] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
|
14
|
Leblebici C, Ozkur E, Gurel MS, Koku Aksu AE, Savas S, Kiremitci U. Rare Case of Trichogenic Tumor: Trichoblastic Carcinoma. Istanbul Med J 2016. [DOI: 10.5152/imj.2016.38159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
15
|
Turgut Erdemir A, Gurel MS, Koku Aksu AE, Falay T, Inan Yuksel E, Sarikaya E. Demodex mites in acne rosacea: reflectance confocal microscopic study. Australas J Dermatol 2016; 58:e26-e30. [PMID: 26969834 DOI: 10.1111/ajd.12452] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 12/28/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND/OBJECTIVES Demodex mite density is emphasised in the aetiopathogenesis of acne rosacea. Reflectance confocal microscopy (RCM) has been shown to be a good method for determining demodex mite density. The objective was to determine demodex mite density using RCM in acne rosacea patients and compare them with controls. METHODS In all, 30 papulopustular rosacea (PPR) and 30 erythematotelangiectatic rosacea (ETR) totally 60 acne rosacea patients and 40 controls, were enrolled in the study. The right cheek was selected for imaging and RCM was used for scanning. Ten images of 1000 × 1000 μm (total 10 mm2 ) area were scanned from adjacent areas. The numbers of follicles, infested follicles and mites were counted. The mean numbers of mites per follicle and infested follicles were calculated and compared in the patients and control groups. RESULTS The mean number of mites was 44.30 ± 23.22 in PPR, 14.57 ± 15.86 in ETR and 3.55 ± 6.48 in the control group (P < 0.001). The mean number of mites per follicle was 1.77 ± 0.90 in PPR, 0.57 ± 0.63 in ETR and 0.13 ± 0.23 in the control group (P < 0.001). The cut-off for the mean number of mites for determining mite infestation was 0.17 and above. CONCLUSIONS Demodex mite density was markedly increased in both ETR and PPR patients. It is believed that the presence of demodex mites plays an important role in rosacea aetiopathogenesis. Demodex mite treatment may reduce the severity of the disease and slow its progressive nature.
Collapse
Affiliation(s)
- Asli Turgut Erdemir
- Department of Dermatology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Salih Gurel
- Department of Dermatology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Ayse Esra Koku Aksu
- Department of Dermatology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Tugba Falay
- Department of Dermatology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Esma Inan Yuksel
- Department of Dermatology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Ebru Sarikaya
- Department of Dermatology, Istanbul Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|
16
|
Yuksel EI, Gurel MS, Erdemir AT, Aksu AEK, Bagci IS, Leblebici C. The reflectance confocal microscopy in diagnosis of recurrent basal cell carcinoma. J DERMATOL TREAT 2015; 27:182-90. [PMID: 26325338 DOI: 10.3109/09546634.2015.1087460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Reflectance confocal microscopy (RCM) is very valuable, non-invasive diagnostic tool in the diagnosis of basal cell carcinoma (BCC). Objective: We aimed to demonstrate the positive predictive value (PPV), negative predictive value, sensitivity and specificity of RCM and dermoscopic features in recurrent BCC. METHODS The 152 entire lesion sites in 128 patients with BCC were evaluated by clinical examination, dermoscopy and RCM imaging techniques. Biopsy was performed from 46 lesions if there was at least one of the clinical findings or at least one of the diagnostic criteria of BCC with dermoscopy or RCM examination. Histopathological examination was considered as a gold standard for the diagnosis of recurrence BCC. RESULTS Recurrence was observed in 29 cases (63%). In the dermoscopic examination, arborizing telangiectasia and blue-grey globules were found to be statistically significantly correlated with BCC recurrence (p<0.05). The specificity and PPV of nucleated corneocytes in the stratum corneum and polarisation of elongated nuclei in the epidermis was 100%. PPV of streaming of aggregated tumour cells and variable refractile stroma was 92% with RCM examination. CONCLUSION RCM is a diagnostic tool with a high PPV, sensitivity and specificity for the diagnosis of recurrence of BCC lesions.
Collapse
|
17
|
Aksu AEK, Erdemir VAT, Gurel MS, Sarikaya E, Ozkur E. In vivo evaluation of Phthirus pubis with reflectance confocal microscopy. Parasitol Res 2015; 114:3559-61. [PMID: 26099238 DOI: 10.1007/s00436-015-4585-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 06/12/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Ayse Esra Koku Aksu
- Department of Dermatology, Istanbul Training and Research Hospital, Kasap İlyas Mah. Org. Abdurrahman Nafiz Gürman Cd., PK: 34098, Istanbul, Turkey,
| | | | | | | | | |
Collapse
|
18
|
Falay T, Sarikaya E, Koku Aksu AE, Leblebici C, Kiremitci U. Granular Cell Tumor: A Case Report. Istanbul Med J 2015. [DOI: 10.5152/imj.2015.33154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
19
|
Aksu AEK, Saracoglu ZN, Sabuncu I, Ciftci E, Gulbas Z, Isiksoy S. Necrotic ulcer: a manifestation of leukemia cutis. Skinmed 2012; 10:108-110. [PMID: 22545328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A 71-year-old man presented to our dermatological clinic with a 3-month history of a wound on his leg. He complained of weakness for the past few months. On his dermatological examination he had a 3x3-cm necrotic ulcer on his left tibia (Figure 1). On physical examination, there was 1 x 1-cm axillary lymphadenopathy. There was no other lymph node enlargement, hepatosplenomegaly, or gingival hypertrophy. Peripheral blood results showed 2.4x103/mm3 leukocytes (normal range 4-11 x 103/mm3) with 66% neutrophils. The hemoglobin value was 10.1 g/dL (13-18 g/dL), and the platelet count was 63x103/mm3 (150-440 x 103/mm3). No blasts were detected in a peripheral blood smear. His lactate dehydrogenase level was 567 U/L (240-480 U/L). All other results of blood chemistry were within normal limits. Punch biopsy of the skin lesion showed ulceration and dense dermal acute and chronic inflammation. There was a superficial and deep perivascular and periadnexal infiltrate of neoplastic cells composed of relatively abundant eosinophilic cytoplasm and large nuclei with blastic chromatin and occasional small nucleoli (Figure 2). Mitotic figures were prominent. Immunohistochemical stains were performed, and the neoplastic cells were CD3, CD20, CD138, and S100 protein negative. Myeloperoxidase and CD68 were positive. The histopathological findings were consistent with leukemic infiltration. Examination of bone marrow biopsy revealed that the blastic cells constituted more than 20% of the bone marrow cellularity. Cytogenetic analysis of bone marrow aspiration with fluorescence in situ hybridization was negative for inversion 16, t(8;21) and t(15;7). Histochemical stains for myeloperoxidase, sudan black, periodic acid-Schiff, and alpha naphthyl acetate were also negative. Blastic cells were DR, CD13, CD117, and CD34 positive and CD5, CD7, CD10, CD14, CD19, CD20, CD33, CD41, CD56, CD64, and CD79 negative according to flow cytometry immunophenotyping. Blastic cells were 35% in the bone marrow. Based on the findings of bone marrow examination, the patient was diagnosed as having acute myeloblastic leukeamia (AML) with minimal differentiation (subtype MO) according to French-American-British and World Health Organization classification. The examination of abdominal ultrasonography and thorocic and abominal computed tomography revealed no metastases. The patient was treated with chemotherapy that consisted of cytarabin and daunorubicin. After chemotherapy, the lesion regressed. One month after chemotherapy, the patient presented to the hospital with a complaint of fever. He was diagnosed with febrile neutropenia. He died of cardiac failure 12 months after appearance of skin infiltration.
Collapse
Affiliation(s)
- Ayse Esra Koku Aksu
- Department of Dermatology, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey.
| | | | | | | | | | | |
Collapse
|
20
|
Abstract
BACKGROUND There is a clear need for a useable measure of health-related quality-of-life (HRQoL) for dermatology patients. Most of the existing dermatology-specific measures were developed for the English language, and these measures should be adapted for use in other cultures. OBJECTIVE To adapt Skindex-29 (one of the most widely recognized dermatology-specific quality-of-life indices) for the Turkish cultural setting. PATIENTS AND METHODS Forward and backward translations were carried out, and for doubtful items the process was repeated until a satisfactory agreement with the original version of Skindex-29 was achieved. The intermediate Turkish version was administered to a group of 20 randomly selected Turkish adults with and without skin conditions. The final Turkish version of the Skindex-29 was administered to 456 patients attending Osmangazi University Dermatology outpatient clinics. Reliability, construct and content validity were assessed. RESULTS The instrument was internally consistent, with Cronbach's alpha-coefficients of 0.94, 0.76, 0.88, and 0.92 for entire questionnaire, symptom, emotional, and functional scales, respectively. The Turkish Skindex-29 demonstrated construct and content validity. CONCLUSION Our evaluation of the Skindex-29 indicates that the instrument is a comprehensible, useable, reliable and valid measure of quality-of-life for Turkish dermatologic patients.
Collapse
Affiliation(s)
- Ayse Esra Koku Aksu
- Department of Dermatology, Osmangazi University Medical School, Eskisehir, Turkey.
| | | | | | | | | |
Collapse
|