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Erduran F, Adışen E, Emre S, Hayran Y, Başkan EB, Yazıcı S, Bilgiç A, Alpsoy E, Günaydın SD, Elmas L, Akyol M, Güner R, Arıca DA, Aypek Y, Ergun T, Karavelioğlu D, Yazıcı AC, Aydoğan K, Bayramgürler D, Kıran R, Erdoğan HK, Acer E, Aktaş A. Evaluation of the Factors Influencing Mortality in Patients with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Multicenter Study of 166 Patients. Dermatol Ther (Heidelb) 2024:10.1007/s13555-024-01180-6. [PMID: 38758423 DOI: 10.1007/s13555-024-01180-6] [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: 03/04/2024] [Accepted: 05/01/2024] [Indexed: 05/18/2024] Open
Abstract
INTRODUCTION Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening acute mucocutaneous disorders usually triggered by drugs. In this study, we aimed to evaluate the factors affecting mortality in patients with SJS-TEN. METHODS Our study is a retrospective cohort study, analyzing data collected from a total of 12 tertiary care centers between April 2012 and April 2022. RESULTS The study included 59 males and 107 females, a total of 166 patients, with an average age of 50.91 ± 21.25 years. Disease classification was TEN in 50% of cases, SJS in 33.1%, and SJS-TEN overlap in 16.9%. The average SCORTEN within the first 24 h was 2.44 ± 1.42. Supportive care was provided to 99.4% of patients. The most commonly used systemic immunomodulatory treatments were systemic steroids (84.3%), IVIG (intravenous immunoglobulin) (49.3%), and cyclosporine (38.6%). Plasmapheresis was administered to five patients. While 66.3% of patients were discharged, 24.1% resulted in exitus. Our comparative analysis of survivors and deceased patients found no effect of systemic steroids, IVIG, and cyclosporine treatments on mortality. Univariate analysis revealed that the SCORTEN scores on days 1 and 3 as well as the rates of detachment at the onset and during follow-up were significantly higher in deceased patients compared to survivors. The rates of fever, positive blood cultures, and systemic antibiotic use were higher in deceased patients compared to survivors. The presence of comorbidities, diabetes, and malignancy were significantly more common in deceased patients. Multivariate regression analysis indicated that over SCORTEN 2, the mortality risk exponentially rose with each SCORTEN increment, culminating in an 84-fold increase in mortality at SCORTEN 5-6 (odds ratio [95% confidence interval]: 13.902-507.537, p < 0.001) compared to SCORTEN 0-1. Additionally, the utilization of plasmapheresis was associated with a 22-fold increase in mortality (odds ratio [95% confidence interval]: 1.96-247.2, p = 0.012). CONCLUSION Our study found that a high SCORTEN score within the first 24 h and the use of plasmapheresis were related to increased mortality, while systemic steroids, IVIG, and cyclosporine treatments had no impact on mortality. We believe that data gathered from one of the most comprehensive studies which we conducted on SJS-TEN will enrich the literature, although additional research is warranted.
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Affiliation(s)
- Funda Erduran
- Ankara Bilkent City Hospital, Department of Dermatology, Ankara, Turkey.
| | - Esra Adışen
- Department of Dermatology, Gazi University, Ankara, Turkey
| | - Selma Emre
- Department of Dermatology, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Yıldız Hayran
- Ankara Bilkent City Hospital, Department of Dermatology, Ankara, Turkey
| | | | - Serkan Yazıcı
- Department of Dermatology, Bursa Uludağ University, Bursa, Turkey
| | - Aslı Bilgiç
- Department of Dermatology, Akdeniz University, Antalya, Turkey
| | - Erkan Alpsoy
- Department of Dermatology, Akdeniz University, Antalya, Turkey
| | | | - Leyla Elmas
- Department of Dermatology, Hacettepe University, Ankara, Turkey
| | - Melih Akyol
- Department of Dermatology, Sivas Cumhuriyet University, Sivas, Turkey
| | - RukiyeYasak Güner
- Department of Dermatology, Sivas Cumhuriyet University, Sivas, Turkey
| | - Deniz Aksu Arıca
- Department of Dermatology, Karadeniz Technical University, Trabzon, Turkey
| | - Yağmur Aypek
- Department of Dermatology, Gazi University, Ankara, Turkey
| | - Tülin Ergun
- Department of Dermatology, Marmara University, Istanbul, Turkey
| | | | | | - Kübra Aydoğan
- Department of Dermatology, Mersin University, Mersin, Turkey
| | | | - Rebiay Kıran
- Department of Dermatology, Kocaeli University, Kocaeli, Turkey
| | - Hilal Kaya Erdoğan
- Department of Dermatology, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Ersoy Acer
- Department of Dermatology, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Akın Aktaş
- Department of Dermatology, Ankara Yıldırım Beyazıt University, Ankara, Turkey
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Açıkel SÜ, Özdemir AK, Emre S. The Reliability and Quality of YouTube Videos About Isotretinoin Treatment and Suicide. Clin Exp Dermatol 2024:llae166. [PMID: 38699954 DOI: 10.1093/ced/llae166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/09/2024] [Accepted: 05/01/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND Seeking health information online has drastically increased. Isotretinoin is one of the agents used to treat acne. OBJECTIVES In this study, we aimed to investigate the reliability and quality of YouTube videos related to acne treatment, which have been misconception to increase suicide. METHODS We used the terms "isotretinoin suicide" and "acne treatment suicide" to search YouTube videos. Videos that were not in English, irrelevant, or devoid of audio were not included. The information in the videos was primarily categorized as reliable or unreliable based on its scientific validation. DISCERN and the Global Quality Score were used to evaluate the videos' overall quality. RESULTS 200 videos in total were examined. 112 videos were included in the study. 39 videos (34.8 %) were found to be reliable, and 73 videos (65.2%) were found to be unreliable. DISCERN values of videos uploaded by physicians or professional organizations and health information websites were found to be significantly higher. There was a statistically significant negative correlation between DISCERN score and video length and the length of time the video was on YOUTUBE, while a positive correlation was observed between DISCERN score and subscriber. CONCLUSION Although videos created by dermatologists have become widespread in recent years, it is still insufficient. Patient experience videos mostly contain information which does not reflect the reality and emphasize that isotretinoin increases the risk of suicide without evidence. As the number of dermatologists posting videos on YouTube increases, the chances of people accessing correct information will increase.
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Affiliation(s)
- Sezin Ünlü Açıkel
- Department of Dermatology and Venereology, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
| | - Ahmet Kağan Özdemir
- Department of Dermatology and Venereology, Health Science University of Türkiye, Sincan Training and Research Hospital, Ankara, Turkey
| | - Selma Emre
- Department of Dermatology and Venereology, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
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Cebeci Kahraman F, Temiz SA, Erdoğan SS, Öztürk P, Güven M, Çelik HA, Tellal ES, Akbayrak A, Selçuk LB, Akbulak Ö, Emre S, Gençoğlan G, Ataseven A, Kaya Erdoğan H, Ertekin SS, Taşolar MK, An İ, Öztürk M, Karakuzu A, Erdal SA, Solak SS, Albayrak H, Cömert Özer E, Bayramgürler D, Özgöztaşı O, Yulek T, Aydoğan K, Zindancı İ, Çalıkoğlu E, Kuş C. Prevalence of hirsutism in Turkey: Data of the dermatoendocrinology study group. J Eur Acad Dermatol Venereol 2023. [PMID: 38147489 DOI: 10.1111/jdv.19763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 12/11/2023] [Indexed: 12/28/2023]
Affiliation(s)
- Filiz Cebeci Kahraman
- Department of Dermatology, University of Health Sciences Sultan 2. Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Selami Aykut Temiz
- Department of Dermatology, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey
| | - Sevil Savaş Erdoğan
- Department of Dermatology, University of Health Sciences, İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Perihan Öztürk
- Department of Dermatology, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Münevver Güven
- Department of Dermatology, Aydın Adnan Menderes University, Aydın, Turkey
| | - Hilal Ayvaz Çelik
- Department of Dermatology, Isparta Süleyman Demirel University, Isparta, Turkey
| | - Ebru Sarıkaya Tellal
- Department of Dermatology, University of Health Sciences, İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Atiye Akbayrak
- Department of Dermatology, Gaziosmanpaşa University, Tokat, Turkey
| | | | - Özge Akbulak
- Department of Dermatology, Ümraniye Training and Research Hospital, İstanbul, Turkey
| | - Selma Emre
- Department of Dermatology, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Gülsüm Gençoğlan
- Department of Dermatology, Celal Bayar University, Manisa, Turkey
| | - Arzu Ataseven
- Department of Dermatology, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey
| | - Hilal Kaya Erdoğan
- Department of Dermatology, Eskişehir Osmangazi University, Eskişehir, Turkey
| | | | | | - İsa An
- Department of Dermatology, Şanlıurfa Training and Research Hospital, Şanlıurfa, Turkey
| | - Murat Öztürk
- Department of Dermatology, Van Training and Research Hospital, Van, Turkey
| | - Ali Karakuzu
- Department of Dermatology, İzmir Katip Çelebi University, İzmir, Turkey
| | - Semahat Alp Erdal
- Department of Dermatology, Mardin Artuklu University, Mardin, Turkey
| | | | - Hülya Albayrak
- Department of Dermatology, Namık Kemal University, Tekirdağ, Turkey
| | | | | | - Orhan Özgöztaşı
- Department of Dermatology, Gaziantep University, Gaziantep, Turkey
| | - Tugba Yulek
- Department of Dermatology, Adana City Hospital, Adana, Turkey
| | - Kenan Aydoğan
- Department of Dermatology, Bursa Uludağ University Medical Faculty, Bursa, Turkey
| | - İlkin Zindancı
- Department of Dermatology, Ümraniye Training and Research Hospital, İstanbul, Turkey
| | - Emel Çalıkoğlu
- Department of Dermatology, İzmir Private Sağlık Hospital, İzmir, Turkey
| | - Celal Kuş
- Department of Family Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
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Emre S, Süngü N, Hayran Y, Demirseren DD, Aktas A, Duman TÖ. Investigation of the PD-1/PD-L1 Expression in the Lesional Skins of Patients With Psoriasis. Dermatol Pract Concept 2023; 13:dpc.1302a134. [PMID: 37196303 DOI: 10.5826/dpc.1302a134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2022] [Indexed: 05/19/2023] Open
Abstract
INTRODUCTION Psoriasis is an immune-mediated, chronic and inflammatory disease whose pathogenesis is affected by the interactions of several immune cells and cytokines. PD-1 is an inhibitor receptor that is expressed to a large extent in T lymphocytes and responsible for regulating autoimmunity and self-tolerance. OBJECTIVES In this study, we aimed to investigate the expression of PD-1/PD-L molecules in the lesioned skins of psoriasis patients. METHODS The study included 30 psoriasis patients, and 15 healthy volunteers as the control group. Anti PD-1 and PD-L1 antibodies were applied to the skin biopsy samples that were collected from the patient and control groups. Cytoplasmic and membranous staining of PD-1 and PD-L1 were considered positive. The number of stained immune cells that was examined for each case. RESULTS The percentage of the tissues with high PD-1 (+) and PDL-1 (+) immune cell counts were significantly higher in the psoriasis patients compared to healthy controls (P values = 0.004 and 0.002, respectively). A negative and statistically significant correlation was detected between PDL-1(+) immune cell numbers and PASI scores (P = 0.033, r=-0.57). CONCLUSIONS In the lesioned skin samples of psoriasis patients, the PD-1 and PD-L1 expressions were significantly higher in immune cells than that in the skin samples of the healthy controls. This study was the first investigation of the expression of PD-1/PD-L molecules in the immune cells in found the lesioned skins of psoriasis patients.
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Affiliation(s)
- Selma Emre
- Yildirim Beyazit University, Medical School, Department of Dermatology, Ankara, Turkey
| | - Nuran Süngü
- Yildirim Beyazit University, Medical School, Department of Pathology, Ankara, Turkey
| | - Yıldız Hayran
- Ministry of Health, Ankara City Hospital, Department of Dermatology, Ankara, Turkey
| | - D Deniz Demirseren
- University of Health Science, Ankara City Hospital, Department of Dermatology, Ankara, Turkey
| | - Akın Aktas
- Yildirim Beyazit University, Medical School, Department of Dermatology, Ankara, Turkey
| | - Tuce Özkara Duman
- Yildirim Beyazit University, Medical School, Department of Dermatology, Ankara, Turkey
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5
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Kutlu Ö, Demircan YT, Yıldız K, Kalkan G, Demirseren DD, An İ, Oba MÇ, Emre S, Şenel E, Bilgili SG, Savaş SE, Aktürk AŞ, Türkmen D, Çakmak SK, Kulaklı S, Demirbaş A, Altunışık N, Coşansu NC, Aksoy GG, Tosun M, Kurt BÖ, Şentürk N, Şener S, Özden HK, Temiz SA, Atak MF, Süslü H, Oğuz ID, Kılıç S, Ustaoğlu E, Topal İO, Akbulut TÖ, Korkmaz İ, Kılıç A, Hızlı P, Küçük ÖS, Çaytemel C, Kara RÖ, Koska MC, Tatar K, Dikicier BS, Ağırgöl Ş, Akşan B, Karadağ AS. The effect of COVID-19 on development of hair and nail disorders: a Turkish multicenter, controlled study. Int J Dermatol 2023; 62:202-211. [PMID: 36281828 PMCID: PMC9874876 DOI: 10.1111/ijd.16454] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 08/07/2022] [Accepted: 10/05/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND A broad spectrum of skin diseases, including hair and nails, can be directly or indirectly triggered by COVID-19. It is aimed to examine the type and frequency of hair and nail disorders after COVID-19 infection. METHODS This is a multicenter study conducted on consecutive 2171 post-COVID-19 patients. Patients who developed hair and nail disorders and did not develop hair and nail disorders were recruited as subject and control groups. The type and frequency of hair and nail disorders were examined. RESULTS The rate of the previous admission in hospital due to COVID-19 was statistically significantly more common in patients who developed hair loss after getting infected with COVID-19 (P < 0.001). Telogen effluvium (85%) was the most common hair loss type followed by worsening of androgenetic alopecia (7%) after COVID-19 infection. The mean stress scores during and after getting infected with COVID-19 were 6.88 ± 2.77 and 3.64 ± 3.04, respectively, in the hair loss group and were 5.77 ± 3.18 and 2.81 ± 2.84, respectively, in the control group (P < 0.001, P < 0.001). The frequency of recurrent COVID-19 was statistically significantly higher in men with severe androgenetic alopecia (Grades 4-7 HNS) (P = 0.012; Odds ratio: 2.931 [1.222-7.027]). The most common nail disorders were leukonychia, onycholysis, Beau's lines, onychomadesis, and onychoschisis, respectively. The symptoms of COVID-19 were statistically significantly more common in patients having nail disorders after getting infected with COVID-19 when compared to the control group (P < 0.05). CONCLUSION The development of both nail and hair disorders after COVID-19 seems to be related to a history of severe COVID-19.
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Affiliation(s)
- Ömer Kutlu
- Department of Dermatology and Venereology, School of Medicine, Tokat Gaziosmanpaşa UniversityTokatTurkey
| | | | - Kenan Yıldız
- Department of Dermatology and Venereology, Adana Seyhan State HospitalAdanaTurkey
| | - Gӧknur Kalkan
- Department of Dermatology and Venereology, School of Medicine, Ankara Bilkent City Hospital, Ankara Yıldırım Beyazıt UniversityAnkaraTurkey
| | - Duriye Deniz Demirseren
- Department of Dermatology and Venereology, School of Medicine, Ankara Bilkent City Hospital, University of Health ScienceAnkaraTurkey
| | - İsa An
- Department of Dermatology and Venereology, Şanlıurfa Training and Research HospitalŞanlıurfaTurkey
| | - Muazzez Çiğdem Oba
- Department of Dermatology and Venereology, Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research HospitalIstanbulTurkey
| | - Selma Emre
- Department of Dermatology and Venereology, School of Medicine, Ankara Bilkent City Hospital, Ankara Yıldırım Beyazıt UniversityAnkaraTurkey
| | - Engin Şenel
- Department of Dermatology and Venereology, School of Medicine, Erol Olcak Training and Research Hospital, Hitit ÜniversityÇankırıTurkey
| | - Serap Güneş Bilgili
- Department of Dermatology and Venereology, School of Medicine, Van Yüzüncü Yıl UniversityVanTurkey
| | - Sevil Erdoğan Savaş
- Department of Dermatology and Venereology, School of Medicine, Sultan 2. Abdülhamid Han Training and Research Hospital, Health Science UniversityIstanbulTurkey
| | - Aysun Şikar Aktürk
- Department of Dermatology and Venereology, School of Medicine, Kocaeli UniversityKocaeliTurkey
| | - Dursun Türkmen
- Department of Dermatology and Venereology, School of Medicine, İnönü UniversityMalatyaTurkey
| | - Seray Külcü Çakmak
- Department of Dermatology and Venereology, School of Medicine, Ankara Bilkent City Hospital, University of Health ScienceAnkaraTurkey
| | - Sevgi Kulaklı
- Department of Dermatology and Venereology, School of Medicine, Giresun UniversityKocaeliTurkey
| | - Abdullah Demirbaş
- Department of Dermatology and Venereology, School of Medicine, Evliya Çelebi Training and Research Hospital, Kütahya Health Science UniversityKonyaTurkey
| | - Nihal Altunışık
- Department of Dermatology and Venereology, School of Medicine, İnönü UniversityMalatyaTurkey
| | - Nur Cihan Coşansu
- Department of Dermatology and Venereology, Sakarya Training and Research HospitalSakaryaTurkey
| | - Güneş Gur Aksoy
- Department of Dermatology and Venereology, School of Medicine, Ankara Bilkent City Hospital, University of Health ScienceAnkaraTurkey
| | - Mustafa Tosun
- Department of Dermatology and Venereology, School of Medicine, Sivas Cumhuriyet UniversitySivasTurkey
| | - Birgül Özkesici Kurt
- Department of Dermatology and Venereology, Adıyaman Training and Research HospitalAntalyaTurkey
| | - Nilgün Şentürk
- Department of Dermatology and Venereology, School of Medicine, Samsun Ondokuz Mayıs UniversitySamsunTurkey
| | - Serpil Şener
- Department of Dermatology and Venereology, School of Medicine, İnönü UniversityMalatyaTurkey
| | - Hatice Kaya Özden
- Department of Dermatology and Venereology, Kocaeli Derince Training and Research HospitalKocaeliTurkey
| | - Selami Aykut Temiz
- Department of Dermatology and Venereology, Meram School of Medicine, Necmettin Erbakan UniversityKonyaTurkey
| | - Mehmet Fatih Atak
- Department of Dermatology and Venereology, Tokat State HospitalTokatTurkey
| | - Hülya Süslü
- Department of Dermatology and Venereology, ıstanbul Haseki Training and Research HospitalIstanbulTurkey
| | - Işil Deniz Oğuz
- Department of Dermatology and Venereology, School of Medicine, Giresun UniversityKocaeliTurkey
| | - Sevilay Kılıç
- Department of Dermatology and Venereology, School of Medicine, Çanakkale Onsekiz Mart UniversityÇanakkaleTurkey
| | - Eda Ustaoğlu
- Department of Dermatology and Venereology, Bursa City HospitalBursaTurkey
| | - İlteriş Oğuz Topal
- Department of Dermatology and Venereology, Prof. Dr. Cemil Tascioglu City Hospital, Health Science UniversityIstanbulTurkey
| | - Tuğba Özkök Akbulut
- Department of Dermatology and Venereology, ıstanbul Haseki Training and Research HospitalIstanbulTurkey
| | - İbrahim Korkmaz
- Department of Dermatology and Venereology, ıstanbul Haseki Training and Research HospitalIstanbulTurkey
| | - Arzu Kılıç
- Department of Dermatology and Venereology, School of Medicine, Balıkesir UniversityBalıkesirTurkey
| | - Pelin Hızlı
- Department of Dermatology and Venereology, School of Medicine, Balıkesir UniversityBalıkesirTurkey
| | - Özlem Su Küçük
- Department of Dermatology and Venereology, School of Medicine, Bezmialem Vakıf UniversityIstanbulTurkey
| | - Ceyda Çaytemel
- Department of Dermatology and Venereology, School of Medicine, Başakşehir Çam ve Sakura City HospitalIstanbulTurkey
| | - Rabia Öztaş Kara
- Department of Dermatology and Venereology, Sakarya Training and Research HospitalSakaryaTurkey
| | - Mahmut Can Koska
- Department of Dermatology and Venereology, Artvin State HospitalArtvinTurkey
| | - Kübra Tatar
- Department of Dermatology and Venereology, School of Medicine, Van Yüzüncü Yıl UniversityVanTurkey
| | - Bahar Sevimli Dikicier
- Department of Dermatology and Venereology, School of Medicine, Sakarya Training and Research Hospital, Sakarya UniversitySakaryaTurkey
| | - Şenay Ağırgöl
- Department of Dermatology and Venereology, School of Medicine, Başakşehir Çam ve Sakura City HospitalIstanbulTurkey
| | - Burak Akşan
- Department of Dermatology and Venereology, School of Medicine, Giresun UniversityKocaeliTurkey
| | - Ayşe Serap Karadağ
- Memorial Health Group, Atasehir and Sisli Hospital, Dermatology ClinicIstanbulTurkey
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6
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Oguz Topal I, Tokmak A, Kurmuş GI, Kalkan G, Demirseren DD, Tosun M, Emre S, Özkök Akbulut T, Kaya Özden H, Koska M, Külcü Çakmak S, Kutlu Ö, Mutlu E, Gür Aksoy G, Topaloğlu Demir F, Karadağ A. Skin manifestations following anti-COVID-19 vaccination: A multicentricstudy from Turkey. J Cosmet Dermatol 2023; 22:354-363. [PMID: 36575896 PMCID: PMC9880666 DOI: 10.1111/jocd.15570] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 11/19/2022] [Accepted: 12/05/2022] [Indexed: 12/29/2022]
Abstract
PURPOSE After the emergence of the pandemic caused by the COVID-19 virus, vaccination with various vaccines has started to be implemented across the world. To identify dermatological reactions developing after the COVID-19 vaccines administered in Turkey and determine their clinical features and risk factors that may play a role in their development. MATERIALS AND METHODS The study included patients aged ≥18 years, who presented to 13 different dermatology clinics in Turkey between July 2021 and September 2021 after developing dermatological reactions following the administration of the COVID-19 vaccine. After providing written consent, the patients were asked to complete a standard survey including questions related to age, gender, occupation, comorbidities, the regular medication used, the onset of cutaneous reactions after vaccination, and localization of reactions. Dermatological reactions were categorized according to whether they developed after the first or second dose of the vaccine or whether they occurred after the inactivated or messenger RNA (mRNA) vaccine. The relationship between dermatological reactions and some variables such as gender and comorbidities was also evaluated. RESULTS A total of 269 patients [116 women (43.1%), 153 men (56.9%)] were included in the study. It was observed that the dermatological diseases and reactions that most frequently developed after vaccination were urticaria (25.7%), herpes zoster (24.9%), maculopapular eruption (12.3%), and pityriasis rosea (4.5%). The rate of dermatological reactions was 60.6% after the administration of the mRNA vaccine and 39.4% after that of the inactivated vaccine. There was a statistically significantly higher number of reactions among the patients that received the mRNA vaccine (p = 0.001). CONCLUSION The most common reactions in our sample were urticaria, herpes zoster, and maculopapular eruption. Physicians should know the dermatological side effects of COVID-19 vaccines and their clinical features.
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Affiliation(s)
- Ilteris Oguz Topal
- Department of Dermatology and Venereology, University of Health SciencesProf. Dr. Cemil Tascioglu City HospitalIstanbulTurkey
| | - Aslı Tokmak
- Department of Dermatology and VenereologyAgri Training and Research HospitalAgriTurkey
| | - Gökçe Işıl Kurmuş
- Department of Dermatology and Venereology, Faculty of MedicineYüksek İhtisas UniversityAnkaraTurkey
| | - Göknur Kalkan
- Department of Dermatology and VenereologyYildirim Beyazit University, Medical SchoolAnkaraTurkey
| | - Düriye Deniz Demirseren
- Department of Dermatology and Venereology, University of Health SciencesAnkara City HospitalAnkaraTurkey
| | - Mustafa Tosun
- Department of Dermatology and VenereologySivas Cumhuriyet UniversitySivasTurkey
| | - Selma Emre
- Department of Dermatology and VenereologyYildirim Beyazit University, Medical SchoolAnkaraTurkey
| | - Tuğba Özkök Akbulut
- Department of Dermatology and Venereology, University of Health SciencesHaseki Training and Research HospitalIstanbulTurkey
| | - Hatice Kaya Özden
- Department of Dermatology and VenereologyKocaeli Derince Training and Research HospitalKocaeliTurkey
| | - Mahmut Can Koska
- Department of Dermatology and VenereologyArtvin State HospitalArtvinTurkey
| | - Seray Külcü Çakmak
- Department of Dermatology and Venereology, University of Health SciencesAnkara City HospitalAnkaraTurkey
| | - Ömer Kutlu
- Department of Dermatology and VenereologyGaziosmanpaşa University Medical FacultyTokatTurkey
| | - Emine Mutlu
- Department of Dermatology and VenereologyCankiri State HospitalCankiriTurkey
| | - Güneş Gür Aksoy
- Department of Dermatology and Venereology, University of Health SciencesAnkara City HospitalAnkaraTurkey
| | - Filiz Topaloğlu Demir
- Department of Dermatology and Venereology, Faculty of MedicineIstanbul Medipol UniversityIstanbulTurkey
| | - Ayşe Serap Karadağ
- Department of Dermatology and VenereologyMemorial Ataşehir HospitalIstanbulTurkey
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7
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Kayıran MA, Karadağ AS, Topal İO, Emre S, Adışen E, Kılıç S, Keskin N, Polat AK, Cemil BÇ, Polat M, Yılmaz O, Ayvaz H, Demir FT, Solak SS, Uçmak D, Aytekin S, Gürel MS, Ekinci AP, Bölük KN, Şendur N, Akbulut TÖ, Öztürk G, Erbas A, Alpsoy E. Patient Use of Complementary and Alternative Medicine for Psoriasis Vulgaris and Factors Believed to Trigger the Disease: a Multicenter Cross-Sectional Study With 1621 Patients. Dermatol Pract Concept 2022; 12:e2022190. [PMID: 36534567 PMCID: PMC9681383 DOI: 10.5826/dpc.1204a190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 03/01/2022] [Indexed: 12/11/2023] Open
Abstract
INTRODUCTION Due to the chronic recurrent nature of psoriasis vulgaris (PV) and lack of definitive treatment for the disease, patients often resort to alternative treatments. Physicians seem to have low awareness of this issue. OBJECTIVES To elicit the perceptions of 1,621 PV patients on complementary and alternative medicine (CAM) and examine factors reported to worsen PV. METHODS The patients sociodemographic characteristics, Psoriasis Area Severity Index (PASI), Dermatology Life Quality Index (DLQI), disease duration, and severity were recorded, and the patients CAM use was questioned in detail. The patients were also asked about factors that worsened PV and their experiences with a gluten-free diet. RESULTS Of the patients, 56.51% had used CAM. The mean age, illness duration, PASI scores and DLQI of those using CAM were significantly higher. CAM use was significantly higher in those with facial, genital involvement, and arthralgia/arthritis. The patients mostly referred to CAM when PV became severe (46.4%). Of the CAM users, 45.52% used herbal topicals. The physicians of 67.03% did not inquire whether they used CAM. Of the participants, 37.73% considered that stress worsened their disease. Gluten-free diet did not affect PV symptoms in 52.22%. CONCLUSIONS Patients CAM use is often overlooked by dermatologists. Our results showed that more than half the patients used CAM and did not share this information with their physicians. Therefore, the awareness of physicians should be increased and patients should be asked about the use of CAM and directed to the appropriate medical treatment options by physicians.
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Affiliation(s)
- Melek Aslan Kayıran
- İstanbul Medeniyet University, Göztepe Prof Dr Süleyman Yalçın City Hospital, Department of Dermatological and Venereal Diseases, İstanbul, Turkey
| | - Ayşe Serap Karadağ
- Ataşehir Memorial Hospital, Department of Dermatological and Venereal Diseases, İstanbul, Turkey
| | - İlteriş Oğuz Topal
- Health Sciences University, Prof. Dr. Cemil Taşçıoğlu Hospital, Department of Dermatological and Venereal Diseases, İstanbul, Turkey
| | - Selma Emre
- Yıldırım Beyazıt University, Faculty of Medicine, Department of Dermatological and Venereal Diseases, Ankara, Turkey
| | - Esra Adışen
- Gazi University, Faculty of Medicine, Department of Dermatological and Venereal Diseases, Ankara, Turkey
| | - Sevilay Kılıç
- Çanakkale 18 Mart University, Faculty of Medicine, Department of Dermatological and Venereal Diseases, Çanakkale, Turkey
| | - Nuray Keskin
- Gazi University, Faculty of Medicine, Department of Dermatological and Venereal Diseases, Ankara, Turkey
| | - Asude Kara Polat
- Health Sciences University, İstanbul Training and Research Hospital, Department of Dermatological and Venereal Diseases, İstanbul, Turkey
| | - Bengü Çevirgen Cemil
- Health Sciences University, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Dermatological and Venereal Diseases, Ankara, Turkey
| | - Mualla Polat
- Bolu Abant İzzet Baysal University, Faculty of Medicine, Department of Dermatological and Venereal Diseases, Bolu, Turkey
| | - Oğuz Yılmaz
- Akdeniz University, Faculty of Medicine, Department of Dermatological and Venereal Diseases, Antalya, Turkey
| | - Hilal Ayvaz
- Süleyman Demirel University, Faculty of Medicine, Department of Dermatological and Venereal Diseases, Isparta, Turkey
| | - Filiz Topaloğlu Demir
- Medipol University, Faculty of Medicine, Department of Dermatological and Venereal Diseases, İstanbul, Turkey
| | - Sezgi Sarıkaya Solak
- Trakya University, Faculty of Medicine, Department of Dermatological and Venereal Diseases, Edirne, Turkey
| | - Derya Uçmak
- Dicle University, Faculty of Medicine, Department of Dermatological and Venereal Diseases, Diyarbakır, Turkey
| | - Sema Aytekin
- Health Sciences University, Haydarpaşa Training and Research Hospital Faculty of Medicine, Department of Dermatological and Venereal Diseases, İstanbul, Turkey
| | - Mehmet Salih Gürel
- İstanbul Medeniyet University, Göztepe Prof Dr Süleyman Yalçın City Hospital, Department of Dermatological and Venereal Diseases, İstanbul, Turkey
| | - Algün Polat Ekinci
- İstanbul University, İstanbul Faculty of Medicine, Department of Dermatological and Venereal Diseases, İstanbul, Turkey
| | - Kübra Nursel Bölük
- İstanbul University, İstanbul Faculty of Medicine, Department of Dermatological and Venereal Diseases, İstanbul, Turkey
| | - Neslihan Şendur
- Adnan Menderes University, Faculty of Medicine, Department of Dermatological and Venereal Diseases, Aydın, Turkey
| | - Tuğba Özkök Akbulut
- Health Sciences University, Haseki Training and Research Hospital, Department of Dermatological and Venereal Diseases, İstanbul, Turkey
| | - Günseli Öztürk
- Ege University, Faculty of Medicine, Department of Dermatological and Venereal Diseases, İzmir, Turkey
| | - Ayda Erbas
- Ege University, Faculty of Medicine, Department of Dermatological and Venereal Diseases, İzmir, Turkey
| | - Erkan Alpsoy
- Akdeniz University, Faculty of Medicine, Department of Dermatological and Venereal Diseases, Antalya, Turkey
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Kara Polat A, Alpsoy E, Kalkan G, Aytekin S, Uçmak D, Yasak Güner R, Topkarcı Z, Yılmaz O, Emre S, Borlu M, Türkoğlu Z, Özkök Akbulut T, Özaydın Yavuz G, Kaya Erdoğan H, Adışen E, Satılmış A, Oğuz Topal İ, Yazıcı S, Yılmaz E, Koku Aksu AE, Kartal SP, Deveci BN, Öksüm Solak E, Karadağ AS, Sarıkaya Solak S, Altunay İK, Türel Ermertcan A, Özkesici Kurt B, Kaçar NG, Ataseven A. Sociodemographic, Clinical, Laboratory, Treatment, and Prognostic Characteristics of 156 Generalized Pustular Psoriasis Patients in Turkey: A multicenter case series. J Eur Acad Dermatol Venereol 2022; 36:1256-1265. [DOI: 10.1111/jdv.18103] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 03/14/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Asude Kara Polat
- University of Health Sciences Istanbul Training and Research Hospital Department of Dermatology Istanbul Turkey
| | - Erkan Alpsoy
- Akdeniz University Faculty of Medicine Department of Dermatology Antalya Turkey
| | - Göknur Kalkan
- Ankara Yıldırım Beyazıt University Faculty of Medicine Department of Dermatology Ankara Turkey
| | - Sema Aytekin
- University of Health Sciences Haydarpaşa Numune Training and Research Hospital Department of Dermatology Istanbul Turkey
| | - Derya Uçmak
- Dicle University Faculty of Medicine Department of Dermatology Diyarbakır Turkey
| | - Rukiye Yasak Güner
- Sivas Cumhuriyet University Faculty of Medicine Department of Dermatology Sivas Turkey
| | - Zeynep Topkarcı
- University of Health Sciences Bakırköy Dr. Sadi Konuk Training and Research Hospital Department of Dermatology Istanbul Turkey
| | - Oğuz Yılmaz
- Akdeniz University Faculty of Medicine Department of Dermatology Antalya Turkey
| | - Selma Emre
- Ankara Yıldırım Beyazıt University Faculty of Medicine Department of Dermatology Ankara Turkey
| | - Murat Borlu
- Erciyes University Faculty of Medicine Department of Dermatology Kayseri Turkey
| | - Zafer Türkoğlu
- Başakşehir Çam and Sakura City Hospital Department of Dermatology Istanbul Turkey
| | - Tuğba Özkök Akbulut
- University of Health Sciences Haseki Training and Research Hospital Department of Dermatology Istanbul Turkey
| | | | - Hilal Kaya Erdoğan
- Eskişehir Osmangazi University Faculty of Medicine Department of Dermatology Eskişehir Turkey
| | - Esra Adışen
- Gazi University Faculty of Medicine Department of Dermatology Ankara Turkey
| | - Ayşegül Satılmış
- Gazi University Faculty of Medicine Department of Dermatology Ankara Turkey
| | - İlteriş Oğuz Topal
- Prof. Dr. Cemil Taşcıoğlu City Hospital Department of Dermatology Istanbul Turkey
| | - Serkan Yazıcı
- Uludağ University Faculty of Medicine Department of Dermatology Bursa Turkey
| | - Ertan Yılmaz
- Akdeniz University Faculty of Medicine Department of Dermatology Antalya Turkey
| | - Ayşe Esra Koku Aksu
- University of Health Sciences Istanbul Training and Research Hospital Department of Dermatology Istanbul Turkey
| | - Selda Pelin Kartal
- University of Health Sciences Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital Department of Dermatology Ankara Turkey
| | - Beyza Nur Deveci
- University of Health Sciences Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital Department of Dermatology Ankara Turkey
| | - Eda Öksüm Solak
- Erciyes University Faculty of Medicine Department of Dermatology Kayseri Turkey
| | | | | | - İlknur Kıvanç Altunay
- University of Health Sciences Şişli Hamidiye Etfal Training and Research Hospital Department of Dermatology Istanbul Turkey
| | - Aylin Türel Ermertcan
- Manisa Celal Bayar University Faculty of Medicine Department of Dermatology Manisa Turkey
| | - Birgül Özkesici Kurt
- Adıyaman University Training and Research Hospital Department of Dermatology Adıyaman Turkey
| | - Nida Gelincik Kaçar
- Pamukkale University Faculty of Medicine Department of Dermatology Denizli Turkey
| | - Arzu Ataseven
- Necmettin Erbakan University Meram Faculty of Medicine Department of Dermatology Konya Turkey
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9
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Emre S, Unal E, Celik B, Sungu N. The case of granuloma annulare associated with SARS-CoV-2 infection. Dermatol Ther 2022; 35:e15369. [PMID: 35142417 PMCID: PMC9111399 DOI: 10.1111/dth.15369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 01/27/2022] [Accepted: 02/03/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Selma Emre
- Department of Dermatology, Ankara Yıldırım Beyazıt University, Medical School, Ankara, Turkey
| | - Esranur Unal
- Department of Dermatology, Ankara Yıldırım Beyazıt University, Medical School, Ankara, Turkey
| | - Burak Celik
- Department of Dermatology, Ankara Yıldırım Beyazıt University, Medical School, Ankara, Turkey
| | - Nuran Sungu
- Department of Pathology, Ankara Yıldırım Beyazıt University, Medical School, Ankara, Turkey
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10
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Aslan Kayıran M, Kara Polat A, Alyamaç G, Demirseren DD, Taş B, Kalkan G, Özkök Akbulut T, Kaya Özden H, Koska MC, Emre S, Kaya Erdoğan H, Tükenmez Demirci G, Güngör Ş, Özcan Arslan N, Ağaoğlu E, Kurmuş GI, Aksoy H, Tatlıparmak A, Süslü H, Oğuz Topal İ, Topaloğlu Demir F, Acer E, Duman H, Gürel MS, Karadağ AS. Has the COVID-19 pandemic changed attitudes and behaviors concerning cosmetic care and procedures among patients presenting to the dermatology outpatient clinic? A multicenter study with 1437 participants. J Cosmet Dermatol 2021; 20:3121-3127. [PMID: 34460987 PMCID: PMC8661620 DOI: 10.1111/jocd.14420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 07/15/2021] [Revised: 07/31/2021] [Accepted: 08/18/2021] [Indexed: 11/29/2022]
Abstract
Background The rate of cosmetic procedures and use of skincare products is considered to be affected during the pandemic period; however, this has not been investigated yet. Objective To determine whether the ongoing pandemic has changed people's habits related to skincare products and cosmetic procedures. Methods We conducted a multicenter survey study covering both private and public hospitals. Sociodemographic characteristics and clinical diagnoses of the patients were noted by dermatologists. A survey was used to determine the type and application areas of skincare products and cosmetic procedures before and during the pandemic, whether the patients were concerned about being infected, and any change in the make‐up habits of female patients. Results Of the 1437 patients, 86.7% presented to the hospital due to dermatological complaints and 13.3% for cosmetic procedures. The rate of those that did not use skincare products was 0.05% before and 0.06% during the pandemic. Of the participants, 43.2% had undergone cosmetic procedures before and 38.1% during the pandemic. For both periods, the most frequent cosmetic procedure applied was laser epilation, followed by skincare treatment and chemical peeling. While undergoing these procedures, 34.9% of the patients were concerned about contracting coronavirus. Conclusion There was no significant difference in the use of skincare products and cosmetic procedures before and during the pandemic. The majority of the patients continued to undergo these procedures despite their fear of being infected. This shows that during the pandemic period, patients are concerned with their appearance and continue to undergo cosmetic procedures and pay attention to their skincare.
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Affiliation(s)
- Melek Aslan Kayıran
- Department of Dermatology and Venereology, Göztepe Prof. Dr Süleyman Yalçın City Hospital, İstanbul Medeniyet University, Istanbul, Turkey
| | - Asude Kara Polat
- Department of Dermatology and Venereology, İstanbul Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Gökçen Alyamaç
- Department of Dermatology and Venereology, Private Medicana Bursa Hospital, Bursa, Turkey
| | - Düriye Deniz Demirseren
- Department of Dermatology and Venereology, Ankara City Hospital, Health Sciences University, Ankara, Turkey
| | - Betül Taş
- Department of Dermatology and Venereology, İstanbul Bağcılar Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Göknur Kalkan
- Department of Dermatology and Venereology, Ankara City Hospital, Health Sciences University, Ankara, Turkey
| | - Tuğba Özkök Akbulut
- Department of Dermatology and Venereology, Haseki Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Hatice Kaya Özden
- Department of Dermatology and Venereology, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey
| | - Mahmut Can Koska
- Department of Dermatology and Venereology, Artvin State Hospital, Artvin, Turkey
| | - Selma Emre
- Department of Dermatology and Venereology, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
| | - Hilal Kaya Erdoğan
- Department of Dermatology and Venereology, Faculty of Medicine, Eskişehir Osmangazi University, Eskisehir, Turkey
| | - Gülşen Tükenmez Demirci
- Department of Dermatology and Venereology, Faculty of Medicine, Altunizade Acıbadem Hospital, M. A. A. Acıbadem University, Istanbul, Turkey
| | - Şule Güngör
- Department of Dermatology and Venereology, İstanbul Florence Nightingale Hospital, Istanbul, Turkey
| | - Nimet Özcan Arslan
- Department of Dermatology and Venereology, Beykoz State Hospital, Istanbul, Turkey
| | - Esra Ağaoğlu
- Department of Dermatology and Venereology, Kars Harakani State Hospital, Kars, Turkey
| | - Gökçe Işıl Kurmuş
- Department of Dermatology and Venereology, Faculty of Medicine, Yüksek İhtisas University, Ankara, Turkey
| | - Hasan Aksoy
- Department of Dermatology and Venereology, Göztepe Prof. Dr Süleyman Yalçın City Hospital, İstanbul Medeniyet University, Istanbul, Turkey
| | - Aslı Tatlıparmak
- Department of Dermatology and Venereology, Faculty of Medicine, İstinye University, Istanbul, Turkey
| | - Hülya Süslü
- Department of Dermatology and Venereology, Haseki Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - İlteriş Oğuz Topal
- Department of Dermatology and Venereology, Prof Dr Cemil Taşçıoğlu City Hospital, Health Sciences University, Istanbul, Turkey
| | - Filiz Topaloğlu Demir
- Department of Dermatology and Venereology, Faculty of Medicine, İstanbul Medipol University, Istanbul, Turkey
| | - Ersoy Acer
- Department of Dermatology and Venereology, Faculty of Medicine, Eskişehir Osmangazi University, Eskisehir, Turkey
| | - Hatice Duman
- Private Medstar Antalya Hospital, Antalya, Turkey
| | - Mehmet Salih Gürel
- Department of Dermatology and Venereology, Göztepe Prof. Dr Süleyman Yalçın City Hospital, İstanbul Medeniyet University, Istanbul, Turkey
| | - Ayşe Serap Karadağ
- Department of Dermatology and Venereology, Memorial Ataşehir Hospital, Istanbul, Turkey
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11
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Kutlu Ö, Karadağ AS, Ünal E, Kelekçi KH, Yalçınkaya İyidal A, Topaloğlu Demir F, Aksoy B, Çölgeçen E, Tosun M, Emre S, Tatlıparmak A, Demirseren DD, Kaya Özden H, Öztürk M, Özlü E, Chen W. Acne in pregnancy: A prospective multicenter, cross-sectional study of 295 patients in Turkey. Int J Dermatol 2020; 59:1098-1105. [PMID: 32562263 DOI: 10.1111/ijd.14999] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 05/06/2020] [Accepted: 05/12/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND There are only a few studies on acne in pregnancy. This study was aimed to investigate the demographic, clinical, and familial characteristics of acne in pregnancy, triggering factors including endocrine diseases, and association of these findings with acne in different trimesters of pregnancy. METHODS Pregnant women aged 18 years and older with acne at any stage of pregnancy were consecutively interviewed at the participating centers during the study period from 2016 to 2019. Acne severity was evaluated using the Comprehensive Acne Severity Scale. RESULTS A total of 295 pregnant women with acne were included, with 167 (56.6%) patients showing mild, 87 (29.5%) moderate, six (12.2%) severe, and five (1.7%) very severe acne. Truncal acne was significantly higher in the third trimester than in the other stages (P < 0.001). Onset of acne before pregnancy, prepubertal, pubertal or adult onset, or acne history in previous pregnancies did not influence acne severity in pregnancy. Women with irregular menstruation before pregnancy, polycystic ovary syndrome, hirsutism, and higher body weight index tended to show severe acne in pregnancy. CONCLUSIONS Severe acne during pregnancy is generally uncommon, while severity of facial acne, truncal acne, and hirsutism is higher in the third trimester than in other trimesters. Acne in pregnancy shares many characteristics with female adult acne. Substantial changes in different kinds of hormones play a more complex role in acne during pregnancy, but the pathogenesis remains to be determined.
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Affiliation(s)
- Ömer Kutlu
- Department of Dermatology and Venereology, School of Medicine, Uşak University, Uşak Training and Research Hospital, Uşak, Turkey
| | - Ayşe Serap Karadağ
- Department of Dermatology and Venereology, School of Medicine, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Emine Ünal
- Department of Dermatology and Venereology, Lokman Hekim Hospital, Ankara, Turkey
| | - Kıymet Handan Kelekçi
- Department of Dermatology and Venereology, İzmir Katip Çelebi University, İzmir, Turkey
| | | | - Filiz Topaloğlu Demir
- Department of Dermatology and Venereology, School of Medicine, Medipol University, İstanbul, Turkey
| | - Berna Aksoy
- Department of Dermatology and Venereology, School of Medicine, Bahçeşehir University, Istanbul, Turkey
| | - Emine Çölgeçen
- Department of Dermatology and Venereology, School of Medicine, Yozgat Bozok University, Yozgat, Turkey
| | - Mustafa Tosun
- Department of Dermatology and Venereology, Konya Training and Research Hospital, Konya, Turkey
| | - Selma Emre
- Department of Dermatology and Venereology, School of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
| | - Aslı Tatlıparmak
- Department of Dermatology and Venereology, School of Medicine, Bahçeşehir University, Istanbul, Turkey
| | | | - Hatice Kaya Özden
- Department of Dermatology and Venereology, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey
| | - Murat Öztürk
- Department of Dermatology and Venereology, Van Training and Research Hospital, Health Sciences University, Van, Turkey
| | - Emin Özlü
- Department of Dermatology and Venereology, School of Medicine, Düzce, Turkey
| | - Wenchieh Chen
- Department of Dermatology and Allergy, Technische Universität München, Munich, Germany.,Department of Dermatology, Pingtung Hospital, Ministry of Health and Welfare, Taiwan
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12
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Alpsoy E, Polat M, Yavuz IH, Kartal P, Didar Balci D, Karadag AS, Bilgic A, Arca E, Karaman BF, Emre S, Adisen E, Sendur N, Bilgic O, Cordan Yazici A, Yalcin B, Koca R, Gunduz K, Borlu M, Ergun T, Dursun P, Bilgili SG, Surer Adanir A, Gulekon A, Yagcioglu G, Yilmaz E, Kavuzlu U, Senol Y. Internalized Stigma in Pediatric Psoriasis: A Comparative Multicenter Study. Ann Dermatol 2020; 32:181-188. [PMID: 33911736 PMCID: PMC7992623 DOI: 10.5021/ad.2020.32.3.181] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 11/30/2019] [Accepted: 12/13/2019] [Indexed: 11/08/2022] Open
Abstract
Background Internalized stigma, adoption of negative attitudes and stereotypes of the society regarding persons' illness, has not been studied previously in pediatric psoriasis patients. Objective We aimed to investigate the internalized stigma in pediatric psoriasis patients and to determine differences according to factors affecting internalized stigma compared to adult psoriasis patients. Methods This multicenter, cross-sectional, comparative study included 125 pediatric (55 female, 70 male; mean age±standard deviation [SD], 14.59±2.87 years) and 1,235 adult psoriasis patients (577 female, 658 male; mean age±SD, 43.3±13.7 years). Psoriasis Internalized Stigma Scale (PISS), Dermatology Life Quality Index (DLQI), Perceived Health Status (PHS), and the General Health Questionnaire (GHQ)-12 were the scales used in the study. Results The mean PISS was 58.48±14.9 in pediatric group. When PISS subscales of groups were compared, the pediatric group had significantly higher stigma resistance (p=0.01) whereas adult group had higher scores of alienation (p=0.01) and stereotype endorsement (p=0.04). There was a strong correlation between mean values of PISS and DLQI (r=0.423, p=0.001). High internalized stigma scores had no relation to either the severity or localization of disease in pediatric group. However, poor PHS (p=0.007) and low-income levels (p=0.03) in both groups, and body mass index (r=0.181, p=0.04) in the pediatric group were related to high PISS scores. Conclusion Internalized stigma in pediatric patients is as high as adults and is related to poor quality of life, general health, and psychological illnesses. Unlike adults, internalized stigma was mainly determined by psoriasis per se, rather than disease severity or involvement of visible body parts, genitalia or folds.
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Affiliation(s)
- Erkan Alpsoy
- Department of Dermatology and Venereology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Mualla Polat
- Department of Dermatology and Venereology, Abant Izzet Baysal University School of Medicine, Bolu, Turkey
| | - Ibrahim Halil Yavuz
- Department of Dermatology and Venereology, Van Yuzuncu Yil University School of Medicine, Van, Turkey
| | - Pelin Kartal
- Department of Dermatology and Venereology, University of Health Sciences Ankara Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
| | - Didem Didar Balci
- Department of Dermatology and Venereology, Izmir Tepecik Education and Research Hospital, Izmir, Turkey
| | - Ayse Serap Karadag
- Department of Dermatology and Venereology, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey
| | - Asli Bilgic
- Department of Dermatology and Venereology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ercan Arca
- Department of Dermatology and Venereology, Guven Hospital, Ankara, Turkey
| | | | - Selma Emre
- Department of Dermatology and Venereology, Yildirim Beyazit University Ankara Atatürk Education and Research Hospital, Ankara, Turkey
| | - Esra Adisen
- Department of Dermatology and Venereology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Neslihan Sendur
- Department of Dermatology and Venereology, Adnan Menderes University School of Medicine, Aydın, Turkey
| | - Ozlem Bilgic
- Department of Dermatology and Venereology, Selcuk University School of Medicine, Konya, Turkey
| | - Ayca Cordan Yazici
- Department of Dermatology and Venereology, Mersin University School of Medicine, Mersin, Turkey
| | - Basak Yalcin
- Department of Dermatology and Venereology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Rafet Koca
- Department of Dermatology and Venereology, Bulent Ecevit University School of Medicine, Zonguldak, Turkey
| | - Kamer Gunduz
- Department of Dermatology and Venereology, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Murat Borlu
- Department of Dermatology and Venereology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Tulin Ergun
- Department of Dermatology and Venereology, Marmara University School of Medicine, Istanbul, Turkey
| | - Pinar Dursun
- Department of Dermatology and Venereology, Mersin State Hospital, Mersin, Turkey
| | - Serap Gunes Bilgili
- Department of Dermatology and Venereology, Van Yuzuncu Yil University School of Medicine, Van, Turkey
| | - Asli Surer Adanir
- Department of Child and Adolescent Psychiatry, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ayla Gulekon
- Department of Dermatology and Venereology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Gizem Yagcioglu
- Department of Dermatology and Venereology, Adnan Menderes University School of Medicine, Aydın, Turkey
| | - Ertan Yilmaz
- Department of Dermatology and Venereology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ufuk Kavuzlu
- Department of Dermatology and Venereology, Mersin University School of Medicine, Mersin, Turkey
| | - Yesim Senol
- Department of Medical Education, Akdeniz University School of Medicine, Antalya, Turkey
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Emre S, Kalkan G, Erdoğan S, Aktaş A, Ergin M. Dynamic Thiol/Disulfide Balance in Patients with Seborrheic Dermatitis: A Case-Control Study. Saudi J Med Med Sci 2019; 8:12-16. [PMID: 31929773 PMCID: PMC6945316 DOI: 10.4103/sjmms.sjmms_50_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/10/2019] [Accepted: 05/16/2019] [Indexed: 01/14/2023]
Abstract
Background: Seborrheic dermatitis is a chronic, inflammatory skin disease, in which many endogenous and exogenous factors play a role. Recent studies have shown that oxidative stress increases in these patients. The role of the dynamic thiol/disulfide homeostasis, an important component of the oxidative stress, in the pathogenesis of seborrheic dermatitis has not yet been investigated. Objectives: The objective was to investigate the relationship between the dynamic thiol/disulfide balance in the plasma of seborrheic dermatitis patients and disease severity. Methods: In this case–control study, 70 seborrheic dermatitis patients and 61 age- and sex-matched healthy controls were included. Thiol/disulfide homeostasis was calculated from venous blood samples, and tests were performed by automated spectrophotometric method. The thiol/disulfide balance between the patient and control groups was compared. In addition, disease severity and other demographic characteristics and thiol/disulfide balance parameters were compared. Results: Native and total thiols were significantly higher in the patient group than that in the control group (P < 0.001). Disulfide levels were nonsignificantly lower in the patient group than controls (P = 0.821). Patients' age and age at the onset of disease were found to have a negative correlation with native and total thiol levels. Conclusion: Higher levels of thiols in the serum may be responsible for the increased proliferation of seborrheic dermatitis lesions. To the best of the authors' knowledge, this is the first report on the correlation between thiol/disulfide homeostasis in patients with seborrheic dermatitis.
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Affiliation(s)
- Selma Emre
- Department of Dermatology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Atatürk Training and Research Hospital, Ankara, Turkey
| | - Göknur Kalkan
- Department of Dermatology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Atatürk Training and Research Hospital, Ankara, Turkey
| | - Serpil Erdoğan
- Department of Biochemistry, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Atatürk Training and Research Hospital, Ankara, Turkey
| | - Akın Aktaş
- Department of Dermatology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Atatürk Training and Research Hospital, Ankara, Turkey
| | - Merve Ergin
- Department of Biochemistry, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Atatürk Training and Research Hospital, Ankara, Turkey
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Emre S, Demirseren DD, Unal E, Sungu N. Recurrent radiation recall dermatitis triggered by radiological procedures in a patient with breast cancer. Australas J Dermatol 2019; 60:308-310. [PMID: 31012084 DOI: 10.1111/ajd.13037] [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: 01/20/2019] [Accepted: 03/03/2019] [Indexed: 11/29/2022]
Abstract
Radiation recall dermatitis is an acute inflammatory reaction that occurs on previously irradiated skin by usage of chemotherapeutic agents and other triggering drugs. The recall reaction is usually associated with drugs but may also occur following ultraviolet radiation. We report a patient with radiation recall dermatitis, triggered after imaging procedures that involved radiation.
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Affiliation(s)
- Selma Emre
- Department of Dermatology, Medichal School, Yıldırım Beyazit University, Ankara, Turkey
| | | | - Esranur Unal
- Department of Dermatology, Medichal School, Yıldırım Beyazit University, Ankara, Turkey
| | - Nuran Sungu
- Department of Pathology, Medichal School, Yıldırım Beyazit University, Ankara, Turkey
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15
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Emre S. Intravenous immunoglobulin treatment: Where do dermatologists stand? Dermatol Ther 2019; 32:e12854. [PMID: 30756448 DOI: 10.1111/dth.12854] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 12/27/2018] [Revised: 01/08/2019] [Accepted: 02/10/2019] [Indexed: 11/29/2022]
Abstract
Intravenous immunoglobulins (IVIG) are therapeutic products, comprising polyclonal IgGs, which are obtained from human plasma pool of healthy blood donors. Despite the lack of Food and Drug Administration (FDA) approval, the experience of using IVIG in various dermatological diseases increases day by day and exciting results are reported. However, experience with the use of IVIG in dermatological indications are mostly case reports whereas randomized, controlled, double-blind, multicentric studies have not been performed. Dermatological diseases treated with IVIG are autoimmune bullous skin diseases, Stevens-Johnson syndrome and toxic epidermal necrolysis, connective tissue diseases, pyoderma gangrenosum, severe atopic dermatitis, chronic urticaria, Kawasaki disease, pretibial myxoedema, scleredema, and graft-versus-host disease.
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Affiliation(s)
- Selma Emre
- Department of Dermatology, Yildirim Beyazit University, Medical School, Ankara, Turkey
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16
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Kalkan G, Emre S, Alisik M, Aktaş A, Baran P. Dynamic thiol/disulfide homeostasis in patients with lichen planus. J Clin Lab Anal 2018; 33:e22642. [PMID: 30076643 DOI: 10.1002/jcla.22642] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 06/18/2018] [Revised: 07/16/2018] [Accepted: 07/16/2018] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Lichen planus (LP) is an autoimmune inflammatory disease of the mucocutaneous tissue, whose exact pathological course remains unclear. Abnormal thiol/disulfide homeostasis has been postulated to be responsible for a number of diseases predominated by chronic inflammation. To be able to contribute complicated and unclear pathogenesis of LP, we aimed to investigate dynamic thiol/disulfide homeostasis in patients with LP, using an original automated method developed by Erel and Neselioglu in this study. METHODS The study group consisted of 81 unrelated patients with LP and 80 unrelated healthy controls with no LP lesions in their personal history or on clinical examination. Thiol/disulphide homeostasis tests have been measured with a novel automatic spectrophotometric method developed and the results have been compared statistically. RESULTS Native thiol and total thiol levels were found as significantly higher in patients with LP than the control group (P = 0.026 and 0.035, respectively). There was no significant difference between the disulfide levels of the patients with LP and the control group. CONCLUSIONS We provide evidence that that thiol/disulphide homeostasis impaired in favor of thiol levels in LP patients compared to the control group based on the data of our study. To the best of our knowledge, the present study is the first examination on the correlation between thiol and disulfide homeostasis in patients with LP.
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Affiliation(s)
- Göknur Kalkan
- Department of Dermatology, School of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Selma Emre
- Department of Dermatology, School of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Murat Alisik
- Department of Biochemistry, Polatlı Duatepe State Hospital, Ankara, Turkey
| | - Akın Aktaş
- Department of Dermatology, School of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Pervin Baran
- Department of Biochemistry, Ministry of Health Atatürk Training and Research Hospital, Ankara, Turkey
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Emre S, Çankaya C, Demirel S, Doganay S. Comparison of Preoperative and Postoperative Anterior Segment Measurements with Pentacam in Horizontal Muscle Surgery. Eur J Ophthalmol 2018; 18:7-12. [DOI: 10.1177/112067210801800102] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose To evaluate the effect of horizontal muscle surgery (recession or recession plus resection) on the anterior chamber parameters in patients after strabismus surgery. Patients and Methods. The Scheimpflug of 18 eyes of 12 patients with horizontal deviations were recorded just before surgery and 1 month after surgery. The power of anterior surface of cornea in horizontal and vertical axis, thinnest corneal thickness, anterior chamber depth, anterior chamber volume, and cornea volume were analyzed. The clinical characteristics of patients, the size of the deviations, the surgical doses, and observed responses to surgery were reviewed. Results There were six male and six female patients with an average age of 11.4 years (range, 4 to 22 years). Mean preoperative deviation was 47.91 PD (range, 20 to 75 PD), eight patients had esotropia with 57.5 PD average deviation (range, 40 to 75 PD), and four patients had exotropia with 28.75 PD average deviation (range, 20 to 35 PD). Of these 18 eyes, 12 eyes had horizontal muscle recession and 6 eyes had recession plus resection surgery. At the end of 1 month, three patients were orthophoric and eight patients had residual deviations varying between 16 and 35 PD. Preoperative and postoperative comparison of the whole study group documented insignificant changes in anterior chamber parameters and in keratometer readings. However, after dividing patients into two groups–recession or recession plus resection group–only one parameter, anterior chamber volume, was significantly reduced in recession plus resection group. Conclusions Patients with strabismus who undergo recession plus resection procedure are prone to change in anterior chamber volume. Study with larger groups and long follow-up is necessary for clearer documentation of alterations at anterior chamber parameters.
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Affiliation(s)
- S. Emre
- Department of Ophthalmology, School of Medicine, Inonu University, Malatya - Turkey
| | - C. Çankaya
- Department of Ophthalmology, School of Medicine, Inonu University, Malatya - Turkey
| | - S. Demirel
- Department of Ophthalmology, School of Medicine, Inonu University, Malatya - Turkey
| | - S. Doganay
- Department of Ophthalmology, School of Medicine, Inonu University, Malatya - Turkey
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18
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Abstract
Erythema nodosum (EN), is the most common variant of septal panniculitis and is possibly a delayed hypersensitivity reaction triggered by a wide range of antigenic stimuli. Hypersensitivity reactions due to medications have been recognized as a cause of 3–10% of EN cases. Case reports of EN associated with the anti-thyroid drugs are quite rarely reported in the literature even if there is a common use of anti-thyroid drugs. We report an EN case due to methimazole. The complaints of patients arose immediately fifteen days after the beginning of methimazole treatment. To the best of our knowledge, this case report is the first of an erythema nodosum induced by methimazole.
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Affiliation(s)
- Selma Emre
- Yildirim Beyazit University, Ataturk Training and Research Hospital, Dermatology Clinic, Ankara, Turkey
| | - Didem Ozdemir
- Yildirim Beyazit University, Ataturk Training and Research Hospital, Endocrinology Clinic, Ankara, Turkey
| | - Sibel Orhun
- Yildirim Beyazit University, Ataturk Training and Research Hospital, Pathology Department, Ankara, Turkey
| | - Goknur Kalkan
- Yildirim Beyazit University, Ataturk Training and Research Hospital, Dermatology Clinic, Ankara, Turkey
| | - Sertac Sener
- Yildirim Beyazit University, Ataturk Training and Research Hospital, Dermatology Clinic, Ankara, Turkey
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Emre S, Demirseren DD, Alisik M, Aktas A, Neselioglu S, Erel O. Dynamic thiol/disulfide homeostasis and effects of smoking on homeostasis parameters in patients with psoriasis. Cutan Ocul Toxicol 2017; 36:393-396. [PMID: 28397526 DOI: 10.1080/15569527.2017.1311339] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE Recently, increased reactive oxygen species (ROS), reduced antioxidant capacity, and oxidative stress have been suggested in the pathogenesis of psoriasis. The aim of this study to evaluate the thiol/disulfide homeostasis in patients with psoriasis. MATERIALS AND METHODS Ninety patients with psoriasis who did not receive any systemic treatment in the last six months were included in the study. Seventy-six age and gender-matched healthy volunteers served as control group. Thiol/disulfide homeostasis was measured in venous blood samples obtained from patient and control groups. RESULTS Native thiol and total thiol levels were significantly higher in patients than in control group. When thiol/disulfide hemostasis parameters and clinical and demographic characteristics were compared, a negative correlation was detected between native thiol and total thiol with age. The levels of total thiols had also negative correlation with PASI and duration of the disease. When we divided the patients into smokers and non-smokers, native thiol and total thiol levels were significantly higher in smokers than in controls, whereas native thiol and total thiol levels were comparable in non-smoker patients and controls. CONCLUSIONS Thiol/disulfide balance shifted towards thiol in psoriasis patients and this may be responsible for increased keratinocyte proliferation in the pathogenesis of psoriasis.
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Affiliation(s)
| | | | - Murat Alisik
- b Department of Biochemistry , Yıldırım Beyazıt University, Medical School, Atatürk Training and Research Hospital , Ankara , Turkey
| | | | - Salim Neselioglu
- b Department of Biochemistry , Yıldırım Beyazıt University, Medical School, Atatürk Training and Research Hospital , Ankara , Turkey
| | - Ozcan Erel
- b Department of Biochemistry , Yıldırım Beyazıt University, Medical School, Atatürk Training and Research Hospital , Ankara , Turkey
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Alpsoy E, Polat M, FettahlıoGlu-Karaman B, Karadag AS, Kartal-Durmazlar P, YalCın B, Emre S, Didar-Balcı D, Bilgic-Temel A, Arca E, Koca R, Gunduz K, Borlu M, Ergun T, Dogruk-Kacar S, Cordan-Yazici A, Dursun P, BilgiC O, Gunes-Bilgili S, Sendur N, Baysal O, Halil-Yavuz I, Yagcioglu G, Yilmaz E, Kavuzlu U, Senol Y. Internalized stigma in psoriasis: A multicenter study. J Dermatol 2017; 44:885-891. [PMID: 28407292 DOI: 10.1111/1346-8138.13841] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [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: 10/05/2016] [Accepted: 02/13/2017] [Indexed: 11/30/2022]
Abstract
Internalized stigma is the adoption of negative attitudes and stereotypes of the society regarding a person's illness. It causes decreased self-esteem and life-satisfaction, increased depression and suicidality, and difficulty in coping with the illness. The primary aim of this study was to investigate the internalized stigma state of psoriatic patients and to identify the factors influencing internalized stigma. The secondary aim was to identify the correlation of internalized stigma with quality of life and perceived health status. This multicentre, cross-sectional study comprised 1485 patients. There was a significant positive correlation between mean values of Psoriasis Internalized Stigma Scale (PISS) and Psoriasis Area and Severity Index, Body Surface Area, Dermatological Life Quality Index and General Health Questionnaire-12 (P < 0.001 in all). Lower percieved health score (P = 0.001), early onset psoriasis (P = 0.016), family history of psoriasis (P = 0.0034), being illiterate (P < 0.001) and lower income level (P < 0.001) were determinants of high PISS scores. Mean PISS values were higher in erythrodermic and generalized pustular psoriasis. Involvement of scalp, face, hand, genitalia and finger nails as well as arthropathic and inverse psoriasis were also related to significantly higher PISS scores (P = 0.001). Our findings imply that psoriatic patients experience high levels of internalized stigma which are associated with psoriasis severity, involvement of visible body parts, genital area, folds or joints, poorer quality of life, negative perceptions of general health and psychological illnesses. Therefore, internalized stigma may be one of the major factors responsible from psychosocial burden of the disease.
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Affiliation(s)
- Erkan Alpsoy
- Department of Dermatology and Venereology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Mualla Polat
- Department of Dermatology and Venereology, Abant Izzet Baysal University School of Medicine, Bolu, Turkey
| | | | - Ayse Serap Karadag
- Department of Dermatology and Venereology, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey
| | - Pelin Kartal-Durmazlar
- Department of Dermatology and Venereology, Ministry of Health Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
| | - Basak YalCın
- Department of Dermatology and Venereology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Selma Emre
- Department of Dermatology and Venereology, Yildirim Beyazit University Ankara Atatürk Education and Research Hospital, Ankara, Turkey
| | - Didem Didar-Balcı
- Department of Dermatology and Venereology, Izmir Tepecik Education and Research Hospital, Izmir, Turkey
| | - Asli Bilgic-Temel
- Department of Dermatology and Venereology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ercan Arca
- Department of Dermatology and Venereology, Gulhane School of Medicine, Ankara, Turkey
| | - Rafet Koca
- Department of Dermatology and Venereology, School of Medicine, Bulent Ecevit University, Zonguldak, Turkey
| | - Kamer Gunduz
- Department of Dermatology and Venereology, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Murat Borlu
- Department of Dermatology and Venereology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Tulin Ergun
- Department of Dermatology and Venereology, Marmara University School of Medicine, Istanbul, Turkey
| | - Seval Dogruk-Kacar
- Department of Dermatology and Venereology, Afyon Kocatepe University School of Medicine, Afyon, Turkey
| | - Ayca Cordan-Yazici
- Department of Dermatology and Venereology, School of Medicine, Mersin University, Mersin, Turkey
| | - Pınar Dursun
- Department of Dermatology and Venereology, Mersin State Hospital, Mersin, Turkey
| | - Ozlem BilgiC
- Department of Dermatology and Venereology, Selcuk University School of Medicine, Konya, Turkey
| | - Serap Gunes-Bilgili
- Department of Dermatology and Venereology, School of Medicine, Van Yuzuncu Yil University, Van, Turkey
| | - Neslihan Sendur
- Department of Dermatology and Venereology, School of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Ozge Baysal
- Department of Psychiatry, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ibrahim Halil-Yavuz
- Department of Dermatology and Venereology, School of Medicine, Van Yuzuncu Yil University, Van, Turkey
| | - Gizem Yagcioglu
- Department of Dermatology and Venereology, School of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Ertan Yilmaz
- Department of Dermatology and Venereology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ufuk Kavuzlu
- Department of Dermatology and Venereology, School of Medicine, Mersin University, Mersin, Turkey
| | - Yesim Senol
- Department of Medical Education, Akdeniz University School of Medicine, Antalya, Turkey
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Abstract
BACKGROUND Fixed drug eruption (FDE) is a special variant of drug reaction seen on skin or mucous membrane, and typically recurs at the same location. Ornidazole-induced FDE cases have been reported extremely rare. CASE The 48-year-old female patient was diagnosed for ornidazole-induced fixed drug reaction on the sole. The patient's history revealed that the lesion occurred for the third time in the last 6 months and she was administered ornidazole tablet 3 times by the gynecologist for genitourinary tract infection. CONCLUSION This report presents a case of fixed drug reaction located at the sole induced by ornidazole use and a literature review.
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Affiliation(s)
- Selma Emre
- a Department of Dermatology , Yıldırım Beyazıt Univercity, Medical School , Ankara , Turkey and
| | - Hilal Ahsen
- b Department of Pathology , Atatürk Training and Research Hospital , Ankara , Turkey
| | - Akın Aktaş
- a Department of Dermatology , Yıldırım Beyazıt Univercity, Medical School , Ankara , Turkey and
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Demirseren DD, Kilinc F, Emre S, Akyol M, Metin A, Aktas A. The weeks and the cumulative doses of the first adverse events related to oral isotretinoin in acne patients: analysis of 300 patients. J DERMATOL TREAT 2016; 28:309-313. [DOI: 10.1080/09546634.2016.1230175] [Citation(s) in RCA: 6] [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] [Indexed: 10/21/2022]
Affiliation(s)
| | - Fadime Kilinc
- Department of Dermatology, Ataturk Training and Research Hospital, Ankara, Turkey
| | - Selma Emre
- Department of Dermatology, Ataturk Training and Research Hospital, Ankara, Turkey
| | - Mesut Akyol
- Biostatistics and Medical Informatic, Yildirim Beyazit University, Faculty of Medicine, Ankara, Turkey
| | - Ahmet Metin
- Department of Dermatology, Ataturk Training and Research Hospital, Ankara, Turkey
| | - Akin Aktas
- Department of Dermatology, Ataturk Training and Research Hospital, Ankara, Turkey
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Emre S, Metin A, Caykoylu A, Akoglu G, Ceylan GG, Oztekin A, Col ES. Clinical characteristics and HLA alleles of a family with simultaneously occurring alopecia areata. Cutis 2016; 97:E30-E36. [PMID: 27416096] [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: 06/06/2023]
Abstract
Alopecia areata (AA) is a T-cell-mediated autoimmune disease resulting in partial or total noncicatricial hair loss. HLA class II antigens are the most important markers that constitute genetic predisposition to AA. Various life events and intense psychological stress may play an important role in triggering AA attacks. We report an unusual case series of 4 family members who had simultaneously occurring active AA lesions. Our aim was to evaluate the clinical and psychiatric features of 4 cases of active AA lesions occurring simultaneously in a family and determine HLA alleles. The clinical and psychological features of all patients were examined. HLA antigen DNA typing was performed by polymerase chain reaction with sequence-specific primers. All patients had typical AA lesions over the scalp and/or beard area. Psychological examinations revealed obsessive-compulsive personality disorder in the proband's parents as well as anxiety and lack of self-confidence in both the proband and his sister. HLA antigen types were not commonly shared with family members. These findings suggest that AA presenting concurrently in members of the same family was not associated with genetic predisposition. Shared psychological disorders and stressful life events might be the major key points in the concurrent presentation of these familial AA cases and development of resistance against treatments.
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Affiliation(s)
- Selma Emre
- Department of Dermatology, Atatürk Training and Research Hospital, Ankara, Turkey
| | - Ahmet Metin
- Department of Dermatology, Atatürk Training and Research Hospital, Ankara, Turkey
| | - Ali Caykoylu
- Department of Psychiatry, Atatürk Training and Research Hospital, Ankara, Turkey
| | - Gulsen Akoglu
- Department of Dermatology, Atatürk Training and Research Hospital, Ankara, Turkey
| | - Gülay G Ceylan
- Department of Medical Genetics, Atatürk Training and Research Hospital, Ankara, Turkey
| | - Aynure Oztekin
- Department of Dermatology, Atatürk Training and Research Hospital, Ankara, Turkey
| | - Esra S Col
- Department of Psychiatry, Atatürk Training and Research Hospital, Ankara, Turkey
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Abstract
While actinic keratoses (AKs) have been considered precancerous until recently for being able to turn into squamous cell carcinomas (SCCs), it is now agreed that it would be more appropriate to call them cancerous. Although not all AKs turn into SCC and some of them may even have a spontaneous regression, there is an obvious association between SCC and AK. Approximately 90% of SCs have been reported to develop from AKs and AKs are the preinvasive form of SCCs. The presence of two or more AKs on a photodamaged skin is an indicator of field cancerization and represents an increased risk of invasive SCC. All lesions should be treated since it cannot be foreseen which of the lesions will regress and which will progress to SCC. AK can be a single lesion or it can involve multiple lesions in a field of cancerization; thus, AK treatment is grouped under two headings: (1) Lesion-specific treatment; and (2) Field-targeted treatment. Lesion-specific treatments are practicable in patients with a small number of clinically visible and isolated lesions. These treatments including cryotherapy, surgical excision, shave excision, curettage and laser are based on physical destruction of the visible lesions. Field-targeted treatments are effective in the treatment of visible lesions, subclinical lesions and keratinocyte changes in the areas surrounding the visible lesions. Field targeted treatment options are topical imiquimod cream, 5% 5-fluorouracil cream, ingenol mebutate, diclofenac gel, resimiquimod and photodynamic therapy.
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Abstract
Background: Pityriasis rosea (PR) is usually an asymptomatic and self-limiting papulosquamous skin disease with acute onset. The etiology has not been clarified yet. Recently, increased oxidative stress was found to play a role in etiopathogenesis of multiple cutaneous diseases with T cell-mediated immune response. However, there are no studies demonstrating the oxidative stress status in PR. Aim: The aim of the study is to determine the status of oxidative stress (OS) and paraoxonase (PON) 1/arylesterase enzyme activities in PR. Materials and Methods: Study included 51 patients with active PR lesions, and 45 healthy volunteers. Serum levels of total oxidant status (TOS), total antioxidant status (TAS), and PON1/arylesterase (ARES) activity were determined and oxidative stress index (OSI) was calculated in all patients and controls. Results: TAS levels and ARES activities in the patient group were significantly lower than the control group. On the other hand, TOS and OSI levels were significantly higher in patients compared with controls. There was no significant correlation between the duration of disease and TAS, TOS, OSI levels, and ARES activities. Conclusion: A systemic oxidative stress exists in PR, which suggests that OS may be involved in the etiopathogenesis of disease.
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Affiliation(s)
- Selma Emre
- Dermatology Clinic, Atatürk Training and Research Hospital, Ankara, Turkey
| | - Gulsen Akoglu
- Dermatology Clinic, Atatürk Training and Research Hospital, Ankara, Turkey
| | - Ahmet Metin
- Dermatology Clinic, Atatürk Training and Research Hospital, Ankara, Turkey
| | | | - Semra Isikoglu
- Department of Biochemistry, Atatürk Training and Research Hospital, Ankara, Turkey
| | - Aynure Oztekin
- Dermatology Clinic, Atatürk Training and Research Hospital, Ankara, Turkey
| | - Ozcan Erel
- Department of Biochemistry, Atatürk Training and Research Hospital, Ankara, Turkey
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Durmus B, Emre S, Sahin N, Karincaoglu Y, Dogan E, Baysal O, Ersoy Y, Altay Z. Isokinetic Evaluation of Knee Extensor/Flexor Muscle Strength in Behcet's Patients. Acta Reumatol Port 2015; 40:348-354. [PMID: 26922198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Behçet's disease (BD) is an idiopathic, multisystemic, progressive disease. The purpose of this study is to compare the knee flexor and extensor isokinetic muscle strengths of Behcet's patients with that of healthy subjects. METHODS Twenty-five (13 male and 12 female) patients with BD and 25 (15 male and 10 female) healthy individuals were included in the study. Velocities of 90°/sec, 120°/sec, and 150°/sec were used for the isokinetic muscle strength testing. Patients with active inflammatory knee arthritis were excluded. Peak torque (Nm) and peak torque adjusted to body weight (%) were taken into consideration for comparison between study groups. RESULTS Compared to healthy controls, there was a statistically significant decrease in both the bilateral knee extensor and flexor muscle isokinetic peak torques(Nm) as well as the peak torques adjusted to body weight (%) at velocities of 90°/sec, 120°/sec and 150°/sec in patients with BD (p < 0.05). However, there was no significant difference in the agonist-antagonist ratio of the isokinetic peak torques of knee muscles between the two groups. CONCLUSION In light of these findings, we have concluded that both knee flexor and extensor isokinetic muscle strengths are lower in BD. We therefore recommend careful monitoring of patients with BD in terms of muscle strength.
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Yesilkaya S, Acikel C, Fidanci BE, Sozeri B, Ayaz NA, Akıncı N, Kavukçu S, Özçelik G, Aydogan U, Ozenç S, Emre S, Donmez O, Delibaş A, Yüksel S, Berdelli A, Poyrazoğlu H, Saldır M, Çakar N, Peru H, Bakkaloğlu S, Tabel Y, Sarı O, Polat A, Basbozkurt G, Unsal E, Kasapcopur O, Gok F, Ozen S, Demirkaya E. Developing of a new scale for assessing the adherence to colchicine treatment in pediatric patients with FMF. Pediatr Rheumatol Online J 2015. [PMCID: PMC4599882 DOI: 10.1186/1546-0096-13-s1-p109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Akoglu G, Emre S, Metin A, Kurtoglu G, Onursever NM. A Turkish patient with Hermansky-Pudlak syndrome. Skinmed 2014; 12:313-315. [PMID: 25632653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A 34-year-old woman presented to our outpatient clinic with photosensitivity, photophobia, and facial pruritus (Figure 1). She had brown eyes and fair skin, hair, eyelashes, and eyebrows since birth. Her sister had similar skin and hair pigments. The patient had no systemic disease and was not taking any medication. Her parents were second-degree relatives. A dermatologic examination revealed small hyperkeratotic papules with an erythematous background, minimal desquamation, and some excoriation over the nose, zygomatic arch, and forehead consistent with actinic keratosis and solar damage. An ophthalmological examination demonstrated impaired visual acuity (60/100 in both eyes, reaching 80/100 in the left eye with best correction). Hypopigmentation at the albinotic retinal midperiphery (Figure 2) by fundoscopy was noted. She had no nystagmus or strabismus. The patient had no complaints or symptoms of the neurological, gastrointestinal, or respiratory system, and she had no recurrent skin or systemic infection.
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Akoğlu G, Metin A, Ceylan GG, Emre S, Akpolat D, Süngü N. Focal epithelial hyperplasia associated with human papillomavirus 13 and common human leukocyte antigen alleles in a Turkish family. Int J Dermatol 2014; 54:174-8. [PMID: 24738569 DOI: 10.1111/ijd.12538] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Focal epithelial hyperplasia (FEH) is a rare and benign papillomatous disease of the oral cavity, which is closely associated with human papillomavirus (HPV) type 13 and 32. Genetic susceptibility to HPV infections are supported by recent studies involving the human leukocyte antigen system (HLA). In this report, we aimed to determine the clinicopathological features of a Turkish family with FEH and to detect the shared HLA DR and DQ types. METHODS HPV DNA typing of tissue samples and HLA determination from blood samples of four family members were performed by polymerase chain reaction. RESULTS Histopathological examination of all patients revealed acanthotic papillomatous epidermis, koilocytes, apoptotic keratinocytes, and mitosoid bodies. HPV13 was detected by polymerase chain reaction. HLA DQA1*0501, HLA DQB1*0302, and HLA DRB1*11 alleles were common in all family members. HLA DRB1*04 was detected in three of them. CONCLUSION This report is the first step for the investigation of involvement of HLA types in the pathogenesis of Turkish patients with FEH.
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Affiliation(s)
- Gülşen Akoğlu
- Dermatology, Atatürk Training and Research Hospital, Ankara, Turkey
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Demirseren D, Ceylan G, Akoglu G, Emre S, Erten S, Arman A, Metin A. HLA-B51 subtypes in Turkish patients with Behçet's disease and their correlation with clinical manifestations. Genet Mol Res 2014; 13:4788-96. [DOI: 10.4238/2014.july.2.8] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Demirkaya E, Acikel C, Basbozkurt G, Gul A, Kasapcopur O, Aydog O, Erdem H, Duzova A, Kisacik B, Kasifoglu T, Erken E, Tunca M, Sayarlioglu M, Yuksel S, Yildiz F, Donmez O, Berdeli A, Senel S, Ayaz NA, Polat A, Sozer B, Tabel Y, Akar S, Onat AM, Ozkaya O, Emre S, Akinca N, Ozcelik G, Yavuz S, Yesilkaya S, Gok F, Poyrazoglu HM, Direskeneli H, Bakkaloglu S, Erten S, Tufan A, Goker B, Kavukcu S, Cakar N, Saldir M, Delibas A, Makay B, Kısaarslan A, Unsal SE, Ozdogan H, Topaloglu R, Ozen S. PReS-FINAL-2213: Validation of inadequate drug response and definition of colchicum resistance in FMF. Pediatr Rheumatol Online J 2013. [PMCID: PMC4044079 DOI: 10.1186/1546-0096-11-s2-p203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Yesilkaya S, Acıkel C, Eren Fidanci B, Sozeri B, Aktay Ayaz N, Akıncı N, Ozcelik G, Kavukcu S, Aydogan Ü, Ozenc S, Emre S, Donmez O, Yuksel S, Delibas A, Berdelli A, Poyrazoglu H, Saldir M, Cakar N, Peru H, Bakkaloglu S, Tabel Y, Sari O, Polat A, Basbozkurt G, Unsal E, Gok F, Kasapcopur O, Ozen S, Demirkaya E. PReS-FINAL-2204: Developing of a new scale for assessing the adherence to colchicines treatment in pediatric patients with FMF. Pediatr Rheumatol Online J 2013. [PMCID: PMC4044573 DOI: 10.1186/1546-0096-11-s2-p194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Demirkaya E, Acikel C, Tufan A, Kucuk A, Berdeli A, Gul A, Onat AM, Delibas A, Duzova A, Dinc A, Yavascan O, Kasapcopur O, Makay B, Goker B, Sozeri B, Kisacik B, Comak E, Unsal E, Erken E, Gunal E, Baskin E, Yalcinkaya F, Yildiz F, Gok F, Basbozkurt G, Ozcelik G, Demircin G, Poyrazoglu H, Erdem H, Direskeneli H, Ozer H, Ozdogan H, Simsek I, Dursun I, Gokce I, Tunca M, Gurgoze M, Cakar N, Akinci N, Ayaz N, Donmez O, Ozkaya O, Topaloglu R, Kavukcu S, Yuksel S, Akar S, Bakkaloglu S, Emre S, Senel S, Erten S, Yavuz S, Kalman S, Kasifoglu T, Kalyoncu U, Tabel Y, Ekinci Z, Ozen S. PW01-025 – Definition of colchicine resistance in FMF. Pediatr Rheumatol Online J 2013. [PMCID: PMC3952434 DOI: 10.1186/1546-0096-11-s1-a78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Emre S, Metin A, Demir-Pektaş S, Kılıçarslan A. Papular elastorrhexis. Cutis 2013; 92:E4-E5. [PMID: 23961532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Stey A, Doucette J, Florman S, Emre S. Donor and Recipient Factors Predicting Time to Graft Failure Following Orthotopic Liver Transplantation: A Transplant Risk Index. Transplant Proc 2013; 45:2077-82. [DOI: 10.1016/j.transproceed.2013.06.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Akoglu G, Emre S, Metin A, Akbas A, Yorulmaz A, Isikoglu S, Sener S, Kilinc F. Evaluation of total oxidant and antioxidant status in localized and generalized vitiligo. Clin Exp Dermatol 2013; 38:701-6. [PMID: 23601201 DOI: 10.1111/ced.12054] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Vitiligo is an acquired depigmentation disorder, and oxidative stress is suggested to have a major role in its aetiopathogenesis. AIM To assess whether oxidative stress has a greater role in generalized than in localized vitiligo. METHODS We assessed 31 patients with active vitiligo (17 localized, 14 generalized) and 38 healthy controls. Serum total oxidant status (TOS), total antioxidant status (TAS) and oxidative stress index (OSI) were determined. RESULTS Patients with vitiligo had significantly lower TAS and higher TOS and OSI values than controls. Both localized and generalized vitiligo were associated with lower TAS and higher TOS and OSI values, compared with controls, and all three did not differ with vitiligo type. CONCLUSIONS A systemic oxidative stress exists in patients with vitiligo. These results indicate that the global antioxidant capacity of patients might have been exhausted through a defence mechanism against oxidative processes. The imbalance in TOS/TAS status may have an important role in the aetiopathogenesis of vitiligo, regardless of the clinical variant of the disease.
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Affiliation(s)
- G Akoglu
- Dermatology Clinic, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
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Chung RT, Gordon FD, Curry MP, Schiano TD, Emre S, Corey K, Markmann J, Hertl M, Pomposelli JJ, Pomfret EA, Florman S, Schilsky M, Broering TJ, Finberg RW, Szabo G, Zamore PD, Khettry U, Babcock GJ, Ambrosino DM, Leav B, Leney M, Smith HL, Molrine DC. Human monoclonal antibody MBL-HCV1 delays HCV viral rebound following liver transplantation: a randomized controlled study. Am J Transplant 2013; 13:1047-1054. [PMID: 23356386 PMCID: PMC3618536 DOI: 10.1111/ajt.12083] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [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: 10/25/2012] [Revised: 11/20/2012] [Accepted: 12/04/2012] [Indexed: 01/25/2023]
Abstract
Rapid allograft infection complicates liver transplantation (LT) in patients with hepatitis C virus (HCV). Pegylated interferon-α and ribavirin therapy after LT has significant toxicity and limited efficacy. The effect of a human monoclonal antibody targeting the HCV E2 glycoprotein (MBL-HCV1) on viral clearance was examined in a randomized, double-blind, placebo-controlled pilot study in patients infected with HCV genotype 1a undergoing LT. Subjects received 11 infusions of 50 mg/kg MBL-HCV1 (n=6) or placebo (n=5) intravenously with three infusions on day of transplant, a single infusion on days 1 through 7 and one infusion on day 14 after LT. MBL-HCV1 was well-tolerated and reduced viral load for a period ranging from 7 to 28 days. Median change in viral load (log10 IU/mL) from baseline was significantly greater (p=0.02) for the antibody-treated group (range -3.07 to -3.34) compared to placebo group (range -0.331 to -1.01) on days 3 through 6 posttransplant. MBL-HCV1 treatment significantly delayed median time to viral rebound compared to placebo treatment (18.7 days vs. 2.4 days, p<0.001). As with other HCV monotherapies, antibody-treated subjects had resistance-associated variants at the time of viral rebound. A combination study of MBL-HCV1 with a direct-acting antiviral is underway.
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Affiliation(s)
- R. T. Chung
- Massachusetts General Hospital, Boston, MA, United States
| | - F. D. Gordon
- Lahey Clinic Medical Center, Burlington, MA, United States
| | - M. P. Curry
- Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - T. D. Schiano
- Mount Sinai Medical Center, New York, NY, United States
| | - S. Emre
- Yale New Haven Hospital, New Haven, CT, United States
| | - K. Corey
- Massachusetts General Hospital, Boston, MA, United States
| | - J. Markmann
- Massachusetts General Hospital, Boston, MA, United States
| | - M. Hertl
- Massachusetts General Hospital, Boston, MA, United States
| | | | - E. A. Pomfret
- Lahey Clinic Medical Center, Burlington, MA, United States
| | - S. Florman
- Mount Sinai Medical Center, New York, NY, United States
| | - M. Schilsky
- Yale New Haven Hospital, New Haven, CT, United States
| | - T. J. Broering
- MassBiologics, University of Massachusetts Medical School, Boston, MA, United States
| | - R. W. Finberg
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - G. Szabo
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - P. D. Zamore
- Howard Hughes Medical Institute and Department of Biochemistry & Molecular Pharmacology, University of Massachusetts Medical School, Worcester, MA, United States
| | - U. Khettry
- Lahey Clinic Medical Center, Burlington, MA, United States
| | - G. J. Babcock
- MassBiologics, University of Massachusetts Medical School, Boston, MA, United States
| | - D. M. Ambrosino
- MassBiologics, University of Massachusetts Medical School, Boston, MA, United States
| | - B. Leav
- MassBiologics, University of Massachusetts Medical School, Boston, MA, United States
| | - M. Leney
- MassBiologics, University of Massachusetts Medical School, Boston, MA, United States
| | - H. L. Smith
- MassBiologics, University of Massachusetts Medical School, Boston, MA, United States
| | - D. C. Molrine
- MassBiologics, University of Massachusetts Medical School, Boston, MA, United States
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Emre S, Emre C, Akoglu G, Demirseren DD, Metin A. Evaluation of dermatological consultations of patients treated in intensive care unit. Dermatology 2013; 226:75-80. [PMID: 23485728 DOI: 10.1159/000346939] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Accepted: 12/30/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Skin disorders which require treatment are a common development in patients treated in intensive care units (ICUs). There are very few prospective studies about skin complications in adult ICUs. OBJECTIVE The aim of this study is to evaluate skin disorders in ICU-treated adult patients who were consulted for dermatological problems. METHODS Eighty-two of 591 patients admitted to ICUs who were consulted for dermatological problems were included in the study. The correlation between skin complications and associated comorbidities, age, gender and ICU length of stay were analyzed. RESULTS Ninety dermatological complications were observed. Cutaneous drug reactions were significantly more frequent in female patients than males (p = 0.020). Candidal intertrigo was more frequent in diabetic patients than in nondiabetic patients (p = 0.042). CONCLUSION Patients in ICUs may develop various skin disorders that need to be evaluated by dermatological consultations. Clinical features of the patients, especially gender and comorbidities, may predispose skin complications.
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Affiliation(s)
- Selma Emre
- Dermatology Clinic, Atatürk Training and Research Hospital, TR-06640 Ankara, Turkey.
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Akoglu G, Metin A, Emre S, Ersoy R, Cakir B. Cutaneous findings in patients with acromegaly. Acta Dermatovenerol Croat 2013; 21:224-229. [PMID: 24476608] [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: 06/03/2023]
Abstract
Acromegaly is a systemic syndrome caused by overproduction of growth hormone. The syndrome affects cutaneous, endocrine, cardiovascular, skeletal, and respiratory systems. Cutaneous manifestations of acromegaly are various, usually being the first presenting findings of the disease. Forty-nine patients with acromegaly, followed-up at a tertiary referral hospital, underwent dermatological examination. There were 27 (55.1%) female and 22 (44.9%) male patients. The age at onset of the disease was older in females than males (P=0.045). Most patients had acral enlargements, large triangular nose, coarse face, thickened lower lip, and prognathism. Fourteen (28.6%) patients had multiple cherry angiomas, five (10.2%) had varicose veins in lower limbs, and two (4.1%) had psoriasis. In conclusion, a wide spectrum of cutaneous symptoms and features may be associated with acromegaly. Detailed dermatological examination of patients with acromegaly should be an essential component of systemic evaluation. Future prospective studies investigating the relationships between changes in skin signs, hormone levels, and response to treatments may help understand details of skin involvement in acromegaly.
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Affiliation(s)
| | - Ahmet Metin
- Professor Ahmet Metin, MD, PhD, Department of Dermatology, Atatürk Training and Research Hospital, Bilkent, Ankara, Turkey;
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Abstract
Pili annulati (PA) is typically characterized by shinny beads seen along the hair shaft. PA is accepted to belong to the classification of hair shaft abnormalities without fragility. Herein, we described a 14-year-old, fair skin with dark-haired girl diagnosed as PA with fragility which was demonstrated by weathering features in electron microscopic examinations. The patient had shinny beaded, easily breakable hairs since the age of four. A few broken hairs were observed by a light pull test. Transmitted light microscopy revealed periodic dark bands in the hair shaft. These dark bands disappeared after application of 10% aqueous potassium hydroxide. Multiple cavities within hair shaft and severe cuticular damages representing the weathering pattern were observed in electron microscopic examinations. All these findings were found to be consistent with presence of fragility in PA. This case provides evidences of fragile hair structure of PA which may be due to pathological cavities within hair shafts.
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Affiliation(s)
- Gulsen Akoglu
- Dermatology Clinic, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
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Emre S, Metin A, Demirseren DD, Kilic S, Isikoglu S, Erel O. The relationship between oxidative stress, smoking and the clinical severity of psoriasis. J Eur Acad Dermatol Venereol 2012; 27:e370-5. [PMID: 23004342 DOI: 10.1111/j.1468-3083.2012.04700.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Recent studies suggested that increased oxidant products and decreased antioxidant system functions may be involved in the pathogenesis of psoriasis. In this study, we investigated total oxidative status, Paraoxonase (PON)1/arylesterase enzyme activities and severity of the disease in smoker and non-smoker psoriatic patients. METHODS Fifty-four patients with plaque type psoriasis (28 smokers and 26 non-smokers) and 62 healthy volunteers (16 smokers and 46 non-smokers) were enrolled in the study. Serum total oxidant status (TOS), total antioxidant capacity (TAC) and arylesterase levels were measured, and oxidative stress index (OSI) was calculated in all participants. RESULTS Psoriasis Area and Severity Index scores were significantly higher in smoker patients than in non-smoker patients (P = 0.014). Both smoker and non-smoker patients had significantly increased TOS levels and OSI values and decreased TAC levels than healthy subjects (all P values = 0.000). The TAC and TOS levels, OSI values and arylesterase activities were similar between smoker and non-smoker patients. The levels of triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL) and high-density lipoprotein (HDL) were not significantly different between smoker and non-smoker psoriasis patients. When compared with non-smoking controls, only smoking psoriasis patients had significantly higher TG (P = 0.005), lower HDL (P = 0.022) and lower arylesterase levels (P = 0.015). There were no significant correlations with Psoriasis Area and Severity Index (PASI) scores and TAC, TOS, OSI, TG, TC, HDL and LDL levels in all psoriasis patients. CONCLUSIONS Oxidative stress is increased in psoriasis patients regardless of their smoking status. The decreased arylesterase activity in smoker psoriasis patients suggested that smoking may be a considerable risk factor that increases the severity of psoriasis by increasing oxidative stress in these patients.
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Affiliation(s)
- S Emre
- Clinics of Dermatology Biochemistry, Atatürk Training and Research Hospital, Ankara, Turkey
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Emre S, Metin A, Demirseren DD, Akoglu G, Oztekin A, Neselioglu S, Erel O. The association of oxidative stress and disease activity in seborrheic dermatitis. Arch Dermatol Res 2012; 304:683-7. [DOI: 10.1007/s00403-012-1254-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Revised: 05/29/2012] [Accepted: 06/01/2012] [Indexed: 01/05/2023]
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Uğurlu N, Emre S, Yülek F, Akcay EK, Sengun A. Hereditary hemorrhagic telangiectasia with multiple fusiform retinal aneurysms. J Ocul Biol Dis Infor 2012; 5:48-50. [PMID: 24596937 DOI: 10.1007/s12177-013-9100-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Accepted: 01/17/2013] [Indexed: 10/27/2022] Open
Affiliation(s)
- Nagihan Uğurlu
- Atatürk Research and Training Hospital, Department of Ophthalmology, Yıldırım Beyazıt University, Ankara, Turkey ; 48.cadde 1474. Sokak 3/10 Çukurambar, Ankara, Turkey
| | - Selma Emre
- Atatürk Research and Training Hospital, Department of Dermatology, Yıldırım Beyazıt University, Ankara, Turkey
| | - Fatma Yülek
- Atatürk Research and Training Hospital, Department of Ophthalmology, Yıldırım Beyazıt University, Ankara, Turkey
| | - Emine Kalkan Akcay
- Atatürk Research and Training Hospital, Department of Ophthalmology, Yıldırım Beyazıt University, Ankara, Turkey
| | - Ahmet Sengun
- Department of Ophthalmology, Ufuk University School of Medicine, Ankara, Turkey
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Takasawa K, Takaeda C, Higuchi M, Maeda T, Tomosugi N, Ueda N, Sasaki Y, Ikezoe M, Hagiwara M, Furuhata S, Murakami M, Shimonaka Y, Yamazaki S, Hamahata S, Hamahata S, Oue M, Kuragano T, Furuta M, Yahiro M, Kida A, Otaki Y, Hasuike Y, Nonoguchi H, Nakanishi T, Sarafidis P, Rumjon A, Ackland D, Maclaughlin H, Bansal SS, Macdougall IC, Panichi V, Rosati A, Malagnino E, Giusti R, Casani A, Betti G, Conti P, Bernabini G, Bernabini G, Gabrielli C, Caiani D, Scatena A, Migliori M, Pizzarelli F, Mitsopoulos E, Tsiatsiou M, Minasidis I, Kousoula V, Intzevidou E, Passadakis P, Vargemezis V, Tsakiris D, Yahiro M, Kida A, Otaki Y, Hasuike Y, Nonoguchi H, Nakanishi T, Kuragano T, Lines SW, Carter AM, Dunn EJ, Wright MJ, Aoyagi R, Miura T, De Paola L, Lombardi G, Coppolino G, Lombardi L, Hasuike Y, Fukumoto H, Kaibe S, Tokuyama M, Kida A, Otaki Y, Kuragano T, Nonoguchi H, Hiwasa M, Miyamoto T, Ohue H, Matsumoto A, Toyoda K, Nakanishi T, Rottembourg J, Emery C, Lafuma A, Wernli J, Zakin L, Mahi L, Borzych-Duzalka D, Bilginer Y, Pape L, Ha IS, Bak M, Chua A, Rees L, Pesle S, Cano F, Urzykowska A, Emre S, Russcasso J, Ramela V, Printza N, White C, Kuzmanovska D, Andrea V, Muller-Wiefel D, Warady B, Schaefer F, Chung JH, Park MK, Kim HL, Shin BC, Fujikawa T, Kuji T, Kakimoto M, Shibata K, Satta H, Nishihara M, Kawata S, Koguchi N, Toya Y, Umemura S, David V, Michel G, Maxime H, Paul L, Sebastien K, Francois V, Kuntsevich V, Dou Y, Thijssen S, Levin NW, Kotanko P, Kim BS, Kim BS, Park WD, Song HC, Kim HG, Kim YO, Woodburn K, Fong KL, Moriya Y, Tagawa Y, Maeda T, Kanda F, Morita N, Tomosugi N, London G, London G, Zaoui P, Covic A, Dellanna F, Goldsmith D, Gesualdo L, Mann J, Combe C, Turner M, Meunzberg M, Macdonald K, Abraham I, Gesualdo L, Combe C, Covic A, Dellanna F, Goldsmith D, London G, Mann J, Zaoui P, Turner M, Meunzberg M, Macdonald K, Abraham I, Rottembourg J, Guerin A, Diaconita M, Apruzzese R, Dou Y, Thijssen S, Kruse A, Ouellet G, Levin NW, Kotanko P, Bond C, Jensen D, Wang S, Pham E, Rubin J, Sika M, Niecestro R, Woodburn K, Fong KL, Sloneker S, Strzemienski P, Solon E, Moriya Y, Tagawa Y, Stamopoulos D, Mpakirtzi N, Grapsa E, Gogola B, Manios E, Afentakis N, Ewer J, Macdougall IC. Renal anaemia - CKD 5D. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs244] [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: 11/13/2022] Open
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Polat KY, Tosun MS, Ertekin V, Aydinli B, Emre S. Brucella infection with pancytopenia after pediatric liver transplantation. Transpl Infect Dis 2012; 14:326-9. [PMID: 22260451 DOI: 10.1111/j.1399-3062.2011.00709.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Revised: 08/08/2011] [Accepted: 10/06/2011] [Indexed: 12/15/2022]
Abstract
Brucellosis is considered the most widespread zoonosis in the world. It has been reported that the prevalence of seropositivity among the Turkish population varies from 3% to 14%. We present a case of brucellosis after pediatric liver transplantation. A 15-year-old boy with the diagnosis of neuro Wilson's disease underwent deceased-donor liver transplantation. The postoperative immunosuppressive protocol consisted of steroids and tacrolimus. Two months after the operation the patient experienced fever to 40°C. The patient complained of poor appetite, headache, and diarrhea. He had had pancytopenia. Despite administration of appropriate antibiotics, antiviral and antifungal agents, fever persisted for > 1 month. Multiple blood, urine, stool, and sputum cultures were negative. Bone marrow aspirate revealed hypocellularity. Liver biopsy was performed, but rejection was not observed on biopsy specimen. Brucella serology was positive and Brucella agglutination titer was 1:320. Bone marrow culture was positive for Brucella but blood culture was negative. The patient was then treated with oral doxycycline and rifampin for 8 weeks. No previous case report about Brucella infection after liver transplantation has appeared in the literature, to our knowledge; our case is presented as the first. Bone marrow hypoplasia is a rare feature of Brucella infection. Our patient with brucellosis and pancytopenia had had hypocellular bone marrow. The clinical and hematologic findings resolved with treatment of the infection. Brucella infection should be suspected in liver transplanted recipients with fever of unknown origin, especially in a recipient who has lived in an endemic area. Brucella also should be considered as a possible diagnosis in patients with pancytopenia.
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Affiliation(s)
- K Y Polat
- Department of Transplant Surgery, Memorial Atasehir Hospital, Istanbul, Turkey
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Akoglu G, Emre S, Metin A, Bozkurt M. High Frequency of Hypertrichosis after Cast Application. Dermatology 2012; 225:70-4. [DOI: 10.1159/000341521] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Accepted: 06/12/2012] [Indexed: 11/19/2022] Open
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Kerkar N, Morotti RA, Iyer K, Arnon R, Miloh T, Sturdevant M, Suchy F, Florman S, Emre S. Anti-lymphocyte therapy successfully controls late "cholestatic" rejection in pediatric liver transplant recipients. Clin Transplant 2011; 25:E584-91. [PMID: 21919961 DOI: 10.1111/j.1399-0012.2011.01494.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Rejection is independently associated with liver graft loss in children. We report the successful rescue of grafts using ATG+/-OKT3 in late rejection associated with cholestasis. Retrospective chart review was performed after IRB approval. Between 2003 and 2010, 14 pediatric liver transplant recipients received anti-lymphocyte treatment for "cholestatic" rejection. Median age at transplantation was 12.7 yr (range 0.9-23.4), eight were boys, and immunosuppression was tacrolimus based. Median time from transplantation to rejection was five yr (range 1.1-10.5). Median peak total bilirubin was 11.1 mg/dL (range 1.4-18). All showed moderate to severe acute rejection and hepatocellular cholestasis on histology. ATG/OKT3 was started as first-line therapy in six and in the remaining eight as second-line therapy after failure of pulse steroids. Thirteen responded with normalization of aminotransferases and bilirubin, median time 16 wk (range 7-112); one non-adherent recipient has still not achieved normal graft function at last follow-up. Patient survival is 100%, with no re-transplantation and no post-transplant lymphoproliferative disease, median follow-up 2.9 yr (range 1.1-7.2). Cholestasis associated with acute rejection occurring late after liver transplantation may herald steroid resistance. First-line therapy with anti-lymphocyte preparations, prophylactic anti-microbial therapy, and close monitoring allow excellent rates of patient and graft survival.
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Affiliation(s)
- N Kerkar
- Department of Surgery, Recanati Miller Transplant Institute, The Mount Sinai School of Medicine, New York, NY 10029, USA.
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Cimsit B, Schilsky M, Moini M, Cartiera K, Arvelakis A, Kulkarni S, Formica R, Caldwell C, Taddei T, Asch W, Emre S. Combined liver kidney transplantation: critical analysis of a single-center experience. Transplant Proc 2011; 43:901-4. [PMID: 21486624 DOI: 10.1016/j.transproceed.2011.02.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Combined liver kidney transplantation (LKT) can be successfully performed on patients with liver and renal failure; however, outcomes are inferior to liver transplantation alone (OLT). Our aim was to determine the indications for and outcome of LKT and whether patients with longer wait times required more frequent LKT versus OLT alone. We included 18/93 adults who underwent LKT from August 2007 to August 2010 for hepatitis C virus (HCV, n = 7), alcohol (n = 5), nonalcoholic steatohepatitis (n = 2), primary biliary sclerosis, polycystic kidney disease with liver involvement, hepatic adenomatosis, and ischemic hepatitis. Eleven were originally listed for LKT and 7 required listing for-kidney transplantation while awaiting OLT. Eight were on dialysis when first listed and 10 had a low glomerular filtration rate or known kidney disease. The mean calculated Model for End-Stage Liver Disease (MELD) score for LKT was 31.2 ± 3.54. Seven had hepatocellular carcinoma in explants. Two patients had acute cellular kidney rejection that responded to treatment. Recurrence of HCV was documented in 5 patients within 6 months of LKT; 2/5 received HCV therapy (interferon and ribavirin) without renal allograft rejection. One-year liver graft/patient survival was 94% after LKT. One patient died at 6 months post LKT due to severe HCV recurrence. Last mean serum creatinine level was 1.35 ± 0.28 mg/dL for LKT patients. LKT is a safe procedure with favorable outcomes even in patients with a high MELD score. Transplantation of patients with a high MELD score due to regional variations in organ allocation results in additional use of kidneys by OLT patients. Improved organ allocation algorithms in OLT would help to reduce combined transplants, sparing more kidneys.
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Affiliation(s)
- B Cimsit
- Yale School of Medicine, Department of Surgery, New Haven, CT, USA
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Abstract
Liver transplantation (OLT) has become the only treatment modality for patients with end-stage liver diseases. Establishment of standard liver transplantation technique, development of better immunosuppressive medications and accumulated experience using them safely, and improvement of intensive care and anesthesia played major role to have current 88%-90% 1-year survival after liver transplantation. As liver transplantations became more successful with the growing experience and development in the field, the increased demand for liver allografts could not match the available supply of donor organs. As a result of this imbalance, each year nearly 3000 patients die in the United States awaiting liver transplantation on the national waiting list. Split liver transplantation (SLT) has been perceived as an important strategy to increase the supply of liver grafts by creating 2 transplants from 1 allograft. The bipartition of a whole liver also carries utmost importance by increasing the available grafts for the pediatric patients, where size-matched whole liver allografts are scarce, leading increased incidence of waiting list mortality in this group. In the common approach of the split liver procedure, liver is divided into a left lateral segment graft (LLS) to be transplanted to a child and a right extended liver lobe graft for an adult recipient. In a technically more challenging variant of this procedure, the principle is to split the liver into 2 hemigrafts and use the left side for a small adult or a teenager and the right for a medium-sized adult patient. Donor selection for splitting, technical expertise in both OLT and hepatobiliary surgery, logistics to decrease total ischemia time, and manpower of the transplantation team are important factors for successful outcomes after SLT. The liver can be split on the back table (ex situ) or in the donor hospital before the donor cross-clamp using in situ splitting technique, which was developed directly from living donor liver transplantation. The most important advantage of in situ splitting is to decrease the total ischemia time and increased the possibility of inter-center sharing. The in situ technique of splitting has other advantages, including evaluation of the viability of segment IV in case of LLS splitting and better control of bleeding from cut surface upon reperfusion on the recipient. Recipient selection for split liver grafts is also crucial for success after SLT. In this review, we aim to summarize the advances that have occurred in SLT. We also discuss anatomic and technical aspects, including both approaches to SLT, which is now considered by many centers to be a routine operation.
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Affiliation(s)
- S Emre
- Yale University School of Medicine, New Haven, CT, USA.
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