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    Akneli hastalarda sistemik isotretinoin tedavisinin laboratuvar değişkenleri üzerine etkisi ve literatürün gözden geçirilmesi
    (Dicle Üniversitesi Tıp Fakültesi, 2014) Uçak, Haydar; Akkurt, Zeynep Meltem; Uçmak, Derya; Sula, Bilal; Arıca, Mustafa
    Amaç: İsotretinoin (İSO), bir sentetik retinoid olup konvansiyonel tedavilere yanıt vermeyen şiddetli kistik aknenin tedavisinde tercih edilen bir ilaçtır. Bu çalışmada oral İSO tedavisi başlanan akne hastalarında laboratuvar değerlerinin retrospektif olarak değerlendirilmesi amaçlanmıştır. Yöntemler: Çalışmaya dermatoloji polikliniğine başvuran ve klinik olarak akne tanısı konularak İSO tedavisi başlanan 40 hasta alındı. Hastaların tedavi öncesi ve tedavinin 3. ayındaki karaciğer fonksiyon testleri (AST, ALT), kan üre ve kreatinin değerleri ile total kolesterol, yüksek dansiteli lipoprotein (HDL), düşük dansiteli lipoprotein (LDL) ve trigliserid (TG) değerleri hasta dosyaları taranarak elde edildi. Bulgular: Hastaların tedavi öncesi ve tedavinin 3. ayındaki laboratuvar sonuçları karşılaştırıldığında total kolesterol, LDL, HDL, TG ve AST değerlerinde istatistiksel olarak anlamlı değişiklikler saptandı (p<0.001, p<0.001, p= 0.003, p= 0.01, p=0.001 sırasıyla). Sonuç: İSO tedavisi başlanmadan önce hastalara uygulanacak iyi bir diyetin TG bozukluğunu önlemek adına fayda vereceğini düşünüyoruz. Buna ek olarak ailesel hipertrigliseridemili olgularda tedavi sırasında yapılacak sıkı laboratuvar takibin faydalı olacağı kanaatindeyiz. KC ve böbrek fonksiyon testlerinden daha ziyade kan lipid değerlerinin takibinin daha gerekli olduğu ancak takiplerin 2-3 ayda bir olacak şekilde daha az sıklıkla yapılmasının yeterli olabileceği saptanmıştır
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    Atypical cutaneous features in adult onset Still's disease
    (Wolters Kluwer Medknow Publications, 2014) Akkurt, Zeynep Meltem; Bozkurt, Mehtap; Ucmak, Derya; Turkcu, Gul; Ucak, Haydar
    Adult onset Still's disease is a rare but potentially serious disease. We present five cases of adult-onset Still's disease seen by us over a period of one year. The patients were all females and 28-39 years of age. Symptoms had been present for 2-6 weeks in three patients. The other two had been on a few years' follow-up for rheumatoid arthritis before the onset of rashes and fever. The patients had persistent erythematous maculopapular eruptions on face, body and extremities, with moderate to severe pruritus and/or a burning sensation that decreased their quality of life. The typical evanescent rash was not observed. High ferritin values were detected in all the patients and total serum IgE was increased in two. All the patients were started on oral prednisolone (0.5-1.0 mg/kg/day), and methotrexate (10-15 mg/week) had to be added in three patients. One patient was started on tocilizumab due to recalcitrant disease and one was lost to follow-up. Further investigation and classification of the various atypical cutaneous findings in adult-onset Still's disease is necessary.
  • Küçük Resim
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    Bir üniversite hastanesi dermatoloji polikliniğine başvuran çocuk hastaların deri biyopsilerinin klinikopatolojik korelasyonu
    (Dicle Üniversitesi Tıp Fakültesi, 2014) Uçak, Haydar; Uçmak, Derya; Akkurt, Zeynep Meltem; Sula, Bilal; Türkçü, Gül; Arıca, Mustafa
    Amaç: Bu çalışmada, Dicle Üniversitesi Tıp Fakültesi Hastanesi Dermatoloji Polikliniği’ne başvuran çocuk hastalardan alınan deri biyopsilerinde klinikopatolojik korelasyonun değerlendirilmesi amaçlandı. Yöntemler: Çalışmaya Ocak 2008- Aralık 2013 yılları arasında Dicle Üniversitesi Hastanesi Dermatoloji Polikliniği’ne başvuran 16 yaş ve öncesi 15337 hasta dahil edildi. Bu hastaların dosyaları retrospektif olarak tarandı ve 121 hastada tanı amaçlı deri biyopsisi yapıldığı saptandı. Bu hastaların 68’inden elde edilen veriler değerlendirildi. Elde edilen sonuçlar, ön tanı ve tanı korelasyonu açısından değerlendirildi. Klinisyen tarafından belirtilen ön tanılar ile elde edilen tanı arasında örtüşme mevcutsa korelasyon pozitif olarak kabul edildi. Bulgular: Hastaların 39’u (%57,3) kız, 29’u (%42,7) ise erkekti. Patoloji incelemesinde 57 (%83,8) hastada ön tanılar ile patolojik tanı arasında korelasyon vardı. Birinci ön tanı ile patoloji korelasyonu 42 (%61,7) hastada, ikinci ön tanı ile patoloji korelasyonu 8 (%11,7) hastada, üçüncü ön tanı ile patoloji korelasyonu ise 4 (%5,8) hastada saptandı. 10 (%14,7) hastada biyopsi tanı koymada bir katkı sağlamamıştı. 1 (%1,47) hastada ise ön tanıların dışında bir tanı konmuştu. Sonuç: Erişkin dönem hastalarda olduğu gibi çocukluk çağındaki hastalarda da özellikle atipik seyirli klinik tablolarda deri biyopsisi, tanıda kullanılan ve klinisyenin elini güçlendiren bir tanı tekniği olarak karşımıza çıkmaktadır. Ancak bu tanı tekniğinin daha verimli bir şekilde kullanılabilmesinin yolunun, klinisyen tarafından iyi bir bilgi paylaşımı ve gerektiğinde görsel malzemelerle patoloğun desteklenmesi olduğu görülmektedir
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    BLUE RUBBER BLEB NEVUS SYNDROME: A CASE REPORT
    (Carbone Editore, 2013) Ucmak, Derya; Ucmak, Feyzullah; Akkurt, Zeynep Meltem; Sula, Bilal; Yakut, Yunus
    Blue Rubber Bleb Nevus Syndrome (BRBNS) is a syndrome that is characterized with cutaneous venous malformations besides visceral involvement. Visceral involvement affects mostly the gastrointestinal (GI) system. As these venous malformations can lead to life-threatening serious GI bleeding, anemia is an important clue to diagnosis. A 18-year-old female presented to the department of internal medicine with complaints of weakness and paleness. Hypochromic microcytic anemia was diagnosed and upper and lower GI screenings were done. On endoscopy, reddish-purple polypoid lesions were detected throughout the GI tract and nodular lesions compatible with venous malformations were observed on both lower extremities. A diagnosis of BRBNS was made. Symptoms of iron deficiency anemia guide patients with BRBNS to general practitioners and internal medicine specialists. If cutaneous findings are present, collaboration with dermatologists at this stage will improve diagnostic accuracy.
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    Bullous Pemphigoid Mimicking Discoid Lupus Erythematosus: A Case Report
    (Aves, 2014) Ucmak, Derya; Akkurt, Zeynep Meltem; Sula, Bilal; Acar, Gurbet; Alabalik, Ulas; Arica, Mustafa
    [Abstract Not Available]
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    Burns due to wet wood ash: three cases
    (Informa Healthcare, 2014) Ayhan, Erhan; Akkurt, Zeynep Meltem; Ucmak, Derya
    Wood ash, a traditional multipurpose agent, is sometimes used under occlusion as a folkloric prescription to ease pain and edema. Adding water or oil to ash forms a mixture with strong alkaline properties. We present interesting three cases who sustained full-thickness burns after application of a poultice of wetted wood ash for the treatment of leg pain.
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    A Case of Myxoid Dermatofibrosarcoma Protuberan
    (2015) Akkurt, Zeynep Meltem; Uçmak, Derya; Sula, Bilal; Arıca, Mustafa; Uğur, Fırat
    Dermatofibrosarcoma protuberans (DFSP) is a slow-growing dermal spindle cell tumor. Its rare myxoid variant is characterized by extensive myxoid degeneration. We report a case of myxoid DFSP of the lower abdomen in a 35-year-old man. Histopathologically, the tumor consisted of spindle-shaped cells that were strongly positive for CD34 with a typical storiform pattern and myxoid stromal changes.
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    Clinical and dermoscopic evaluation of cutaneous leishmaniasis
    (Wiley, 2015) Ayhan, Erhan; Ucmak, Derya; Baykara, Sule Nergiz; Akkurt, Zeynep Meltem; Arica, Mustafa
    BackgroundDermoscopy is a method to aid in the visualization of the epidermis and dermis. In recent years, the use of dermoscopy in the diagnosis of non-melanocytic lesions such as those of leishmania cutis has increased. ObjectivesThis study was intended to establish whether dermoscopic investigation has any diagnostic value in cutaneous leishmaniasis (CL). MethodsFifty-five patients diagnosed with CL at the Department of Dermatology, Faculty of Medicine, Dicle University, between February and October 2012, were included in the study. Collectively, the patients exhibited a total of 127 lesions. ResultsThe meanstandard deviation age of the patients was 25.7 +/- 21.3years (range: 4-86years). Twenty-three (41.8%) patients were male, and 32 (58.2%) were female. In dermoscopy, teardrop-like structures were observed in 42.5% of the lesions. Vascular structures were detected in 115 (90.6%) lesions; no vascular structures were observed in 12 (9.4%) lesions. Branching, linear, comma-like, and polymorphic vessels were seen more commonly in lesions on the face; pin-point and hairpin-like vessels were seen more commonly in lesions on the upper extremities. ConclusionsWhen the findings obtained in this study were evaluated along with those reported in the literature, it became apparent that follicular plugs, also called teardrop-like structures, seen on the face and neck may be a dermoscopic feature specific to CL. As hairpin-like vessels seen in an asymmetric radial arrangement were often observed on parts of the body other than the face, further dermoscopic studies comparing the lesions of CL with other ulcerating lesions are necessary.
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    Coğrafik Dil ve Fissürlü Dil Birlikteliği
    (2015) Tosun, Betül; Akkurt, Zeynep Meltem; Uçmak, Derya; Uçak, Haydar; Yılmaz, Beyhan
    Coğrafik dil, tekrarlayarak yer değiştiren sınırları belirgin depapille alanlardan oluşan benign bir durumdur. Yanma ve ağrı semptomlarına yol açabilir. Fissürlü dilde ise dil üzerinde çeşitli derinliklerde asemptomatik oluklanmalar mevcuttur. 25 yaşında bir bayan hasta polikliniğimize ağzında yanma ve ağrı şikayeti ile başvurdu. Muayenesinde dil dorsumunda birkaç adet hafif kabarık keratotik bant şeklinde sınırı olan eritemli yamalar tespit edildi. Ayrıca dilinde oluklanmalar mevcuttu. Alınan anamnezinde beslenme durumunun iyi olduğu, herhangi bir siste mik hastalığı olmadığı, aile bireylerinde ve kendisinde psoriasis tanısı olmadığı görüldü. Bu olgu sunumunda coğrafik dil ve fissürlü dile değinilmiştir.
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    Cryoglobulin and antineutrophil cytoplasmic antibody positive cutaneous vasculitis due to propylthiouracil
    (Wolters Kluwer Medknow Publications, 2014) Akkurt, Zeynep Meltem; Ucmak, Derya; Acar, Gurbet; Beysel, Selvihan; Turkcu, Gul; Ucak, Haydar; Akdeniz, Sedat
    [Abstract Not Available]
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    Dermatitis artefacta: a retrospective analysis
    (Informa Healthcare, 2014) Ucmak, Derya; Harman, Mehmet; Akkurt, Zeynep Meltem
    Background: Factitial dermatitis describes self-produced and consciously made skin lesions usually intended to win sympathy, avoid responsibilities and even gain disability insurance. Dermatitis artefacta belongs to an extensive spectrum of self-inflicted diseases termed factitious diseases. Objectives: The study is retrospective, and the patients were seen in our department from 2002 to 2012. Materials and methods: For patients with skin lesions, the demographic features and clinical descriptive characteristics of their lesions were ascertained. Patient files and photographs were reviewed and the patients were called for follow-up. Results: A total of 25 patients were recorded. Mean age of the patients was 25.64 +/- 11.80. With the exception of two cases, all patients were females. With regard to location, 27% of the patients showed facial localization, whereas the lesions have been localized on the extremities in 44%. The most common clinical appearance of DA was crusted eroded lesions (24%) and excoriations (24%) followed by ulcers (12%), superficial erosion (12%), acute eczematous lesions (8%), purpuric lesions (8%), pigment application (8%), diffuse erythema (8%), hyperpigmentation (8%), blister (4%), hair cutting (4%), hypopigmentation (4%) and cellulitis (4%). Forty percent of the patients had multiple lesions. There were eight children with dermatitis artefacta whose mean age was 14.50. The predominant lesion in these cases was superficial eroded plaque (37.5%). While patients with mild lesions limited in number receive ambulatory care, almost half of the patients require hospitalization. In this study, all patients were referred to psychiatric consultation, but most of them either refused treatment or did not receive medications. Conclusion: Although it is primarily a psychiatric disease, dermatitis artefacta is frequently diagnosed by dermatologists. Detailed history and physical examination are key factors because it imitates an extensive spectrum of diseases.
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    Efficacy of topical tacrolimus for the treatment of persistent pruritus ani in patients with atopic dermatitis
    (Taylor & Francis Ltd, 2013) Ucak, Haydar; Demir, Betul; Cicek, Demet; Dertlioglu, Selma Bakar; Akkurt, Zeynep Meltem; Ucmak, Derya; Halisdemir, Nurhan
    Background: Pruritus ani (PA) is defined as intense chronic itching affecting perianal skin. Objective: We aimed to determine the efficacy of topical tacrolimus treatment in atopic dermatitis (AD) patients who have PA. Methods: The study included 32 patients with AD who were suffering PA. Patients were randomized into two groups. In total, 16 patients used 0.03% tacrolimus ointment and 16 patients used vaseline as placebo. All groups applied topical treatments to their perianal area twice daily for 4 weeks. The treatments were then reversed for 4 weeks after a 2 weeks wash out period. Results: In total, 32 patients with AD who had refractory anal itching were enrolled in this study. None of the patients had obtained successful results with previous treatments. There was a statistically significant decrease in the recorded EASI, DLQI and itching scores for the tacrolimus group compared to the placebo group at weeks 4 and 6 of treatment (p < 0.05). Conclusion: Topical tacrolimus treatment was well tolerated and effective in controlling persistent PA in AD patients.
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    Erythema multiforme developing secondary to orf disease: Ten cases
    (Turkish Society of Hematology, 2018) Aktaş, Hamza; Uçmak, Derya; Akkurt, Zeynep Meltem; Karlı, Şahinan
    Turkey is a country which acquired a significant part of their income from farming and animal husbandry. Orf is a frequent disease all over the world, in areas where sheep and goat are raising. Complications due to orf are rare. Erythema multiforme is one of the complications of orf. A total of ten patients with lesions of erythema multiforme following orf were existed. Eight of the patients were female and two were male. All of the patients were living in rural areas and occupied with animal husbandry. The mean age of the patients was 34.3 years and ages of the patients ranged from 17 to 63. The mean time for the formation of orf lesions was 11.4 (range 7-20) days, while the mean time passed for erythema multiforme development was 6.7 (range 5-9) days. In terms of orf position; in two of our patients there was localization on the left side whereas in the remaining patients, localization was found on the right side. Topical corticosteroids, systemic antibiotherapy and systemic corticosteroid therapy were planned to patients as a treatment. The results of this study show that orf-related erythema multiforme occurs more frequently than we thought. Patients referred to us with a complaint of erythema multiforme following orf infection. Awareness of the public and physicians will provide a better understanding of the relationship between orf and erythema multiforme.
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    Evaluation of Hearing and Outer Hair Cell Function of Cochlea in Patients With Psoriatic Arthritis
    (Korean Soc Otorhinolaryngol, 2015) Akdag, Mehmet; Ucmak, Derya; Ozkurt, Fazil Emre; Bozkurt, Mehtap; Akkurt, Zeynep Meltem; Topcu, Ismail
    Objectives. The aim of this study was to investigate hearing and outer cells function in patients with psoriatic arthritis. Our investigation was a prospective case control study. Methods. A total of 31 psoriatic arthritis patients (62 ears) and 31 healthy control subjects (62 ears) were enrolled in the study. We investigated hearing changes of patients and controls via pure tone audiometry, speech discrimination scores, tympanometry, acoustic reflex, and transient product otoacoustic emission. Results. The mean age of psoriatic arthritis patients was 36.1 +/- 8.5 years (range, 14 to 62 years). The average age of the control group was 37.9 +/- 8.1 years (range, 16 to 62 years). There were statistically significant differences between pure tone audiometry in all frequencies and right and left emission at the 4.0 and 1.0 in psoriatic arthritis patients versus controls (P < 0.05). This difference was evident, especially at high frequencies. There was no statistically significant difference between the ages and genders of the patient and control groups (P > 0.05). Both audiological and otoacoustic emissions were not significantly different between right and left ear (P > 0.05). Conclusion. Based on the audiological and otoacoustic findings; it is likely that the cochlear outer hair cells become subtly damaged in psoriatic arthritis patients, consequently leading to changes in hearing thresholds. These data suggest that it is important to screen psoriatic arthritis patients for hearing changes with otoacoustic emissions and audiologic tests regularly.
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    Expression of interleukin-17 in lesions of erythema multiforme may indicate a role for T helper 17 cells
    (Termedia Publishing House Ltd, 2014) Akkurt, Zeynep Meltem; Ucmak, Derya; Turkcu, Gul; Yuksel, Hatice; Yildiz, Kenan; Arica, Mustafa
    Introduction: The aim of this study was to evaluate levels of interleukin (IL)-2, IL-6, IL-8, IL-10, IL-17A and interferon gamma (IFN-gamma) in the serum of patients with erythema multiforme (EM) and to search for the presence of IL-17-expressing cells in lesional samples of EM. Material and methods: A total of 32 patients (22 females and 10 males) diagnosed with EM of the minor or major type were included in the study. Levels of IL-2, IL-6, IL-8, IL-10, IL-17A and IFN-gamma in the serum were determined and compared with healthy controls. Biopsy specimens were stained with haematoxylin and eosin (HE) and monoclonal antibodies to CD4, CD8 and IL-17 for immunohistochemical examination. Results: IL-2, 6, 8 and 17A were significantly higher in the patient group (p = 0.016, p = 0.001, p = 0.004, p = 0.006, respectively) and levels of IL-10 were significantly lower than in the control group (p = 0.046). The cellular infiltrate in lesions of EM was composed mainly of CD4+ T lymphocytes. The presence of IL-17-expressing cells, at proportion of 5 to 50%, was observed in the infiltrate. Conclusions: The demonstration of IL-17-expressing cells in lesions of EM in this study has brought forth the assumption that Th17 cells may be involved in the pathogenesis of EM.
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    Güneydoğu Anadolu bölgesindeki Behçet hastalarında oküler tutulum ve demografik özellikler
    (Modestum Publishing Ltd., 2013) Türkçü, Fatih Mehmet; Yüksel, Harun; Uçmak, Derya; Akkurt, Zeynep Meltem; Şahin, Alparslan; Çınar, Yasin; Cingü, Abdullah Kürşat; Çaça, İhsan
    Amaç: Kliniğimizde takip edilen oküler tutulumu olan ve olmayan Behçet hastalarının demografik özelliklerini irdelemektir. Yöntemler: Bu retrospektif çalışmada 2009-2013 yılları arasında Behçet hastalığı nedeni ile göz ve dermatoloji kliniklerinde takip edilen olguların verileri tarandı. Hastalar oküler tutulumu olanlar ve olmayanlar olarak 2 gruba ayrıldı. Her bir olgu için başlangıç yaşı, cinsiyet, aile öyküsü ve sistemik tutulum özellikleri incelendi. Verilerin sıklıkları değerlendirildi. Bulgular: Dosya kayıt bilgileri değerlendirilen toplam 295 olgunun 177’inde oküler tutulum mevcut iken 118’nde oküler tutulum yoktu. Erkek olgularda oküler tutulum daha fazla izlendi. Gruplar arasında hastalığın başlangıç yaşı, tromboflebit öyküsü, gastrointestinal, pulmoner ve eklem tutulumu açısından farklılık izlenmedi. Paterji testi pozitifliği ve genital ülser varlığı oküler tutulum olmayan olgularda daha fazla izlendi. Sonuç: Yaptığımız çalışma ile Güneydoğu Anadolu Bölgesindeki oküler tutulumu olan ve olmayan Behçet hastalarının genel özellikleri, klinik ve demografik verileri sunulmuştur. Daha önceden bölgemizde benzer bir çalışma yapılmadığından verilerimizin hastaların tanı ve takiplerinde faydalı olacağı düşünülmüştür.
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    Hasta gözüyle dermatoloji pratiğinde tıp öğrencilerine bakış
    (2014) Uçmak, Derya; Özuğuz, Pınar; Akkurt, Zeynep Meltem; Doğruk, Seval Kaçar; Arıca, Mustafa; Karaca, Şemsettin
    Amaç: Hasta odaklı pratik eğitim tıp eğitiminin vazgeçilmez bir parçasıdır. Özellikle dermatoloji gibi, hastaların daha sık ayaktan değerlendirildiği kliniklerde tıp öğrencilerinin uygulamalı eğitimleri poliklinik ortamında yapılmaktadır. Bu çalışmada ülkemizde iki farklı bölgedeki Üniversite hastanelerinde (X Y) dermatoloji polikliniğine başvuran hastaların tıp öğrencilerine bakışını değerlendirdik. Gereç ve Yöntem: Çalışmaya X (grup 1) ve Y (grup 2) üniversite hastanelerine 5. sınıf tıp eğitimi staj programı pratik eğitim saatleri sırasında dermatoloji polikliniğine başvuran toplam 250 hasta dahil edilmiştir. Bu hastalar 16 sorudan oluşan bir anket doldurmuştur. Anketin ilk 8 soruluk kısmı, hastaların tıp öğrencilerinin muayenede yer alması ile ilgili rızaları ve tercihleri ile ilgili iken ikinci 8 soruluk kısımda hastaların tıp öğrencileriyle ilgili genel tutum ve düşünceleri sorgulanmıştır. Bulgular: Her iki grup da öğrencilerin eğitim programında yer almaya oldukça istekliydi (sırasıyla, %39,8, %53,5). Hastalar muayene sırasında tıp öğrencilerini istememe hakları olduğunun farkındaydı (%61,0, %62,3) ve çoğunluk öğrencilerin varlığı ile ilgili bilgilendirilmek istiyordu (%72,4, %80,7). Ancak öğrencilerle olmayı grup 1 hastaları (%43,1) eğlenceli olarak değerlendirirken grup 2de çoğunluk (%44,7) bu yoruma katılmadı. Bunun yanında her iki grupta da çoğunluk öğrencilerle kişisel bilgi paylaşımından rahatsızlık duymazken (%50,4, %44,7), arkadaş ve akrabalarına tıp öğrencileriyle muayene olmayı tavsiye edeceklerini (%51,2, %41,2) belirtti. Sonuç: Tıp öğrencilerinin dermatoloji eğitiminde aktif yer alması kısmen farklı kültürlere sahip olsalar da ülkemizin hem doğusu hem de batısındaki hastalar tarafından çoğunlukla memnuniyetle karşılanmaktadır. Hastaların muayeneleri sırasında tıp öğrencilerin varlığı konusunda bilgilendirilme isteği gerek sözlü gerek yazılı onamın gerekliliğini ortaya koymaktadır. (Türk­derm 2014; 48: 249-53)
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    Hypereosinophilia in Erythrodermic Psoriasis: Superimposed Scabies
    (Quadrant Healthcom Inc, 2014) Harman, Mehmet; Ucmak, Derya; Akkurt, Zeynep Meltem; Turkcu, Gul
    Scabies is a common ectoparasitic disease that can be diagnosed based on the presence of pruritus and typical clinical signs including burrows, vesicles, and erythematous papules. If a desquamative disease such as psoriasis precedes scabies, then the disease course may be altered. Pruritus may be absent and typical scabies lesions may be concealed due to the preexisting disease, resulting in delayed diagnosis. We present 2 cases of scabies in a brother and sister with erythrodermic psoriasis. In both cases peripheral hypereosinophilia suggested scabies. In patients with erythematous scaly inflammatory skin diseases who are treated with immunosuppressive agents, peripheral eosinophilia also could suggest scabies; therefore, a search for sarcoptic mites in skin scrapings should be undertaken.
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    Immunohistochemical and Histopathological Changes in the Skin of Rats After Maneb Application
    (Sci Printers & Publ Inc, 2014) Sula, Bilal; Ekinci, Cenap; Ucak, Haydar; Ucmak, Derya; Akkurt, Zeynep Meltem; Yavuz, Dilek; Arica, Mustafa
    OBJECTIVE: To determine the immunohistochemical and histo pathological changes in facial skin after exposure to maneb (manganese ethylene bisdithiocarbamate), a fungicidal dithiocarbamate pesticide. STUDY DESIGN: In the experimental group maneb was administered by inhalation to 10 male Wistar albino rats for 5 days each week for 3 weeks. As a biological control, the control group (n=10) received distilled water by spray for the same time period. The experiment was terminated after 3 weeks. Sections of rat facial skin were examined histopathologically. RESULTS: In the experimental group, microscopic examination of facial skin revealed degeneration of the epidermis, detection of mild inflammatory reaction, and vascular dilation in the connective tissue. Hair follicles and degenerative changes were observed in the deeper parts. In the experimental group, dilation of the blood vessels in the dermis and hemorrhage were supported by an increase in CD34 expression. In addition, a reduction in the number of melanocytes (hypopigmentation) was observed in the hair follicles and epidermis, along with a decrease in the expression of CD117. CONCLUSION: Epidermal degeneration, intradermal cell infiltration, vascular changes, and reduction in the number of melanocytes in the follicle and content of cytokeratin in both the epidermis and hair follicle ker-atinocytes were detected after maneb application. These findings may have important implications in the association with main signaling pathways, including keratinocyte proliferation and differentiation. Disruption of these pathways may cause some dermatoses.
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    Is erythema nodosum coexisting with lesions of the breast a suggestive sign for idiopathic granulomatous mastitis?
    (Aves, 2018) Gumus, Metehan; Akkurt, Zeynep Meltem; Gumus, Hatice
    Coexistence of idiopathic granulomatous mastitis and erythema nodosum is very unusual. In this paper, we present a patient with idiopathic granulomatous mastitis accompanied by erythema nodosum to highlight the diagnostic importance of erythema nodosum and its relationship with treatment response of breast lesion. A 39-year-old female with a breast lesion and erythema nodosum was started on treatment with corticosteroids before the results of her histopathological evaluation were obtained. The response to treatment was very quick. Erythema nodosum totally disappeared and the breast lesion regressed noticeably within a week. We think that erythema nodosum associated with a breast lesion may be a sign suggestive of idiopathic granulomatous mastitis and can be used for the evaluation of the response to corticosteroid treatment. More case reports are needed to justify the use of erythema nodosum as a sign suggestive of idiopathic granulomatous mastitis.