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Öğe 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]Öğe Clinical and dermoscopic evaluation of cutaneous leishmaniasis(Wiley, 2015) Ayhan, Erhan; Ucmak, Derya; Baykara, Sule Nergiz; Akkurt, Zeynep Meltem; Arica, MustafaBackgroundDermoscopy 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.Öğe Clinical and the demographic characteristics of patients with alopecia areata(Deri Zuhrevi Hastaliklar Dernegi, 2013) Yorgancilar, Sibel; Anli, Ruken Azizoglu; Abdioglu, Roza Zelal; Arica, MustafaBackground and Design: In this study, our aim was to determine clinical and demographical characteristics of patients with alopecia areata in our region. Materials and Methods: In the study, we evaluated 100 patients (44 female, 56 male; age range: 2-52 years) who applied to the outpatient clinic of Dicle Medical Faculty Dermatology Department between October and November 2009 and received the diagnosis of alopecia areata. Results: The male:female ratio was 1.2:1, the mean age was 19.19 +/- 10.93 years. Alopecia areata was present in 90(90%) patients, alopecia totalis in 5 (5%), and alopecia universalis in 5 (5%) patients. The age of the disease onset was below the age of 20 years in 64% of patients. In 77.2% of patients, mild and in 22.8% of patients, severe scalp involvement was detected. There was no significant relationship of the severity of the disease in the scalp with gender and the disease onset period (p=0.62, p=0.22). Nail involvement was detected in 43%, mostly as pitting (39.5%) and longitudinal ridging (39.5%). No significant relationship was found between disease severity in the scalp and nail involvement (p=0.08). A family history was present in 22% of patients. There was no significant relationship of family history with the onset period of the disease and the disease severity in the scalp (p=0.13, p=0.07). Conclusion: Our results were found to be consistent with the clinical and demographic data obtained in previous studies.Öğe Comparative study of 5% and 2.5% potassium hydroxide solution for molluscum contagiosum in children(Taylor & Francis Ltd, 2014) Ucmak, Derya; Akkurt, Meltem Zeynep; Kacar, Seval Dogruk; Sula, Bilal; Arica, MustafaBackground: Molluscum contagiosum (MC) is a pediatric viral infection that is fairly contagious. Although various treatment methods are available, the presence of facial lesions limits options of therapy. Aim: We aimed to test an alternative treatment consisting of application of two different concentrations of potassium hydroxide (of KOH 5% solution and of KOH 2.5% solution) aqueous solution. Methods: In this study we evaluated the effectiveness and side-effects of daily applications of potassium hydroxide (KOH) aqueous solution at 2.5% and 5% concentrations, twice daily in 29 children with MC. Out of a total of 29 patients with molluscum contagiosum included in the study, 13 patients in the 2.5% KOH group and 12 patients in the KOH 5% group completed the study. Families were instructed to apply potassium hydroxide twice a day. The assessment of response and side-effects were performed on days 0, 15, 30, 45 and 60 (visits were numbered 1, 2, 3, 4 and 5, respectively) and one month after. Results: We had a total of 11 (44%) patients who completely recovered after the fifth visit. While eight (66.7%) of these 11 patients were in the 5% treatment group, three (23.1%) patients were in the 2.5% treatment group, and there was a statistically meaningful difference (p<0.047). Patients with fewer lesions remitted better (p<0.05). When number of lesions were taken into consideration, difference between the two treatment groups appeared after the fourth visit (p<0.001). There were no statistical differences between the two groups with respect to side-effects (p = 0.682). Conclusions: Potassium hydroxide solution at a concentration of 5% was more effective than 2.5% in our patients. The treatment was well-tolerated on the face with the advantage of administration of lower concentrations. This study suggests potassium hydroxide may be a more preferable mode of treatment for molluscum contagiosum lesions on the face.Öğe Demographic and Clinical Characteristics of Hospitalized Patients in Dermatology Clinic(Galenos Yayincilik, 2015) Sula, Bilal; Ucak, Haydar; Arica, MustafaObjective: In this study our aim was to determine demographic and clinical features of patients who were diagnosed and treated in dermatology clinic. Methods: The inpatient clinical records of the Dermatology Department of Dicle University, between 1 January 2010 and 31 December 2013, were retrospectively assessed. Results: A total of 1223 patients were evaluated between the ages of 2 to 105 years. The most common causes of admission were eczema, inflammatory skin disease and autoimmune bullous disease. The average length of patient admission was 9.81 days. The average cost was found to be 926 Turkish Lira. The longest length of stay was seen in malignant skin tumors, autoimmune bullous diseases and inflammatory diseases. The shortest length of stay was found in eczemas, drug reactions and urticaria. The highest cost was detected for autoimmune bullous diseases, malignant skin tumors and inflammatory dermatoses while the lowest cost was detected for eczemas and urticaria. Conclusion: We think that knowing the demographic and clinical characteristics of the patients hospitalized in the dermatology service would be helpful for the planning, sustainability of health care services and treatment and to be held in a more appropriate level of cost ratio.Öğe Epidemiological and clinical characteristics of malignant melanoma in Southeast Anatolia in Turkey(African Field Epidemiology Network-Afenet, 2016) Sula, Bilal; Ucmak, Feyzullah; Kaplan, Mehmet Ali; Urakci, Zuhat; Arica, Mustafa; Isikdogan, AbdurrahmanIntroduction: The present study aimed to establish the epidemiological and clinical characteristics of patients who were histopathologically diagnosed with malignant melanoma (MM). Methods: The present study retrospectively analyzed the data of 78 patients who were histopathologically diagnosed with MM in Dicle University Medical Faculty, Dermatology and Medical Oncology departments between 2005 and 2014. Results: The study included 78 patients in total with 44 (56.4%) male and 34 (43.6%) female. Median age of the patients was 62.50 years (range: 27 - 84 years). Of the patients, 78.2% (n=61) had cutaneous melanoma, 8.9% had solid organ melanoma, and 2.5% had ocular and mucosal melanoma. The most common tumor localization among the patients was the lower extremities with 29.4% (n=23). The most common histopathological type was nodular malignant melanoma with 35.8% (n=28). Based on TNM, Clark and Breslow classifications, 26.9% (n=21) of the patients were stage 4, 26.9% (n=21) were Clark stage 4, and 37.1% (n=29) were Breslow stage 4. Median overall survival in all patients was 14.9 months (95% CI 10.9 - 18.8 months). In the multivariate Cox analysis, only stage statistically significantly affecting survival [ odds ratio (OR): 0.54; (95% CI 0.16-1.82, p=0.02)]. Conclusion: Malignant melanoma data are also important for the optimal utilization of effective methods and healthcare resources to prevent the disease. In order to minimize MM mortality and morbidity, not only the society but also physicians from primary and secondary care hospitals should become familiar with melanoma.Öğe 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, MustafaIntroduction: 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.Öğe Immune mechanisms and the role of oxidative stress in intrahepatic cholestasis of pregnancy(Termedia Publishing House Ltd, 2014) Ozler, Ali; Ucmak, Derya; Evsen, Mehmet Siddik; Kaplan, Ibrahim; Elbey, Bilal; Arica, Mustafa; Kaya, MuhsinIntroduction: The purpose of this study was to investigate levels of inflammatory cytokines such as interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-alpha) and neopterin and oxidative stress status in patients with intrahepatic cholestasis of pregnancy (ICP) as well as their potential role in the pathophysiology. Material and methods: Thirty patients with ICP (Group 1) and 30 healthy pregnant women (Group 2) were included in this prospective case-control study. Levels of IL-6, TNF-alpha and neopterin were determined in both of the groups. Total anti-oxidant status (TAS) and total oxidative stress (TOS) levels were determined by means of a fully automated Erel method. Oxidative stress index (OSI) was calculated as the ratio of TOS to TAS. Results: There was no significant difference between the groups in IL-6 and TNF-alpha levels (p = = 0.105 and p = 0.722, respectively). The mean neopterin level was significantly higher in Group 1 compared to Group 2 (2.34 +/- 0.77 and 1.57 +/- 0.38, respectively, p = 0.001). In addition, TAS, TOS and OSI levels were significantly higher in Group I (p = 0.004, p = 0.001 and p = 0.001, respectively) compared to Group 2. Discussion: Intrahepatic cholestasis of pregnancy is an inflammatory disorder in which maternal immune reaction may play a role. Interleukin 6 and TNF-alpha, which are some of the markers of humoral reaction, act as an indicator of abnormal reaction rather than acute-phase reaction in ICP. Further clinical trials and supportive placental findings are needed on the role of cytokines in cellular and humoral immune reactions during the symptomatic period and delivery to better understand the role of immune mechanisms in the aetiology of ICP.Öğe 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, MustafaOBJECTIVE: 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.Öğe Investigation of dermatology life quality index and serum prolactin and serum dehydroepiandrosterone sulphate levels in patients with chronic urticaria(Allergy Immunol Soc Thailand,, 2014) Ucmak, Derya; Akkurt, Meltem; Ucmak, Feyzullah; Toprak, Gulten; Acar, Gurbet; Arica, MustafaBackground: Chronic urticaria (CU) is known to be one of the most disturbing diseases which significantly affect the quality of life. Prolactin (PRL) and DHEA-S (dehydroepiandrosterone sulfate) are stress-associated hormones in chronic urticaria. Objective: In the present study, we measured DHEA-S and prolactin levels of CU patients, compared them with healthy subjects and evaluated the association between disease status and serum levels. Methods: Plasma DHEA-S and serum PRL concentrations were measured in 48 CU patients and 31 healthy subjects. CU activity was assessed with the use of the symptom scores recommended with EAACI/GALEN/EDF guidelines. All the patients participating in this study were evaluated by means of Dermatology Life Quality Index (DLQI). With respect to DLQI and clinical activity scores, plasma DHEA-S and serum prolactin levels were compared. Results: Median plasma concentration of DHEA-S was significantly lower in CU patients as compared with healthy subjects (p = 0.026). DHEA-S levels of females were significantly lower than males (p = 0.001). Mean PRL values of the patients were higher than the controls, but not statistically significant (p = 0.619) and there was a statistically signifcant inverse correlation with DHEA-S levels (p = 0.04, r = -0.298). There was a significant correlation between DLQI and clinical disease activity (p < 0.001, r = 0.748). Conclusions: The exact relation of hormones to CU pathogenesis remains to be determined by further clinical studies. In addition, therapies aiming to increase DHEA-S and decrease PRL may be subject to trial in CU.Öğe Patients' view on medical students in dermatology practice(Deri Zuhrevi Hastaliklar Dernegi, 2014) Kacar, Seval Dogruk; Ucmak, Derya; Ozuguz, Pinar; Akkurt, Zeynep Meltem; Karaca, Semsettin; Arica, MustafaBackground and Design: Practical training of medical students, especially in specialties such as dermatology, is performed in outpatient clinics where mostly outpatients are encountered. The aim of this study was to compare patients' perspectives on medical students in two university hospitals (X-Y) situated in different regions of Turkey. Materials and Methods: A total of 250 patients, who visited outpatient clinics of X (group 1) and Y (group 2) university hospitals during practical training for fifth year medical students, were included in this study. A questionnaire composed of 16 items was filled by all patients. The first eight questions were about patients' consent and preferences on the presence of medical students during their interview and the remaining eight questions inquired patients' overall thoughts on medical students. Results: The patients in both groups were willing to be a part of the educational programme of medical students (39.8%, 53.5%, respectively). The patients were aware that they had the right to refuse the presence of medical students (61.0%, 62.3%) and majority wanted to be informed on the presence of medical students during the interview (72.4%, 80.7%). While patients in group 1 evaluated being with medical students as pleasurable (43.1%), patients in group 2 did not agree (44.7%). In addition, both groups were not bothered to share personal information with medical students (50.4%, 44.7%) and stated that they would recommend their friends and relatives to have a physical examination done by medical students (51.2%, 41.2%). Conclusion: The active role of medical students during dermatology training is positively viewed by patients in both western and eastern parts of our country. The patients' request on being informed for the presence of medical students during clinical examination reveals the requirement of oral and written informed consent.Öğe A Rare Case of Facial Steatocystoma Multiplex(Croation Dermatovenerological Soc, 2013) Ucmak, Derya; Sula, Bilal; Akkurt, Zeynep Meltem; Fidan, Veysi; Firat, Ugur; Arica, Mustafa[Abstract Not Available]Öğe The Relationship of Neutrophil to Lymphocyte Ratio with Pemphigus Vulgaris(Duzce Univ, 2015) Ucmak, Derya; Akkurt, Ltem; Ucak, Haydar; Arica, MustafaAim: Pemphigus vulgaris (PV) is an autoimmune blistering skin disease. The aim of this study is to determine the relationship between the neutrophil-to-lymphocyte ratio (NLR) and PV. Methods: A total of 49 newly diagnosed patients with PV and 48 healthy controls were included in the study. The patients were grouped into mild, moderate and severe types according to the dose of administered corticosteroids. All data was obtained using inpatient records. Disease severity, findings on physical examination, complete blood count (CBC), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) parameters were noted. Lymphocyte and neutrophil numbers were noted from CBC findings. The NLR was compared between the patients and controls and among the patient groups. Analysis of data was done using SPSS 15.0. Results: Neutrophil count, NLR, ESR and CRP levels of the patients with PV were higher than the controls (p<0.001, p=0.002, p<0.001, p<0.001, respectively). NLR, CRP and ESR were not correlated with disease activity. Conclusion: NLR has been shown to be a useful indicator of disease severity and prognosis in many diseases. This study demonstrates that it is a parameter distinguishing patients with PV from healthy controls.Öğe Results of patch testing in pediatric patients with plantar dermatitis and literature review(Turkish J Pediatrics, 2014) Akkurt, Zeynep Meltem; Ucmak, Derya; Ayhan, Erhan; Ucak, Haydar; Arica, MustafaWe aimed to determine the frequency of positive patch test reactions in pediatric patients with plantar dermatitis. Children diagnosed as inflammatory dermatitis of the plantar foot were included. Demographic and clinical characteristics of the patients were recorded, and patch testing was done using the European standard series antigens. Seventeen patients (9 females, 8 males) were included in the study. Ages of the patients ranged from 4-13 years, and the median age was 7.0. Seven patients had one to three positive reactions, seven had all negative reactions, one showed angry back syndrome, and results of two could not be assessed. Dermatitis of the feet is not rare in pediatric patients, and a significant percentage of these patients will be diagnosed as allergic contact dermatitis (ACD) if detailed and appropriate patch testing is done.Öğe Treatment of Primary Cicatricial Alopecia(Derman Medical Publ, 2015) Akkurt, Zeynep Meltem; Ucmak, Derya; Arica, MustafaPrimary cicatricial alopecia is classified amongst hairs diseases with permanent inflammatory destruction of the hair follicle. The treatment of primary cicatricial alopecia is quite a challenge. The aim of treatment is to slow down or halt progression of the disease. Topical and intralesional corticosteroids and antimalarials are the mainstay in the treatment of lymphocytic primary cicatricial alopecia. Systemic immunosuppresants are used in refractory cases. Antibiotics and retinoids are first-line treatment in the treatment of neutrophilic cicatricial alopecia. In addition to medical treatment, various surgical treatment methods are effective in the treatment of primary cicatricial alopecia, if used under correct indications. This article reviews the treatment of this special group of hair diseases.
