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Öğe Acute Generalized Exanthematous Pustulosis Associated with Tigecycline(Korean Dermatological Assoc, 2014) Ozturk, Savas; Ustun, Cemal; Pehlivan, Sultan; Ucak, HaydarAcute generalized exanthematous pustulosis (AGEP) is a severe and rare eruption that develops mostly from factors related to drugs. It is characterized by a fever and a pustular eruption on the erythematous skin with an acute onset and without follicular localization. Etiopathogenesis has not yet been fully explained. Although it is similar to pustular psoriasis, its clinical, historical and histopathological characteristics are different. In this article, we present a case of AGEP associated with tigecycline that developed in a patient followed up in the intensive care unit for three months with an intra-abdominal injury after a trauma and Acinetobacter baumannii infection.Öğe Assessment of nasal carriage of staphylococcus aureus in patients with acne vulgaris(Turkish Soc Dermatology Venerology, 2015) Demir, Betul; Denk, Affan; Erden, Ilker; Cicek, Demet; Ucak, HaydarBackground and Design: Systemic antibiotics, such as tetracycline and doxycycline are used in the treatment of inflammatory forms of moderate acne, or acne that is resistant to topical treatment. Oral isotretinoin treatment is the most effective treatment option in severe papulopustular and nodular forms of acne. Dose-related nasal carrier state of Staphylococcus aureus (S. aureus), has been reported in 90% of patients using isotretinoin. Long-term oral and/or topical antibiotic use in the treatment of acne causes changes in antibiotic susceptibility and emergence of methicillin-resistant S. aureus (MRSA) pathogens. The present retrospective study examined the colonization rates of S. aureus in patients who had an increase in acneiform lesions while taking medications for the treatment of acne and whose nasal swap samples were obtained and also investigated their relationship with treatment options. Materials and Methods: A total of 86 patients with moderate acne who attended our dermatology outpatient clinic with the complaints of acne and in whom nasal swap samples were obtained due to increased pustules during acne therapy. The patients were divided into three groups according to the treatment methods as patients receiving topical treatment, patients treated with oral doxycycline, and patients treated with oral isotretinoin. The results of the cultures were evaluated in three groups: no growth, methicillin-sensitive S. aureus (MSSA), and MRSA-isolated. Results: 39.5% culture positivity (S. aureus) were determined in 34 patients. Thirty two (94.1%) culture positivity were MSSA, and 2 (5.9%) culture positivity were MRSA. Twenty nine (58%) culture positivity were found in the patients using the oral isotretinoin. There was statistically significant culture positivity in the patients using oral isotretinoin compared to patients receiving other treatments (p<0.001). Conclusion: We observed that S. aureus colonization increased in patients using systemic isotretinoin independent from the drug dose and duration of drug use. There was no significant change in patients using systemic doxycycline and the colonization decreased in patients using topical antibiotic treatment.Öğe Atypical cutaneous features in adult onset Still's disease(Wolters Kluwer Medknow Publications, 2014) Akkurt, Zeynep Meltem; Bozkurt, Mehtap; Ucmak, Derya; Turkcu, Gul; Ucak, HaydarAdult 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.Öğe Changes in serum desnutrin levels in patients with acne vulgaris(John Libbey Eurotext Ltd, 2014) Demir, Betul; Ucak, Haydar; Cicek, Demet; Aydin, Suleyman; Erden, Filter; Dertlioglu, Selma BakarBackground: Androgens and insulin may contribute to increased sebum production in the pathogenesis of acne vulgaris. Objective: We investigated the association between serum desnutrin levels and acne vulgaris in the pathogenesis of insulin resistance. Material and methods: 25 patients presenting with acne vulgaris and 25 control subjects participated in this study. Fasting blood glucose, triglycerides, LDL, VLDL, HDL, total cholesterol, insulin, C-peptide and thyroid function tests were measured. The homeostasis model assessment of insulin resistance (HOMA-IR) was used to calculate insulin resistance. Desnutrin levels were determined by enzyme-linked immunosorbent assay (ELISA) according to the manufacturer's protocol. Results: Patients with acne vulgaris had a mean serum desnutrin level of (8.83 +/- 1.13 mu IU/mL), which was statistically significantly lower in the control group (10:58 +/- 3.43 mu IU/mL). In patients with acne vulgaris the serum glucose levels, insulin levels and HOMA-IR values (87.92 +/- 7:46 mg/dL, 11.33 +/- 5.93 mu IU/mL, 2.49 +/- 1.40, respectively) were significantly higher than the control group (77.36 +/- 9.83 mg/dL, 5.82 +/- 2.68 mu IU/mL, 1.11 +/- 0.51, respectively) (p = 0.01, p<0.001, p<0.001, p<0.001, respectively). Conclusion: Full cohort (patients and controls) evaluation revealed a negative correlation between the serum glucose and desnutrin levels (r = -0.31, p<0.05). A positive correlation was found between insulin and desnutrin levels (r = 0.42, p<0.001). In patients with acne vulgaris, as a result of increased levels of serum glucose and insulin, the function of desnutrin was suppressed, perhaps contributing to insulin resistance.Öğe 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]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 Effect of Oral Isotretinoin Treatment on Retinal Nerve Fiber Layer Thickness(B C Decker Inc, 2014) Ucak, Haydar; Aykut, Veysel; Ozturk, Savas; Cicek, Demet; Erden, Ilker; Demir, BetulBackground: Oral isotretinoin treatment can cause ocular side effects. Objective: This study was performed to detect possible toxic effects of oral isotretinoin treatment on the retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL). Methods: The study population consisted of 54 eyes of 27 patients with nodulocystic acne who used oral isotretinoin (Roaccutane) treatment. Macular GCL and peripapillary RNFL thickness measurements were performed using spectral domain optical coherence tomography (OCT) before and after therapy. Results: Before and after treatment, a complete ophthalmologic examination was normal in all eyes. However, posttreatment lower temporal (TL) values were significantly lower (76.80 +/- 16.31) than pretreatment TL values (84.96 +/- 24.83) (p = .02). There was no statistically significant difference in the other OCT values, upper temporal, superotemporal, superonasal, upper nasal, lower nasal, inferonasal, and inferotemporal (p = .35, p = .40, p = .56, p = .95, p = .94, p = .93, p = .61, respectively). Also, there was no statistically significant difference between the right and left eyes and between genders for all parameters (p > .05). Conclusion: The use of oral isotretinoin treatment has increased in recent years. In addition, oral isotretinoin treatment has a broad adverse effect potential on the ocular system. The measurement of RNFL thickness, especially TL thickness, by OCT may be useful for detecting the possible toxic effect of oral isotretinoin therapy on RNFL.Öğe 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, NurhanBackground: 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.Öğe Ghrelin in the pilosebaceous unit: alteration of ghrelin in patients with acne vulgaris(John Libbey Eurotext Ltd, 2015) Cicek, Demet; Demir, Betul; Erden, Ilker; Kuloglu, Tuncay; Ucer, Ozlem; Aydin, Suleyman; Ucak, HaydarBackground: Ghrelin in the pilosebaceous tissues of human skin and ghrelin levels in patients with acne vulgaris have not yet been investigated. Objective: The purpose of this study was to screen ghrelin immunoreactivity by immunohistochemistry in human pilosebaceous tissues of human skin and also to determine the quantities of ghrelin in the serum of the patients with acne vulgaris. Methods: 30 patients presenting with acne vulgaris and 30 control subjects participated in this study. Ghrelin levels were determined by enzyme linked immunosorbent assay (ELISA). Human hair follicles and sebaceous glands were immunohistochemically examined. Results: Immunohistochemistry results showed that there is a strong ghrelin immunoreactivity in the hair follicles and sebaceous glands in sections of human skin. The mean serum ghrelin levels (27.58 +/- 15.44 pg/mL) in patients with acne vulgaris was significantly lower than those of controls (35.62 +/- 20.46 pg/mL). Conclusions: Ghrelin produced in hair follicles and sebaceous glands of the skin might participate in the pathogenesis of acne vulgaris and also acne vulgaris in humans might be associated with decreased serum ghrelin.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 Presentation of three cases with phyto contact dermatitis caused by Ranunculus and Anthemis genera(Journal Dermatological Treatment, 2014) Ucmak, Derya; Erhan, Ayhan; Akkurt, Zeynep Meltem; Ucak, HaydarIn addition to being used especially in a systematic way, herbal treatments are preferred topically by the elderly population in some rheumatological and dermatological diseases. Although alternative medicine treatments may have beneficial effects, certain plants are known to cause common contact dermatitis. Protoanemonin and sesquiterpene lactones, which are found in such plant types as respectively Ranunculus and Anthemis, often cause contact dermatitis. In this article, three cases of phyto contact dermatitis, which are the result of topical use of plant types of Ranunculus ve Anthemis as an alternative method of treatment due to myalgia or arthralgia, have been presented.Öğe Quality of life in lepromatous leprosy patients(Deri Zuhrevi Hastaliklar Dernegi, 2014) Demir, Betul; Ucak, Haydar; Dertlioglu, Selma Bakar; Demir, Sukru; Guler, Kubilay; Cicek, Demet; Halisdemir, NurhanBackground and Design: Leprosy is a chronic infectious disease caused by Mycobacterium leprae bacillus affecting the skin and peripheral nervous system. Leprosy can lead to severe deformities depending on the extent of the disease. In this study, we aimed to investigate the quality of life of patients with lepromatous leprosy. Materials and Methods: Thirty-five patients with lepromatous leprosy and 35 healthy controls were included in the study. The patients were evaluated with the Turkish version of the Dermatology Life Quaky Index (DLQI) and the 36-Item Short Form Health Survey (SF-36). The relationship of quality of life with age, gender, marital status, and the grade of the visual impairment was studied and compared with the healthy controls. Results: Total and all the subgroup DLQI scores were higher in the leprosy group than in the control group (p<0.05). The patients with grade 2 visual impairment were more severely affected by the disease with regard to symptoms/feelings and school/work life as compared to the patients with grade 1 visual impairment (p=0.04, p=0.03, respectively). SF-36 physical functioning, physical role functioning, general health perceptions, vitality, social role functioning, and emotional role functioning scores were statistically lower in the patient group than in the control group (p<0.05). Conclusion: We observed that DLQI scores were lower in patients with lepromatous leprosy than in the control group, while increasing impairment in eyes was found to have a negative impact on quality of life. The SF-36 revealed that physical functioning, physical role functioning, general health perceptions, vitality, social role functioning, emotional role functioning, and mental health were negatively influenced in patients with lepromatous leprosy.Öğe Quality of life in patients with calluses(Wiley-Blackwell, 2016) Demir, Betul; Cicek, Demet; Erden, Ilker; Ucak, Haydar; Demir, Sukru; Ozturk, Savas[Abstract Not Available]Öğe Rapid and Easy Diagnosis of Netherton Syndrome with Dermoscopy(B C Decker Inc, 2014) Akkurt, Zeynep Meltem; Tuncel, Tuba; Ayhan, Erhan; Ucmak, Derya; Uluca, Unal; Ucak, HaydarBackground: Netherton syndrome is a rare autosomal recessive disease demonstrating ichthyosis linearis circumflexa, atopic findings, and hair shaft anomalies. Trichorrhexis invaginata is the pathognomonic hair shaft anomaly seen in this syndrome. Objective: In recent years, hair shaft anomalies have been described as matchstick and golf tee signs. We present a patient with Netherton syndrome diagnosed by the presence of matchstick and golf tee hairs in addition to trichorrhexis invaginata.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 Serum ghrelin levels in patients with Behcet's disease(Termedia Publishing House Ltd, 2016) Erden, Ilker; Ucak, Haydar; Demir, Betul; Cicek, Demet; Dertlioglu, Selma Bakar; Aydin, Suleyman; Ozturk, SavasIntroduction: Behcet's disease (BD) is a chronic, relapsing, systemic vasculitis of unknown etiology. Aim: To measure serum ghrelin levels in BD patients and healthy controls and to investigate its association with metabolic syndrome (MetS). Material and methods: Thirty BD patients and 30 healthy individuals were enrolled in the study. Ghrelin levels were measured in blood samples using ELISA. Results: The mean serum ghrelin level in BD patients (28.57 +/- 14.04) was significantly lower compared to healthy controls (40.72 +/- 23.21) (p = 0.01). The mean serum ghrelin level in BD patients who had MetS (24.18 +/- 12.73) was lower compared to BD patients who did not have MetS (30.77 +/- 14.45), but this difference was not significant (p > 0.05). Conclusions: Ghrelin levels were lower in BD patients compared to healthy controls. There was no association between reduced ghrelin levels and MetS; however, there was a negative correlation between ghrelin levels and disease activity.Öğe Serum salusin-? and salusin-? levels in patients with Behcet's disease(John Libbey Eurotext Ltd, 2014) Erden, Ilker; Demir, Betul; Ucak, Haydar; Cicek, Demet; Dertlioglu, Selma Bakar; Aydin, SuleymanBackground: Behcet' s disease (BD) is a chronic, relapsing, systemic vasculitis of unknown etiology. There is an increased predisposition to insulin resistance and metabolic syndrome (MetS) in BD patients. Objective: The aim of this study was to determine serum salusin-alpha and salusin-beta levels in BD patients and healthy controls and to investigate their association with MetS. Patients and Methods: Twenty-five BD patients and 25 healthy controls were included in the study. Salusin-alpha and salusin-beta levels were measured in blood samples using ELISA. In addition, BD patients and healthy controls were evaluated in terms of MetS. Results: The mean serum salusin-alpha level in BD patients was significantly lower compared to healthy controls (p = 0.03), whereas the mean serum salusin-beta level in BD patients was significantly higher compared to healthy controls (p = 0.03). The mean serum salusin-alpha level was significantly lower in BD patients with MetS compared to BD patients without MetS (p = 0.04). Conclusions: Serum salusin-a level (an anti-atherogenic molecule) was lower, while serum salusin-beta level (a pro-atherogenic molecule) was higher in BD patients. We consider that the decrease in salusin-alpha and the increase in salusin-beta levels contribute to the development of MetS.Öğe Serum salusin-? and salusin-? levels in patients with psoriasis(John Libbey Eurotext Ltd, 2015) Erden, Ilker; Ucak, Haydar; Demir, Betul; Cicek, Demet; Bakar Dertlioglu, Selma; Ozturk, Savas; Aydin, Suleyman[Abstract Not Available]
