Ayşe Boyvat

The International Criteria for Behcet's Disease (ICBD): a collaborative study of 27 countries on the sensitivity and specificity of the new criteria

Behçets disease (BD) is a chronic, relapsing, inflammatory vascular disease with no pathognomonic test. Low sensitivity of the currently applied International Study Group (ISG) clinical diagnostic criteria led to their reassessment.

Evaluation of clinical findings according to sex in 2313 Turkish patients with Behcet's disease

Background Behçets disease is a multisystem disease featuring mucocutaneous, ocular, articular, vascular, intestinal, urogenital, and neurologic involvement and occurs with a high prevalence in the Mediterranean including Turkey. Higher incidence of severe clinical course and systemic involvement is observed in male patients.

The depression, anxiety, life satisfaction and affective expression levels in psoriasis patients

The aim of this study was to determine the effect of stressful life events on the onset and exacerbation of psoriasis, depression, anxiety, life satisfaction and affective expression levels in psoriasis patients and psychological risk factors related to psoriasis.

The prevalence of Behçet's disease above the age of 10 years. The results of a pilot study conducted at the Park Primary Health Care Center in Ankara, Turkey.

PURPOSE The aim of this study was to determine the prevalence of Behçet’s disease above the age of 10 years by means of a population-based study. METHODS The epidemiological investigation (cross-sectional study) was made between May 1997 and May 1998 at the Park Primary Health Care Center, which is one of the education and research divisions of the Department of Public Health, Faculty of Medicine, Ankara University. The research aimed to cover all 17,256 (49.2% male, 50.8% female) inhabitants over 10 years of age living in this area. The screening team first surveyed and selected patients with recurrent aphthous stomatitis. These patients were further examined, free of charge, in the Preventive Ophthalmology Unit of the Public Health Center, at Ibni Sina Hospital’s Behçet Center or in other clinics if necessary. In this study the International Study Group For Behçet’s disease Criteria were used. RESULTS As the final result of the screening, 11 female and 5 male patients with Behçet’s disease were found (female/male = 2.2). These patients represented 9 already known and 7 newly diagnosed cases of Behçet’s disease. The prevalence of Behçet’s disease over 10 years of age is 0.11%. CONCLUSION The existing regional prevalance studies conducted in Turkey have indicated that the real number of Behçet’s patients in our country is markedly higher than the number of registered patients. Therefore the National Behçet’s Disease Commity and Surveillance System was founded by our research group in December 1999.

Contact sensitivity to standard series allergens in 1038 patients with contact dermatitis in Turkey

We planned to determine the frequency of sensitivity to European standard patch test allergens in 1038 patients with contact dermatitis. From 1992 to 2004, 1038 patients with the diagnosis of contact dermatitis were patch tested with the European standard series. Seven hundred and five patients were female (67.9%) and 333 patients were male (32.1%). A total of 336 patients (32.3%) had one or more positive patch test reactions. The most common allergens were nickel (17.6%), cobalt chloride (5.3%), potassium dichromate (4.6%), neomycin (2.4%), fragrance mix (2.1%) and balsam of Peru (2.1%). Contact sensitivity to potassium dichromate and thiuram was significantly more frequent in male patients, whereas nickel and primin sensitivity was significantly more frequent in female patients. Higher sensitivity rates for potassium dichromate, neomycin, balsam of Peru, wool alcohol, fragrance mix and primin were noted in patients over 40 years of age. Sensitivity rates of the standard series allergens were all similar in atopic patients and in non‐atopic patients. Metals, neomycin and fragrances are the leading allergens in Turkey. Although fragrances are among the most important sensitizers, sensitivity rates to fragrances and also to preservatives are much lower than the rates in Europe and the US.

Long-Term Effects of Interferon Alpha 2A Treatment in Behçet’s Disease

Background: Between May 1995 and April 1996, 20 patients with Behçet’s disease were successfully treated with interferon α2a (IFN-α2a) 9 million IU/day three times a week and 16 patients with colchicine 1.5 mg/day orally for 3 months. Objective: To study the long-term effects of IFN treatment in Behçet’s disease. Methods: Between the years of 1996 and 1999, the patients were followed up every 3 months or whenever indicated. Retrospective evaluation was performed. Results: In 56% of the patients with complete remission or partial remission at the end of IFN-α2a treatment, long-term remissions ranging from 36 to 48 months were observed. Conclusion: IFN-α2a treatment is an effective treatment modality in Behçet’s disease with the advantage of inducing prolonged remissions.

Behçet Disease in Children

Purpose: To investigate the incidence and clinical characteristics of Behçet disease in children. Methods: The authors retrospectively reviewed the charts of 3382 patients with Behçet disease from October 1986 to December 2005 at Ankara University Medical School Behçet Unit and/or Atmaca private clinic. Results: 110 children were diagnosed with Behçet disease. The 110 children represented 3.3% of the total number of Behçet patients that were reviewed. 62.7% were girls and 37.3% were boys. The mean age at initial manifestation was 11.63 ± 3.46 years and at diagnosis was 14.15 ± 2.13 years. Ocular involvement was found in 30.9% of the children. Of these, 61.8% were bilateral and 38.2% were unilateral. Anterior uveitis was found in 18 eyes (32.8%), posterior uveitis in 24 eyes (43.6%), and panuveitis in 13 eyes (23.6%). Conclusion: Behçet disease should be considered in the differential diagnosis of childhood uveitis, particularly in endemic areas. The collaboration of pediatricians, rheumatologists, dermatologists, ophthalmologists, and other specialists when necessary is required in the diagnosis and management of children with Behçet disease.

Diagnosis of Immediate Hypersensitivity to β-Lactam Antibiotics Can Be Made Safely with Current Approaches

Background: Diagnosing immediate hypersensitivity to β-lactam antibiotics is still a significant problem. Recently, a new penicillin testing reagent was introduced to the market. In this study, the recommendations of the European Network of Drug Allergy (ENDA) for the diagnosis of immediate reactions to β-lactams were followed, and the negative predictive value of this approach with currently available reagents was assessed. Methods: Eighty patients (age range: 6–74 years) with a history of immediate reactions to β-lactams were included. All cases underwent skin testing with benzylpenicilloyl-polylysine (PPL) and minor determinant mixture (MDM), followed by the culprit drug if necessary. If this step was negative, a drug provocation test was offered. If this step also yielded a negative result, then the patients were recommended to use β-lactam antibiotics in future whenever their use was indicated. Results: Overall, 29 patients (36.2%) were diagnosed as β-lactam allergic. The majority of the cases (72.4%) were diagnosed by positive skin tests to either PPL or MDM, whereas 10.3% were diagnosed by skin testing with culprit drugs and 17.2% with drug provocation tests. Regarding the use of the tested drug in the long term, almost half of the contacted patients had had an indication to use the tested drug and the majority had taken the whole course without problems. Conclusions: Although currently available new penicillin tests provide sufficient allergy data, all the steps recommended by ENDA should be followed in the diagnosis of immediate reactions to β-lactams. If these steps are negative, the patients usually tolerate β-lactams and only a few develop mild, non-life-threatening reactions in the long term.

Comparative evaluation of Type 1 latex hypersensitivity in patients with chronic urticaria, rubber factory workers and healthy control subjects.

Latex hypersensitivity manifests itself most commonly with contact urticaria. In this study, we investigated the frequency of latex hypersensitivity as a possible aetiological factor in patients with chronic urticaria (CU) and compared latex hypersensitivity of CU patients (n = 50) with that of rubber factory workers (n = 50) and healthy controls (n = 50). Prick test with latex and fruit extracts and determination of latex‐specific immunoglobulin E (IgE) were performed. As a risk factor, contact dermatitis due to rubber additives was tested by patch test. Latex hypersensitivity was detected in 14% of CU patients, 12% of rubber factory workers and 12% of healthy controls (P > 0·05). Positive patch test with rubber additives was detected in 6% of CU and 4% of rubber factory workers. 3 of 7 CU patients had sensitivity to fruits in addition to latex hypersensitivity. In 1 patient with CU, the clinical complaints were found to be related to latex hypersensitivity. These findings suggest that the frequency of latex hypersensitivity in CU patients is no higher than that in healthy individuals. However, CU patients should be carefully asked about latex allergy, as we demonstrated that 1 of the CU patients had undiagnosed symptomatic latex allergy.

Congenital pilar leiomyoma.

Piloleiomyomas are benign smooth muscle tumors arising from the arrectores pilorum muscles in the skin. They usually occur as multiple firm dermal nodules located on the extremities and trunk. Solitary lesions are rare. Leiomyomas usually develop during adolescence or early adult life. Congenital pilar leiomiyoma is an extremely rare entity. We present a case of congenital solitary pilar leiomyoma located on the face.