Hilal Kaya Erdoğan

Clinical Effects of Topical Tacrolimus on Fox-Fordyce Disease

Fox-Fordyce Disease (FFD) is a rare, chronic, pruritic, inflammatory disorder of apocrine glands. It is characterized by dome-shaped, firm, discrete, skin-colored, and monomorphic perifollicular papules. The most common sites of involvement are axillae and anogenital and periareolar regions which are rich in apocrine sweat glands. Treatment is difficult. Topical, intralesional steroids, topical tretinoin, adapalene, clindamycin, benzoyl peroxide, oral contraceptives, isotretinoin, phototherapy, electrocauterisation, excision-liposuction and curettage, and fractional carbon dioxide laser are among the treatment options. In the literature, there are articles reporting beneficial effects of pimecrolimus in FFD. Nevertheless, there have not been any reports about the use of tacrolimus in FFD. We report two patients diagnosed with FFD by clinical and histopathologic examination and discussed therapeutic effects of topical tacrolimus on FFD in the light of literature.

The role of oxidative stress in early‐onset androgenetic alopecia

Androgenetic alopecia (AGA) is the most common cause of alopecia in men. In the literature, although there are in vitro studies investigating the relationship between oxidative stress and AGA, any in vivo study does not exist.

Superimposed segmental manifestation of juvenile amyopathic dermatomyositis in a 9-year-old boy

Dermatomyositis is a well-known autoimmune disorder. On the other hand, juvenile amyopathic dermatomyositis (JADM) occurs rather rarely. Here, we report an unusual case in a 9-year-old Turkish boy showing a unilateral linear inflammatory skin lesion that was followed, after 16 months, by the appearance of bilateral disseminated features JADM.

The effect of omalizumab on hematological and inflammatory parameters in patients with chronic spontaneous urticaria

Abstract Purpose: The mechanism of action of omalizumab in chronic spontaneous urticaria (CSU) is not exactly known. In previous studies, d-dimer which is a fibrin-degradation product and interleukin-31 which has a role in inflammation were found to be decreased in patients with chronic urticaria treated with omalizumab. However, to our knowledge, there is no study on the effects of omalizumab on the ratio of neutrophil to lymphocyte (NLR) and the ratio of platelet to lymphocyte (PLR) which are inflammatory parameters in patients with CSU in the PubMed database. In this study, we aimed to evaluate the effects of omalizumab on hematological and inflammatory parameters in patients with CSU. Materials and Methods: One hundred six CSU patients treated with omalizumab were evaluated retrospectively. Complete blood count (CBC) and C-reactive protein (CRP) levels before treatment and at the third month of treatment were recorded. NLR and PLR were calculated from the CBC results. CBC parameters, CRP levels, NLR and PLR of the patients before treatment and at the end of third month of treatment were compared. Results: There was a significant decrease in white blood cell count, platelet count, neutrophil count, CRP level, NLR and PLR and a significant increase in mean platelet volume and eosinophil count with omalizumab treatment in CSU patients (p < 0.05). Basophil count increased; but there was no statistically significant difference (p = 0.293). Conclusion: This study shows that omalizumab has not only anti Ig E effect, but also it may have inhibitory effects on inflammation and coagulation in patients with CSU. Further prospective studies are warranted in order to evaluate the effect of omalizumab on hematological and inflammatory parameters and correlation between omalizumab response rate and these inflammatory parameters in patients with CSU.

The Evaluation of Contact Sensitivity with Standard and Cosmetic Patch Test Series in Rosacea Patients

Background Rosacea is a common dermatosis characterized by erythema, telangiectasia, papules and pustules. Objective We aimed to evaluate contact sensitivity in the rosacea patients. Methods We included 65 rosacea patients and 60 healthy volunteers in the study. The patient and control groups were patch tested with European baseline series and cosmetic series. Results A positive reaction to at least 1 allergen in the European standard series was found in 32.3% of rosacea patients and 20.0% of subjects in the control group while the relevant numbers were 30.8% of rosacea patients and 10% of controls with the cosmetic series (p=0.08). In total, we found a positive reaction to at least 1 allergen in 38.5% of patients and 25.0% of controls (p=0.15). We did not find a statistically significant relationship between a positive reaction to 1 allergen in total and the gender, skin type, rosacea type, ocular involvement, age and disease duration. There were more symptoms in patients with a positive reaction to allergens (p<0.001). Conclusion Contact sensitivity was detected more common in rosacea patients. Patch testing may be useful in the treatment and follow up of rosacea patients especially if symptoms such as itching, burning and stinging are present.

The efficacy and safety of phototherapy in geriatric patients: a retrospective study

BACKGROUND While phototherapy is a well-established treatment for many dermatoses, data from the literature regarding its use in elderly patients are quite limited. OBJECTIVE In this study, we aimed to determine the phototherapy indications in geriatric patients and to evaluate the effectiveness and reliability of phototherapy in this group. METHODS This study included 95 patients of 65 years of age and older who were treated in our phototherapy unit between 2006 and 2015. The data for this study were collected retrospectively from patient follow-up forms in the phototherapy unit. RESULTS Phototherapy was administered to 28 (29.5%) patients for mycosis fungoides, 25 (26.3%) patients foplaque type psoriasis, 12 (12.6%) patients for palmoplantar psoriasis, 12 (12.6%) patients for generalized pruritus, and 18 (19%) for other dermatoses. Of the patients, 64.2% had received a narrowband UVB (NB-UVB), 21.1% oral psoralen UVA (PUVA), and 14.7% local PUVA treatment. A complete response was achieved in 76.9-85.7% of the mycosis fungoides and in 73.71-100% of the psoriasis vulgaris patients treated with NB-UVB and PUVA, respectively. All the patients with generalized pruritus were treated with NB-UVB, and 80% of these patients achieved significant improvement. The erythema rate was found to be 0.43% per session for NB-UVB treatment and 0.46% per session for PUVA treatment as a side effect. STUDY LIMITATIONS The limitations of our study are that it was retrospective and the remission durations of the patients are not known. CONCLUSION This study showed that phototherapy is effective and reliable in the elderly population with proper dose increases and close follow-up.Background While phototherapy is a well-established treatment for many dermatoses, data from the literature regarding its use in elderly patients are quite limited. Objective In this study, we aimed to determine the phototherapy indications in geriatric patients and to evaluate the effectiveness and reliability of phototherapy in this group. Methods This study included 95 patients of 65 years of age and older who were treated in our phototherapy unit between 2006 and 2015. The data for this study were collected retrospectively from patient follow-up forms in the phototherapy unit. Results Phototherapy was administered to 28 (29.5%) patients for mycosis fungoides, 25 (26.3%) patients foplaque type psoriasis, 12 (12.6%) patients for palmoplantar psoriasis, 12 (12.6%) patients for generalized pruritus, and 18 (19%) for other dermatoses. Of the patients, 64.2% had received a narrowband UVB (NB-UVB), 21.1% oral psoralen UVA (PUVA), and 14.7% local PUVA treatment. A complete response was achieved in 76.9-85.7% of the mycosis fungoides and in 73.71-100% of the psoriasis vulgaris patients treated with NB-UVB and PUVA, respectively. All the patients with generalized pruritus were treated with NB-UVB, and 80% of these patients achieved significant improvement. The erythema rate was found to be 0.43% per session for NB-UVB treatment and 0.46% per session for PUVA treatment as a side effect. Study limitations The limitations of our study are that it was retrospective and the remission durations of the patients are not known. Conclusion This study showed that phototherapy is effective and reliable in the elderly population with proper dose increases and close follow-up.

Advanced oxidation protein products and serum total oxidant/antioxidant status levels in rosacea

Introduction Rosacea is a chronic, inflammatory dermatosis which develops due to the effect of genetic and environmental factors. Aim To evaluate the oxidative stress in rosacea patients by measuring serum total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI) and advanced oxidation protein products (AOPP) levels in our study. Material and methods Our study included rosacea patients and healthy volunteers aged between 18 and 65 years. Total antioxidant status, TOS and AOPP levels were measured and OSI was calculated. Results The study included 70 rosacea patients and 30 healthy volunteers as a control group. When TAS, TOS, OSI and AOPP levels were compared between rosacea and control groups, there was no difference for OSI levels; while TAS, TOS and AOPP levels were significantly higher in the rosacea group (p = 0.151, p = 0.013, p = 0.034, p = 0.017, respectively). In the rosacea group, there was no correlation between TAS, TOS, OSI and AOPP levels and disease duration. Besides there was no difference between family history, rosacea type, symptom frequency and ocular involvement and TAS, TOS, OSI and AOPP levels in the rosacea group. Conclusions We observed that serum TAS, TOS and AOPP levels were significantly higher in rosacea patients, but there was no significant difference among the disease activity parameters. These results can support the role of oxidative stress in the pathogenesis of rosacea.

Evaluation of Serum Resistin Levels and Metabolic Syndrome Related Parameters in Chronic Spontaneous Urticaria

Amaç: Kronik spontan ürtiker (KSÜ) hastalarında serum resistin düzeyi ve metabolik sendrom (MetS) ilişkisini değerlendirmek. Yöntemler: Çalışmaya 42 KSÜ hastası ve 42 sağlıklı gönüllü dahil edildi. Boy, kilo, bel çevresi ve kan basıncı ölçümleri her iki grupta da değerlendirildi. Açlık kan şekeri, serum lipid düzeyleri, resistin ve tümör nekroz faktörü-alpha (TNF-α) düzeyleri venöz kan örneklerinde değerlendirildi. MetS tanısı National Cholesterol Education Program Adult Treatment Panell III tanı kriterleri ile belirlendi. Bulgular: KSÜ hastalarının 14’ünde (%33,3) ve kontrol grubunun 5’inde (%11,9) MetS saptandı. İki grup arasında MetS varlığı açısından istatistiksel olarak anlamlı fark bulundu, p=0,037. KSÜ hastalarının serum resistin düzeyleri ortalaması 1928,31±212,85 pg/mL ve kontrol grubunun serum resistin düzeyleri ortalaması 2107,60±156,71 pg/mL olarak saptandı. Her iki grup arasında serum resistin düzeyi açısından istatistiksel anlamlı fark görülmedi. KSÜ hastalarında MetS tanısı olan hastalar ile MetS tanısı olmayan hastalar arasında ürtiker aktivite skoru, hastalık süresi, otolog serum deri testi pozitifliği, serum immünoglobulin E düzeyi, otoimmünite varlığı, serum resistin ve TNF-α düzeyi açısından farklılık görülmedi. Sonuç: Çalışmamızda KSÜ hasta grubunda MetS görülme sıklığında artış olduğu saptanmıştır. Diğer taraftan KSÜ hastaları içinde MetS’yi olan ve olmayan iki grup arasında hastalık ilişkili parametreler ile serum resistin ve TNF-α düzeyi farklılık göstermemiştir. Anahtar kelimeler: Kronik spontan ürtiker, metabolik sendrom, resistin, tümör nekroz faktörü-alfa, ürtiker aktivite skoru, otolog serum deri testi Öz Abstract

Evaluation of the effects of acne vulgaris on quality of life in Turkey by using TAQLI

Acne vulgaris (AV) is a chronic, inflammatory skin disease that may cause various psychiatric and/or psychological problems.

Morphea in Middle Anatolia, Turkey: a 5-year single-center experience

Introduction Morphea, also referred to as localized scleroderma, is a rare fibrosing skin disorder of undetermined cause. Aim We report our single-center experience with morphea. Material and methods The study included 53 patients who were diagnosed with morphea by histopathology in our department between 2010 and 2015. Study data were collected retrospectively from the records of morphea patients. Results The study included 53 patients (38 women, 15 men), and median age at onset was 39.0 (range: 8–85) years. Thirty (56.6%) patients had circumscribed morphea, 15 (28.3%) had generalized morphea, and 7 (13.2%) had linear morphea. One patient had mixed variant morphea (generalized, pansclerotic and linear morphea). ANA positivity was detected in 12 (22.6%) patients, but analysis for an association between the presence of ANA and morphea types, patients’ characteristics did not reveal any significant associations. We did not observe any extracutaneous manifestations in patients during follow-up period. There were 2 of 53 patients who had concomitant autoimmune disorder including vitiligo and spondyloarthritis. Thirty (56.6%) patients received only topical treatment. The patients with clinical improvement who were treated with systemic therapy received methotrexate (26.4%), colchicine (9.4%), mycophenolate mofetil (5.7%) and prednisolone (1.9%). Conclusions Our results related to the demographic data of the patients and morphea types were consistent with the literature. On the other hand we observed that methotrexate was mostly used as an effective treatment option for generalized morphea.