Zekayi Kutlubay

Precancerous lesions of oral mucosa

Precancerous lesions of oral mucosa, known as potentially malignant disorders in recent years, are consists of a group of diseases, which should be diagnosed in the early stage. Oral leukoplakia, oral submucous fibrosis, and oral erythroplakia are the most common oral mucosal diseases that have a very high malignant transformation rate. Oral lichen planus is one of the potentially malignant disorders that may be seen in six different subtypes including papular, reticular, plaque-like, atrophic, erosive, and bullous type, clinically. Atrophic and erosive subtypes have the greater increased malignant transformation risk compared to another subtypes. Although there are various etiological studies, the etiology of almost all these diseases is not fully understood. Geographically, etiologic factors may vary. The most frequently reported possible factors are tobacco use, alcohol drinking, chewing of betel quid containing areca nut, and solar rays. Early diagnosis is very important and can be lifesaving, because in late stages, they may be progressed to severe dysplasia and even carcinoma in situ and/or squamous cell carcinoma. For most diseases, treatment results are not satisfactory in spite of miscellaneous therapies. While at the forefront of surgical intervention, topical and systemic treatment alternatives such as corticosteroids, calcineurin inhibitors, and retinoids are widely used.

Rosacea and rhinophyma

Rosacea is a common and chronic inflammatory cutaneous disease with unknown etiology. The pathophysiology of rosacea is still poorly understood. Epidemiological studies indicate a genetic component, but a rosacea gene has not been detected yet. Recent molecular studies propose that an altered innate immune response is involved in the pathogenesis of the rosacea disease. Signs of rosacea are indicated by the presence of characteristic facial or ocular inflammation involving both the vascular and tissue stroma. A wide range of drug options is available for the treatment of rosacea, including several topical ones (metronidazole, antibiotics, azelaic acid, benzoyl peroxide, sulfacetamide/sulfur, retinoids) and oral ones (mainly tetracyclines, metronidazole, macrolides, isotretinoin). This review highlights the recent clinical and pathophysiological developments concerning rosacea.

Photodermatoses, including phototoxic and photoallergic reactions (internal and external)

Photodermatoses are caused by an abnormal reaction mainly to the ultraviolet component of sunlight. Photodermatoses can be broadly classified into four groups: immunologically mediated photodermatoses, chemical- and drug-induced photosensitivity, photoaggravated dermatoses, and DNA repair-deficiency photodermatoses. In this review, we focus mainly on chemical- and drug-induced photosensitivity, namely, phototoxicity and photoallergy.

Evaluation of body composition parameters in patients with psoriasis

Body composition parameters, such as weight, body mass index (BMI), and visceral fat rating, have been found to be associated with psoriasis. However, the associations of these parameters with psoriasis have not been demonstrated clearly.

Acanthosis nigricans: A fold (intertriginous) dermatosis

Acanthosis nigricans (AN) is a mucocutaneous disorder that is characterized by focal or diffuse hyperkeratotic, surfaces, which are symmetrically distributed hyperpigmented lesions of the skin. It rarely affects mucosal surfaces like oral cavities. Although it is commonly seen in adolescents, AN is also increasingly seen in children who are obese. Recent studies have found that AN can be a cutaneous indicator of insulin resistance and malignancy. Acanthosis nigricans has been associated with type 2 diabetes mellitus, obesity, endocrinopathies, drugs, and malignancies.

Darier disease: A fold (intertriginous) dermatosis.

Darier disease, also known as Darier-White disease, is characterized by yellow to brown, oily keratotic papules and plaques in the seborrheic areas of the face and chest. This disorder may show different clinical manifestations, such as palmoplantar pits and nail abnormalities. The trigger factors are mechanical trauma, heat, humidity, ultraviolet B, and pyogenic infections. The disease usually becomes apparent in the second decade of life. The ATP2 A2 (SERCA2) gene mutation was detected in all patients. Histopathologic changes include epidermal adhesion loss, acantholysis, abnormal keratinization, eosinophilic dyskeratotic cells in the spinous layer known as corps ronds, and the presence of grains in the stratum corneum. Although the treatment for Darier disease is unsatisfactory, some relief has been achieved with the use of corticosteroids and retinoids.

An alternative treatment modality for cellulite: LPG endermologie

Abstract Background: LPG endermologie is a worldwide FDA-approved massage system used in the treatment of cellulite. Objective: The aim of this study is to evaluate safety, efficacy, and the slimming potential of LPG endermologie. Material and methods: A total of 118 women (mean age, 34.59 ± 8.02 years) were enrolled in this study. The LPG treatment sessions were performed twice weekly and continued for at least 15 sessions. The outcome was clinically evaluated using digital photography for cellulite grade assessment while perimetric measurements for eight body sites were performed. The evaluation also included measurements of body weight and body fat percentage (BFP). Results: One hundred and seventeen patients (99%) showed loss in body circumference measurements. A mean body circumference reduction of 2.9 ± 1.6 cm was obtained per site for all patients. There was a mean body circumference loss which was statically significant with p < 0.001. Weight loss was detected in one hundred and three patients (87%). The mean body weight loss was 2.717 ± 1.938 kg for all patients. One hundred and ten subjects (93%) also showed decreases in BFP. The questionnaire indicated high satisfaction in 81 (69%) patients. Conclusion: LPG endermologie is a well-tolerated and effective alternative treatment modality for slimming and body contouring.

Evaluation of Advanced Oxidation Protein Products, Prooxidant-Antioxidant Balance, and Total Antioxidant Capacity in Untreated Vitiligo Patients

Background Vitiligo is a chronic, common disease of unknown etiology, and oxidative stress is suggested to have a role in its etiopathogenesis. Objective Advanced oxidation protein products (AOPPs), prooxidant-antioxidant balance (PAB), and ferric-reducing antioxidant power (FRAP) were evaluated regarding their role in the pathogenesis of vitiligo as well as their relationship with clinical presentation and disease severity, and these parameters were compared with those of healthy controls. Methods The study included 53 patients with vitiligo and 20 healthy volunteers as the control group. AOPP level, PAB, and FRAP were determined by colorimetric methods. Results PAB and FRAP level were significantly higher in patients with vitiligo than in healthy controls (p<0.001). The AOPP levels in vitiligo patients were not statistically significantly higher than those in healthy controls. The Vitiligo Area Scoring Index positively correlated with disease duration (rs: 0.531, p<0.001). Conclusion To the best of our knowledge, this is the first report of AOPP and PAB status in vitiligo. PAB may be used as an indicator for oxidative stress in the etiopathogenesis of vitiligo. Our results show that these parameters may play a major role in the melanocyte damage observed in vitiligo. Further studies are required to confirm the mechanisms underlying this effect.

Helicobacter pylori infection and skin disorders.

Helicobacter pylori is a Gram-negative bacterium that has been linked to peptic ulcer disease, gastric lymphoma, and gastric carcinoma. Apart from its well-demonstrated role in gastroduodenal diseases, some authors have suggested a potential role of Helicobacter pylori infection in several extra-intestinal pathologies including haematological, cardiovascular, neurological, metabolic, autoimmune, and dermatological diseases. Some studies suggest an association between Helicobacter pylori infection and skin diseases such as chronic idiopathic urticaria and rosacea. There have also been few case reports documenting association between Helicobacter pylori and psoriasis vulgaris, Behçets disease, alopecia areata, Henoch-Schönlein purpura, and Sweets syndrome. However, more systematic studies are required to clarify the proposed association between Helicobacter pylori and skin diseases; most of the studies do not show relevant relationships of these diseases with Helicobacter pylori infections. This review discusses skin diseases that are believed to be associated with Helicobacter pylori.

Treatment of atrophic facial acne scars with the Er:YAG laser: a Turkish experience.

Abstract Background Acne scars are extremely disturbing to patients, both physically and psychologically. This study assessed the safety and efficacy of the erbium:yttrium-aluminum-garnet (Er:YAG) laser on acne scars. Objective: To evaluate the clinical effects of resurfacing atrophic facial acne scars with the Er:YAG laser in the Turkish population. Methods: A total of 128 patients, aged 22–42 years, underwent laser resurfacing. The patients had Fitzpatrick skin types ranging from II to V. Photographs were taken before and 3 months after treatment. Results were evaluated for the degree of clinical improvement, pigmentary change, and any adverse events. Results: Clinical improvements in facial skin texture, acne scarring and dyschromia were noted in all patients. There was a 50.2% average clinical improvement. Complete wound healing occurred between 6 and 8 days. Erythema occurred in all patients and lasted longer than 3 months in five patients (3.9%). Post-inflammatory hyperpigmentation occurred in nine patients (7%) and lasted longer than 3 months in one patient (0.8%). No patient experienced hypopigmention. Mild to moderate postoperative acne flare-up occurred in 14 patients (11%). No other adverse effects were observed. Conclusion: Er:YAG laser resurfacing is a safe and effective treatment modality for facial acne scars in the Turkish population who have darker skin tones.