Zeynep Meltem Akkurt

Serum Cytokine Levels in Behçet's Disease

The aim of this study is to investigate and compare the serum levels of various cytokines in patients with Behçets Disease and healthy controls.

Efficacy of topical tacrolimus for the treatment of persistent pruritus ani in patients with atopic dermatitis

Background: 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.

Clinical and dermoscopic evaluation of cutaneous leishmaniasis

Dermoscopy 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.

The role of vitamin B1-B2 and plasma lipid profile in intrahepatic cholestasis of pregnancy.

Abstract Aim: The present study aimed to determine the levels of total cholesterol, triglycerides (TG), low-density lipoproteins (LDL), high-density lipoproteins (HDL), and vitamins B1 and B2 in intrahepatic cholestasis of pregnancy (ICP) patients, and to evaluate if these were involved in the pathophysiology of the disease. Methods: The prospective randomized study included 35 pregnant patients who were admitted to the Gynecology and Obstetrics Polyclinic, Faculty of Medicine at Dicle University and who were diagnosed with ICP (Group 1), and 40 healthy pregnant women who were admitted in the same period and who had no systemic diseases that might complicate the pregnancy during the pregnancy follow-up (Group 2). Serum lipid levels and vitamins B1 and B2 were determined and compared, and statistical comparisons of the groups were made. Results: There was no difference between the TG levels of the two groups (P=0.631). Total cholesterol, LDL, HDL, and vitamin B1 and B2 levels were higher in Group 1 than in Group 2 (P=0.001, P=0.001, P=0.001, P=0.001, and P=0.032, respectively). Conclusions: Increased levels of vitamins B1 and B2 may indicate a need for increased energy metabolism at the fetus. So we believe that new studies are required, which will be supported by the placental analyses of the pyruvate and lactate levels in maternal blood at delivery and fetal cord blood in order to develop a better understanding on the fetal effects of energy metabolism.

Rapid and Easy Diagnosis of Netherton Syndrome with Dermoscopy

Background: 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.

Multiple Primary Cutaneous Plasmacytomas: An Unusual Presentation

Background: Extramedullary plasmacytoma of the skin, a rare type of cutaneous B-cell lymphoma, is characterized by clonal proliferation of plasma cells primarily in the skin without evidence of multiple myeloma. Only about 30 cases with extramedullary plasmacytoma of the skin are reported in the literature. Case Report: An 82-year-old male patient presented to our clinic with complaints of asymptomatic red nodular swelling and pain in the anterior chest wall. A dermatologic examination revealed multiple nodular lesions of varying sizes with a hard smooth surface and vivid red color. Serum protein and immunoglobulin electrophoresis, skeletal radiography, and bone marrow biopsy showed normal results in this patient. Here a rare case of multiple primary plasmacytoma localizing in the skin is reported.

Burns due to wet wood ash: three cases

Abstract Wood ash, a traditional multipurpose agent, is sometimes used under occlusion as a folkloric prescription to ease pain and edema. Adding water or oil to ash forms a mixture with strong alkaline properties. We present interesting three cases who sustained full-thickness burns after application of a poultice of wetted wood ash for the treatment of leg pain.

Dermatitis artefacta: a retrospective analysis.

Abstract Background: Factitial dermatitis describes self-produced and consciously made skin lesions usually intended to win sympathy, avoid responsibilities and even gain disability insurance. Dermatitis artefacta belongs to an extensive spectrum of self-inflicted diseases termed factitious diseases. Objectives: The study is retrospective, and the patients were seen in our department from 2002 to 2012. Materials and methods: For patients with skin lesions, the demographic features and clinical descriptive characteristics of their lesions were ascertained. Patient files and photographs were reviewed and the patients were called for follow-up. Results: A total of 25 patients were recorded. Mean age of the patients was 25.64 ± 11.80. With the exception of two cases, all patients were females. With regard to location, 27% of the patients showed facial localization, whereas the lesions have been localized on the extremities in 44%. The most common clinical appearance of DA was crusted eroded lesions (24%) and excoriations (24%) followed by ulcers (12%), superficial erosion (12%), acute eczematous lesions (8%), purpuric lesions (8%), pigment application (8%), diffuse erythema (8%), hyperpigmentation (8%), blister (4%), hair cutting (4%), hypopigmentation (4%) and cellulitis (4%). Forty percent of the patients had multiple lesions. There were eight children with dermatitis artefacta whose mean age was 14.50. The predominant lesion in these cases was superficial eroded plaque (37.5%). While patients with mild lesions limited in number receive ambulatory care, almost half of the patients require hospitalization. In this study, all patients were referred to psychiatric consultation, but most of them either refused treatment or did not receive medications. Conclusion: Although it is primarily a psychiatric disease, dermatitis artefacta is frequently diagnosed by dermatologists. Detailed history and physical examination are key factors because it imitates an extensive spectrum of diseases.

Expression of interleukin-17 in lesions of erythema multiforme may indicate a role for T helper 17 cells.

Introduction The aim of this study was to evaluate levels of interleukin (IL)-2, IL-6, IL-8, IL-10, IL-17A and interferon γ (IFN-γ) 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-γ 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.

Acquired Vulvar Lymphangioma Circumscriptum

Lymphangioma circumscriptum (LC) is a benign dilation of lymph channels localized to the skin and subcutaneous tissues. It is generally localized in mouth mucosa, tongue, proximal regions of arms and legs, groin, axilla, and trunk. Primary vulvar involvement is very rare. Vulvar involvement occurs in various clinical settings. Here, two uncommon cases with giant lymphangioma circumscriptum mimicking genital warts will be presented: a 55-year-old female patient with extensive lymphangiectasic lesions and genital wart-like papular lesions in the vulva secondary to diffuse scrofuloderma scars and a 60-year-old female patient with verruca-like lesions secondary to chronic inflammation.