Publications by authors named "Ülker Gül"

114 Publications

Patch Test Results to European Baseline Series in Turkey: A Prospective and Multicenter Study.

Dermatitis 2021 Mar 13. Epub 2021 Mar 13.

From the Department of Dermatology, Faculty of Medicine, Zonguldak Bülent Ecevit University Department of Dermatology, Koç University School of Medicine, Istanbul Department of Dermatology, Faculty of Medicine, Aydin Menderes University Department of Dermatology, Faculty of Medicine, Uludağ University, Bursa Department of Dermatology, Faculty of Medicine, Ondokuz Mayis University, Samsun Department of Dermatology, Faculty of Medicine, Yildirim Beyazit University, Ankara Department of Dermatology, Faculty of Medicine, Akdeniz University, Antalya Department of Dermatology, Faculty of Medicine, Dicle University, Diyarbakir Department of Dermatology, Faculty of Medicine, Atatürk University, Erzurum Department of Dermatology, Faculty of Medicine, İstanbul Bilim University Department of Dermatology, Faculty of Medicine, Dokuz Eylül University, Izmir Department of Dermatology, Fulya Acibadem Hospital, İstanbul Department of Biostatistics, Faculty of Medicine, Zonguldak Bülent Ecevit University, Turkey.

Background: Patch testing with the European Baseline Series (EBS) is an essential diagnostic tool for the assessment of allergic contact dermatitis.

Objective: The aims of the study were to describe the most common contact allergens identified with patch testing in Turkey and to establish the distribution of contact allergens among different regions in Turkey.

Patients And Methods: Twelve centers consisting of tertiary health care institutions were included in the study. A total of 1169 patients were patch tested with the EBS from 2015 to 2017.

Results: A total of 596 patients (51.0%) had 1 or more positive patch test reactions to the EBS. A total of 30.2% (n = 353) of those tested had clinical relevance. Contact sensitivity was more common in young patients. The most common 10 allergens were nickel sulfate (20.4%), followed by textile dye mix (8.6%), cobalt chloride (8.3%), potassium dichromate (8.0%), p-phenylenediamine base (4.5%), balsam of Peru (4.3%), methylchloroisothiazolinone/methylisothiazolinone (3.8%), thiuram mix (3.6%), fragrance mix I (3.0%), and methylisothiazolinone (2.9%).

Conclusions: This study provides a comprehensive profile of patch test results with the EBS in Turkey. An ongoing decrease in contact allergy to methylchloroisothiazolinone/methylisothiazolinone and methylisothiazolinone was observed. Textile dye mix and p-phenylenediamine are beginning to pose a new risk in Turkey.
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http://dx.doi.org/10.1097/DER.0000000000000631DOI Listing
March 2021

Cutaneous adnexal tumors: the diagnostic role of dermatoscopic examination

Turk J Med Sci 2021 04 30;51(2):875-876. Epub 2021 Apr 30.

Department of Dermatology and Veneorology, Health Science University, Kayseri City Hospital, Kayseri, Turkey

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http://dx.doi.org/10.3906/sag-2007-86DOI Listing
April 2021

COVID-19 and dermatology

Authors:
Ülker Gül

Turk J Med Sci 2020 12 17;50(8):1751-1759. Epub 2020 Dec 17.

Department of Dermatology, Gülhane Faculty of Medicine, Health Sciences University, İstanbul, Turkey

Background/aim: Sars-CoV-2 virus infection (COVID-19) was observed in China in the last months of 2019. In the period following, this infection spread all over the world. In March 2020 the World Health Organization announced the existence of a pandemic. The aim of this manuscript is to investigate skin diseases associated with COVID-19 under three main headings: skin problems related to personal protective equipment and personal hygiene measures, skin findings observed in SARS-CoV-2 virus infections, and skin findings due to COVID-19 treatment agents.

Materials And Methods: In PubMed, Google Scholar databases, skin lesions related to personal protective equipment and personal hygiene measures, skin findings observed in SARS-CoV-2 virus infections and skin findings due to COVID-19 treatment agents subjects are searched in detail.

Results: Pressure injury, contact dermatitis, itching, pressure urticaria, exacerbation of preexisting skin diseases, and new skin lesion occurrence/new skin disease occurrence may be due to personal protective equipment. Skin problems related to personal hygiene measures could include itching, dryness, and contact dermatitis. Skin findings may also be observed in SARS-CoV-2 virus infections. The incidence of skin lesions due to COVID-19 was reported to be between 0.2% and 29%. Many skin lesions including maculopapular, urticarial, vesicular, chilblain-like, thrombotic/ischemic, etc. are observed in COVID-19 patients. Some authors have stated that there is an absence of SARS-CoV-2 virus infection-specific skin findings. However, in asymptomatic or presymptomatic COVID-19 patients in particular, skin lesions can lead to the diagnosis of COVID-19. In addition, skin lesions may occur due to COVID-19 treatment agents.

Conclusion: Many skin lesions may appear as a result of COVID-19. Even in the absence of a COVID-19 diagnosis, skin findings should be evaluated carefully in this pandemic period.
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http://dx.doi.org/10.3906/sag-2005-182DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7775718PMC
December 2020

Effect of a novel bioceramic root canal sealer on the angiogenesis-enhancing potential of assorted human odontogenic stem cells compared with principal tricalcium silicate-based cements.

J Appl Oral Sci 2020 10;28:e20190215. Epub 2020 Jan 10.

Yeditepe University, Faculty of Engineering and Architecture, Department of Genetics and Bioengineering, Istanbul, Turkey.

Objective: This study evaluated the angiogenesis-enhancing potential of a tricalcium silicate-based mineral trioxide aggregate (ProRoot MTA), Biodentine, and a novel bioceramic root canal sealer (Well-Root ST) in human dental pulp stem cells (hDPSCs), human periodontal ligament stem cells (hPLSCs), and human tooth germ stem cells (hTGSCs).

Methodology: Dulbecco's modified Eagle's medium was conditioned for 24 h by exposure to ProRoot MTA, Biodentine, or Well-Root ST specimens (prepared according to the manufacturers' instructions). The cells were cultured in these conditioned media and their viability was assessed with 3-(4,5-dimethyl-thiazol-2-yl)-5-(3-carboxy-methoxy-phenyl)-2-(4-sulfo-phenyl)-2H tetrazolium (MTS) on days 1, 3, 7, 10, and 14. Angiogenic growth factors [platelet-derived growth factor (PDGF), basic fibroblast growth factor (FGF-2), and vascular endothelial growth factor (VEGF)] were assayed by sandwich enzyme-linked immunosorbent assay (ELISA) on days 1, 7, and 14. Human umbilical vein endothelial cell (HUVEC) migration assays were used to evaluate the vascular effects of the tested materials at 6-8 h. Statistical analyses included Kruskal-Wallis, Mann-Whitney U, and Friedman and Wilcoxon signed rank tests.

Results: None of tricalcium silicate-based materials were cytotoxic and all induced a similar release of angiogenic growth factors (PDGF, FGF-2, and VEGF) (p>0.05). The best cell viability was observed for hDPSCs (p<0.05) with all tricalcium silicate-based materials at day 14. Tube formation by HUVECs showed a significant increase with all tested materials (p<0.05).

Conclusion: The tricalcium silicate-based materials showed potential for angiogenic stimulation of all stem cell types and significantly enhanced tube formation by HUVECs.
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http://dx.doi.org/10.1590/1678-7757-2019-0215DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6919198PMC
January 2020

Clinical significance of NCOA5 gene rs2903908 polymorphism in Behçet's disease.

EXCLI J 2017 4;16:609-617. Epub 2017 May 4.

Gaziosmanpasa University, Faculty of Medicine, Department of Medical Biology, Tokat, Turkey.

Behçet's disease (BD) is an autoimmune multisystemic disease. The precise etiology of BD is not fully understood; however, it is thought that interactions between genetic and environmental factors play an essential role in its pathogenesis. The nuclear receptor coactivator-5 () gene encodes a coregulator for nuclear receptor subfamily 1 group D member 2 () and estrogen receptor 1 and 2 ( and ). Also, the gene insufficiency leads to an elevated expression of IL-6, and increased levels of IL-6 were found to be related to the pathogenesis of BD. In this study, we aimed to clarify the impact of the rs2903908 polymorphism on susceptibility and clinical findings of BD. This study included 671 participants (300 BD patients and 371 healthy controls). The analyses of rs2903908 polymorphism was performed by using the TaqMan allelic discrimination assay. The frequency of TT genotype of the rs2903908 polymorphism was found significantly higher in BD patients compared to those in healthy controls (p=0.016, OR=1.46, 95 % CI=1.08-1.99). Also, the frequencies of CT genotype was observed significantly higher in BD patients with genital ulceration and uveitis than without genital ulceration and uveitis (p=0.002 and p=0.005, respectively). The most significant association was found between C allele frequencies of BD patients with and without uveitis (p=0.0001). Our study represents for the first time that the rs2903908 polymorphism seemed to be linked to BD susceptibility and clinical findings.
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http://dx.doi.org/10.17179/excli2017-189DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5491927PMC
May 2017

Prediction of atopy via total immunoglobulin E levels andskin prick tests in patients with psoriasis.

Turk J Med Sci 2017 Apr 18;47(2):577-582. Epub 2017 Apr 18.

Department of Immunology and Allergology, Ankara Atatürk Chest Diseases and Chest Surgery Training and Research Hospital, Ankara, Turkey.

Background/aim: Although the etiopathogeneses of psoriasis and atopy appear to be different, psoriasis has been found to be associated with atopy and atopic dermatitis. In this study, we aimed to determine the role of atopy by examining the medical history and clinical and laboratory findings of patients with psoriasis.

Materials And Methods: Patients with psoriasis, asthma patients, and healthy volunteers were included in the study. Serum total immunoglobulin E (IgE) levels were obtained, and prick tests were administered to all groups.

Results: Psoriatic patients demonstrated percentages of atopy history (21.3%) that were higher than those of the healthy subjects (15.7%). The median total IgE level in psoriatic patients was found to be statistically higher than that in the healthy control group (P > 0.05). With respect to mite positivity, there were statistically significant differences in the psoriatic (P < 0.05) and asthmatic groups (P < 0.001) when compared to the healthy control group.

Conclusion: Our study is the first to use skin prick tests with psoriatic patients. Skin prick test sensitivity to mites increased in psoriatic patients, and we believe that this finding may be useful in protecting psoriatic patients from activation of psoriasis and in determining the appropriate treatment approach.
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http://dx.doi.org/10.3906/sag-1601-133DOI Listing
April 2017

Acral manifestations of paraneoplastic and collagen vascular diseases.

Authors:
Ülker Gül

Clin Dermatol 2017 Jan - Feb;35(1):50-54. Epub 2016 Sep 10.

Department of Dermatology, Akdeniz University, Faculty of Medicine, Antalya, Turkey. Electronic address:

The skin often signals a number of systemic disease, making skin findings of paramount significance. Paraneoplastic diseases and collagen vascular diseases are vitally important illnesses. Paraneoplastic diseases and collagen vascular diseases may also occur with many different acral skin findings. Paraneoplastic skin diseases, associated with some cancers, are by definition nonmalignant skin disorders. These diseases can occur before, simultaneously, or after the diagnosis of cancer. Acral paraneoplastic diseases include acanthosis nigricans maligna, acquired pachydermatoglyphia, acrokeratosis paraneoplastica, palmoplantar keratoderma, and paraneoplastic nail disorders. Collagen vascular diseases include the acral skin findings of lupus erythematosus, scleroderma, dermatomyositis, and rheumatoid arthritis. Any acral skin finding may be encountered as the first finding of an undiagnosed malignancy or collagen vascular diseases. The role of the dermatologist is significant for often being the first physician to suspect a malignancy or collagen vascular disease.
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http://dx.doi.org/10.1016/j.clindermatol.2016.09.007DOI Listing
June 2017

Number and size of acquired melanocytic nevi and affecting risk factors in cases admitted to the dermatology clinic.

Postepy Dermatol Alergol 2016 Oct 21;33(5):375-380. Epub 2016 Oct 21.

Dermatology Clinic, School of Medicine, Balıkesir University, Balıkesir, Turkey.

Introduction: The size and number of acquired melanocytic nevi (AMN) and presence of dysplastic nevi are the leading risk factors that should be recognized in the development of malignant melanoma.

Aim: To evaluate AMN and risk factors in the development of AMN in all age groups admitted to a dermatology outpatient clinic.

Material And Methods: Four hundred and twelve patients who were admitted to the dermatology outpatient clinic for any dermatological symptom and who accepted to participate in the study were randomly included in the study. For each case, background-family history and dermatological findings were recorded. All AMN observed in the patients were dermatoscopically examined.

Results: The presence of more than 50 nevi was significantly higher in males, in individuals who had a history of sunburn and smokers. The number of nevi that were 5 mm and below was found to be higher in individuals who regularly sunbathed their face/body, in individuals using sunscreen, in individuals who had a history of sunburn, smokers and alcohol users. The number of nevi that were above 5 mm was higher in smokers. The total dermatoscopy score between 4.75 and 5.45 was found to be higher in individuals who had more than 50 nevi, in individuals exposed to more than one chemical substance and in alcohol users.

Conclusions: When determining the patient's risk factors, factors such as the patient's sunbathing habits and chemical substance exposure features should be taken into consideration besides the number and size of nevi.
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http://dx.doi.org/10.5114/ada.2016.62845DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5110627PMC
October 2016

Investigation of Enthesopathy with Ultrasonography and Comparison with Skin Findings in Asymptomatic Psoriatic Patients.

Dermatology 2016 31;232(3):312-8. Epub 2016 Mar 31.

Department of Dermatology, Prof. Dr. A. x0130;lhan x00D6;zdemir State Hospital, Giresun, Turkey.

Background: Joint involvement associated with psoriasis is referred to as psoriatic arthritis. A late diagnosis of psoriatic arthritis may cause a variety of morbidities; therefore, an early diagnosis and treatment of psoriatic arthritis are required. Asymptomatic psoriatic arthritis has been found in 8-70% of patients with psoriasis using imaging techniques.

Objective: To investigate joint and enthesis regions by ultrasonography in patients with psoriasis without inflammatory joint symptoms to detect subclinical psoriatic arthritis.

Methods: We included 50 psoriasis patients and 30 healthy control subjects without joint complaint in this study. Twelve joint regions of all subjects in each group were examined by ultrasonography.

Results: The presence of any pathological ultrasonography finding (30%) was higher but did not significantly differ in psoriasis patients compared with the control group (13.33%; p > 0.05).

Conclusion: Although statistically not significant, the pathological ultrasonography findings were approximately twofold more common in patients with psoriasis compared with the control group. Therefore, the development of psoriatic arthritis in patients with psoriasis should be more closely followed.
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http://dx.doi.org/10.1159/000444218DOI Listing
April 2017

Serological test results of sexually transmitted diseases in patients with condyloma acuminata.

Postepy Dermatol Alergol 2015 Aug 12;32(4):286-9. Epub 2015 Aug 12.

Family Medicine, Kilis Public Health Research, Kilis, Turkey.

Introduction: Human papillomavirus (HPV) is one of the most common causes of sexually transmitted diseases (STD). The incidence of condyloma acuminata (CA) has increased in recent years.

Aim: To determine demographical features and serological test results of STD in patients with CA.

Material And Methods: A cross-sectional survey was conducted on 94 patients presenting to a dermatology clinic in Ankara, Middle Anatolia, Turkey. Dermatological examinations were made and the patients completed a questionnaire which consisted of questions about their marital status, partners and condom use. In all cases, VDRL/RPR, anti-HIV, HBsAg, anti-HCV and in 57 cases - HSV type 1-2 IgM and IgG were studied. If the value of VDRL or RPR was positive, TPHA was conducted.

Results: In our study, 83 men and 11 women had CA. We could not analyze whether our cases had multiple partners and a habit of condom use as some of the patients did not answer questions about their sexual life. We observed VDRL and TPHA positivity in 3 (3.1%) cases, none of those cases had clinical findings of syphilis and they denied using any therapy for syphilis. HBsAg positivity was found in 3 cases. No anti-HIV and anti-HCV antibody positivity was detected.

Conclusions: The seroprevalence of HBsAg in our study was similar to that of the general population of Turkey. But as we found positive syphilis serology in 3 patients, we suggest that syphilis serology should be investigated in patients with CA.
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http://dx.doi.org/10.5114/pdia.2015.48065DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4565835PMC
August 2015

Mucocutaneous warts in Middle Anatolia, Turkey: clinical presentations and therapeutic approaches.

Postepy Dermatol Alergol 2015 Jun 15;32(3):179-83. Epub 2015 Jun 15.

Family Medicine, Kilis Public Health Research, Kilis, Turkey.

Introduction: Viral warts are common skin condition caused by the human papilloma virus.

Aim: To determine the clinical features of warts and therapeutic approaches to warts and compare them with the literature.

Material And Methods: A cross-sectional survey was conducted on 362 consecutive patients presenting to a dermatology clinic in Ankara, Middle Anatolia, Turkey. Age, gender, anatomic localization, clinical types, number of warts, and medical therapy histories were recorded.

Results: In our study 139 (38.4%) children and 223 (61.6%) adults had warts. Warts were seen in 191 men, and 171 women. The mean age was 24.7 ±13.5. In all groups the incidence and the number of warts were higher in men. Clinical types of warts were vulgar, anogenital, plantar, verruca plana, filiform, and mosaic. Thirty-six (9.9%) of 362 cases had more than one type. The locations of warts were as follows extremities (n = 233, 64.4%), anogenital (n = 86, 23.7%) and head and neck (n = 73, 20.2%). The incidence of anogenital warts was statistically higher in men than women (p < 0.05). Topical medical treatment was the first choice (n = 60, 57.1%).

Conclusions: In our study, the incidence and the number of warts were higher in men, which is different than in previous reports. The anogenital wart (AW) was ranked second in all types of warts. According to this finding, we can say that the frequency of AW has been increased in Turkey. To our knowledge recently there have been no studies investigating the clinical features of viral warts in all ages in the literature.
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http://dx.doi.org/10.5114/pdia.2015.48054DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4495115PMC
June 2015

A case of pachyonychia congenita with unusual manifestations: an unusual type or a new syndrome?

Int J Dermatol 2015 Mar 29;54(3):334-7. Epub 2013 Oct 29.

Ankara Numune Education and Research Hospital, Dermatology Department, Ankara, Turkey.

A 30-year-old man presented with lesions on his oral mucosa and soles. There were no similar complaints in his family members. The dermatological examination revealed follicular hyperkeratosis on his trunk and upper extremities and flesh-colored, firm cystic lesions on his axillae. He had focal, painful, hyperkeratotic areas sited particularly on both his soles and palms. In addition to these, leukokeratosis and ulcerative areas on buccal, labial mucosa, tongue, and at corners of the mouth, and complete loss of teeth was observed. The proximal layering was revealed on all of his nails. The laboratory investigations produced normal results except the deficiency of immunoglobulin A. The psychiatric examination revealed mild mental retardation. Keratin gene (KRT6a, KRT6b, KRT16, and KRT17) mutations for pachyonychia congenita were negative. He got removable dental prosthesis because of inadequate alimentation. Squamous cell cancer developed on lower lip mucosa during follow-up. We present an individual who had different nail dystrophy, epidermal cysts, mental retardation, blepharitis, complete loss of teeth, and negative keratin gene mutations for pachyonychia congenita and developed squamous cell cancer on the oral leukokeratosis lesions. We think that the present case may be an unusual new type of pachyonychia congenita.
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http://dx.doi.org/10.1111/j.1365-4632.2012.05851.xDOI Listing
March 2015

Associations of rs4810485 and rs1883832 polymorphisms of CD40 gene with susceptibility and clinical findings of Behçet's disease.

Rheumatol Int 2015 May 6;35(5):837-43. Epub 2014 Nov 6.

Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey,

There are evidences that besides geographic tendency, interactions between genetic and environmental factors play an essential role in the pathogenesis of Behçet's disease (BD). In this study, we have evaluated the associations between rs4810485 and rs1883832 single nucleotide polymorphism (SNP)s of CD40 gene with the susceptibility and clinical findings of BD. Two hundred and eighty-five patients with BD and 225 age-matched healthy controls were enrolled in this study. The clinical findings of patients were noted. The distributions of genotypes, alleles, combined genotypes and haplotypes of these two SNPs in BD patients were compared with those in healthy controls. In further evaluation, we evaluated the patients with and without any of clinical findings with regarding to distribution of genotypes and alleles of these two SNPs. There was no significant difference concerning frequencies of genotypes, alleles, combined genotypes and haplotypes of rs4810485 and rs1883832 between patients and controls (p > 0.05 for all). Frequency of GT genotype of CD40 rs4810485 polymorphism was found to be significantly higher in patients with skin lesions (p < 0.05, OR 1.65, 95 % CI 1.02-2.64). Also, we have found significantly higher frequencies of CC genotype and C allele of CD40 rs1883832 polymorphism in patients with genital ulcers (p < 0.05 for both, OR 2.30, 95 % CI 1.07-4.94 and OR 1.78, 95 % CI 1.06-2.97, respectively). However, these significances were disappeared after Bonferroni correction. We suggest that differences in the expression levels of CD40 because of different genotypes of these two SNPs may take part in the development of skin lesions or genital ulcers in patients with BD.
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http://dx.doi.org/10.1007/s00296-014-3171-3DOI Listing
May 2015

Two cases of unilateral lichen planus following the lines of blaschko.

Ann Dermatol 2014 Oct 26;26(5):636-8. Epub 2014 Sep 26.

Dermatology Clinic, Ankara Numune Education and Research Hospital, Ankara, Turkey.

A 50-year-old man and 71-year-old woman presented to our clinic with unilateral, linear, erythematous, pruritic lesions along the lines of Blaschko. On the basis of clinical and histopathological findings, the lesions were diagnosed as lichen planus with a Blaschkoian distribution, which is a rare form of lichen planus. The patients were treated with topical corticosteroids and antihistamines.
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http://dx.doi.org/10.5021/ad.2014.26.5.636DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4198595PMC
October 2014

Clinical and laboratory findings of pigmented purpuric dermatoses.

Ann Dermatol 2014 Oct 26;26(5):610-4. Epub 2014 Sep 26.

Department of Biostatistic, Ankara University Faculty of Medicine, Ankara, Turkey.

Background: Pigmented purpuric dermatoses (PPD) are chronic, recurrent group of disorders characterized by petechial and pigmentary macules usually localized on the lower limbs. Its etiopathogenesis is unknown. There are very few clinical and etiological studies on PPD in the literature.

Objective: We aim to examine the etiopathogenetic factors of PPD retrospectively.

Methods: Demographic characteristics, history of co-morbid disorders and drug usage, hepatitis markers, levels of serum lipids, findings of Doppler ultrasonography in lower extremities, and patch test results of the 24 patients of PPD were examined retrospectively. The patch test results, history of drug use, and co-morbid disorders of the patients were compared with those of the control groups.

Results: The male-to-female ratio was 1 : 2, and 83.3% of the patients had Schamberg disease. Seventeen patients had co-morbid disorders and 16 used various drugs, but there was no statistically significant difference between the controls and patients. One patient was positive for hepatitis B surface antigen and 1, for anti-hepatitis C virus antibody. Nine had elevated total cholesterol levels, and 5 had elevated triglyceride levels. Further, 30% of them were positive for at least 1 allergen, while 16% of the control subjects were positive for at least 1 allergen, but statistically significant difference was not found between the 2 groups. Variable degrees of venous insufficiency were detected in 75% of the patients on Doppler ultrasonography of the lower extremities.

Conclusion: Venous insufficiency and hypercholesterolemia might be the basic predisposing factors for PPD. Further studies are needed to show if diabetes mellitus and hypertension may cause perivascular inflammation in PPD.
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http://dx.doi.org/10.5021/ad.2014.26.5.610DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4198589PMC
October 2014

Patch test results of the dental personnel with contact dermatitis.

Cutan Ocul Toxicol 2014 Dec 18;33(4):299-302. Epub 2014 Mar 18.

Department of Dermatology, Kütahya Evliya Çelebi Education and Research Hospital, Dumlupinar University , Kütahya , Turkey and.

Objectives: Dental personnel have high risk of occupational contact dermatitis. The aim of this study is to detect the materials which cause contact sensitization and the frequency of contact dermatitis by using patch tests with European standard series and dental screening series in dental personnel.

Methods: Between August 2008 and July 2009, 461 dental personnel working in Ankara (Turkey) were examined and age, gender, previous history of dermatitis, area of the skin affected and clinical diagnosis were noted. About 198 (43%) of the dental personnel were diagnosed contact dermatitis. Sixty-five of the dental personnel accepted to be patch tested.

Results: Dental technicians, dentists and dental nurses constitute 69.2%, 24.6% and 6.2% of patch tested 65 patients, respectively. Positive reactions to at least one allergen were detected with European standard series at 20% and with dental series at 10.8% among the dental personnel. The most common allergens were nickel sulfate (12.3%), acrylates (6.1%) and para-tertiary-butylphenol-formaldehyde resin (4.6%). The most common acrylate was ethyleneglycol dimethacrylate (3.1%).

Conclusions: We believe our study will be helpful to dermatologists about frequency of contact dermatitis among dental personnel and allergens that cause contact sensitivity for developing new methods to protect the personnel in dentistry against sensitization.
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http://dx.doi.org/10.3109/15569527.2013.866132DOI Listing
December 2014

Klippel-Trenaunay syndrome with rudimentary polydactyly.

Int J Dermatol 2015 Apr 14;54(4):465-7. Epub 2014 Feb 14.

Dermatology Clinic, Ankara Numune Education and Research Hospital, Sıhhıye, Ankara, Turkey.

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http://dx.doi.org/10.1111/ijd.12032DOI Listing
April 2015

Is the health-related quality of life and functional status of patients with psoriatic arthritis worse than that of patients with psoriasis alone?

Int J Rheum Dis 2015 Jan 27;18(1):63-9. Epub 2014 Jan 27.

Department of Physical Medicine and Rehabilitation, Ankara Numune Education and Research Hospital, Ankara, Turkey.

Aim: The aim of this study was to compare the health-related quality of life and functional status of patients with psoriasis (Ps), psoriatic arthritis (PsA) and control subjects.

Method: Eighty patients with PsA, 40 patients with Ps and 40 healthy subjects were included. Physical functions were evaluated with the Health Assessment Questionnaire for Spondyloarthropathies (HAQ-S) while life satisfaction was evaluated with the Psoriatic Arthritis Quality of Life (PsAQoL) questionnaire. The Disease Activity Score 28 (DAS28), Disease Activity Index for the Assessment of Reactive Arthritis (DAREA), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Ankylosing Spondylitis Disease Activity Score-C-Reactive Protein (ASDAS-CRP), Maastrich Ankylosing Spondylitis Enthesitis Score (MASES) and visual analog scale-pain were calculated.

Results: The HAQ-S data revealed that physical functional status in the PsA group was worse than the Ps and control groups (mean scores: 0.5 ± 0.5, 0.2 ± 0.5 and 0.1 ± 0.3, respectively). The PsAQoL data revealed a worse quality of life in the PsA and Ps groups than in the control group but the same quality of life in the PsA and Ps groups (mean scores: 6.9 ± 5.4, 7 ± 5.9 and 3.3 ± 4.2, respectively). Both the HAQ-S and PsAQoL data were found to be moderately to weakly correlated with disease activity measures (DAS28, DAREA, BASDAI, ASDAS-CRP), pain and enthesitis.

Conclusion: Patients with Ps and PsA had worse quality of life and patients with PsA had worse functional status than healthy individuals. Although Ps patients with arthritis had a worse functional status than the ones without arthritis, quality of life according to PSAQoL was found to be similar between them.
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http://dx.doi.org/10.1111/1756-185X.12283DOI Listing
January 2015

Common MEFV gene mutations in Turkish patients with Behcet's disease.

Gene 2013 Nov 22;530(1):100-3. Epub 2013 Aug 22.

Tokat Gaziosmanpasa University, Medical Faculty, Dept. of Internal Medicine, Turkey.

Behcet's disease (BD) is a chronic systemic inflammatory disorder whose etiology has not been fully established yet. The MEditerranean FeVer (MEFV) gene has been identified as the cause of Familial Mediterranean Fever (FMF). BD shows similarities with FMF, in terms of clinical findings and treatments, as well as their geographical and ethnic co-occurrence. In this study we investigated common MEFV gene mutation frequencies in Turkish patients with BD in an area of Turkey where both diseases are frequently encountered. We screened 207 BD patients who had no symptoms and family history for FMF and 200 healthy subjects for five common MEFV gene mutations (E148Q, M680I, M694V, V726A, P369S) and clinical features. Seventy-five patients were found to carry a single MEFV mutation, and six patients were compound heterozygous. The difference in the frequency of the MEFV mutation between the BD and control groups was statistically significant (p<0.001, odds ratio [OR] 2.74, 95% confidence interval [CI] 1.75-4.29). The frequencies of E148Q and M680I mutations were significantly higher in the BD group (p=0.001, p=0.046, respectively). The frequency of uveitis was significantly lower in patients with the mutation than in patients without the mutation (p=0.029, OR 0.54, 95% CI 0.30-0.98). There was no statistical significance between carriers and non-carriers with respect to gender and other manifestations of BD. The frequency of the MEFV mutation was significantly higher in patients with BD compared to the healthy control group. Based on our results, MEFV mutations appear to have a role in the pathogenesis of BD.
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http://dx.doi.org/10.1016/j.gene.2013.08.026DOI Listing
November 2013

A case of Beau's lines associated with familial Mediterranean fever.

Int J Dermatol 2014 Feb 14;53(2):e121-2. Epub 2013 Mar 14.

2nd Dermatology Clinic Ankara Numune Education and Research Hospital, Sıhhıye, Ankara, Turkey.

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http://dx.doi.org/10.1111/j.1365-4632.2012.05618.xDOI Listing
February 2014

Skin findings in newborns and their relationship with maternal factors: observational research.

Ann Dermatol 2013 Feb 14;25(1):1-4. Epub 2013 Feb 14.

Department of Dermatology, Ankara Etlik Ihtisas Education and Research Hospital, Ankara, Turkey.

Background: Cutaneous lesions are commonly seen in the newborn period and exhibit inconsistency from the skin lesions of an adult.

Objective: The present study was carried out with an aim to determine the frequency of physiologic and pathologic cutaneous findings in newborns.

Methods: Typically, 1234 newborns were included in this study. A questionnaire about maternal gestational history, maternal and family history was issued to the parents of each newborn. The presence of cutaneous lesions was recorded.

Results: Overall, 642 (52%) of the newborns were male and 592 (48%) were female. Typically, 831 newborns (67.3%) had at least one cutaneous lesion. The prevalence of genital hyperpigmentation and milia was significantly higher in males. In premature newborns, the pervasiveness of cutis marmorata and genital hyperpigmentation was found to be significantly higher. Caput succedaneum, transient neonatal pustular melanosis and cyanosis appeared predominantly in vaginally born infants. Erythema toxicum neonatorum was seen in infants, who were born by cesarean section. The predominance of Mongolian spots and erythema toxicum neonatorum were significantly higher in the newborns of the multiparous mothers; however, caput succedaneum was significantly higher in newborns of the primiparous mothers.

Conclusion: A number of studies about neonatal dermatoses have been carried out involving different methods in various countries. We consider that our study may be useful in literature, as it has been carried out involving large number of maternal parameters.
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http://dx.doi.org/10.5021/ad.2013.25.1.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3582906PMC
February 2013

Half-and-half nail in Behçet's disease.

Int J Dermatol 2014 Jan 3;53(1):e26-7. Epub 2013 Mar 3.

Second Dermatology Clinic, Ankara Numune Education and Research Hospital, Ankara, Turkey.

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http://dx.doi.org/10.1111/j.1365-4632.2012.05471.xDOI Listing
January 2014

Intravenous immunoglobulın therapy in dermatology: an update.

Inflamm Allergy Drug Targets 2013 Apr;12(2):132-46

Ankara Numune Education and Research Hospital, Dermatology Clinic, and Ankara University, Faculty of Medicine, General Surgery Department, 701, sok 18/8 Y ld z Cankaya, Ankara, Turkey.

Intravenous immunoglobulin (IVIG) is a fractioned blood product consisting of IgG antibodies which was first used in antibody deficiency disorders. It is increasingly being used for several inflammatory and autoimmune conditions. IVIG can also be used in a wide range of dermatological diseases which are difficult to treat including autoimmune bullous skin diseases and toxic epidermal necrolysis. The use of IVIG in dermatological disorders is discussed in this article.
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http://dx.doi.org/10.2174/1871528111312020007DOI Listing
April 2013

DD genotype of ACE gene I/D polymorphism is associated with Behcet disease in a Turkish population.

Mol Biol Rep 2013 Jan 12;40(1):365-8. Epub 2012 Oct 12.

Department of Medical Biology, Faculty of Medicine, Gaziosmapaşa University, Tokat, Turkey.

Behcet's disease (BD) is a chronic, multi-systemic and inflammatory disorder. The local renin-angiotensin system (RAS) in the vessel wall plays a role in the endothelial control and contributes to inflammatory processes. Angiotensin-converting enzyme (ACE) is the regulatory component of the RAS. This study was conducted in Turkish patients with BD to determine the frequency of I/D polymorphism genotypes of ACE gene. Genomic DNA obtained from 566 persons (266 patients with BD and 300 healthy controls). ACE gene I/D polymorphism genotypes were determined using polymerase chain reaction using I and D allele-specific primers. There was statistically significant difference between the groups with respect to genotype distribution (p < 0.001). This study is the largest study in Turkish population that ACE gene I/D polymorphism investigated in BD. As a result of this study, ACE gene I/D polymorphism DD genotype could be a genetic marker in BD in Turkish study population.
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http://dx.doi.org/10.1007/s11033-012-2069-yDOI Listing
January 2013

Deep Trichophyton rubrum infection presenting with umbilicated papulonodules in a cardiac transplant recipient.

Mycoses 2013 May 14;56(3):361-4. Epub 2012 Sep 14.

2nd Dermatology Clinic, Ankara Numune Education and Research Hospital, Ankara, Turkey.

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http://dx.doi.org/10.1111/myc.12001DOI Listing
May 2013

Association between the methylene tetrahydrofolate reductase gene C677T mutation and colchicine unresponsiveness in Behcet's disease.

Mol Vis 2012 22;18:1696-700. Epub 2012 Jun 22.

Ondokuz Mayis University, Faculty of Medicine, Department of Medical Biology, Samsun, Turkey.

Purpose: Behcet's disease (BD) is a multisystemic immunoinflammatory disorder characterized by mucocutaneous, ocular, vascular, and central nervous system manifestations. The common methylene tetrahydrofolate reductase (MTHFR) gene C677T mutation is a known risk factor for thrombosis. The aim of this study was to investigate the MTHFR gene C677 mutation in patients with BD and evaluate if there was an association with clinical features, especially thrombosis, in a relatively large cohort of patients with BD.

Methods: The study included 318 patients with BD and 207 healthy controls. Genomic DNA was isolated and genotyped using PCR-based restriction fragment length polymorphism assay for the MTHFR gene C677T mutation.

Results: The genotype and allele frequencies of the C677T mutation showed a statistically significant difference between BD patients and controls (p=0.003 and p=0.001, respectively). There was also a significant association between C677T alteration and response to colchicine in BD patients (p=0.046).

Conclusions: The results of this study showed that there was a high association between the MTHFR gene C677T mutation and BD. Stratification analysis according to clinical features for this disease did not reveal an association except response to colchicine that was shown to be influenced by the MTHFR C677T mutation.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3388981PMC
November 2012

MDR1 gene polymorphisms may be associated with Behçet's disease and its colchicum treatment response.

Gene 2012 Sep 15;505(2):333-9. Epub 2012 Jun 15.

Gaziosmanpasa University, Medical Faculty, Department of Medical Biology, 60100, Tokat, Turkey.

Behçet's disease (BD) is a chronic multisystem disorder. Infectious agents, immune system mechanisms, and genetic factors are implicated in the etiopathogenesis of BD, which remains to be explained. The human MDR1 (ABCB1) gene encoder P-glycoprotein (P-gp) plays a key role in drug disposition, serves as a protective mechanism against xenobiotics, and provides additional protection for the brain, testis, and fetus. We investigated the genotype and haplotype distributions of three MDR1 gene polymorphisms (C1236T, G2677T/A, and C3435T) in 104 BD patients and 130 control subjects. The genotyping analysis was performed by using PCR-RFLP methods. No statistically significant differences were found for the genotypic and allelic distributions of three individual single nucleotide polymorphisms (SNPs) in the MDR1 gene between BD patients and control subjects in this study (p>0.05). However, combined genotype and haplotype frequencies have found statistically significant differences between BD and control subjects for some combinations (p<0.05). The CC-GG binary genotype for C1236T-G2677T/A loci couple in particular may have a high degree of predisposition to BD (p=0.009; OR, 3.03; 95% CI, 1.41-6.54). Furthermore, significant differences between colchicine-responsive and -nonresponsive groups were found. Genotypic and allelic distributions of C3435T and G2677T/A loci, as well as their genotype and haplotype combinations, were found to have statistically significant differences (p<0.05). The TT genotype for the C3435T locus (p=0.001; OR, 6.59; 95% CI, 1.86-23.30) and T allele (p=0.009; OR, 2.09; 95% CI, 1.18-3.70) plays a substantial role in the colchicine response. Our study showed that MDR1 genes and their polymorphisms may affect a patient's BD susceptibility and colchicine response.
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http://dx.doi.org/10.1016/j.gene.2012.05.040DOI Listing
September 2012

Pentoxifylline use in dermatology.

Inflamm Allergy Drug Targets 2012 Dec;11(6):422-32

Ankara Numune Education and Research Hospital Dermatology Clinic, 701. sok 18/8 Yildiz Çankaya, Ankara, Turkey.

Pentoxifylline is methylxanthine derivative which is used in microcirculatory disorders as a vasoactive drug. Novel immunomodulatory properties of pentoxifylline have been reported including the down regulation of tumour necrosis factor-α synthesis and other inflammatory cytokines. Studies have shown that pentoxifylline might be efficacious in a wide spectrum of skin diseases. This article focuses on the use of pentoxifylline which is a safe and cheap drug in various dermatological disorders.
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http://dx.doi.org/10.2174/187152812803590028DOI Listing
December 2012

A family of Bart-Pumphrey syndrome.

Indian J Dermatol Venereol Leprol 2012 Mar-Apr;78(2):178-81

2nd Dermatology Clinic, Ankara Numune Education and Research Hospital, Ankara, Turkey.

Bart-Pumphrey syndrome (BPS) is an autosomal-dominant disorder characterized by hearing loss, leukonychia, knuckle pads and palmoplantar keratoderma. Two mutations in the extracellular domain of GBJ2 are resposible for this syndrome. To date, less than 10 case reports or clinical series about BPS have been published in the literature. Hearing loss and knuckle pads are the more commonly seen findings of this syndrome. Three generations and six family members with variable findings of knuckle pads, leukonychia, hearing loss and palmoplantar hyperkeratosis were presented in this report. We want to emphasize that dermatogists must be alert during the evaluation of these findings because some findings of this disorder may be vague or absent.
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http://dx.doi.org/10.4103/0378-6323.93636DOI Listing
July 2012

Smoking, alcohol consumption and denture use in patients with oral mucosal lesions.

J Dermatol Case Rep 2011 Dec;5(4):64-8

2nd Dermatology Clinic, Ankara Numune Education and Research Hospital, Ankara, Turkey.

Background: Epidemiologic researches about oral mucosal lesions have been performed in different populations. But, in dermatology outpatients, oral mucosal lesions have not been investigated previously.

Objective: We aimed to determine the prevalence of oral mucosal lesions among dermatology outpatients and the relationship between OML and smoking, alcohol intake, denture and dental filling use and skin diseases.

Methods: Randomly selected 1041 dermatology outpatients were examined for dermatological diseases and oral mucosal lesions. All of the patients were questioned about smoking, alcohol intake, denture and dental filling use.

Results: In 235 patients, oral mucosal lesions were recorded. 268 (25.7%) of the patients had history of smoking, 42 (4%) drinking alcohol and 180 (17.3%) denture and dental filling. 32 (64%) of the smokers, 54 (30%) of denture users and 10 (23.8%) alcohol consumers had at least one OML. Age and smoking were found as significant risk factors for oral mucosal lesions. Fissured tongue was the most common oral lesion and it was seen significantly higher in patients with denture. Smoking was risk factor for coated tongue and linea alba.

Conclusions: Oral mucosa should be examined carefully even if the patients do not attend with the complaint of oral lesions, especially in elderly patients, smokers and denture users.
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http://dx.doi.org/10.3315/jdcr.2011.1079DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3241948PMC
December 2011