Publications by authors named "Can Baykal"

51 Publications

Skin tumors in xeroderma pigmentosum: Evaluation of a large series and a literature review.

J Cutan Pathol 2021 Jul 9;48(7):884-895. Epub 2021 Mar 9.

Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.

Background: Xeroderma pigmentosum (XP) is a rare genodermatosis with a lifelong propensity to develop malignant skin tumors.

Methods: In this retrospective study, 24 XP patients were evaluated with regard to frequency and clinicopathological features of benign and malignant skin tumors.

Results: Seventeen patients had at least one malignant skin tumor diagnosed: basal cell carcinoma (BCC) in 13 patients (n = 72), basosquamous carcinoma in three patients (n = 4), squamous cell carcinoma in six patients (n = 13), keratoacanthoma in three patients (n = 15), and melanoma in six patients (n = 18). Most melanomas (n = 15) were in situ lesions. Several benign skin tumors were noted such as tricholemmoma (n = 1), trichoepithelioma (n = 1), trichoblastoma (n = 1), follicular infundibulum tumor (n = 1), keratoacanthoma-like follicular lesion (n = 1), adnexal tumors with folliculosebaceous (n = 1) and tricholemmal differentiation (n = 1), and neurofibroma (n = 1). Benign vascular proliferations including pyogenic granulomas (n = 8), widespread telangiectasias, and senile angioma-like lesions were also observed in 3, 5, and 5 patients, respectively.

Conclusions: Similar to many reports, BCC was found to be the most common malignant skin tumor. The high prevalence of benign adnexal tumors of follicular differentiation, some of them showing mixed histopathological features and various vascular proliferations in our series raises the question of whether they indicate a formerly undescribed association with XP.
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http://dx.doi.org/10.1111/cup.13979DOI Listing
July 2021

Evaluation of Associated Lymphomas and Their Risk Factors in Patients with Lymphomatoid Papulosis: A Retrospective Single-Center Study from Turkey

Turk J Haematol 2021 02 4;38(1):49-56. Epub 2021 Jan 4.

İstanbul University, İstanbul Faculty of Medicine, Department of Pathology, İstanbul, Turkey

Objective: Lymphomatoid papulosis (LyP) is an indolent skin disease with variable clinical features classified among the primary cutaneous CD30+ T-cell lymphoproliferative disorders. It may show association with cutaneous and systemic lymphomas. We aimed to identify the frequency and characteristics of associated lymphomas among Turkish patients with LyP and to determine the risk factors for secondary lymphomas.

Materials And Methods: The files of patients diagnosed with LyP between 1998 and 2018 in a tertiary dermatology clinic were retrospectively analyzed. Univariate and multivariate models were used to assess the possible risk factors for secondary lymphomas, such as demographic and clinical characteristics of the patients.

Results: Among 61 patients (47 adults, 14 children) with LyP, a total of 22 secondary lymphomas were observed in 20 patients. Nineteen of them were adults. Mycosis fungoides (MF) was the major associated lymphoma (n=19) followed by systemic anaplastic large cell lymphoma (ALCL) (n=2) and primary cutaneous ALCL (n=1). The most common stage in patients with accompanying MF was stage IB (n=11). While 18 patients showed the classical type of MF, one patient had folliculotropic MF. When the risk factors for association between LyP and other lymphomas were evaluated, only older age was found to be a significant risk factor and existence of ulcerated lesions was found to be a negative indicator.

Conclusion: LyP is not rare in the pediatric population. MF is the most common associated lymphoma in patients with LyP. Adult LyP patients are more commonly associated with secondary lymphomas than pediatric patients. Older age at the time of diagnosis of LyP is a significant risk factor for associated lymphomas.
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http://dx.doi.org/10.4274/tjh.galenos.2020.2020.0685DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7927440PMC
February 2021

Efficacy of narrow-band ultraviolet-B therapy in patch-stage mycosis fungoides: A clinical study and review of the literature.

Photodermatol Photoimmunol Photomed 2020 Jul 21;36(4):271-277. Epub 2020 Mar 21.

Department of Dermatology and Venereology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.

Background/purpose: We investigated the efficacy of narrow-band UVB in patch-stage MF and reviewed the literature to re-evaluate the role of this phototherapy method in early MF.

Methods: Early-stage MF patients treated with narrow-band UVB were included. Number of narrow-band UVB treatment sessions, treatment duration, cumulative UV dose, clinical response results, side effects, duration of the remission period and relapse rate were evaluated.

Results: Complete response rate was 86.7% in sixty patients with MF. Mean number of treatment sessions was 62.9 ± 15.1, treatment duration was 32.1 ± 10.7 weeks, and mean cumulative UV dose was 62.1 ± 41.9 J/cm in patients with complete response. Mean duration of remission was 10.3 ± 11.0 months, and relapse rate was 70% in a mean follow-up of 21.9 ± 16.4 months. Mild regional erythema (6.7%) and pruritus (8.3%) were main side effects. There were no significant differences between stage IA and stage IB patients in terms of treatment parameters and duration of remission period.

Conclusions: Our study confirms that narrow-band UVB is effective for the management of the patch-stage MF without serious side effects. Extent of the skin lesions did not affect the efficacy of phototherapy. However, due to the short duration of remission, a further option such as an optimal maintenance therapy protocol should be considered.
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http://dx.doi.org/10.1111/phpp.12547DOI Listing
July 2020

The Spectrum of Underlying Causes of Iatrogenic Kaposi's Sarcoma in a Large Series: A Retrospective Study.

Indian J Dermatol 2019 Sep-Oct;64(5):392-399

Department of Dermatology and Venereology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.

Background: The frequency of clinicoepidemiological variants of Kaposi's sarcoma (KS) differs markedly throughout the world. The iatrogenic variant is mainly associated with the use of immunosuppressive therapy.

Aims: We aimed to investigate the distribution of KS variants in our practice and elucidate the underlying causes of iatrogenic KS.

Methods: Consecutive KS patients seen in a single tertiary center were grouped according to the tumor variants and iatrogenic KS patients were evaluated about associated conditions.

Results: Among 137 patients, classic variant was the most frequent presentation ( = 88), followed by iatrogenic ( = 37) variant. Among the iatrogenic group, ten were transplant recipients. In 16 iatrogenic KS patients, systemic corticosteroid was used, in four for myasthenia gravis (MG) and in three for rheumatoid arthritis. In three patients, KS developed under topical corticosteroid (TC) treatment. Among iatrogenic KS patients, ten of them had a second primary neoplasm and one had congenital immunodeficiency syndrome.

Conclusions: Our study revealed one of the highest rates for iatrogenic KS (27%) reported in the literature. Besides well-known causes, relatively frequent association with MG was remarkable. Usage of different forms of TCs was the cause of KS in a few cases.
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http://dx.doi.org/10.4103/ijd.IJD_217_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6749761PMC
September 2019

Lichen Sclerosus on the Sites of Striae Distensae and a Surgical Scar in a Patient with Coexistent Morphea.

Acta Dermatovenerol Croat 2019 Mar;27(1):44-46

Sevkiye Copur, MD, Department of Dermatology & Venereology, Istanbul University, Istanbul Medical Faculty , Millet Street (Caddesi), 34093 Capa , Istanbul, Turkey;

Lichen sclerosus (LS), also known as lichen sclerosus et atrophicus, is a chronic inflammatory mucocutaneous disease affecting the genital and/or extragenital areas. Although LS usually occurs alone, its coexistence in morphea patients has been reported in 5.7% and 38.0% (genital LS) of cases, in two series (1). A 74-year-old woman presented with a 6-month history of multiple asymptomatic, shiny , indurated, brownish large flat plaques located on the abdomen (Figure 1, a-b) and back, intermingled with slightly atrophic, white-colored, guttate, and patchy areas (Figure 1, d-e). Both punch biopsies of the sclerotic plaques on the back and abdomen showed findings consistent with morphea (Figure 1, c, f). Furthermore, the punch biopsy of a well-demarcated white plaque on the back revealed findings compatible with LS (Figure 1, f). Remarkably, there were also multiple white-colored lesions on the sites of pregnancy-induced striae distensae (SD) (Figure 2, a-b) on the lower abdomen and an old appendectomy scar (Figure 2, c). There was no anogenital involvement. A diagnosis of morphea-LS overlap was established and white lesions located on the surgical scar and SD were clinically evaluated as LS. Methotrexate (15 mg/week) achieved a partial regression of morphea plaques in three months. However, white LS lesions remained unchanged. Our patient presented with coexistence of LS and morphea on different sites of the trunk and on the same lesion. Additionally, one of the isolated LS lesions was located on a surgical scar. Occurrence of LS on skin grafts, irradiated areas, injection sites, or burn/surgical scars has been attributed to the Koebner phenomenon, also called isomorphic response, defined as "the formation of the skin lesions in the same morphology of the existing disease on the areas of various cutaneous injuries" (2). LS is classified under the Koebner category-III (occasional lesions) (2). However, in a case of morphea with features of LS that developed in 1 month following a herpes zoster infection has been suggested to represent "Wolf's isotopic response" (3), which was originally defined as "the occurrence of a new skin disease at the site of another, unrelated and already healed skin disorder" with a time interval between the first and second diseases ranging from months to several years (4). Remarkably, typical morphea plaques in our patient did not involve the surgical scar, in contrast to a cohort in which 16% of 329 patients developed initial morphea lesions at sites of prior (surgery) or ongoing/repetitive (chronic friction) skin trauma (5). SD appear on skin as atrophic linear bands mostly due to rapid weight changes, pregnancy, Cushing syndrome, or prolonged use of corticosteroids (6). The mechanism underlying the occurrence of several diseases on striae is still elusive. Blunt trauma occurring during the development of striae has been suggested to cause the Koebner phenomenon in patients with vitiligo, psoriasis, and lichen planus (7), but it has been suggested that the occurrence of leukemia cutis on SD in a patient reflects Wolf's isotopic response (8). Although chronic graft-versus-host disease, urticarial vasculitis, keloid, lupus erythematosus, diffuse normolipemic plane xanthoma, and drug-induced cutaneous eruptions have been reported to occur on striae (6,9), such an association with LS as in our patient has not been previously documented in the literature. Concomitant occurrence of LS patches on different previous lesions such as a surgical scar and SD in our patient raises the possibility of a common underlying mechanism. As mentioned above, the terms "Koebner phenomenon" or "Wolf's isotopic response" have been used to designate the development of some diseases in injured areas. However, Happle and Kluger (10) claimed in a recent statement that "there is no clear-cut criterion to distinguish isotopic response from Koebner phenomenon and all reactions of this kind represent examples of Koebner phenomenon", which seems to be the best way to describe the site-specific occurrence of LS lesions in our patient.
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March 2019

Complete healing of basal cell carcinoma under bendamustine and brentuximab vedotin therapy in a patient with cutaneous lymphoma.

Dermatol Ther 2019 07 29;32(4):e12934. Epub 2019 Apr 29.

Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.

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http://dx.doi.org/10.1111/dth.12934DOI Listing
July 2019

Verruciform xanthoma of the penis: A rare case with an unusual clinical morphology.

Indian J Dermatol Venereol Leprol 2018 Sep-Oct;84(5):600-602

Department of Pathology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.

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http://dx.doi.org/10.4103/ijdvl.IJDVL_733_17DOI Listing
August 2019

Periunguale pyogene Granulom-ähnliche Läsionen nach Gipsruhigstellung: Heilung durch symptomatische Therapie.

J Dtsch Dermatol Ges 2018 Jan;16(1):74-76

Department of Dermatology and Venereology, Fırat University Medical Faculty, Elazig, Türkei.

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http://dx.doi.org/10.1111/ddg.13352_gDOI Listing
January 2018

Darier disease-like hyperkeratotic papules and invasive squamous cell carcinoma in a patient with melanoma treated with dabrafenib.

Australas J Dermatol 2018 Aug 4;59(3):e231-e233. Epub 2018 Jan 4.

Department of Pathology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.

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http://dx.doi.org/10.1111/ajd.12776DOI Listing
August 2018

Periungual pyogenic granuloma-like lesions following plaster cast immobilization: a case managed with symptomatic therapy.

J Dtsch Dermatol Ges 2018 Jan 6;16(1):74-75. Epub 2017 Oct 6.

Department of Dermatology and Venereology, Fırat University Medical Faculty, Elazig, Turkey.

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http://dx.doi.org/10.1111/ddg.13352DOI Listing
January 2018

Evaluation of the umbilical sparing phenomenon of large congenital melanocytic nevi in a large case series.

Authors:
Can Baykal

J Dtsch Dermatol Ges 2017 Nov 17;15(11):1139-1141. Epub 2017 Jul 17.

Department of Dermatology and Venereology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.

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http://dx.doi.org/10.1111/ddg.13292DOI Listing
November 2017

The clinical spectrum of xanthomatous lesions of the eyelids.

Int J Dermatol 2017 Oct 13;56(10):981-992. Epub 2017 May 13.

Pathology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.

Yellowish papules, nodules, or plaques, namely "xanthomatous" lesions, may be seen on the eyelids in the course of various disorders. The prototype is "xanthelasma palpebrarum" (XP) that is localized only to the eyelids and may be associated with hyperlipidemia. On the other hand, different types of normolipemic disorders may also cause xanthomatous eyelid lesions. Among these, Langerhans cell histiocytosis, diffuse normolipemic xanthoma, and non-Langerhans cell histiocytoses (papular xanthoma, juvenile xanthogranuloma, xanthoma disseminatum, adult-onset xanthogranuloma, adult-onset asthma and periocular xanthogranuloma, necrobiotic xanthogranuloma, Erdheim-Chester disease, Rosai-Dorfman disease, and reticulohistiocytosis) can be listed. The eyelid findings of this heterogeneous group of disorders are challenging to differentiate from each other due to common clinical aspects that may even sometimes mimic XP. Nodularity, induration, ulceration, diffuse eyelid involvement, and extension from eyelids to the neighboring skin may represent the clinical features of xanthomatous lesions other than XP. It is necessary to obtain a thorough history and exclude XP and then perform detailed dermatological and systemic examination, biopsy for histopathologic confirmation, and appropriate specific imaging screens. As some of the conditions may be associated with other systemic disorders, especially malignancies, the differentiation of xanthomatous eyelid lesions has a critical importance, and clinical signs can be guiding.
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http://dx.doi.org/10.1111/ijd.13637DOI Listing
October 2017

Novel Clinical Observations on Benign Cephalic Histiocytosis in a Large Series.

Pediatr Dermatol 2017 Jul 3;34(4):392-397. Epub 2017 May 3.

Department of Dermatology and Venereology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.

Background/objectives: Benign cephalic histiocytosis (BCH) is a rare form of non-Langerhans cell histiocytosis in infants and young children characterized by self-healing macules and papules occurring primarily in the head and neck region. So far there have been nearly 60 reported cases in the English-language literature.

Methods: In this retrospective study, we evaluated clinical features and follow-up data of 11 patients diagnosed with BCH between 2004 and 2016 in the Department of Dermatovenereology, Istanbul Medical Faculty.

Results: There were 5 girls and 6 boys (median age 24 months, range 9-72 months). The median age at the onset of lesions was 8 months (range 3-36 months). The lesions first appeared on the face in 10 patients and on the trunk in 1. Proximal parts of the extremities and trunk were also involved in nine patients (81.8%). Patients were categorized into two groups based on their clinical features; five had 20 to 30 predominantly red-brown dome-shaped papules and six had 50 to hundreds of yellow-brown or predominantly pinkish brown flat papules. Four patients were lost to follow-up. In seven patients with a mean follow-up of 5 years, four had nearly complete resolution and three showed remarkable regression without treatment.

Conclusion: With 11 additional cases from a single center, BCH seems to be an underrecognized disease. Its clinical presentation is not uniform. Considering that most of the patients in this series and those previously reported had extracephalic involvement, the term "cephalic" needs to be reevaluated.
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http://dx.doi.org/10.1111/pde.13153DOI Listing
July 2017

The Characteristics and Long-Term Course of Epilepsy in Lipoid Proteinosis: A Spectrum From Mild to Severe Seizures in Relation to ECM1 Mutations.

Clin EEG Neurosci 2018 May 23;49(3):192-196. Epub 2017 Apr 23.

1 Departments of Neurology and Clinical Neurophysiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey.

Lipoid proteinosis (LP) is a rare autosomal recessive disease characterized by deposition of hyaline material in skin and mucosae. Epilepsy, as an extracutaneous manifestation associated with typical mesial temporal calcifications, has already been identified, but its characteristics and long-term prognosis have not been thoroughly investigated. We included 7 consecutive patients with LP with typical intracranial calcifications out of 16 patients with ECM1 mutations and investigated the semiologic features, ictal and interictal EEG findings, and long-term prognosis of epilepsy in this genodermatosis. Four of them had seizures (57.1%), and focal seizures with motionless staring were the most common seizure phenotype, originating from bilateral mesial temporal areas, but interictal spikes were scant. Auras were observed in three patients, mostly as epigastric sensation and déjà vu, which indicated mesial temporal lobe origin. Three patients with homozygous mutations in sixth and seventh exons of the ECM1 gene had a drug-resistant course at the end of long-term follow-up. Molecular genetic testing showed a rare compound heterozygous mutation in one patient, which was also associated with seizures but without drug-resistance. Our findings indicated a spectrum for epilepsy with a desperate drug-resistant course for decades in most patients with LP, which is still an underrecognized disease by neurologists.
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http://dx.doi.org/10.1177/1550059417705280DOI Listing
May 2018

Superficial cutaneous hemorrhagic lesions in three mycosis fungoides patients using acitretin.

Dermatol Ther 2017 Jul 31;30(4). Epub 2017 Mar 31.

Associate Professor of Dermatology and Venereology, Department of Dermatology and Venereology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.

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http://dx.doi.org/10.1111/dth.12482DOI Listing
July 2017

Vernachlässigte klinische Merkmale der follikulotropen Mycosis fungoides: eine große klinische Fallserie.

J Dtsch Dermatol Ges 2017 Mar;15(3):289-301

Department of Pathology, Istanbul Medical Faculty, Istanbul University, Istanbul, Türkei.

Hintergrund Und Ziel: Als seltene Form der Mycosis fungoides (MF), ist die follikulotrope MF (FMF) durch ein breites Spektrum klinischer Symptome gekennzeichnet. Dazu gehören, neben den vorherrschenden follikulären Läsionen, auch viele atypische Manifestationen. Das Ziel der vorliegenden Studie war eine klinische Bewertung von FMF-Patienten, unter besonderer Berücksichtigung von vernachlässigten dermatologischen Merkmalen.

Patienten Und Methodik: Insgesamt wurden 27 FMF-Patienten aus dem 572 Patienten umfassenden MF-Register unserer Abteilung retrospektiv bezüglich ihrer Demographie sowie der klinischen Merkmale, Behandlungsformen, Nachsorge und Therapieergebnisse bewertet.

Ergebnisse: Neben den bekannten klinischen Symptomen der FMF fanden wir Lichen-spinulosus-artige Läsionen mit begleitender Hypopigmentierung (n = 3) und Alopezie (n = 2), infiltrierte/erhabene, erythematöse Plaques im Gesicht, die zunächst als Lupus tumidus angesehen wurden (n = 2), pseudotumorale Läsionen, die klinisch eine MF im Tumorstadium vortäuschten (n = 1), dauerhafte Exkoriationen (n = 1), erythematöse, Rosazea-artige Papeln im Gesicht (n = 1) sowie kuppelförmige, asymptomatische, mit Muzin gefüllte (in der Histologie) Papeln/Knoten (n = 2), die andere krankheitsbedingte Läsionen überlagerten. Es kamen mehrere Therapieansätze mit unterschiedlichem Ergebnis zur Anwendung. Acht (29,6 %) Patienten hatten FMF im Spätstadium.

Schlussfolgerungen: Das Bewusstsein für vernachlässigte klinische Symptome kann wesentlich dazu beitragen, verspätete Diagnosen dieser aggressiven MF-Variante zu verringern.
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http://dx.doi.org/10.1111/ddg.12976_gDOI Listing
March 2017

Underrecognized clinical features of folliculotropic mycosis fungoides: a large clinical series.

J Dtsch Dermatol Ges 2017 Mar 27;15(3):289-299. Epub 2017 Feb 27.

Department of Pathology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.

Background And Objective: A rare variant of mycosis fungoides (MF), folliculotropic MF (FMF) is characterized by a broad clinical spectrum that primarily includes follicle-based lesions but also many atypical clinical manifestations. The objective of the present study was to conduct a clinical analysis of patients with FMF, with a particular focus on highlighting underrecognized dermatological features.

Patients And Methods: Overall, 27 FMF patients enrolled in our department';s MF registry, which includes 572 patients, were retrospectively reevaluated with regard to demographics, clinical features, treatment modalities, follow-up, and outcomes.

Results: Besides the well-known clinical features of FMF, we found lichen spinulosus-like lesions in association with hypopigmentation (n = 3) and alopecia (n = 2), infiltrated/elevated erythematous facial plaques initially considered to be lupus tumidus (n = 2), pseudotumoral lesions clinically mimicking tumor-stage MF (n = 1), persistent excoriations (n = 1) and erythematous facial papules mimicking rosacea (n = 1), as well as white dome-shaped asymptomatic papules/nodules filled with mucin (on histology) (n = 2) that overlay other disease-related lesions. Various therapeutic methods were used with variable results. Eight (29.6 %) patients had late-stage disease.

Conclusions: Awareness of underrecognized clinical manifestations may be key to reducing delayed diagnosis of this aggressive MF variant.
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http://dx.doi.org/10.1111/ddg.12976DOI Listing
March 2017

Lichen myxedematosus: eine Fallserie mit Schwerpunkt auf klinischen Merkmalen, Krankheitsassoziationen und Behandlung.

J Dtsch Dermatol Ges 2017 Feb;15(2):214-217

Department of Dermatology and Venereology, Istanbul Medical Faculty, Istanbul University.

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http://dx.doi.org/10.1111/ddg.12970_gDOI Listing
February 2017

Lichen myxedematosus: a case series focusing on clinical features, disease associations, and management.

J Dtsch Dermatol Ges 2017 Feb 13;15(2):215-218. Epub 2017 Jan 13.

Department of Dermatology and Venereology, Istanbul Medical Faculty, Istanbul University.

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http://dx.doi.org/10.1111/ddg.12970DOI Listing
February 2017

Epidermotropic skin involvement of splenic marginal zone B-cell lymphoma: a diagnostic challenge.

J Cutan Pathol 2017 Mar 23;44(3):312-314. Epub 2016 Dec 23.

Department of Pathology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.

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http://dx.doi.org/10.1111/cup.12862DOI Listing
March 2017

Annular Erythematous Patches as the Presenting Sign of Extranodal Natural Killer/T-Cell Lymphoma.

Turk J Haematol 2016 Dec 15;33(4):360-361. Epub 2016 Jul 15.

İstanbul University İstanbul Faculty of Medicine, Department of Dermatology and Venereology, İstanbul, Turkey, Phone: +90 212 635 29 39, E-mail:

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http://dx.doi.org/10.4274/tjh.2016.0071DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5204199PMC
December 2016

Unguales Plattenepithelkarzinom bei einem Patienten mit Mal de Meleda.

J Dtsch Dermatol Ges 2016 May;14(5):514-6

Department of Medical Genetics, Istanbul Medical Faculty, Istanbul University, Istanbul, Türkei.

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http://dx.doi.org/10.1111/ddg.12865_gDOI Listing
May 2016

Ungual squamous cell carcinoma in a patient with Mal de Meleda.

J Dtsch Dermatol Ges 2016 May;14(5):514-6

Department of Medical Genetics, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.

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http://dx.doi.org/10.1111/ddg.12865DOI Listing
May 2016

The Dilemma of Coexisting Nevoid Hyperkeratosis of the Nipple and Areola in Mycosis Fungoides: A Report of Three Cases.

Dermatopathology (Basel) 2015 Jul-Dec;2(3):61-6. Epub 2015 Nov 17.

Departments of Dermatology and Venereology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.

Nevoid hyperkeratosis of the nipple and areola (NHNA) is a rare clinicopathological entity showing persistent and strictly localized hyperkeratotic lesions of the nipple, areola or both with unknown etiopathogenesis. A similar clinical appearance may also be seen in different diseases with specific histopathological features. There are a few anecdotal reports on the association of NHNA with mycosis fungoides (MF), but they do not describe a uniform condition. In this report, we present 3 patients with hyperkeratotic lesions of the nipple and areola associated with MF but showing different histopathological features. We also review similar cases in the literature and discuss possibilities concerning this association. Two of our cases represent the association between MF and NHNA without histopathological features of MF on the nipple-areola complex. The other case represents hyperkeratosis of the nipple and areola with specific histological and immunohistochemical features of MF. Hence, we would like to hypothesize that MF may involve the nipple and areola and have an appearance similar to NHNA. Intriguingly, however, NHNA may occasionally also be seen in association with MF. However, this peculiar association requires further explanation.
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http://dx.doi.org/10.1159/000441618DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4816432PMC
April 2016

Pigment Loss in Patients with Large Congenital Melanocytic Nevi: Various Clinical Presentations Documented in a Large Series.

Pediatr Dermatol 2016 May 2;33(3):307-10. Epub 2016 Mar 2.

Department of Dermatology and Venereology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey.

Background/objectives: The association between vitiligo and congenital melanocytic nevi remains incompletely understood. The objective of this study was to investigate the frequency of depigmentation, including vitiligo, in patients with a large congenital melanocytic nevus (LCMN), which is a rare melanocytic tumor variant.

Methods: We retrospectively reviewed the files of 92 patients with an LCMN, including photographic documentation regarding the presence of pigment loss on the nevus mass, around the nevus, around the satellites, and elsewhere on the body.

Results: Depigmentation was observed in 8 (8.7%) of 92 patients with an LCMN. Depigmented areas within the main nevus mass were observed in six patients, and adjacent or remote vitiligo was observed in four patients. One patient also demonstrated halo depigmentation around some satellite nevi.

Conclusion: The coexistence of an LCMN with vitiligo does not appear to be rare and may occur with a spectrum of clinical presentations.
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http://dx.doi.org/10.1111/pde.12823DOI Listing
May 2016

Linear syringocystadenoma papilliferum on the retroauricular area associated with nevus sebaceus.

Dermatol Online J 2016 Nov 15;22(11). Epub 2016 Nov 15.

Specialist of Dermatology and Venereology, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey.

Syringocystadenoma papilliferum is a rare cutaneous adnexal tumor that usually arises in the head and neck region. It may develop de novo or within a nevus sebaceus. Linear syringocystadenoma papilliferum is an uncommon variant of this benign tumor. We report a child with linear retroauricular distribution of syringocystadenoma papilliferum. A background nevus sebaceus was shown histologically. Total excision was curative with no recurrence. An association between the linear variant of syringocystadenoma papilliferum and nevus sebaceus has not been reported previously.
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November 2016

Large Congenital Melanocytic Nevus on the Breast Sparing the Nipple and Areola.

Pediatr Dermatol 2015 Jul-Aug;32(4):514-7. Epub 2015 May 4.

Department of Dermatology and Venereology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.

Background: Divided nevus is a rare entity that has been described for a special appearance of congenital melanocytic nevi (CMNs) occurring on the eyelid and penis. It is presumed that the formation of divided nevi is related with the embryologic development of the eyelid and penis, thus giving a hint about the occurrence time of CMN in utero. This article focuses on a formerly undescribed observation of another special clinical appearance of CMN discussing possible relation with embryogenesis.

Methods: The data including photographic documentations of a total number of 86 patients with large CMN seen in a single center were reviewed according to the involvement of the nipple and areola by the main mass of the nevus and associated satellite lesions.

Results: Eight patients presented with CMNs involving one (n=6) or both (n=2) breast region. In all of them, CMN surrounded the nipple-areola complex without involving these structures. Furthermore, satellite nevi have not been observed on the nipple and areola in any of the 86 patients.

Conclusion: We presume that different developmental time periods of the breast and the nipple-areola complex and the occurrence of the melanocytic lesion before the embryologic development of nipple-areola complex could explain our observation of CMN sparing the nipple-areola complex. The term "nipple-sparing nevus of the breast" is suggested for this special clinical appearance of CMN.
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http://dx.doi.org/10.1111/pde.12610DOI Listing
April 2016

Osteoporosis and osteopathy markers in patients with mastocytosis.

Turk J Haematol 2015 Mar;32(1):43-50

İstanbul University İstanbul Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, İstanbul, Turkey. E-mail:

Objective: Osteoporosis, osteosclerosis, and lytic bone lesions have been observed in patients with systemic mastocytosis (SM). We examined bone mineral density (BMD) biochemical turnover markers and serum tryptase levels in SM, which is considered a rare disease.

Materials And Methods: Seventeen adult patients (5 females, 12 males; median age: 33 years, range: 20-64) with mastocytosis were included in this study. We investigated the value of quantitative ultrasound (QUS) of the calcaneus in the assessment of BMD in SM patients, as well as BMD of the lumbar spine (L1-L4), femoral neck, and distal radius using dual energy x-ray absorptiometry (DXA) and plasma tryptase levels, biochemical markers of bone turnover.

Results: At lumbar spine L1-L4, the femoral neck, and the distal radius or as calcaneus stiffness, 12 of 17 patients had T-scores of less than -1 at least at 1 site, reflecting osteopenia. Three of 17 patients had T-scores showing osteoporosis (T-score <-2.5). There was no relationship between DXA and bone lesion severity. We also found a significant positive correlation between tryptase levels and disease severity, as well as between disease severity and pyridinoline (p<0.01 by Spearman's test).

Conclusion: DXA and calcaneal QUS may not be appropriate techniques to assess bone involvement in SM patients because of the effects of osteosclerosis. This study further shows that the osteoclastic marker pyridinoline is helpful in patients with severe disease activity and sclerotic bone lesions to show bone demineralization.
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http://dx.doi.org/10.4274/tjh.2013.0170DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4439906PMC
March 2015

Two Clinically Unusual Cases of Folliculotropic Mycosis Fungoides: One with and the Other without Syringotropism.

Ann Dermatol 2014 Jun 12;26(3):385-91. Epub 2014 Jun 12.

Department of Pathology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.

Mycosis fungoides is the most common form of cutaneous T-cell lymphoma, and it rarely exhibits predilection for hair follicle and eccrine gland infiltration. Here, we present 2 similar cases that display folliculotropism with varying amounts of follicular mucinosis, with and without syringotropism. The features observed in both cases were cystic, comedo-like, acneiform lesions; generalized involvement with loss of body hair; pruritus; and hidradenitis suppurativa-like lesions. Hypohidrosis as well as nail and palmoplantar involvement with lichen planopilaris-like clinical features were unique characteristics of the first case. Despite the well-known aggressive behavior of follicular mycosis fungoides, the presented cases had a subtle, slowly progressive, but persistent, clinical course. Folliculotropic and syringotropic mycosis fungoides are variants of cutaneous T-cell lymphoma. Clinical presentations might be challenging, and multiple, deep biopsy specimens containing adnexal structures are required for this critical diagnosis. Aggressive treatment may not be necessary in cases having an indolent course, especially in those with syringotropism.
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http://dx.doi.org/10.5021/ad.2014.26.3.385DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4069652PMC
June 2014

Osteoma cutis.

Pediatr Int 2013 Apr;55(2):257-8

Pediatric Endocrinology Unit, Department of Pediatrics, Istanbul University, Istanbul, Turkey.

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http://dx.doi.org/10.1111/ped.12062DOI Listing
April 2013