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Öğe Assessment of change in neutrophil-lymphocyte ratio, platelet-lymphocyteratio in patients with acute and chronic urticaria(2018) Sarac, Gulbahar; Mantar, İrem; Sener, Serpil; Cenk, Hülya; Kapicioglu, YeldaAim: Urticaria is a skin disease characterized by erythematous, oedematous, itchy,and spontaneously disappearing urticaria lesions. One of the most common skin diseases, it is the most common reason underlying the presentations to emergency departments. Our objective is to investigate the role of systemic inflammation in urticaria pathogenesis by measuring the indicators of NeutrophilLymphocyte ratio (NLR) and Platelet-Lymphocyte ratio (PLR) in routine hemograms in patients with acute and chronic urticaria. Material and Methods: Of patients visiting the Dermatology Policlinic of İnönü University Medical School Hospital between July 2017 and February 2018, 69 patients diagnosed with acute urticaria and 188 patients diagnosed with chronic urticaria as well as 90 healthy people taken as controls with an age range of 18to 70 were included in our study. Blood values of patients were studied retrospectively. (For the study, a Research Ethics Approval was obtained from Malatya Research Ethics Board.) Results: No significant difference was detected among the study groups in terms of demographic properties. Whereas a significant difference was noted among the three groups with regard to NLR values, no statistically significant difference was detected among the groups with respect to PLR values. No statistically significant difference was observed between the group of patients with urticaria and the control group in terms of erythrocyte distribution(p:0.01). On the other hand, when the patient group with chronic urticaria was divided into two subgroups as patients with a complaint duration of 90 days and less, and those with a complaint duration of more than 90 days and evaluated, no statistically significant difference was detected between these groups in terms of RDW, lymphocytes, neutrophils, platelets, NLR and PLR values Conclusion: In our study, we have determined that systemic inflammation has increased in the group of patients with urticaria as compared to the control group. What’s more interesting in this study is our conclusion that the pathways involved in continued inflammation do not change by time in chronic urticaria.Öğe Autologous mesenteric vein and peritoneum for repair of portal vein and hepatic artery injuries accompanying bile duct injury following laparoscopic cholecystectomy(2018) Kapıcıoğlu, Yelda; Cenk, Hülya; Şener, Serpil; Mantar, İrem; Saraç, GülbaharAbstract: Biliary tract injuries are still the most hazardous complications of laparoscopic cholecystectomy. Concomi-tant vascular injuries make them further more complicated and complex surgical interventions including autologous grafting can be required. We presented a 32-year-old female referred us with combined bile duct, portal vein and hepatic artery injuries occurred during laparascopic surgery. The repairs of hepatic artery and portal vein were achieved by autologous inferior mesenteric vein and peritoneum grafts, respectively. Bile duct reconstruction was done by Roux-en-Y hepaticojejunostomy. Postoperative course was unevent-ful and she was asymptomatic following 16 months follow-up. Autologous vein and peritoneal grafts can be used for repair of vascular injuries of laparascopic cholecystectomy.Öğe Bullous dermatosis in the southeastern of Turkey: A study of125 cases(2022) Mantar, Irem; Saraç, Gülbahar; Karatoprak, Hacer Vural; Cenk, HülyaAim: Autoimmune bullous diseases occur when antibodies against proteins such as desmosomes and hemidesmosomes cause separation in the skin. Detailed epidemiological studies examining these diseases are limited in our country. We aim to contribute to the demographic, clinical, and treatment data on bullous diseases from an important geographic region of our country. Materials and Methods: The data of 125 cases who were followed up with a diagnosis of bullous disease between 2006 and 2019 were evaluated retrospectively. Socio-demographic characteristics, diagnoses, age and duration of disease onset, clinical findings, accompanying systemic diseases, treatments given, and side effects related to treatment were recorded. Results: 57.6% of the patients (72 people) were diagnosed as pemphigus, 31.2% (39 people) bullous pemphigoid (BP), 8% (10 people) dermatitis herpetiformis (DH), 3.2% (4 people) linear Ig A dermatosis ( LAD). BP patients were found to be significantly older than the other patients (p = 0.002). While pemphigus, BP, and LAD were more common in women, 70% of DH patients were men. Malignancy was detected in 2.8% of pemphigus patients and 5.1% of BP patients. Accompanying autoimmune disease was found in 9.7% of pemphigus patients, 17.9% of BP patients, and 20% of DH patients. The only systemic steroid was used in 20.8% of pemphigus patients, and azathioprine as a conventional agent was used in 76.4% with systemic steroid. Rituximab was started in patients who did not respond to therapy. The systemic steroid was used in 35.9% of BP patients, and azathioprine with systemic steroid was used in 43.6% of BP patients. Doxycycline was added to the treatment in 41% of the patients. Rituximab was used in 5 (12.8%) patients. Conclusion: Since our study is the first data obtained on bullous diseases from the southeastern Anatolia region, it is useful for the literature in terms of providing a basis for future studies. İremÖğe A case with pyoderma gangrenosum, after an abdominal surgery(2019) Saraç, Gülbahar; Mantar, Irem; Cenk, Hülya; Sarac, MehmetAbstract: Pyoderma gangrenosum (PG) is a pathergy positive, ulcerative neutrophilic dermatosis. Pathergy phenomenon is described as a sterile pustule and an ulcer development after minor skin traumas like a bump or bruise, or needlestick injury. In the literature, there are PG cases associated with the pathergy phenomenon on the post-surgical scar tissue. It presents as a necrotic and an ulcerative lesion clinically and, debridement is performed mostly with wrong pre-diagnoses. Debridement makes the lesion get wider and the morbidity increase. There are some PG case reports in the literature which were ended up with amputation due to debridement of a lesion which was an overlooked PG. Herein, we present a case with a giant abdominal pyoderma gangrenosum developed after a surgery in the abdominal drainage site and has reached to 30 cm size after debridement.Öğe Complication of lichen sclerosus(2017) Cenk, Hülya; Özcan, Hamdi; Şahin, NurhanAbstract: Liken sklerozus; daha çok genital alanda ve kadınlarda görülen, sebebi tam olarak bilinmeyen, kronik, inflamatuar, mukokütanöz bir hastalıktır. Asemptomatik seyredebileceği gibi, kaşıntı, skar ve malignite gelişimi gibi durumlara yol açabilir. Tanı klinik olarak konur, fakat bazı durumlarda biyopsi almak gerekebilir. Biyopside; beklenen tipik bulguların yanında, hücresel atipisi olan hastalar skuamöz hücreli karsinom (SCC) gelişimi açısından riskli kabul edilirler. Burada sunulan 49 yaşında bir kadın hastada uzun süren inatçı genital kaşıntı ve sonrasında o bölgede gelişen tümoral oluşum nedeni ile alınan biyopsi sonucunda SCC tespit edilmiştir. Liken sklerozus zemininde gelişebilecek maligniteler açısından geç kalmamak ve daha dikkatli olabilmek açısından vakanın paylaşılması uygun görülmüştürÖğe A milia en plaque case(Cukurova unıv, fac medıcıne, yayın ve dokumentasyon kurulu, balcalı, adana, 01330, turkey, 2018) Cenk, Hülya; Sarac, Gülbahar; Şahin, NurhanÖğe Sistemik isotretinoin kullanan akne hastalarında kontakt dermatit gelişim riski(İnönü Üniversitesi, 2017) Cenk, HülyaAmaç: Sistemik isotretinoin, 13-cis retinoik asit (13-cRA), şiddetli akne tedavisinde etkili ve güvenli bir tedavidir. Ancak aynı zamanda, azalmış sebum sekresyonu ve epidermal bariyerde bozulma gibi kutanöz yan etkilerin yanında T hücre aktivitesini ve epidermal Langerhans hücrelerinde antijen sunma kapasitesini artırıcı etkilere sahiptir. Epidermal bariyer ve immünolojik durum, hem allerjik hem de irritan kontakt dermatit gelişimi için önemlidir. Bu bilgiler ışığında, çalışmamızda, 13-cRA tedavisi alan akne hastalarındaki sensitizasyon ve irritasyon riskini araştırmak amaçlanmıştır. Materyal ve metot: Çalışmaya 65 şiddetli ya da dirençli akne hastası dâhil edildi. 13-cRA ile tedavi öncesi ve tedavinin 3. ayının sonunda uygulanan Avrupa standart yama testi değerlendirmelerinde görülen sensitizasyon ve irritasyon reaksiyonları kaydedildi. Bulgular: Yama testi sonuçlarında yeni gelişen sensitizasyon ve irritasyon reaksiyonları tespit edildi. Birinci ve ikinci yama testi sonuçları karşılaştırıldığında; irritasyon oranları arasında istatistiksel olarak anlamlı bir fark saptanmazken, ikinci testte saptanan sensitizasyon yüzdesi (%43.1), ilk test sonucuna göre (%27.7) anlamlı bir şekilde yükselme gösterdi (p: 0.002). Sonuç: Bu çalışma, 13-cRA tedavisinden sonra, bazı allerjenlere karşı duyarlılığın arttığını göstermiştir. Bu durum; daha fazla antijen penetrasyonuna sebep olan bozulmuş deri bariyeri ve / veya tedaviye bağlı antijen sunma aktivitesi artan Langerhans hücreleri üzerinden daha belirgin bir immün yanıt gelişmiş olması ile açıklanabilir. Çalışmamızdaki hasta sayısı az olmakla birlikte, 13-cRA'nın duyarlandrıcı etkisi olabileceğinden, 13-cRA tedavisi sırasında artmış kontakt dermatit riski göz önünde bulundurulmalıdır ve bu konuda daha ileri çalışmalara ihtiyaç vardır.Öğe Tinea inkognito: Olgu serisi(Türkderm-Deri Hastalıkları ve Frengi Arşivi, 2015) Yılmaz, Mikail; Kapıcıoğlu, Yelda; Şener, Serpil; Cenk, Hülya; Polat, Ayşegül; Yaşar, DeryaÖz: Tinea inkognito, topikal veya sistemik steroidlerin uygunsuz kullanımı sonucu tipik dermatofit kliniğinden uzaklaşan dermatofit enfeksiyonudur. Tinea inkognito klinik görünüm olarak egzema, psoriasis, alerjik kontakt dermatit, rozasea, seboreik dermatit, atopik dermatit gibi birçok dermatozu taklit edebilmektedir. Tinea inkognito tanısı, lezyondan direkt KOH (potasyum hidroksit) incelemesi (nativ preperatı), lezyondan mantar kültürü yapılması ve bazı olgularda histopatolojik inceleme ile konulur. Tinea inkognito tedavisinde sistemik antifungal tedavi önerilmektedir. Burada, kliniğimizde 2014 yılı içinde çeşitli dermatozları taklit eden tinea inkognito tanısı almış ve tedavi edilmiş 10 olgu sunulmaktadır
