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Öğe Association Between Initial Findings Leading to Behcet's Disease Diagnosis and Further Organ Involvements(Wolters Kluwer Medknow Publications, 2022) Yanatma, Irem; Sarac, Gulbahar; Cenk, Hulya; Arslan, Selami; Durmaz, Imge; Ay, GoncaObjectives: Studies show that the symptoms are clustered in certain ways in Behcet's disease (BD), which causes involvement of multiple organs. We aimed to investigate the association between clinical findings at onset and further organ involvements, which may occur during follow-up. Materials and Methods: A total of 363 patients diagnosed with BD in accordance with the International Criteria for BD (ICBD) between 2003 and 2019 at the Inonu University were included in the study, and all the first findings were compared with further organ involvements. Results: A statistical significance was detected between erythema nodosum like lesions and both pulmonary (P = 0.002) and vascular (P = 0.022) involvements. The frequency of neurological involvement was higher in patients with papulopustular/pseudo-follicular lesions (P = 0.043). Gastrointestinal involvement was detected in 33.3% of the patients with herpetiform aphthae. The frequency of ocular involvement was significantly higher in patients with a negative pathergy test result (P = 0.013). Conclusion: The clinical clusters in BD may provide a predictive value about the disease course for clinicians. Although it has been shown that there is an association between some clinical findings and involvements which are mentioned before, this is one of the most comprehensive studies according to us. The clinical clusters in BD may provide a predictive value about the disease course for clinicians. Although it has been shown that there is an association between some clinical findings and involvements in the literature, this is one of the most comprehensive studies as far as we know.Öğe Dermatological signs in liver transplant recipients(Wiley, 2021) Sarac, Gulbahar; Ozcan, Kubra Nur; Baskiran, Adil; Cenk, Hulya; Sarac, Mehmet; Sener, Serpil; Yilmaz, SezaiBackground In recent years, the number of liver transplantations for advanced-stage liver diseases has considerably increased and the patients have a wide range of dermatologic manifestations. Aim This study aims to reveal cutaneous, mucosal, and nail lesions in liver transplant recipients in quite large patient series. Patients/Methods The study included 520 patients in the Inonu University Liver Transplantation Institute. New and followed-up patients attended to the study between May and October 2019. The patients were examined by a dermatologist, and their data were recorded. Results The study included 163 female and 357 male patients with the main age of 44.20 +/- 18.18 (range: 1-83 years), and 465 livers (89.4%) were taken from live donors, while 54 livers (10.4%) were taken from cadavers. A total of 314 (60.4%) patients had dermatophyte infections, 174 (33.4%) patients had pathological nail changes, and 427 (82.1%) patients had oral mucosal lesions. Graft-versus-host disease (GVHD) developed in 9 (1.73%) patients after the transplantation, and 5 patients died of GVHD. Four patients had cutaneous malignancies. Conclusions Tumoral and nontumoral dermatological diseases may be encountered following the transplantation depending on underlying liver disease, immunosuppressive treatment, the graft itself, or any primary cutaneous disease. Liver transplantation recipients require a multidisciplinary clinical approach, and dermatological care must be an integral part of this approach.Öğe Effectiveness and safety of 2940-nmmultifractional Er:YAGlaser on acne scars(Wiley, 2020) Cenk, Hulya; Sarac, GulbaharErbium: Yttrium-aluminum-garnet laser (Er: YAG) treatment has been used in resurfacing the acne scars for a long time; however, we could not find any study reporting the recovery rates after each session of the treatment. In this study, we aimed to report the improvement rates after each session. We retrospectively analyzed the data of 35 patients with acne scars treated with fractional ablative Er: YAG laser. The patients received one to four sessions of treatment with 4-week intervals and improvement rates were recorded after each session. Data are available on request from the authors. The improvement rate of the lesions varied between 1% and 25% in 34 patients at the end of the first session, while in one patient, the improvement rate was detected as 26% to 50%. At the end of the fourth session, the rate of improvement was 26% to 50% in 14 out of 24 patients and 51% to 75% in 10 patients. None of the patients showed a 76% to 100% improvement at the end of the fourth session, whereas 48.6% of the patients were satisfied with the treatment. In patients with a high expectation of an excellent improvement, a higher number of sessions of the laser treatment and/or combination treatments with different treatment methods should be planned.Öğe Efficacy of 2940 nm Multifractional Er: YAG Lasers in Self-inflicted Razor Blade Incision Scars(Wiley, 2022) Cenk, Hulya; Sarac, GulbaharBackground Deliberate self-harm (DSH) can be defined as self-inflicted injury without an intention to suicide, and it may result in scar formation with a particular shape. Aims There is no treatment algorithm for DSH scars, nor is there a gold standard for the treatment of hypertrophic scars. Therefore, we aimed to share our experience with Er: YAG laser treatment of self-inflicted razor blade incision scars. Patients/Methods The study involved 18 patients with DSH scars treated with fractional ablative Er: YAG laser (MCL 31 Asclepion laser Technologies) between 2017 and 2020, with the parameters of 40 J/cm(2), 300 mu s, and 4 Hz. The sessions were repeated by increasing 10 joules in every session with 4-week intervals until reaching a maximum of 80 joules. The patients were evaluated retrospectively by two different dermatologists in terms of scar improvement over digital photographs taken before and 4 weeks after the treatment. Evaluations have been made based on a 4-point score (0:no change, 1:1%-25% mild, 2:26%-50% moderate, 3:51%-75% well, and 4:76%-100% excellent improvement). Results After the third session, 90.9% of the patients showed a moderate improvement. After the fourth session, only 27.2% of the patients had a good, and 63.2% of the patients had a moderate improvement rate. Conclusions Er: YAG laser is a safe and effective treatment method for the hypertrophic scars induced by razor blades. Also, we believe that combined treatments with other treatment modalities will provide better results in DSH scars.Öğe An evaluation of the efficacy of a single-session 577 nm pro-yellow laser treatment in patients with postacne erythema and scarring(Wiley, 2021) Sarac, Gulbahar; Kapicioglu, Yelda; Cenk, HulyaErythema and scarring are among the most common complications of severe inflammatory acne. In this study, we aimed to share our experience with pro-yellow laser and document the efficacy and safety of this treatment in postacne erythema and scarring. The study included 40 patients, 24 (60%) females, and 16 (40%) males with a mean age of 29.5 +/- 8.16 (min. 18 years, max. 57 years). The pro-yellow laser was applied to all patients as a single session with irradiation of 22 J/cm(2). Improvement in postacne erythema and scars were evaluated after the treatment. The study included 40 patients, 24 patients (60%) were females and 16 patients (40%) were males with the mean age of 29.5 +/- 8.16 (ranged between 18 and 57 years old). A total of 21 patients (52.5%) had good improvement (51%-75% regression), 10 patients (25%) had excellent improvement (76%-100% regression), and a moderate improvement (26%-50%) was detected in 9 patients (22.5%). Also, there were mild improvement (1%-25%) in 20 patients (76.9%) and a moderate improvement (26%-50%) in 6 patients (23.1%). We found that pro-yellow laser is highly effective in the treatment of postacne erythema, while its effectiveness was mild to moderate in atrophic acne scars. Also, it has been observed that the pro-yellow laser system can be used safely immediately after cessation of systemic isotretinoin treatment.Öğe Increased frequency of Demodex blepharitis in rosacea and facial demodicosis patients(Wiley, 2020) Sarac, Gulbahar; Cankaya, Cem; Ozcan, Kubra Nur; Cenk, Hulya; Kapicioglu, Yelda KarincaogluBackground Rosacea is an inflammatory disease with 50% of ocular involvement rate. Primary demodicosis is an eruption caused by Demodex mites, and there is no data about the rate of ocular involvement in primary demodicosis. Aims In this cross-sectional study, it is aimed to reveal the frequency of Demodex blepharitis in rosacea and primary demodicosis patients. Methods In total, 58 rosacea, 33 primary demodicosis patients, and 31 healthy volunteers were included in the study. Four samples were obtained from eyelashes with a forceps and from facial skin by standardized skin surface biopsy. A positive result is described as detecting at least one Demodex mite on an eyelash or at five mites in the face. The patients were also examined by an ophthalmologist in terms of ocular involvement. Results Both rosacea and primary demodicosis patients had significantly more complaints like burning and stinging in the eyes compared to the control patients (P = .001). Primary demodicosis and papulopustular rosacea patients had the highest numbers of eyelash mites, respectively, and significantly a higher rate of blepharitis than the control group. Conclusion As a result, the Demodex count was significantly higher in the primary demodicosis and rosacea patients than the control group. We think that every Demodex-positive patients should be evaluated for also eyelash mites to prevent a possible chronic blepharitis.Öğe Inguinal Papule with a Milky Secretion(Karger, 2021) Cenk, Hulya; Uner, Meral; Sarac, Gulbahar[Abstract Not Available]Öğe Management of complications of vitamin e injections into the face(Wıley, 111 rıver st, hoboken 07030-5774, nj usa, 2018) Sarac, Gulbahar; Kapicioglu, Yelda; Sener, Serpil; Cenk, Hulya; Akatli, AysenurÖğe Management of complications of vitamin E injections into the face(Wiley, 2018) Sarac, Gulbahar; Kapicioglu, Yelda; Sener, Serpil; Cenk, Hulya; Akatli, Aysenur[Abstract Not Available]Öğe A milia en plaque case(Cukurova Univ, Fac Medicine, 2018) Cenk, Hulya; Sarac, Gulbahar; Sahin, Nurhan[Abstract Not Available]Öğe A new treatment option for poikiloderma of Civatte: 577 nm pro-yellow laser(Wiley, 2022) Sarac, Gulbahar; Kapicioglu, Yelda; Cenk, HulyaBackground Although many laser systems have been used in the treatment for Poikiloderma of Civatte (POC), there is no standard treatment guideline. Objectives We aimed to present our data on the efficacy and safety of single-session pro-yellow laser treatment for POC. Methods The study included 14 patients treated with pro-yellow laser (QuadroStarPRO YELLOW(R) Asclepion Laser Technologies, Germany) between 2017 and 2019. Treatment had been applied in two passes during the same session; a general pass with 22 j/cm(2) over the whole lesion, then, one more pass only on the telangiectatic lesions with 18 j/cm(2) fluence. They were evaluated based on their pictures taken before and 4 weeks after the treatment and scored by a 4-item scoring in terms of the improvement (0:no change, 1:1%-25% mild, 2:26%-50% moderate, 3:51%-75% well, and 4:76%-100% excellent improvement). Results The mean age of the patients (1 female, 13 males) was 59.64 +/- 8.16 years. Five patients had Fitzpatrick-2 and 9 patients had Fitzpatrick-3 skin types. Six patients had mild, 8 patients had moderate improvement, one of them has been illustrated in Figure 1. Sixty-minute mild erythema was the only adverse effect observed. Conclusions We think that pro-yellow laser is a good treatment option for POC treatment. Repeated sessions are required for the complete healing of the lesions, while one single session has proved to be deficient. We observed that it was a quite safe treatment option, especially for the neck region, which was inclined to scarring and atrophy development.Öğe Psychiatric morbidity in children and adolescents with dermatological disorders(Exeley Inc, 2021) Miniksar, Dilsad Yildiz; Ozcan, Ozlem Ozel; Cenk, Hulya; Kapicioglu, Yelda; Polat, AysegulBackground: Understanding the existence of a cycle, where psychological disturbances cause skin diseases and in turn, skin diseases cause psychological disorders, provides the basis for good dermatological practice. Objective: The aim of this case-control study is to examine the psychiatric morbidity of dermatological disorders in children and adolescents with no history of psychiatric disorders. Method: In this study, 502 participants (251 patients and 251 healthy individuals) were evaluated according to DSM-IV criteria. All participants were interviewed and evaluated using the Turkish version of the Kiddie Schedule for Affective Disorders and Schizophrenia -Present and Lifetime Version (K-SADS-PL) and the State-Trait Anxiety Inventory for Children (STAI-1 and STAI-2), the Childhood Depression Inventory (CDI), adolescent and parent forms of the Strengths and Difficulties Questionnaire (SDQ-A and SDQ-P) and a questionnaire evaluating child's level of school success. Results: Our results indicated that the rates of general psychiatric comorbidity, mood disorders, anxiety disorders, and adjustment disorders were significantly higher in the study group compared to the control group. The CDI, STAI-1, STAI-2, and SDQ (and subscales) scores were significantly higher in the study group. Moreover, psychiatric comorbidity was higher in inflammatory and allergic dermatoses compared to other dermatological subgroups. Having a dermatological disease restricts physical activity thus increasing the risk of psychiatric comorbidity. Conclusions: Investigating the education, attitudes, and awareness of dermatologists about psychocutaneous disorders might contribute to the development of new educational strategies and elicit appropriate biopsychosocial approaches.Öğe Tinea incognito: Case series(Deri Zuhrevi Hastaliklar Dernegi, 2015) Yilmaz, Mikail; Kapicioglu, Yelda; Sener, Serpil; Cenk, Hulya; Polat, Aysegul; Yasar, DeryaTinea incognito is a dermatophytic infection which has lost its typical clinical appearance because of inappropriate use of topical or systemic corticosteroids. The clinical manifestations of tinea incognito can mimic many dermatoses such as eczema, psoriasis, allergic contact dermatitis, rosacea, seborrheic dermatitis and atopic dermatitis. The diagnosis of tinea incognito is confirmed by direct KOH (potassium hydroxide) examination (native preparation), making the fungal cultures from the lesion and histopathological examination in some cases. Systemic antifungal therapy is recommended in the treatment of tinea incognito. Herein, 10 cases of tinea incognito which mimicking various dermatoses were diagnosed and treated in our clinic in 2014 is presented.Öğe Toxic epidermal necrolysis due to concomitant use of valproic asid and lamotrigine(Deri Zuhrevi Hastaliklar Dernegi, 2015) Ozcan, Hamdi; Cenk, Hulya; Cumurcu, BirgulToxic epidermal necrolysis (TEN) is a rare but life-threatening acute mucacutaneous hypersensitivity reaction, usually related to medications. Concomitant use of lamotrigine and valproic acid can cause this serious reaction. A 36-year-old male was admitted to the emergency department with the complaints of high fever, burning sensation at eyes, oral and genital mucous erosions, generalized rush and weakness. He had been taking valproic asid, olanzapine, and sertraline for bipolar affective disorder. Lamotrigine 25 mg/day treatment was added to his treatment protocol 15 days before the rush and lamotgine dose was increased 50 mg/day 10 days later. The patient was diagnosed with TEN caused by concomitant use of valproic acid and lamotrigine. The patient was followed up and treated at the burn unit with intravenous immunoglobulin, corticosteroid and antibiotics. Concomitant use of valproic acid and lamotrigine increases the frequency of adverse reaction. TEN may cause serious complications and death. Patients with TEN should be followed by a multi-disciplinary team. Early determination of complications and suitable management can increase the odds for survival.Öğe Treatment of erythematotelangiectatic rosacea, facial erythema, and facial telangiectasia with a 577-nm pro-yellow laser: a case series(Springer London Ltd, 2019) Kapicioglu, Yelda; Sarac, Gulbahar; Cenk, HulyaVarious lasers have been used for the treatment of erythematotelangiectatic rosacea (ETR), facial erythema (FE), and facial telangiectasias (FT). The assessment of the treatments of all of these conditions with a 577-nm pro-yellow laser has not been reported yet. The aim of this work was to assess the efficacy and safety of the 577-nm pro-yellow laser in ETR, FE, and FT. Forty patients suffering from ETR, FE, and FT (25 female and 15 male) were enrolled in this study. All of the patients were treated with 577-nm pro-yellow laser (QuadroStarPRO YELLOW (R) Asclepion Laser Technologies, Germany) at 4-week intervals, for one to four sessions. The assessment of the treatment was made based on the digital photographs and the percentage of fading of the erythema and telangiectasias in the lesions. Significant clinical improvement (80-100%) was observed in the first or second sessions of the treatment in FE and ETR patients and in second and fourth sessions of the treatment in FT patients. The treatment was very well tolerated. No side effect was observed except for a few patients who had mild to moderate erythema fading away in 12-24h. This case series has shown that the pro-yellow laser is a very effective, safe, and well-tolerated treatment for ETR, FE, and FT.
