Browsing by Author "Alpsoy, Erkan"
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Article Clinical Features and Natural Course of Hidradenitis Suppurativa in Turkey: a Multicenter Study(Karger, 2024) Alpsoy, Erkan; Karaman, Bilge Fettahlioglu; Demirseren, Duriye Deniz; Cinar, S. Levent; Kacar, Nida; Ermertcan, Aylin Turel; Bilgic, AsliIntroduction:The natural history, the progression of a diseaseprocess in an individual over time, has not yet been fully elu-cidated in hidradenitis suppurativa (HS). In this large multicenterstudy, we aimed to investigate the natural history of HS and itsgender differences.Methods:This cross-sectional study in-cluded 827 patients. The chronological order of the clinicalmanifestations for each patientwas recorded retrospectively.Sociodemographic characteristics, triggering factors, clinical,treatment, and prognostic features were also evaluated.Results:The mean age of disease onset was significantly younger inwomen than in men (22.42 +/- 9.28 vs. 27.06 +/- 20.56,p<0.001)and those with a family history (p<0.0001). The mean diseaseduration was 91.17 +/- 83.64 months. The most commonsymptom was purulent discharge (81%). The mean duration ofabscess was shorter in women than in men (3.11 +/- 2.65 vs.3.75 +/- 3.75,p= 0.01). The axilla was the most common onsetarea followed by the inguinal and gluteal regions. The diseaseran a more severe course in men. Abscess/inflammatory nodulewas defined in the last 6 months in 88.6% of the patients;however, thefirst 5 years of the disease were the most activedisease period in 67.5% of the patients. Multivariate analysisrevealed being male, older age, family history, involvement ofthe axillary, inguinal, and perianal regions independently as-sociated with HS severity. While antibiotic use was the mostimportant factor in improving thedisease symptoms, stress wasthe most common aggravating factor. Biological therapy in men,laser epilation and pregnancy in women were significant alle-viating factors, whereas weight gain was a more commonaggravating factor for women.Conclusion:HS shows a re-lentlessly progressive course with inflammatory attacks, but thefirst years of the disease are the most active period. This studyconfirms that environmental and hormonal factors may play animportant role in the disease course, probably with other en-dogenous or exogenous factors.(c) 2024 S. Karger AG, BaselArticle Internalized Stigma in Hidradenitis Suppurativa: a Multicenter Cross-Sectional Study(Karger, 2023) Bilgic, Asli; Karaman, Bilge Fettahlioglu; Demirseren, Duriye Deniz; Cinar, Levent; Kacar, Nida; Ermertcan, Aylin Türel; Alpsoy, ErkanBackground: Hidradenitis suppurativa (HS) causes significant physical, social, and psychological burdens. Internalized stigma, acceptance of negative attitudes and stereotypes of society regarding a person's illness, has not been studied previously in HS. Objectives: The objective of this study was to investigate the internalized stigma state of HS patients and identify the factors affecting it. Methods: This multicenter, prospective, cross-sectional study included 731 patients. Internalized Stigma Scale (ISS), Hurley staging, Physician Global Assessment, Dermatology Life Quality Index (DLQI), Skindex-16, Beck Depression Inventory-II (BDI-II), and Visual Analog Scale (VAS)-pain score were used in the study. Results: The mean ISS value (57.50 +/- 16.90) was comparable to the mean ISS values of studies in visible dermatological and various psychiatric diseases. A significant correlation was found between the mean values of ISS and all disease activity scores, quality of life measures, BDI-II, and VAS-pain scores. Obesity, family history, low education and income level, vulva/scrotum involvement and being actively treated are significant and independent predictive factors for high internalized stigma in multivariate analysis. Conclusions: HS patients internalize society's negative judgements, which may create a profound negative effect on access to health care. Therefore, in addition to suppressing disease activity, addressing internalized stigma is fundamental for improving health care quality.Article Internalized Stigma in Pediatric Psoriasis: a Comparative Multicenter Study(Korean dermatological Assoc, 2020) Alpsoy, Erkan; Polat, Mualla; Yavuz, Ibrahim Halil; Kartal, Pelin; Balci, Didem Didar; Karadag, Ayse Serap; Senol, YesimBackground: Internalized stigma, adoption of negative attitudes and stereotypes of the society regarding persons' illness, has not been studied previously in pediatric psoriasis patients. Objective: We aimed to investigate the internalized stigma in pediatric psoriasis patients and to determine differences according to factors affecting internalized stigma compared to adult psoriasis patients. Methods: This multicenter, cross-sectional, comparative study included 125 pediatric (55 female, 70 male; mean age +/- standard deviation [SD], 14.59 +/- 2.87 years) and 1,235 adult psoriasis patients (577 female, 658 male; mean age +/- SD, 43.3 +/- 13.7 years). Psoriasis Internalized Stigma Scale (PISS), Dermatology Life Quality Index (DLQI), Perceived Health Status (PHS), and the General Health Questionnaire (GHQ)-12 were the scales used in the study. Results: The mean PISS was 58.48 +/- 14.9 in pediatric group. When PISS subscales of groups were compared, the pediatric group had significantly higher stigma resistance (p = 0.01) whereas adult group had higher scores of alienation (p = 0.01) and stereotype endorsement (p = 0.04). There was a strong correlation between mean values of PISS and DLQI (r = 0.423, p = 0.001). High internalized stigma scores had no relation to either the severity or localization of disease in pediatric group. However, poor PHS (p = 0.007) and low-income levels (p = 0.03) in both groups, and body mass index (r = 0.181, p = 0.04) in the pediatric group were related to high PISS scores. Conclusion: Internalized stigma in pediatric patients is as high as adults and is related to poor quality of life, general health, and psychological illnesses. Unlike adults, internalized stigma was mainly determined by psoriasis per se, rather than disease severity or involvement of visible body parts, genitalia or folds.Article Internalized Stigma in Psoriasis: a Multicenter Study(Wiley, 2017) Alpsoy, Erkan; Polat, Mualla; Fettahlioglu-Karaman, Bilge; Karadag, Ayse Serap; Kartal-Durmazlar, Pelin; Yalcin, Basak; Senol, YesimInternalized stigma is the adoption of negative attitudes and stereotypes of the society regarding a person's illness. It causes decreased self-esteem and life-satisfaction, increased depression and suicidality, and difficulty in coping with the illness. The primary aim of this study was to investigate the internalized stigma state of psoriatic patients and to identify the factors influencing internalized stigma. The secondary aim was to identify the correlation of internalized stigma with quality of life and perceived health status. This multicentre, cross-sectional study comprised 1485 patients. There was a significant positive correlation between mean values of Psoriasis Internalized Stigma Scale (PISS) and Psoriasis Area and Severity Index, Body Surface Area, Dermatological Life Quality Index and General Health Questionnaire-12 (P < 0.001 in all). Lower percieved health score (P = 0.001), early onset psoriasis (P = 0.016), family history of psoriasis (P = 0.0034), being illiterate (P < 0.001) and lower income level (P < 0.001) were determinants of high PISS scores. Mean PISS values were higher in erythrodermic and generalized pustular psoriasis. Involvement of scalp, face, hand, genitalia and finger nails as well as arthropathic and inverse psoriasis were also related to significantly higher PISS scores (P = 0.001). Our findings imply that psoriatic patients experience high levels of internalized stigma which are associated with psoriasis severity, involvement of visible body parts, genital area, folds or joints, poorer quality of life, negative perceptions of general health and psychological illnesses. Therefore, internalized stigma may be one of the major factors responsible from psychosocial burden of the disease.Conference Object The Natural History Study of Hidradenitis Suppurativa: a Large-Scale Multicenter Study in Turkey(Wiley, 2023) Alpsoy, Erkan; Karaman, Bilge Fettahlioglu; Demirseren, Deniz; Cinar, Levent; Kacar, Nida; Ermertcan, Aylin Turel; Bilgic, Asli