Browsing by Author "Karadag, A. S."

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Birt-Hogg Syndrome: a Case Report
(Medecine Et Hygiene, 2015) Karadag, A. S.; Bilgili, S. G.; Yavuz, I. H.; Demircan, Y. T.; Kosem, M.
Clinical Characteristics, Quality of Life and Risk Factors for Severity in Palmoplantar Pustulosis: a Cross-Sectional, Multicentre Study of 263 Patients
(Oxford Univ Press, 2022) Solak, S. Sarikaya; Polat, A. Kara; Kilic, S.; Topal, I. Oguz; Saricaoglu, H.; Karadag, A. S.; Alpsoy, E.
Background Palmoplantar pustulosis (PPP) is a rare, chronic, inflammatory skin disease characterized by sterile pustules on palmar or plantar areas. Data on PPP are scarce. Aim To investigate the clinical characteristics and risk factors for disease severity in a large cohort of Turkish patients with PPP. Methods We conducted a cross-sectional, multicentre study of patients with PPP recruited from 21 tertiary centres across Turkey. Results In total, 263 patients (165 women, 98 men) were evaluated. Most patients (75.6%) were former or current smokers. The mean Palmoplantar Pustulosis Area and Severity Index (PPPASI) was 8.70 +/- 8.06 and the mean Dermatology Life Quality Index (DLQI) score was 6.87 +/- 6.08, and these scores were significantly correlated (r = 0.52, P < 0.001). Regression analysis showed that current smoking was significantly associated with increased PPPASI (P = 0.03). Coexisting psoriasis vulgaris (PsV) was reported by 70 (26.6%) patients. Male sex prevalence, PPP onset incidence, disease duration, DLQI, and prevalence of nail involvement and psoriatic arthritis (PsA) were significantly increased among patients with PPP with PsV. Of the 263 patients, 18 (6.8%) had paradoxical PPP induced by biologic therapy, and these patients had significantly increased mean DLQI and prevalence of PsA (r = 0.03, P = 0.001). Conclusion Our data suggest that smoking is a risk factor for both PPP development and disease severity. Patients with PPP with PsV present distinct clinical features and patients with biologic therapy-induced paradoxical PPP have reduced quality of life and are more likely to have PsA.
Decreased Serum Paraoxonase and Arylesterase Activities in Patients With Rosacea
(Wiley, 2015) Takci, Z.; Bilgili, S. G.; Karadag, A. S.; Kucukoglu, M. E.; Selek, S.; Aslan, M.
Background: Recent evidence suggests that oxidative stress may be an important phenomenon in the pathophysiology of rosacea. Paraoxonase-1 (PON1) is an antioxidant enzyme with three activities: paraoxonase, arylesterase and dyazoxonase. In this study, we evaluated serum paraoxonase and arylesterase activities, and serum lipid hydroperoxide (LOOH) levels in patients with rosacea in comparison to healthy controls. Material and methodThe study included 39 rosacea patients and healthy controls, consisting of 40 age- and sex-matched healthy volunteers. Serum paraoxonase and arylesterase activities were measured using paraoxon and phenylacetate substrates. Serum LOOH levels were measured with the ferrous ion oxidation-xylenol orange assay. ResultsIn rosacea group mean serum paraoxonase and arylesterase activities were 74.5438.30UL(-1) and 141.29 +/- 22.27kUL(-1) respectively, which were significantly lower than controls (P=0.010, 0.005; respectively). Mean serum LOOH level of rosacea group was 8.17 +/- 1.91molL(-1) which was significantly higher than controls (P=0.009). There were no statistically significant differences between the clinical subtypes of the disease, menopause situation or ocular involvement with the respect to the serum paraoxonase and arylesterase activities and LOOH levels (all; P>0.05). ConclusionsSerum PON1 enzyme activities have decreased significantly in rosacea. These findings support that decreased PON1 activity and increased oxidative stress may play a role in the pathogenesis of rosacea. Further studies are needed to elucidate the role of PON1 activity in the pathophysiology of rosacea.
Effects of Isotretinoin Treatment on General Psychiatric Symptoms, Quality of Life and Social Phobia in Acne Vulgaris Patients
(Wiley-blackwell, 2013) Karadag, A. S.; Bilgili, S. G.; Selvi, Y.; Tutuncu, R.; Aydin, A.; Calka, O.; Dalkilic, A.
Elevated Insulin Resistance in Patients With Recurrent Aphthous Stomatitis
(Springer Heidelberg, 2015) Takci, Z.; Karadag, A. S.; Ertugrul, D. T.; Bilgili, S. G.
Objectives The role of glucose metabolism disorders in periodontal diseases including recurrent aphthous stomatitis (RAS) is currently attracting attention. The aim of this study is to investigate insulin resistance (IR) in patients with RAS in otherwise healthy individuals. Materials and methods The study enrolled 81 patients with RAS and 61 healthy control subjects. Blood glucose, insulin, C-peptide, hemoglobin A1c, total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, and HOMA-IR were measured in each individual. Results Forty-two of the RAS group were in the active, and 39 of the RAS group were in the passive stage. The levels of c-peptide, insulin, and HOMA-IR were remarkably higher in the RAS group (p=0.015; p<0.0001; p<0.0001, respectively) than the control group. The levels of HbA1c, glucose (p=0,045), TC (p=0,008), HDL cholesterol (p=0,002), and HOMA-IR (p=0.022) were significantly higher in patients with RAS in the active stage. Conclusion The study revealed an elevated IR in patients with RAS that was not previously shown. IR was more prominent when the patients were in the active stage that elevated inflammatory cytokines may induce IR by interfering with insulin signaling. Further studies, investigating the interplay between RAS, inflammation, and IR are needed. Clinical relevance Patients who admitted the hospital with RAS might be screened for prediabetes.
Expression of Gstm4 and Gstt1 in Patients With Tinea Versicolor, Tinea Inguinalis and Tinea Pedis Infections: a Preliminary Study
(Wiley, 2011) Kilic, M.; Oguztuzun, S.; Karadag, A. S.; Cakir, E.; Aydin, M.; Ozturk, L.
Background. Several skin diseases are believed to be associated with oxidative stress. Defence against reactive oxygen species in the skin involves a variety of antioxidant enzymes, including glutathione-S-transferases (GSTs) catalysing the reaction between reduced glutathione, and a variety of exogenously and endogenously derived electrophilic compounds. The mammalian soluble GSTs are divided into five main classes: alpha (A), mu (M), pi (P), theta (T) and zeta (Z). Aim. To investigate the expression of GSTM4 and GSTT1 in lesional and nonlesional skin of patients with dermatophytoses and Tinea versicolor infection. Methods. Expression of GSTM4 and GSTT1 was assessed by immunohistochemistry for dermatophytoses in 15 patients with T. versicolor, 15 patients with Tinea pedis and 8 patients with Tinea inguinalis, and compared with healthy controls (n = 9). After written consent was signed by each participant, punch biopsies were excised from the centre of the lesional skin sites in patients and from the normal skin sites in controls. The relationships between expression of GSTM4 and GSTT1 isoenzymes and fungal infections were also examined. Results. When the normal and infected tissue of these cases were compared according to their staining intensity, GSTM4 expression was found to be stronger in control epithelium than in the epithelium of patients with T. pedis, T. inguinalis or T. versicolor (P < 0.05). By contrast, expression of GSTT1 was stronger in the epithelium of patients infected with any of the three dermatophytes than in control epithelium (P < 0.05). Conclusions. There is a significant relationship between presence of T. versicolor, T. inguinalis and T. pedis and expression of GSTM4 and GSTT1.
Fixed Drug Eruption Induced by Topical Olopatadine Ophthalmic Solution
(Sage Publications Ltd, 2012) Bilgili, S. G.; Karadag, A. S.; Karadag, R.; Bulut, G.; Calka, O.
Fixed drug eruption (FDE) usually develops after oral administration and is described as a cutaneous reaction recurring at the same location each time the drug is taken. Olopatadine is both a H I histamine receptor antagonist and a mast cell stabilizer, indicated for the treatment of allergic conjunctivitis. Here, we report a 14-year-old male patient who developed FDE localised on the lateral side of periorbital rim bilaterally, whilst applying olopatadine 0.1% ophthalmic solution for the treatment of allergic conjunctivitis. As far as we know, FDE due to olopatadine has not been previously reported in the literature. We deem it appropriate to report this case because FDE that results from the application of topical drugs is a rare event in the literature.
Gapo Syndrome Associated With Pyoderma Vegetans: an Unreported Co-Existence
(Medecine Et Hygiene, 2013) Karadag, A. S.; Calka, O.; Bilgil, S. G.; Karadag, R.; Bulut, G.
GAPO syndrome associated with pyoderma vegetans: an unreported co-existence: GAPO syndrome is a rare autosomal recessive disease and an acronym composed of growth retardation, alopecia, pseudoanodontia, optic atrophy. Approximately 38 cases have been reported in literature until now. Pyoderma vegetans is a chronic inflammatory disease characterized with vesicopustular, exudative and vegetative lesions usually localized on face, scalp, axilla and genitalia. Pyoderma vegetans is attributed to a bacterial infection frequently occurring in individuals with an underlying immunosuppressive condition. A 30-year-old female patient was admitted to our clinic with complaint of a hemorrhagic, crusted, exudative vegetative two plaques on the scalp. On her physical examination, she had a prematurely aged face, predominant lower lips, total tooth loss, frontal bossing, enlarged anterior fontanelle, marked scalp veins, micrognatia, depressed nasal bridge, short stature, growth retardation. She was diagnosed as GAPO syndrome as the result of her physical examination. Result of the biopsy taken from scalp was evaluated as pyoderma vegetans. And the diagnosis of pyoderma vegetans was established based on the correlate of both clinical and histopathologic findings. Pyoderma vegetans coexisting with GAPO syndrome has not been reported previously. Thus we wished to report it.
Icmthyosis Linearis Circlimflexa: Not Always a Part of Netherton Syndrome
(Medecine Et Hygiene, 2016) Bilgili, S. Gunes; Karadag, A. S.; Calka, O.; Onder, S.; Bayram, I.
Ichthyosis Linearis Circumflexa: not always apart ofNetherton syndrome: Ichthyosis Linearis Circumflexa (ILC) is a rarely seen autosomal recessive keratinization disorder and is characterized by erythematous, polycystic, plaques with 'double-edged' scales. Its histological features resemble psoriasis. A triad of ichthyosis (usually Ichthyosis Linearis Circumflexa), trichorrhexis invaginata (a distinctive hair shaft disorder) and atopy is named as Netherton syndrome. Herein, we report a 12 year-old girl presenting with ILC not accompanied with typical atopy findings and hair shaft disorder.
Immunoregulatory Effects of Isotretinoin in Patients With Acne
(Wiley-blackwell, 2012) Karadag, A. S.; Ertugrul, D. T.; Bilgili, S. G.; Takci, Z.; Akin, K. O.; Calka, O.
Background In vitro studies have shown that retinoids influence T-cell differentiation. Objectives To study the effect of isotretinoin on T-cell differentiation markers in patients with acne. Methods A total of 37 patients with acne vulgaris (25 female, 12 male, age 19.6 +/- 3.7 years) and 30 age- and sex-matched healthy controls (19 female, 11 male, age 20.5 +/- 4.4 years) were included in the study. Screening for biochemical parameters in serum samples were done just before initiation (pretreatment) and after 3 months of isotretinoin treatment (post-treatment) in the acne group. Results Baseline levels of tumour necrosis factor (TNF)-alpha (P < 0.0001), interleukin (IL)-4 (P < 0.0001), IL-17 (P < 0.0001) and interferon (IFN)-gamma (P = 0.002) were significantly higher in the acne group compared with the control group. TNF-alpha (P < 0.0001), IL-4 (P < 0.0001), IL-17 (P < 0.0001) and IFN-gamma (P < 0.0001) levels decreased after isotretinoin treatment. TNF-alpha and IL-4 values after isotretinoin treatment were similar to those of the control group. However, levels of IL-17 (P < 0.0001) after isotretinoin treatment were higher than those of the control group, despite a significant decline after treatment. Levels of IFN-gamma (P < 0.0001) after isotretinoin treatment were lower than those of the control group. Conclusions This study shows that isotretinoin treatment significantly decreases TNF, IL-4, IL-17 and IFN-gamma levels in patients with acne. We failed to show that isotretinoin redirects naive T helper (Th) differentiation preferentially towards the Th2 cell lineage.
Incontinentia Pigmenti With Ocular Involvement: Two Cases
(Medecine Et Hygiene, 2012) Bilgili, S. G.; Karadag, A. S.; Karadag, R.; Akdeniz, N.; Bulut, G.; Calka, O.
Incontinentia pigmenti with ocular involvement: two cases: Incontinentia pigmenti (IP) is a rare, X-linked dominant disorder that presents at or soon after birth and presents with cutaneous signs and symptoms. Besides its typical skin signs presenting in all patients, central nervous system (CNS), ophthalmologic and dental involvement are encountered as well. In this report, we present two patients at the verrucous stage of IP and review the literature concerning the diagnosis and course of IP.
A Lamotrigine Induced Toxic Epidermal Necrolysis in a Child
(informa Healthcare, 2013) Calka, O.; Karadag, A. S.; Bilgili, S. G.; Bulut, G.; Altun, F.; Burakgazi, A. Z.
Toxic epidermal necrolysis (TEN) is rare, life-threatening skin disorder that usually is caused by an adverse drug reaction. The exact pathogenesis of TEN is still unknown. Many treatments including prednisolone, cyclosporine and intravenous immunoglobulin (IVIG) can be used to halt the disease process. We present a 12-year-old girl with epilepsy who developed TEN after about 14 days of lamotrigine treatment. Lamotrigine was immediately discontinued. After receiving systemic corticosteroid treatment, the patient had a complete recovery. Antiepileptic-induced TEN can be mortal in some cases. Thus, we would like to point out the importance of early diagnosis and treatment.
Mucocutaneous Disorders in Children With Down Syndrome: Case-Controlled Study
(Medecine Et Hygiene, 2011) Bilgili, S. Gunes; Akdeniz, N.; Karadag, A. S.; Akbayram, S.; Calka, O.; Ozkol, H. Uce
Mucocutaneous disorders in children with Down syndrome: case controlled study: Objective: Down's syndrome is the most frequent chromosomal anomaly that can affect a multiple organ systems, including skin. In this study, we compared the frequency of mucocutaneous disorders in children with Down's syndrome with normal children. Methods: We recruited fifty children with Down's syndrome and 50 healthy children as a control in our study. Mucocutaneous abnormalities were examined in both groups. Findings: Of 50 patients, 22 were girls and 28 were boys. The skin findings such as xerosis and Mongolian spots were the most frequently seen in the patients with Down's syndrome. Seborrheic dermatitis, cheilitis and fissured tongue were seen frequently, as well. The rare findings were plantar hyperkeratosis, alopecia areata, geographic tongue, cafe-au-lait macula, livedo reticularis, cutaneous infections, pityriasis capitis simplex, cutis marmorata, neurotic excoriation, trichotillomania, keratosis pilaris and diaper dermatitis. No mucocutaneous finding was seen in 16 patients. The prevalence of the skin disorders including Mongolian spot, seborrheic dermatitis, cheilitis, fissured tongue was significantly higher in patients with Down syndrome than normal individuals (p<0.05). Conclusion: Therefore, large-scaled epidemiological studies covering the entire population are needed. We believe that these studies could provide better understanding the dermatological diseases in children with Down's syndrome that would help to practitioners to treat these problems.
Nine Case Series With Phototoxic Dermatitis Related To Chenopodium Album
(Sage Publications Ltd, 2012) Ozkol, H. U.; Calka, O.; Karadag, A. S.; Akdeniz, N.; Bilgili, S. G.; Behcet, L.
Chenopodium album L. ssp. album is a common plant species worldwide, especially in humid areas. Sun exposure after oral intake of the plant can lead to sunburn-like rashes owing to its furocoumarin content. In this article, we reported nine patients who developed dermatitis with edema, erythema and necrosis on the face and dorsum of the hands. Each was exposed to sunlight after eating selemez (the vernacular name of C. album L. ssp. album). The plant samples analyzed by an expert botanist were described as C. album L. ssp. album belonging to Chenopodiacea family.
Nonsteroidal Anti-Inflammatory Drugs-Induced Generalized Fixed Drug Eruption: Two Cases
(Sage Publications Ltd, 2012) Bilgili, S. G.; Calka, O.; Karadag, A. S.; Akdeniz, N.; Kosem, M.
Fixed drug eruption (FDE) is a drug-induced cutaneous reaction that occurs at the same site with each exposure to a specific medication and usually manifests as round or oval, sharply demarcated erythematous or edematous plaques. The exact mechanism is unknown. The most common causative agent is co-trimoxazole. Other major categories of causative agents of FDE include antibiotics, antiepileptics, and nonsteroidal anti-inflammatory drugs (NSAIDs). FDE usually causes localized eruptions and very rarely generalized lesions. We report two cases of developing generalized FDEs after exposure to diclofenac and naproxen.
Response To 'letter To the Editor' by Agilli Et Al. Entitled 'assessment of Decreased Serum Paraoxonase Activity in Patients With Rosacea in Terms of Methodology
(Wiley-blackwell, 2016) Takci, Z.; Bilgili, S. G.; Karadag, A. S.; Kucukoglu, M. E.; Selek, S.; Aslan, M.
Serum Holotranscobalamine, Vitamin B12, Folic Acid and Homocysteine Levels in Patients With Vitiligo
(Wiley-blackwell, 2012) Karadag, A. S.; Tutal, E.; Ertugrul, D. T.; Akin, K. O.; Bilgili, S. G.
Few studies have investigated the role of vitamin B12 metabolism in vitiligo. We tested the hypothesis that vitamin B12 and folate metabolism might have an influence on the pathogenesis of vitiligo. Full blood count and levels of folic acid, vitamin B12, homocysteine and holotranscobalamine were examined for 69 patients with vitiligo and 52 controls. The vitiligo group had higher levels of homocysteine (P < 0.01) and haemoglobin (P < 0.01) levels, and lower levels of vitamin B12 (P < 0.01) and holotranscobalamine (P < 0.0001) than the control group. Folic acid levels were similar for both groups. In a risk analysis, hyperhomocysteinaemia (= 15 mu mol/L, P < 0.01) and vitamin B12 deficiency (< 200 pg/mL, P < 0.01) were significant risk factors for vitiligo. Patients with holotranscobalamine levels in the lowest quartile had an increased risk for co-occurrence of vitiligo (P < 0.005). Vitamin B12 deficiency and hyperhomocysteinaemia may share a common genetic background with vitiligo.
Thyroid Autoimmunity Associated With Recurrent Aphthous Stomatitis
(Wiley, 2012) Ozdemir, I. Y.; Calka, O.; Karadag, A. S.; Akdeniz, N.; Ozturk, M.
Background Recurrent aphthous stomatitis (RAS) is an autoimmune disorder characterized by the periodic appearance of aphthous lesions on the oral mucosa. TH1 cytokines plays a key role in the aetiopathogenesis. Autoimmune thyroid disease (ATD) is the most common autoimmune disease and is frequently accompanied by various other autoimmune diseases. Objective To investigate the frequency of ATD which has not been studied in the patients with RAS. Methods Ninety patients and 30 healthy volunteers were included into the study. The serum samples were assayed for thyroid stimulant hormone (TSH), free and total triiodothyronine (fT3, TT3), free and total thyroxine (fT4, TT4), thyroglobuline, anti-thyroid peroxidase antibody (anti-TPO) and anti-thyroglobuline antibody (anti-TG) levels. Thyroid ultrasonography was performed as well. Results In RAS patients, the fT3, TT3 levels were higher; whereas the fT4 levels were lower that the control group (P < 0.05). The anti-thyroid antibody was positive in 31.11% of the patients with RAS, and in only 10% of the individuals in the control group (P < 0.05). The mean anti-TG level was also higher in the RAS group. Ultrasonography revealed nodules in 28.8% of the patients with RAS and in 16.7% of the individuals in the control group (P < 0.05). The sT4 levels were lower and the TSH, anti-TPO and anti-TG levels were significantly higher in the RAS patients with thyroid nodules than the RAS patients without nodules (P < 0.05). Discussion These results may be related to either the advance age of the patients or the increased duration of the autoimmune activation which may affect the thyroid. Conclusions The frequency of thyroid autoimmune-related problems was higher in patients with RAS. It would be worthy of searching autoimmune thyroid disorders in patients with RAS.
The Use of Complementary and Alternative Medicine Among Dermatology Outpatients in Eastern Turkey
(Sage Publications Ltd, 2014) Bilgili, S. G.; Ozkol, H. U.; Karadag, A. S.; Calka, O.
Introduction: Over the past decade, complementary and alternative medicine (CAM) has become increasingly popular around the world. Objectives: In this study, we aim to investigate how frequently CAM is used and the types of CAM methods used for dermatological disease in Eastern Turkey. Materials and methods: We recruited 1610 patients from our clinic for this study. The sociodemographic features and the CAM methods were investigated with a survey. Results: The most common dermatological disorders included contact dermatitis (21.4%), acne vulgaris (17.5%), fungal infections (10.9%), eczema (6.3%), and warts (5.7%). The ratio of patients using at least one CAM method was 43.7% and that of those using two or more CAM methods was 20.8%. The most commonly used CAM methods were those using henna, cologne, moisturizing cream, prayer, and herbal therapy. Some patients were found to use some interesting and unusual CAM methods, such as putting out a cigarette over the skin on the back for anthrax, applying raw meat for furuncle, using fuel oil and nitric acid for contact dermatitis. Conclusions: CAM methods are commonly used in our population. CAM methods often cause adverse reactions that may alter diagnostic skin findings and interfere with the efficacy of other medical therapies. Therefore, physicians should ask their patients about the use of CAM methods while collecting patient history. Physicians have a critical role in preventing improper use of CAM. In addition, further investigations into the efficacy, benefits, and risks of CAM methods should be carried out for better insight into those CAM methods.