Browsing by Author "Alpsoy, E"

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    Epidemiological characteristics of different types of adult acne in Turkey: a prospective, controlled, multicenter study
    Kutlu, Ö; Karadag, AS; Demirseren, DD; Iyidal, AY; Tosun, M; Kalkan, G; Polat, M; Kemeriz, F; Türkoglu, Z; Erdogan, HK; Aktürk, AS; Alyamaç, G; Özden, HK; Kiliç, S; Kilinç, F; Akbulut, TO; Ermertcan, AT; Saricaoglu, H; Cemil, BC; Kayiran, MA; Aksoy, H; Alpsoy, E
    Introduction: Acne occurring in adults over the age of 25 years is known as acne tarda or adult acne. Three types of adult acne are recognized: persistent, late-onset, and recurrent acne. Most studies do not compare the characteristics between the three vari-ants. In addition, little is known about adult acne in males. This study describes the epidemiological factors of adult acne and investigates certain triggering factors by sex and different types of adult acne. Methods: A multicenter, prospective, descriptive study was conducted. Patients with adult acne and an acne-free control group were compared regarding medical history, family history, smoking and drinking habits, and dietary factors. In addition, triggering and prognostic factors were investigated by sex and three different types of acne: persistent, late-onset, and recurrent acne. Results: The participants included 944 (88.56%) female and 122 (11.44%) male patients with adult acne, and 709 (73.85%) female and 251 (26.15%) male control patients. The consumption of crackers, chocolate, and pasta was significantly more common in the acne group than in the control group (p = 0.017, 0.002, and 0.040, respectively). Male patients with adult acne had a significantly longer disease duration than female patients with adult acne (p = 0.024). The most common type of acne was recurrent acne, followed by persistent and late-onset acne. Among patients with persistent acne, 14.5% had polycystic ovary syndrome (PCOS), whereas 12.2% of patients with recurrent acne and 11.1% of patients with late-onset acne had PCOS. Severe acne was more com-mon in the persistent acne type (28.13%). The cheek (59.90%) was the most common involvement area, and stress (55.23%) was the most common triggering factor regardless of sex. Conclusions: Although adult female and male patents with adult acne share similar triggering factors, the involvement areas can differ, which may indicate the additional hormonal etiology of female adult acne. Further epidemiological studies on adult acne in both sexes may illuminate the pathogenesis of the disease, thus making possible the development of new treatment strategies.
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    The natural history study of hidradenitis suppurativa: A large-scale multicenter study in turkey
    Alpsoy, E; Karaman, BF; Demirseren, D; Cinar, L; Kacar, N; Ermertcan, AT; Baskan, EB; Ucmak, D; Mammadli, K; Kilinç, F; Yazici, S; Temiz, SA; Akbulut, TÖ; Ataseven, A; Aktürk, AS; Saricaoglu, H; Türkmen, M; Gülbasaran, F; Engin, B; Ozden, HK; Durmaz, K; Ozden, MG; Ozdemir, H; Cemil, BC; Solak, SS; Yavuz, IH; Yavuz, GO; Guven, M; Ekinci, AP; Atici, T; Balci, DD; Oztürk, A; Altunay, IK; Ozkur, E; Ugurer, E; Karadag, AS; Kalkan, G; Erdogan, B; Yayli, S; Selcuk, LB; Donmez, L; Bilgic, A
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    Internalized stigma in psoriasis: A multicenter study
    Alpsoy, E; Polat, M; Fettahlioglu-Karaman, B; Karadag, AS; Kartal-Durmazlar, P; Yalcin, B; Emre, S; Didar-Balci, D; Bilgic-Temel, A; Arca, E; Koca, R; Gunduz, K; Borlu, M; Ergun, T; Dogruk-Kacar, S; Cordan-Yazici, A; Dursun, P; Bilgic, O; Gunes-Bilgili, S; Sendur, N; Baysal, O; Halil-Yavuz, I; Yagcioglu, G; Yilmaz, E; Kavuzlu, U; Senol, Y
    Internalized 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.
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    Clinical characteristics, quality of life and risk factors for severity in palmoplantar pustulosis: a cross-sectional, multicentre study of 263 patients
    Solak, SS; Polat, AK; Kilic, S; Topal, IO; Saricaoglu, H; Karadag, AS; Canpolat, F; Kartal, SP; Deveci, BN; Kacar, N; Ekinci, AP; Guner, R; Polat, M; Dogan, G; Ozden, MG; Baskan, EB; Yavuz, GO; Adisen, E; Gulekon, A; Tanribilir, ME; Yilmaz, O; Karakas, AA; Ozturk, P; Balci, DD; Gonulal, M; Yondem, H; Ermertcan, AT; Sendur, N; Topyildiz, H; Korkmaz, 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.
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    Internalized Stigma in Pediatric Psoriasis: A Comparative Multicenter Study
    Alpsoy, E; Polat, M; Yavuz, IH; Kartal, P; Balci, DD; Karadag, AS; Bilgic, A; Arca, E; Karaman, BF; Emre, S; Adisen, E; Sendur, N; Bilgic, O; Yazici, AC; Yalcin, B; Koca, R; Gunduz, K; Borlu, M; Ergun, T; Dursun, P; Bilgili, SG; Adanir, AS; Gulekon, A; Yagcioglu, G; Yilmaz, E; Kavuzlu, U; Senol, Y
    Background: 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.
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    Sociodemographic, clinical, laboratory, treatment and prognostic characteristics of 156 generalized pustular psoriasis patients in Turkey: a multicentre case series
    Polat, AK; Alpsoy, E; Kalkan, G; Aytekin, S; Uçmak, D; Güner, RY; Topkarci, Z; Yilmaz, O; Emre, S; Borlu, M; Türkoglu, Z; Akbulut, TÖ; Yavuz, GÖ; Erdogan, HK; Adisen, E; Kaya, AS; Topal, IO; Yazici, S; Yilmaz, E; Aksu, AEK; Kartal, SP; Deveci, BN; Solak, EÖ; Karadag, AS; Solak, SS; Altunay, IK; Ermertcan, AT; Kurt, BÖ; Kaçar, NG; Ataseven, A
    Background Generalized pustular psoriasis (GPP) is a rare and severe inflammatory disease characterized by widespread and superficial sterile pustules on an erythematous background. Objectives This multicentre study aimed to determine the clinical profile and course in a large cohort of patients with GPP. Methods One hundred and fifty-six GPP patients (mean age, 44.2 +/- 18.7 years) who met the diagnostic criteria of the European Consensus Report of GPP were included in the study. Sociodemographic characteristics, quality of life, triggering factors of the disease, clinical, laboratory, treatment and prognostic features were evaluated. Results 61.5% of the patients were female. The rate of working at or below the minimum wage (<=$332.5/month) was 44.9%. Drugs (36.5%) were the most common trigger. While hypocalcaemia (35.7%) was the most important cause of GPP during pregnancy, systemic steroid withdrawal (20%) was the most frequently reported trigger for infantile/juvenile and mixed-type GPP (15%) (P < 0.05). Acute GPP (53.8%) was the most common clinic. Nails were affected in 43.6% of patients, and subungual yellow spots (28.2%) were the most common change. In annular GPP, fever (P < 0.001) and relapse frequency (P = 0.006) were lower than other subtypes, and the number of hospitalizations (P = 0.002) was lower than acute GPP. GPP appeared at a later age in those with a history of psoriasis (P = 0.045). DLQI score (P = 0.049) and joint involvement (P = 0.016) were also higher in this group. Infantile/juvenile GPP was observed in 16.02% of all patients, and arthritis was lower in this group (24.4 vs. 16%). GPP of pregnancy had the worst prognosis due to abortion observed in three patients. Conclusions Recent advances in treatment have improved mortality associated with GPP, but abortion remains a significant complication. Although TNF-alpha inhibitors have proven efficacy in GPP, they can also trigger the disease. Mixed-type GPP is more similar to acute GPP than annular GPP with systemic manifestations and course.
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    Internalized Stigma in Hidradenitis Suppurativa: A Multicenter Cross-Sectional Study
    Bilgic, A; Karaman, BF; Demirseren, DD; Cinar, L; Kacar, N; Ermertcan, AT; Baskan, EB; Güven, M; Yazici, S; Akbulut, TÖ; Ucmak, D; Ataseven, A; Temiz, SA; Engin, B; Aktürk, AS; Saricaoglu, H; Özden, MG; Özdemir, H; Mammadli, K; Durmaz, K; Gülbasaran, F; Kilinc, F; Özden, HK; Gönülal, M; Balci, DD; Cemil, BÇ; Solak, SS; Selçuk, LB; Yavuz, GÖ; Yavuz, IH; Dönmez, L; Alpsoy, E
    Background: 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.
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    Clinical Features and Natural Course of Hidradenitis Suppurativa in Turkey: A Multicenter Study
    Alpsoy, E; Karaman, BF; Demirseren, DD; Cinar, SL; Kacar, N; Ermertcan, AT; Baskan, EB; Ucmak, D; Mammadli, K; Kilinc, F; Yazici, S; Temiz, SA; Akbulut, TO; Ataseven, A; Aktürk, AS; Saricaoglu, H; Türkmen, M; Gülbasaran, F; Engin, B; Özden, HK; Durmaz, K; Özden, MG; Özdemir, H; Cemil, BÇ; Solak, SS; Bilgili, SG; Yavuz, IH; Yavuz, GÖ; Güven, M; Ekinci, AP; Atci, T; Balci, DD; Oztürk, A; Altunay, IK; Özkur, E; Ugurer, E; Karadag, AS; Kalkan, G; Kilic, S; Erdogan, B; Yayli, S; Selcuk, LB; Dönmez, L; Bilgic, A
    Introduction: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, Basel
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    Clinical and demographic features of hidradenitis suppurativa: a multicentre study of 1221 patients with an analysis of risk factors associated with disease severity
    Özkur, E; Karadag, AS; Üstüner, P; Aksoy, B; Esme, P; Çaliskan, E; Akoglu, G; Kalkan, G; Demirseren, DD; Polat, M; Ozden, MG; Kilinç, F; Iyidal, AY; Altunay, IK; Türkmen, M; Ugurer, E; Baysak, S; Karaman, BF; Mammadli, K; Selçuk, LB; Türkoglu, Z; Atci, T; Balci, DD; Adisen, E; Temel, B; Aktan, S; Kaçar, N; Gündüz, K; Ertmertcan, AT; Özdemir, M; Çakiter, AÜ; Çölgeçen, E; Uçmak, D; Kelekçi, H; Ataseven, A; Durmaz, K; Özden, HK; Engin, B; Yazici, S; Alpsoy, E
    Background Hidradenitis suppurativa (HS) is a chronic, relapsing and debilitating inflammatory disease associated with profound morbidity. Aim In this multicentre study, we investigated the demographic and clinical features of HS, and determined risk factors of disease severity. Methods In total, 1221 patients diagnosed with HS from 29 centres were enrolled, and the medical records of each patient were reviewed. Results The mean age of disease onset was 26.2 +/- 10.4 years, and almost 70% (n = 849) of patients were current or former smokers. Mean disease duration was 8.9 +/- 8.4 years with a delay in diagnosis of 5.8 +/- 3.91 years. Just over a fifth (21%; n = 256) of patients had a family history of HS. The axillary, genital and neck regions were more frequently affected in men than in women, and the inframammary region was more frequently affected in women than in men (P < 0.05 for all). Acne (40.8%), pilonidal sinus (23.6%) and diabetes mellitus (12.6%) were the most prevalent associated diseases. Of the various therapies used, antibiotics (76.4%) were most common followed by retinoids (41.7%), surgical interventions (32.0%) and biologic agents (15.4%). Logistic regression analysis revealed that the most important determinants of disease severity were male sex (OR = 2.21) and involvement of the genitals (OR = 3.39) and inguinal region (OR = 2.25). More severe disease was associated with comorbidity, longer disease duration, longer diagnosis delay and a higher number of smoking pack-years. Conclusions Our nationwide cohort study found demographic and clinical variation in HS, which may help broaden the understanding of HS and factors associated with disease severity.