Browsing by Author "Borlu, M"

Now showing 1 - 6 of 6
  • No Thumbnail Available
    Item
    Atopic dermatitis diagnosis and treatment consensus report
    (GALENOS PUBL HOUSE) Atakan, N; Yalçin, B; Özkaya, E; Küçük, ÖS; Öztürkcan, S; Salman, A; Borlu, M; Sentürk, N; Akman-Karakas, A; Serdaroglu, S
    Atopic dermatitis (AD) is a chronic, itchy, and recurrent inflammatory skin disease. AD, which is known as a childhood disease because of its common occurrence, is also an important health problem in adults. With increasing prevalence rates throughout each year, particularly in developed countries, AD has a heterogeneous clinical presentation that varies with age and different degrees of severity. The treatment includes the use of topical or systemic agents after identifying the needs of the patients. Especially, the identification of molecules responsible for pathogenesis recently has allowed the development of tailored treatments. With a better understanding of both the disease and the economic burden of AD recently, studies have gained momentum on diagnosis, treatment, and quality of life. Guidelines and consensus reports addressing diagnostic and therapeutic approaches have been published in our country, too, in parallel to publications in various countries. In this age of rapid information sharing, all kinds of information need to be updated frequently and become further useful. For this purpose, it is planned to develop a current consensus guideline under the leadership of the Dermatoimmunology and Allergy Association, with the contributions of the Cosmetology and the Dermatology Academy Association, Kayseri Dermatology and the Venereal Diseases Association, and Manisa Dermatology and the Venereal Diseases Association, and through the participation of faculty members experienced in the diagnosis and treatment of AD. The topics and the authors were chosen in December 2020. All Medline data published in the years between 1980 and 2021, current AD diagnosis and treatment guidelines, meta-analytical studies, and expert opinions and experiences were reviewed, and section drafts were developed. Literature data and section drafts were assessed and discussed during a meeting held in March 2021 with the participation of all authors. Then, the sections were finalized via e-mail correspondences and submitted as a final consensus report.
  • No Thumbnail Available
    Item
    Internalized stigma in psoriasis: A multicenter study
    (WILEY) 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.
  • No Thumbnail Available
    Item
    Internalized Stigma in Pediatric Psoriasis: A Comparative Multicenter Study
    (KOREAN DERMATOLOGICAL ASSOC) 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.
  • No Thumbnail Available
    Item
    Sociodemographic, clinical, laboratory, treatment and prognostic characteristics of 156 generalized pustular psoriasis patients in Turkey: a multicentre case series
    (WILEY) 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.
  • No Thumbnail Available
    Item
    A multicentre prospective analysis of the incidence of pemphigoid diseases in Turkey
    (WILEY) Durdu, M; Bozca, BC; Enli, S; Özgen, ZY; Yayli, S; Aktan, S; Mutlu, D; Erturan, I; Çelik, HHA; Melikoglu, M; Pala, E; Ürün, YG; Harman, M; Savk, E; Isik, S; Duygulu, S; Imren, IG; Karaman, BF; Erdogan, HK; Kiliç, A; Özçelik, S; Inan, K; Yilmaz, MA; Sanli, HE; Yildizhan, IK; Mülayim, MK; Çiçek, D; Demir, B; Güner, RY; Selçuk, LB; Gündüz, K; Daye, M; Borlu, M; Solak, EO; Dizman, D; Günes, B; Ozkur, E; Polat, M; Eskiocak, AH; Uzun, S
    Background: The differentiation between the pemphigoid diseases is essential for treatment and prognosis. In Turkey, data on the incidence of these diseases are insufficient. Our aim in this study is to determine the incidence, demographics and clinical characteristics associated with diseases of the pemphigoid group. Methods: We prospectively analysed 295 patients with pemphigoid who visited dermatology clinics of tertiary referral hospitals in 12 different regions of Turkey within a year. The diagnosis was based on clinical, histopathological, direct immunofluorescence (DIF) and serological (multivariant enzymelinked immunosorbent assay [ELISA], indirect immunofluorescence and mosaic-based BIOCHIP) examinations. Clinical and demographic findings, aetiological factors and concomitant diseases observed in the patients were recorded. Results: A total of 295 (female/male ratio: 1.7/1) patients with pemphigoid were diagnosed in 1-year period. The overall incidence rate of pemphigoid diseases was found to be 3.55 cases per millionyears. The ratio of pemphigoid group diseases to pemphigus group diseases was 1.6. The most common pemphigoid type was bullous pemphigoid (BP, 93.2%). The others were epidermolysis bullosa acquisita (3.1%), pemphigoid gestationis (2.4%), linear IgA disease (1%) and mucous membrane pemphigoid (0.3%). The most common (26.8%) possible trigger of the bullous pemphigoid was gliptin derivative drugs. The most common concomitant diseases with pemphigoid were cardiovascular (27.8%) and neurological diseases (23.7%). Conclusions: This study showed that the increased frequency of bullous pemphigoid reversed the pemphigoid/pemphigus ratio in Turkey. Further studies are warranted regarding the reasons for this increase.
  • No Thumbnail Available
    Item
    Analysis of factors influencing target PASI responses and side effects of methotrexate monotherapy in plaque psoriasis: a multicenter study of 1521 patients
    (SPRINGER) Erduran, F; Emre, S; Hayran, Y; Adisen, E; Polat, AK; Üstüner, P; Öztürkcan, S; Öztürk, P; Ermertcan, AT; Selçuk, LB; Aksu, EK; Akbas, A; Kalkan, G; Demirseren, D; Kartal, SP; Topkarci, Z; Kilic, A; Yaldiz, M; Aytekin, S; Hizli, P; Gharehdaghi, S; Borlu, M; Isik, L; Botsali, BR; Solak, EO; Albayrak, H; Gönülal, M; Balci, DD; Polat, M; Daye, M; Ataseven, A; Yildiz, S; Özer, I; Zorlu, O; Dogan, S; Erdemir, VA; Dikicier, BS
    Methotrexate (MTX) is commonly used as first-line systemic treatment agent in psoriasis. We aimed to evaluate the clinical characteristics and treatment responses of patients with psoriasis undergoing MTX monotherapy. Data from adult patients with plaque psoriasis who received MTX monotherapy for at least 3 months between April 2012 and April 2022 were retrospectively evaluated in 19 tertiary care centers. Our study included 722 female and 799 male patients, a total of 1521 participants. The average age of the patients was 44.3 +/- 15.5 years. Mode of treatment was oral in 20.4% of patients while in 79.4% it was subcutaneous. The median treatment duration was 8 months (IQR = 5-15). The median weekly dose was 15 mg (IQR = 11-15). 1448 (95.2%) patients were taking folic acid supplementation. At week 12, 16.3% of the patients achieved PASI (Psoriasis Area and Severity Index) 90 response while at week 24, 37.3% achieved it. Logistic regression analysis for week 12 identified the following independent factors affecting PASI 90 achievement positively: median weekly MTX dose <= 15 mg (P = 0.011), subcutaneous administration (P = 0.005), no prior systemic treatment (< 0.001) and folic acid use (0.021). In logistic regression analysis for week 24; median weekly MTX dose <= 15 mg (P = 0.001), baseline PASI >= 10 (P < 0.001), no prior systemic treatment (P < 0.004), folic acid use (P = 0.001) and absence of comorbidities (P = 0.009) were determined as independent factors affecting the achievement of PASI 90. Adverse effects were observed in 38.8% of the patients, with nausea/vomiting (23.9%) and transaminase elevation (13%) being the most common. The most common reasons for interruptions (15.3%) and discontinuations (27.1%) of the treatment were patient related individual factors. The use of MTX as the first systemic treatment agent, at doses <= 15 mg/week and concurrent folic acid application are positive predictive factors for achieving the target PASI response both at weeks 12 and 24. In our study, which is one of the most comprehensive studies on MTX treatment in psoriasis, we observed that MTX is an effective and safe treatment option.