Browsing by Author "Ermertcan, AT"
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Item Sexual Dysfunction in Female Patients With NeurodermatitisErmertcan, AT; Gencoglan, G; Temeltas, G; Horasan, GD; Deveci, A; Ozturk, FNeurodermatitis is a chronic disease affecting the patient's psychosocial status and quality of life. It is associated with a variety of psychologic problems, including demoralization, depression, anxiety, obsessive-compulsive disorder, and sleep disturbances. Coexistence of sexual dysfunction, especially in women, with several systemic diseases has gained interest in recent years. In this study, we evaluated sexual function in female patients with neurodermatitis. We enrolled 89 women (43 patients, 46 controls) in the study. Quality of life was assessed with the Dermatology Life Quality Index (DLQI), and the Female Sexual Function Index (FSFI) was used to determine sexual function. Individuals with psychiatric disorders and/or those using antidepressants were excluded. The total DLQI score was 11.95 +/- 5.65 in patients with neurodermatitis. The total FSFI score was significantly lower in patients compared with healthy controls (22.76 +/- 5.31 and 28.83 +/- 3.50, respectively; P=.001). Domain scores of FSFI (desire, arousal, lubrication, orgasm, and satisfaction) except pain were significantly lower in patients with neurodermatitis (P=.001). The pain score was also lower in patients than controls, but the difference was not statistically significant (P=.073). Neurodermatitis may be associated with sexual dysfunction, and patients with neurodermatitis should be evaluated with regard to sexual function to provide a better quality of life.Item Risk factors for delaying treatment seeking in obsessive-compulsive disorderDemet, MM; Deveci, A; Taskin, EO; Dündar, PE; Ermertcan, AT; Demet, SM; Bayraktar, D; Öztürkcan, SBackground: Despite the multiple alternatives of treatment, it is well known that patients with obsessive-compulsive disorder (OCD) delay seeking treatment. In this study, the aim was to determine the risk factors for delaying treatment seeking in OCD patients. Methods: The sample consisted of 132 OCD who completed the Yale-Brown Obsessive-Compulsive Scale, Yale-Brown Obsessive-Compulsive Scale Symptom Checklist, and Beck Depression Inventory. Results: In univariate analyses with risk evaluation, income level, being single or divorced, having a history of psychiatric treatment, poor insight for the symptoms, and obsessions of hoarding were the variables that were found to be significant. In the regression model, history of psychiatric treatment and duration of OCD were the 2 variables that remained statistically significant. Conclusion: This was the first study wherein the sample included patients who were recruited from a nonpsychiatric department: the dermatology clinic. Application to dermatology has not been determined as a risk factor for delaying treatment seeking in OCD patients. (c) 2010 Elsevier Inc. All rights reserved.Item Amlodipine-induced generalized fixed drug eruption clinically mimicking mycosis fungoidesCetinarslan, T; Ermertcan, AT; Temiz, PItem Hyperbaric oxygen therapy for the management of chronic woundsÖztürk, F; Ermertcan, AT; Inanir, IWound healing is actually a complex, precisely coordinated interaction between inflammatory cells and mediators, establishing significant overlap between the phases of wound healing. Chronic wounds are defined as wounds that do not follow the well-defined stepwise process of physiologic healing. The true incidence and economic impact of chronic wounds are difficult to assess because of the wide range of causative diseases and available treatment options. Despite multiple simultaneous and sequential therapeutic approaches, chronic wounds are highly resistant to treatment and are often indolent or even slowly progressive. Hyperbaric oxygen therapy (HBOT) has been explored as a treatment modality for chronic wounds because of its potential to promote healing and reduce bioburden in the wound bed. Multiple potential beneficial effects for wound healing have been demonstrated in various laboratory studies and experimental animal models. In this manuscript, HBOT, its mechanism of action, adverse effects and usage in diabetic and nondiabetic chronic wounds have been reviewed.Item Sexual dysfunction in patients with psoriasisErmertcan, AT; Temeltas, G; Deveci, A; Dinç, G; Güler, HB; Öztürkcan, SPsoriasis can have a significant impact upon sexual function. The aim of this study was to investigate sexual function in females and males with psoriasis and to evaluate whether coexistent depression has an additional negative effect on sexual function in these patients. A total of 66 female subjects (39 with psoriasis and 27 healthy volunteers as a control group) and 70 male subjects (39 with psoriasis and 31 healthy volunteers as a control group) were enrolled in the study. A Psoriasis Area and Severity Index (PASI) was used to determine the severity of psoriasis for the patient groups. The Female Sexual Function Index (FSFI) was used to assess female sexual function and the International Index of Erectile Function (IIEF) was used to evaluate male sexual function. Quality of life was assessed with the Dermatology Life Quality Index (DLQI). The diagnosis of depression was made according to the Structured Clinical Interview for DSM-IV (SCID-I) interview and Hamilton Depression Rate Scale (HDRS) was used for grading depression. FSFI total score was found to be significantly decreased in female psoriatic patients without depression and psoriatic patients plus depression compared with healthy controls (24.09 +/- 5.33 vs. 24.25 +/- 4.52 vs. 28.12 +/- 3.48, respectively, p = 0.004). However, FSFI score was not significantly different between patients with psoriasis without depression and those with psoriasis plus depression (p > 0.05). IIEF total score was also found to be significantly decreased in male psoriasis without depression and psoriasis plus depression patients compared with healthy controls (54.21 +/- 13.07 vs. 52.0 +/- 14.73 vs. 61.69 +/- 9.49, respectively, p = 0.023). The difference in IIEF scores between patients with psoriasis without depression and in those with psoriasis plus depression were not statistically significant (p > 0.05). The results of the study demonstrated that patients with psoriasis, especially females have distinct sexual dysfunction compared with healthy controls, and coexistent depression has no additional negative effect on sexual dysfunction in our patients. Patients with psoriasis should be evaluated in terms of sexual function in order to provide a better quality of life.Item Giant eccrine porocarcinoma in an unusual locationErmertcan, AT; Evrenos, MK; Öztürk, F; Temiz, PItem Netherton's Syndrome: An Ultrastructural Study: Case ReportÖztürkcan, S; Inan, S; Sahin, MT; Ermertcan, AT; Güzel, EE; Müftüoglu, SHair samples taken from 12-year-old boy prediagnosed with Netherton's syndrome were evaluated by using light and electron microscopic methods. Hair samples were prepared according to routine electron microscopic procedures. Semi-thin sections were stained with methylene blue-azure II, thin sections were contrasted with uranyl acetate-lead citrate. Besides atopy symptoms, hyperparakeratosis and inflammatory cell infiltration were seen in dermis. Results were in accordance with icthyosis linearis circumflexa. In cortex portion of hair, nodulary thickening and swelling were observed. There was a punctured proximal portion like a telescope in distal hair shaft segment. Cells that make up hair cortex were seen to be loosely arranged and there was detachment between cells exterior of cuticle. In evaluating all results trichorrhexis invaginata was identified. Patients given long term therapy for atopic dermatitis, which have breaking of hair in addition to icthyosis, Netherton's syndrome should be thought and investigation of hair samples for supporting the diagnosis is important.Item Dermoscopy of scalp cutaneous metastasis of sarcomatoid renal cell carcinomaÇetinarslan, T; Ermertcan, AT; Temiz, P; Evrenos, MK; Müezzinoglu, TItem NANOMATERIALS: PROMISING STRUCTURES FOR THE MANAGEMENT OF ORAL CANCEREskiizmir, G; Ermertcan, AT; Yapici, KItem The reliability of tuberculin skin test in the diagnosis of latent tuberculosis infection in psoriasis patients: A case-control studySürücüoglu, S; Ermertcan, AT; Çetinarslan, T; Özkütük, NTuberculin skin test (TST), which is used in the diagnosis of latent tuberculosis infection, may cause Koebner's phenomenon and false-positive results in psoriasis patients. The purpose of this study is to compare TST with QuantiFERON-TB Gold Plus (QFT-plus) test in psoriasis patients and to determine the effects of psoriasis on TST results. Ninety-two psoriasis patients and 30 control subjects were included in the study. QFT-plus test, TST, and prick test to distinguish the increase of induration because of the skin trauma were performed on both groups. The demographics, risk factors for latent tuberculosis infection, BCG vaccination history, Koebner's history, psoriasis severity, and treatment history of the patients were recorded. The effects of these variables on test results were investigated by comparing those with control group. The criteria of National Tuberculosis Diagnosis and Treatment Guidelines were used in the evaluation of test results, and threshold value of positivity for TST was taken as 10 mm in BCG-vaccinated patients who are planned to start biological treatment. Prick test results were negative in the control group. There was no significant relation between the results of prick test and TST induration diameters in the patient group. Although TST positivity was significantly higher in patients (62%) compared with control group (33%), QFT-plus test results were not statistically different between two groups. Agreement between two tests was determined to be low in patient group with 48% (K = 0.1), and it was determined to be moderate with 77% in control group (K = 0.4). QFT-plus test was found to be negative in 46 of 57 TST-positive patients (80.7%) in patient group. It was determined in both groups that vaccination did not have any effect on test results. When threshold value was lowered to 5 mm in patient group without considering BCG reaction, the number of TST-positive patients increased from 57 to 65. Mean TST induration diameter was 10 mm and 14 mm in cases with mild and moderate to severe clinical manifestation, respectively (P = .04). However, no effect of disease period and treatment was determined on both test results. TST positivity was higher in psoriasis patients compared with control group. It was considered due to the increased reaction of the skin to mycobacterial antigens rather than the Koebner's response. Although TST results were not affected by BCG, it was concluded that a 10-mm threshold value of positivity was a suitable approach in order to reduce the number of patients receiving unnecessary preventive treatment in patients who are considered to initiate biologic agents. Furthermore, it was also concluded that QFT-plus test may be preferred in psoriasis patients since it is applied in vitro and its specificity is higher and not affected by disease severity.Item A comparison of dermoscopic features among lentigo senilis/initial seborrheic keratosis, seborrheic keratosis, lentigo maligna and lentigo maligna melanoma on the faceSahin, MT; Öztürkcan, S; Ermertcan, AT; Günes, ATClinical differentiation of facial lentigo senilis/initial seborrheic keratosis (LS/ISK), seborrheic keratosis (SK), lentigo maligna, (LM), and lentigo maligna melanoma (LMM) can be difficult. Dermoscopy improves the diagnoses in pigmented skin lesions (PSLs), but it is not helpful for the sun-exposed face because of the flat rete ridges without network-derived features. Therefore, development of new diagnostic criteria for this particular localization is a current issue of dermatology. In this retrospective study, dermoscopic slides of facial pigmented skin lesions of 66 patients referred to two clinics in Turkey were evaluated. Our aim was to determine the reliability of dermoscopy in the differentiation of these entities. The facial PSLs of 66 patients (34 males and 32 females) (median age: 58.2) were photographed with a Dermaphot (Heine, Hersching, Germany) over a five year period from November of 1995 to May of 2000. All of the dermoscopic slides were analysed according to 27 dermoscopic criteria developed by Schiffner et al. This data set contained 22 histologically proven malignant (14 LM, 8 early LMM) and 44 benign (18 SK, 26 LS/ISK) PSLs. In general, asymmetric pigmented follicular openings, dark streaks, slate-gray streaks, dark globules, slate-gray globules, dark dots, dark rhomboidal structures, light brown rhomboidal structures, dark homogeneous areas and dark pseudonetworks were statistically significant for malignant growth. On the other hand, milia-like cysts, pseudo-follicular openings, cerebriform structures, light brown globules, light brown dots, light brown homogeneous areas, yellow opaque homogeneous areas, and light brown pseudonetworks were statistically significant for benign growth. This research emphasizes that dermoscopic features on the face differ from criteria used in other locations of the body. Analysis of the data suggests that dermoscopy can be used in the differentiation of LS/ISK, SK, LM and LMM from each other.Item Clinicopathological characteristics and mutation profile of BRAF and NRAS mutation in cutaneous melanomas in the Western Turkish populationEvrenos, MK; Temiz, P; Çam, FS; Yaman, M; Yoleri, L; Ermertcan, ATBackground/aim: Malignant melanoma is the most common cause of death due to skin cancers. The most common mutations in RAF-RAS pathway from tumor oncogenes are BRAF and NRAS. In this study, we analyzed the frequency of BRAF and NRAS gene mutations and investigated their association with clinicopathological features of melanomas in the Turkish population. Materials and methods: 65 primary cutaneous melanoma were included in the study. The mutations were evaluated with real-time PCR-based PCR-array through allele-specific amplification, and the results were correlated with various clinicopathological characteristics. Results: 52.3% of the patients were female and 47.7% were male. The mean age of the patients with a mutation was lower than those without mutation. 16 patients had BRAF mutation. 12 patients had NRAS mutation. NRAS mutation was statistically more common in men (P = 0.036). The number of mitoses increased with the increase of the tumor thickness (P = 0.003). There was more mitosis in the presence of ulceration (P = 0.05). A total of 41.7% of NRAS mutations had adjuvant chemotherapy. Conclusion: We found lower mutation rate when compared to regional studies. NRAS mutation was common in men. This is the first study from our region evaluating the prognostic value of clinical stage and necessity of adjuvant treatment with the presence of BRAF and NRAS mutations.Item Obsessive-compulsive disorder in a dermatology outpatient clinicDemet, MM; Deveci, A; Taskin, EO; Ermertcan, AT; Yurtsever, F; Deniz, F; Bayraktar, D; Ozturkcan, SObjective: The aims of present study were to (a) to determine the prevalence of obsessive-compulsive disorder (OCD) in dermatological patients, (b) to determine the possible relationship between dermatological lesions and OCD and (c) to determine the clinical and phenomenological features of the OCD subgroup. Method: The sample consisted of 166 out of 250 consecutively presenting dermatological patients who agreed to participate in the study. The subjects were assessed with the Structured Clinical Interview for DSM-IV Turkish Version (SCID-I) and also completed the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Results: Of the whole sample, 41 (24.7%) met DSM-IV criteria for OCD. Only 14.6% of them had previously been diagnosed as OCD. The mean score of Y-BOCS in the OCD group was 17.05 +/- 9.75. The most common obsessions were contamination (61 %) and pathologic doubt (53.7%), while washing (61%) and checking (51.2%) were the most frequent compulsions. Those suffering from diseases of sebaceous glands were the only group that showed a significant difference between the OCD and non-OCD group. onclusion: There is a high prevalence of OCD in dermatological patients, although the nature of the relationship between OCD and dermatology has not previously been ascertained. Genetic-based studies and future researches focused on individual anxiety, and sensitivity may provide information that better explains this relationship. (c) 2005 Elsevier Inc. All rights reserved.Item Primary cutaneous CD30-positive anaplastic large cell lymphoma in a 16-year-old girlKocabas, E; Ermertcan, AT; Akinci, S; Temiz, P; Gündüz, KItem Whorled Scarring Alopecia: A Rare Cutaneous Finding in Incontinentia Pigmenti or Overlooked Phenomenon? A Case Report of Incontinentia Pigmenti with Trichoscopic and Dermoscopic FindingsÇetinarslan, T; Masat, AK; Ermertcan, AT; Fölster-Holst, RItem Evaluation of the effect of surgical treatment on quality of life with the Dermatology Life Quality Index in patients with facial nonmelanoma skin cancerÇetinarslan, T; Evrenos, MK; Bilaç, C; Özyurt, B; Ermertcan, ATSkin cancers are the most common type of cancer. Nonmelanoma skin cancers (NMSCs) are more common than melanoma. Although the mortality rate is low, cancer word can be frightening for patients. Surgery is the main treatment. As skin cancers are most commonly located on the face, undesirable cosmetic results can occur as a result of treatments or due to primary disease. Therefore, the quality of life of patients could be affected. To determine the effect of surgical treatment on quality of life of the patients with facial NMSC using the Dermatology Life Quality Index (DLQI) at baseline and 3 months after surgery. We aimed to see if there was any improvement in quality of life scores after surgery, and to identify factors affecting quality of life. A total of 255 patients; 174 basal cell carcinoma (BCC) (68.2%) and 81 squamous cell carcinoma (SCC) (31.8%) were included in our study. All participants completed DLQI at baseline and 3 months after surgery. The mean total DLQI scores were 6.37 +/- 6.28 in patients with BCC, and 6.35 +/- 6.16 in patients with SCC. The mean total DLQI scores were 3.96 +/- 5.14 in patients with BCC (P < .001), and 4.49 +/- 5.24 in patients with SCC (P < .001) 3 months after surgery. In patients with primary skin cancer, all subscale scores and total DLQI scores were worse than the recurrent skin cancer group in both BCC and SCC at baseline. According to the treatment modalities, total DLQI scores and all subscales were worse in the graft group in BCC and SCC patients at baseline. Interestingly, the sex and the type of skin cancer did not affect quality of life, but tumor localization ([auricula OR: 6.45 [95% CI: 1.28-37.47] and eyelid OR:0.20 [95% CI: 0.04-0.96]) treatment procedure ([flap procedure OR: 7.90 [95% CI: 2.64-23.62] and graft procedure OR: 5.47 [95% CI: 1.60-18.71]) and, primary tumor OR:3.86 (95% CI: 1.01-14.78) were significant. The quality of life of skin cancer patients was affected by tumor localization, treatment procedure, primary, or recurrent tumor. The quality of life showed a significant improvement in patients with facial NMSC after surgical treatment. However, the type of NMSC seems to have no effect on the quality of life.Item Urticarial Vasculitis Successfully Treated With OmalizumabErmertcan, AT; Aktas, A; Öztürk, F; Temiz, PItem An Update on Quality of Life in Malignant Melanoma and Nonmelanoma Skin CancersCetinarslan, T; Evrenos, MK; Ermertcan, ATSkin cancer is the most common type of cancer. Nonmelanoma skin cancers (NMSCs) are more common than malignant melanoma. It is expected that the incidence of skin cancer will increase in the future. Although the mortality rate is low, cancer wording can be frightening for patients. Because skin cancers are most commonly located in the head and neck, unwanted cosmetic consequences can occur as a result of treatments. Therefore, the quality of life (QOL) of patients could be affected negatively. Today, there are various scales that assess the QOL of patients. These can be grouped as general, disease-specific, and cancer-specific questionnaires. Studies have been carried out and are still in progress to develop scales of QOL specific to skin cancers. In this paper, the questionnaires used in malignant melanoma and/or NMSCs and studies on this subject are reviewed.Item Histopathological and ultrastructural effects of glycolic acid on rat skinInan, S; Oztukcan, S; Vatansever, S; Ermertcan, AT; Zeybek, D; Oksal, A; Giray, G; Muftuoglu, SUse of alpha hydroxy acids (AHA) to ameliorate specific dermatological, problems with keratinization has become fairly widespread. The aim of this study was to evaluate the effects of the AHA derivative of glycolic acid, applied in different dosages, on rat skin using tight and electron microscopy. Skin biopsies were taken from the dorsal side of rats (n = 16) and at the end of each week after applying solutions containing AHA: week 1, 8% (n = 5); week 2, 50% (n = 5); week 3, 70% (n = 6). The skin samples were fixed in 10% formalin for histology and 2.5% glutaraldehyde solution for electron microscopy and processed using routine protocols. Histological sections were stained with hematoxylin and eosin (H-E), Masson's trichrome and were also Labelled for binding of a primary antibody against collagen I using the avidin-biotin-peroxidase method. The epidermal thicknesses were measured and the fibroblast count of the dermis was taken and the results compared using the statistical ANOVA test. Semi-thin sections were stained with toluidine blue-azure II solution and ultrathin sections were contrasted with uranyl acetate and lead citrate. Histochemical and immunohistochemical observations demonstrated that AHA treatment resulted in statistically significant increased thickness of the epidermis and an increase in numbers of active fibroblasts and in the amount of dense collagen, especially at higher dosages of AHA. Ultrastructural examination of rat skin from AHA-treated groups showed cytoplasmic vacuolization in epidermal keratinocytes, intercellular dysjunctions, and increased quantities of organized bundles of collagen fibers in the dermis. The use of AHA in appropriate dosages has been found to play an important role in the treatment of specific skin disorders, however, the harmful effects of use of AHAs at higher concentrations should not be ignored. We conclude that alpha hydroxyl acids have a wide spectrum of use in the field of dermatology but, due to side-effects, their use, dosage, and time frame should be restricted to the advice of dermatologists. (C) 2006 Elsevier GmbH. All rights reserved.Item Nonmelanoma Skin Cancer of the Head and Neck Nonsurgical TreatmentErmertcan, AT; Hellings, PW; Cingi, CNonmelanoma skin cancer (NMSC) is one of the most prevalent types of cancer worldwide, with basal cell carcinoma and squamous cell carcinoma being the most frequent histologic types. Surgical excision remains the mainstay of treatment, but nonsurgical treatment options may be indicated in specific cases. Nonsurgical treatment options for NMSC may be preferred as good alternatives under certain circumstances. This review provides a comprehensive overview of the nonsurgical treatment modalities for NMSCs, such as curettage and electrodesiccation, cryotherapy, radiotherapy, laser, photodynamic therapy, immunotherapy, and retinoid therapy.