Browsing by Author "Ermertcan A.T."
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Item Developing a quality of life questionnaire in patients with psoriasis; [Psoriasisli hastalarda yaşam kalite ölçeǧi geliştirilmesi](2003) Inanir I.; Aydemir Ö.; Gündüz K.; Danaci A.E.; Ermertcan A.T.Background and design: Psoriasis is a chronic skin disease which causes psychological, social and physical problems and affecting quality of life. Developing a quality of life instrument for patients with psoriasis which is suitable for our country is aimed in this study. Materials and methods: Twenty five patients with psoriasis, 25 relatives and 25 doctors were questionned about daily life problems caused by psoriasis and the mostly defined problems were collected in an questionnaire. The reliability and validity of this questionnaire were analysed in a group of 156 patients. Results: For reliability, Chronbach's α coefficient was 0.87, and item-total correlations were between 0,37-0,60 in internal consistency. There was a high test-retest reliability (r=0.98, p<0.001). For validity, three factors were extracted in the Principal Components Method in construct validity. The maximum factor loadings of each item were between 0.456-0.681. In convergent validity, all patients' self-ratings and PASI were correlated with the questionnaire score (p<0.001). Conclusion: The questionnaire consisting of 17 items were found to be suitable for both epidemiologic and clinical trials.Item Efficiency of benzoyl peroxide-erythromycin gel in comparison with metronidazole gel in the treatment of acne rosacea(Japanese Dermatological Association, 2004) Öztürkcan S.; Ermertcan A.T.; Şahin M.T.; Afşar F.Ş.Oral wide-spectrum antibiotics are the linchpin of rosacea treatment. Oral and topical metronidazole, topical tretinoin, and topical benzoyl peroxide may also be used in the treatment of rosacea. We aimed to show that benzoyl peroxide-erythromycin gel is efficient in the treatment of acne rosacea. Fifty-six patients with acne rosacea were enrolled in our study. We administered benzoyl peroxide-erythromycin gel to 27 patients and metronidazole gel to 29 patients. In all the patients, the intensities of erythema, telangiectasia, papules/pustules, and nodules were evaluated before, during and after the treatment. The positivity of Demodex folliculorum from skin scratches was compared between the two groups at each visit. At the end of the therapy on the third examination, in the benzoyl peroxide-erythromycin group, 91.7% of the patients showed marked clinical improvement, and 8.3% of them showed complete remission. In the metronidazole group, 73.3% showed marked clinical improvement, and 26.7% of them showed complete remission. Clinical improvement in the papular component was 65.2% for the benzoyl peroxide-erythromycin group, and 81.5% for metronidazole group. In the first examination, the clinical results of the agents were similar. Although both of the drugs were found to be effective in the second and third examinations, metronidazole gel was more effective than benzoyl peroxide-erythromycin. Both of the drugs were found to be significantly effective especially in treating the papular component of rosacea. Demodex folliculorum was found to be positive in 74.1% of the benzoyl peroxide-erythromycin group and in 62.1% of the metronidazole group at the beginning. In the benzoyl peroxide-erythromycin group, 40.7% of Demodex folliculorum positive patients, became negative by the first examination. This was 17.2% for the metronidazole group. In the benzoyl peroxide-erythromycin group, among the patients who were positive for Demodex folliculorum in the first examination, 37.5% of them became negative. This was 36.7% for the metronidazole group. Benzoyl peroxide-erythromycin gel was superior to metronidazole gel in decreasing Demodex folliculorum by the first examination, but the effect of the two drugs on Demodex folliculorum was similar by the second examination. As a result, topically applied combined benzoyl peroxide-erythromycin gel may be an alternative choice of treatment for acne rosacea.Item Bullous pemphigoid associated with prostate adenocarcinoma(2004) Öztürkcan S.; Ermertcan A.T.; Şahin M.T.; Türkdoǧan P.; Inanir I.; Lekili M.Bullous pemphigoid is a common autoimmune skin disease characterized by the presence of subepidermal blisters. It has been associated with underlying neoplasia in isolated reports. A 78-year-old man with generalized blisters was diagnosed as bullous pemphigoid on clinical, histopathological and direct immunofluorescence grounds. His free and total prostate specific antigen (PSA) levels were high and histopathological examination of a prostate specimen revealed prostate adenocarcinoma. We present this rare case to discuss the possible association between bullous pemphigoid and prostate adenocarcinoma.Item A comparison of dermoscopic features among lentigo senilis/initial seborrheic keratosis, seborrheic keratosis, lentigo maligna and lentigo maligna melanoma on the face(Japanese Dermatological Association, 2004) Şahin M.T.; Öztürkcan S.; Ermertcan A.T.; Güneş A.T.Clinical 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 Transient eruptive seborrhoeic keratoses associated with erythrodermic pityriasis rubra pilaris [8](2004) Sahin M.T.; Öztürkcan S.; Ermertcan A.T.; Saçar T.; Türkdogan P.[No abstract available]Item Sunscreen use and sun protection practices in students and personnel of Celal Bayar University(2005) Ermertcan A.T.; Öztürkcan S.; Dinç G.; Yurtman D.; Pala T.; Şahin M.T.Background/Purpose: The steady increase in the incidence of melanoma, non-melanoma cutaneous neoplasia and preneoplastic disorders has contributed to the demand for more effective protection from the sun. In this study, we aimed to determine the prevalence of sunscreen use and other sun protection behaviors in a large sample of students and personnel of Celal Bayar University, Manisa, Turkey. Methods: The study group included 1018 participants of whom 607 work in the Celal Bayar University Hospital and 411 are students from the Medical Faculty and School for Health Professionals. All participants completed a questionnaire composed of 45 items about sun protection and other health behaviors, such as sports activity, use of cigarettes, alcohol and seat-belts. Sun protection factor (SPF) of sunscreen, avoiding sun exposure during peak hours, wearing clothing, a hat and sunglasses were studied. Results: Of the 1018, 403 participants were male and 615 were female. While avoiding sun exposure during peak hours was the most popular preventive behavior for men (42.5%), wearing sunglasses was the most popular one for women (50.7%). Avoiding exposure was the second preventive behavior for women (42.1%). Use of sunscreen with SPF 15+ was the second popular protective measure for men (19.4%) and the third one for women (39.2%). There were no significant relationships between sun protection behaviors and obesity, use of cigarettes and alcohol. We also investigated behavioral changes with sunburn experience in the participants who had sunburn history. Among these behavioral changes, increased use of sunscreen and decreased sun exposure during peak hours with sunburn experience were significant. Conclusion: Our study demonstrated that the risk of sun exposure is largely unrecognized in Manisa, Turkey, and we have very incomplete information about protective measures. An efficient policy of education on the effective use of sun protection methods should be developed to prevent skin cancer. Copyright © Blackwell Munksgaard 2005.Item Obsessive-compulsive disorder in a dermatology outpatient clinic(2005) Demet M.M.; Deveci A.; Taskin E.O.; Ermertcan A.T.; Yurtsever F.; Deniz F.; Bayraktar D.; Ozturkcan S.Objective: 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. Conclusion: 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. © 2005 Elsevier Inc. All rights reserved.Item Cross validation of the Turkish version of dermatology life quality index(2006) Öztürkcan S.; Ermertcan A.T.; Eser E.; Turhan Şahin M.Background: The aim of this study was to test the linguistic validation of the Turkish version of the Dermatology Life Quality Index (DLQI) for Turkish speaking dermatology patients. Methods: The DLQI is a 10-item dermatology specific index developed originally in English. The methodology of this study consists of four consecutive sections: Translation, cognitive debriefing, field testing and statistical analysis. Translation steps: (a) Two forward independent translations into Turkish, (b) reconciliation of these translations by a dermatologist, (c) backward translation of the consensus Turkish version by a bilingual person into its original language (English), (d) and comparing the original questionnaire with the backward translated one. Cognitive debriefing: Sessions were performed on five patients from each of the seven different dermatological diagnosis groups. Field testing: The final Turkish version on which the face validity was approved by specialists on a total of 79 inpatients/outpatients with various dermatological diagnoses treated at Celal Bayar University Hospital. Statistical analysis: Internal consistency (using Cronbach a) and item-total score correlations (Pearson correlation) were used for reliability analysis. Validity analysis was carried out by construct testing (principal components factor analysis), convergent (Pearson correlation) and (discriminate Student's t-test and Mann-Whitney U-test) validity, and SF-36 was used in parallel with DLQI in order to test convergent validity. The data were analyzed by the SPSS version 10.0 (SPSS Inc., Chicago, IL, USA) statistical package. Results: The mean age of the patients in the study was 30.77 ± 15.91 years; the mean score of DLQI was 7.61 ± 6.12. The median of item-total correlation coefficient was found to be 0.66, within a range of 0.48-0.81. The internal consistency of the index was found to be highly sufficient (α = 0.85). The DLQI was found to be highly related to the physical domain of SF-36. Life quality score was found to be significantly low for the inpatients compared with outpatients (differential validity). Conclusion: It was found that the Turkish version of the DLQI was an acceptable index for dermatologists and dermatology patients and, moreover, to be valid and reliable in a cross-sectional level. The responsiveness of the Turkish version of the DLQI needs to be tested further on a variety of dermatological conditions with different severities. © 2006 The International Society of Dermatology.Item A case of peristomal pyoderma gangrenosum following enterocutaneous fistula; [Enterokutan fistül açilimini takiben gelişen peristomal piyoderma gangrenozum](2006) Şahin M.T.; Öztürkcan S.; Ermertcan A.T.; Erhan Y.; Türkdoǧan P.Pyoderma gangrenosum (PG) is an uncommon ulcerative skin disorder that is often associated with underlying systemic diseases, the most common of which is inflammatory bowel disease. It can rarely develop after minor trauma or surgery. Most reports of this condition developing after abdominal surgery have been reported following ostomy formation. Peristomal pyoderma gangrenosum (PPG), an unusual variant of PG, has been reported almost exclusively in patients with inflammatory bowel disease and is frequently misdiagnosed. We describe a 62-year-old woman with refractory PG, which has developed at surgical site of enterocutaneous fistula operation. As PG can mimic a necrotizing soft tissue infection, multiple unnecessary surgical procedures can be performed on such a patient, without improvement. A right diagnosis, based upon the distinctive clinical features and a compatible histology, is essential to avoid surgical procedure that often tends to exacerbate this unusual process.Item Cardiovascular findings in patients with psoriasis [5](King Faisal Specialist Hospital and Research Centre, 2006) Öztürkcan S.; Ermertcan A.T.; Şekuri C.; Kýlýççýodolu B.[No abstract available]Item Erythromelanosis follicularis faciei et colli associated with keratosis pilaris in two brothers(2006) Ermertcan A.T.; Öztürkcan S.; Şahin M.T.; Türkdoǧan P.; Saçar T.Erythromelanosis follicularis faciei et colli is characterized by well-demarcated erythema, hyperpigmentation, and follicular papules. Since the original description, it has seldom been reported in the literature. We present two adolescent brothers who had this disorder associated with keratosis pilaris on the shoulders and the extensor surfaces of the arms. Dermatologic examination found brown-red pigmentation, erythema, and follicular papules on both maxillary, preauricular regions, and the cheeks. The lesions of the older brother were more prominent. Histopathologic examination of skin biopsy specimens taken from both brothers revealed hyperpigmentation of the basal layer, follicular plugging, dermal vascular dilatation and congestion, and perivascular inflammatory infiltration. We suggest that the coexistence of these two conditions in brothers implies a genetic inheritance and a possible relationship between the disorders. © 2006 Blackwell Publishing, Inc.Item Topical calcineurin inhibitors, pimecrolimus and tacrolimus(2007) Ermertcan A.T.; Öztürkcan S.Pinecrolimus and tacrolimus represent the first members of a new class of medications, calcineurin inhibitors. These topical macrolide immunomodulators have been successfully introduced in the treatment of atopic dermatitis. They inhibit T cell proliferation, mast cell degranulation, production and release of IL-2, IL-4, IF-γ and TNF-αa. They do not effect endothelial cells and fibroblasts, so they do not induce skin atrophy. In several studies, it has been shown that topical pimecrolimus and tacrolimus are effective, well tolerated and safe in both adults and children with atopic dermatitis. Picmecrolimus permeates less through the skin than tacrolimus and much lessthan corticosteroids. It has a lower potential for transcutaneous absorption resulting in a lower risk of systemic effects. In addition, they have been used in other inflammatory skin diseases including psoriasis, lichen planus, seborrheic dermatitis, allergic contact dermatitis, vitiligo, pyoderma gangrenosum, alopecia areata, graft versus host disease, akne rosacea, etc. In this review article mechanism of action, efficacy, safety of pimecrolimus and tacrolimus, and future directions of these immunomodulators were discussed. © 2007 Bentham Science Publishers Ltd.Item Acute irritant contact dermatitis due to 'apium graveolens'(2007) Ermertcan A.T.; Öztürkcan S.; Şahin M.T.; Bilaç C.; Bilaç D.B.[No abstract available]Item Comparison of the effects of collagenase and extract of Centella asiatica in an experimental model of wound healing: An immunohistochemical and histopathological study(2008) Ermertcan A.T.; Inan S.; Ozturkcan S.; Bilac C.; Cilaker S.In this study, we compared the effects of collagenase and Centella asiatica in the rat model. Twenty-seven female rats were divided into three groups, and two full-thickness wounds were made for each animal. Collagenase ointment was applied topically to Group I and C. asiatica ointment to Group II rats. In Group III, no treatment was applied. On the third day of treatment, wounds on the left side of three animals of each group were excised. On the fifth and eighth day of the treatments, the same procedure was performed for the remaining animals. Indirect immunohistochemical examination was performed to detect transforming growth factor beta (TGF)-β, endothelial and inducible nitric oxide synthase (eNOS and iNOS), vascular endothelial growth factor, TGF-α, laminin, fibronectin, collagen I, and interleukin-1β. According to the measurements of the wound areas and wound healing periodo, collagenase was superior to the control group. Immunohistochemical examinations showed strong (+++) iNOS and TGF-β immunoreactivities in C. asiatica group. eNOS immunoreactivity was moderate (++) in this group. For the collagenase group, iNOS, eNOS, and TGF-β immunoreactivities were moderate (++). In the collagenase group, while TGF-β and iNOS immunoreactivities were weaker, laminin and fibronectin reactivities were stronger than in C. asiatica and control groups. Collagenase was superior to C. asiatica according to the immunohistochemical findings. Collagenase ointment significantly improves the quality of wound healing and scar formation and is a more appropriate treatment choice than extract of C. asiatica in the early stages of the wound healing process. © 2008 by the Wound Healing Society.Item Acute generalized exanthematous pustulosis (AGEP) due to exposure to sulfuric acid and bromic acid vapor: A case report(2008) Bilaç D.B.; Ermertcan A.T.; Öztürkcan S.; Şahin M.T.; Temiz P.Acute generalized exanthematous pustulosis (AGEP, toxic pustuloderma, pustular drug eruption) is a not uncommon cutaneous reaction pattern that is usually related to drug administration. The eruption is of sudden onset and appears 7-10 days after the medication is started. A 22-year-old male patient who was a student at a chemical faculty attended our outpatient clinic with a complaint of pustular eruption on his face. According to his history, the eruption started with pruritus and erythema on his chin 3 days ago and spread to his face and chest. He explained that he had performed an experiment with sulfuric acid and bromic acid and was exposed to their vapor. His dermatological examination revealed erythema and pustules on his cheeks, on his chin, above his upper lip, and on his eyebrows. He also had a few pustules on his chest. There were no ocular, mucous membrane, or pulmonary symptoms. Histopathological examination of the skin biopsy specimen revealed superficial orthokeratosis, focal subcorneal pustule formation, and perivascular chronic inflammatory cell infiltration in superficial dermis. After administration of systemic antihistamines and wet dressing topically, we observed rapid healing of the lesions. Because there was no systemic drug intake in his history, we were concerned that exposure to sulfuric acid and bromic acid vapor caused AGEP in this patient. We present this rare case to show that the vapor of chemical materials may cause AGEP or other drug eruptions. Copyright © Informa Healthcare.Item Calciphylaxis with recalcitrant ulcers in the presence of moderate renal insufficiency(2009) Bilac C.; Ozturk F.; Ermertcan A.T.; Bilac D.B.; Sahin M.T.; Temiz P.; Gumuser F.G.; Ozturkcan S.A 69-year-old woman with painful crural ulcers of 3 months duration presented at the authors outpatient clinic. Dermatological examination revealed a necrotic ulceration with eschar formation localized on the anterior left crural region and the lateral malleolus of the right ankle. According to the clinical and histopathological findings, she was diagnosed with calciphylaxis. She had moderate renal insufficiency and secondary hyperparathyroidism due to hypertension. The ulcers improved significantly after 3 months of topical wound therapy. This case of calciphylaxis with recalcitrant ulcers in the presence of moderate renal insufficiency is presented to stress the importance of early diagnosis and management in this life-threatening disorder.Item The relationship between symptoms and patient characteristics among psoriasis patients.(2009) Bilac C.; Ermertcan A.T.; Bilac D.B.; Deveci A.; Horasan G.D.BACKGROUND: Pruritus is a common symptom of many dermatological and systemic diseases. It is a common complaint among patients with psoriasis of the chronic plaque type. Patients with pruritus suffer from more severe psoriasis although some authors did not find a significant relationship between pruritus intensity and psoriasis severity. AIMS: In this study, we aimed to investigate the relationship between clinical features and symptoms among psoriasis patients. And also we aimed to evaluate whether the severity of disease, depression and quality of life scores could effect these symptoms or not. METHODS: Eighty seven patients with psoriasis were enrolled in this study. Epidemiological data of patients were noted. Clinical symptoms, such as pruritus, pain, burning, exudation, bleeding, weakness, etc. were interrogated. The answers to these questions were classified as 'never', 'rare', 'sometimes', 'often' and 'all the time'. Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI), Hamilton Anxiety-Depression Scale (HAD) were calculated for each patient. PASI and DLQI scores were classified as > or = and < 10. RESULTS: We found that the most frequent symptom was pruritus (96.6%). Other frequent symptoms were burning (56.3%), exudation (56.3%) and bleeding (49.4%). Hurting, sensitiveness and bothering were more frequent in women. Percentages of hurting, pain, exudation and weakness symptoms had been increasing with age. Frequency of weakness was significantly high in PASI > or = 10 patients. CONCLUSION: Pruritus is a very common symptom in psoriasis. Burning, exudation and bleeding are also common symptoms seen in psoriasis. New scoring systems including symptoms of psoriasis patients may be developed for evaluating the severity of the disease.Item Two therapeutic challenges: Facial vitiligo successfully treated with 1% pimecrolimus cream and 0.005% calcipotriol cream(2009) Bilaç D.B.; Ermertcan A.T.; Şahin M.T.; Öztürkcan S.[No abstract available]Item Sorafenib-induced erythema multiforme in metastatic renal cell carcinoma(2009) Bilaç C.; Müezzinoǧlu T.; Ermertcan A.T.; Kayhan T.C.; Temeltaş G.; Özütrkcan S.; Temiz P.Sorafenib is a new therapeutic agent being used in metastatic renal cell carcinoma, hepatocellular carcinoma, and malignant melanoma. The most frequently seen cutaneous side effects due to sorafenib are erythema, exfoliative dermatitis, acne vulgaris, and flushing. Folliculitis, eczema, and erythema multiforme are other, rare side effects of sorafenib. A 59-year-old man underwent left radical nephrectomy due to renal cell carcinoma 8 months ago, and after the operation he received immunochemotherapy and then sorafenib. On the third day of sorafenib therapy his lesions occurred. His dermatologic examination revealed multiple erythematous papules on his neck, arms, and legs and bullae and iris lesions on his palms and soles. He was diagnosed as having erythema multiforme. In the literature we found only 1 other erythema multiforme case due to sorafenib. We present this interesting case to show and discuss cutaneous side effects of sorafenib, especially erythema multiforme as a very rare cutaneous side effect. © 2009 Informa UK Ltd.Item Sexual dysfunction in dermatological diseases(2009) Ermertcan A.T.Decrease or loss of sexual function in many chronic diseases has recently attracted significant attention owing to its impact on quality of life. Generic and disease-specific quality-of-life questionnaires measure changes in work, school, social life and emotional status regarding the disease and its treatment. Specific questionnaires have been designed to evaluate changes in sexuality and sexual function. Sexual dysfunction, especially female sexual dysfunction, in different diseases became a popular and important health concern in recent years. There are a lot of studies about sexual dysfunction in the areas of other specialities of medicine, but there are only a few studies in dermatological diseases. In this paper, sexual dysfunction and the studies performed about this subject in dermatology will be reviewed. Conflict of Interest None declared. © 2009 European Academy of Dermatology and Venereology.