Browsing by Author "Güner, RY"

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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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    A multicentre prospective analysis of the incidence of pemphigoid diseases in Turkey
    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.