Browsing by Author "Kartal S.P."

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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
    (John Wiley and Sons Inc, 2022) Sarıkaya Solak S.; Kara Polat A.; Kilic S.; Oguz Topal İ.; Saricaoglu H.; Karadag A.S.; Canpolat F.; Kartal S.P.; Deveci B.N.; Kacar N.; Polat Ekinci A.; Guner R.; Polat M.; Dogan G.; Guler Ozden M.; Bulbul Baskan E.; Ozaydin Yavuz G.; Adisen E.; Gulekon A.; Tanribilir M.E.; Yilmaz O.; Akman Karakas A.; Ozturk P.; Didar Balci D.; Gonulal M.; Yondem H.; Turel Ermertcan A.; 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. © 2021 British Association of Dermatologists.
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    Sociodemographic, clinical, laboratory, treatment and prognostic characteristics of 156 generalized pustular psoriasis patients in Turkey: a multicentre case series
    (John Wiley and Sons Inc, 2022) Kara Polat A.; Alpsoy E.; Kalkan G.; Aytekin S.; Uçmak D.; Yasak Güner R.; Topkarcı Z.; Yılmaz O.; Emre S.; Borlu M.; Türkoğlu Z.; Özkök Akbulut T.; Özaydın Yavuz G.; Kaya Erdoğan H.; Adışen E.; Satılmış Kaya A.; Oğuz Topal İ.; Yazıcı S.; Yılmaz E.; Koku Aksu A.E.; Kartal S.P.; Deveci B.N.; Öksüm Solak E.; Karadağ A.S.; Sarıkaya Solak S.; Kıvanç Altunay İ.; Türel Ermertcan A.; Özkesici Kurt B.; Gelincik Kaçar N.; 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-α 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. © 2022 European Academy of Dermatology and Venereology.
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    Analysis of factors influencing target PASI responses and side effects of methotrexate monotherapy in plaque psoriasis: a multicenter study of 1521 patients
    (Springer Nature, 2024) Erduran F.; Emre S.; Hayran Y.; Adışen E.; Polat A.K.; Üstüner P.; Öztürkcan S.; Öztürk P.; Ermertcan A.T.; Selçuk L.B.; Aksu E.K.; Akbaş A.; Kalkan G.; Demirseren D.; Kartal S.P.; Topkarcı Z.; Kılıç A.; Yaldız M.; Aytekin S.; Hızlı P.; Gharehdaghi S.; Borlu M.; Işık L.; Botsalı B.R.; Solak E.Ö.; Albayrak H.; Gönülal M.; Balcı D.D.; Polat M.; Daye M.; Ataseven A.; Yıldız S.; Özer İ.; Zorlu Ö.; Doğan S.; Erdemir V.A.; Dikicier B.S.
    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. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024.
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    Relationship of psoriatic arthritis with nail and scalp involvement in Turkish psoriasis patients: Multicentered cross-sectional study
    (Lippincott Williams and Wilkins, 2024) Askin O.; Engin B.; Ozdede A.; Kartal S.P.; Ugurlu S.; Akbulut T.O.; Ekinci A.P.; Aydogdu İ.H.; Ozden M.G.; Kok H.; Dogan S.; Ozturkcan S.; Borlu M.; Baskan E.B.; Yilmaz N.; Ak T.; Topkarci Z.; Serdaroglu S.
    Psoriasis is a common multisystem inflammatory disease, and arthritis is an essential component of the disorder, requiring early diagnosis and prompt treatment for successful management. In this study, we aimed to investigate the relationship between nail and scalp involvement and other covariates with psoriatic arthritis (PsA). This cross-sectional study, conducted from June 2021 through December 2021, included 763 patients from 11 different centers in Turkey. The severity of involvement was evaluated using psoriasis area severity index (PASI), nail psoriasis severity index (NAPSI), and psoriasis scalp severity index (PSSI) scores. Predictors for PsA were evaluated using univariate and multivariate logistic regression models. PsA (n = 155, 21.5%) was significantly more common in patients having a family history of psoriasis (43.2% vs 30.9%, P = .004), nail involvement (68.4% vs 52.3%, P < .001), and coexistence of nail and scalp involvement (53.7% vs 39.6%, P = .002). Furthermore, patients with PsA had considerably higher PASI (7 vs 5.6, P = .006), NAPSI (5 vs 2, P < .001), and PSSI scores (7 vs 4, P = .002) and longer disease duration (months) (126 vs 108, P = .009). In multivariate analysis, female gender [OR: 3.01, 95% CI (1.861-4.880), P < .001], nail involvement [OR: 2.06, 95% CI (1.293-3.302), P = .002)], and body mass index (BMI) [OR: 1.06, 95% CI (1.017-1.100), P = .005] were identified as independent predictors for PsA. Female gender, nail involvement, and high BMI are significant predictors for PsA and warrant detailed rheumatological assessment. Notably, being female is the strongest predictor of increased risk of PsA in our survey. Scalp involvement appears not to be associated with PsA. Also, the presence of PsA seems related to a more severe skin involvement phenotype. Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.