Browsing by Author "Selçuk, LB"

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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
    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.
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    Internalized Stigma in Hidradenitis Suppurativa: A Multicenter Cross-Sectional Study
    Bilgic, A; Karaman, BF; Demirseren, DD; Cinar, L; Kacar, N; Ermertcan, AT; Baskan, EB; Güven, M; Yazici, S; Akbulut, TÖ; Ucmak, D; Ataseven, A; Temiz, SA; Engin, B; Aktürk, AS; Saricaoglu, H; Özden, MG; Özdemir, H; Mammadli, K; Durmaz, K; Gülbasaran, F; Kilinc, F; Özden, HK; Gönülal, M; Balci, DD; Cemil, BÇ; Solak, SS; Selçuk, LB; Yavuz, GÖ; Yavuz, IH; Dönmez, L; Alpsoy, E
    Background: Hidradenitis suppurativa (HS) causes significant physical, social, and psychological burdens. Internalized stigma, acceptance of negative attitudes and stereotypes of society regarding a person's illness, has not been studied previously in HS. Objectives: The objective of this study was to investigate the internalized stigma state of HS patients and identify the factors affecting it. Methods: This multicenter, prospective, cross-sectional study included 731 patients. Internalized Stigma Scale (ISS), Hurley staging, Physician Global Assessment, Dermatology Life Quality Index (DLQI), Skindex-16, Beck Depression Inventory-II (BDI-II), and Visual Analog Scale (VAS)-pain score were used in the study. Results: The mean ISS value (57.50 +/- 16.90) was comparable to the mean ISS values of studies in visible dermatological and various psychiatric diseases. A significant correlation was found between the mean values of ISS and all disease activity scores, quality of life measures, BDI-II, and VAS-pain scores. Obesity, family history, low education and income level, vulva/scrotum involvement and being actively treated are significant and independent predictive factors for high internalized stigma in multivariate analysis. Conclusions: HS patients internalize society's negative judgements, which may create a profound negative effect on access to health care. Therefore, in addition to suppressing disease activity, addressing internalized stigma is fundamental for improving health care quality.
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    Prevalence of hirsutism in Turkey: Data of the dermatoendocrinology study group
    Kahraman, FC; Temiz, SA; Erdogan, SS; Öztürk, P; Güven, M; Çelik, HA; Tellal, ES; Akbayrak, A; Selçuk, LB; Akbulak, Ö; Emre, S; Gençoglan, G; Ataseven, A; Erdogan, HK; Ertekin, SS; Tasolar, MK; An, IS; Öztürk, M; Karakuzu, A; Erdal, SA; Solak, SS; Albayrak, H; Özer, EC; Bayramgürler, D; Özgöztasi, O; Yulek, T; Aydogan, K; Zindanci, I; Çalikoglu, E; Kus, C
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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.
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    Clinical and demographic features of hidradenitis suppurativa: a multicentre study of 1221 patients with an analysis of risk factors associated with disease severity
    Özkur, E; Karadag, AS; Üstüner, P; Aksoy, B; Esme, P; Çaliskan, E; Akoglu, G; Kalkan, G; Demirseren, DD; Polat, M; Ozden, MG; Kilinç, F; Iyidal, AY; Altunay, IK; Türkmen, M; Ugurer, E; Baysak, S; Karaman, BF; Mammadli, K; Selçuk, LB; Türkoglu, Z; Atci, T; Balci, DD; Adisen, E; Temel, B; Aktan, S; Kaçar, N; Gündüz, K; Ertmertcan, AT; Özdemir, M; Çakiter, AÜ; Çölgeçen, E; Uçmak, D; Kelekçi, H; Ataseven, A; Durmaz, K; Özden, HK; Engin, B; Yazici, S; Alpsoy, E
    Background Hidradenitis suppurativa (HS) is a chronic, relapsing and debilitating inflammatory disease associated with profound morbidity. Aim In this multicentre study, we investigated the demographic and clinical features of HS, and determined risk factors of disease severity. Methods In total, 1221 patients diagnosed with HS from 29 centres were enrolled, and the medical records of each patient were reviewed. Results The mean age of disease onset was 26.2 +/- 10.4 years, and almost 70% (n = 849) of patients were current or former smokers. Mean disease duration was 8.9 +/- 8.4 years with a delay in diagnosis of 5.8 +/- 3.91 years. Just over a fifth (21%; n = 256) of patients had a family history of HS. The axillary, genital and neck regions were more frequently affected in men than in women, and the inframammary region was more frequently affected in women than in men (P < 0.05 for all). Acne (40.8%), pilonidal sinus (23.6%) and diabetes mellitus (12.6%) were the most prevalent associated diseases. Of the various therapies used, antibiotics (76.4%) were most common followed by retinoids (41.7%), surgical interventions (32.0%) and biologic agents (15.4%). Logistic regression analysis revealed that the most important determinants of disease severity were male sex (OR = 2.21) and involvement of the genitals (OR = 3.39) and inguinal region (OR = 2.25). More severe disease was associated with comorbidity, longer disease duration, longer diagnosis delay and a higher number of smoking pack-years. Conclusions Our nationwide cohort study found demographic and clinical variation in HS, which may help broaden the understanding of HS and factors associated with disease severity.