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Öğe Adverse effects of antihistamines on skin tests and antihistamines in pregnancy(2005) Kilinc I.; Alper S.Allergy skin tests are the best and most reliable method of diagnosing allergies. Medications may influence the interpretation of skin testing. Antihistamines interfere with prick and intradermal skin tests, while they do not suppress patch tests. Some other medications also have influence on allergy skin tests. It's important to know the suppression mechanism and the duration of the inhibitory effect of these drugs on the skin test to get correct interpretation, which would be a valuable guide in allergen identification and avoidance in treatment of allergies. Allergic diseases are common and bothering medical problems in pregnant patients. It's generally recommended to avoid all medications during pregnancy, if possible. But sometimes antihistamines are needed to be used in the treatment of allergic diseases regarding the benefit/risk ratio. In such cases, antihistamines should be carefully chosen. Considering the animal and human data available, chlorpheniramine seems to be the antihistamine to choose with the least risk. © 2005 Bentham Science Publishers Ltd.Öğe Association between IL4 (-590), ACE (I)/(D), CCR5 (?32), CTLA4 (+49) and ILl-RN (VNTR in intron 2) gene polymorphisms and vitiligo(2009) Sacide Pehlivan; Özkınay F.; Alper S.; Onay H.; Yuksel E.; Pehlivan M.; Özkınay, CihangirVitiligo is a common skin disorder characterized by patterned depig-mentation, because of a decrease of melanin pigment resulting from apparent melanocyte loss. The aim of this study was to investigate interleukin 4 (IL4), Angiotensin Converting Enzyme (ACE), C-C Che-mocine Receptor 5 (CCR5), Cytotoxic T Lymphocyte-associated Anti-gen Receptor 4 (CTLA4) and Interleukin 1 Receptor Antagonist (ILl-RN) gene polymorphisms in 48 Turkish vitiligo patients and 50 healthy controls. Polymorphisms for the genes ACE insertion(I)/dele- tion(D), CCR5 (A32), ILl-RN (VNTR in intron 2) were detected by PCR methods. IL4 (-590) and CTLA4 (+49) gene polymorphisms were typed using PCR-RFLP methods. No significant differences in either the genotype distribution or allele frequencies of IL4, CCR5 and ACE gene polymorphisms were observed. GG genotype and G allele in CTLA4 genes were found to be significantly higher in vitiligo patients compared to the controls. (0.002, 0.000). CTLA4 (AA) and ILl-RN (1/5) genotypes and 5 allele frequency in the ILl-RN gene were found to be significantly lower in vitiligo patients compared to healthy controls (p: 0.014, 0.015, 0.016, respectively). As a conclu-sion, CTLA4 and ILl-RN genes might play roles in the genetic etiology of vitiligo.Öğe Atopic dermatitis [Atopik dermatit](2011) Alper S.; Türk B.G.Atopic dermatitis is one of the important public health problems of the industrialized communities, and the prevalence of the disease has been increasing in our developing country. In this paper, etiopathogenesis, clinical characteristics and current therapeutic approaches of atopic dermatitis is reviewed under highlights of recently published guidelines and the literature.Öğe Autoantibodies other than antineutrophil cytoplasmic antibodies are not positive in patients with psoriasis vulgaris(Japanese Dermatological Association, 2005) Kutukculer N.; Yuksel S.E.; Aksu G.; Alper S.There is a great deal of evidences that a link may exist between psoriasis and autoimmunity. In this study, thirty-six patients with psoriasis vulgaris and twenty healthy controls were screened for antinuclear antibody (ANA), anti-ds-DNA antibodies, anti-SSA (anti-Ro), anti-SSB (anti-La), anti-Scl-70, anti-Jo-1, rheumatoid factor (RF), C3 and C4 levels, IgG and IgM anti-cardiolipin antibodies (aCL) and anti-neutrophil cytoplasmic antibodies (pANCA and cANCA) in order to determine the role of autoimmunity in the pathogenesis. In addition, the MPO-ANCA test was performed on pANCA-positive patients. In ANA screening, one patient showed 1/80 granular positivity. No positive results were obtained from either the study or control groups for anti-dsDNA, anti-SSA, anti-SSB, anti-Scl-70, or anti-Jo-1 determinations. For RF, 5.8% of the patients had positive values. Both C3 and C4 levels were found to be significantly elevated in psoriasis patients compared to healthy controls (p<0.001). IgG-aCL and IgM-aCL positivity was not significantly different between the two group. pANCA was positive in 33.3% of the patients and a significant difference was observed between study and control groups (p<0.05). MPO-ANCA was negative in all the pANCA-positive patiente. In conclusion, only serum C3 and C4 levels and pANCA determinations showed significant differences when compared to healthy controls. Our findings may be evidence of associations between autoimmunity and psoriasis vulgaris. However, more detailed studies in this field need to be done to determine the relationship between them.Öğe A case of erythema annulare centrifigum with Sjögren syndrome [Sjögren sendromu ile birlikteligi olan eritem anüler santrifüj tanili bir olgu](2010) Ertam I.; Erçal H.E.; Kazandi A.; Ünal I.; Alper S.Erythema annulare centrifigum is a dermatose which is frequently seen in adults. It is characterized by erythematous lesions which spread asymmetrically to periphery and have a collarette desquamation. Although infection, tumor, food allergy, drug reaction can play a role in the aetiology, most of the cases are idiopathic. A forty-nine years old, female patient presented to our clinic with erythematous lesions on both of her lower extremities. Six weeks prior to her referral, she treated with quinine for Sjogren syndrome. She had a diagnosis of granuloma annulare in her personal history. There was no significance in her family history. In dermatologic examination; annular erythematous plaques and collarette desquamation were detected on lower extremities. Histopathologic examination of the lesional biopsy specimen revealed focal spongiosis in the epidermis, dermal oedema, vascular proliferation and perivascular infiltration of lymphocytes, eosinophils and histiocytes. In the laboratory examination; blood count, liver and kidney function tests, sedimentation, C-reactive protein was normal. Rheumatoid factor was 30. Antinuclear antibody was 1/640 granular pattern. A case of erythema annulare centrifigum with Sjögren Syndrome is discussed with the other skin findings of the disease.Öğe A case of reversible telogen effluvium caused by a drug [İlaca bagli gelişen bir reversibl effluvium olgusu](2006) Ertam I.; Ünal I.; Alper S.Effluvium, known as diffuse hair loss, is seen as anagen and telogen effluvium. In telogen effluvium, hair follicles pass from anagen phase to telogen phase prematurely. Certain drugs such as anticoagulants, cytostatics, interpherons, retinoids, lithium carbonate, ß- blockers, antimalarials, sexual hormone preparations and angiotensin converting enzyme inhibitors may be cause of effluvium. In this case, we present a 52 years old female patient suffering from diffuse hair loss after using conjugate estrogen plus progesterone preparation for nearly one-month. Etiological investigations revealed no certain pathological results. After cessation of treatment, hair loss diminished and complete hair regrowth was observed during follow up period. In this report, current literatures related to the topic were reviewed and the role of sexual hormone preparations on hair loss was emphasized.Öğe Comparison of psoriasis area and severity index and physician’s global assessment in determining psoriasis severity(Kuwait Medical Association, 2021) Acar A.; Bozkurt A.; Yenipazar G.K.; Alper S.; Ceylan C.Objective: In clinical studies, it is crucial to assess psoriasis severity accurately and with no substantial variation between different raters. The Psoriasis Area and Severity Index (PASI) and Physician Global Assessment (PGA) are the two most commonly used tools for the assessment of psoriasis severity. The aim of this study was to evaluate the intra-rater and inter-rater reliability of these methods and to determine whether inter-rater reliability is affected by rater experience. Design: An open uncontrolled study Setting: Dermatology Department of Ege University, Medical Faculty Subjects: Fifty-five patients with plaque psoriasis who were examined between 15 August 2012 and 15 November 2012 in the dermatology department of Ege University Interventions: Three dermatology residents with varying experience evaluated the patients individually using both the PASI and PGA for each patient (in that order). Main Outcome Measure: PASI and PGA Results: PASI and PGA scores showed high intra-rater correlation for all three residents. Inter-rater reliability for PASI was high between the most experienced and second most experienced resident and between the most experienced and least experienced resident. However, inter-rater reliability for PGA was high between the most experienced and second most experienced residents, but only moderate between the most experienced and least experienced resident. Conclusions: There were no significant interrater differences between PGA and PASI scores in our study. However, because PGA is more subjective and may be affected by rater experience, PASI is considered to be a more reliable method for assessing severity of psoriasis. © 2021, Kuwait Medical Association. All rights reserved.Öğe Cutaneous tuberculosis: A 18-year retrospective evaluation [Deri tüberkülozu: 18 Yillik retrospektif degerlendirme](2003) Ünal I.; Özdemir F.; Kazandi A.C.; Alper S.; Yazkan F.Background and Design: While the incidence and prevalence of cutaneous tuberculosis dropped markedly around the world, it has re-emerged in areas with a high incidence of HIV infection. Cutaneous tuberculosis still keeps its importance among other skin infections in developing countries. This study was conducted to determine the epidemiology, clinical and histopathological properties of cutaneous tuberculosis in Dermatology Department of Ege University Medical Faculty. Materials and Methods: The cases of cutaneous tuberculosis which was diagnosed in Dermatology Department of Ege University Medical faculty were studied retrospectively. 93 cases of cutaneous tuberculosis were investigated epidemiologically, clinically and histopathologically. The biopsy specimens were examined and the histopathological features were reevaluated. Results: 69 (%74) cases of lupus vulgaris, 12(%13) cases of scrofuloderma, 12(%13) cases of tuberculosis verrucosa cutis were observed. The increase in the incidence of tuberculosis verrucosa cutis was noticed comparing with recent epidemiological studies. Lupus vulgaris lesions have been found to be localized mostly on head and neck region (% 72.4), scrofuloderma lesions on the neck (%66.6) and tuberculosis verrucosa cutis lesions on extremities (%100). Conclusions: Although number of skin tuberculosis have been observed to decrease by years it has still an important incidence in Turkey. In our study, lupus vulgaris was the most common form of cutaneous tuberculosis followed by the equal proportion of scrofuloderma and tuberculosis verrucosa cutis.Öğe Discrete papular dermal mucinosis with Hashimoto thyroiditis: a case report.(2011) Ertam I.; Karaca N.; Ceylan C.; Kazandi A.; Alper S.The cutaneous focal mucinoses are a group of connective tissue disorders characterized by deposition of mucin found either focally or diffusely in the dermis. A 47-year-old woman presented with asymptomatic flesh-colored papules on the neck, inguinal area, intergluteal area, vulvar area, and extremities of 5 months' duration. There was no history of preceding trauma or insect bites. The patient had undergone a subtotal thyroidectomy 21 years prior but had not used any thyroid medication before she was referred to our clinic. Thyroid ultrasonography was consistent with Hashimoto thyroiditis. During dermatologic examination, flesh-colored, well-defined, smooth papules that measured approximately 1.5 x 1 cm in size on the genital region, fingers, face, and scalp were seen. Histopathologic examination of a lesional biopsy revealed no abnormalities in the epidermis. Alcian blue staining showed that abundant deposits of dermal mucin had replaced collagen in the dermis.Öğe Effectiveness of Intense Pulsed Light treatment in solar lentigo: A retrospective study [Solar lentigoda yogun atimli işik (Intense Pulse Light) tedavisinin etkinligi: Retrospektif çalişma](Istanbul Assoc. of Dermatology and Venerology, 2014) Ertam I.; Türk B.G.; Karaarslan I.K.; Ünal I.; Alper S.Background and Design: Intense Pulsed Light (IPL) is a light system of 500-1200 nm wavelength which is used for hair removal and nonablative skin resurfacing as well as for the treatment of hyperpigmentation and superficial vascular lesions. The mechanism of action is thought to be the focal epidermal coagulation due to selective photothermolysis in the epidermal keratinocytes and melanocytes. A variety of laser systems can be used in the treatment of solar lentigo. The aim of this study was to investigate the effectiveness of IPL in solar lentigo. Materials and Methods: We retrospectively reviewed the medical records of patients with the diagnosis of solar lentigo in our Cosmetology Unit from March 2007 to November 2010. There were 139 files of patients who received clinical and dermoscopic diagnosis of solar lentigo and treated by IPL (L900 A&M). Informed consent was taken from all patients. Among them, 42 patients, who had attended regular follow-up visits and had pictures taken both before and after treatment, were included in the study. Results: A total of 52 lesions in 42 female and 1 male patients were included in the study. The mean age of the patients was 42±9.6 (33-88) years. Thirty-seven lesions (51.9%) were on the cheek, 7 lesions (13.5%) were on the zygoma, 6 lesions (11.5%) were on the chin, 4 lesions (7.7%) were on the hands, 4 lesions (7.7%) were on the forehead, 2 lesions (3.8%) were on the nose, and 2 lesions (3.8%) were on the forearm. The mean number of sessions was 3.28, ranging between 1 and 7. After treatment, more than 75% improvement was observed in 57.7% of the lesions, 50-75% in 17.3% of the lesions, 25-50% in 17.3% of the lesions, and less than 25% improvement was obtained in 7.7% of the lesions. Conclusion: According to the results of our work, IPL can be considered to be an effective, cheap and safe method in terms of its side effects in the treatment of solar lentigo.Öğe Efficiency of ellagic acid and arbutin in melasma: A randomized, prospective, open-label study(2008) Ertam I.; Mutlu B.; Unal I.; Alper S.; Kivçak B.; Ozer O.The aim of this study was to compare the effectiveness of gel formulations containing arbutin, synthetic ellagic acid and plant extracts that contain ellagic acid, on patients with melasma. Thirty patients who applied to Ege University Medical Faculty, Department of Dermatology, were included in the study. A signed consent was obtained from each patient prior to study. Patients whose type of melasma was determined via Wood's lamp were randomized to groups of arbutin, synthetic ellagic acid and plant extract containing natural ellagic acid. The pigment density of patients was evaluated via Mexameter before and after the treatment. The approval of the Institutional Ethics Committee of Ege University was obtained before the study. Wilcoxon and Kruskal-Wallis tests were used in the statistical analysis. Nine of 10 patients, for whom synthetic ellagic acid was started, completed the study. A decrease in the level of melanin was determined in eight of these nine patients (P = 0.038). A significant decrease in the level of melanin was also determined in all 10 patients who used plant extract containing ellagic acid (P = 0.05). A significant response was obtained from all of 10 patients who used arbutin. The difference between pre- and post-treatment levels of melanin was statistically significant (P = 0.05). Formulations prepared with plant extracts containing ellagic acid was found effective on melasma, similar to the formulations containing synthetic ellagic acid and arbutin. This material that is not yet being used widespread commercially on melasma could be an effective alternative for treatment of melasma. © 2008 Japanese Dermatological Association.Öğe Erythromelanosis follicularis faciei et colli: Report of involvement in two female patients(2005) Ertam I.; Unal I.; Alper S.Erythromelanosis follicularis faciei is a rare disease characterized by reddish brown pigmentation and follicular papules localized on certain areas such as the face and neck. Young men are usually affected, but young women or children may be affected. Bilateral distribution is usual, but it may occur unilaterally. Histopathologically, hyperkeratosis, increased melanization and dilatation of the hair follicle are characteristic. Two female patients with typical localizations and clinical findings of the disease are reported here. © 2005 Dermatology Online Journal.Öğe Exon-3 polymorphism of CTLA-4 gene in Turkish patients with vitiligo [1](2005) Itirli G.; Pehlivan M.; Alper S.; Yüksel S.E.; Onay H.; Özkınay F.; Pehlivan S.[No abstract available]Öğe The frequency of skin diseases among students in a University clinic(Pulse Marketing and Communications LLC, 2010) Ertam I.; Babur Y.; Unal I.; Alper S.This study was conducted to assess the frequency of dermatologic diseases in Turkish university students. University students who visited two dermatology outpatient clinics within the Ege University Health, Culture and Sports Office were included in the study. Each student was examined by two dermatologists. Questions about demographic data and information about the frequency of using the swimming pool were directed to the patients. All dermatological diseases were recorded. Patients were asked to assess and give a score for the state of their mental wellness using the visual analog scale (0-100) during the past month. Chi-square and Student t tests were used for statistical analyses. A total of 1733 individuals, 750 (43.3%) men and 983 (56.7%) women, were included in the study. The most frequently seen diseases were acne vulgaris (40.1%) and fungal diseases (17.08%), whereas the least frequently seen were parasitic skin diseases (0.46%) and vascular diseases (0.51%). The mean mental wellness score was found to be 61.03±21.34 (0-100, median: 65.00). It can be concluded that students visit university dermatology outpatient clinics frequently and the most common complaints are acne vulgaris and fungal diseases. © 2010 Pulse Marketing & Communications, LLC.Öğe Generalized Trichophyton rubrum infection in a subject with pemphigus vulgaris [6](2000) Özdemir F.; Erboz S.; Ünal I.; Alper S.; Aytimur D.; Özol A.; Aytimur M.[No abstract available]Öğe Grover disease(Springer Berlin Heidelberg, 2015) Turk B.G.; Alper S.Grover disease (GD), namely, “transient acantholytic dermatosis,” is an acquired disease which is characterized by pruritic papulovesicular rash on the trunk and extremities. Management includes avoidance of exacerbating factors, topical agents for localized disease, systemic agents or phototherapy for generalized and recalcitrant disease and oral antihistamines for pruritus. © Springer-Verlag Berlin Heidelberg 2015.Öğe Grover Disease(Springer International Publishing, 2023) Turk B.G.; Alper S.Grover disease (GD), namely, “transient acantholytic dermatosis,” is an acquired disease which is characterized by pruritic papulovesicular rash on the trunk and extremities. Management includes avoidance of exacerbating factors, topical agents for localized disease, systemic agents or phototherapy for generalized and recalcitrant disease, and oral antihistamines for pruritus. © Springer Nature Switzerland AG 2023.Öğe IgG-anti-IgA antibodies: An autoimmune finding in patients with psoriasis vulgaris(2012) Azarsiz E.; Ertam I.; Karaca N.; Aksu G.; Alper S.; Kutukculer N.Aim. Psoriasis is thought to be an autoimmune disease caused by inappropriate activation of the cellular immune system. In this study, we aimed to search out IgG-anti-IgA antibody levels, serum immunoglobulins and antinuclear antibodies (ANA). Methods. The study entrolled 38 psoriasis vulgaris patients and 40 healthy controls. Results. Mean IgG-anti-IgA levels were significantly higher in psoriasis patients. The frequency of positive ANA testing was 21.1%; however, there was no correlation between IgG-anti-IgA antibody levels and ANA positivity. Only one patient had low IgA levels without high IgG-anti-IgA concentrations. Conclusion. The data about high IgG-anti-IgA antibody levels are noteworthy for a new evidence of autoimmune mechanism.Öğe Öğe Malassezia furfur onychomycosis in an immunosuppressed liver transplant recipient [3](Medknow Publications and Media Pvt. Ltd, 2007) Ertam I.; Aytimur D.; Alper S.[No abstract available]
