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Öğe Adverse cutaneous drug reactions among hospitalized patients: five year surveillance(Taylor & Francis Ltd, 2013) Turk, Bengu Gerceker; Gunaydin, Asli; Ertam, Ilgen; Ozturk, GunseliContext: Cutaneous Adverse Drug Reactions (CADRs) are observed in 2-3% of hospitalized patients. The clinical presentation of the CADRs varies among different populations. Objective: To study the CADRs in hospitalized patients and their outcome. Materials and methods: Patients hospitalized at our department between 2005 May and 2010 May were retrospectively reviewed for the diagnosis of CADRs. Results: A total of 94 patients (3.3%) were diagnosed with CADR among 2801 hospitalized patients. Of them, 56 patients were female (59.6%) and 38 patients were male (40.4%). The culprit drugs were antibiotics (24.5%), non-steroid anti-inflammatory drugs (NSAID) (22.4%), anticonvulsants (13.8%), antihypertensive agents (8.5%), paracetamol with or without pseudoephedrine or phenylephrine (6.4%), intravenous contrasts (3.2%), terbinafine (2.1%), biologic agents (2.1%) and various other medications (17.0%). The most common clinical type of CADRs was morbilliform exanthemas in 59.6% of the patients, followed by erythroderma (6.4%), drug reactions with eosinophilia and systemic symptoms (6.4%), lichenoid drug reaction (5.3%), urticaria and angioedema (4.3%), acute generalized exanthematous pustulosis (4.3%), drug-induced vasculitis (3.2%), drug induced psoriasis (2.1%), Stevens-Johnson syndrome/toxic epidermal necrolysis overlap (2.1%), psoriasiform drug reaction (2.1%). Fixed drug reaction, erythema multiforme, bullous drug reaction, drug induced panniculitis were observed in one each. No deaths occurred on the follow-up. Fever was observed in 35.1% of the patients. Eosinophilia was present in 51.1% of them. Latency period ranged between 0-15 days in 59 patients (62.8%), 15-30 days in 19 patients (20.2%), 30-90 days in 13 patients (13.8%), 90-120 days in three of them (3.2%). The latency for anticonvulsant drugs was statistically longer than the other group of drugs (p: 0.027). Discussion and conclusions: CADRs were more common in women and most of them were caused by antimicrobial agents followed by NSAIDs and anticonvulsants. Latency period of anticonvulsants were longer than the other groups.Öğe Adverse cutaneous drug reactions among hospitalized patients: five year surveillance(Taylor & Francis Ltd, 2013) Turk, Bengu Gerceker; Gunaydin, Asli; Ertam, Ilgen; Ozturk, GunseliContext: Cutaneous Adverse Drug Reactions (CADRs) are observed in 2-3% of hospitalized patients. The clinical presentation of the CADRs varies among different populations. Objective: To study the CADRs in hospitalized patients and their outcome. Materials and methods: Patients hospitalized at our department between 2005 May and 2010 May were retrospectively reviewed for the diagnosis of CADRs. Results: A total of 94 patients (3.3%) were diagnosed with CADR among 2801 hospitalized patients. Of them, 56 patients were female (59.6%) and 38 patients were male (40.4%). The culprit drugs were antibiotics (24.5%), non-steroid anti-inflammatory drugs (NSAID) (22.4%), anticonvulsants (13.8%), antihypertensive agents (8.5%), paracetamol with or without pseudoephedrine or phenylephrine (6.4%), intravenous contrasts (3.2%), terbinafine (2.1%), biologic agents (2.1%) and various other medications (17.0%). The most common clinical type of CADRs was morbilliform exanthemas in 59.6% of the patients, followed by erythroderma (6.4%), drug reactions with eosinophilia and systemic symptoms (6.4%), lichenoid drug reaction (5.3%), urticaria and angioedema (4.3%), acute generalized exanthematous pustulosis (4.3%), drug-induced vasculitis (3.2%), drug induced psoriasis (2.1%), Stevens-Johnson syndrome/toxic epidermal necrolysis overlap (2.1%), psoriasiform drug reaction (2.1%). Fixed drug reaction, erythema multiforme, bullous drug reaction, drug induced panniculitis were observed in one each. No deaths occurred on the follow-up. Fever was observed in 35.1% of the patients. Eosinophilia was present in 51.1% of them. Latency period ranged between 0-15 days in 59 patients (62.8%), 15-30 days in 19 patients (20.2%), 30-90 days in 13 patients (13.8%), 90-120 days in three of them (3.2%). The latency for anticonvulsant drugs was statistically longer than the other group of drugs (p: 0.027). Discussion and conclusions: CADRs were more common in women and most of them were caused by antimicrobial agents followed by NSAIDs and anticonvulsants. Latency period of anticonvulsants were longer than the other groups.Öğe Alopecia Areata and Vitiligo as a Long-term Sequelae of Drug Reaction with Eosinophilia and Systemic Symptoms Syndrome(Wolters Kluwer Medknow Publications, 2016) Iskandarli, Mehdi; Ozturk, GunseliÖğe Development of a New Incontinence Containment Product and an Investigation of Its Effect on Perineal Dermatitis in Patients With Fecal Incontinence: A Pilot Study in Women(Hmp, 2019) Leblebiciglu, Hulya; Khorshid, Leyla; Ondogan, Ziynet; Ozturk, GunseliResearch related to the design and development of new incontinence containment products for women is scarce. PURPOSE: the purpose of this 2-part study was to 1) develop a new incontinence containment product for fecal incontinence and 2) examine the effect of this new product on the occurrence of incontinence-associated dermatitis (IAD). METHODS: in part 1, a new incontinence containment product was designed, developed, and trialed among 10 healthy female volunteers. the product was comprised of a double layer of polypropylene nonwoven fabric and 100% cotton interlock fabric with a 3-ply 100% cotton interlock fabric added into the perianal section. Participants wore the product for 8 hours and were asked to defecate into the product and evaluate its comfort, ability to contain liquids and protect privacy, any personal allergic reaction, and air permeability. in part 2, after any product modifications, 12 bedridden women treated in the neurology unit of a hospital in western Turkey who had an indwelling urinary catheter and fecal incontinence and who did not have diabetes mellitus, a darkly pigmented area in the perianal area, pressure injury, or erythema were randomized to 2 groups (study product and control, a premium adult diaper) and monitored for 8 days for the development and severity of perineal dermatitis (scored from 0 [no erythema] to 4 [broken, abraded skin]) using a skin assessment tool. Any type of erythema was considered IAD. Skin care (cleansing with a washcloth and water) was provided daily and after each defecation to all study participants. Data were collected via paper-and-pencil completion of the perineal skin integrity assessment and patient observation forms and entered into and analyzed by a computerized statistical program. Fisher's exact test and the chi-squared test were used to analyze the difference in IAD incidence and severity between the 2 groups, and the Mann Whitney U test was used to detect differences in the number and consistency of defecations. RESULTS: No statistically significant differences were noted among the characteristics of the 12 participants (6 in each group) except for age; patients in the study product group were significantly older (70.66 +/- 10.36 vs 52.20 +/- 16.78 years; P <.05. Four (4) patients in the study group exhibited 13 areas of perineal dermatitis (degree 1 = 6 areas; degree 2 = 6 areas; degree 3 = 1 area; and degree 4 = 0); 1 patient in the control group had 4 areas with degree 1. CONCLUSION: This prototype product is not sufficient to be used in clinical practice in patients with fecal incontinence, but further study in a larger population is warranted.Öğe Early and Late Side Effects Associated with Photo(chemo)therapy(Deri Zuhrevi Hastaliklar Dernegi, 2010) Ozturk, GunseliPhototherapy (PUVA ye UVB) is a widely used and effective treatment method for a variety of dermatological diseases. Adverse effects associated with phototherapy can be classified as acute and chronic side effects. Acute side effects are mostly related with UV doses and drug intolerance, and include itching, nausea, erythema, edema and phototoxic reactions that sometimes blister formation is seen. Acute side effects are usually moderate and transient. Chronic side effects of phototherapy are early aging of skin, pigmentary changes and increased risk of skin carcinogenesis. The major concern is development of skin cancer. This risk is especially related to long-term exposure and high cumulative doses of PUVA, increase in time and is persistent. Therefore, risk/advantage ratio of phototherapy should be carefully evaluated in each patient, and treatment protocols with minimal UV exposure should be chosen according to the phototherapy guides. Follow-up of the patients for long terms is important in prevention or in reduction of this risk by detecting and treating any premalignant or malignant lesion early. In this article, acute and chronic side effects of phototherapy are reviewed with recent literature findings.Öğe Exanthematous drug eruption due to valsartan(Informa Healthcare, 2012) Ozturk, Gunseli; Turk, Bengu Gerceker; Senturk, Bircan; Turkmen, Meltem; Kandiloglu, GulsenObjective: Valsartan is an angiotensin II receptor blocker (ARB) used for treatment of hypertension. The well-known adverse effects of valsartan are dizziness, headache and cough. Valsartan-related cutaneous side effects have been reported previously in a limited number of case reports. Materials and methods: A 47-year-old man admitted with diffuse, itchy erythematous maculopapular eruption all over the body. He has been taking 160 mg valsartan daily for 10 days before onset of the eruption. On the third day of valsartan therapy, erythema had appeared over the face and spread throughout the whole body within a week. Histopathologic examination of the lesions showed lymphocyte exocytosis, spongiosis, necrotic keratinocytes in the epidermis, and mixed inflammatory cell infiltrates including perivascular eosinophils in the dermis. The patient was diagnosed as drug reaction due to valsartan with historical, clinical and histopathologic features. Discussion and conclusion: Most common antihypertensive agents including diuretics, beta blockers, calcium-channel blockers, angiotensin-converting enzyme inhibitors have many cutaneous side effects. However, there are a few reports about the cutaneous side effects of ARBs. Physicians should be aware of the cutaneous side effects of this commonly used agent and valsartan should be considered as a triggering factor of an exanthematous drug reactions.Öğe Experience with Omalizumab for the treatment of chronic spontaneous urticaria in a tertiary center: real life experience(Taylor & Francis Ltd, 2020) Acar, Ayda; Gerceker Turk, Bengu; Ertam Sagduyu, Ilgen; Ceylan, Can; Ozturk, Gunseli; Unal, IdilPurpose Chronic spontaneous urticaria (CSU) is defined as urticaria and/or angioedema that appears spontaneously due to known or unknown causes and lasts for at least 6 weeks. Omalizumab, an anti-IgE antibody that binds circulating free IgE, has recently emerged as a promising treatment for CSU, a condition which impairs patients' quality of life. We aimed to contribute real life data by reporting our experience with omalizumab in the treatment of intractable CSU. Methods of 140 patients treated with omalizumab in our clinic between September 2013 and January 2018, 86 CSU patients with available current data were retrospectively evaluated in terms of sex, age, urticaria duration, urticaria activity score over 7 days (UAS7) before and after omalizumab, relapses and time to relapse, length of remission after omalizumab cessation, adverse events, and comorbidities. Results the mean age of the patients was 45.5 +/- 14.3 years and 73.3% were women. Mean duration of urticaria before initiation of omalizumab therapy was 54.5 +/- 67 months. All patients had used antihistamines before starting omalizumab treatment. the mean number of omalizumab doses was 11.9 +/- 9.3. the mean duration of omalizumab treatment was 13.3 +/- 10.4 months. Mean UAS7 score was 38.9 +/- 4.1 before the start of omalizumab treatment, and 7.9 +/- 10.5 after treatment. Treatment was discontinued in 10 patients (11.6%) due to nonresponse or loss of effect. Four patients (4.65%) experienced adverse events. Treatment was discontinued in 1 patient (1.16%) due to side effects. of the 55 patients whose treatment was discontinued after their symptoms resolved, 31 (56.3%) relapsed after omalizumab cessation. Twenty-four patients (43.6%) did not relapse after omalizumab cessation. Conclusions Our results show that omalizumab was an effective treatment for intractable CSU and did not cause any serious adverse effects other than asthenia, vertigo, and injection site reaction in four patients. These findings are relevant because they reflect real-life data.Öğe Gabapentin for the treatment of recalcitrant chronic prurigo nodularis(John Libbey Eurotext Ltd, 2008) Dereli, Tugrul; Karaca, Nezih; Inanir, Isil; Ozturk, GunseliÖğe Generalized pustular eruptions due to terbinafine(Taylor & Francis Ltd, 2012) Ozturk, Gunseli; Turk, Bengu Gerceker; Karaca, Nezih; Karaarslan, Isil Kilinc; Ertekin, Banu; Ertam, Ilgen; Kazandi, Alican; Kandiloglu, GulsenTerbinafine, a widely used antifungal agent, may rarely cause cutaneous side effects with an incidence of 2.7%. Generalized pustular eruptions are quite uncommon but severe adverse cutaneous reactions of terbinafine have been reported. The main pustular eruptions due to terbinafine include acute generalized exanthematous pustulosis and drug induced pustular psoriasis. In this report, two cases of acute generalized exanthematous pustulosis and one case of generalized pustular psoriasis triggered with terbinafine are presented.Öğe Long-term Follow-up of Positive Surgical Margins in Basal Cell Carcinoma of the Face(Lippincott Williams & Wilkins, 2015) Bozan, Aykut; Gode, Sercan; Kaya, Isa; Yaman, Banu; Uslu, Mustafa; Akyildiz, Serdar; Apaydin, Fazil; Ceylan, Can; Ozturk, GunseliBACKGROUND Basal cell carcinoma (BCC) in central facial locations and tumors with positive margins are at a higher risk of recurrence. The most effective treatment is total excision, which includes an adequate pathological margin. OBJECTIVE To evaluate the outcome of the patients who underwent surgery for BCCs of the head and neck and of those who had positive surgical margins where Mohs surgery is not available. METHODS This study was conducted at Ege University Medical School between 2004 and 2014. One hundred thirty patients with 154 BCC who underwent surgical excision were included. In the histopathologic report, the existence of positive margin, BCC subtype, localization of the tumor, and distance of margins to the tumor were evaluated. RESULTS Twenty-three lesions (14.9%) of 22 patients revealed positive surgical margins. Six patients (26.1%) had recurrences on the surgical site. The BCC subtypes of recurrent patients were reported to be multifocal superficial in 2 (33.3%), infiltrative (16.7%) in 1, and micronodular (50%) in 3. CONCLUSION Patients with superficial multifocal or micronodular tumors should undergo reoperation because of high recurrence rates.Öğe Long-term Follow-up of Positive Surgical Margins in Basal Cell Carcinoma of the Face(Lippincott Williams & Wilkins, 2015) Bozan, Aykut; Gode, Sercan; Kaya, Isa; Yaman, Banu; Uslu, Mustafa; Akyildiz, Serdar; Apaydin, Fazil; Ceylan, Can; Ozturk, GunseliBACKGROUND Basal cell carcinoma (BCC) in central facial locations and tumors with positive margins are at a higher risk of recurrence. The most effective treatment is total excision, which includes an adequate pathological margin. OBJECTIVE To evaluate the outcome of the patients who underwent surgery for BCCs of the head and neck and of those who had positive surgical margins where Mohs surgery is not available. METHODS This study was conducted at Ege University Medical School between 2004 and 2014. One hundred thirty patients with 154 BCC who underwent surgical excision were included. In the histopathologic report, the existence of positive margin, BCC subtype, localization of the tumor, and distance of margins to the tumor were evaluated. RESULTS Twenty-three lesions (14.9%) of 22 patients revealed positive surgical margins. Six patients (26.1%) had recurrences on the surgical site. The BCC subtypes of recurrent patients were reported to be multifocal superficial in 2 (33.3%), infiltrative (16.7%) in 1, and micronodular (50%) in 3. CONCLUSION Patients with superficial multifocal or micronodular tumors should undergo reoperation because of high recurrence rates.Öğe Long-term Follow-up of Positive Surgical Margins in Basal Cell Carcinoma of the Face(Lippincott Williams & Wilkins, 2015) Bozan, Aykut; Gode, Sercan; Kaya, Isa; Yaman, Banu; Uslu, Mustafa; Akyildiz, Serdar; Apaydin, Fazil; Ceylan, Can; Ozturk, GunseliBACKGROUND Basal cell carcinoma (BCC) in central facial locations and tumors with positive margins are at a higher risk of recurrence. The most effective treatment is total excision, which includes an adequate pathological margin. OBJECTIVE To evaluate the outcome of the patients who underwent surgery for BCCs of the head and neck and of those who had positive surgical margins where Mohs surgery is not available. METHODS This study was conducted at Ege University Medical School between 2004 and 2014. One hundred thirty patients with 154 BCC who underwent surgical excision were included. In the histopathologic report, the existence of positive margin, BCC subtype, localization of the tumor, and distance of margins to the tumor were evaluated. RESULTS Twenty-three lesions (14.9%) of 22 patients revealed positive surgical margins. Six patients (26.1%) had recurrences on the surgical site. The BCC subtypes of recurrent patients were reported to be multifocal superficial in 2 (33.3%), infiltrative (16.7%) in 1, and micronodular (50%) in 3. CONCLUSION Patients with superficial multifocal or micronodular tumors should undergo reoperation because of high recurrence rates.Öğe Pemphigoid Diseases as a Sign of Active Psoriasis: A Case Report and Brief Review(Karger, 2015) Iskandarli, Mehdi; Turk, Bengu Gerceker; Yaman, Banu; Ozturk, GunseliBackground: Overlap of bullous pemphigoid (BP) with chronic psoriatic plaques (CPP) is a common condition. However, the association of BP with pustular psoriasis (PP) is uncommon. Moreover, perilesional erythema and pustular lesions on CPP are accepted as a sign of unstable psoriasis. Unstable psoriasis could be triggered by certain irritant topical treatments against psoriasis. These chemical agents could also induce a localized pattern of generalized PP. Here, we describe BP and PP collision in unstable CPP. Objective: By this observation we suggest that BP could be a sign of active psoriasis. Presumably, psoriasis-induced BP is an inflammation activity-dependent condition. Methods: This study is a case report and literature review. Results: The dramatic response of bullo-pustular lesions to short-term methotrexate (MTX) treatment suggests the rule of 'no psoriasis, no BP'. Presumably, MTX supressed the active inflammation of CPP and BP disappeared following CPP control. Conclusion: BP can be a sign of active psoriasis in the present case. (C) 2015 S. Karger AG, BaselÖğe Pityriasis Rotunda(Turkish Soc Dermatology Venerology, 2010) Gencoglan, Guelsuem; Karaarslan, Isil Kilinc; Kazandi, Ali Can; Ozturk, GunseliPityriasis rotunda is a rare skin disease characterized by round or oval patches, localized mainly on the trunk, arms, and legs. The patches are usually lighter than the surrounding skin, but sometimes may be darker, and are covered by fine, adherent scales. It is very rare in caucasoids, common in Japanese and is also seen in South African blacks and West Indian black and Mediterrean area predominantly in Sardinia have been reported but it is seldom observed in Europe. We present the first two cases diagnosed from Turkey. There were well-demarcated circumscribed scaly plagues with a erythematous periphery and hypopigmented center on the trunk and proximal parts of upper limbs. Their skin phototype was III. Histopathologic examination revealed a moderate degree of compact hyperkeratosis without a granular layer. Complete clearing was observed with only emollients. (Turkderm 2010; 44: 99-101)Öğe Reflectance confocal microscopic findings in a case of huge dermatofibrosarcoma protuberans(Springer Wien, 2020) Acar, Ayda; Karaarslan, Isil; Ozturk, Gunseli; Yaman, Banu; Ozdemir, FezalDermatofibrosarcoma protuberans is a slowly progressive, locally aggressive fibroblastic tumor which can be misdiagnosed in the early stage. Reflectance confocal microscopic features of dermatofibrosarcoma protuberans has been scarcely described in the literature. We described the dermoscopic and reflectance confocal microscopic findings of 12x 15cm sized tumoral lesion of 45-year-old man.
