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    Allergic Contact Dermatitis due to Medical Mask; A Case Report
    (BILIMSEL TIP YAYINEVI, 2020) Alpagat, Gulistan; Dumanoglu, Betul; Poyraz, Merve; Alan Yalim, Sumeyra; Baccioglu, Ayse; Kalpaklioglu, Ayse Fusun
    Allergic contact dermatitis occurs as a result of delayed hypersensitivity reaction caused by various exogenous substances. Here, a case of allergic contact dermatitis due to medical mask use is presented. A 39-year-old female patient was admitted to Allergy outpatient clinic with complaints of red and itchy maculopapular lesions, and small blisters on the cheeks, nasolabial folds, chin and neck under the chin that started three days ago. She had no chronic illness, massive sunshine exposure, history of systemic and topical medication intake and cosmetic use. The patient has been using washable masks for the whole COVID-19 pandemic period, however she used medical masks instead of washable ones 15 days ago once and for the last two days before the beginning of her complaints. Even though there was no reaction in her first contact, the above dermatitis lesions restricted to mask area developed 24-48 hrs after starting to use it for the second time. Allergic contact dermatitis was diagnosed due to skin lesions suitable with dermatitis and occurrence of the reaction after the second contact to a suspicious substance. She was recommended to stop using medical masks, and a treatment of oral antihistamine and topical steroid was prescribed. After her complaints resolved completely, a challenge with a different brand of medical mask was performed, and no reaction was observed. As a result, this case implicates that allergic contact dermatitis may occur due to using medical masks, and it is important to use masks with standardized approval since they are essential in preventing airborne infections including corona virus.
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    Anaphylaxis After Consumption of Guar Gum-Containing Food: A Report of Two Cases
    (Springernature, 2022) Dumanoglu, Betul; Alpagat, Gulistan; Poyraz, Merve; Yalim, Sumeyra Alan; Baccioglu, Ayse
    Guar gum is a food additive that acts as a thickening agent. Although the relationship between guar gum and occupational rhinitis/asthma has already been established, only very few cases of anaphylaxis were associated with guar gum ingestion. We present two examples of anaphylaxis induced by guar gum. Both cases were successfully treated with adrenaline. Moreover, serum-specific immunoglobulin E (IgE) with the culprit agent was detected in blood samples. To the best of our knowledge, here we present the first case of class 6 guar gum-specific IgE-positive anaphylaxis. This report aims to raise awareness of rare food additive allergies such as guar gum.
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    Evaluation of systemic inflammation markers in patients with rhinitis
    (Springer Heidelberg, 2024) Yalim, Suemeyra Alan; Kalpaklioglu, Ayse Fuesun; Baccioglu, Ayse; Poyraz, Merve; Alpagat, Gulistan; Dumanoglu, Betul
    Background: Rhinitis affects the majority of the population. It may generate localized nasal mucosal inflammation via allergic (AR) or nonallergic (NAR) processes, but it is unknown if this might also result in systemic inflammation, which can raise morbidity and death. Using current serum inflammatory markers, we sought to investigate systemic inflammation in patients with chronic rhinitis. Methods: In this retrospective case-control study, we included 439 patients with newly diagnosed AR (n = 179), NAR (n = 157), and 103 healthy individuals. Inflammation-related blood parameters were collected as lymphocyte/monocyte ratio (LMR), neutrophil/lymphocyte ratio (NLR), eosinophil/neutrophil ratio (ELR), and systemic immune inflammation index (SII). Results: All groups were similar in terms of age, gender, and body mass index. Neutrophil counts were significantly higher both in AR and NAR groups compared to controls (4.51 +/- 0.09, 4.54 +/- 0.1 vs. 3.73 +/- 0.1, p < 0.001). NLR (1.91 +/- 0.56, 1.89 +/- 0.61, 1.61 +/- 0.59, p < 0.001), LMR (5.76 +/- 0.17, 5.93 +/- 0.17, 5.1 +/- 0.15, p = 0.005), ELR (0.1335 +/- 0.007, 0.0999 +/- 0.006, 0.12 +/- 0.009, p = 0.003), SII (533.3 +/- 16.6, 558.1 +/- 20.9, 479.9 +/- 22.2, p = 0.035), and CRP (1.44 +/- 0.09, 1.67 +/- 0.09, 0.87 +/- 0.04, p < 0.001) were significantly higher in AR and NAR groups than the controls, respectively. SII (r = 0.146, p = 0.007) and ELR (r = 0.254, p < 0.001) were correlated with the presence of asthma. Conclusion: We found that systemic circulation of inflammatory cells was significantly increased in rhinitis with/without allergy compared to the control group. This study showed that not only AR, but also NAR triggers a systemic increase of inflammation which supports the link between rhinitis and comorbid conditions such as asthma. Therefore, effective treatment may be suggested for local inflammation and its systemic manifestations.
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    Rare Interstitial Pneumonia Due to the Use of Aripiprazol: A Case Report
    (2022) Alpagat, Gulistan; Baccıoğlu, Ayse; Yalim, Sumeyra Alan; Poyraz, Merve; Dumanoğlu, Betul; Kalpaklıoğlu, Ayse Fusun
    It is accepted that 2–3% of interstitial lung diseases (ILD) are due to drugs, and that 70% of drug-induced lung diseases are due to ILD. We present here the case of a 51-year-old female patient who had been taking aripiprazole for bipolar disorder for 3 years and had been undergoing asthma treatment for 2 years. ILD was considered based on the patient's clinic, a restrictive pattern in the pulmonary function test (PFT), a decreased carbon monoxide diffusion test, laboratory results, radiological findings and biopsy. The possible etiologies of infection, aspiration, heart failure, pet feeding status and exposure to haz-ardous respiratory substances were excluded. The suspected drug was discontinued and oral cortico-steroid treatment was started. Lung toxicity can devel-op with drug treatments, and so drug history should be questioned in detail and discontinued immediately in case of any doubt. ILD is rare, and if the drug is not suspected and continued, the disease may be-come chronic and progress to respiratory failure. We present this case to increase awareness of the disease.