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Öğe Bullous scabies, the light shed on etiopathogenesis and treatment: report of five paediatric cases(Termedia Publishing House Ltd, 2023) Arslan, Hakan; Gunduz, OzgurIntroduction: Bullous scabies (BS) is an infrequent and atypical presentation of scabies, with a predilection for el- derly males. The mechanism of BS is not fully understood; superinfection, friction due to pruritus, autoeczemation, direct injury from mite's lytic enzymes, cross-reactivity of scabies protein with basal membrane zone antigens are considered to be possible reasons. Aim: To define clinical features of paediatric BS cases, which is an extremely rare subtype of scabies. Material and methods: This is a retrospective study of paediatric BS cases seen at two tertiary care centres. Previ- ously described bacterial culture, antibiogram and follow-up records were investigated retrospectively. Confirmed scabies cases, according to the International Alliance for the Control of Scabies (IACS) with bullae were included. All cases were treated with 10% sulfur ointment for 3 consecutive days, two cycles. Households of cases were also treated simultaneously. Systemic antibiotics were added to patients with elevated acute phase reactants according to the antibiogram results. Informed consent was obtained from patients' parents. Results: Five BS cases were included. Three cases were male, two cases were female. Four cases had staphylococcus aureus, one had group-A beta haemolytic streptococcus positive bullae culture. All cases achieved a rapid complete resolution of symptoms after topical 10% sulfur ointment. Conclusions: Paediatric BS is an extremely rare entity of scabies. Bacterial superinfection plays a key role in bullae formation. 10% sulfur ointment is a highly effective treatment option for paediatric BS.Öğe CAG polymorphism in the androgen receptor gene in women may be associated with nodulocystic acne(Termedia Publishing House Ltd, 2019) Demirkan, Serkan; Sayin, Derya Beyza; Gunduz, OzgurIntroduction: Acne vulgaris (AV) is a multifactorial, inflammatory disease of the pilosebaceous unit. Hormones play a major role in the pathogenesis of acne. In cases of hyperandrogenism; hirsutism, acne, seborrhoea and alopecia appear in women. However, severe acne can also be seen without evidence of hyperandrogenism. In this case, hypersensitivity of the androgen receptor gene (ARG) encoded in the X chromosome, which is the only receptor for androgens, can be considered. ARG contains a polymorphic CAG triple loop encoding the polyglutamine pathway at the 5'end of exon 1. Aim: To investigate CAG repeat polymorphism in the ARG in nodulocystic acne patients in Turkish population. Material and methods: This prospective clinical study was conducted between 2016 and 2017 in accordance with the tenets of the Declaration of Helsinki. DNA isolation from blood was performed using the RTA (R) Genomic DNA Isolation Kit. The fragment lengths obtained from the device to determine CAG repeat numbers were analysed based on -288 bp length 22 CAG repeat content. Results: A total of 199 subjects; 100 patients (51 males, 49 females) and 99 controls (49 males, 50 females) were included in the study. The mean allele length in the patient group was 19.34; and 19.7 in the control group. There was a statistically significant difference between female patients and the control group, when the patients and control groups were compared by gender (p = 0.0059). Conclusions: The CAG trinucleotide repeat count in the ARG may be associated with acne, without hirsutism findings.Öğe Candidal vulvitis: a possible trigger for lichen striatus(John Libbey Eurotext Ltd, 2018) Gunduz, Ozgur; Cakartas, Rebiye; Demirkan, Serkan; Atasoy, Pinar…Öğe A Case of Two Synchronous Cutaneous Collision Tumors(Gazi Univ, Fac Med, 2017) Ayva, Sebnem Kupana; Tepeoglu, Merih; Gunduz, Ozgur; Yazici, Ilker; Bozdogan, OnderCutaneous collision tumors are known as two independent tumors which are close anatomically and separated from one another by well boundaries. We, herein report a 83-year-old female patient with two cutaneous collision tumors in two different localizations at the same time. First cutaneous collision tumor located on left ala nasi was squamous cell carcinoma and basal cell carcinoma and second one located on the right commisure was composed of malignant melanoma (Clark Level IV) and basal cell carcinoma. However, the presence of collision tumors is not uncommon and is often reported in the literature, to the best of our knowledge, it is the first case which shows the association of two synchronous cutaneous collision tumor in the same individual.Öğe Decreased choroidal thickness in vitiligo patients(Bmc, 2018) Demirkan, Serkan; Onaran, Zafer; Samav, Guzin; Ozkal, Fatma; Yumusak, Erhan; Gunduz, Ozgur; Karabulut, AyseBackground: Vitiligo is a disease characterized by depigmented macules and patches that occur as a result of the loss of functional melanocytes from the affected skin through a mechanism which has not been elucidated yet. Destruction of pigment cells in vitiligo may not remain limited to the skin; the eyelashes, iris, ciliary body, choroid, retinal pigment epithelium and meninges may also be affected. This study aims to compare the choroidal thickness of patients with and without vitiligo using optical coherence tomography (OCT). Methods: Spectral-domain optical coherence tomography (SD-OCT) (Retina Scan Advanced RS-3000 NIDEK, Japan) instrument (with lambda = 840 nm, 27,000 A-scans/second and 5 mu m axial resolution) was used for the imaging. Statistical analysis was performed using SPSS 21.0 software package. Results: In all values except optic nevre area measurements, the choroidal thickness of all vitiligo patients was found out to be thinner compared to the control group. Conclusions: In vitiligo, the choroidal thickness may be affected by the loss of melanocytes.Öğe Evaluation Of Optic Nerve With Strain And Shear Wave Elastography In Patients With Behcet's Disease And Healthy Subjects(Elsevier Science Inc, 2017) Inal, Mikail; Tan, Sinan; Demirkan, Serkan; Burulday, Veysel; Gunduz, Ozgur; Ornek, KemalThe objective of this study was to investigate the elasticity characteristics of the optic nerve using strain and shear wave elastography in patients with Behc, et's disease and to compare the results with those of healthy volunteers. Forty-six optic nerves from patients with Behc, et's disease and 54 optic nerves from healthy volunteers were investigated prospectively in this study using strain and shear wave elastography. There was a statistically significant difference in terms of elasticity patterns between patients and healthy volunteers (p < 0.001). Elastographic images of healthy volunteers revealed most optic nerves to be type 3 (51.8%); however, type 2 (40.7%) and type 1 (7.5%) were also observed. Elastographic examination of Behc, et's disease patients revealed type 2 in 52.2%, type 1 in 43.5% and type 3 in 4.3% of patients. Statistically significant differences were observed between patients and healthy volunteers in the analysis of shear wave elastography values (p < 0.001). Receiver operating characteristic curve analysis was perfect (0.933) (95% CI = 0.885-0.980), and a cutoff value of 16.5 kPa shear had very high sensitivity and specificity for the patient group. Strain and shear wave elastography findings for the optic nerves of patients with Behc, et's disease were significantly different from those for healthy volunteers. (E-mail: inal_m@hotmail.com) (C) 2017 World Federation for Ultrasound in Medicine & Biology.Öğe Intralesional Avirulent Bacillus Calmette-Guerin Injection as a Promising Method for the Treatment of Tuberculosis Verrucosa Cutis(Karger, 2022) Gunduz, Ozgur; Kocak, Gulsah; Kacmaz, Birgul; Devrim, Tuba; Simsek, HulyaCutaneous involvement is a relatively uncommon manifestation of tuberculosis (TB), particularly outside the endemic regions. Cutaneous TB manifests itself in various clinical forms, depending on the host's immune status and mode of transmission. Nonetheless, the same treatment regimen is recommended for every subtype. Tuberculosis verrucosa cutis (TBVC) is a specific subgroup in which the affected persons are usually healthy adults who are vaccinated or exposed to mycobacteria during their occupational activities. These patients have the ability to launch a strong cellular immune reaction against mycobacteria. In this article, we present an elderly patient with a 4-year history of TBVC who was treated with intralesional injection of avirulent Bacillus Calmette-Guerin (BCG) and report our clinical observation on the inflammatory and healing process of the patient's lesion following the intralesional BCG injection.Öğe Markers of Endothelial Dysfunction and Evaluation of Vascular Reactivity Tests in Behcet Disease(Sage Publications Inc, 2014) Ozuguz, Pinar; Karabulut, Ayse Anil; Tulmac, Murat; Kisa, Ucler; Kocak, Mukadder; Gunduz, OzgurWe assessed endothelial dysfunction (ED) in patients with Behcet disease (BD; n = 40) and healthy controls (n= 20). Serum lipid, homocysteine, asymmetric dimethylarginine (ADMA) and high-sensitivity C-reactive protein (hsCRP) levels, erythrocyte sedimentation rates (ESRs), and ultrasonographic flow-mediated dilatation (FMD) were measured. Mean hsCRP, ESR, homocysteine, and ADMA were significantly higher in the BD group (P <.001 for all). Patients with active BD had higher serum levels of hsCRP, homocysteine, and ESR compared with those in remission (P <.001, P <.001, and P =.005, respectively). Flow-mediated dilatation was significantly lower in patients with BD than in controls (P =.001). Flow-mediated dilatation correlated negatively with BD duration and serum ADMA levels (P <.001, r =-.745 and P <.001, r = -.682); a positive correlation was seen between serum ADMA levels and BD duration (P <.001, r =.552). Only stepwise multivariate regression analysis revealed BD duration to have a significant effect on FMD. Flow-mediated dilatation, in conjunction with markers of inflammation, may evaluate ED in patients with BD.Öğe Micronutrient Deficiencies and Digital Computerized Phototrichogram Analysis in Telogen Effluvium: a Retrospective Correlation Study in a Tertiary Medical Center(Mattioli 1885, 2023) Arslan, Hakan; Gunduz, OzgurIntroduction: Telogen effluvium (TE) is a common form of non-scarring alopecia that may manifest as acute or chronic hair shedding. Several studies evaluated a possible relationship between various vitamin and mineral deficiencies and TE, but it is still a controversial topic. Objectives: This study aimed to investigate the status of vitamin and mineral deficiencies in patients diagnosed with TE and to evaluate their correlation with anagen hair ratios (AHR) calculated with an automated digital phototrichogram (ADCP). Methods: Electronic records of 973 TE patients were retrospectively analyzed. Demographic, clinical data, parameters such as ferritin, vitamin B12 (Vit-B12), vitamin D (Vit-D), folic acid, zinc and hemoglobin (HGB) serum levels were evaluated. Anagen to telogen hair ratios were also assessed in forty-two patients via ADCP. Results: The rates of anemia, low ferritin level, and Vit-B12, folate, Vit-D, and zinc deficiencies were 11.9% (N = 109), 44% (N = 332), 1.5% (N = 13), 2.5% (N = 14), 87% (N = 51), and 4.5% (N = 2), respectively. A positive correlation was found between HGB levels and AHR in female patients (Spearman rank, r = 0.417, P = 0.008). No statistically significant relationship was found between ferritin, Vit-B12, folate, zinc serum levels and AHR. The relationship between Vit-D and AHR could not be assessed due to the insufficient number of patients with Vit-D data. Conclusions: HGB value is the only marker that is positively correlated with the AHR of patients with TE. Ordering HGB can be used as an initial test for managing TE patients cost-effectively.Öğe Retrospective analysis of endemic melasma patients(Pagepress Publ, 2017) Demirkan, Serkan; Gunduz, Ozgur; Dayangan, CemileMelasma is an acquired diffuse hypermelanosis characterized by localized, symmetrical, irregular, light-to-dark brown maculae occurring in sun-exposed areas of skin. The aim of this retrospective study was to determine demographics of patients, analysis of etiologic factors, clinical features, efficacy and side effects of available topical treatments due to high incidence of melasma patients. In this study melasma patients in Birecik State Hospital were investigated retrospectively. Between January 2014 and October 2015, 1008 patients had diagnosis of melasma in 49,809 applications of 24,603 different patients who admitted to Dermatology Outpatient Clinics. Of the 1008 patients, 263 had completed 3-month treatment period. These patients did not receive treatment in June, July, August and September. All melasma patients were rural and dealing with agriculture. There was no significant difference between female and male patients in terms of age. Of the 253 female melasma patients, only 2 of them had not child and none of them were using hormone drug. Of the 263 patients with melasma, Fitzpatrick skin type was 3 in 79 (30%) patients, 4 in 184 (70%) patients. Sanliurfa city showed higher fertility rate, sun exposure, and skin type than Turkey as a whole. These predisposing factors may explain higher melasma occurrence in Sanliurfa. Patient information about preventive measures and treatment play important role in treatment of cosmetic condition. The most important measure seems to advise patients about sun-protection especially during pregnancy.Öğe Signet-ring cells in the skin: a case of late-onset cutaneous metastasis of gastric carcinoma and a brief review of histological approach(Pagepress Publ, 2016) Gunduz, Ozgur; Emeksiz, Mehmet Can; Atasoy, Pinar; Kidir, Mehtap; Yalcin, Selim; Demirkan, SerkanUp to 10% of patients with visceral malignancies develop skin metastases during their clinical course and these metastases constitute about 2% of all skin cancers. Skin metastasis may be the first sign of a clinically silent visceral cancer or represent recurrence of an internal malignancy. In both situations, they are associated with poor prognosis, which can partly be attributed to underdiagnosis. In this paper, a case of relapsing gastric adenocarcinoma, which manifested itself as asymptomatic cutaneous papules and nodules on a patient's head and neck, is reported and histopathological approach to the cutaneous lesions containing signet-ring cell is briefly reviewed.
