Gülbin YAŞAR, Aslı BİLGİÇ, Ertan YILMAZ
Gülbin YAŞAR, Aslı BİLGİÇ, Ertan YILMAZ
Background and Design: Atopic dermatitis (AD) is a common chronic, recurrent, and itchy inflammatory skin disease. Various therapeutic
agents are available, but severe side effects may limit their usage. Recently, dupilumab, a human monoclonal antibody that targets the
interleukin-4 (IL-4) receptor alpha subunit of heterodimeric IL-4 and IL-13 receptors, is approved and might be used in patients with resistant
AD, with the permission of the Ministry of Health.
Materials and Methods: This study aimed to retrospectively evaluate the clinical characteristics of patients and dupilumab treatment
responses in our center. This study included patients with AD who were unresponsive to conventional treatments and treated with dupilumab.
Sociodemographic, laboratory data, previous treatments, and responses along with disease severity scores [eczema area and severity index
(EASI)] before and after dupilumab were evaluated through the electronic files of patients.
Results: A total of 21 patients (13 males and 8 females) between June 2019 and March 2021 were identified. The mean age of patients was
40.57±15.21 years. The mean duration of dupilumab treatment was 6.59±5.88 months. The mean EASI score at the beginning of dupilumab
was 15.35±8.03, whereas 4.6±2.9 after treatment. A 70-100% improvement was found in approximately 75% of the patients. No side effects
were observed that required treatment discontinuation or dose changes.
Conclusion: Our study has the highest number of reported patients in our country, which revealed that dupilumab is highly effective and safe
for conventional treatment-resistant
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Tülin ERGUN, İlkay ERGENÇ, Seda SEVEN, Dilek SEÇKİN, Elif Cömert ÖZER, Meryem AKTAŞ, Elif TÜKENMEZ TİGEN
Tülin ERGUN, İlkay ERGENÇ, Seda SEVEN, Dilek SEÇKİN, Elif Cömert ÖZER, Meryem AKTAŞ,
... Devamını oku
Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infections can be associated with several cutaneous lesions, among which
maculopapular rash is the most common. A maculopapular rash can also be induced by medications used for Coronavirus disease-2019
(COVID-19) treatment. The distinction between viral rash and drug eruption may be difficult especially in case of several medication use for
COVID-19. Thus, this study aimed to describe cutaneous manifestations in six patients with COVID-19 and highlight clues for distinguishing
SARS-CoV-2-related rash and drug eruption. Between March and June 2020, 1,492 patients were hospitalized for COVID-19 and treated
with hydroxychloroquine in Marmara University Hospital. Among them, six cases were consulted for possible COVID-19-related rash or
drug reaction. Hydroxychloroquine was given as monotherapy in one patient. All six patients developed an erythematous, symmetrical, and
maculopapular eruption that mainly affected the trunk, axilla, and genitocrural region, 5-21 days after the onset of COVID-19 symptoms. Five
patients developed rash in 4-11 days after treatment completion. Pruritus was severe. All were treated with topical corticosteroids and oral
antihistamines, which provided partial relief. The resolution of the eruption was typically slow, which took a few weeks. A long period between
the COVID-19 symptoms and the eruption, as well as slow recovery, is in favor of drug eruption. The effects of co-existent viral infection, a
well-known promoting drug eruption factor, in facilitating adverse drug reaction in patients with COVID-19 needs further observations and
research
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Mine Müjde KUŞ, Perihan ÖZTÜRK, Hülya NAZİK, Mehmet Kamil MÜLAYİM, Tutku BULUT, Esra Rabia AKGÜÇ, Sezen KOÇARSLAN
Mine Müjde KUŞ, Perihan ÖZTÜRK, Hülya NAZİK, Mehmet Kamil MÜLAYİM, Tutku BULUT, Esra Rabia AKGÜÇ,
... Devamını oku
Coronavirus disease-2019 (COVID-19) has been associated with multiple skin lesions as well as causing common respiratory symptoms. We
presented a case of pityriasis rubra pilaris that developed after COVID-19 infection and treated with anti-tumor necrosis factor (adalimumab),
which was not previously reported in an adult.
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Sinem ÖRNEK, Aslı BİLGİÇ, Serkan YAZİC, Dilek BAYRAMGÜRLER, Hatice ŞANLI, Nahide ONSUN
Sinem ÖRNEK, Aslı BİLGİÇ, Serkan YAZİC, Dilek BAYRAMGÜRLER, Hatice ŞANLI, Nahide ONSUN
Coronavirus disease-2019 (COVID-19) is a serious cause of respiratory tract infection, and its severe course has been associated with some
risk factors, including malignancies and immunosuppressive treatments. Primary cutaneous lymphomas (PCL) are a heterogeneous group
of immune system neoplasms, which are subclassified as indolent and aggressive types according to their survival rates. PCL treatment
ranges from skin-based therapies to systemic treatments, of which immunosuppressive effects occur in some. During the COVID-19 pandemic,
patients with PCL should be protected from possible COVID-19 complications, and the optimal treatment should be provided to control the
disease taking into account the treatment-related risks. Therefore, recommendations about the management of patients with PCL during the
COVID-19 pandemic were overviewed in light of the literature. Topical treatments can generally be considered low-risk therapies and can be
continued without interruption. Phototherapy, skin radiotherapy, and total skin electron beam therapy increase the risk of COVID-19 exposure
due to hospital visits. Moderate-risk therapies like interferons, systemic retinoids, methotrexate, and systemic corticosteroids might be used
with caution. Advanced-stage patients with COVID-19 related comorbidity and who previously received immunosuppressive therapy should be
carefully evaluated. Biological agents and systemic chemotherapeutics, which are considered high-risk, should not be delayed when needed.
However, increasing intervals between treatments or switching to alternative therapies may be preferable in stabl
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Esra SARAÇ, Alkım ÜNAL
Esra SARAÇ, Alkım ÜNAL
Background and Design: Excessive hair growth after isotretinoin treatment for acne vulgaris is not common, but may be one of the most
undesirable side effects of the drug. The aim of this study is to investigate the relationship between systemic isotretinoin use and facial
hypertrichosis.
Materials and Methods: Female acne patients in premenopausal age were included in this prospective study. Laboratory tests [beta-human
chorionic gonadotropin, total cholesterol, triglyceride, low-density lipoprotein, high-density lipoprotein, aspartate aminotransferase, alanine
aminotransferase] were evaluated initially and monthly during the study period. Hormone levels [luteinizing hormone, follicle stimulating
hormone, total testosterone, free testosterone, dehydroepiandrosterone-sulfate (DHEAS), prolactin, 17-hydroxyprogesterone, glucose, and
insulin] and abdominopelvic/transvaginal ultrasonography were also evaluated when there was a complaint or clinical findings of excessive hair
growth. Body mass index (BMI) was calculated at the beginning of the study. Severity of the acne was assessed with Global Evaluation Acne
Scale (GEAS). Hirsutism scores were calculated with Modified Ferriman-Gallwey score (m-FGS). Baseline and monthly taken digital dermoscopic
photographs from the chin and cheeks were transferred to the ImageJ program to count the hair. Hair increases of >5% at the end of the
treatment according to the basal hair count was accepted as hypertrichosis.
Results: Thirty patients aged between 18-34 (median: 21.5) participated in the study. Mean duration of the therapy was 6.2±0.6 months. Facial
hair growth was detected in three (10%) patients. One patient had an elevated DHEAS level with normal abdominal ultrasonography findings.
Without the cessation of isotretinoin therapy, DHEAS level decreased to normal limits after two months. There was no statistically significant
difference found between the mean GEAS (p=0.52), basal m-FGS (p=0.42), and BMI (p=0.71) of three patients with facial hypertrichosis,
and in the remaining 27 patients. Facial hypertrichosis disappeared spontaneously 2 months (1-3 month) after the treatment courses were
completed.
Conclusion: The patho-mechanism of isotretinoin induced facial hair growth is not fully clarified. Since the facial hypertrichosis disappeared
spontaneously when the treatment was ended, we think that this may be due to a temporary drug induced hormonal imbalance in susceptible
individuals.
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Swayamsidda MİSHRA, Manjunath KADNUR, Shishira R. JARTARKAR, Hanumanthayya KELOJİ, Ritu AGARWAL, Spoorthy BABU
Swayamsidda MİSHRA, Manjunath KADNUR, Shishira R. JARTARKAR, Hanumanthayya KELOJİ, Ritu AGARWAL, Spoorthy BABU
Background and Design: Although multiple investigations have been conducted to identify important serum biomarkers in patients with
psoriasis, no simple, useful biomarker that could be specific for psoriasis has been identified. Objectives: 1) To determine the levels of serum
uric acid (SUA), C-reactive protein (CRP), and neutrophil-to-lymphocyte ratio (NLR) among individuals with psoriasis and controls, 2) to assess
the correlation of SUA and CRP levels and NLR with disease severity calculated through the psoriasis area severity index (PASI) in patients with
psoriasis.
Materials and Methods: A hospital-based, case-control study included 45 patients clinically diagnosed with psoriasis and 45 age- and sex-
matched controls attending the outpatient dermatology clinic of our hospital. After a complete history was taken, and general, systemic, and
cutaneous examinations were performed, all the cases were subjected to the following investigations: Complete blood count (NLR), CRP, and
SUA.
Results: Mean SUA level was significantly higher in the patients with psoriasis compared to the controls (p<0.01). However, no difference
in CRP levels and NLR was observed (p>0.05). A significant correlation of SUA level and NLR was found with disease severity in the patients
with psoriasis as determined by the PASI. In multivariate analysis, only SUA was found to be independently associated with psoriasis severity
(p<0.05).
Conclusion: The results showed that only SUA to be independently associated with psoriasis severity. No association was found between CRP
levels and NLR and disease severity, as well as no difference between the disease and controls groups.
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Ayşe KAVAK, Çiğdem AYDOĞMUŞ, Kübra YILMAZ
Ayşe KAVAK, Çiğdem AYDOĞMUŞ, Kübra YILMAZ
Recently, dupilumab treatment in atopic dermatitis (AD) has been an effective and safe option in terms of adverse effects. However, combination
therapies can sometimes be better at increasing efficacy or reducing adverse effects or cumulative doses. Early combination therapies may
be more rational, especially considering that dupilumab treatment alone is less effective and has a late-onset efficacy. Here, we discussed
dupilumab and a short-term narrowband ultraviolet B combination therapy in a child wit AD
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Ercan ÇALIŞKAN, Ayşenur BOTSAL
Ercan ÇALIŞKAN, Ayşenur BOTSAL
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Esra İNAN DOĞAN, Özlem Yağız AGHAYAROV
Esra İNAN DOĞAN, Özlem Yağız AGHAYAROV
Background and Design: Systemic isotretinoin (ISO) is one of the most important treatment agents that are used in nodulocystic acne
treatment. It has many effects on many systems of the body. Previous studies reported positive and negative results related to systemic ISO
and its effects on hearing. Thus, this study aimed to investigate the effects of systemic ISO on hearing functions.
Materials and Methods: This study included 53 patients with acne vulgaris (106 ears) that were treated with 0.8 mg/kg oral ISO for 6 months.
Pure tone audiometry (PTA), speech discrimination test (SD), and distortion product otoacoustic emission (DPOAE) tests were performed.
Results: No significant differences were found in the mean SD and PTA threshold values between the pre-treatment period, after 3 months
of treatment, and 4 months after the end of treatment. Statistically significant increases were detected in the amplitudes at 6,000, 8,000,
and 10,000 Hz frequencies when DPAOE values in 3 months of treatment were compared with the pre-treatment DPAOE values; however, no
significant differences were detected in the DPAOE values between the pre-treatment and 4 months after the end of treatment.
Conclusion: Systemic ISO increased DPOAE amplitudes during the treatment in patients with acne; however, these changes returned to pre-
treatment levels in 4 months after the end of treatment. Our results indicate that ISO treatment has temporary effects on DPOAE values, which
is an important parameter in measuring the cochlear function. Therefore, ISO seems a safe and well-tolerated agent for the audi
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Münevver GÜVEN, Tolga ATAKUL, Serkan Yaşar ÇELİK, Mustafa YILMAZ, Buket DEMİRCİ
Münevver GÜVEN, Tolga ATAKUL, Serkan Yaşar ÇELİK, Mustafa YILMAZ, Buket DEMİRCİ
Background and Design: Acitretin is widely used on many dermatological diseases. No adequate studies have evaluated its effects on ovarian
reserve. Thus, this experimental study aimed to investigate the possible effects of acitretin on ovarian reserve by examining ovarian follicle
counts and serum anti-Mullerian hormone (AMH) values.
Materials and Methods: This study randomly distributed 31 female Wistar albino rats into 3 groups including one control group (group 1)
and two equal experimental groups. Acitretin was given at doses of 0 mg/kg/day (group 1, n=11), 1 mg/kg/day (group 2, n=10), and 5 mg/
kg/day (group 3, n=10) for 4 weeks. All the rats in three groups were kept drug-free for 4 weeks before being sacrificed. The blood samples
and both ovarian tissues were obtained from the rats. Serum values of AMH were assessed and the number of ovarian follicles was counted
by histopathological examination.
Results: The AMH levels were lower in both acitretin groups (groups 2 and 3) than group 1. However, no significant difference was found
between the groups in terms of AMH values (p=0.338). Primordial, secondary, tertiary, and total follicle numbers in group 3 were statistically
lower than that of groups 1 and 2. The number of primary follicles in group 1 was statistically higher than that of groups 2 and 3. Additionally,
the number of secondary follicles in group 2 was statistically higher than that of group 1.
Conclusion: This study showed that ovarian reserve can be affected by acitretin treatment. Particularly, high doses of acitretin may reduce
ovarian reserve. Further experimental and clinical studies are needed to clarify the effect of acitretin on ovarian res
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