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    Cutaneous manifestations in brucellosis: A prospective study
    (Springer, 2007) Akcali, Cenk; Savas, Lutfu; Baba, Mete; Turunc, Tuba; Seckin, Deniz
    Brucellosis remains an important public health problem in Turkey, just as it is in other regions of the world. This study was conducted to determine the types and rates of cutaneous lesions that occur in patients with brucellosis. Brucellosis was diagnosed by standard tube agglutination testing for Brucella antibodies at a titer of 1/160 or higher in the presence of compatible clinical findings. A total of 140 patients who had been given a diagnosis of brucellosis were prospectively observed in the dermatology clinic. Of these patients, 102 (72.9%) were female, with a mean age of 44.11 +/- 18.22 y, and 38 (27.1 %) were male, with a mean age of 46.44 +/- 14.58 y. The duration of symptoms was less than 2 mo (acute) in 75 patients (53.5%), from 2 to 12 mo (subacute) in 30 patients (21.4%), and longer than 12 mo (chronic) in 35 patients (25.0%). Cutaneous findings related to brucellosis were observed in 8 (5.71%) of the 140 cases. Maculopapular eruptions were observed in 2 patients (25%), erythema nodosum-like lesions in 2 (25%), psoriasiform lesions in 1 (12.5%), palmar erythema in 1 (12.5%), malar eruption in 1 (12.5%), and palmar eczema in 1 (12.5%). The investigators concluded that although cutaneous findings encountered in brucellosis are generally not specific to this disease, the presence of these findings may be useful in diagnosing brucellosis in persons who live in, or used to live in, endemic regions.
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    The prevalance, epidemiology and risk factors for onychomycosis in hemodialysis patients
    (Bmc, 2007) Kuvandik, Gueven; Cetin, Meryem; Genctoy, Gultekin; Horoz, Mehmet; Duru, Mehmet; Akcali, Cenk; Satar, Salim
    Background: Onychomycosis has a high prevalance among immunocompromised patients such as diabetics and hemodialysis patients. In the present study, we aimed to investigate the prevalence of onychomycosis among hemodialysis patients with and without diabetes mellitus, and to find out the factors likely to be associated with the development of onychomycosis among hemodialysis patients. Methods: One hundred and nine hemodialysis patients were enrolled. Fifty-seven of hemodialysis patients had the diagnosis of diabetes mellitus. Nail scrapings were obtained from 76 patients who had dystrophic nail changes. Samples were examined with 20% potassium hydroxide solution and all of the samples were inoculated on Saboraud's dextrose agar, potateus dextrose agar and mycobiotic agar. Diagnosis of onychomycosis was based on the presence of both positive clinical signs and positive potassium hydroxide test. Results: Onychomycosis was diagnosed in 26.6% of hemodialysis patients. Diabetes mellitus was present in 68.9% of patients with onychomycosis. Toenail scraping cultures were reported to be positive in 19.7% of patients with dystrophic nail changes. Logistic regression analysis revealed that the presence of diabetes mellitus and the mean duration of hemodialysis were the significant predictors associated with the development of onychomycosis. Conclusion: The prevalence of dystrophic nail changes and onychomycosis is increased among hemodialysis patients. The dialysis duration and the presence of diabetes mellitus are the independent risk factors associated with the development of onychomycosis in uraemic patients.
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    Treatment of Xanthelasma Palpebrarum By Secondary Healing After Excision
    (Galenos Yayincilik, 2007) Akcali, Cenk; Saygili, Oguzhan; Inaloz, Serhat; Oksuz, Huseyin; Tamer, Cengaver
    Objective: Xanthelasma palpebrarum (XP) are soft or hard yellow lipomatous plaques that are commonly located on the upper or lower eyelids and in the medial canthus. Various methods have been used in the treatment of XP. In this study, our aim was to investigate the efficacy of secondary healing after excision in the treatment of XP. Method: Thirteen patients with 29 lesions were enrolled on this study. After excision, the secondary healing of the lesions was investigated during a period of minimum two months minimum and 18 months maximum. Results: All lesions were removed with excision. After treatment, crusting was seen in 4-5 days and sloughing was observed within 6-8 days. The postoperative erythema disappeared in 14-24 days. Of the 13 patients, two (% 15,38) developed a recurrence within a mean follow-up period of ten months. In three patients (% 23,07) temporary complications were seen. The complications observed included minimal bleeding, local bacterial infection and minimal hypopigmentation. During follow-up, no patient had any complaints and they were all satisfied with the results. Conclusion: Because of the efficacy, cost-effectiveness and ambulatory applications of secondary healing after excision in the management of XP, this method is an appropriate choice of treatment.