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Öğe Acitretin treatment in acrokeratosis verruciformis of Hopf(Taylor & Francis Ltd, 2007) Serarslan, Gamze; Balci, Didem Didar; Homan, SeydoAcrokeratosis verruciformis of Hopf is a rare disorder and characterized by flesh-coloured, wart-like, flat papules on the dorsum of the hands and feet. The disease is an autosomal disorder, but sporadic cases also occur. We present a 38-year-old woman diagnosed with acrokeratosis verruciformis without family history and treated successfully with acitretin.Öğe A Case of Nonhealing Leg Ulcer: Basal Cell Carcinoma(Galenos Yayincilik, 2008) Balci, Didem Didar; Yenin, Julide Zehra; Atik, Esin; Akansu, BulentA 75-year-old woman was admitted to our outpatient clinic with a three-year history of a painless, nonhealing ulcer located on the left lower leg. She had no response to previous therapy with local wound care. Skin examination revealed an ulcer 2.7 x 3.7 cm in size, and the surrounding skin showed minimal erythema. The surface of the ulcer demonstrated shiny granulation tissue. Biopsy of the ulcer edge and base showed basal cell carcinoma. Venous Doppler ultrasonography and dermatological examination did not reveal chronic venous insufficiency. Basal cell carcinomas rarely arise from previous long-term ulcers or developing de novo. We suggest that patients who develop non-healing leg ulcers, should be examined for basal cell carcinoma.Öğe The Co-Existence of Vulvar Lichen Sclerosus, Ulcerated Calcinosis Cutis, and Dermatomyositis: Coincidence or Immunological Mechanism?(Korean Dermatological Assoc, 2011) Balci, Didem Didar; Celik, Ebru; Sarikaya, Gokhan; Yenin, Julide Zehra; Atik, EsinCalcinosis cutis is a condition characterized by the deposition of calcium salts in the skin and subcutaneous tissues, and patients suffering from it encounter various connective tissue disorders, such as dermatomyositis (DM), scleroderma, and systemic lupus erythematosus. Although calcinosis cutis is frequently accompanied by juvenile dermatomyositis, rare cases have been reported in adult patients with DM. On the other hand, lichen sclerosus (LS) is a chronic inflammatory disease of the skin and mucosal surfaces. In the present report, we present a rare case of a 71-year-old patient with DM accompanied by ulcerated calcinosis cutis and vulvar LS. (Ann Dermatol 23(S3) S375 similar to S379, 2011)Öğe Coexistence of Acral Syringomas and Multiple Trichoepitheliomas on the Face(Sage Publications Inc, 2009) Balci, Didem Didar; Atik, Esin; Altintas, SuleymanBackground: An extremely rare variant of syringoma is an acral form, which affects the upper extremities as an isolated finding. The acral syringomas may also be associated with syringomas on the feet or usual distribution around the eyelids. Of the eight previously documented cases of acral syringomas, all were located on the dorsal aspect of the upper extremities (fingers, hand, wrist, or forearm) dominantly. Objective: We report a 41-year-old woman who presented with multiple flesh-colored to reddish brown papules on the inner aspect of the forearms and many pearly, small papules on the periorbital regions. Results: The clinical picture and histopathology indicated the coexistence of acral syringomas and multiple trichoepitheliomas on the face. Conclusion: To the best of our knowledge, this is the first case of acral syringomas coexisting with multiple trichoepitheliomas.Öğe Delayed Diagnosis: Giant Basal Cell Carcinoma of Scalp(Deri Zuhrevi Hastaliklar Dernegi, 2008) Balci, Didem Didar; Serarslan, Gamze; Hakverdi, SibelAlthough basal cell carcinoma (BCC) is the most common form of skin cancer, the scalp lesions of BCC have been rarely reported. Giant BCC is defined as a tumor larger than 5 cm in diameter and only 0.5-1% of all BCCs achieve this size. We report a case of giant BCC on the scalp that was treated with topical coticosteroids and antifungal shampoo for five years. BCC should be considered in the differential diagnosis in erythematous plaque type lesions resistant to therapy with long duration localized on the scalp. (Turkderm 2008; 42: 67-9)Öğe Dermatology Life Quality Index Scores in Lichen Planus: Comparison of Psoriasis and Healthy Controls(Deri Zuhrevi Hastaliklar Dernegi, 2008) Balci, Didem Didar; Inandi, TacettinBackground and Design: Skin diseases affect physical and social activities and psychological status. The aim of this study was to investigate the Dermatology Life Quality Index (DLQI) scores in patients with lichen planus and compared with that in psoriasis patients and healthy controls. Material and Method: Thirty consecutive patients with lichen planus, 30 with psoriasis vulgaris attending our dermatology outpatient clinic and 30 sex- and age-matched healthy controls completed the DLQI. Results: Total DLQI scores of patients with lichen planus (9.60 +/- 7.32) and psoriasis (9.50 +/- 6.10) were comparable (p>0.05) and significantly higher than that of healthy controls (0.67 +/- 0.80) (p<0.001). No significant difference were detected between the subscale scores in patients with lichen planus and psoriasis (p>0.05). Lichen planus patients with oral involvement demonstrated higher mean DLQI score than that of lichen planus patients without oral involvement (13.27 +/- 8.05 vs. 7.47 +/- 6.11, p=0.034). Conclusion: The quality of life (QoL) of patients with lichen planus is impaired as much as that of psoriasis. The DLQI questionnaire is a reliable and valid instrument for assessing the QoL in patients with lichen planus. (Turkderm 2008; 42: 127-30)Öğe Dermatology life quality index scores in lichen planus: Comparison of psoriasis and healthy controls(2008) Balci, Didem Didar; Inandi, TacettinBackground and Design: Skin diseases affect physical and social activities and psychological status. The aim of this study was to investigate the Dermatology Life Quality Index (DLQI) scores in patients with lichen planus and compared with that in psoriasis patients and healthy controls. Material and Method: Thirty consecutive patients with lichen planus, 30 with psoriasis vulgaris attending our dermatology outpatient clinic and 30 sex- and age-matched healthy controls completed the DLQI. Results: Total DLQI scores of patients with lichen planus (9.60±7.32) and psoriasis (9.50±6.10) were comparable (p>0.05) and significantly higher than that of healthy controls (0.67±0.80) (p<0.001). No significant difference were detected between the subscale scores in patients with lichen planus and psoriasis (p>0.05). Lichen planus patients with oral involvement demonstrated higher mean DLQI score than that of lichen planus patients without oral involvement (13.27±8.05 vs. 7.47±6.11, p=0.034). Conclusion: The quality of life (QoL) of patients with lichen planus is impaired as much as that of psoriasis. The DLQI questionnaire is a reliable and valid instrument for assessing the QoL in patients with lichen planus.Öğe DLQI scores in patients with keloids and hypertrophic scars: a prospective case control study(Wiley, 2009) Balci, Didem Didar; Inandi, Tacettin; Dogramaci, Cigdem Asena; Celik, EbruP>Background: Keloids and hypertrophic scars (HTS) can cause functional impairment and psychosocial burdens, both of which affects quality of life (QoL). Our aim was to compare Dermatology Life Quality Index (DLQI) scores in patients with keloids and HTS to those of psoriasis patients and normal controls. Patients and Methods: Forty-eight consecutive patients with keloids and HTS and 48 with psoriasis vulgaris attending our dermatology outpatient clinic, as well as 48 sex- and age-matched healthy controls completed the DLQI. Results: Total DLQI scores of patients with keloids and HTS (7.79 +/- 5.10) and psoriasis (8.73 +/- 5.63) were comparable and significantly higher than that of healthy controls (0.58 +/- 0.77). No significant difference were found between patients with psoriasis and patients with keloids and HTS in terms of the total DLQI scores and the subscale scores (p > 0.05) except treatment (p < 0.05) sub-scale scores which were higher in psoriasis. Conclusions: The QoL of patients with keloids and HTS is impaired as much as that of those with psoriasis. The DLQI questionnaire is a reliable and valid instrument for assessing the QoL in patients with keloids and HTS.Öğe Erythrokeratodermia variabilis: Successful palliative treatment with acitretin(Wolters Kluwer Medknow Publications, 2008) Balci, Didem Didar; Yaldiz, Mehmet[Abstract Not Available]Öğe Evaluation of self-esteem and dermatological quality of life in adolescents with atopic dermatitis(Deri Zuhrevi Hastaliklar Dernegi, 2013) Erturan, Ijlal; Aktepe, Evrim; Balci, Didem Didar; Yildirim, Mehmet; Sonmez, Yonca; Ceyhan, Ali MuratBackground and Design: Atopic dermatitis is a chronic, inflammatory skin disease characterized by itchy skin lesions. Since adolescents are intensely interested in their physical appearance, chronic skin diseases in this period can adversely affect the development of self esteem. Atopic dermatitis is a skin disease that affects the appearance and there is an heightened attention to the body image in adolescence which is an important period of time in the development of self-esteem. Therefore, we aimed to investigate self-esteem and dermatological quality of life in adolescents with atopic dermatitis. Materials and Methods: Thirty-three patients with atopic dermatitis and 33 healthy controls were included in the study. The Piers-Harris Children's Self-Concept Scale and the Children's Dermatology Life Quality Index (CDLQI) were used for determining self-esteem and quality of life. The Scoring of Atopic Dermatitis (SCORAD) Index was used to assess the severity of atopic dermatitis. Results: It was found that patient group had lower self-esteem than healthy controls according to the Piers-Harris Children's Self-Concept Scale. A statistically significant difference was observed in happiness/satisfaction and anxiety subscale scores between the patients and healthy controls while there was no significant difference between the other sub-scale scores. Mean value of dermatological quality of life in patients with atopic dermatitis was significantly lower than in healthy controls. A moderate negative correlation was found between self-esteem and CDLQI scores among adolescents with atopic dermatitis. Discussion: This study results have shown that self-esteem and dermatological quality of life were adversely affected in adolescents with atopic dermatitis irrespective of gender. These patients should be examined psychiatrically besides dermatological examination and treatment. We suggest that improvement will be observed in self-esteem and quaky of life of adolescents with atopic dermatitis by providing the necessary psychosocial support.Öğe The Evaluation of Solid Phase Gastric Emptying in Patients with Behcet's Disease(Derman Medical Publ, 2015) Dogramaci, Asena Cigdem; Yalcin, Hulya; Balci, Didem Didar; Ucar, Edip; Yenin, Julide Zehra; Kalender, EbuzerAim: Behcet's disease is a multisystemic disease that includes the mucocutaneous, ocular, cardiovascular, renal, pulmonary, joint and central nervous system involvement. Gastrointestinal system involvement is rare in Behcet's disease. Current study was planned to investigate the rate of gastric emptying in patients with Behcet's disease by using gastric emptying scintigraphy. Material and Method: In order to determine gastric emptying rate of solids, 14 patients with Behcet's disease and 14 healthy controls were studied scintigraphically. After an overnight fast, all subjects ingested a Tc-99m DTPA labeled solid meal consisted of an egg and toasted white bread. Immediately after ingestion of the meal, subjects were positioned supine under the gamma camera and serial images were recorded continuously for 90 minutes. Half empyting time (t 1/2) and percentage of radioactive material remaining in the stomach at 60 min. were calculated. Results: The mean ages of Behcet's patients was 41.00 +/- 10.25 years and 40.57 +/- 10.05 years in control group. T 1/2 of Behcet's patients was found 85 +/- 61 min. and 63 +/- 22 min. in control cases (p=0.122). Percentage of radioactive material remaining in the stomach at 60 min. was 69.3 +/- 14.0 % and 54.6 +/- 22.0 % in Behcet's patients and controls, respectively (p=0.035). Discussion: Although there was not a significant difference between half gastric emptying times, we determined that percentage of radioactive material remaining in the stomach at 60 min. was significantly greater in Behcet's patients than that in controls. As a result, gastric stasis could be seen in Behcet's patients due to multisystemic involvement.Öğe Frequency, Distribution and Genotyping of Malassezia Species in Patients with Psoriasis vulgaris(Univ Press, 2021) Celik, Ebru; Duran, Nizami; Balci, Didem Didar; Dogramaci, Asena Cigdem; Pasa, OzgurBackground: Malassezia species are reported to play a role in the etiology of Psoriasis vulgaris. Objective: The aim of this study was to determine the presence, frequency, distribution, and genotyping of skin colonization of Malassezia species in Psoriasis vulgaris and to compare with healthy individuals and to investigate its relationship with the severity of the disease. Methods: Skin samples were taken from scalp, arm, body, and leg of 34 psoriasis patients (lesional/ non-lesional skin) and 30 healthy volunteers. Overall, 392 skin scraping samples were taken for the isolation of Malassezia species, which were incubated on the modified-Dixon agar. Conventional culture methods were used for Malassezia species identification. In isolates, genotyping was carried out by PCR-RFLP method. Results: In the samples from psoriatic lesions, most frequently isolated Malassezia species were M.globosa and M.furfur. Similarly, the most frequently isolated species in healthy volunteers was M. globosa; followed by M.restricta and M.sympodialis. The M.furfur isolation rate in psoriatic scalp and leg lesions of the patients was significantly higher than in healthy volunteers. There was no relationship between the severity of the disease and the isolated species. Conclusion: It was found that there was a difference between patients with psoriasis and healthy controls regarding presence and frequency of Malassezia species. Therefore, our study results support the view that Malessezia species may be associated with the etiopathogenesis of psoriasis. In addition, we surmise that the treatment applications for the regulation of skin microbiota of psoriasis patients will contribute positively to the treatment of psoriasis.Öğe High prevalence of Staphylococcus aureus cultivation and superantigen production in patients with psoriasis(John Libbey Eurotext Ltd, 2009) Balci, Didem Didar; Duran, Nizami; Ozer, Burcin; Gunesacar, Ramazan; Onlen, Yusuf; Yenin, Julide ZehraThe aim of this study was to evaluate the association of Staphylococcal enterotoxins (se) a through e, exfoliative toxin (et) a and b, toxin and toxic shock syndrome toxin (tst) and mecA with psoriasis. We also investigated the distribution of Staphylococcus aureus (S. aureus) in the skin and nares. Fifty consecutive patients with chronic plaque-type psoriasis and 50 sex- and age-matched healthy controls were included in this study. There was a statistical difference in cultivation of S. aureus between lesional (64%) and non-lesional skin (14%) in patients with psoriasis (p = 0.037). S. aureus was cultivated from the nares in 25 (50%) of 50 patients with psoriasis and in 17 (34%) of 50 healthy controls (p > 0.05). In psoriasis patients, 31 (96.8%) out of the 32 strains isolated from the lesional skin and 3 (42.3%) out of the 7 strains isolated from the non-lesional skin were toxigenic (p = 0.01). Isolated strains from the nares were toxigenic in 96% (24/25) for patients with psoriasis and in 41.2% (7/17) for healthy controls, respectively (p = 0.006). Patients with cultivation-positive in lesional skin had a significantly higher PASI score than patients who were cultivation-negative in lesional skin (8.28 +/- 3.97 vs. 5.89 +/- 2.98, p = 0.031). Our results confirm that S. aureus colonization and its toxigenic-strains are associated with psoriasis. According to our findings, non-classical superantigens such as methicillin resistance gene (mecA), see and etb may also be associated with psoriasis.Öğe Ichthyosis Vulgaris Coexisted with Acrokeratosis Verruciformis: A Case Report(Deri Zuhrevi Hastaliklar Dernegi, 2008) Serarslan, Gamze; Balci, Didem Didar; Atik, EsinIchthyosis vulgaris is an autosomal dominant inherited, keratinization disorder and characterized by diffuse scaling Acrokeratosis verruciformis is also an autosomal dominant, rare keratinization disorder and characterized by warty, brownish to skin colored papules on the dorsa of the hands and feet. We present a case of ichthyosis vulgaris coexisted with acrokeratosis verruciformis in a 24-year-old woman. (Turkderm 2008; 42: 134-6)Öğe Increased Amount of Visceral Fat in Patients with Psoriasis Contributes to Metabolic Syndrome(Karger, 2010) Balci, Ali; Balci, Didem Didar; Yonden, Zafer; Korkmaz, Inan; Yenin, Julide Zehra; Celik, Ebru; Okumus, NeseBackground: Psoriasis is associated with obesity and metabolic syndrome. Metabolic syndrome is associated with visceral fat accumulation. There is no study on the accumulation of visceral fat in patients with psoriasis. Objective: The aim of this study was to compare the visceral fat accumulation in patients with psoriasis and controls. Subjects and Methods: 46 patients with psoriasis and 46 sex-and age-matched control patients were included in this study. The abdominal fat area [visceral fat area (VFA), subcutaneous fat area (SFA) and total fat area (TFA)] at the level of the umbilicus was evaluated by computed tomography. Results: The mean VFA value and VFA/SFA ratio of the psoriasis patients were significantly higher compared with the control patients (123.4 +/- 80.3 vs. 81.2 +/- 59.8 cm(2) and 0.734 +/- 0.593 vs. 0.491 +/- 0.336; p = 0.005 and p = 0.017, respectively). Fasting blood sugar levels were also found to be significantly higher in psoriasis patients, compared with the control patients (101.8 +/- 43.5 vs. 83.4 +/- 9.1 mg/dl; p = 0.005). Multiple linear regression analysis indicated that waist-to-hip ratio, age, body weight, the presence of psoriasis and metabolic syndrome were significantly associated with VFA. Conclusion: Psoriasis patients had a higher amount of VFA, compared with the control patients. Copyright (C) 2009 S. Karger AG, BaselÖğe Inflammatory linear verrucous epidermal nevus with genital involvement(Pulse Marketing and Communications LLC, 2012) Balci, Didem Didar; Yenin, Jülide Zehra; Çelik, Ebru; Sarikaya, Gökhan; Atik, EsinAn 18-year-old woman was admitted to our clinic complaining of pruritic lesions on her inguinal and genital areas that had been present since birth. She had previously used topical steroids and a combination of topical steroids and calcipotriol for approximately 6 months; however, the treatment was unsuccessful. Her medical history was unremarkable. On dermatologic examination, mild erythematous, lichenified, and verrucous papules occurring in a linear pattern on the right inguinal area and on the region extending from the right labium majus to the perianal area were noted (Figure). Additionally, an erythematous area with central erosion surrounded by maceration was noted on the intergluteal area. Two separate punch biopsy samples were obtained from the erythematous, lichenified, verrucous, papular lesion on the inguinal area and from the erythematous, eroded, macerated lesion on the intergluteal area. Histopathological examination of both biopsy specimens revealed a thin orthokeratotic layer and scattered parakeratotic layers, as well as papillomatosis and acanthosis of the epidermis with a slight hyperpigmentation of the basal layer. A mild, perivascular, chronic inflammatory cell infiltration was noted in the dermis. Based on the clinical and histopathological findings, the patient was considered to have inflammatory linear verrucous epidermal nevus, and cryotherapy was initiated. At the 2-week follow-up after the first application, it was observed that the itching complaint decreased substantially and the eroded lesions in the intergluteal area were re-epithelialized. On clinical follow-up, no improvement was observed in the papular component of the lesion after 4 sessions of cryotherapy. The patient voluntarily discontinued the follow-up after 4 sessions of cryotherapy. © 2012 Pulse Marketing & Communications, LLC.Öğe Photodynamic Therapy and Extracorporeal Photochemotherapy in Dermatology(Deri Zuhrevi Hastaliklar Dernegi, 2010) Balci, Didem Didar; Ozkan, Ayse SebnemExtracorporeal photochemotherapy or photopheresis is an extracorporeal ultraviolet and a photosensitizer (8-MOP) exposure of plasma. It is reported to be effective for several dermatoses such as cutaneous T cell lymphoma, autoimmune diseases and graft versus host disease. Photodynamic therapy involves the use of a photosensitizer in combination with visible light which is the correct wavelight for the photosensitizer. It has become an alternative treatment method for dermatooncologic conditions like actinic keratosis and basal cell carcinoma. In addition to these dermatoses, it is used for many non-neoplastic dermatoses such as acne, localized scleroderma and in some aesthetic indications.Öğe A Rare Case of Vulvar Langerhans Cell Histiocytosis and Review of the Literature(Galenos Yayincilik, 2009) Balci, Didem Didar; Kundakci, Nihal; Gurel, Mehmet Salih; Yaldiz, Mehmet; Dogramaci, Cigdem Asena; Akay, Bengu NisaLangerhans cell histiocytosis (LCH) of the vulva is rare. A 32 year-old woman presented with a two year history of non-healing vulvar ulceration and a nine month history of ulcerative nodular lesion in the left inguinal region. Biopsy results of the vulva and inguinal lesions were consistent with LCH. Screening of the body systems revealed hepatosplenomegaly, iliac, inguinal, paraaortic lymph nodes and lung involvement. She was treated with systemic steroid, resulting in complete improvement of vulvar lesion. She also underwent a local excision of left inguinal lesion. Three months later, we found a lesion on her left inguinal region that was consistent with a recurrence and enlargement in the lymph nodes. Therefore, high dose systemic steroid therapy and then a 12-session radyotherapy were given. After the treatment, a complete improvement was obtained. A 1-year of systemic methotrexate therapy was recommended to prevent recurrence of the disease. In women with vulvar ulcer, LCH should be considered in the differential diagnosis.Öğe A rare cause of oral papillomatous lesions: Cowden syndrome(Medknow Publications, 2012) Balci, Didem Didar; Celik, M. Murat; Celik, Ebru; Demir, Mehmet; Yaldiz, Mehmet[Abstract Not Available]Öğe Serum High Sensitivity C Reactive Protein and Homocysteine Levels in Patients with Mild to Moderate Psoriasis(Galenos Publ House, 2009) Balci, Didem Didar; Yonden, Zafer; Dogramaci, Cigdem Asena; Duran, NizamiBackground and Design: Psoriasis has been reported to be associated with increased cardiovascular risk profile. High sensitivity C reactive protein (hs-CRP) and homocysteine (Hcy) have been demonstrated to be novel biomarkers for subsequent cardiovascular events. The aim of the present study was to examine hs-CRP, Hcy and folic acid levels in patients with mild to moderate psoriasis vulgaris. Material and Method: Fifty one consecutive patients with mild to moderate psoriasis vulgaris and thirty two sex- and age-matched healthy controls were included in this study. After excluding factors that may affect serum Hcy levels, blood samples were obtained for hs-CRP, Hcy and folic acid determination. Lipid levels were also evaluated. Results: The mean Hcy values of the psoriasis patients was significantly higher, compared with the controls (p=0.001). There were no significant difference in hs-CRP and folic acid levels between psoriasis patients and controls (p > 0.05). The total cholesterol (TC) high density lipoprotein cholesterol (HDL C) ratio was significantly higher in patients with psoriasis than in controls (p=0.044). There was a significant relationship between Hcy level and sex in psoriasis patients. The hs-CRP values had significant positive correlation with body mass index (BMI) and TC in psoriasis patients (p < 0.05). Conclusion: Serum hs-CRP and folic acid levels did not show any significant difference between patients with mild to moderate psoriasis and controls. However, serum Hcy levels increased and inversely correlated with folic acid levels in psoriasis patients. These biomarkers could provide additional information in the evaluation of the atherosclerotic risk in psoriasis. (Turkderm 2009; 43: 53-7)
