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Öğe Angioedema is an unfavorable factor for the response to omalizumab in chronic spontaneous urticaria: A retrospective study(Wiley, 2019) Serarslan, Gamze; Uzun, Mehmet; Dogramaci, Asena Cigdem; Celik, EbruAntihistamines are the first-line treatment option for chronic urticaria. In recent years, omalizumab, an anti-immunoglobulin-E humanized monoclonal antibody, has been used in patients with recalcitrant disease. The present study aimed to retrospectively evaluate the efficacy and safety of omalizumab and determine whether there was a difference between complete and partial responses to omalizumab with respect to age, gender, disease duration and coexistence of angioedema. From May 2014 to December 2016, a total of 40 refractory chronic urticaria patients were treated with omalizumab. Complete response was observed in 19 (47.5%) patients, and partial response was observed in 18 (45%) patients. There were no statistically significant differences between the rates of complete and partial responses in patients with respect to gender, age, and disease duration. However, complete response was more frequent (60%) in patients without angioedema. Remission was observed in 40.5% (n = 15) of patients, and the follow-up time was 5.5 +/- 2.4 months. There was a statistically significant association between remission and coexistence of angioedema (p < .05). Eighty-seven percent (13/15) of the remission patients did not have angioedema. Thus, omalizumab can be used effectively and safely in refractory chronic urticaria patients. However, the coexistence of angioedema may be an unfavorable factor for complete response and remission.Öğe Dermanyssus gallinae infestation: An unusual cause of scalp pruritus treated with permethrin shampoo(Informa Healthcare, 2010) Dogramaci, Asena Cigdem; Culha, Gulnaz; Ozcelik, SemraDermanyssus gallinae is a blood parasite of wild birds, but it is also a pest in the poultry industry. It occasionally bites mammals and thus rarely creates skin problems such as itching, papules, vesicles, and dermatitis. A 92-year-old man presented with severe itch on his head, particularly at night. He had been misdiagnosed with senile pruritus and treated with antihistamines and topical corticosteroids with temporary relief of the symptoms. On the basis of clinical and parasitological findings, D. gallinae dermatitis was diagnosed. Decontamination of the patient's immediate environment was not helpful. The patient was successfully treated using a 1% permethrin shampoo once a week for 2 weeks. During 3 months of follow-up he was free of symptoms. The case is of significance because most dermatologists have difficulty identifying ectoparasitoses, such as those that arise within new or atypical conditions.Öğe The Effects of COVID-19 on Psoriasis Patients Using Biologic Treatment: Two-Center Retrospective Study(OrtadogŸu Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S., 2022) Kus, Mine Mujde; Ozturk, Perihan; Dogramaci, Asena Cigdem; Guner, Mehmet Enes; Bozkurt, Yemliha; Nazik, Hulya; Mulayim, Mehmet KamilObjective: The aim of our study is to evaluate the status of continuation of treatment of our patients who received biologic treatment during the pandemic and how they were affected by coronavirus disease-2019 (COVID-19). Material and Methods: The clinical processes of patients with moderate-severe plaque psoriasis who were treated with biologics between March 2020 and February 2021 were evaluated. Results: Thirty-three (21.2%) of our 156 psoriasis patients who received biologic therapy stopped treatment at the beginning of the pandemic. Fourteen of the 123 patients who were continuing the treatment were positive for COVID-19. One of the 33 psoriasis patients who stopped biologic treatment was positive for COVID-19. There was no statistical difference between those who continued with biologic treatment and those who did not in the rates of positivity for COVID- 19 after contact with a COVID-19 positive person, and frequency of severe symptoms (p=0.607, p=1.00, respectively). In terms of the difference between the mean of Psoriasis Area Severity Index (PASI) scores at the onset of the pandemic and the mean of PASI scores at the 12th month, there was no statistical difference between those who were positive for COVID-19 and those who did not (p=0.782). Conclusion: We have observed that the treatment with biologic agents in psoriasis patients does not increase the COVID-19 transmission risk, does not cause severe disease, and does not increase the hospitalization rate and mortality rate. © 2022 OrtadogŸu Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S.. All rights reserved.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 Hypopigmented Disorders Except Vitiligo(Deri Zuhrevi Hastaliklar Dernegi, 2011) Dogramaci, Asena CigdemHypopigmentation disorders in children can be due to a wide variety of congenital and acquired diseases. They can be classified on the basis of lesion extent, and can generally be divided into disorders with localized or generalized lesions. Clinical findings, comprising the degree of pigment loss and associated morphological findings are used to further distinguish the disorders. This review deals with skin diseases with hypopigmentation other than vitiligo as the main clinical presenting feature in children. (Turkderm 2011; 45 Suppl 2: 122-6)Öğe Induction of allergic contact dermatitis and pervasive face edema due to Brazilian keratin treatment(Wiley, 2021) Celik, Ebru; Esin Korkmaz, Kubra; Dogramaci, Asena CigdemBrazilian keratin treatment (BKT) is a prevalent hair straightening method widely used by women in the world. The degree of concentration of formaldehyde safe for sensitive patients is still obscure. Report claims that these products contain intolerably high levels of formaldehyde. Yet, hair straightening products may lead to severe allergic contact dermatitis, by means of the responsible allergens such as formaldehyde and its releasers. This case report presents the case of a 37-year-old female patient developing extensive edema of the face and acute inflammatory changes in the scalp from chemical-induced irritation, on the day following the application of BKT to straighten her hair.Öğe Investigation of the Relation Between FAS, FASLG Polymorphisms and Serum Fas, FasL Levels in Patients with Psoriasis(Univ Press, 2018) Duran, Gulay Gulbol; Kasap, Mulkiye; Gunesacar, Ramazan; Dogramaci, Asena Cigdem; Denli, Yasar GulBackground: Psoriasis is a multifactorial and inflammatory chronic skin disease indicated with T-cell-mediated keratinocyte hyper-proliferation. Demographic, epidemiological (family, twin), serological, and genetic studies have clearly demonstrated that psoriasis is a polygenic and multifactorial disease. Aim: The objectives of the study are; to determine the prevalence of the polymorphisms of FAS (Fas cell surface receptor gene) -671 A>G (rs: 1800682) and FASLG (Fas ligand gene) -844 T>C (rs: 763110), to investigate the serum levels of sFas and sFasL, and also to discover any relationship between gene polymorphisms and serum levels in psoriatic patients. Material and Methods: 50 treated and 69 untreated patients, and 140 healthy controls were included in the study. Polymorphisms were determined using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. The serum levels were measured in randomly selected treated (39) and untreated (40) patients, also in 84 healthy controls using micro-ELISA technique. Results: There was no statistical difference between polymorphisms in the patient and control groups. However, sFas and sFasL levels in both treated and untreated patients were higher than that of the controls. Conclusion: The investigated FAS and FASLG polymorphisms were not found to be directly associated with the psoriasis. Elevated sFas and sFasL levels in psoriatic patients showed that these factors may possess a significant role in the pathogenesis of psoriasis.Öğe Leishmaniasis Recidiva Cutis of the Lips Mimicking Granulomatous Cheilitis(Medknow Publications & Media Pvt Ltd, 2015) Ekiz, Ozlem; Rifaioglu, Emine Nur; Sen, Bilge Bulbul; Culhal, Gulnaz; Ozgur, Tumay; Dogramaci, Asena CigdemLeishmaniasis recidiva cutis (LRC) is an unusual form of acute cutaneous leishmaniasis. Herein, we present a case of LRC of the lips mimicking granulomatous cheilitis. An 8-year-old, Syrian child admitted with a swelling and disfigurement of his lips for 4 years. Abundant intra and extracellular Leishmania amastigotes were determined in the smear prepared from the lesion with Giemsa stain. Histopathology showed foamy histiocytes and leishmania parasites within the cytoplasm of macrophages in the epidermis and a dense dermal mixed type inflammatory cell infiltrate composed of lymphocytes, foamy histiocytes with multinucleated giant cells. On the basis of anamnestic data, the skin smears results, clinical and histopathologic findings, LRC was diagnosed. The patient was treated with meglumine antimoniate intramuscularly and fluconazole orally. Cryotherapy was applied to the residual papular lesions. The lesion improved markedly at the first month of the treatment.Öğe Localized bullous pemphigoid occurring on surgical scars(Medknow Publications & Media Pvt Ltd, 2013) Sen, Bilge Bulbul; Ekiz, Ozlem; Rifaioglu, Emine Nur; Sen, Tugba; Atik, Esin; Dogramaci, Asena Cigdem[Abstract Not Available]Öğe Mean platelet volume and eosinophilia relationship in patients with bullous pemphigoid(Informa Healthcare, 2014) Rifaioglu, Emine Nur; Sen, Bilge Bulbul; Ekiz, Ozlem; Dogramaci, Asena CigdemIntroduction: Bullous pemphigoid (BP) is an autoimmune skin disease that is characterized by the formation of blisters on normal or erythematous skin. In patients with BP, eosinophils are highly represented in the inflammatory infiltrate of the lesional skin and their levels are often increased in peripheral blood. It is known that eosinophils are the major intravascular source of tissue factor (TF), an initiator of the extrinsic coagulation pathway. Patients with BP are also three times more likely to develop pneumonia and pulmonary embolism than the matched controls. We hypothesized that there might be an association between the eosinophil level and mean platelet volume (MPV) in these patients. Patient and method: A total of 19 patients with BP and age-sex match 22 healthy controls were included in this study retrospectively. MPV before treatment, MPV after treatment, platelet, eosinophil count before treatment, eosinophil count after treatment, white blood cell, glucose, C reactive protein and sedimentation rate were evaluated in BP patients and the control group. Results: The MPV value (8.32fl +/- 1.8) and eosinophil count (1.03x10(3)mu L-1 +/- 0.36) in patients with BP was significantly higher than that of control subjects (p=- 0.036) and (0.22x10(3)mu L-1 +/- 0.29) (p= 0.002) (p< 0.05, Mann-Whitney U-test). Conclusion: In this study high levels of MPV and eosinophil levels have been detected. MPV may be a useful indicator of the risk of vascular events. Prospective studies are needed to compare disease activity, thromboembolic events and MPV in BP patients.Öğe Narrow-band ultraviolet B phototherapy in childhood(Informa Healthcare, 2014) Sen, Bilge Bulbul; Rifaioglu, Emine Nur; Ekiz, Ozlem; Sen, Tugba; Celik, Ebru; Dogramaci, Asena CigdemBackground: Narrow-band ultraviolet B (UVB) has been used for skin diseases in children. However, the use of phototherapy in childhood has limited due to the possible risk of skin cancer. The aim of this study is to evaluate the efficacy and safety of the narrow-band UVB phototherapy in children for the treatment of various skin diseases. Methods: The data of the children aged 16 years or under who were treated with narrow-band UVB in our clinic's phototherapy unit were analyzed, retrospectively. Results: The study included 77 children (42 girls, 35 boys) aged 5-16 years (mean 12.18 +/- 3.53) who were treated with a total of 81 courses of narrow-band UVB phototherapy in the last 4.5 years. The majority of patients had vitiligo (47%) and psoriasis (39%). Thirty-four (44.2%) patients showed complete response, 15 (19.5%) good response, 12 (15.6%) partial response, 5 (6.5%) poor response and 11(14.3%) no response. Acute side effects of phototherapy were observed only in 11 (14.3%) patients. Conclusions: Narrow-band UVB phototherapy is an effective and well-tolerated treatment in childhood.Öğe Neutrophil to lymphocyte ratio in Behcet's disease as a marker of disease activity(Dermatovenerological Soc Slovenia, 2014) Rifaioglu, Emine Nur; Sen, Bilge Bulbul; Ekiz, Ozlem; Dogramaci, Asena CigdemIntroduction: Behcet's disease (BD) is a rare autoimmune disease. The neutrophil to lymphocyte ratio (NLR) is used as a marker of inflammation in several diseases nowadays. This study investigated the NLR as an inflammation marker in BD. Methods: Sixty-five patients diagnosed with BD and 100 healthy subjects were enrolled in this study retrospectively. The white blood cell (WBC), neutrophil, and lymphocyte counts were recorded, and the NLR was calculated from these parameters. Results: The NLR and the CRP and WBC levels were higher in patients with BD than controls (p < 0.001, p < 0.001, and p = 0.026, respectively). In addition, the NLR was higher in patients with active BD than in those with inactive BD (p = 0.033). Discussion: The results demonstrate that the NLR is higher in patients with active BD compared to controls and those with inactive BD.Öğe Pili Annulati: Light and Electron Microscopic Findings of a Case(Ortadogu Ad Pres & Publ Co, 2009) Serarslan, Gamze; Nacar, Ahmet; Dogramaci, Asena CigdemPili annulati is a rare autosomal dominant inherited hair shaft disorder. It is characterized by alternating light and dark bands and there is no association with hair fragility. A 8-year-old girl presented to our dermatology outpatient clinic with a 7-year history of hair disorder. Dermatologic examination revealed light and dark banding of hairs. Light microscopy of the hairs displayed intermittent dark banding. Scanning electron microscopy revealed cavities within the cortex of hair. In the light of clinical and microscopic findings, the patient was diagnosed with pili annulati and to the best of our knowledge, our patient is the first case reported from Turkey.Öğe Postpartum Pemphigoid Gestationis: Good Respons to Topical Clobetasol(Derman Medical Publ, 2016) Rifaloglu, Emine Nur; Sen, Bilge Bulbul; Ekiz, Ozlem; Atik, Esin; Dogramaci, Asena CigdemPemphigold gestationes is a rare pregnancy related autoimmune subepidermal bullous disease. It frequently occurs at second and third trimester of pregnancy. Also it rarely appears at first trimester of pregnancy or postpartum period. Twenty-five years old woman was admitted our outpatient clinic at 12 th day of delivery with distance bullous lesions over erythematous area at abdominal skin, medial site of thighs and flexor site of forearms bilaterally. She and her baby were healthy in other respect. She was diagnosed as pemphigoid gestationes after hematoxylin and eosin and direct immunofluorescence examination of biopsy and topical clobetasol propionate ointment was initiated topically twice daily. The lesions were regressed almost completely. We present this case because of its' infrequent situation of pregnancy related autoimmune bullous disease and good respond to topical steroid treatment.Öğe The Safe and Effective Use of Methylphenidate in the Psychiatric Treatment of an Adolescent with Epidermolysis Bullosa(Cukurova Univ, Fac Medicine, 2013) Ekinci, Ozalp; Celik, Tanju; Dogramaci, Asena Cigdem; Toros, FevziyeEpidermolysis Bullosa is a group of inherited dermatological disorder with severe clinical symptoms. Children and adolescents with epidermolysis bullosa have been reported to experience psychosocial problems in addition to the symptoms associated with epidermolysis bullosa. Although children and adolescents with epidermolysis bullosa commonly have psychiatric symptoms, limited research has been conducted on the psychiatric treatment options. In this case report, psychiatric treatment and the safe and effective use of methylphenidate in the treatment of attention deficit hyperactivity disorder in an adolescent with epidermolysis bullosa will be discussed.Öğe Scleredema Diabeticorum Partially Treated with Low-Dose Methotrexate: a Report of Five Cases(Galenos Publ House, 2012) Dogramaci, Asena Cigdem; Inan, Mehmet Ugur; Atik, Esin; Gokce, CumaliScleredema is a rare connective tissue disorder that belongs to a group of scleroderma-like disorders. Although no known curative therapy exists, various specific treatments have been proposed in the literature. In this report, we describe five cases of scleredema partially treated with low-dose methotrexate therapy. All patients have diabetes mellitus type II. All patients were started on methotrexate 15 mg subcutaneously once weekly for 3 months. Biopsy specimens were taken from all patients and were examinated histologically before the treatment and after 3 months of treatment. All cases partially responded to low-dose methotrexate therapy. We believe that methotrexate therapy may be an alternative therapeutic options in scleredema in view of its efficacy.Öğe Severe allergic reactions to prilocaine during intravenous regional anesthesia(John Libbey Eurotext Ltd, 2008) Dogramaci, Yunus; Dogramaci, Asena Cigdem; Esen, Erdinc; Korkmaz, Tulay[Abstract Not Available]Öğe Skin diseases in patients with ?-thalassemia major(Wiley, 2009) Dogramaci, Asena Cigdem; Savas, Nazan; Ozer, Burcin; Duran, NizamiBackground beta-Thalassemia major affects multiple organs and is associated with considerable morbidity and mortality. The goal of this analysis was to document the frequency of skin diseases among patients with beta-thalassemia major. Methods A sample of 78 patients with beta-thalassemia major was recruited and interviewed at the thalassemia clinic between April and June 2008. A dermatologist completed a skin examination of each patient and recorded any skin disease present. The patients' laboratory results and treatment modalities were recorded from the charts. Results Sixty-five (83.3%) of the 78 patients examined had a diagnosed skin disease: pruritus (37.2%), xerosis (34.6%), scars (24.4%), ephelides (23.1%), skin irritation/erythema caused by deferoxamine pump (12.8%), idiopathic guttate hypomelanosis (6.4%), pityriasis alba (6.4%), tinea infections (5.1%), verruca vulgaris (5.1%), urticaria (3.8%), hyperhidrosis, contact dermatitis, and acne (2.6%), necrobiosis lipoidica (1.3%), melasma (1.3%), and others (14.1%). Pruritus and xerosis increased in frequency with age. The mean serum ferritin level was higher in patients with xerosis than in those without (5607.7 +/- 2997.5 ng/mL and 4285.2 +/- 4732.4 ng/mL, respectively) (P = 0.005). Moreover, xerosis was observed significantly more frequently in patients using deferoxamine and deferiprone than in those using deferasirox (P = 0.047, P = 0.027, and P = 0.273, respectively). Conclusion Skin diseases, especially pruritus and xerosis, are observed highly frequently in patients with beta-thalassemia major. Treatment is needed for these patients who already have other significant morbidities.Öğe SKIN PROBLEMS IN FIBROMYALGIA(Nobel Ilac, 2009) Dogramaci, Asena Cigdem; Yalcinkaya, Ebru YilmazObjective: Fibromyalgia is a chronic disease characterized by diffuse or specific muscle, joint, or bone pain, fatigue, and a wide range of other symptoms. The aim of this study was to highlight the association between fibromyalgia and dermatological diseases. Material and Method: 66 female patients diagnosed with fibromyalgia between March and June 2007 in Physical Therapy and Rehabilitation outpatient clinic and 79 healthy female control were enrolled to the controlled, cross-sectional study. All patients were seen in same day by the dermatologist. The patients' diagnoses were categorized into 14 different dermatological diseases. Results: The incidence of xerosis (respectively 32 vs 13 cases, p<0.001) and neurotic excoriation (respectively 11 vs 0 cases, p<0.001) were found to be significantly higher in fibromyalgia group than that of control group. The presence or absence of dermatological diseases in patients with fibromyalgia did not have a statistically significant impact to short form-36 quality of life. Conclusion: Our results showed that some stress-induced dermatological problems were common in patients with fibromyalgia. Further studies are necessary in order to have better idea about the relation between the skin problems and fibromyalgia.
