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Öğe Assesment of the Retinal Nerve Fiber Layer Thickness with Optical Coherence Tomography in Patients with Psoriasis(Galenos Yayincilik, 2014) Rifaioglu, Emine Nur; Tuzcu, Esra Ayhan; Sen, Bilge Bubul; Ekiz, OzlemObjective: Psoriasis is an auto inflammatory disorder that affects the skin and joints. Psoriasis-related conditions that involve the eye are mainly blepharitis, conjunctivitis and keratitis and these conditions are seen in about 10% of psoriasis patients. However optic neuritis and pathologies of visual fields are rarely seen. Our study aims to investigate the mean retinal nerve fibres layer (RNFL) thickness using OCT in patient psoriasis. Methods: A total of 40 patients with psoriasis and 35 controls were included in our study. The average retinal nerve fibre layer thickness was measured using the optic disc cube protocol (200x200) and the Cirrus SD-OCT (Carl Zeiss Meditec, Dublin, CA) device. The statistical analyses were performed using the SPSS v 19 software programme. Results: The mean psoriasis area and severity index (PASI) was 8.04 and the mean disease duration was 8.9 years. The average RNFL thickness was not statistically different between the patients and the controls, and there was no correlation between the mean RNFL thickness and the severity and duration of the disease. Conclusion: To our knowledge this study is the first assessment of RNFL thickness in patient with psoriasis. However, of greater scope are needed to investigate possible retinal changes in such patients.Öğe Assessment of left ventricular dyssynchrony in patients with psoriasis(Wiley-Blackwell, 2014) Sen, Bilge Bulbul; Rifaioglu, Emine Nur; Ekiz, Ozlem; Buyukkaya, Eyup; Kurt, Mustafa; Karakas, Mehmet Fatih; Buyukkaya, SuleBackground Psoriasis is an inflammatory disorder, which has been reported to be associated with cardiovascular (CV) risks. Although increased CV risks in psoriasis are well established, there are no data about changes of contraction synchrony in psoriasis. Therefore, we aimed to study the left ventricular (LV) contraction synchrony in patients with psoriasis with narrow QRS and normal ejection fraction. Methods Fifty patients with psoriasis and 50 age- and sex-matched control subjects were included in the study. LV dyssynchrony was investigated by color-coded tissue Doppler imaging. Results In the psoriasis group, the mean high-sensitive C-reactive protein values were significantly higher compared with the controls. Peak A velocity, deceleration time, isovolumetric relaxation time, and E/E' values were higher in the psoriasis group; however, E/A ratio and average Em were higher in the control group. LV systolic dyssynchrony parameters [including standard deviation of Ts of the 12 LV segments (Ts-SD-12), maximal difference in Ts between any two of the 12 LV segments, standard deviation of Ts of the six basal LV segments, and maximal difference in Ts between any two of the six basal LV segments] were found to be higher in the psoriasis group. The patients with ventricular dyssynchrony (a Ts-SD-12 > 34.4 ms) were higher in the psoriasis group than the control group (34% vs. 6%, P < 0.01). Conclusion In patients with psoriasis with normal ejection fractions and narrow QRS, LV systolic dyssynchrony is an early manifestation of heart involvement and may coexist with diastolic dysfunction.Öğe Assessment of subclinical left ventricular dysfunction in patients with psoriasis by speckle tracking echocardiography: A Speckle Tracking Study(Wiley, 2016) Bulbul Sen, Bilge; Ekiz, Ozlem; Rifaioglu, Emine Nur; Buyukkaya, Eyup; Karakas, Mehmet Fatih; Buyukkaya, Sule; Bilen, PerihanBackgroundPsoriasis is a systemic inflammatory disease and is reportedly associated with adverse cardiovascular risks. Left ventricular (LV) function has not been studied comprehensively in psoriasis. ObjectivesThis study was conducted to study LV mechanics in patients with psoriasis by speckle tracking echocardiography. MethodsThe study population consisted of 40 patients with psoriasis and 35 age- and sex-matched control subjects. Two-dimensional echocardiography images were obtained from LV apical four-chamber (4C), long axis (LAX), and two-chamber (2C) views. Peak longitudinal strain and strain rate were obtained from 4C, LAX, and 2C views. Global strain and strain rate were calculated by averaging data for the three apical views. ResultsPatients with psoriasis had significantly lower meanstandard deviation (SD) 4C (17.1 +/- 1.7 vs. 19.2 +/- 2.3; P<0.01), LAX (16.6 +/- 1.5 vs. 19.5 +/- 2.3; P<0.01), and 2C (16.5 +/- 1.5 vs. 19.4 +/- 2.2; P<0.01) peak longitudinal strain values compared with the control group. Moreover, mean +/- SD LV global strain (16.6 +/- 1.5 vs. 19.9 +/- 2.1; P<0.01) and strain rate (1.39 +/- 0.30 vs. 1.51 +/- 0.20; P<0.01) values were found to be significantly lower in the psoriasis group. In a multiple regression model, global strain was independently associated with high-sensitivity C-reactive protein (=0.29, P=0.04), duration of disease (=0.35, P<0.01), ejection fraction (EF) (=0.38, P=0.01), and the ratio of early diastolic mitral inflow velocity to early diastolic annular velocity (E/E ratio) (=0.34, P=0.02). Also, in a multiple regression model, global strain rate was independently associated with duration of disease (=0.36, P<0.01), EF (=0.32, P=0.01), and E/E ratio (=0.35, P<0.01). ConclusionsUsing 2-D strain imaging, we have demonstrated that patients with psoriasis have lower LV functions.Öğe A case of atypical scleromyxedema mimicking angioedema which responded well to acitretin treatment(Deri Zuhrevi Hastaliklar Dernegi, 2015) Ekiz, Ozlem; Sen, Bilge Bulbul; Rifaioglu, Emine Nur; Yaldiz, MehmetA 37-year-old male patient was admitted our clinic with the complaints of edema and mild pruritus of the eyelids, ears, and the neck. On dermatological examination, there were edema and pale erythema on the eyelids and ears as well as coarsening of the facial features and lines grooving the forehead. His medical history revealed that the patients received systemic corticosteroids, antihistamines and epinephrine treatments for about two months with the diagnosis of urticaria and angioedema, however, he did not benefit from these treatments. A diagnosis of atypical scleromyxedema without monoclonal gammopathy was established according to the clinical, histopathological and laboratory findings. Acitretin treatment with a dose of 35 mg/day was started. Marked regression in the lesions was observed two months later.Öğe Clinical and Demographic Characteristics of 626 Patients with Moderate and Severe Psoriasis(Derman Medical Publ, 2014) Rifaioglu, Emine Nur; Ozarmagan, GuzinAim: In our study, we aim to investigate the demographic, clinic features and the treatments of patients with moderate to severe psoriasis who were followed in outpatient clinic of psoriasis of Department of Dermatology in Istanbul Medical School of Istanbul University. Material and Method: One thousand eight hundred and thirty-one patients, who were followed between 2002-2008 in outpatient clinic of psoriasis. were screened and 626 (34%) of them, who were moderate and severe. were evaluated retrospectively. Results: Three hundred five of the patients who participated in our study were female and 321 were male. Mean age of onset was 28.1. Most frequently clinical type was plaque psoriasis. Most frequently nail involvement was pitting in patients. Nail involvement was statistically common in arthropathic patients. Family history was statistically common in psoriasis patients with early onset Retinoid was the most common used systemic drug. Narrow band UVB was the most common used phototherapy. Discussion: Moderate to severe psoriasis rate was 34%. Female to male ratio was close to one another. Peak age of onset of psoriasis was between 16-25 years old. The most common concomitant systemic disease was diabetes mellitus. The findings were consistent with the literature. Consequently psoriasis is a chronic. recurrent, inflammatory dermatologic disease which affect 2% of the word and which negatively affect the quality of life in patients with comorbidities. Especially in severe forms of psoriasis can cause loss of labor in patients. A good knowledge of demographic and clinical characteristics of psoriasis is important to shedding light on the further clinical studies.Öğe Erythematous indurated plaque lesions Net Quiz on the breast(Scientific Scholar Llc, 2013) Sen, Bilge Bulbul; Rifaioglu, Emine Nur; Ekiz, Ozlem; Ozgur, Tumay; Akkucuk, Seckin; Inan, Mehmet Ugur; Dogramaci, Asena Cigden[Abstract Not Available]Öğe The Etiology of Behcet Disease: Is It Really Inflammation or Not!(Sage Publications Inc, 2014) Ekiz, Ozlem; Balta, Ilknur; Sen, Bilge Bulbul; Rifaioglu, Emine Nur; Balta, Sevket; Demirkol, Sait[Abstract Not Available]Öğe Follicular Porokeratosis at alae Nasi; A Case Report and Short Review of Literature(Medknow Publications & Media Pvt Ltd, 2014) Rifaioglu, Emine Nur; Oyalvacli, GulzadePorokeratosis are disorders of keratinization, characterized histologically by a parakeratotic column, the cornoid lamellae, and clinically by a distinct peripheral ridge. Porokeratosis usually occurs on the trunk or extremities, and facial lesions are rare. Follicular involvement, identified by follicular localization of cornoid lamellae, is uncommon and described only in association with disseminated superficial actinic porokeratosis (DSAP) and porokeratosis Mibelli (PM). A 34-Year- old woman is presented with asymptomatic 1 cm plaque lesion with hyperkeratotic ridge and depressed center on her nose since three years. Histopathological examination of a biopsy revealed cornoid lamellae confined exclusively to the follicle.Öğe Graham-Little-Piccardi-Lassueur Syndrome: A Case Report(Galenos Yayincilik, 2015) Rifaioglu, Emine Nur; Sen, Tuba; Ozgur, Tumay; Sen, Bilge Bulbul; Ekiz, OzlemA rare type of liken pilanopilaris, Graham-Little-Piccardi-Lassueur syndrome (GLPLS), is characterized by cicatricial alopecia of the scalp, follicular hyperkeratosis of trunk and extremities and non-cicatricial alopecia of axilla and pubis. A forty year-old woman admitted with hair loss and palpabl wheals on her body. On her dermatologic examination alopecic plaques with irregular border and atrophic appearance and milimetric papules around follicules on fronto-parietal part of scalp were detected. Also there were purple like-brown milimetric papules around follicules on both extensor part of distal arm, axilla, upper and lower back with alopecia on hairy areas. Additionally milimetric purplish papules on flexor area of wrists were accompanied to other signs. In histopathological investigation of the biopsy from scalp and back lesions were demonstrated orthokeratosis on superficial layer of epidermis, vacuolar degeneration and exocytosis on basal layer of epidermis and basal layer of follicular epithelium, perifollicular infiltration of mix type inflammatory cells, a few pigmentation deposited macrophages. The patient was diagnosed as GLPLS based on these symptoms and signs. Early diagnosis and treatment of this chronic, progressive characterized, rare type of lichen planopilaris is important. Treatments modalities could stop progression and provide partial remission, although they can't success complete improvement.Öğe Gynecomastia: a rare complication of isoretinoin?(Taylor & Francis Ltd, 2013) Ustun, Ihsan; Rifaioglu, Emine Nur; Sen, Bilge Bulbul; Inam, Mehmet Ugur; Gokce, CumaliIsotretinoin is a retinoic acid derivative mostly used in the treatment of cystic acne vulgaris. The adverse effects of isotretinoin are well defined being the major limitation factor for its usage. The decrement of testosteron during isoretinoin treatment is defined in literature. We present a case with 20 years old man who developed gynecomastia after treatment with isotretinoin. To the best of our knowledge, this is the third report of the development of gynecomastia after isotretinoin treatment.Öğe Increased Epicardial Fat Tissue is a Marker of Subclinic Atherosclerosis in Patients with Psoriasis(Elsevier Science Inc, 2013) Sen, Bilge Buelbuel; Atci, Nesrin; Rifaioglu, Emine Nur; Ekiz, Oezlem; Kartal, Ismail; Buyukkaya, Eyup; Kurt, Mustafa[Abstract Not Available]Öğe Is there a relationship between disease duration and P-wave dispersion in patients with psoriasis?(Taylor & Francis Ltd, 2013) Sen, Bilge Bulbul; Rifaioglu, Emine Nur; Ekiz, Ozlem; Buyukkaya, Eyup; Sen, Nihat[Abstract Not Available]Öğe Is there a relationship between left atrium size and p-wave dispersion in patients with lichen planus?(Hospital Clinicas, Univ Sao Paulo, 2013) Sen, Bilge Bulbul; Rifaioglu, Emine Nur; Erayman, Ali; Sen, Nihat[Abstract Not Available]Öğe Isotretinoin treatment in patients with acne vulgaris: Does it impact muscle strength, fatigue, and endurance?(Quadrant Healthcom Inc., 2015) Yildizgoren, Mustafa Turgut; Rifaioglu, Emine Nur; Demirkapi, Musa; Ekiz, Timur; Micoogullari, Ahmet; Sen, Tugba; Turhanoglu, Ayse DicleThe objective of this study was to evaluate the effects of isotretinoin on muscle strength, fatigue, and endurance in patients with acne vulgaris. The study included 27 patients with acne vulgaris who underwent treatment with isotretinoin as well as 26 control patients for comparison. Participants in the treatment group received oral isotretinoin 0.5 mg/kg once daily for 1 month followed by an increased dose of 1 mg/kg once daily for 2 months. Isokinetic measurements were obtained from the hamstrings and quadriceps on the nondominant side of the body at baseline and 3-month follow-up using an isokinetic dynamometer. Results indicated that systemic isotretinoin did not significantly alter muscle strength, fatigue, and endurance.Öğe Isotretinoin Treatment in Patients With Acne Vulgaris: Does It Impact Muscle Strength, Fatigue, and Endurance?(Quadrant Healthcom Inc, 2015) Yildizgoeren, Mustafa Turgut; Rifaioglu, Emine Nur; Demirkapi, Musa; Ekiz, Timur; Micoogullari, Ahmet; Sen, Tugba; Turhanoglu, Ayse DicleThe objective of this study was to evaluate the effects of isotretinoin on muscle strength, fatigue, and endurance in patients with acne vulgaris. The study included 27 patients with acne vulgaris who underwent treatment with isotretinoin as well as 26 control patients for comparison. Participants in the treatment group received oral isotretinoin 0.5 mg/kg once daily for 1 month followed by an increased dose of 1 mg/kg once daily for 2 months. lsokinetic measurements were obtained from the hamstrings and quadriceps on the nondominant side of the body at baseline and 3-month follow-up using an isokinetic dynamometer. Results indicated that systemic isotretinoin did not significantly alter muscle strength, fatigue, and endurance.Öğe Koebner Phenomenon as a Complication of Tattoo; a Case Diagnosed as Psoriasis(Galenos Yayincilik, 2014) Rifaioglu, Emine Nur; Sen, Bilge Bulbul; Ekiz, Ozlem[Abstract Not Available]Öğe Lectin-like oxidized low density lipoprotein receptor 1(LOX-1) levels and endothelial dysfunction in patients with primary essential hyperhidrosis(2013) Rifaioglu, Emine Nur; Erfan,Gamze; Doğruk Kaçar, Seval; Güzel, Savaş; Alpsoy, Şeref; Kulaç, Mustafa; Karaca, Şemsettin; Bülbül Şen, Bilge; Ekiz, Özlem; Şen, NihatAmaç: Primer esansiyel hiperhidroz avuç içi ayak tabanı ve aksiler bölgenin aşırı terlemesi ile karakterize bir hastalıktır. Etyolojisi henüz açıklığa kavuşmamış olmakla beraber otonom sinir sisteminin artmış aktivitesinin rolü tartışılmaktadır. Biz bu çalışmada primer esansiyel hiperhidroz hastalarında akım aracılı dilatasyon ve lektin benzeri okside düşük dansiteli lipoprotein reseptör 1 düzeylerini inceleyerek endotelyal disfonfonksiyonun varlığını araş- tırmayı amaçladık. Yöntemler: Tanısı nişasta iyot testi ile konmuş otuzüç primer esansiyel hiperhidroz hastası ile 19 yaş ve cinsiyet uyumlu kontrol bu çalışmaya dahil edildi. Akım aracılı dilatasyon ultrasonografik olarak brakiyel arterden ölçüldü. Serum LOX-1 seviyeleri Enzim-Bağlı İmmun Sorbent Testi (ELISA) ile ölçüldü. Bulgular: Brakiyel arter akım aracılı dilatasyon çapları ve post nitrat dilatasyon çapları hasta ve kontrol grubu için istatistiksel olarak farklı değildi. LOX-1 değerleri açısından karşılaştırıldığında da hasta ve kontrol grubu arasında istatistiksel olarak fark yoktu. Sonuç: Primer esansiyel hiperhidrozda aşırı terleme erkin bezlerin normal sempatik aktiviteye verdiği aşırı bir periferik yanıt mı yoksa kardiyovasküler etkileri nitrik oksit ile maskelenmiş sistemik sempatik bir hiperaktivite mi olduğunu anlamak için daha geniş çalışmalara ihtiyaç vardır.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.
