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    Analysis of Consultation Cases Referred from Pediatrics Department to Dermatology Outpatient Clinic: Retrospective Study
    (Marmara Univ, Inst Health Sciences, 2019) Daye, Munise; Temiz, Selami Aykut; Durduran, Yasemin; Balevi, Sukru; Dursun, Recep; Ataseven, Arzu; Ozer, Ilkay
    Objective: There are a few studies in the literature about dermatology consultations requested from Pediatrics Department. In the present study, it was aimed to assess the clinical features, pre-diagnosis and dermatologic diagnosis of patients consulted to the Dermatology Department from Pediatrics Department, and also to detect possible different approaches between the clinics. Methods: The list of dermatology consultations requested from Pediatrics Department between 1 September 2016 and 1 September 2017 were retrospectively evaluated by means of pre-diagnosis, dermatological diagnosis and unit consultations. Results: The mean age of patients was 7.4 +/- 5.3 years. Of the 628 patients, 52.1% were males, and 85% of the consultations were requested from outpatient clinics and 15% were from the inpatient clinics. Among all consultations 28.7% general pediatrics unit and 17.5% pediatric emergency unit required consultations. The most common diagnosis reported from Dermatology Department were eczema (28.2%), viral diseases (13.2%), parasitic diseases (8.4%) and fungal diseases (5.4%). Although, the ratio of an accurate pre-diagnosis was significantly higher in consultations requested from the inpatient clinics than those from outpatient clinics(p<0.001), 42.7% of the patients were referred to Dermatology Outpatient Clinic with an incorrect pre-diagnosis. Conclusion: Almost half of the patients, who were referred to Dermatology consultation, were diagnosed with incorrect pre-diagnosis. It was seen that pediatricians were difficult to recognize dermatoses. The awareness of Pediatric Dermatology Department should be raised for both specialties.
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    Cetuximab Induced Acneiform Eruption, Telangiectasia, Hypertrichosis, Paronychia, and Digital Fissures: a Case Report
    (Galenos Yayincilik, 2019) Unal, Mehmet; Unal, Gulbahar Urun; Arslan, Sevket; Tol, Huseyin; Balevi, Sukru
    Epidermal growth factor plays a critical role in tumor growth and progression, including cell proliferation, inhibition of apoptosis, angiogenesis, invasion, and metastasis. Cetuximab is the first monoclonal antibody that effects by binding to epidermal growth factors in the treatment of metastatic colorectal cancer. Because of the increasingly frequent use of epidermal growth factors inhibitors such as cetuximab in oncology services, perhaps more patients with the dermatologic complaints may require evaluation by dermatologists. Here, we report a case of severe acneiform eruption, hypertrichosis, telangiectasia, paronychia, ingrown toenails, pyogenic granuloma-like lesions, and digital fissures due to cetuximab in a 53-year-old female patient with colorectal cancer with metastases.
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    Histopathological comparison of pathergy positive and negative areas of newly diagnosed Behcet patients
    (Wiley-Hindawi, 2021) Temiz, Selami Aykut; Balevi, Sukru; Oltulu, Pembe; Ozer, Ilkay
    Background Behcet's disease is an inflammatory vasculitis, and pathergy reaction is a compulsory element of the diagnostic criteria. In the literature, there is no study comparing the histopathology of negative pathergy tests and positive pathergy tests in newly diagnosed Behcet's patients. The primary goal was to investigate the frequency of vasculitis, which is an important finding of Behcet's disease, in pathergy histopathology. Methods The histopathology of patients with positive and negative pathergy tests revealed vasculitis or vasculopathy. In histopathology, neutrophils, lymphocytes, eosinophils, and mast cells in the perivascular area were counted and recorded as a percentage. Results Of the 88 Behcet's patients who participated in the study, 45 were female and 43 were male. The rate of vasculitis in the histopathology of those who were positive for the pathergy test was not statistically different than those of those with negative pathergy tests (P = .14). In our study, although the relationship between the male gender and uveitis was significant at the border, and the relationship between pathergy positivity and uveitis was not found to be significant, a significant relationship was found between vasculitis in histopathology and uveitis (P = .023). Conclusions Based on the results of our study, we think that a pathergy test of histopathology will contribute to the clinical diagnostic evaluation in cases with suspicious clinical pathergy tests and especially in cases with negative pathergy tests.
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    Mean platelet volume, neutrophil to lyphocyte ratio and platelet to lymphocyte ratio in psoriasis
    (Deri Zuhrevi Hastaliklar Dernegi, 2015) Unal, Mehmet; Kucuk, Adem; Unal, Gulbahar Urun; Balevi, Sukru; Tol, Huseyin; Aykol, Caner; Uyar, Mehmet
    Background and Design: It has been demonstrated that neutrophil and platelet count to lymphocyte ratio may be a useful predictor of systemic inflammation and with prognosis of many cardiovascular diseases, malignancies and chronic inflammatory diseases. To the best of our knowledge, there are no studies investigating neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and mean platelet volume (MPV) values together within the context of psoriasis, a chronic and systemic inflammatory disease. Materials and Methods: In this study, we evaluated 320 patients with psoriasis vulgaris followed up in our outpatient clinic and 200 healthy controls. Results: Leukocyte, neutrophil, platelet, MPV, NLR and PLR values in patients with psoriasis were significantly higher, and lymphocyte count, on the other hand, was significantly lower than in controls. No significant difference was found in MPV, NLR and PLR values between patients with or without a family history and nail and joint involvement. Conclusions: These parameters may be used as cheap and easily applicable methods in predicting which psoriasis patients are under the risk of cardiovascular disease. PLR is a better inflammation marker than MPV and NLR in patients with psoriasis. We did not observe a significant relationship of MPV, NLR and PLR values with disease characteristics, such as severity of disease, joint involvement, nail involvement and duration of disease in patients with psoriasis. Therefore, we believe that there is little information on the extent to which MPV, NLR and PLR might be useful regarding these characteristics.
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    Retrospective evaluation of childhood alopecia areata cases
    (Turkish Soc Dermatology Venerology, 2013) Daye, Munise; Dogan, Seda; Balevi, Sukru; Mevlitoglu, Inci
    Background and Design: Approximately 20% of alopecia areata (AA) cases are children. There is limited information about childhood AA. We aimed to examine demographic features, treatments and prognosis of children with AA followed in our clinic. Materials and Methods: We retrospectively analyzed the records of 110 AA patients 16 years of age or older. Data on age, gender, age at disease onset, duration of the disease, types of AA and onset area, nail involvement, accompanying systemic and dermatological diseases, laboratory tests, treatments and the prognosis, and follow-up period were evaluated. Results: 46.4% of subjects were female and 53.6% were male. The mean age was 10.35 years. The age at disease onset was 8.65 years. Primary onset areas of AA were: scalp in 83.6% of patients, - eyebrows - in 5.4%, - body hair - in 5.4%, - eyelashes - in 2.7%, and eyebrows and eyelashes in 2.7% of patients. Types of the disease were: AA in 73.4% cases, - alopecia totalis -in 19%, - alopecia universalis - in 5.4%, and ophiaisis in 1.8% of subjects. Nail involvement and nevus flammeus were observed in 36.3% and 27% of subjects, respectively. The mean disease duration was 17.02 months. The accompanying dermatoses were: vitiligo in 2.7% of cases and atopic dermatitis in 6.3% of cases. The accompanying systemic diseases were: autoimmune thyroiditis and Down syndrome in in 1.8% and 2.7% of patients, respectively. Thyroid autoantibodies were found to be high in 0.9% of subjects. We have treated 24.5%of patients with topical corticosteroid lotion, - 30.9%- with anthralin, - 0.9%- with 2% minoxidil lotion, - 0.9%- with calcipotriol lotion, - 1.8%- with topical calcineurin inhibitors, and 10% of cases with intralesional corticosteroids. We have treated 15.4% of subjects, who were resistant to topical treatment, with systemic corticosteroids and PUVA therapy. 14.5% of patients received different combinations of topical treatments. Remission was observed in 34.5% of cases. The mean remission duration was 12.2 months. On average, two relapses occurred in 26.3% of subjects. Conclusion: We assume that our results will contribute to epidemiologic data on childhood AA in our country.
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    The Second to Fourth Digit Ratio in Acne Vulgaris
    (Wiley, 2015) Unal, Mehmet; Unal, Gulbahar Urun; Balevi, Sukru; Tol, Huseyin; Uyar, Mehmet
    BackgroundAndrogen hormones are thought to play a leading role in acne vulgaris (AV). The 2D:4D digit ratio refers to the ratio of the length of the second finger (index finger) to that of the fourth finger (ring finger). It is thought that the balance between fetal testosterone and fetal estrogen during the prenatal period largely determines this ratio, which does not change with age in the postnatal period. MethodsPatients with no other disease except AV and a control group of healthy patients were included in the study. Sex, age, family history, age of onset, and duration of disease in patients diagnosed with AV were recorded. The lengths of the patients' second and fourth fingers were measured using a digital caliper with a resolution of 0.01mm. Hormone levels were also measured. ResultsWhen the 2D:4D ratio for the right hand and the left hand (separately) as well as the average (mean) 2D:4D ratio of both hands in male and female patients were compared with those of the control group, no statistically significant difference was observed. The right 2D:4D ratio of female patients was positively correlated with free androgen index percentage and prolactin values and negatively correlated with sex hormone-binding globulin. The left 2D:4D ratio of female patients was found to be positively correlated with disease duration and follicle-stimulating hormone values. ConclusionThe 2D:4D ratio was not significantly different between the group with AV and the control group independent of sex. Also, we did not observe a significant association with age of onset, severity of disease, or family history.