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Classic Kaposi's sarcoma: The clinical, demographic and teratment characteristics of seventy-four patients

Demirel, Beril Gulus | Koca, Rafet | Tekin, Nilgun Solak | Kandemir, Nilufer Onak | Gun, Banu Dogan | Kokturk, Furuzan


Background and Design: Classic Kaposi's sarkoma (CKS) is a rare disease, generally seen across Mediterranean and the Middle East region. It's an angioproliferative disorder associated with human herpes virus-8 infection. There is a few data on epidemiology and clinical characteristics among Turkish patients with CKS. This study aims to evaluate epidemiologic, clinical characteristics and treatment results in patients with the diagnosis of CKS in Zonguldak. Materials and Methods: We retrospectively evaluated the hospital records of patients with CKS who attended the dermatological and venereal diseases department between 2003 and 201 . . .4. Seventy-four patients were included in this study. Demographic and clinical characteristics, applied treatments and responses to treatments were evaluated. Results: During the eleven year examination period, 74 CKS patients have been diagnosed in the dermatology clinic. The prevalence of CKS among dermatologic patients was found to be 0.02%. Patient age at diagnosis ranged from 33 to 90 years (mean: 70.2 +/- 11.7). Fifty-two patients were male (70.3%) and 22 patients were female (29.7%). Multiple nodules were the most frequently seen clinical forms and the distal lower extremity was the most common site of involvement (80.6%). According to the CKS staging system, it was observed that 47 patients (62.7%) were at stage 1, 11 patients (15.49%) at stage 2, eight patients (10.7%) at stage 3, and six patients (8%) were at stage 4. Treatment options were excision for 35.1% of patients (n= 26), radiotherapy for 25.7% of patients (n= 19), cryosurgery for 14.9% of patients (n= 11), and chemotherapy for 10.8% of patients (n= 8). Relapse was found to occur most commonly after excision (58.3%). Conclusion: Larger, multicenter studies are needed in order to determine the prevalence of CKS and characteristics of patients with CKS in our country Daha fazlası Daha az

Laugier-Hunziker Syndrome: A Case Report

Kartal, Demet | Kartal, Levent | Borlu, Murat


Laugier-Hunziker syndrome (LHS) is a rare, acquired mucocutaneous hyperpigmentation often associated with longitudinal melanonychia. It is important to differentiate this condition from the pigmentary disorders of the oral mucosa. The correct clinical identification avoids the need for invasive investigations. A 32-year-old female presented with a number of variably sized, hyperpigmented macules over the oral mucosa and longitudinal melanonychia. Herein, we report a case of LHS and discuss the conditions related with pigmented mucocutaneous lesions. (Turkderm 2011; 45: 158-60)

The Turkish Guideline for the Diagnosis and Management of Urticaria-2016

Goncu, Emek Kocaturk | Aktan, Sebnem | Atakan, Nilgun | Baskan, Emel Bulbul | Erdem, Teoman | Koca, Rafet | Savk, Ekin


Background and Design: Albeit an easily recognized disease, urticaria features many diverse approaches which rationalize the need for an algorithm for the diagnosis, classification, etiopathogenesis, diagnostic evaluation and therapeutic approach. Therefore, authors from Dermatoallergy Working Group of the Turkish Society of Dermatology and the Turkish Dermatoimmunology and Allergy Association aimed to create an urticaria guideline for the diagnosis, treatment and follow-up of urticaria. Materials and Methods: Each section of the guideline has been written by a different author. The prepared sections were evaluated in part by e-mail . . . correspondence and have taken its final form after revision in the last meeting held by the participation of all authors. Results: The guideline includes the description, classification, pathophysiology as well as diagnosis and treatment of urticaria. Urticaria is classified into two main types: acute urticaria and chronic urticaria while chronic urticaria is further subdivided into spontaneous urticaria and inducible urticaria. The first step of treatment includes standard doses of H1-blockers. In patients who do not respond to the first step, antihistamine dose is increased up to four times; if unsuccessful, another second-generation antihistamine is given in the same dose. In antihistamine-resistant cases, introduction of omalizumab is required. Omalizumab dose may be increased in patients failing to respond to the standard dose. In patients unresponsive to omalizumab, cyclosporine-A may be given. Routine diagnostic tests are not recommended in acute urticaria. In chronic urticaria, erythrocyte sedimentation rate, differential blood count and C-reactive protein testing are the only investigations that are needed routinely. Conclusion: Chronic urticaria is a disease that can be challenging for the physician in terms of treatment and follow-up. Depending on evidence-based data (and individual experiences), this guideline will have a leading role in the diagnosis and treatment of urticaria and help the physician to overcome the challenges in the management Daha fazlası Daha az

Patch Test Results in Patients with Allergic Contact Dermatitis in the Western Black Sea Region: A Five-Year Retrospective Study

Koca, Rafet | Altinyazar, Cevdet | Tekin, Nilgun Solak | Cinar, Saniye | Ceylan, Sibel | Sezer, Tuna


Background and Design: In this retrospective study, patch test results of 304 patients with allergic contact dermatitis (ACD), who were tested with the European Standard Series, were evaluated. The aim of the study was to determine the frequency of positive reactions to different sensitizers in patients with ACD and to identify sex and age differences. Material and Method: We evaluated a total of 304 patients (195 (64.1%) female and 109 (35.9%) male) who applied to our clinic between the period of January 2003 and December 2008 and who were tested with patch test with the consideration of ACD. Patch test results were assessed accord . . .ing to the International Contact Dermatitis Research Group at 48 and 72 hours after initial application. Results: Lesions of ACD were found to be most frequent on the hands (65.5%). A total of 95 (31.3%) patients had one or more positive patch test reactions. The most common allergens were nickel sulfate (14.8%) followed by cobalt chloride (9.2%), potassium dichromate (6.6%), balsam of Peru (3.6%), fragrance mix (3.3%), mercaptobenzothiazole (3%) and colophonium (2.3%). Positive reactions to nickel sulfate were more common among women, especially those in younger group. Frequency of contact allergy to lanolin, mercapto mix, epoxy resin, paraben mix and quaternium-15 were relatively low, while no positive reaction was obtained to formaldehyde in any case. In 51.6% of patients with positive reaction, the responsible allergen was detected by testing with the European Standard Series. Conclusion: Although this study shows that sensitization rate to metals and fragrance are still high in our region, as well as in our country, and are more frequent in females than in males, future prospective multicenter studies with large number of patients would point out the adequacy of the European Standard Series in our country. (Turkderm 2011; 45: 198-202 Daha fazlası Daha az

A Family with Hereditary Angioedema Having Been Followed as Familial Mediterranean Fever

Sarici, Guelben | Koca, Rafet | Tekin, Nilguen Solak | Altinyalzar, Hilmi Cevdet


Hereditary angioedema is a rare autosomal dominant disorder resulting from the congenital deficiency of functional C1 esterase inhibitor protein. Patients with hereditary angioedema are clinically characterized by recurrent episodes of swelling of the extremities, face, trunk, airways and abdominal viscera. Attacks may occur either spontaneously or following stress or trauma. The disease is usually associated with attacks of abdominal pain, So, patients may apply for this complaint to other clinics rather than dermatology, and may be misdiagnosed and followed for a long time. Therefore hereditary angioedema should be thought in diff . . .erential diagnosis of patients suffering from abdominal pain. Here in this writing, we describe a family with hereditary angioedema who has been followed as Familial Mediterranean Fever for a long time. The family members complained from swellings which have been occuring in various regions of the body and disappearing spontaneously, and complained from severe abdominal pain, since childhood. These patients have been followed and tried to be treated with the misdiagnosis of Familial Mediterranean Fever for many years. These patients were diagnosed as hereditary angioedema in our clinic, and benefited from danazol treatment. (Turkderm 2009; 43: 29-31 Daha fazlası Daha az

Histological subgroups in classic kaposi sarcoma: A preliminary study

Kandemir, Nilüfer Onak | Gün, Banu Doğan | Barut, Figen | Yurdakan, Gamze | Bahadır, Burak | Bektaş, Sibel | Gün, Mustafa | Keser, Sevinç Hallaç | Özdemir, Nagehan | Özdamar, Şükrü Oğuz


Background and Design: Kaposi sarcomas (KS) are vascular tumors with a low malignant potential which include overlapping infectious, immunologic, and neoplastic processes. Recently, many histological subtypes have been defined. Material and Method: In the present study, 151 cutaneous classic KS lesions in 56 patients were retrospectively evaluated with regard to histological subtypes. Determination of the subtypes was based on the predominant histopathological component in the lesion. We examined changes in epidermis and dermis along with intratumoral inflammatory response characteristics in the lesions. By defining histopathologica . . .l variants of the cases, differences regarding subtypes were investigated. Results: Cases that bear the ordinary characteristics of KS and those that can not be classified otherwise, comprised 82..8% of the study group. Twenty-six cases showed consistency with the subtypes outlined in the literature in terms of their histopathological properties. The most common histological subtype was the lymphangiectatic variant in 7.3% of the cases. Bullous (2.6%), lymphangioma like (2.6%), intravascular (2%), and pyogenic granuloma like (2%) variants were less common. The most uncommon histological subtype was micronodular (0.6%) type. Lymphangiectatic, bullous, intravascular, and pyogenic granuloma like variants were frequently observed in the nodular stage of KSs. Lympangioma like changes were seen to be present in the early KS lesions. Lymphangiectatic type was oftenly associated with bullous component, whereas pyogenic granuloma like type demonstrated superficial ulceration and intense inflammatory response. Lymphangioma like and intravascular types exhibited a characteristic appearance, while other variants were accompanied by components belonging to different subtypes. Conclusion: In KS, histopathological subtypes can develop as a result of different pathological processes. The next stage of the current study, which is one of the largest case series in the literature, will be investigation of the clinical and prognostic characteristics of the variants. (Turkderm 2010; 44: 73-8 Daha fazlası Daha az

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