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ABSTRACT: Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare form of cytotoxic T-cell lymphoma. The disease has a poor prognosis in patients with the complication of hemophagocytic syndrome, especially in those with Epstein-Barr virus (EBV) positivity. A 20-year-old woman presented with multiple, itchy, purplish nodules and excoriations on both of her upper limbs. The histopathologic, immunohistochemical staining, and clonal T-cell receptor gene rearrangement examinations of skin lesions revealed the diagnosis of SPTCL. In situ hybridization performed for EBV was positive. There were no findings suggesting systemic involvement of SPTCL, or hemophagocytic syndrome. The lesions improved with systemic corticosteroid therapy and radiotherapy, with no recurrence. We present a patient with a protracted course of SPTCL in whom EBV positivity was demonstrated. This apparent conflict may be explained by geographic and ethnic variations in EBV infection. Further studies may shed light on the real relationship between EBV-RNA and the course of SPTCL.
American Journal of Clinical Dermatology 01/2010; 11(2):147-50. · 1.71 Impact Factor
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ABSTRACT: A 30-year-old man presented with indurated violaceous plaques all over his body that had been present for 7 months. The patient had also had vitiligo for 3.5 years, and hepatitis B virus (HBV) infection and cirrhosis for a 2-year period. Histopathologic examination of the indurated plaques confirmed the diagnosis of morphea. Localized scleroderma and vitiligo have only rarely been reported to occur simultaneously. Although the etiologies of vitiligo and morphea are both uncertain, their association with autoimmune diseases favors an autoimmune hypothesis. Both vitiligo and morphea might have appeared coincidentally. However, this association could be significant because it may be related to the presence of HBV and alterations in the immune system that are caused by this virus. Therefore, this rare combination of vitiligo and morphea in a patient with chronic HBV infection warrants attention because it suggests a possible immunologic association, which may merit future study.
American Journal of Clinical Dermatology 11/2009; 10(5):336-8. · 1.71 Impact Factor
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International journal of dermatology 10/2009; 48(9):1018-20. · 1.18 Impact Factor
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European journal of dermatology: EJD 08/2009; 19(5):527-8. · 2.53 Impact Factor
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ABSTRACT: The mechanism for vascular involvement of Behçet disease (BD) includes arterial and venous thrombosis. Although the exact etiology of systemic vasculitis and thrombosis is still unknown, many hypotheses have been suggested. One of these hypotheses is that hyperhomocysteinemia causes vascular disease and thrombosis. The aim of this study was to compare the levels of homocysteine, vitamin B(12), and folic acid of BD patients with those of recurrent aphthous stomatitis (RAS) patients and healthy controls. Forty-five BD patients, 47 RAS patients, and 69 healty control subjects were included in this study. Vitamin B(12), folic acid, and homocysteine levels of the patients and controls were measured, and statistical differences among the groups were determined. BD patients had mostly cutaneous symptoms. Arthritis and ocular and vascular involvement were seen in 24.4%, 22%, and 11% of BD patients, respectively. No significant difference was detected among the groups in the levels of vitamin B(12), folic acid, and homocysteine. There was no significant difference in any parameters according to sex and age of the patients and activity of BD and if the patients with BD were treated or not. Homocysteine level inversely correlated with vitamin B(12) and folic acid levels in the BD group. We could not find any differences in homocysteine, vitamin B(12), and folic acid levels between BD and RAS patients and controls. This may be due to the fact that our patients mostly had cutaneous symptoms rather than vascular involvement.
Clinical Rheumatology 08/2009; 28(10):1153-6. · 2.00 Impact Factor
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Southern medical journal 06/2009; 102(7):678-9. · 0.92 Impact Factor
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Acta Dermato Venereologica 04/2009; 89(2):180-1. · 3.18 Impact Factor
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International journal of dermatology 03/2009; 48(2):178-80. · 1.18 Impact Factor
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ABSTRACT: Mycosis fungoides is a cutaneous T-cell lymphoma that has been rarely reported to involve ocular structures. A 33-year-old woman who had received therapy for mycosis fungoides on the trunk for 11 years, presented to our clinic with new plaques and tumors on her eyebrows and eyelid margin, and alopecia of her eyelashes and eyebrow. The histopathological examinations supported the diagnosis of mycosis fungoides. There was no intraocular involvement with tumor. The mycosis fungoides was of stage II B, and the patient was referred to medical oncology and radiation oncology clinics for treatment. She was placed on a radiotherapy schedule. The involvement of mycosis fungoides in the ocular area is rare in the published work. The importance of eye involvement is being seen in advanced cases, and there is a possible association between mycosis fungoides and poor prognosis by being an indicator of systemic involvement.
The Journal of Dermatology 10/2008; 35(9):581-4. · 1.49 Impact Factor
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ABSTRACT: Intravenous immunoglobulin (IVIG) is sterilized and purified human plasma which contains supra-physiologic levels of immunoglobulin G. IVIG is currently used in the treatment of immunodeficiency syndromes, inflammatory disorders and infectious diseases. Although numerous immunomodulatory mechanisms have been suggested, the exact mechanisms of action are poorly understood. There is also accumulating evidence that high-dose IVIG is efficacious in the treatment of some skin diseases, despite the lack of evidence from randomized, double-blind, placebo-controlled trials. Though in most cases, IVIG is only effective in combination with other immunomodulating strategies, it offers new hope for the treatment of many severe dermatologic conditions. This article focuses on the efficacy and safety of IVIG therapy in skin diseases.
Inflammation & Allergy - Drug Targets (Formerly ?Current Drug Targets - Inflammation & Allergy) 07/2008; 7(2):75-84.
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Dermatology 06/2008; 217(2):143. · 2.05 Impact Factor
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Acta Dermato Venereologica 02/2008; 88(3):285-6. · 3.18 Impact Factor
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Acta Dermato Venereologica 02/2008; 88(5):528-9. · 3.18 Impact Factor
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ABSTRACT: Xeroderma pigmentosum (XP) is a rare, autosomal recessive genodermatosis in which affected individuals exhibit sun sensitivity, cutaneous pigment abnormalities, and a high incidence of skin cancers of sun-exposed skin.
We studied the clinical features of 12 XP patients from Turkey, who were followed for 5 years.
Consanguinity was confirmed in 10 cases. The onset of hyperpigmented macules and photosensitivity was between the ages of 6 months and 5 years (average age, 25 months). The first appearance of cutaneous tumors was at 3-28 years of age (average age, 12 years). In nine of the 12 patients, cutaneous malignancies were confirmed histopathologically, and all nine were squamous cell carcinomas. One patient developed both squamous cell carcinoma and malignant melanoma.
This study presents the epidemiological and clinical features of Turkish XP patients. We believe this study will provide new data for further studies in the future.
International Journal of Dermatology 12/2007; 46(11):1125-8. · 1.14 Impact Factor
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ABSTRACT: A 30-year-old woman was evaluated in our clinic with swelling localized to the left submandibular region and extending to the anterior part of the neck. Her symptoms first appeared 2 years earlier in the mid region of her neck. After a few months, the lesion enlarged to the left side of her neck and became crusted. She had been treated by several physicians with antibiotics, analgesics, and anti-inflammatory drugs without response. On physical examination, the patient had an axillary temperature of 38.2°C. Bilateral axillary, cervical, and supraclavicular lymph nodes were detected. Dermatologic examination revealed erythematous nodules of varying sizes starting at the middle of the neck and extending to the left cervical region; an ulcerated lesion on the mid portion of the neck; and a sinus tract in the left cervical region (Figure 1). Laboratory findings included an erythrocyte sedimentation rate of 62 mm/h, but no irregularities were detected in the other hematologic and biochemical parameters. The results were negative for hepatitis markers, human immunodeficiency virus, and syphilis. A purified protein derivative test revealed an 18-mm induration with a scar of bacilli Calmette-Guérin at 48 hours. Results of chest radiography were normal, but a computerized tomographic scan of the lung revealed emphysematous changes. Acid-fast bacilli examination of the sputum was performed 3 times, all with negative results, and sputum cultures were negative for tuberculosis and deep fungal infections. Results of polymerase chain reaction testing of skin tissue, sputum, and urine were negative as well. Abdominal and pelvic ultrasonographic finding were normal; no tuberculous focus was detected from detailed examinations of pulmonary, genitourinary, and skeletal systems. Staining of a biopsy specimen obtained from lesions in the cervical region was positive for acid-fast bacilli, and cultures were positive for Mycobacterium tuberculosis. The histopathologic features of the biopsy specimen included caseation necrosis at the center and epithelioid histiocytes, lymphocytes, plasma cells, and Langhans cells at the periphery of the granulomas (Figure 2). These findings confirmed the diagnosis of scrofuloderma. The patient received multiagent (isoniazid, rifampicin, ethambutol, and pyrazinamide) antituberculosis treatment for 3 months. The treatment was continued with isoniazid, rifampicin, and ethambutol for 1 year, with follow-up clinic visits throughout the period. The lesions improved within the first 3 months of treatment (Figure 3).Figure 1. The ulcerated lesion on the middle and left side of the neck before multiagent antituberculosis treatment.Download figure to PowerPointFigure 2. A close-up view showing caseation necrosis, granulomatous inflammatory cells, epithelioid tubercles, and Langhans cells (hematoxylin and eosin stain; original magnification ×40).Download figure to PowerPointFigure 3. The appearance of the lesions after 3 months of treatment.Download figure to PowerPoint
SKINmed 11/2007; 6(6):303 - 304.
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ABSTRACT: A skin finding may be an indicator of internal malignant diseases. In this report, we investigated the skin findings of the cases who have had internal malignancy within the last 1 month.
Seven hundred cases who were diagnosed as internal malignancy and who did not have any treatment for the malignancy were enrolled in our study between February 2002 and September 2003. A form was completed for all of the cases, including name, surname, and the carcinoma type. All cases were examined in detail, and the observed skin findings or dermatosis was recorded.
The most frequent skin findings among the cases were tinea pedis/onychomycosis, followed by xerosis and pruritus. The skin findings in terms of frequency were determined mostly in hematological malignancies (68.96%).
We would like to emphasize that the skin is an indicator of the functions of internal organs and their disorders.
International Journal of Dermatology 11/2007; 46(10):1055-60. · 1.14 Impact Factor
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ABSTRACT: Cutaneous diseases can indicate the presence of hepatitis C virus (HCV) infection. The aim of this study was to analyse the frequency of cutaneous findings in HCV infection and HCV RNA positive cases in Turkey. Fifty consecutive patients positive for anti-HCV antibodies,negative controls, and patients positive and negative for HCV RNA were examined for any cutaneous findings that could be associated with HCV infection. The risk of infected patients developing cutaneous finding was higher than for non-infected individuals. Only pruritus showed a statistically significant difference in separate assessment of cutaneous symptoms. There were no differences in cutaneous findings in HCV RNA positive and negative cases. The risk of developing a dermatological finding, especially pruritus, was increased in HCV infection.However, because the number of patients in this study was too low to allow statistical evaluation of the prevalence of dermatological symptoms and diseases, multicentre studies including large numbers of patients are needed.
Acta Dermato Venereologica 02/2007; 87(1):49-53. · 3.18 Impact Factor
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Leukemia and Lymphoma 01/2007; 47(12):2674-5. · 2.58 Impact Factor
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International Journal of Dermatology 12/2006; 45(11):1381-2. · 1.14 Impact Factor
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European journal of dermatology: EJD 17(3):255-6. · 2.53 Impact Factor
