Ilgen Ertam

Ege University, İzmir, Izmir, Turkey

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Publications (28)40.84 Total impact

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    ABSTRACT: Abstract Purpose: To evaluate the ocular surface and topography findings of lamellar ichthyosis, and to investigate the correlation of these findings with mutations in TGM1, CYP4F22 and NIPAL4 genes. Methods: Twelve patients with lamellar ichthyosis were evaluated. Routine ophthalmic examination including Schirmer 1, tear break-up time and ocular surface staining score, topography, and genetic evaluation for coding exons of TGM1, NIPAL4 and CYP4F22 genes were performed. Results: The mean age of the patients was 19.75 ± 9.15 (range, 4-31) years. Mean Schirmer 1 scores of the right and the left eyes were similar (18.75 ± 3.10 mm). Mean tear break-up time of the right and the left eyes were 6.58 ± 2.74, 6.58 ± 3.02 seconds, respectively. Mean ocular surface staining grade was 0.36 ± 0.20 in the right, and 0.39 ± 0.17 in the left eyes. Keratoconus was detected in two patients. Two patients with bilateral cataract formation were found. Genetic sequencing revealed that one case had homozygous R326X mutation in the CYP4F22 gene, two cases had homozygous A176D mutation in the NIPAL4 gene, and three had homozygous M1T mutation in the same gene. Mutations were detected in patients with keratoconus and in a patient with bilateral cataract formation. Conclusions: In lamellar ichthyosis, eyelid malformations together with decreased tear break-up time might cause sight-threatening complications. Genetic counseling for mutations might enable the physician to predict the possibility of upcoming ocular problems in lamellar ichthyosis patients.
    Ophthalmic Genetics 01/2014; · 1.07 Impact Factor
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    ABSTRACT: Objective: Follicular mucinosis is a disease characterized by follicular degeneration and mucin accumulation. It can be seen in mycosis fungoides, although idiopathic or forms associated with other diseases are also known. Follicular mycosis fungoides is a type of mycosis fungoides with diff erent clinicopathological and prognostic features. Material and Method: Seven cases with follicular centered lesions and multiple biopsies (2-6) were included. Cases were evaluated according to their clinical, histological and immunophenotypical features and follow-up data. Results: All cases were male, and the mean age was 40.3 (range 18-61). Clinical complaints were follicular prominence, erythema and alopecia at head and neck, trunk, and lower limbs. Follicular mucinosis (6/7), and dermal lymphoid infiltration showing minimal-intensive folliculotropism accompanied by eosinophils was seen. Lymphoid infiltration was composed of small-medium sized cells, with scattered hyperchromatic nuclei in six cases. In one case there was only minimal cytological atypia. Intense folliculotropism of atypical lymphocytes and dense dermal infiltration without follicular mucinosis was seen in one case. Local and/or systemic treatments were applied and partial remission was achieved histologically. In three cases new and increasing lesions were seen. Density of infiltration and atypia were increased. Conclusion: The findings supported the opinion that follicular mucinosis is an important finding seen in mycosis fungoides. There can be important diff erences concerning the amount of infiltration and degree of atypia. In cases where the density of infiltration associated with follicular mucinosis is not diagnostic for MF, there can be progression over time. Long-term follow up is necessary in such cases where the diff erential diagnosis is diff icult.
    Turk Patoloji Dergisi 01/2013; 29(2):108-116.
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    ABSTRACT: Context: Cutaneous Adverse Drug Reactions (CADRs) are observed in 2-3% of hospitalized patients. The clinical presentation of the CADRs varies among different populations. Objective: To study the CADRs in hospitalized patients and their outcome. Materials and methods: Patients hospitalized at our department between 2005 May and 2010 May were retrospectively reviewed for the diagnosis of CADRs. Results: A total of 94 patients (3.3%) were diagnosed with CADR among 2801 hospitalized patients. Of them, 56 patients were female (59.6%) and 38 patients were male (40.4%). The culprit drugs were antibiotics (24.5%), non-steroid anti-inflammatory drugs (NSAID) (22.4%), anticonvulsants (13.8%), antihypertensive agents (8.5%), paracetamol with or without pseudoephedrine or phenylephrine (6.4%), intravenous contrasts (3.2%), terbinafine (2.1%), biologic agents (2.1%) and various other medications (17.0%). The most common clinical type of CADRs was morbilliform exanthemas in 59.6% of the patients, followed by erythroderma (6.4%), drug reactions with eosinophilia and systemic symptoms (6.4%), lichenoid drug reaction (5.3%), urticaria and angioedema (4.3%), acute generalized exanthematous pustulosis (4.3%), drug-induced vasculitis (3.2%), drug induced psoriasis (2.1%), Stevens-Johnson syndrome/toxic epidermal necrolysis overlap (2.1%), psoriasiform drug reaction (2.1%). Fixed drug reaction, erythema multiforme, bullous drug reaction, drug induced panniculitis were observed in one each. No deaths occurred on the follow-up. Fever was observed in 35.1% of the patients. Eosinophilia was present in 51.1% of them. Latency period ranged between 0-15 days in 59 patients (62.8%), 15-30 days in 19 patients (20.2%), 30-90 days in 13 patients (13.8%), 90-120 days in three of them (3.2%). The latency for anticonvulsant drugs was statistically longer than the other group of drugs (p: 0.027). Discussion and conclusions: CADRs were more common in women and most of them were caused by antimicrobial agents followed by NSAIDs and anticonvulsants. Latency period of anticonvulsants were longer than the other groups.
    Cutaneous and Ocular Toxicology 07/2012; · 1.04 Impact Factor
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    ABSTRACT: Inflammatory linear verrucous epidermal nevus is a rare cutaneous disorder characterized by pruritic, erythematous, and verrucous papules and plaques along the lines of Blaschko. Histopathologically, there is a benign verrucous proliferation of keratinocytes together with alternating parakeratosis and orthokeratosis as well as inflammatory changes. We report a patient who developed squamous cell carcinoma (SCC) on an inflammatory linear verrucous epidermal nevus and we discuss the importance of regular follow-up of patients with epidermal nevi.
    Cutis; cutaneous medicine for the practitioner 06/2012; 89(6):273-5. · 0.82 Impact Factor
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    ABSTRACT: Psoriasis is thought to be an autoimmune disease caused by inappropriate activation of the cellular immune system. In this study, we aimed to search out IgG-anti-IgA antibody levels, serum immunoglobulins and antinuclear antibodies (ANA). The study enrolled 38 psoriasis vulgaris patients and 40 healthy controls. Mean IgG-anti-IgA levels were significantly higher in psoriasis patients. The frequency of positive ANA testing was 21.1%; however, there was no correlation between IgG-anti-IgA antibody levels and ANA positivity. Only one patient had low IgA levels without high IgG-anti-IgA concentrations. The data about high IgG-anti-IgA antibody levels are noteworthy for a new evidence of autoimmune mechanism.
    Minerva medica 06/2012; 103(3):183-7. · 0.77 Impact Factor
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    ABSTRACT: Terbinafine, a widely used antifungal agent, may rarely cause cutaneous side effects with an incidence of 2.7%. Generalized pustular eruptions are quite uncommon but severe adverse cutaneous reactions of terbinafine have been reported. The main pustular eruptions due to terbinafine include acute generalized exanthematous pustulosis and drug induced pustular psoriasis. In this report, two cases of acute generalized exanthematous pustulosis and one case of generalized pustular psoriasis triggered with terbinafine are presented.
    Cutaneous and Ocular Toxicology 09/2011; 31(1):81-4. · 1.04 Impact Factor
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    ABSTRACT: The cutaneous focal mucinoses are a group of connective tissue disorders characterized by deposition of mucin found either focally or diffusely in the dermis. A 47-year-old woman presented with asymptomatic flesh-colored papules on the neck, inguinal area, intergluteal area, vulvar area, and extremities of 5 months' duration. There was no history of preceding trauma or insect bites. The patient had undergone a subtotal thyroidectomy 21 years prior but had not used any thyroid medication before she was referred to our clinic. Thyroid ultrasonography was consistent with Hashimoto thyroiditis. During dermatologic examination, flesh-colored, well-defined, smooth papules that measured approximately 1.5 x 1 cm in size on the genital region, fingers, face, and scalp were seen. Histopathologic examination of a lesional biopsy revealed no abnormalities in the epidermis. Alcian blue staining showed that abundant deposits of dermal mucin had replaced collagen in the dermis.
    Cutis; cutaneous medicine for the practitioner 03/2011; 87(3):143-5. · 0.82 Impact Factor
  • Clinical and Experimental Dermatology 12/2009; 35(4):e165-6. · 1.33 Impact Factor
  • Clinical and Experimental Dermatology 12/2009; 34(8):e1012-3. · 1.33 Impact Factor
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    ABSTRACT: It has been shown that the family of interleukin-1 receptor antagonist (IL-1 RA) and tumour necrosis factor-alpha (TNFalpha) genes are polymorphic and related to some inflammatory diseases. Allergic contact dermatitis is the classic presentation of delayed-type hypersensitivity responses to exogenous agents. A number of genes playing role in inflammatory response may be associated with allergic contact dermatitis. To investigate whether there is an association between IL-1RA and TNFalpha gene polymorphisms and allergic contact dermatitis in Turkish patients with allergic contact dermatitis. This study was performed by the collaboration of Departments of Dermatology and Medical Genetics, Ege University, Faculty of Medicine. A total of 50 patients (31 females and 19 males) with allergic contact dermatitis, and 100 age- and sex-matched controls (58 females and 42 males) were included in the study. IL-1RA Variable Number of Tandem Repeats (VNTR) polymorphism in intron 2 and TNFalpha-308G-A polymorphism were genotyped by using polymerase chain reaction and agarose gel electrophoresis. The frequency of IL-1RA 1/2 (48%) genotype was significantly higher (P = 0.002) in patient group than that is found in control group (22%). The frequency of TNFalpha (TNF G-308A) G/G genotype was significantly higher in patient group (68%) than that is found in control group (31%) (P = 0.008). Our findings suggest that TNFalpha (G/G) gene polymorphism may play role in susceptibility to allergic contact dermatitis in Turkish patients.
    Contact Dermatitis 09/2009; 61(2):86-90. · 2.93 Impact Factor
  • Clinical and Experimental Dermatology 04/2009; 34(7):e231-3. · 1.33 Impact Factor
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    ABSTRACT: Linear and whorled nevoid hypermelanosis (LWNH) is a pigmentation disorder characterized by macular hyperpigmentation following the lines of Blaschko. Dermatoscopy can be used in the differential diagnosis of this pigmentation disorder. To our knowledge, the dermatoscopic features of pigmented lesions in LWNH have not been described previously. Here, a case of LWNH is discussed together with its dermatoscopic findings. An 11-year-old girl presented to our department with hyperpigmentation along the lines of Blaschko over the entire body. The mental status of the patient was normal and no associated anomaly was detected in the physical examination or genetic analysis. Dermatologic examination revealed a whorled-like configuration of hyperpigmented macules on the neck, trunk, and buttocks, and a linear configuration of hyperpigmented macules, some of which were arranged in a parallel linear fashion on the extremities along the lines of Blaschko. Histopathologic examination confirmed the diagnosis. Dermatoscopic examination revealed linear or circular arrangement of streak-like pigmentations arranged in a parallel manner. This is the first known reported case of LWNH that describes its dermatoscopic findings. Dermatoscopy may be used to facilitate the differential diagnosis of melanotic lesions of this pigmentation disorder.
    Journal of the American Academy of Dermatology 03/2009; 60(2):328-31. · 4.91 Impact Factor
  • International journal of dermatology 02/2009; 48(1):98-9. · 1.18 Impact Factor
  • Journal of the European Academy of Dermatology and Venereology 10/2008; 23(6):713-4. · 2.69 Impact Factor
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    ABSTRACT: The aim of this study was to compare the effectiveness of gel formulations containing arbutin, synthetic ellagic acid and plant extracts that contain ellagic acid, on patients with melasma. Thirty patients who applied to Ege University Medical Faculty, Department of Dermatology, were included in the study. A signed consent was obtained from each patient prior to study. Patients whose type of melasma was determined via Wood's lamp were randomized to groups of arbutin, synthetic ellagic acid and plant extract containing natural ellagic acid. The pigment density of patients was evaluated via Mexameter before and after the treatment. The approval of the Institutional Ethics Committee of Ege University was obtained before the study. Wilcoxon and Kruskal-Wallis tests were used in the statistical analysis. Nine of 10 patients, for whom synthetic ellagic acid was started, completed the study. A decrease in the level of melanin was determined in eight of these nine patients (P = 0.038). A significant decrease in the level of melanin was also determined in all 10 patients who used plant extract containing ellagic acid (P = 0.05). A significant response was obtained from all of 10 patients who used arbutin. The difference between pre- and post-treatment levels of melanin was statistically significant (P = 0.05). Formulations prepared with plant extracts containing ellagic acid was found effective on melasma, similar to the formulations containing synthetic ellagic acid and arbutin. This material that is not yet being used widespread commercially on melasma could be an effective alternative for treatment of melasma.
    The Journal of Dermatology 10/2008; 35(9):570-4. · 1.77 Impact Factor
  • Journal of the European Academy of Dermatology and Venereology 09/2008; 23(6):705-6. · 2.69 Impact Factor
  • Indian journal of dermatology, venereology and leprology 01/2008; 74(3):285-7. · 0.98 Impact Factor
  • Ilgen Ertam, Meltem Turkmen, Sibel Alper
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    ABSTRACT: With the development of industry, the numbers of allergens are increasing, and the frequency of these allergens show variations from country to country. The aim of this retrospective study was to determine the distribution of patch-test results by age, gender, and occupation in our region. In a retrospective study, the patch-test results of 3,017 patients were evaluated. The results were statistically examined by frequency of age, gender, and occupation. Chi-square and Fisher exact tests were used for statistical evaluation. Of 3,017 patients, 1,975 (65.5%) were female and 1,042 (34.5%) were male. Their ages ranged from 5 to 85 years (mean, 40.38 +/-14.69 years). In 944 (31.3%) patients, at least one positive reaction to an allergen was observed. The allergens that most commonly caused positive reactions were nickel sulfate (12.2%), cobalt chloride (7.1%), potassium dichromate (5.6%), and balsam of Peru (2.8%). Balsam of Peru and nickel were the most common allergens in female patients older than 45 years and in female patients younger than 35 years, respectively. Nickel sulfate and cobalt chloride were found to be the most common allergens. The most frequently seen allergens were nickel sulfate (in females) and fragrance (in males).
    Dermatitis 01/2008; 19(4):213-5. · 0.93 Impact Factor
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    ABSTRACT: Chronic urticaria is characterized by oedema of the skin and mucous membranes. Although many agents have been implicated, aetiology is unknown in 70 to 75% of patients. Infections and foci of chronic infections are most commonly held responsible for chronic urticaria. In this study, the frequency of nasal carriage as the occult focus of infection and sensitivity to antimicrobials are explored in patients with chronic urticaria. Ninety-four patients with chronic urticaria and 30 controls participated in the study, which was carried out at the Ege university medical faculty, department of dermatology between January 2004 and January 2005. Nasal swab specimens were taken from the patients and controls and incubated at 37 degrees C degrees for 48 h, and inoculated on standard bacterial medium (blood agar). Antimicrobial susceptibility of a growth from isolates of the nasal swab specimens was conducted. Data were analysed statistically using chi-square and Mann-Whitney U-tests. Ninety-four patients with chronic urticaria (72.3% female and 27.7% male) and 30 controls (63.3% female and 36.7% male) comprised the study group. Mean age of the patients and controls were 42.6 and 33.8 years, respectively. Staphylococcus aureus was detected in swab specimens from the nasal cavity in 50 of the 94 patients (53.2%) with chronic urticaria and four of the 30 controls (13.3%). Testing revealed that the most susceptible antibiotics were cefaclor, ceftriaxone, amoxycillin-clavulanic acid, amikacin, netilmicin, and fucidic acid. Growth on cultures prepared from nasal swab specimens of chronic urticaria patients was statistically higher than the control group. We detected resistance to growth against mupirocin, an antibiotic frequently used in nasal carriage. High nasal carriage of Staphylococcus aureus in patients with chronic urticaria compared to controls suggests that nasal carriage as a focus of infection should be kept in mind as aetiology.
    Journal of the European Academy of Dermatology and Venereology 08/2007; 21(6):777-80. · 2.69 Impact Factor
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    ABSTRACT: To evaluate the frequency and the specificity of nail changes associated with connective tissue diseases (CTD). In a case-control study, 190 patients including those with systemic lupus erythematosus (SLE; 56), rheumatoid arthritis (RA, 47), primary Sjögren's syndrome (pSS; 35), systemic sclerosis (SSc; 39), and dermatomyositis/polymyositis (DM/PM; 13) were enrolled in the study. Patients with SLE and other CTDs were compared with two different control groups. Twenty nails were examined. Nail features were noted and classified. Nail samples were collected for mycological cultures. In patients with SLE, erythema of proximal nailfold (P<0.01), splinter haemorrhages in fingernails (P<0.01), capillary loops in proximal nailfold (P<0.05), periungual erythema (P<0.05), and thin nail plates (P<0.05) were more common than those in controls. Only splinter haemorrhages were associated with the disease activity. In patients with SSc and DM/PM, splinter haemorrhages (P<0.05) and capillary loops in proximal nailfold (P<0.01) in fingernails were common as well. Increase in longitudinal curvature (P<0.001), transverse curvature (P<0.01), and white dull colour in fingernails were other frequent findings in patients with SSc. Increase in transverse curvature was associated with the disease activity in SSc. In patients with RA, splinter haemorrhages (P<0.05), red lunula (P<0.05), and white dull colour (P<0.05) in fingernails were frequent. The sensitivity values of all these changes were very low. However, their specificity values were found to be relatively high. Proximal nailfold is the most important site of affection in CTDs. These nail changes can be used in combination with highly sensitive diagnostic modalities to establish an accurate diagnosis.
    Journal of the European Academy of Dermatology and Venereology 05/2007; 21(4):497-503. · 2.69 Impact Factor