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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; · 0.91 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. · 0.81 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. · 0.91 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. · 0.81 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. · 3.51 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. · 3.99 Impact Factor
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International journal of dermatology 02/2009; 48(1):98-9. · 1.18 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. · 1.49 Impact Factor
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ABSTRACT: Several side effects can be observed from isotretinoin use, which has been used in acne therapy for years. In this study, the side effects of isotretinoin on skin and mucosa, blood test changes and their relation with total dose were investigated in patients who used equal doses of isotretinoin.
A total of 91 outpatients with acne vulgaris (57 females and 34 males; age range 17-28 years, mean 21+/-2.19 years) were enrolled in this study. Skin and mucosal findings and pre- and post-treatment blood tests and their correlation with the total dose were investigated. Student's t-test and the Mann-Whitney U-test were used in the statistical analyses.
In all, 89 out of 91 patients completed the study. Cholesterol (p = 0.00), triglyceride (p = 0.00) and low density lipoprotein (LDL) (p = 0.001) levels were found to be significantly elevated. But these values were not over the double of the upper limits. No correlations were found among the total dose and the skin and mucosal changes as well as the blood test results.
It is concluded that examination of cholesterol, triglyceride and LDL-cholesterol should be performed monthly if the initial blood tests are close to the upper limits; otherwise, examinations at 2- or 3-month intervals are sufficient, which would save unnecessary costs.
Journal of Dermatological Treatment 02/2006; 17(4):214-6. · 1.23 Impact Factor
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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 19(4):213-5. · 1.21 Impact Factor
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Indian journal of dermatology, venereology and leprology 73(6):425-6. · 0.98 Impact Factor
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Indian journal of dermatology, venereology and leprology 74(3):285-7. · 0.98 Impact Factor
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ABSTRACT: This study was conducted to assess the frequency of dermatologic diseases in Turkish university students. University students who visited two dermatology outpatient clinics within the Ege University Health, Culture and Sports Office were included in the study. Each student was examined by two dermatologists. Questions about demographic data and information about the frequency of using the swimming pool were directed to the patients. All dermatological diseases were recorded. Patients were asked to assess and give a score for the state of their mental wellness using the visual analog scale (0-100) during the past month. Chi-square and Student t tests were used for statistical analyses. A total of 1733 individuals, 750 (43.3%) men and 983 (56.7%) women, were included in the study. The most frequently seen diseases were acne vulgaris (40.1%) and fungal diseases (17.08%), whereas the least frequently seen were parasitic skin diseases (0.46%) and vascular diseases (0.51%). The mean mental wellness score was found to be 61.03 +/- 21.34 (0-100, median: 65.00). It can be concluded that students visit university dermatology outpatient clinics frequently and the most common complaints are acne vulgaris and fungal diseases.
SKINmed 8(5):261-3.
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Indian Journal of Dermatology, Venereology and Leprology (ISSN: 0378-6323) Vol 74 Num 3.
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ABSTRACT: Observations: A 72-year-old woman presented to our clinic with edema on her face. The patient reported that she underwent augmentation of her face with a dermal filler 3 months ago. She did not know the name of the filler. On dermatologic examination, bilateral eyelid and facial odema, firm, irregular subcutaneous nodules were observed. Skin biopsy showed foreign body granuloma, microcyst formation and pink, polygonal, translucent material. The affected areas treated with 60 mg/d oral corticosteroid during 2 months at tapering doses and repeated intralesional corticosteroid injections (20 mg/ml). Facial odema disappared, but firm nodules slightly improved. Here, we report a case with foreign body granulomas to a dermal filler, its treatment and discuss histopathological differential diagnosis.
