Rafet Koca

Bülent Ecevit Üniversitesi, Songuldak, Zonguldak, Turkey

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Publications (30)48.45 Total impact

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    ABSTRACT: Anogenital warts are caused by human papillomavirus (HPV), over 30 types of which are infectious for the anogenital tract. Without treatment, warts may regress spontaneously, remain unchanged, or increase in number and size. This study compared the efficacy of a topical 5% potassium hydroxide (KOH) solution with that of a topical 0.5% 5-fluorouracil (5-FU) and 10% salicylic acid (SA) combination in the treatment of anogenital warts. Sixty patients were randomly assigned to receive topical KOH or 5-FU + SA. Both groups demonstrated a significant decrease in numbers of lesions (P < 0.05), but this difference was not significant at week 12 (P > 0.05). The mean number of lesions decreased from baseline to week 12 from 17.03 ± 12.64 to 3.73 ± 7.30 and from 16.13 ± 12.97 to 3.10 ± 4.90 in the KOH and 5-FU + SA groups, respectively (P < 0.001). Excellent clearance was achieved by 70.0 and 76.7% of patients in the KOH and 5-FU + SA groups, respectively. Marked improvement was seen in 13.3 and 20.0% of patients in the KOH and 5-FU + SA groups, respectively. At week 16, relapse was observed in two patients in the KOH group and three in the 5-FU + SA group (P > 0.05). No serious adverse events were reported. Neither treatment was more efficacious. Safety and ease of application are important goals in treatments for anogenital warts. A 5% KOH solution is a promising alternative treatment because it is effective and inexpensive and causes minimal side effects.
    International journal of dermatology 07/2014; · 1.18 Impact Factor
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    ABSTRACT: This study aimed to evaluate serum prolidase activity and the effects of gender, body mass index (BMI), disease severity and duration, and therapy type on prolidase activity in patients with psoriatic as well as the relationship between serum NO· and prolidase levels in these patients. The study included 29 clinically documented plaque patients with psoriasis and 24 healthy volunteers. Data such as age, sex, BMI, duration and severity of disease, and type of therapy were assessed. NO· levels were determined by the Griess reaction. Serum prolidase assay is based on a colorimetric determination of proline by Chinard's reagent. We did not determine any difference in serum NO· levels of psoriatic patients when compared to controls. Serum prolidase levels in psoriasis patients were significantly higher than those in controls. There was no significant difference in prolidase activity between male and female. No statistically significant correlations were found between serum prolidase levels and BMI, PASI and disease duration. When compared between topical treatment group and systemic treatment group, there was no significant difference in serum prolidase activity. In conclusion, patients with psoriasis exhibit higher serum prolidase activity independent of gender, BMI, disease severity or duration, type of treatments or NO· level. However, further studies are needed to verify these findings as well as altered collagen synthesis in patients with psoriasis.
    Archives for Dermatological Research 04/2013; · 2.71 Impact Factor
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    ABSTRACT: Previous studies indicate that 25-45% of chronic urticaria patients have an autoimmune etiology. Autologous serum skin test (ASST) and autologous plasma skin test (APST) are simple tests for diagnosing chronic autoimmune urticaria (CAU). However, there are still some questions about the specificity of these tests. This study consisted of 50 patients with chronic spontaneous urticaria (CSU) and 50 sex- and age-matched healthy individuals aged 18 years, and older. A total of 31 (62%) patients and 5 (10%) control patients had positive ASST; 21 (42%) patients and 3 (6%) control patients had positive APST. Statistically significant differences were noted in ASST and APST positivity between the patient and control groups (ASST P < 0.001; APST P < 0.001). Thirteen (26%) patients and 5 (10%) control patients had antithyroglobulin antibodies or antithyroid peroxidase antibody positivity. No statistically significant differences were noted in thyroid autoantibodies between the patient and control groups (anti-TG P = 0.317; anti-TPO P = 0.269). We consider that the ASST and APST can both be used as in vivo tests for the assessment of autoimmunity in the etiology of CSU and that thyroid autoantibodies should be checked even when thyroid function tests reveal normal results in patients with CSU.
    Dermatology Research and Practice 01/2013; 2013:267278.
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    ABSTRACT: Histiocytic skin disorders are usually classified as either Langerhans' cell histiocytosis (LCH) or non LCH, based on the pathology. Benign cephalic histiocytosis (BCH) is a rare type of non-Langerhans histiocytitic disorder and is characterized by self-healing multiple small eruptions of yellow to red-brown papules on the face and upper trunk. Histologic features of this disorder show dermal proliferation of histiocytes that have intracytoplasmic comma-shaped bodies, coated vesicles and desmosome-like structures. In this study, we report on a 7-month-old boy who contained small yellow-red papules on his face that spread to his upper trunk. The clinical and histologic features in this patient were consistent with BCH.
    Annals of Dermatology 11/2011; 23(4):508-11. · 0.61 Impact Factor
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    ABSTRACT: Digital block with epinephrine is safe in selected patients. Chemical matricectomy with phenol is a successful, cheap, and easy method for the treatment of ingrown nails. To determine the effect of digital block with epinephrine in chemical matricectomy with phenol. Forty-four patients with ingrown toenail were randomly divided into two groups. The plain lidocaine group (n=22) underwent digital anesthesia using 2% plain lidocaine, and the lidocaine with epinephrine group (n=22) underwent digital anesthesia with 2% lidocaine with 1:100,000 epinephrine. In the postoperative period, the patients were evaluated for pain, drainage, and peripheral tissue destruction and were followed for up to 18 months for recurrence. The mean anesthetic volume used in the epinephrine group (2.2 ± 0.4 mL) was significantly lower than the plain lidocaine group (3.1 ± 0.6 mL). There was no statistically significant difference in postoperative pain and recurrence rates, but duration of drainage was significantly shorter in the epinephrine group (11.1 ± 2.5 days) than in the plain lidocaine group (19.0 ± 3.8 days). CONCLUSION Digital block with epinephrine is safe in selected patients, and epinephrine helps to shorten the postoperative drainage period. The authors have indicated no significant interest with commercial supporters.
    Dermatologic Surgery 10/2010; 36(10):1568-71. · 1.87 Impact Factor
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    International Journal of Clinical Practice 01/2010; 64(1):101-3. · 2.43 Impact Factor
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    ABSTRACT: Acne vulgaris is one of the common dermatological diseases and its pathogenesis is multifactorial. In this study, we aimed to determine the effects of oxidative stress in acne vulgaris. The study involved 32 patients with acne vulgaris in the patient group and 34 healthy adults in the control group. The parameters of oxidative stress such as catalase (CAT), superoxide dismutase (SOD), xanthine oxidase (XO), nitric oxide (NO) and malondialdehyde (MDA) in the venous blood of patients were measured spectrophotometrically. The values were compared with those of the control group. The serum levels of MDA and XO activity in the patients with acne vulgaris were significantly higher than those of the controls. A significantly lower SOD and CAT activity was found in the patient group than in the control group. Although the patient group had higher serum levels of NO than the control group, the difference was not statistically significant. These results suggest that oxidative damage may play a role in the pathogenesis of acne; therefore, significant alterations may occur in the antioxidant defence system.
    Journal of the European Academy of Dermatology and Venereology 11/2009; 24(7):763-7. · 2.69 Impact Factor
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    ABSTRACT: There are various treatment options available for rosacea, depending on the subtype, but treatment is still generally unsatisfactory. Some reports have indicated beneficial effects of topical pimecrolimus. To compare the efficacy and safety of pimecrolimus 1% cream and metronidazole 1% cream in the treatment of patients with papulopustular rosacea (PR). A group of 49 patients with PR was investigated in this single-centre, randomized, open-label study. Patients were randomly assigned treatment with either pimecrolimus 1% cream or metronidazole 1% cream for 12 weeks. Response was evaluated by the inflammatory lesion count, the severity of facial erythema and telangiectasia, Physician's Global Assessment (PGA), and safety and tolerability at baseline and at weeks 3, 6, 9 and 12. In total, 48 patients completed the study. Both treatments were very effective in the treatment of PR. There were no significant differences between the treatments in inflammatory lesion counts, overall erythema severity scores and PGA evaluated from baseline to week 12 (P > 0.05). Neither treatment produced any clinically relevant improvement in telangiectasia. Pimecrolimus cream is no more efficacious than metronidazole cream in the treatment of PR.
    Clinical and Experimental Dermatology 07/2009; 35(3):251-6. · 1.33 Impact Factor
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    ABSTRACT: Mediterranean spotted fever (MSF) is one of the tick-borne rickettsial infections caused by Rickettsia conorii. It is transmitted to humans by brown dog ticks (Rhipicephalus sanguineus). In this case report, a 16-years-old male patient who was diagnosed as MSF after an exposure to dog-tick in Bartin province (located at middle Black Sea region of Turkey) has been presented. His history revealed that, five days before admission to the hospital (on June, 2007) he had cleaned dog-ticks from his dog, and after 12 hours he found a stucked tick on his leg and he took it out right away with a tweezer. High fever, headache and generalized maculopapular rash including soles and palms and a black-colored lesion at the tick bite site developed three days later. In clinical examination, there was a black escar circled with a red-purple colored halo in front of the right tibia at the site of the tick bite showing high similarity to "tache noire" which was specific to MSF. Indirect immunofluorescence assay (IFA) for Rickettsia yielded negative result in the serum sample collected on admission day, however, it was found positive at 1/512 titer in the serum sample collected 10 days after admission. The patient has recovered completely without any complication after 10 days of doxycycline therapy. The aim of this presentation is to point out that MSF should be considered for the differential diagnosis of a patient with a history of tick bite, fever, maculopapular rash, headache, myalgia, arthralgia and especially with black escar during summer months in our country where the incidence of tick-borne infections has been increasing since recent years.
    Mikrobiyoloji bülteni 11/2008; 42(4):701-6. · 0.61 Impact Factor
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    ABSTRACT: Recurrent aphthous ulceration (RAU) is one of the most common oral mucosal disorders found in humans. Although the exact etiology of RAU is unkown, local and systemic conditions, and genetic, immunologic, and infectious factors all have been identified as potential etiopathogenic agents. The aim of our study was to compare serum xanthine oxidase (XO) and adenosine deaminase (AD) activities, and malondialdehyde (MDA), nitric oxide (NO) and uric acid (UA) levels in a group of patients affected by RAU and in a group of healthy controls. A total of 26 patients with minor RAU were included in the study. Twenty-six healthy volunteers were selected to form the control group. AD and XO activities, and UA, NO, and MDA levels were studied in the serum samples of all patients and controls. Serum XO and AD activities, and MDA, NO, and UA levels were significantly higher in RAU patients than in controls. Increased XO and AD activities, NO and UA levels and lipid peroxidation were thought to take part in the pathogenesis of RAU. Hence the effects of XO inhibitors in the treatment of RAU should be evaluated in future studies.
    Oral Diseases 12/2007; 13(6):570-4. · 2.38 Impact Factor
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    Pediatrics in Review 09/2007; 28(8):312-8. · 0.82 Impact Factor
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    ABSTRACT: Central nervous system involvement in Behçet disease (BD) has been well documented, but studies evaluating peripheral nervous system involvement are relatively uncommon. The aim of this study is to evaluate the frequency and characteristics of peripheral nervous system involvement in BD. Sixty-nine BD patients (36 women, 33 men) followed by neurology and dermatology outpatient clinics between October 1999 and October 2004 were enrolled into study. A careful history was taken and physical and neurologic examinations were done. All other medical causes that may be related to peripheral nervous system involvement were studied. All patients underwent nerve conduction studies using standard electrophysiologic procedures. Peripheral nervous system involvement was detected in 13 patients. There was no sign and symptom related to peripheral nervous system involvement in these patients. Causes other than BD were found in 5 patients with polyneuropathy. Asymptomatic delay in conduction velocities of the median nerves was detected in 3 patients. In 5 patients with clinically evident peripheral nerve involvement due to BD, 3 had sensorimotor and 2 had sensory axonal neuropathies. Axonal type polyneuropathy may be seen in BD patients. Peripheral involvement may be detected by electrophysiological examinations in asymptomatic BD patients.
    The Neurologist 08/2007; 13(4):225-30. · 1.48 Impact Factor
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    ABSTRACT: Psychogenic factors may play a contributory role in the development or persistence of lichen simplex chronicus (LSC). The objective of this study was to evaluate the psychiatric profile of patients with LSC including depression and dissociative experiences. Dermatology outpatients with a LSC (n=30) were compared with outpatients with tinea in which psychological factors are regarded as negligible (n=30). All subjects were given psychiatric scales including the Symptom Checklist-90-Revised (SCL-90-R), Hamilton Rating Scale for Depression (HAM-D) and Dissociative Experience Scale (DES). All mean SCL-90 scores for general psychopathology were higher in the LSC compared to the control group. HAM-D and DES scores were significantly higher in the LSC group (P<.05) as well. In addition, the number of patients whose total DES score of 30 and above was higher in the LSC group. Psychiatric symptoms appear relatively common among patients with LSC. Further research is needed to confirm the possible role of dissociative tendencies in the etiology of LSC.
    General Hospital Psychiatry 05/2007; 29(3):232-5. · 2.98 Impact Factor
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    Pediatrics in Review 12/2006; 27(11):e71-4. · 0.82 Impact Factor
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    ABSTRACT: Lichen simplex chronicus (LSC) is a common pruritic disorder resulting from repeated rubbing and scratching. Nighttime pruritus is a common feature in LSC and may disrupt the sleep pattern. The aim of this study is to determine whether there are sleep abnormalities in patients with LSC. Fifteen patients with LSC and 15 age-, sex- and body mass index-matched control subjects were enrolled in the study. No participant had any other medical or psychiatric illness. All subjects were evaluated by overnight polysomnography, scratch electrodes, Epworth sleepiness scale and a general questionnaire for demographic data and sleep problems. There were no significant differences in the groups for total sleep time, sleep efficiency, sleep latency, rapid eye movement (REM) latency, percentage of stage 1 non-REM sleep and REM sleep. The percentage of stage 2 non-REM sleep was higher (P < 0.05) and the percentage of slow wave sleep (stages 3 and 4) was lower in the study group (P < 0.05) than in the controls. The patient group had a mean of 15.9 +/- 7.5 arousal index and 22.8 +/- 14.1 awakenings compared with 9.5 +/- 3.1 and 10.4 +/- 3.9, respectively, in the controls (P < 0.05, P < 0.01, respectively). Arousals of patients were mainly observed in non-REM sleep. The number of scratching bouts ranged from 6 to 20 per night. Scratching episodes were observed frequently during stage 2 non-REM sleep. Polysomnographic findings of patients with LSC demonstrated that sleep structure is disturbed by arousals and awakenings related to scratching bouts during sleep.
    Southern Medical Journal 06/2006; 99(5):482-5. · 0.92 Impact Factor
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    Journal of the American Academy of Dermatology 12/2005; 53(5):902-3. · 4.91 Impact Factor
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    ABSTRACT: The pathophysiology of alopecia areata (AA) has not been clearly defined; however, it appears as a tissue-restricted autoimmune disease mediated by T lymphocytes. Immunohistochemical studies have shown peri- and infra-follicular inflammatory infiltrate which damages hair follicles. We analyzed the role of lipid peroxidation and oxidant-antioxidant enzymes in the pathogenesis of AA. Twenty-four patients with AA and 20 age- and sex-matched healthy controls were enrolled in this study. We analyzed serum levels of malondialdehyde (MDA) and nitric oxide (NO) and the serum activities of superoxide dismutase (SOD) and xanthine oxidase (XO) in patients with AA and control subjects. The levels of MDA and NO (nitrite/nitrate) and the activity of XO in serum of patients with AA (0.76+/-0.34 nmol/ml, 14.88+/-6.40 nmol/ml, and 0.34+/-0.10 U/ml, respectively) were significantly higher than those of controls (0.35+/-0.09 nmol/ml, 10.71+/-1.75 nmol/ml, 0.11+/-0.03 U/ml; p<0.001, p<0.001, p<0.05, respectively). The SOD activity (12.95+/-2.16 U/ml) in the serum of patients with AA was significantly lower than that of controls (14.89+/-2.29 U/ml, p<0.05). Increased lipid peroxidation in AA may be related to an increase in NO level and XO activity and a decrease in SOD activity. These results suggest that lipid peroxidation and alterations in the oxidant-antioxidant enzymatic system may play a role in the pathogenesis of AA.
    Medical science monitor: international medical journal of experimental and clinical research 07/2005; 11(6):CR296-299. · 1.22 Impact Factor
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    ABSTRACT: Rosacea is a common, chronic dermatosis that requires long-term therapy. Oral isotretinoin and topical and/or oral antibiotics are effective, but their usage may be limited due to side-effects. The goal of the study was to compare the efficacy of topical adapalene gel (0.1%) and topical metronidazole gel (0.75%) in the treatment of patients with papulopustular rosacea. This study included 55 patients with papulopustular rosacea. Diagnostic efforts were focused on clinical and histological features. Patients were randomly assigned to the adapalene (n = 30) and metronidazole (n = 25) groups. Sunlight protection factor 20 cream was used to protect all patients from sunlight. The characteristics and numbers of inflammatory papules, pustules, erythema and telangiectasia were scored at baseline and after 2, 4, 8 and 12 weeks. Side-effects were recorded at each visit. Fifty patients, 27 in the adapalene group and 25 in the metronidzaole group, completed the study. Significant reductions in the total number of inflammatory lesions were found in the adapalene group compared with the metronidazole group. There was no significant difference in the scores of erythema and telangiectasia in the adapalene group. However, a significant reduction in erythema was seen in the metronidazole group. Adapalene gel is well tolerated and can be used as an alternative for topical treatment of papulopustular rosacea.
    International Journal of Dermatology 04/2005; 44(3):252-5. · 1.34 Impact Factor
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    ABSTRACT: We present a 52-year-old man with widespread cutaneous metastases (CMs) of unknown primary origin. Although we performed many of the investigations, we could not find out a primary origin of malignancy. There are no practical algorithms to identify the primary of cutaneous metastatic tumors of unknown origin. An algorithm in cancer patients with CMs seems to be needed to manipulate such cases. We believe that more reports related with this issue must be published to form an algorithm in such cases.
    Dermatology online journal 02/2005; 11(1):16.
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    ABSTRACT: Vitiligo is a common pigmentary disorder of the skin with selective destruction of melanocytes. The pathogenetic mechanisms in vitiligo have not been completely clarified. The aim of our investigation was to evaluate the oxidative stress in the pathogenesis of generalized vitiligo. Twenty-seven patients with generalized vitiligo and 24 phototype-, age-, and sex-matched healthy controls were included in this study. We analysed serum levels of malondialdehyde (MDA), nitric oxide (NO), and serum activities of superoxide dismutase (SOD) and xanthine oxidase (XO) in the patients with vitiligo and in the controls. We found significantly higher levels of MDA and XO activity (P < 0.001 and P < 0.05, respectively), and a significantly lower level of serum SOD activity (P < 0.05) in patients with vitiligo compared with the controls. However, the increase in the level of serum NO was insignificant (P > 0.05). These results suggest that lipid peroxidation of cellular membrane of melanocytes by free radicals may have a significant role in the pathogenesis of generalized vitiligo.
    Clinical and Experimental Dermatology 08/2004; 29(4):406-9. · 1.33 Impact Factor