Rafet Koca

Bülent Ecevit Üniversitesi, Songuldak, Zonguldak, Turkey

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Publications (42)55.97 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.
    No preview · Article · Jul 2014 · International journal of dermatology
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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.
    Full-text · Article · Jul 2013 · Dermatology Research and Practice
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    ABSTRACT: Background: QRS prolongation and the presence of QRS fragmentation in 12-lead ECG are associated with increased mortality and sudden cardiac death in the long term. In this study we aimed to assess QRS duration and fragmentation in patients with Behçet's disease (BD). Methods: A total of 50 patients (mean age 42.7±12.0 years) previously diagnosed with BD were recruited. In addition, a control group consisting of 50 healthy people (mean age 39.4±12.5 years) was formed. The longest QRS duration was measured in surface 12-lead ECG and QRS complexes were evaluated in terms of fragmentation. Serum C-reactive protein levels were also obtained. Results: QRS duration and corrected QT duration were significantly longer in patients with BD compared with controls (102.75±11.91 vs. 96.99±10.91 ms, P=0.007; 438.55±30.80 vs. 420.23±28.06 ms, P=0.003, respectively). Fragmented QRS (fQRS) pattern was more common in patients with BD than controls [n=27 (54%) vs. n=16 (32%), P=0.026]. Disease duration was longer in patients with BD with fQRS compared with those without (12.67±8.68 vs. 7.09±7.06 years, P=0.010). Furthermore, C-reactive protein level was higher in patients with BD with fQRS compared with those without (6.53±4.11 vs. 4.97±6.32 mg/dl, P=0.043). Correlation analysis revealed no association between disease duration and QRS duration (r=0.219, P=0.126). Conclusion: QRS duration is greater and fQRS complexes are more frequent in patients with BD. These findings may indicate subclinical cardiac involvement in BD. Given the prognostic significance of ECG parameters, it is reasonable to evaluate patients with BD with prolonged and fQRS complexes more in detail such as late potentials in signal averaged ECG in terms of cardiac involvement.
    No preview · Article · Apr 2013 · Coronary artery disease
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    ABSTRACT: In tropical climate regions, black fungal skin in fections may occur by traumatic ino - culation of the pathogens found in soil, trees or damaged plants. Black fungus often causes infections in immunosuppressive patients while a rare culprit in healthy individuals. In this article, a case of 72 years old female with phaeohyphomycosis due to Phialophora verrucosa has been presented. The lesion had begun as a small papule on the right ankle that had started 1 year ago, which turned out to be an ulcerated nodule. The patient was leading a life in rural district and was on systemic immunosuppressive treatment with a diagnosis of systemic sclerosis for 20 years. Treatment with itraconazole 400 mg/day for 4 months resulted with complete recovery. This case shows that though rarely, phaeohyphomycosis may be seen out of tropical regions and it should be considered in the differential diagnosis of nodular lesions.
    No preview · Article · Apr 2013 · Turkiye Klinikleri Dermatoloji
  • Berrak Guven · Murat Can · Mehmet Genc · Rafet Koca
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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.
    No preview · Article · Apr 2013 · Archives for Dermatological Research

  • No preview · Article · Dec 2011 · Deri Hastaliklari ve Frengi Arsivi
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    ABSTRACT: To investigate the atrial electromechanical delay (EMD) duration that is a non-invasive predictor of atrial fibrillation (AF) in patients with Behcet's disease (BD). Thirty-eight Behcet's patients (24 females, 14 males; mean age: 43.6 ± 10.3 years) who were being followed in the dermatology or internal medicine department and 29 demographically matched controls (13 females, 16 males; mean: age 42.6 ± 11.1 years) were included in the study. The inclusion criteria were recurrent oral ulcerations and two of the following features: recurrent genital ulceration, eye lesions, skin lesions or positive pathergy skin test for Behcet's group. Using tissue Doppler imaging, atrial electromechanical coupling [time interval from the onset of P wave on surface electrocardiogram to the beginning of A wave interval with tissue Doppler echocardiography (PA)] were measured from the lateral mitral annulus (PA lateral), septal mitral annulus (PA septum), and right ventricular tricuspid annulus (PA tricuspid). The mean disease duration was 10.5 ± 7.7 years. The inter-atrial and intra-atrial EMD were significantly higher in the Behcet group than those in the controls (19.8 ± 8.2 vs. 13.1 ± 4.4 ms, P = 0.001; 11.5 ± 7.4 vs. 6.9 ± 3.7 ms, P = 0.02; respectively). The left atrial EMD was similar in both of the groups. However, the P(max) and PWD values were significantly higher in the BD group compared with those in the controls (120.5 ± 10.1 vs. 112.1 ± 5.9 ms, P < 0.0001; 44.9 ± 10.7 vs. 28.4 ± 5.9 ms, P < 0.0001; respectively). Atrial electromechanical conduction times were increased in the BD patients compared with those in the controls. The tendency of BD patients to go into AF can be easily and non-invasively detected using tissue Doppler echocardiography. These findings may be indicators for subclinical cardiac involvement.
    Full-text · Article · Nov 2011 · European Heart Journal Cardiovascular Imaging
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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.
    Full-text · Article · Nov 2011 · Annals of Dermatology
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    ABSTRACT: Papuloerythroderma of Ofuji is characterized by a pruritic eruption of widespread, red, flat papules that leads to spare skin folds. The disease occurs primarily in elderly men and is often associated with lymphadenopathy, peripheral blood eosinophilia, lymphopenia and elevated immunoglobulin E levels. Association with T and B cell lymphomas, visceral carcinomas, AIDS, atopic dermatitis, psoriasis and hypersensitivity to drugs have been reported. Topical and systemic corticosteroids, psoralen-UVA, etretinate-PUVA, acitretin-PUVA, UVB, cyclosporin, interferon α and azathioprine have been used in the treatment of this rare disease. In this manuscript, we described two patients with papuloerythroderma of Ofuji.
    No preview · Article · Mar 2011
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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.
    No preview · Article · Oct 2010 · Dermatologic Surgery
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    Full-text · Article · Jan 2010 · International Journal of Clinical Practice
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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.
    Full-text · Article · Nov 2009 · Journal of the European Academy of Dermatology and Venereology
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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.
    No preview · Article · Jul 2009 · Clinical and Experimental Dermatology
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    ABSTRACT: 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 differential 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.
    No preview · Article · Jan 2009
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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.
    No preview · Article · Nov 2008 · Mikrobiyoloji bülteni
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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.
    Full-text · Article · Dec 2007 · Oral Diseases
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    ABSTRACT: Zinc is an essential trace metal whose deficiency leads to growth retardation; an eczematous, vesiculobullous, and pustular rash over the perioral, perianal, and acral areas; alopecia; diarrhea; secondary bacterial and fungal infections; and neurologic, behavioral, and cognitive impairment. Zinc deficiency can result from a zinc-deficient diet, malabsorption (as in AE), a genetic disorder of intestinal zinc uptake, and increased losses. Oral zinc supplementation reverses most signs and symptoms of zinc deficiency, regardless of cause.
    Preview · Article · Sep 2007 · Pediatrics in Review
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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.
    No preview · Article · Aug 2007 · The Neurologist
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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.
    No preview · Article · May 2007 · General Hospital Psychiatry
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    ABSTRACT: AHEI is a benign variant of leukocytoclastic vasculitis that occurs in children younger than 2 years of age. Respiratory tract infection, drug intake, or immunization frequently precedes AHEI. Striking clinical features include acute appearance of the cutaneous lesions in otherwise healthy young infants and children, lack of visceral involvement, and self-limited progression. Laboratory tests, except for punch biopsy of the skin lesions, are nondiagnostic. Differential diagnoses include HSP and other potentially serious disorders such as meningococcemia, erythema multiforme, and Kawasaki disease. No effective therapy exists for AHEI, and treatment is supportive.
    Preview · Article · Dec 2006 · Pediatrics in Review